Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BEARING BMT TIBIAL 146592

Facility

$4,440.00

Hospital Charge Code	270606319
Hospital Revenue Code	278
Min. Negotiated Rate	$666.00
Max. Negotiated Rate	$1,074.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$888.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,074.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$976.80
Rate for Payer: Qualcare PPO/HMO/WC	$666.00

BEARING BMT TIBIAL 14MM 146554

Facility

$4,622.45

Hospital Charge Code	270613046
Hospital Revenue Code	278
Min. Negotiated Rate	$693.37
Max. Negotiated Rate	$1,118.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$924.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,118.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,016.94
Rate for Payer: Qualcare PPO/HMO/WC	$693.37

BEARING BMT TIBIAL 14MM 146554

Facility

$4,622.45

Hospital Charge Code	270613046
Hospital Revenue Code	278
Min. Negotiated Rate	$111.40
Max. Negotiated Rate	$2,311.22
Rate for Payer: Aetna Commercial	$1,756.53
Rate for Payer: Aetna Medicare Advantage	$1,386.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,178.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,178.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$924.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,178.72
Rate for Payer: Cigna Commercial	$2,311.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,118.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,016.94
Rate for Payer: Qualcare PPO/HMO/WC	$693.37
Rate for Payer: UnitedHealthcare Community & State	$111.40
Rate for Payer: Wellpoint Medicaid Managed Care	$122.49

BEARING BMT TIBIAL 16MM 146556

Facility

$5,072.85

Hospital Charge Code	270617365
Hospital Revenue Code	278
Min. Negotiated Rate	$122.26
Max. Negotiated Rate	$2,536.43
Rate for Payer: Aetna Commercial	$1,927.68
Rate for Payer: Aetna Medicare Advantage	$1,521.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,293.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,293.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,014.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,293.58
Rate for Payer: Cigna Commercial	$2,536.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,227.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,116.03
Rate for Payer: Qualcare PPO/HMO/WC	$760.93
Rate for Payer: UnitedHealthcare Community & State	$122.26
Rate for Payer: Wellpoint Medicaid Managed Care	$134.43

BEARING BMT TIBIAL 16MM 146556

Facility

$5,072.85

Hospital Charge Code	270617365
Hospital Revenue Code	278
Min. Negotiated Rate	$760.93
Max. Negotiated Rate	$1,227.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,014.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,227.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,116.03
Rate for Payer: Qualcare PPO/HMO/WC	$760.93

BEARING BMT TIBIAL 71MM 146550

Facility

$4,440.00

Hospital Charge Code	270609079
Hospital Revenue Code	278
Min. Negotiated Rate	$666.00
Max. Negotiated Rate	$1,074.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$888.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,074.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$976.80
Rate for Payer: Qualcare PPO/HMO/WC	$666.00

BEARING BMT TIBIAL 71MM 146550

Facility

$4,440.00

Hospital Charge Code	270609079
Hospital Revenue Code	278
Min. Negotiated Rate	$107.00
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,687.20
Rate for Payer: Aetna Medicare Advantage	$1,332.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,132.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,132.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$888.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,132.20
Rate for Payer: Cigna Commercial	$2,220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,074.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$976.80
Rate for Payer: Qualcare PPO/HMO/WC	$666.00
Rate for Payer: UnitedHealthcare Community & State	$107.00
Rate for Payer: Wellpoint Medicaid Managed Care	$117.66

BEARING DM LONGEVITY 28 X 44 M

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270690470
Hospital Revenue Code	278
Min. Negotiated Rate	$90.38
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$90.38
Rate for Payer: Wellpoint Medicaid Managed Care	$99.38

BEARING DM LONGEVITY 28 X 44 M

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270690470
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

BEARING DM VIVCIT -E 28X 44 MM

Facility

$13,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270689913
Hospital Revenue Code	278
Min. Negotiated Rate	$325.35
Max. Negotiated Rate	$6,750.00
Rate for Payer: Aetna Commercial	$5,130.00
Rate for Payer: Aetna Medicare Advantage	$4,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,442.50
Rate for Payer: Cigna Commercial	$6,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,970.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00
Rate for Payer: UnitedHealthcare Community & State	$325.35
Rate for Payer: Wellpoint Medicaid Managed Care	$357.75

BEARING DM VIVCIT -E 28X 44 MM

Facility

$13,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270689913
Hospital Revenue Code	278
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$3,267.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,970.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

BEARING DUAL MOBILITY

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270688347
Hospital Revenue Code	278
Min. Negotiated Rate	$90.38
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$90.38
Rate for Payer: Wellpoint Medicaid Managed Care	$99.38

BEARING DUAL MOBILITY

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270688347
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

BEARING DUAL MOBL 28x44MM SZ F

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270677543
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

BEARING DUAL MOBL 28x44MM SZ F

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270677543
Hospital Revenue Code	278
Min. Negotiated Rate	$90.38
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$90.38
Rate for Payer: Wellpoint Medicaid Managed Care	$99.38

BEARING E1 VAGD PS 71/75 X 16

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270688441
Hospital Revenue Code	278
Min. Negotiated Rate	$144.60
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$144.60
Rate for Payer: Wellpoint Medicaid Managed Care	$159.00

BEARING E1 VAGD PS 71/75 X 16

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270688441
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

BEARING E1 VNGD PS+ TIB BRG 79

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270683516
Hospital Revenue Code	278
Min. Negotiated Rate	$144.60
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$144.60
Rate for Payer: Wellpoint Medicaid Managed Care	$159.00

BEARING E1 VNGD PS+ TIB BRG 79

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270683516
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

BEARING HIP DM 28X42MM

Facility

$13,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270695447
Hospital Revenue Code	278
Min. Negotiated Rate	$325.35
Max. Negotiated Rate	$6,750.00
Rate for Payer: Aetna Commercial	$5,130.00
Rate for Payer: Aetna Medicare Advantage	$4,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,442.50
Rate for Payer: Cigna Commercial	$6,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,970.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00
Rate for Payer: UnitedHealthcare Community & State	$325.35
Rate for Payer: Wellpoint Medicaid Managed Care	$357.75

BEARING HIP DM 28X42MM

Facility

$13,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270695447
Hospital Revenue Code	278
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$3,267.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,970.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

BEARING HMRL 36 MM+ 3 MM

Facility

$11,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690727
Hospital Revenue Code	278
Min. Negotiated Rate	$277.15
Max. Negotiated Rate	$5,750.00
Rate for Payer: Aetna Commercial	$4,370.00
Rate for Payer: Aetna Medicare Advantage	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,932.50
Rate for Payer: Cigna Commercial	$5,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,783.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,530.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,725.00
Rate for Payer: UnitedHealthcare Community & State	$277.15
Rate for Payer: Wellpoint Medicaid Managed Care	$304.75

BEARING HMRL 36 MM+ 3 MM

Facility

$11,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690727
Hospital Revenue Code	278
Min. Negotiated Rate	$1,725.00
Max. Negotiated Rate	$2,783.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,783.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,530.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,725.00

BEARING HMRL 36 MM STD PRLNG

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270688284
Hospital Revenue Code	278
Min. Negotiated Rate	$84.35
Max. Negotiated Rate	$1,750.00
Rate for Payer: Aetna Commercial	$1,330.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$770.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00
Rate for Payer: UnitedHealthcare Community & State	$84.35
Rate for Payer: Wellpoint Medicaid Managed Care	$92.75

BEARING HMRL 36 MM STD PRLNG

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270688284
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$847.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$770.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

Know your out-of-pocket cost for care.

All Charges