Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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	$103.26
Max. Negotiated Rate	$2,142.32
Rate for Payer: Aetna Commercial	$1,628.17
Rate for Payer: Aetna Medicare Advantage	$1,285.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,092.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,092.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$856.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,092.59
Rate for Payer: Cigna Commercial	$2,142.32
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
Rate for Payer: UnitedHealthcare Community & State	$103.26
Rate for Payer: Wellpoint Medicaid Managed Care	$113.54

TIBIAL INSRT POST STB SZ3 11MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270675759
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 11MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270675759
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 SZ3 13MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270679380
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 13MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270679380
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 SZ3 15MM

Facility

$3,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270681945
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 SZ3 15MM

Facility

$3,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270681945
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 18MM

Facility

$4,284.65

Service Code	HCPCS C1776
Hospital Charge Code	270670754
Hospital Revenue Code	278
Min. Negotiated Rate	$103.26
Max. Negotiated Rate	$2,142.32
Rate for Payer: Aetna Commercial	$1,628.17
Rate for Payer: Aetna Medicare Advantage	$1,285.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,092.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,092.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$856.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,092.59
Rate for Payer: Cigna Commercial	$2,142.32
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
Rate for Payer: UnitedHealthcare Community & State	$103.26
Rate for Payer: Wellpoint Medicaid Managed Care	$113.54

TIBIAL INSRT POST STB SZ3 18MM

Facility

$4,284.65

Service Code	HCPCS C1776
Hospital Charge Code	270670754
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

TIBIAL INSRT POST STB SZ3 19MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270684769
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 SZ3 19MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270684769
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 22MM

Facility

$3,500.00

Hospital Charge Code	270677169
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 22MM

Facility

$3,500.00

Hospital Charge Code	270677169
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 SZ4 13MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270679003
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 SZ4 13MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270679003
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 SZ4 22MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270675366
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 SZ4 22MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270675366
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 SZ5 11MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270677578
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 SZ5 11MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270677578
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 SZ5 9MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270677825
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 SZ5 9MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270677825
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 & SCREW SZ 1 22MM

Facility

$6,903.00

Hospital Charge Code	270670040
Hospital Revenue Code	278
Min. Negotiated Rate	$166.36
Max. Negotiated Rate	$3,451.50
Rate for Payer: Aetna Commercial	$2,623.14
Rate for Payer: Aetna Medicare Advantage	$2,070.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,760.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,760.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,380.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,760.27
Rate for Payer: Cigna Commercial	$3,451.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,670.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,518.66
Rate for Payer: Qualcare PPO/HMO/WC	$1,035.45
Rate for Payer: UnitedHealthcare Community & State	$166.36
Rate for Payer: Wellpoint Medicaid Managed Care	$182.93

TIBIAL INSRT & SCREW SZ 1 22MM

Facility

$6,903.00

Hospital Charge Code	270670040
Hospital Revenue Code	278
Min. Negotiated Rate	$1,035.45
Max. Negotiated Rate	$1,670.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,380.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,670.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,518.66
Rate for Payer: Qualcare PPO/HMO/WC	$1,035.45

TIBIAL INSRT & SCRW SZ2 18MM

Facility

$6,903.00

Service Code	HCPCS C1776
Hospital Charge Code	270670552
Hospital Revenue Code	278
Min. Negotiated Rate	$166.36
Max. Negotiated Rate	$3,451.50
Rate for Payer: Aetna Commercial	$2,623.14
Rate for Payer: Aetna Medicare Advantage	$2,070.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,760.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,760.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,380.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,760.27
Rate for Payer: Cigna Commercial	$3,451.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,670.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,518.66
Rate for Payer: Qualcare PPO/HMO/WC	$1,035.45
Rate for Payer: UnitedHealthcare Community & State	$166.36
Rate for Payer: Wellpoint Medicaid Managed Care	$182.93

TIBIAL INSRT & SCRW SZ2 18MM

Facility

$6,903.00

Service Code	HCPCS C1776
Hospital Charge Code	270670552
Hospital Revenue Code	278
Min. Negotiated Rate	$1,035.45
Max. Negotiated Rate	$1,670.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,380.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,670.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,518.66
Rate for Payer: Qualcare PPO/HMO/WC	$1,035.45

Know your out-of-pocket cost for care.

All Charges