Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TIBIAL INSR POST STAB SZ4 11MM

Facility

$3,425.00

Hospital Charge Code	270669601
Hospital Revenue Code	278
Min. Negotiated Rate	$82.54
Max. Negotiated Rate	$1,712.50
Rate for Payer: Aetna Commercial	$1,301.50
Rate for Payer: Aetna Medicare Advantage	$1,027.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$873.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$873.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$685.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$873.38
Rate for Payer: Cigna Commercial	$1,712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$828.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$753.50
Rate for Payer: Qualcare PPO/HMO/WC	$513.75
Rate for Payer: UnitedHealthcare Community & State	$82.54
Rate for Payer: Wellpoint Medicaid Managed Care	$90.76

TIBIAL INSR POST STAB SZ4 11MM

Facility

$3,425.00

Hospital Charge Code	270669601
Hospital Revenue Code	278
Min. Negotiated Rate	$513.75
Max. Negotiated Rate	$828.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$685.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$828.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$753.50
Rate for Payer: Qualcare PPO/HMO/WC	$513.75

TIBIAL INSRT POST STAB 1.5 9MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270674365
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

TIBIAL INSRT POST STAB 1.5 9MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270674365
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

TIBIAL INSRT POST STB 2.5 13MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270684588
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

TIBIAL INSRT POST STB 2.5 13MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270684588
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

TIBIAL INSRT POST STB 2.5 17MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270678381
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

TIBIAL INSRT POST STB 2.5 17MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270678381
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

TIBIAL INSRT POST STB 2.5 9MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270677172
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

TIBIAL INSRT POST STB 2.5 9MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270677172
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

TIBIAL INSRT POST STB 3.5 15MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270682567
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

TIBIAL INSRT POST STB 3.5 15MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270682567
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

TIBIAL INSRT POST STB SZ2 11MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270673570
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

TIBIAL INSRT POST STB SZ2 11MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270673570
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

TIBIAL INSRT POST STB SZ2 13MM

Facility

$5,596.00

Service Code	HCPCS C1776
Hospital Charge Code	270681294
Hospital Revenue Code	278
Min. Negotiated Rate	$839.40
Max. Negotiated Rate	$1,354.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,119.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,354.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,231.12
Rate for Payer: Qualcare PPO/HMO/WC	$839.40

TIBIAL INSRT POST STB SZ2 13MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270675280
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

TIBIAL INSRT POST STB SZ2 13MM

Facility

$5,596.00

Service Code	HCPCS C1776
Hospital Charge Code	270681294
Hospital Revenue Code	278
Min. Negotiated Rate	$134.86
Max. Negotiated Rate	$2,798.00
Rate for Payer: Aetna Commercial	$2,126.48
Rate for Payer: Aetna Medicare Advantage	$1,678.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,426.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,426.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,119.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,426.98
Rate for Payer: Cigna Commercial	$2,798.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,354.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,231.12
Rate for Payer: Qualcare PPO/HMO/WC	$839.40
Rate for Payer: UnitedHealthcare Community & State	$134.86
Rate for Payer: Wellpoint Medicaid Managed Care	$148.29

TIBIAL INSRT POST STB SZ2 13MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270675280
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

TIBIAL INSRT POST STB SZ2 26MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270673240
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

TIBIAL INSRT POST STB SZ2 26MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270673240
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

TIBIAL INSRT POST STB SZ2 30MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270684941
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

TIBIAL INSRT POST STB SZ2 30MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270684941
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

TIBIAL INSRT POST STB SZ2.5 11

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270678220
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

TIBIAL INSRT POST STB SZ2.5 11

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270678220
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

TIBIAL INSRT POST STB SZ3 11M

Facility

$4,284.65

Service Code	HCPCS C1776
Hospital Charge Code	270670656
Hospital Revenue Code	278
Min. Negotiated Rate	$642.70
Max. Negotiated Rate	$1,036.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$856.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,036.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$942.62
Rate for Payer: Qualcare PPO/HMO/WC	$642.70

Know your out-of-pocket cost for care.

All Charges