Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TIBIAL INLAY POLY SZ 3 6.5MM

Facility

$3,955.00

Hospital Charge Code	270668685
Hospital Revenue Code	278
Min. Negotiated Rate	$95.32
Max. Negotiated Rate	$1,977.50
Rate for Payer: Aetna Commercial	$1,502.90
Rate for Payer: Aetna Medicare Advantage	$1,186.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$791.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,008.52
Rate for Payer: Cigna Commercial	$1,977.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$870.10
Rate for Payer: Qualcare PPO/HMO/WC	$593.25
Rate for Payer: UnitedHealthcare Community & State	$95.32
Rate for Payer: Wellpoint Medicaid Managed Care	$104.81

TIBIAL INLAY POLY SZ 3 7.5MM

Facility

$3,955.00

Hospital Charge Code	270668686
Hospital Revenue Code	278
Min. Negotiated Rate	$593.25
Max. Negotiated Rate	$957.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$791.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$870.10
Rate for Payer: Qualcare PPO/HMO/WC	$593.25

TIBIAL INLAY POLY SZ 3 7.5MM

Facility

$3,955.00

Hospital Charge Code	270668686
Hospital Revenue Code	278
Min. Negotiated Rate	$95.32
Max. Negotiated Rate	$1,977.50
Rate for Payer: Aetna Commercial	$1,502.90
Rate for Payer: Aetna Medicare Advantage	$1,186.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$791.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,008.52
Rate for Payer: Cigna Commercial	$1,977.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$870.10
Rate for Payer: Qualcare PPO/HMO/WC	$593.25
Rate for Payer: UnitedHealthcare Community & State	$95.32
Rate for Payer: Wellpoint Medicaid Managed Care	$104.81

TIBIAL INLAY POLY SZ 3 8.5MM

Facility

$3,955.00

Hospital Charge Code	270668687
Hospital Revenue Code	278
Min. Negotiated Rate	$593.25
Max. Negotiated Rate	$957.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$791.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$870.10
Rate for Payer: Qualcare PPO/HMO/WC	$593.25

TIBIAL INLAY POLY SZ 3 8.5MM

Facility

$3,955.00

Hospital Charge Code	270668687
Hospital Revenue Code	278
Min. Negotiated Rate	$95.32
Max. Negotiated Rate	$1,977.50
Rate for Payer: Aetna Commercial	$1,502.90
Rate for Payer: Aetna Medicare Advantage	$1,186.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$791.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,008.52
Rate for Payer: Cigna Commercial	$1,977.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$870.10
Rate for Payer: Qualcare PPO/HMO/WC	$593.25
Rate for Payer: UnitedHealthcare Community & State	$95.32
Rate for Payer: Wellpoint Medicaid Managed Care	$104.81

TIBIAL INLAY POLY SZ 4 6.5MM

Facility

$3,955.00

Hospital Charge Code	270668688
Hospital Revenue Code	278
Min. Negotiated Rate	$593.25
Max. Negotiated Rate	$957.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$791.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$870.10
Rate for Payer: Qualcare PPO/HMO/WC	$593.25

TIBIAL INLAY POLY SZ 4 6.5MM

Facility

$3,955.00

Hospital Charge Code	270668688
Hospital Revenue Code	278
Min. Negotiated Rate	$95.32
Max. Negotiated Rate	$1,977.50
Rate for Payer: Aetna Commercial	$1,502.90
Rate for Payer: Aetna Medicare Advantage	$1,186.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$791.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,008.52
Rate for Payer: Cigna Commercial	$1,977.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$870.10
Rate for Payer: Qualcare PPO/HMO/WC	$593.25
Rate for Payer: UnitedHealthcare Community & State	$95.32
Rate for Payer: Wellpoint Medicaid Managed Care	$104.81

TIBIAL INLAY POLY SZ 4 7.5MM

Facility

$3,955.00

Hospital Charge Code	270668689
Hospital Revenue Code	278
Min. Negotiated Rate	$593.25
Max. Negotiated Rate	$957.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$791.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$870.10
Rate for Payer: Qualcare PPO/HMO/WC	$593.25

TIBIAL INLAY POLY SZ 4 7.5MM

Facility

$3,955.00

Hospital Charge Code	270668689
Hospital Revenue Code	278
Min. Negotiated Rate	$95.32
Max. Negotiated Rate	$1,977.50
Rate for Payer: Aetna Commercial	$1,502.90
Rate for Payer: Aetna Medicare Advantage	$1,186.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$791.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,008.52
Rate for Payer: Cigna Commercial	$1,977.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$870.10
Rate for Payer: Qualcare PPO/HMO/WC	$593.25
Rate for Payer: UnitedHealthcare Community & State	$95.32
Rate for Payer: Wellpoint Medicaid Managed Care	$104.81

TIBIAL INLAY POLY SZ 4 8.5MM

Facility

$3,955.00

Hospital Charge Code	270668690
Hospital Revenue Code	278
Min. Negotiated Rate	$593.25
Max. Negotiated Rate	$957.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$791.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$870.10
Rate for Payer: Qualcare PPO/HMO/WC	$593.25

TIBIAL INLAY POLY SZ 4 8.5MM

Facility

$3,955.00

Hospital Charge Code	270668690
Hospital Revenue Code	278
Min. Negotiated Rate	$95.32
Max. Negotiated Rate	$1,977.50
Rate for Payer: Aetna Commercial	$1,502.90
Rate for Payer: Aetna Medicare Advantage	$1,186.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$791.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,008.52
Rate for Payer: Cigna Commercial	$1,977.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$870.10
Rate for Payer: Qualcare PPO/HMO/WC	$593.25
Rate for Payer: UnitedHealthcare Community & State	$95.32
Rate for Payer: Wellpoint Medicaid Managed Care	$104.81

TIBIAL INLAY POLY SZ 5 6.5MM

Facility

$3,955.00

Hospital Charge Code	270668691
Hospital Revenue Code	278
Min. Negotiated Rate	$593.25
Max. Negotiated Rate	$957.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$791.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$870.10
Rate for Payer: Qualcare PPO/HMO/WC	$593.25

TIBIAL INLAY POLY SZ 5 6.5MM

Facility

$3,955.00

Hospital Charge Code	270668691
Hospital Revenue Code	278
Min. Negotiated Rate	$95.32
Max. Negotiated Rate	$1,977.50
Rate for Payer: Aetna Commercial	$1,502.90
Rate for Payer: Aetna Medicare Advantage	$1,186.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$791.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,008.52
Rate for Payer: Cigna Commercial	$1,977.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$870.10
Rate for Payer: Qualcare PPO/HMO/WC	$593.25
Rate for Payer: UnitedHealthcare Community & State	$95.32
Rate for Payer: Wellpoint Medicaid Managed Care	$104.81

TIBIAL INLAY POLY SZ 5 7.5MM

Facility

$3,955.00

Hospital Charge Code	270668692
Hospital Revenue Code	278
Min. Negotiated Rate	$593.25
Max. Negotiated Rate	$957.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$791.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$870.10
Rate for Payer: Qualcare PPO/HMO/WC	$593.25

TIBIAL INLAY POLY SZ 5 7.5MM

Facility

$3,955.00

Hospital Charge Code	270668692
Hospital Revenue Code	278
Min. Negotiated Rate	$95.32
Max. Negotiated Rate	$1,977.50
Rate for Payer: Aetna Commercial	$1,502.90
Rate for Payer: Aetna Medicare Advantage	$1,186.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$791.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,008.52
Rate for Payer: Cigna Commercial	$1,977.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$870.10
Rate for Payer: Qualcare PPO/HMO/WC	$593.25
Rate for Payer: UnitedHealthcare Community & State	$95.32
Rate for Payer: Wellpoint Medicaid Managed Care	$104.81

TIBIAL INLAY POLY SZ 5 8.5MM

Facility

$3,955.00

Hospital Charge Code	270668693
Hospital Revenue Code	278
Min. Negotiated Rate	$593.25
Max. Negotiated Rate	$957.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$791.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$870.10
Rate for Payer: Qualcare PPO/HMO/WC	$593.25

TIBIAL INLAY POLY SZ 5 8.5MM

Facility

$3,955.00

Hospital Charge Code	270668693
Hospital Revenue Code	278
Min. Negotiated Rate	$95.32
Max. Negotiated Rate	$1,977.50
Rate for Payer: Aetna Commercial	$1,502.90
Rate for Payer: Aetna Medicare Advantage	$1,186.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$791.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,008.52
Rate for Payer: Cigna Commercial	$1,977.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$870.10
Rate for Payer: Qualcare PPO/HMO/WC	$593.25
Rate for Payer: UnitedHealthcare Community & State	$95.32
Rate for Payer: Wellpoint Medicaid Managed Care	$104.81

TIBIAL INLAY POLY SZ 6 6.5MM

Facility

$3,955.00

Hospital Charge Code	270668694
Hospital Revenue Code	278
Min. Negotiated Rate	$593.25
Max. Negotiated Rate	$957.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$791.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$870.10
Rate for Payer: Qualcare PPO/HMO/WC	$593.25

TIBIAL INLAY POLY SZ 6 6.5MM

Facility

$3,955.00

Hospital Charge Code	270668694
Hospital Revenue Code	278
Min. Negotiated Rate	$95.32
Max. Negotiated Rate	$1,977.50
Rate for Payer: Aetna Commercial	$1,502.90
Rate for Payer: Aetna Medicare Advantage	$1,186.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$791.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,008.52
Rate for Payer: Cigna Commercial	$1,977.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$870.10
Rate for Payer: Qualcare PPO/HMO/WC	$593.25
Rate for Payer: UnitedHealthcare Community & State	$95.32
Rate for Payer: Wellpoint Medicaid Managed Care	$104.81

TIBIAL INLAY POLY SZ 6 7.5MM

Facility

$3,955.00

Hospital Charge Code	270668695
Hospital Revenue Code	278
Min. Negotiated Rate	$593.25
Max. Negotiated Rate	$957.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$791.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$870.10
Rate for Payer: Qualcare PPO/HMO/WC	$593.25

TIBIAL INLAY POLY SZ 6 7.5MM

Facility

$3,955.00

Hospital Charge Code	270668695
Hospital Revenue Code	278
Min. Negotiated Rate	$95.32
Max. Negotiated Rate	$1,977.50
Rate for Payer: Aetna Commercial	$1,502.90
Rate for Payer: Aetna Medicare Advantage	$1,186.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$791.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,008.52
Rate for Payer: Cigna Commercial	$1,977.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$870.10
Rate for Payer: Qualcare PPO/HMO/WC	$593.25
Rate for Payer: UnitedHealthcare Community & State	$95.32
Rate for Payer: Wellpoint Medicaid Managed Care	$104.81

TIBIAL INLAY POLY SZ 6 8.5MM

Facility

$3,955.00

Hospital Charge Code	270668696
Hospital Revenue Code	278
Min. Negotiated Rate	$593.25
Max. Negotiated Rate	$957.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$791.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$870.10
Rate for Payer: Qualcare PPO/HMO/WC	$593.25

TIBIAL INLAY POLY SZ 6 8.5MM

Facility

$3,955.00

Hospital Charge Code	270668696
Hospital Revenue Code	278
Min. Negotiated Rate	$95.32
Max. Negotiated Rate	$1,977.50
Rate for Payer: Aetna Commercial	$1,502.90
Rate for Payer: Aetna Medicare Advantage	$1,186.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$791.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,008.52
Rate for Payer: Cigna Commercial	$1,977.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$870.10
Rate for Payer: Qualcare PPO/HMO/WC	$593.25
Rate for Payer: UnitedHealthcare Community & State	$95.32
Rate for Payer: Wellpoint Medicaid Managed Care	$104.81

TIBIAL INLAY POLY SZ 7 6.5MM

Facility

$3,955.00

Hospital Charge Code	270668697
Hospital Revenue Code	278
Min. Negotiated Rate	$95.32
Max. Negotiated Rate	$1,977.50
Rate for Payer: Aetna Commercial	$1,502.90
Rate for Payer: Aetna Medicare Advantage	$1,186.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$791.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,008.52
Rate for Payer: Cigna Commercial	$1,977.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$870.10
Rate for Payer: Qualcare PPO/HMO/WC	$593.25
Rate for Payer: UnitedHealthcare Community & State	$95.32
Rate for Payer: Wellpoint Medicaid Managed Care	$104.81

TIBIAL INLAY POLY SZ 7 6.5MM

Facility

$3,955.00

Hospital Charge Code	270668697
Hospital Revenue Code	278
Min. Negotiated Rate	$593.25
Max. Negotiated Rate	$957.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$791.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$870.10
Rate for Payer: Qualcare PPO/HMO/WC	$593.25

Know your out-of-pocket cost for care.

All Charges