Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ROD SPINE STRAIGHT 3.5x120MM

Facility

$1,820.00

Hospital Charge Code	270675610
Hospital Revenue Code	278
Min. Negotiated Rate	$43.86
Max. Negotiated Rate	$910.00
Rate for Payer: Aetna Commercial	$691.60
Rate for Payer: Aetna Medicare Advantage	$546.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$464.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$464.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$364.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$464.10
Rate for Payer: Cigna Commercial	$910.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$440.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$400.40
Rate for Payer: Qualcare PPO/HMO/WC	$273.00
Rate for Payer: UnitedHealthcare Community & State	$43.86
Rate for Payer: Wellpoint Medicaid Managed Care	$48.23

ROD SPINE STRAIGHT 3.5x120MM

Facility

$1,820.00

Hospital Charge Code	270675610
Hospital Revenue Code	278
Min. Negotiated Rate	$273.00
Max. Negotiated Rate	$440.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$364.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$440.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$400.40
Rate for Payer: Qualcare PPO/HMO/WC	$273.00

ROD SPINL PRELORD HEX TAP 35MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692502
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

ROD SPINL PRELORD HEX TAP 35MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692502
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

ROD SPINL PRELORD HEX TAP 40MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692501
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

ROD SPINL PRELORD HEX TAP 40MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692501
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

ROD SPIN TITACURVCREO 5.5X50MM

Facility

$5,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270693238
Hospital Revenue Code	278
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$1,306.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,188.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

ROD SPIN TITACURVCREO 5.5X50MM

Facility

$5,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270693238
Hospital Revenue Code	278
Min. Negotiated Rate	$130.14
Max. Negotiated Rate	$2,700.00
Rate for Payer: Aetna Commercial	$2,052.00
Rate for Payer: Aetna Medicare Advantage	$1,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,377.00
Rate for Payer: Cigna Commercial	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,188.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00
Rate for Payer: UnitedHealthcare Community & State	$130.14
Rate for Payer: Wellpoint Medicaid Managed Care	$143.10

ROD SPNL 5.5X40MM EXT TB OVERW

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270693167
Hospital Revenue Code	278
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

ROD SPNL 5.5X40MM EXT TB OVERW

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270693167
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

RODS SPINE 1/4inch 177080450

Facility

$2,653.65

Hospital Charge Code	270629833
Hospital Revenue Code	278
Min. Negotiated Rate	$63.95
Max. Negotiated Rate	$1,326.83
Rate for Payer: Aetna Commercial	$1,008.39
Rate for Payer: Aetna Medicare Advantage	$796.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$676.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$676.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$530.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$676.68
Rate for Payer: Cigna Commercial	$1,326.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$642.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$583.80
Rate for Payer: Qualcare PPO/HMO/WC	$398.05
Rate for Payer: UnitedHealthcare Community & State	$63.95
Rate for Payer: Wellpoint Medicaid Managed Care	$70.32

RODS SPINE 1/4inch 177080450

Facility

$2,653.65

Hospital Charge Code	270629833
Hospital Revenue Code	278
Min. Negotiated Rate	$398.05
Max. Negotiated Rate	$642.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$530.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$642.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$583.80
Rate for Payer: Qualcare PPO/HMO/WC	$398.05

ROD STRAIGHT 100MM SAVANNAH-T

Facility

$2,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270675898
Hospital Revenue Code	278
Min. Negotiated Rate	$357.00
Max. Negotiated Rate	$575.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$476.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$575.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$523.60
Rate for Payer: Qualcare PPO/HMO/WC	$357.00

ROD STRAIGHT 100MM SAVANNAH-T

Facility

$2,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270675898
Hospital Revenue Code	278
Min. Negotiated Rate	$57.36
Max. Negotiated Rate	$1,190.00
Rate for Payer: Aetna Commercial	$904.40
Rate for Payer: Aetna Medicare Advantage	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$606.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$606.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$476.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$606.90
Rate for Payer: Cigna Commercial	$1,190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$575.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$523.60
Rate for Payer: Qualcare PPO/HMO/WC	$357.00
Rate for Payer: UnitedHealthcare Community & State	$57.36
Rate for Payer: Wellpoint Medicaid Managed Care	$63.07

ROD STRAIGHT 3.5X100MM

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270693577
Hospital Revenue Code	278
Min. Negotiated Rate	$21.69
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Community & State	$21.69
Rate for Payer: Wellpoint Medicaid Managed Care	$23.85

ROD STRAIGHT 3.5X100MM

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270693577
Hospital Revenue Code	278
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

ROD STRAIGHT 50MM

Facility

$2,380.00

Hospital Charge Code	270675218
Hospital Revenue Code	278
Min. Negotiated Rate	$357.00
Max. Negotiated Rate	$575.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$476.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$575.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$523.60
Rate for Payer: Qualcare PPO/HMO/WC	$357.00

ROD STRAIGHT 50MM

Facility

$2,380.00

Hospital Charge Code	270675218
Hospital Revenue Code	278
Min. Negotiated Rate	$57.36
Max. Negotiated Rate	$1,190.00
Rate for Payer: Aetna Commercial	$904.40
Rate for Payer: Aetna Medicare Advantage	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$606.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$606.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$476.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$606.90
Rate for Payer: Cigna Commercial	$1,190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$575.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$523.60
Rate for Payer: Qualcare PPO/HMO/WC	$357.00
Rate for Payer: UnitedHealthcare Community & State	$57.36
Rate for Payer: Wellpoint Medicaid Managed Care	$63.07

ROD STRAIGHT 5.5MM 100MM

Facility

$1,365.00

Hospital Charge Code	270670362
Hospital Revenue Code	278
Min. Negotiated Rate	$32.90
Max. Negotiated Rate	$682.50
Rate for Payer: Aetna Commercial	$518.70
Rate for Payer: Aetna Medicare Advantage	$409.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$348.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$348.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$273.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$348.07
Rate for Payer: Cigna Commercial	$682.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$330.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$300.30
Rate for Payer: Qualcare PPO/HMO/WC	$204.75
Rate for Payer: UnitedHealthcare Community & State	$32.90
Rate for Payer: Wellpoint Medicaid Managed Care	$36.17

ROD STRAIGHT 5.5MM 100MM

Facility

$1,365.00

Hospital Charge Code	270670362
Hospital Revenue Code	278
Min. Negotiated Rate	$204.75
Max. Negotiated Rate	$330.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$273.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$330.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$300.30
Rate for Payer: Qualcare PPO/HMO/WC	$204.75

ROD STRAIGHT 5.5MM 110MM

Facility

$1,365.00

Hospital Charge Code	270670395
Hospital Revenue Code	278
Min. Negotiated Rate	$32.90
Max. Negotiated Rate	$682.50
Rate for Payer: Aetna Commercial	$518.70
Rate for Payer: Aetna Medicare Advantage	$409.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$348.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$348.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$273.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$348.07
Rate for Payer: Cigna Commercial	$682.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$330.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$300.30
Rate for Payer: Qualcare PPO/HMO/WC	$204.75
Rate for Payer: UnitedHealthcare Community & State	$32.90
Rate for Payer: Wellpoint Medicaid Managed Care	$36.17

ROD STRAIGHT 5.5MM 110MM

Facility

$1,365.00

Hospital Charge Code	270670395
Hospital Revenue Code	278
Min. Negotiated Rate	$204.75
Max. Negotiated Rate	$330.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$273.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$330.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$300.30
Rate for Payer: Qualcare PPO/HMO/WC	$204.75

ROD STRAIGHT 5.5MM 120MM

Facility

$1,790.00

Hospital Charge Code	270670396
Hospital Revenue Code	278
Min. Negotiated Rate	$43.14
Max. Negotiated Rate	$895.00
Rate for Payer: Aetna Commercial	$680.20
Rate for Payer: Aetna Medicare Advantage	$537.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$456.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$456.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$358.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$456.45
Rate for Payer: Cigna Commercial	$895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$433.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$393.80
Rate for Payer: Qualcare PPO/HMO/WC	$268.50
Rate for Payer: UnitedHealthcare Community & State	$43.14
Rate for Payer: Wellpoint Medicaid Managed Care	$47.44

ROD STRAIGHT 5.5MM 120MM

Facility

$1,790.00

Hospital Charge Code	270670396
Hospital Revenue Code	278
Min. Negotiated Rate	$268.50
Max. Negotiated Rate	$433.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$358.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$433.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$393.80
Rate for Payer: Qualcare PPO/HMO/WC	$268.50

ROD STRAIGHT 5.5MM 130MM

Facility

$1,790.00

Hospital Charge Code	270670397
Hospital Revenue Code	278
Min. Negotiated Rate	$268.50
Max. Negotiated Rate	$433.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$358.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$433.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$393.80
Rate for Payer: Qualcare PPO/HMO/WC	$268.50

Know your out-of-pocket cost for care.

All Charges