Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BEARING SHOULDER 40MM 3 VITE

Facility

$12,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697962
Hospital Revenue Code	278
Min. Negotiated Rate	$301.25
Max. Negotiated Rate	$6,250.00
Rate for Payer: Aetna Commercial	$4,750.00
Rate for Payer: Aetna Medicare Advantage	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,187.50
Rate for Payer: Cigna Commercial	$6,250.00
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
Rate for Payer: UnitedHealthcare Community & State	$301.25
Rate for Payer: Wellpoint Medicaid Managed Care	$331.25

BEARING SSK TIBIA 10X63/67

Facility

$9,200.00

Hospital Charge Code	270638756
Hospital Revenue Code	278
Min. Negotiated Rate	$221.72
Max. Negotiated Rate	$4,600.00
Rate for Payer: Aetna Commercial	$3,496.00
Rate for Payer: Aetna Medicare Advantage	$2,760.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,346.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,346.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,346.00
Rate for Payer: Cigna Commercial	$4,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,226.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,024.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,380.00
Rate for Payer: UnitedHealthcare Community & State	$221.72
Rate for Payer: Wellpoint Medicaid Managed Care	$243.80

BEARING SSK TIBIA 10X63/67

Facility

$9,200.00

Hospital Charge Code	270638756
Hospital Revenue Code	278
Min. Negotiated Rate	$1,380.00
Max. Negotiated Rate	$2,226.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,226.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,024.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,380.00

BEARING TBIAL VNGRD PS10X71/75

Facility

$5,135.00

Service Code	HCPCS C1776
Hospital Charge Code	270642310
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 TBIAL VNGRD PS10X71/75

Facility

$5,135.00

Service Code	HCPCS C1776
Hospital Charge Code	270642310
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 TIBIAL 10mmk X 183520

Facility

$5,260.00

Hospital Charge Code	270640544
Hospital Revenue Code	278
Min. Negotiated Rate	$789.00
Max. Negotiated Rate	$1,272.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,052.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,272.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,157.20
Rate for Payer: Qualcare PPO/HMO/WC	$789.00

BEARING TIBIAL 10mmk X 183520

Facility

$5,260.00

Hospital Charge Code	270640544
Hospital Revenue Code	278
Min. Negotiated Rate	$126.77
Max. Negotiated Rate	$2,630.00
Rate for Payer: Aetna Commercial	$1,998.80
Rate for Payer: Aetna Medicare Advantage	$1,578.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,341.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,341.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,052.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,341.30
Rate for Payer: Cigna Commercial	$2,630.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,272.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,157.20
Rate for Payer: Qualcare PPO/HMO/WC	$789.00
Rate for Payer: UnitedHealthcare Community & State	$126.77
Rate for Payer: Wellpoint Medicaid Managed Care	$139.39

BEARING TIBIAL 10mm X 71/75MM

Facility

$11,205.00

Hospital Charge Code	270645008
Hospital Revenue Code	278
Min. Negotiated Rate	$270.04
Max. Negotiated Rate	$5,602.50
Rate for Payer: Aetna Commercial	$4,257.90
Rate for Payer: Aetna Medicare Advantage	$3,361.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,857.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,857.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,241.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,857.28
Rate for Payer: Cigna Commercial	$5,602.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,711.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,465.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,680.75
Rate for Payer: UnitedHealthcare Community & State	$270.04
Rate for Payer: Wellpoint Medicaid Managed Care	$296.93

BEARING TIBIAL 10mm X 71/75MM

Facility

$11,205.00

Hospital Charge Code	270645008
Hospital Revenue Code	278
Min. Negotiated Rate	$1,680.75
Max. Negotiated Rate	$2,711.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,241.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,711.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,465.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,680.75

BEARING TIBIAL 10x240x25mm

Facility

$5,070.00

Hospital Charge Code	270673872
Hospital Revenue Code	278
Min. Negotiated Rate	$122.19
Max. Negotiated Rate	$2,535.00
Rate for Payer: Aetna Commercial	$1,926.60
Rate for Payer: Aetna Medicare Advantage	$1,521.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,292.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,292.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,014.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,292.85
Rate for Payer: Cigna Commercial	$2,535.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,226.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,115.40
Rate for Payer: Qualcare PPO/HMO/WC	$760.50
Rate for Payer: UnitedHealthcare Community & State	$122.19
Rate for Payer: Wellpoint Medicaid Managed Care	$134.35

BEARING TIBIAL 10x240x25mm

Facility

$5,070.00

Hospital Charge Code	270673872
Hospital Revenue Code	278
Min. Negotiated Rate	$760.50
Max. Negotiated Rate	$1,226.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,014.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,226.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,115.40
Rate for Payer: Qualcare PPO/HMO/WC	$760.50

BEARING TIBIAL 10x63/67mm

Facility

$12,930.00

Hospital Charge Code	270675558
Hospital Revenue Code	278
Min. Negotiated Rate	$311.61
Max. Negotiated Rate	$6,465.00
Rate for Payer: Aetna Commercial	$4,913.40
Rate for Payer: Aetna Medicare Advantage	$3,879.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,297.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,297.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,586.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,297.15
Rate for Payer: Cigna Commercial	$6,465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,129.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,844.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,939.50
Rate for Payer: UnitedHealthcare Community & State	$311.61
Rate for Payer: Wellpoint Medicaid Managed Care	$342.64

BEARING TIBIAL 10x63/67mm

Facility

$12,930.00

Hospital Charge Code	270675558
Hospital Revenue Code	278
Min. Negotiated Rate	$1,939.50
Max. Negotiated Rate	$3,129.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,586.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,129.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,844.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,939.50

BEARING TIBIAL 10X71/75 183640

Facility

$6,169.00

Hospital Charge Code	27063675
Hospital Revenue Code	278
Min. Negotiated Rate	$925.35
Max. Negotiated Rate	$1,492.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,233.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,492.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,357.18
Rate for Payer: Qualcare PPO/HMO/WC	$925.35

BEARING TIBIAL 10X71/75 183640

Facility

$6,169.00

Hospital Charge Code	27063675
Hospital Revenue Code	278
Min. Negotiated Rate	$148.67
Max. Negotiated Rate	$3,084.50
Rate for Payer: Aetna Commercial	$2,344.22
Rate for Payer: Aetna Medicare Advantage	$1,850.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,573.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,573.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,233.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,573.10
Rate for Payer: Cigna Commercial	$3,084.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,492.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,357.18
Rate for Payer: Qualcare PPO/HMO/WC	$925.35
Rate for Payer: UnitedHealthcare Community & State	$148.67
Rate for Payer: Wellpoint Medicaid Managed Care	$163.48

BEARING TIBIAL 10X71/75 183640

Facility

$11,205.00

Service Code	HCPCS C1776
Hospital Charge Code	270636756
Hospital Revenue Code	278
Min. Negotiated Rate	$1,680.75
Max. Negotiated Rate	$2,711.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,241.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,711.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,465.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,680.75

BEARING TIBIAL 10X71/75 183640

Facility

$11,205.00

Service Code	HCPCS C1776
Hospital Charge Code	270636756
Hospital Revenue Code	278
Min. Negotiated Rate	$270.04
Max. Negotiated Rate	$5,602.50
Rate for Payer: Aetna Commercial	$4,257.90
Rate for Payer: Aetna Medicare Advantage	$3,361.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,857.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,857.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,241.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,857.28
Rate for Payer: Cigna Commercial	$5,602.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,711.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,465.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,680.75
Rate for Payer: UnitedHealthcare Community & State	$270.04
Rate for Payer: Wellpoint Medicaid Managed Care	$296.93

BEARING TIBIAL 10x71/75mm

Facility

$11,880.00

Service Code	HCPCS C1776
Hospital Charge Code	270647563
Hospital Revenue Code	278
Min. Negotiated Rate	$286.31
Max. Negotiated Rate	$5,940.00
Rate for Payer: Aetna Commercial	$4,514.40
Rate for Payer: Aetna Medicare Advantage	$3,564.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,029.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,029.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,376.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,029.40
Rate for Payer: Cigna Commercial	$5,940.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,874.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,613.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,782.00
Rate for Payer: UnitedHealthcare Community & State	$286.31
Rate for Payer: Wellpoint Medicaid Managed Care	$314.82

BEARING TIBIAL 10x71/75mm

Facility

$11,880.00

Service Code	HCPCS C1776
Hospital Charge Code	270647563
Hospital Revenue Code	278
Min. Negotiated Rate	$1,782.00
Max. Negotiated Rate	$2,874.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,376.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,874.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,613.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,782.00

BEARING TIBIAL 12mm x 71/75

Facility

$11,205.00

Hospital Charge Code	270644716
Hospital Revenue Code	278
Min. Negotiated Rate	$1,680.75
Max. Negotiated Rate	$2,711.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,241.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,711.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,465.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,680.75

BEARING TIBIAL 12mm x 71/75

Facility

$11,205.00

Hospital Charge Code	270644716
Hospital Revenue Code	278
Min. Negotiated Rate	$270.04
Max. Negotiated Rate	$5,602.50
Rate for Payer: Aetna Commercial	$4,257.90
Rate for Payer: Aetna Medicare Advantage	$3,361.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,857.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,857.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,241.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,857.28
Rate for Payer: Cigna Commercial	$5,602.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,711.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,465.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,680.75
Rate for Payer: UnitedHealthcare Community & State	$270.04
Rate for Payer: Wellpoint Medicaid Managed Care	$296.93

BEARING TIBIAL 12x71/75 146152

Facility

$2,673.50

Hospital Charge Code	270612921
Hospital Revenue Code	278
Min. Negotiated Rate	$401.02
Max. Negotiated Rate	$646.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$534.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$646.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$588.17
Rate for Payer: Qualcare PPO/HMO/WC	$401.02

BEARING TIBIAL 12x71/75 146152

Facility

$2,673.50

Hospital Charge Code	270612921
Hospital Revenue Code	278
Min. Negotiated Rate	$64.43
Max. Negotiated Rate	$1,336.75
Rate for Payer: Aetna Commercial	$1,015.93
Rate for Payer: Aetna Medicare Advantage	$802.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$681.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$681.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$534.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$681.74
Rate for Payer: Cigna Commercial	$1,336.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$646.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$588.17
Rate for Payer: Qualcare PPO/HMO/WC	$401.02
Rate for Payer: UnitedHealthcare Community & State	$64.43
Rate for Payer: Wellpoint Medicaid Managed Care	$70.85

BEARING TIBIAL 12x79/83mm

Facility

$13,195.00

Hospital Charge Code	270669892
Hospital Revenue Code	278
Min. Negotiated Rate	$1,979.25
Max. Negotiated Rate	$3,193.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,639.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,193.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,902.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,979.25

BEARING TIBIAL 12x79/83mm

Facility

$13,195.00

Hospital Charge Code	270669892
Hospital Revenue Code	278
Min. Negotiated Rate	$318.00
Max. Negotiated Rate	$6,597.50
Rate for Payer: Aetna Commercial	$5,014.10
Rate for Payer: Aetna Medicare Advantage	$3,958.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,364.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,364.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,639.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,364.72
Rate for Payer: Cigna Commercial	$6,597.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,193.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,902.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,979.25
Rate for Payer: UnitedHealthcare Community & State	$318.00
Rate for Payer: Wellpoint Medicaid Managed Care	$349.67

Know your out-of-pocket cost for care.

All Charges