Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CERV CAGE 17.5X14X8MM 7DEG

Facility

$15,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705400
Hospital Revenue Code	278
Min. Negotiated Rate	$2,325.00
Max. Negotiated Rate	$3,751.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,751.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,410.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,325.00

CERV CAGE 17.5X14X8MM 7DEG

Facility

$15,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705400
Hospital Revenue Code	278
Min. Negotiated Rate	$373.55
Max. Negotiated Rate	$7,750.00
Rate for Payer: Aetna Commercial	$5,890.00
Rate for Payer: Aetna Medicare Advantage	$4,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,952.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,952.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,952.50
Rate for Payer: Cigna Commercial	$7,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,751.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,410.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,325.00
Rate for Payer: UnitedHealthcare Community & State	$373.55
Rate for Payer: Wellpoint Medicaid Managed Care	$410.75

CERVICAL 3DR RIGEL 16X14X7MM

Facility

$5,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270698897
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

CERVICAL 3DR RIGEL 16X14X7MM

Facility

$5,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270698897
Hospital Revenue Code	278
Min. Negotiated Rate	$120.50
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Community & State	$120.50
Rate for Payer: Wellpoint Medicaid Managed Care	$132.50

CERVICAL CAGE 7MM MEDIUM

Facility

$15,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705435
Hospital Revenue Code	278
Min. Negotiated Rate	$2,250.00
Max. Negotiated Rate	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00

CERVICAL CAGE 7MM MEDIUM

Facility

$15,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705435
Hospital Revenue Code	278
Min. Negotiated Rate	$361.50
Max. Negotiated Rate	$7,500.00
Rate for Payer: Aetna Commercial	$5,700.00
Rate for Payer: Aetna Medicare Advantage	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,825.00
Rate for Payer: Cigna Commercial	$7,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00
Rate for Payer: UnitedHealthcare Community & State	$361.50
Rate for Payer: Wellpoint Medicaid Managed Care	$397.50

CERVICAL CAGE LORDOTIC 7MM

Facility

$10,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705761
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

CERVICAL CAGE LORDOTIC 7MM

Facility

$10,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705761
Hospital Revenue Code	278
Min. Negotiated Rate	$253.05
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,990.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00
Rate for Payer: UnitedHealthcare Community & State	$253.05
Rate for Payer: Wellpoint Medicaid Managed Care	$278.25

CERVICAL CAGE LORDOTIC 8MM

Facility

$10,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705760
Hospital Revenue Code	278
Min. Negotiated Rate	$253.05
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,990.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00
Rate for Payer: UnitedHealthcare Community & State	$253.05
Rate for Payer: Wellpoint Medicaid Managed Care	$278.25

CERVICAL CAGE LORDOTIC 8MM

Facility

$10,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705760
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

CERVICAL COLLAR LG. 4-1/4X22

Facility

$23.80

Hospital Charge Code	270649878
Hospital Revenue Code	270
Min. Negotiated Rate	$3.57
Max. Negotiated Rate	$3.57
Rate for Payer: Qualcare PPO/HMO/WC	$3.57

CERVICAL COLLAR LG. 4-1/4X22

Facility

$23.80

Hospital Charge Code	270649878
Hospital Revenue Code	270
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$11.90
Rate for Payer: Aetna Commercial	$9.04
Rate for Payer: Aetna Medicare Advantage	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.07
Rate for Payer: Cigna Commercial	$11.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.14
Rate for Payer: Oxford Commercial	$4.76
Rate for Payer: Qualcare PPO/HMO/WC	$3.57
Rate for Payer: UnitedHealthcare Commercial	$4.76
Rate for Payer: UnitedHealthcare Community & State	$0.57
Rate for Payer: Wellpoint Medicaid Managed Care	$0.63

CERVICAL COLLAR SMALL

Facility

$31.00

Hospital Charge Code	270331643
Hospital Revenue Code	272
Min. Negotiated Rate	$4.65
Max. Negotiated Rate	$4.65
Rate for Payer: Qualcare PPO/HMO/WC	$4.65

CERVICAL COLLAR SMALL

Facility

$31.00

Hospital Charge Code	270331643
Hospital Revenue Code	272
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$15.50
Rate for Payer: Aetna Commercial	$11.78
Rate for Payer: Aetna Medicare Advantage	$9.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.91
Rate for Payer: Cigna Commercial	$15.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.30
Rate for Payer: Oxford Commercial	$6.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.65
Rate for Payer: UnitedHealthcare Commercial	$6.20
Rate for Payer: UnitedHealthcare Community & State	$0.75
Rate for Payer: Wellpoint Medicaid Managed Care	$0.82

CERVICAL COLLAR VISTA RIGID TR

Facility

$333.05

Service Code	HCPCS C1713
Hospital Charge Code	270690430
Hospital Revenue Code	278
Min. Negotiated Rate	$49.96
Max. Negotiated Rate	$80.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$66.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$73.27
Rate for Payer: Qualcare PPO/HMO/WC	$49.96

CERVICAL COLLAR VISTA RIGID TR

Facility

$333.05

Service Code	HCPCS C1713
Hospital Charge Code	270690430
Hospital Revenue Code	278
Min. Negotiated Rate	$8.03
Max. Negotiated Rate	$166.53
Rate for Payer: Aetna Commercial	$126.56
Rate for Payer: Aetna Medicare Advantage	$99.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$66.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.93
Rate for Payer: Cigna Commercial	$166.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$73.27
Rate for Payer: Qualcare PPO/HMO/WC	$49.96
Rate for Payer: UnitedHealthcare Community & State	$8.03
Rate for Payer: Wellpoint Medicaid Managed Care	$8.83

CERVICAL CONSTRUX 12x12x8MM

Facility

$12,000.00

Hospital Charge Code	270675885
Hospital Revenue Code	278
Min. Negotiated Rate	$289.20
Max. Negotiated Rate	$6,000.00
Rate for Payer: Aetna Commercial	$4,560.00
Rate for Payer: Aetna Medicare Advantage	$3,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,060.00
Rate for Payer: Cigna Commercial	$6,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,640.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00
Rate for Payer: UnitedHealthcare Community & State	$289.20
Rate for Payer: Wellpoint Medicaid Managed Care	$318.00

CERVICAL CONSTRUX 12x12x8MM

Facility

$12,000.00

Hospital Charge Code	270675885
Hospital Revenue Code	278
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$2,904.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,640.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

CERVICAL DISC M6 6X15X12.5MM

Facility

$31,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270697929
Hospital Revenue Code	278
Min. Negotiated Rate	$747.10
Max. Negotiated Rate	$15,500.00
Rate for Payer: Aetna Commercial	$11,780.00
Rate for Payer: Aetna Medicare Advantage	$9,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,905.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,905.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,905.00
Rate for Payer: Cigna Commercial	$15,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,502.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,820.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,650.00
Rate for Payer: UnitedHealthcare Community & State	$747.10
Rate for Payer: Wellpoint Medicaid Managed Care	$821.50

CERVICAL DISC M6 6X15X12.5MM

Facility

$31,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270697929
Hospital Revenue Code	278
Min. Negotiated Rate	$4,650.00
Max. Negotiated Rate	$7,502.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,502.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,820.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,650.00

CERVICAL DISC MOBI-C 7X17X19MM

Facility

$37,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270695829
Hospital Revenue Code	278
Min. Negotiated Rate	$903.75
Max. Negotiated Rate	$18,750.00
Rate for Payer: Aetna Commercial	$14,250.00
Rate for Payer: Aetna Medicare Advantage	$11,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,562.50
Rate for Payer: Cigna Commercial	$18,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,075.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,625.00
Rate for Payer: UnitedHealthcare Community & State	$903.75
Rate for Payer: Wellpoint Medicaid Managed Care	$993.75

CERVICAL DISC MOBI-C 7X17X19MM

Facility

$37,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270695829
Hospital Revenue Code	278
Min. Negotiated Rate	$5,625.00
Max. Negotiated Rate	$9,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,075.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,625.00

CERVICAL PLATE 14MM

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270704155
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,045.00
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

CERVICAL PLATE 14MM

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270704155
Hospital Revenue Code	278
Min. Negotiated Rate	$114.47
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,805.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,045.00
Rate for Payer: Qualcare PPO/HMO/WC	$712.50
Rate for Payer: UnitedHealthcare Community & State	$114.47
Rate for Payer: Wellpoint Medicaid Managed Care	$125.88

CERVICAL PLATE 2 LEVEL 30MM

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704643
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

Know your out-of-pocket cost for care.

All Charges