Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CERV POROUS TI SPACER 7X16X14M

Facility

$5,225.00

Hospital Charge Code	270703562
Hospital Revenue Code	278
Min. Negotiated Rate	$125.92
Max. Negotiated Rate	$2,612.50
Rate for Payer: Aetna Commercial	$1,985.50
Rate for Payer: Aetna Medicare Advantage	$1,567.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,332.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,332.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,045.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,332.38
Rate for Payer: Cigna Commercial	$2,612.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,264.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$783.75
Rate for Payer: UnitedHealthcare Community & State	$125.92
Rate for Payer: Wellpoint Medicaid Managed Care	$138.46

CERV POROUS TI SPACER 7X16X14M

Facility

$8,500.00

Hospital Charge Code	270703560
Hospital Revenue Code	278
Min. Negotiated Rate	$1,275.00
Max. Negotiated Rate	$2,057.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,870.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00

CERV POROUS TI SPACER 7X16X14M

Facility

$8,500.00

Hospital Charge Code	270703567
Hospital Revenue Code	278
Min. Negotiated Rate	$1,275.00
Max. Negotiated Rate	$2,057.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,870.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00

CERV POROUS TI SPACER 7X16X14M

Facility

$8,500.00

Hospital Charge Code	270703567
Hospital Revenue Code	278
Min. Negotiated Rate	$204.85
Max. Negotiated Rate	$4,250.00
Rate for Payer: Aetna Commercial	$3,230.00
Rate for Payer: Aetna Medicare Advantage	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,167.50
Rate for Payer: Cigna Commercial	$4,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,870.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00
Rate for Payer: UnitedHealthcare Community & State	$204.85
Rate for Payer: Wellpoint Medicaid Managed Care	$225.25

CERV POROUS TI SPACER 8X16X14M

Facility

$7,875.00

Hospital Charge Code	270703566
Hospital Revenue Code	278
Min. Negotiated Rate	$189.79
Max. Negotiated Rate	$3,937.50
Rate for Payer: Aetna Commercial	$2,992.50
Rate for Payer: Aetna Medicare Advantage	$2,362.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,008.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,008.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,008.12
Rate for Payer: Cigna Commercial	$3,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,905.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,732.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,181.25
Rate for Payer: UnitedHealthcare Community & State	$189.79
Rate for Payer: Wellpoint Medicaid Managed Care	$208.69

CERV POROUS TI SPACER 8X16X14M

Facility

$7,875.00

Hospital Charge Code	270703566
Hospital Revenue Code	278
Min. Negotiated Rate	$1,181.25
Max. Negotiated Rate	$1,905.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,905.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,732.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,181.25

CERV SPINE 1 VIEW

Facility

$5,100.00

Service Code	HCPCS 72020
Hospital Charge Code	94061053
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

CERV SPINE 1 VIEW

Facility

$5,100.00

Service Code	HCPCS 72020
Hospital Charge Code	94061053
Hospital Revenue Code	320
Min. Negotiated Rate	$23.60
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$281.22
Rate for Payer: Aetna Medicare Advantage	$334.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$373.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$373.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$103.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$373.21
Rate for Payer: Cigna Commercial	$207.24
Rate for Payer: Cigna Medicare Advantage	$72.37
Rate for Payer: Clover Medicare Advantage	$98.22
Rate for Payer: EmblemHealth Commercial	$310.17
Rate for Payer: Humana Medicare Advantage	$106.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$103.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,530.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$122.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$103.39
Rate for Payer: Wellcare Medicare Advantage	$103.39
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$216.59
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

CERV STANDALONE 16X14X8H

Facility

$18,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270703790
Hospital Revenue Code	278
Min. Negotiated Rate	$2,737.50
Max. Negotiated Rate	$4,416.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,416.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,015.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,737.50

CERV STANDALONE 16X14X8H

Facility

$18,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270703790
Hospital Revenue Code	278
Min. Negotiated Rate	$439.82
Max. Negotiated Rate	$9,125.00
Rate for Payer: Aetna Commercial	$6,935.00
Rate for Payer: Aetna Medicare Advantage	$5,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,653.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,653.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,653.75
Rate for Payer: Cigna Commercial	$9,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,416.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,015.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,737.50
Rate for Payer: UnitedHealthcare Community & State	$439.82
Rate for Payer: Wellpoint Medicaid Managed Care	$483.62

CERV VARIABLE TAP SCREW

Facility

$1,000.00

Hospital Charge Code	270702204
Hospital Revenue Code	278
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

CERV VARIABLE TAP SCREW

Facility

$1,000.00

Hospital Charge Code	270702204
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CESAREAN DELIVERY PACK *****

Facility

$128.00

Hospital Charge Code	1801018
Hospital Revenue Code	272
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

CESAREAN DELIVERY PACK *****

Facility

$128.00

Hospital Charge Code	1801018
Hospital Revenue Code	272
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$64.00
Rate for Payer: Aetna Commercial	$48.64
Rate for Payer: Aetna Medicare Advantage	$38.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.64
Rate for Payer: Cigna Commercial	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.40
Rate for Payer: Oxford Commercial	$25.60
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$25.60
Rate for Payer: UnitedHealthcare Community & State	$3.08
Rate for Payer: Wellpoint Medicaid Managed Care	$3.39

CESAREAN SECTION WITHOUT STERILIZATION

Facility

$21,510.03

Service Code	APR-DRG 5404
Min. Negotiated Rate	$21,088.26
Max. Negotiated Rate	$21,510.03
Rate for Payer: UnitedHealthcare Community & State	$21,088.26
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$21,510.03
Rate for Payer: Wellpoint Medicaid Managed Care	$21,088.26

CESAREAN SECTION WITHOUT STERILIZATION

Facility

$7,330.89

Service Code	APR-DRG 5401
Min. Negotiated Rate	$7,187.15
Max. Negotiated Rate	$7,330.89
Rate for Payer: UnitedHealthcare Community & State	$7,187.15
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,330.89
Rate for Payer: Wellpoint Medicaid Managed Care	$7,187.15

CESAREAN SECTION WITHOUT STERILIZATION

Facility

$8,986.73

Service Code	APR-DRG 5402
Min. Negotiated Rate	$8,810.52
Max. Negotiated Rate	$8,986.73
Rate for Payer: UnitedHealthcare Community & State	$8,810.52
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,986.73
Rate for Payer: Wellpoint Medicaid Managed Care	$8,810.52

CESAREAN SECTION WITHOUT STERILIZATION

Facility

$11,418.91

Service Code	APR-DRG 5403
Min. Negotiated Rate	$11,195.01
Max. Negotiated Rate	$11,418.91
Rate for Payer: UnitedHealthcare Community & State	$11,195.01
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,418.91
Rate for Payer: Wellpoint Medicaid Managed Care	$11,195.01

CESAREAN SECTION WITHOUT STERILIZATION WITH CC

Facility

$38,230.89

Service Code	MSDRG 787
Min. Negotiated Rate	$11,640.82
Max. Negotiated Rate	$38,230.89
Rate for Payer: Aetna Commercial	$26,526.30
Rate for Payer: Aetna Medicare Advantage	$38,230.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24,424.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24,424.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,253.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24,424.05
Rate for Payer: Cigna Commercial	$20,899.80
Rate for Payer: Cigna Medicare Advantage	$12,253.49
Rate for Payer: Clover Medicare Advantage	$11,640.82
Rate for Payer: EmblemHealth Commercial	$36,760.47
Rate for Payer: Humana Medicare Advantage	$12,621.09
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,253.49
Rate for Payer: Oxford Commercial	$20,185.00
Rate for Payer: UnitedHealthcare Commercial	$35,393.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,253.49
Rate for Payer: Wellcare Medicare Advantage	$12,253.49

CESAREAN SECTION WITHOUT STERILIZATION WITH MCC

Facility

$55,448.64

Service Code	MSDRG 786
Min. Negotiated Rate	$16,883.40
Max. Negotiated Rate	$55,448.64
Rate for Payer: Aetna Commercial	$38,356.87
Rate for Payer: Aetna Medicare Advantage	$55,448.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40,706.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40,706.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17,772.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40,706.75
Rate for Payer: Cigna Commercial	$30,868.74
Rate for Payer: Cigna Medicare Advantage	$17,772.00
Rate for Payer: Clover Medicare Advantage	$16,883.40
Rate for Payer: EmblemHealth Commercial	$53,316.00
Rate for Payer: Humana Medicare Advantage	$18,305.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17,772.00
Rate for Payer: Oxford Commercial	$20,185.00
Rate for Payer: UnitedHealthcare Commercial	$35,393.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17,772.00
Rate for Payer: Wellcare Medicare Advantage	$17,772.00

CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC

Facility

$35,393.00

Service Code	MSDRG 788
Min. Negotiated Rate	$10,085.85
Max. Negotiated Rate	$35,393.00
Rate for Payer: Aetna Commercial	$23,017.33
Rate for Payer: Aetna Medicare Advantage	$33,124.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20,004.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20,004.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10,616.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20,004.46
Rate for Payer: Cigna Commercial	$17,942.98
Rate for Payer: Cigna Medicare Advantage	$10,616.68
Rate for Payer: Clover Medicare Advantage	$10,085.85
Rate for Payer: EmblemHealth Commercial	$31,850.04
Rate for Payer: Humana Medicare Advantage	$10,935.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10,616.68
Rate for Payer: Oxford Commercial	$20,185.00
Rate for Payer: UnitedHealthcare Commercial	$35,393.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$10,616.68
Rate for Payer: Wellcare Medicare Advantage	$10,616.68

CESAREAN SECTION WITH STERILIZATION

Facility

$7,510.89

Service Code	APR-DRG 5391
Min. Negotiated Rate	$7,363.62
Max. Negotiated Rate	$7,510.89
Rate for Payer: UnitedHealthcare Community & State	$7,363.62
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,510.89
Rate for Payer: Wellpoint Medicaid Managed Care	$7,363.62

CESAREAN SECTION WITH STERILIZATION

Facility

$12,290.88

Service Code	APR-DRG 5393
Min. Negotiated Rate	$12,049.88
Max. Negotiated Rate	$12,290.88
Rate for Payer: UnitedHealthcare Community & State	$12,049.88
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,290.88
Rate for Payer: Wellpoint Medicaid Managed Care	$12,049.88

CESAREAN SECTION WITH STERILIZATION

Facility

$8,690.58

Service Code	APR-DRG 5392
Min. Negotiated Rate	$8,520.18
Max. Negotiated Rate	$8,690.58
Rate for Payer: UnitedHealthcare Community & State	$8,520.18
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,690.58
Rate for Payer: Wellpoint Medicaid Managed Care	$8,520.18

CESAREAN SECTION WITH STERILIZATION

Facility

$28,397.85

Service Code	APR-DRG 5394
Min. Negotiated Rate	$27,841.03
Max. Negotiated Rate	$28,397.85
Rate for Payer: UnitedHealthcare Community & State	$27,841.03
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$28,397.85
Rate for Payer: Wellpoint Medicaid Managed Care	$27,841.03

Know your out-of-pocket cost for care.

All Charges