Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ACETABULAR LINER NEUT-32/52

Facility

$6,660.00

Hospital Charge Code	270668879
Hospital Revenue Code	278
Min. Negotiated Rate	$999.00
Max. Negotiated Rate	$1,611.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00

ACETABULAR LINER NEUT-32/54

Facility

$6,660.00

Hospital Charge Code	270668880
Hospital Revenue Code	278
Min. Negotiated Rate	$160.51
Max. Negotiated Rate	$3,330.00
Rate for Payer: Aetna Commercial	$2,530.80
Rate for Payer: Aetna Medicare Advantage	$1,998.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,698.30
Rate for Payer: Cigna Commercial	$3,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00
Rate for Payer: UnitedHealthcare Community & State	$160.51
Rate for Payer: Wellpoint Medicaid Managed Care	$176.49

ACETABULAR LINER NEUT-32/54

Facility

$6,660.00

Hospital Charge Code	270668880
Hospital Revenue Code	278
Min. Negotiated Rate	$999.00
Max. Negotiated Rate	$1,611.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00

ACETABULAR LINER NEUT-32/56

Facility

$6,660.00

Hospital Charge Code	270668882
Hospital Revenue Code	278
Min. Negotiated Rate	$999.00
Max. Negotiated Rate	$1,611.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00

ACETABULAR LINER NEUT-32/56

Facility

$6,660.00

Hospital Charge Code	270668882
Hospital Revenue Code	278
Min. Negotiated Rate	$160.51
Max. Negotiated Rate	$3,330.00
Rate for Payer: Aetna Commercial	$2,530.80
Rate for Payer: Aetna Medicare Advantage	$1,998.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,698.30
Rate for Payer: Cigna Commercial	$3,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00
Rate for Payer: UnitedHealthcare Community & State	$160.51
Rate for Payer: Wellpoint Medicaid Managed Care	$176.49

ACETABULAR LINER NEUT-32/58-60

Facility

$6,660.00

Hospital Charge Code	270668883
Hospital Revenue Code	278
Min. Negotiated Rate	$999.00
Max. Negotiated Rate	$1,611.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00

ACETABULAR LINER NEUT-32/58-60

Facility

$6,660.00

Hospital Charge Code	270668883
Hospital Revenue Code	278
Min. Negotiated Rate	$160.51
Max. Negotiated Rate	$3,330.00
Rate for Payer: Aetna Commercial	$2,530.80
Rate for Payer: Aetna Medicare Advantage	$1,998.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,698.30
Rate for Payer: Cigna Commercial	$3,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00
Rate for Payer: UnitedHealthcare Community & State	$160.51
Rate for Payer: Wellpoint Medicaid Managed Care	$176.49

ACETABULAR LINER NEUT-32/62-64

Facility

$6,660.00

Hospital Charge Code	270668884
Hospital Revenue Code	278
Min. Negotiated Rate	$160.51
Max. Negotiated Rate	$3,330.00
Rate for Payer: Aetna Commercial	$2,530.80
Rate for Payer: Aetna Medicare Advantage	$1,998.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,698.30
Rate for Payer: Cigna Commercial	$3,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00
Rate for Payer: UnitedHealthcare Community & State	$160.51
Rate for Payer: Wellpoint Medicaid Managed Care	$176.49

ACETABULAR LINER NEUT-32/62-64

Facility

$6,660.00

Hospital Charge Code	270668884
Hospital Revenue Code	278
Min. Negotiated Rate	$999.00
Max. Negotiated Rate	$1,611.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00

ACETABULAR LINER NEUT-32/66-70

Facility

$6,660.00

Hospital Charge Code	270668885
Hospital Revenue Code	278
Min. Negotiated Rate	$999.00
Max. Negotiated Rate	$1,611.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00

ACETABULAR LINER NEUT-32/66-70

Facility

$6,660.00

Hospital Charge Code	270668885
Hospital Revenue Code	278
Min. Negotiated Rate	$160.51
Max. Negotiated Rate	$3,330.00
Rate for Payer: Aetna Commercial	$2,530.80
Rate for Payer: Aetna Medicare Advantage	$1,998.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,698.30
Rate for Payer: Cigna Commercial	$3,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00
Rate for Payer: UnitedHealthcare Community & State	$160.51
Rate for Payer: Wellpoint Medicaid Managed Care	$176.49

ACETABULAR LINER NEUT-36/52

Facility

$6,660.00

Service Code	HCPCS C1776
Hospital Charge Code	270668916
Hospital Revenue Code	278
Min. Negotiated Rate	$160.51
Max. Negotiated Rate	$3,330.00
Rate for Payer: Aetna Commercial	$2,530.80
Rate for Payer: Aetna Medicare Advantage	$1,998.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,698.30
Rate for Payer: Cigna Commercial	$3,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00
Rate for Payer: UnitedHealthcare Community & State	$160.51
Rate for Payer: Wellpoint Medicaid Managed Care	$176.49

ACETABULAR LINER NEUT-36/52

Facility

$6,660.00

Service Code	HCPCS C1776
Hospital Charge Code	270668916
Hospital Revenue Code	278
Min. Negotiated Rate	$999.00
Max. Negotiated Rate	$1,611.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00

ACETABULAR LINER NEUT-36/54

Facility

$6,660.00

Hospital Charge Code	270668917
Hospital Revenue Code	278
Min. Negotiated Rate	$160.51
Max. Negotiated Rate	$3,330.00
Rate for Payer: Aetna Commercial	$2,530.80
Rate for Payer: Aetna Medicare Advantage	$1,998.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,698.30
Rate for Payer: Cigna Commercial	$3,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00
Rate for Payer: UnitedHealthcare Community & State	$160.51
Rate for Payer: Wellpoint Medicaid Managed Care	$176.49

ACETABULAR LINER NEUT-36/54

Facility

$6,660.00

Hospital Charge Code	270668917
Hospital Revenue Code	278
Min. Negotiated Rate	$999.00
Max. Negotiated Rate	$1,611.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00

ACETABULAR LINER NEUT-36/56

Facility

$6,660.00

Service Code	HCPCS C1776
Hospital Charge Code	270668918
Hospital Revenue Code	278
Min. Negotiated Rate	$160.51
Max. Negotiated Rate	$3,330.00
Rate for Payer: Aetna Commercial	$2,530.80
Rate for Payer: Aetna Medicare Advantage	$1,998.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,698.30
Rate for Payer: Cigna Commercial	$3,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00
Rate for Payer: UnitedHealthcare Community & State	$160.51
Rate for Payer: Wellpoint Medicaid Managed Care	$176.49

ACETABULAR LINER NEUT-36/56

Facility

$6,660.00

Service Code	HCPCS C1776
Hospital Charge Code	270668918
Hospital Revenue Code	278
Min. Negotiated Rate	$999.00
Max. Negotiated Rate	$1,611.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00

ACETABULAR LINER NEUT-36/58-60

Facility

$6,660.00

Service Code	HCPCS C1776
Hospital Charge Code	270668919
Hospital Revenue Code	278
Min. Negotiated Rate	$160.51
Max. Negotiated Rate	$3,330.00
Rate for Payer: Aetna Commercial	$2,530.80
Rate for Payer: Aetna Medicare Advantage	$1,998.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,698.30
Rate for Payer: Cigna Commercial	$3,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00
Rate for Payer: UnitedHealthcare Community & State	$160.51
Rate for Payer: Wellpoint Medicaid Managed Care	$176.49

ACETABULAR LINER NEUT-36/58-60

Facility

$6,660.00

Service Code	HCPCS C1776
Hospital Charge Code	270668919
Hospital Revenue Code	278
Min. Negotiated Rate	$999.00
Max. Negotiated Rate	$1,611.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00

ACETABULAR LINER NEUT-36/62-64

Facility

$6,660.00

Hospital Charge Code	270668920
Hospital Revenue Code	278
Min. Negotiated Rate	$999.00
Max. Negotiated Rate	$1,611.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00

ACETABULAR LINER NEUT-36/62-64

Facility

$6,660.00

Hospital Charge Code	270668920
Hospital Revenue Code	278
Min. Negotiated Rate	$160.51
Max. Negotiated Rate	$3,330.00
Rate for Payer: Aetna Commercial	$2,530.80
Rate for Payer: Aetna Medicare Advantage	$1,998.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,698.30
Rate for Payer: Cigna Commercial	$3,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00
Rate for Payer: UnitedHealthcare Community & State	$160.51
Rate for Payer: Wellpoint Medicaid Managed Care	$176.49

ACETABULAR LINER NEUT-36/66-70

Facility

$6,660.00

Hospital Charge Code	270668921
Hospital Revenue Code	278
Min. Negotiated Rate	$160.51
Max. Negotiated Rate	$3,330.00
Rate for Payer: Aetna Commercial	$2,530.80
Rate for Payer: Aetna Medicare Advantage	$1,998.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,698.30
Rate for Payer: Cigna Commercial	$3,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00
Rate for Payer: UnitedHealthcare Community & State	$160.51
Rate for Payer: Wellpoint Medicaid Managed Care	$176.49

ACETABULAR LINER NEUT-36/66-70

Facility

$6,660.00

Hospital Charge Code	270668921
Hospital Revenue Code	278
Min. Negotiated Rate	$999.00
Max. Negotiated Rate	$1,611.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00

ACETABULAR LINER NEUT-40/56

Facility

$6,660.00

Hospital Charge Code	270668922
Hospital Revenue Code	278
Min. Negotiated Rate	$160.51
Max. Negotiated Rate	$3,330.00
Rate for Payer: Aetna Commercial	$2,530.80
Rate for Payer: Aetna Medicare Advantage	$1,998.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,698.30
Rate for Payer: Cigna Commercial	$3,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00
Rate for Payer: UnitedHealthcare Community & State	$160.51
Rate for Payer: Wellpoint Medicaid Managed Care	$176.49

ACETABULAR LINER NEUT-40/56

Facility

$6,660.00

Hospital Charge Code	270668922
Hospital Revenue Code	278
Min. Negotiated Rate	$999.00
Max. Negotiated Rate	$1,611.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00

Know your out-of-pocket cost for care.

All Charges