Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BEARING HUMERAL STD 3mm 44x38

Facility

$5,500.00

Hospital Charge Code	270674701
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

BEARING HUMERAL STD 3mm 44x38

Facility

$5,500.00

Hospital Charge Code	270674701
Hospital Revenue Code	278
Min. Negotiated Rate	$132.55
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Community & State	$132.55
Rate for Payer: Wellpoint Medicaid Managed Care	$145.75

BEARING HUMER COMP PL 36MM PL3

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270694048
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

BEARING HUMER COMP PL 36MM PL3

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270694048
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 INSERT SZ4 PS

Facility

$4,985.25

Service Code	HCPCS C1776
Hospital Charge Code	270691264
Hospital Revenue Code	278
Min. Negotiated Rate	$120.14
Max. Negotiated Rate	$2,492.62
Rate for Payer: Aetna Commercial	$1,894.39
Rate for Payer: Aetna Medicare Advantage	$1,495.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,271.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,271.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$997.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,271.24
Rate for Payer: Cigna Commercial	$2,492.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,206.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,096.76
Rate for Payer: Qualcare PPO/HMO/WC	$747.79
Rate for Payer: UnitedHealthcare Community & State	$120.14
Rate for Payer: Wellpoint Medicaid Managed Care	$132.11

BEARING INSERT SZ4 PS

Facility

$4,985.25

Service Code	HCPCS C1776
Hospital Charge Code	270691264
Hospital Revenue Code	278
Min. Negotiated Rate	$747.79
Max. Negotiated Rate	$1,206.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$997.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,206.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,096.76
Rate for Payer: Qualcare PPO/HMO/WC	$747.79

BEARING INST RING HARD G7

Facility

$1,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270693755
Hospital Revenue Code	278
Min. Negotiated Rate	$26.51
Max. Negotiated Rate	$550.00
Rate for Payer: Aetna Commercial	$418.00
Rate for Payer: Aetna Medicare Advantage	$330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$280.50
Rate for Payer: Cigna Commercial	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00
Rate for Payer: UnitedHealthcare Community & State	$26.51
Rate for Payer: Wellpoint Medicaid Managed Care	$29.15

BEARING INST RING HARD G7

Facility

$1,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270693755
Hospital Revenue Code	278
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$266.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00

BEARING MENISCAL LT 6mm THICK

Facility

$6,425.00

Hospital Charge Code	270645450
Hospital Revenue Code	278
Min. Negotiated Rate	$154.84
Max. Negotiated Rate	$3,212.50
Rate for Payer: Aetna Commercial	$2,441.50
Rate for Payer: Aetna Medicare Advantage	$1,927.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,638.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,638.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,638.38
Rate for Payer: Cigna Commercial	$3,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,554.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,413.50
Rate for Payer: Qualcare PPO/HMO/WC	$963.75
Rate for Payer: UnitedHealthcare Community & State	$154.84
Rate for Payer: Wellpoint Medicaid Managed Care	$170.26

BEARING MENISCAL LT 6mm THICK

Facility

$6,425.00

Hospital Charge Code	270645450
Hospital Revenue Code	278
Min. Negotiated Rate	$963.75
Max. Negotiated Rate	$1,554.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,285.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,554.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,413.50
Rate for Payer: Qualcare PPO/HMO/WC	$963.75

BEARING OSS 12MM 150410

Facility

$4,060.00

Hospital Charge Code	270638568
Hospital Revenue Code	278
Min. Negotiated Rate	$609.00
Max. Negotiated Rate	$982.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$812.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$982.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$893.20
Rate for Payer: Qualcare PPO/HMO/WC	$609.00

BEARING OSS 12MM 150410

Facility

$4,060.00

Hospital Charge Code	270638568
Hospital Revenue Code	278
Min. Negotiated Rate	$97.85
Max. Negotiated Rate	$2,030.00
Rate for Payer: Aetna Commercial	$1,542.80
Rate for Payer: Aetna Medicare Advantage	$1,218.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,035.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,035.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$812.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,035.30
Rate for Payer: Cigna Commercial	$2,030.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$982.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$893.20
Rate for Payer: Qualcare PPO/HMO/WC	$609.00
Rate for Payer: UnitedHealthcare Community & State	$97.85
Rate for Payer: Wellpoint Medicaid Managed Care	$107.59

BEARING OSS 16mm TIBIAL

Facility

$6,205.00

Service Code	HCPCS C1776
Hospital Charge Code	270664282
Hospital Revenue Code	278
Min. Negotiated Rate	$930.75
Max. Negotiated Rate	$1,501.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,241.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,501.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,365.10
Rate for Payer: Qualcare PPO/HMO/WC	$930.75

BEARING OSS 16mm TIBIAL

Facility

$6,205.00

Service Code	HCPCS C1776
Hospital Charge Code	270664282
Hospital Revenue Code	278
Min. Negotiated Rate	$149.54
Max. Negotiated Rate	$3,102.50
Rate for Payer: Aetna Commercial	$2,357.90
Rate for Payer: Aetna Medicare Advantage	$1,861.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,582.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,582.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,241.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,582.28
Rate for Payer: Cigna Commercial	$3,102.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,501.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,365.10
Rate for Payer: Qualcare PPO/HMO/WC	$930.75
Rate for Payer: UnitedHealthcare Community & State	$149.54
Rate for Payer: Wellpoint Medicaid Managed Care	$164.43

BEARING OXFORD SZ B 8 MM RM/LL

Facility

$9,900.00

Service Code	HCPCS C1776
Hospital Charge Code	270684004
Hospital Revenue Code	278
Min. Negotiated Rate	$238.59
Max. Negotiated Rate	$4,950.00
Rate for Payer: Aetna Commercial	$3,762.00
Rate for Payer: Aetna Medicare Advantage	$2,970.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,524.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,524.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,980.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,524.50
Rate for Payer: Cigna Commercial	$4,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,395.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,178.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,485.00
Rate for Payer: UnitedHealthcare Community & State	$238.59
Rate for Payer: Wellpoint Medicaid Managed Care	$262.35

BEARING OXFORD SZ B 8 MM RM/LL

Facility

$9,900.00

Service Code	HCPCS C1776
Hospital Charge Code	270684004
Hospital Revenue Code	278
Min. Negotiated Rate	$1,485.00
Max. Negotiated Rate	$2,395.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,395.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,178.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,485.00

BEARING OXFRD LFT 9 MED 159553

Facility

$3,605.00

Hospital Charge Code	270639276
Hospital Revenue Code	278
Min. Negotiated Rate	$540.75
Max. Negotiated Rate	$872.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$721.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$793.10
Rate for Payer: Qualcare PPO/HMO/WC	$540.75

BEARING OXFRD LFT 9 MED 159553

Facility

$3,605.00

Hospital Charge Code	270639276
Hospital Revenue Code	278
Min. Negotiated Rate	$86.88
Max. Negotiated Rate	$1,802.50
Rate for Payer: Aetna Commercial	$1,369.90
Rate for Payer: Aetna Medicare Advantage	$1,081.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$919.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$919.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$721.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$919.27
Rate for Payer: Cigna Commercial	$1,802.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$793.10
Rate for Payer: Qualcare PPO/HMO/WC	$540.75
Rate for Payer: UnitedHealthcare Community & State	$86.88
Rate for Payer: Wellpoint Medicaid Managed Care	$95.53

BEARING PHALANGEAL XSML METAL

Facility

$4,215.00

Hospital Charge Code	270642725
Hospital Revenue Code	278
Min. Negotiated Rate	$632.25
Max. Negotiated Rate	$1,020.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$843.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,020.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$927.30
Rate for Payer: Qualcare PPO/HMO/WC	$632.25

BEARING PHALANGEAL XSML METAL

Facility

$4,215.00

Hospital Charge Code	270642725
Hospital Revenue Code	278
Min. Negotiated Rate	$101.58
Max. Negotiated Rate	$2,107.50
Rate for Payer: Aetna Commercial	$1,601.70
Rate for Payer: Aetna Medicare Advantage	$1,264.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,074.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,074.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$843.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,074.83
Rate for Payer: Cigna Commercial	$2,107.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,020.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$927.30
Rate for Payer: Qualcare PPO/HMO/WC	$632.25
Rate for Payer: UnitedHealthcare Community & State	$101.58
Rate for Payer: Wellpoint Medicaid Managed Care	$111.70

BEARING PST TB 20x71/75 183750

Facility

$5,875.00

Hospital Charge Code	270639356
Hospital Revenue Code	278
Min. Negotiated Rate	$881.25
Max. Negotiated Rate	$1,421.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,421.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,292.50
Rate for Payer: Qualcare PPO/HMO/WC	$881.25

BEARING PST TB 20x71/75 183750

Facility

$5,875.00

Hospital Charge Code	270639356
Hospital Revenue Code	278
Min. Negotiated Rate	$141.59
Max. Negotiated Rate	$2,937.50
Rate for Payer: Aetna Commercial	$2,232.50
Rate for Payer: Aetna Medicare Advantage	$1,762.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,498.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,498.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,498.12
Rate for Payer: Cigna Commercial	$2,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,421.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,292.50
Rate for Payer: Qualcare PPO/HMO/WC	$881.25
Rate for Payer: UnitedHealthcare Community & State	$141.59
Rate for Payer: Wellpoint Medicaid Managed Care	$155.69

BEARING PS VAN 10x63/67 183620

Facility

$5,135.00

Service Code	HCPCS C1776
Hospital Charge Code	270639768
Hospital Revenue Code	278
Min. Negotiated Rate	$770.25
Max. Negotiated Rate	$1,242.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,027.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,242.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,129.70
Rate for Payer: Qualcare PPO/HMO/WC	$770.25

BEARING PS VAN 10x63/67 183620

Facility

$5,135.00

Service Code	HCPCS C1776
Hospital Charge Code	270639768
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$2,567.50
Rate for Payer: Aetna Commercial	$1,951.30
Rate for Payer: Aetna Medicare Advantage	$1,540.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,309.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,309.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,027.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,309.42
Rate for Payer: Cigna Commercial	$2,567.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,242.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,129.70
Rate for Payer: Qualcare PPO/HMO/WC	$770.25
Rate for Payer: UnitedHealthcare Community & State	$123.75
Rate for Payer: Wellpoint Medicaid Managed Care	$136.08

BEARING SHOULDER 40MM 3 VITE

Facility

$12,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697962
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$3,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

Know your out-of-pocket cost for care.

All Charges