Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PERQ VERTEBRAL AUGMENTATION

Facility

$15,443.85

Service Code	HCPCS 22515
Hospital Charge Code	321022515
Hospital Revenue Code	320
Min. Negotiated Rate	$2,316.58
Max. Negotiated Rate	$2,316.58
Rate for Payer: Qualcare PPO/HMO/WC	$2,316.58

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22513
Hospital Charge Code	321022513
Hospital Revenue Code	320
Min. Negotiated Rate	$5,630.17
Max. Negotiated Rate	$5,630.17
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22514
Hospital Charge Code	5701107
Hospital Revenue Code	320
Min. Negotiated Rate	$5,630.17
Max. Negotiated Rate	$5,630.17
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22513
Hospital Charge Code	5701106
Hospital Revenue Code	360
Min. Negotiated Rate	$5,630.17
Max. Negotiated Rate	$5,630.17
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22513
Hospital Charge Code	5701106
Hospital Revenue Code	360
Min. Negotiated Rate	$904.58
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,260.34
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$904.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$994.66

PERQ VERTEBRAL AUGMENTATION

Facility

$15,443.85

Service Code	HCPCS 22515
Hospital Charge Code	321022515
Hospital Revenue Code	320
Min. Negotiated Rate	$372.20
Max. Negotiated Rate	$7,721.93
Rate for Payer: Aetna Commercial	$5,868.66
Rate for Payer: Aetna Medicare Advantage	$4,633.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,938.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,938.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,128.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,938.18
Rate for Payer: Cigna Commercial	$7,721.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,633.15
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,316.58
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$372.20
Rate for Payer: Wellpoint Medicaid Managed Care	$409.26

PERQ VERTEBRAL AUGMENTATION

Facility

$33,638.52

Service Code	HCPCS 22514
Hospital Charge Code	1600000450
Hospital Revenue Code	360
Min. Negotiated Rate	$5,045.78
Max. Negotiated Rate	$5,045.78
Rate for Payer: Qualcare PPO/HMO/WC	$5,045.78

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22513
Hospital Charge Code	366822513
Hospital Revenue Code	320
Min. Negotiated Rate	$904.58
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,484.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$6,034.40
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,260.34
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$904.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$994.66

PERQ VERTEBRAL AUGMENTATION

Facility

$15,443.85

Service Code	HCPCS 22515
Hospital Charge Code	366822515
Hospital Revenue Code	320
Min. Negotiated Rate	$2,316.58
Max. Negotiated Rate	$2,316.58
Rate for Payer: Qualcare PPO/HMO/WC	$2,316.58

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22514
Hospital Charge Code	321022514
Hospital Revenue Code	320
Min. Negotiated Rate	$5,630.17
Max. Negotiated Rate	$5,630.17
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17

PERQ VERTEBRAL AUGMENTATION

Facility

$33,638.52

Service Code	HCPCS 22514
Hospital Charge Code	1600000450
Hospital Revenue Code	360
Min. Negotiated Rate	$810.69
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,091.56
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,045.78
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$810.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$891.42

PERQ VERTEBRAL AUGMENTATION

Facility

$15,443.85

Service Code	HCPCS 22515
Hospital Charge Code	5701108
Hospital Revenue Code	320
Min. Negotiated Rate	$372.20
Max. Negotiated Rate	$7,721.93
Rate for Payer: Aetna Commercial	$5,868.66
Rate for Payer: Aetna Medicare Advantage	$4,633.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,938.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,938.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,128.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,938.18
Rate for Payer: Cigna Commercial	$7,721.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,633.15
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,316.58
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$372.20
Rate for Payer: Wellpoint Medicaid Managed Care	$409.26

PERQ VERTEBRAL AUGMENTATION

Facility

$15,443.85

Service Code	HCPCS 22515
Hospital Charge Code	7411357
Hospital Revenue Code	320
Min. Negotiated Rate	$2,316.58
Max. Negotiated Rate	$2,316.58
Rate for Payer: Qualcare PPO/HMO/WC	$2,316.58

PERQ VERTEBRAL AUGMENTATION

Facility

$15,443.85

Service Code	HCPCS 22515
Hospital Charge Code	411022515
Hospital Revenue Code	320
Min. Negotiated Rate	$2,316.58
Max. Negotiated Rate	$2,316.58
Rate for Payer: Qualcare PPO/HMO/WC	$2,316.58

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22513
Hospital Charge Code	411022513
Hospital Revenue Code	320
Min. Negotiated Rate	$904.58
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,484.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$6,034.40
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,260.34
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$904.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$994.66

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22514
Hospital Charge Code	321022514
Hospital Revenue Code	320
Min. Negotiated Rate	$904.58
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,443.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$6,034.40
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,260.34
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$904.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$994.66

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22513
Hospital Charge Code	321022513
Hospital Revenue Code	320
Min. Negotiated Rate	$904.58
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,484.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$6,034.40
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,260.34
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$904.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$994.66

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22514
Hospital Charge Code	366822514
Hospital Revenue Code	320
Min. Negotiated Rate	$904.58
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,443.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$6,034.40
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,260.34
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$904.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$994.66

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22513
Hospital Charge Code	366822513
Hospital Revenue Code	320
Min. Negotiated Rate	$5,630.17
Max. Negotiated Rate	$5,630.17
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17

PERQ VERTEBRAL AUGMENTATION

Facility

$15,443.85

Service Code	HCPCS 22515
Hospital Charge Code	5701108
Hospital Revenue Code	320
Min. Negotiated Rate	$2,316.58
Max. Negotiated Rate	$2,316.58
Rate for Payer: Qualcare PPO/HMO/WC	$2,316.58

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22514
Hospital Charge Code	5701107
Hospital Revenue Code	320
Min. Negotiated Rate	$904.58
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,443.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$6,034.40
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,260.34
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$904.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$994.66

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22513
Hospital Charge Code	7411355
Hospital Revenue Code	320
Min. Negotiated Rate	$904.58
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,484.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$6,034.40
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,260.34
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$904.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$994.66

PERQ VERTEBRAL AUGMENTATION

Facility

$15,443.85

Service Code	HCPCS 22515
Hospital Charge Code	7411357
Hospital Revenue Code	320
Min. Negotiated Rate	$372.20
Max. Negotiated Rate	$7,721.93
Rate for Payer: Aetna Commercial	$5,868.66
Rate for Payer: Aetna Medicare Advantage	$4,633.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,938.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,938.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,128.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,938.18
Rate for Payer: Cigna Commercial	$7,721.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,633.15
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,316.58
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$372.20
Rate for Payer: Wellpoint Medicaid Managed Care	$409.26

PERQ VERTERBRAL AUGMENTATION

Facility

$33,092.48

Service Code	HCPCS 22513
Hospital Charge Code	16000605
Hospital Revenue Code	360
Min. Negotiated Rate	$4,963.87
Max. Negotiated Rate	$4,963.87
Rate for Payer: Qualcare PPO/HMO/WC	$4,963.87

PERQ VERTERBRAL AUGMENTATION

Facility

$33,092.48

Service Code	HCPCS 22513
Hospital Charge Code	16000605
Hospital Revenue Code	360
Min. Negotiated Rate	$797.53
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,927.74
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,963.87
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$797.53
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$876.95

Know your out-of-pocket cost for care.

All Charges