Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SPACER CEV BLACKHWK CONV 14X12

Facility

$23,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270693379
Hospital Revenue Code	278
Min. Negotiated Rate	$572.38
Max. Negotiated Rate	$11,875.00
Rate for Payer: Aetna Commercial	$9,025.00
Rate for Payer: Aetna Medicare Advantage	$7,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,056.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,056.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,056.25
Rate for Payer: Cigna Commercial	$11,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,747.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,225.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,562.50
Rate for Payer: UnitedHealthcare Community & State	$572.38
Rate for Payer: Wellpoint Medicaid Managed Care	$629.38

SPACER COALIT 12X14 O D 5MM

Facility

$31,880.00

Service Code	HCPCS C1889
Hospital Charge Code	270694203
Hospital Revenue Code	278
Min. Negotiated Rate	$4,782.00
Max. Negotiated Rate	$7,714.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,376.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,714.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,013.60
Rate for Payer: Qualcare PPO/HMO/WC	$4,782.00

SPACER COALIT 12X14 O D 5MM

Facility

$31,880.00

Service Code	HCPCS C1889
Hospital Charge Code	270694203
Hospital Revenue Code	278
Min. Negotiated Rate	$768.31
Max. Negotiated Rate	$15,940.00
Rate for Payer: Aetna Commercial	$12,114.40
Rate for Payer: Aetna Medicare Advantage	$9,564.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,129.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,129.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,376.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,129.40
Rate for Payer: Cigna Commercial	$15,940.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,714.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,013.60
Rate for Payer: Qualcare PPO/HMO/WC	$4,782.00
Rate for Payer: UnitedHealthcare Community & State	$768.31
Rate for Payer: Wellpoint Medicaid Managed Care	$844.82

SPACER COALIT 12X14 O D 6MM

Facility

$31,880.00

Service Code	HCPCS C1889
Hospital Charge Code	270694202
Hospital Revenue Code	278
Min. Negotiated Rate	$768.31
Max. Negotiated Rate	$15,940.00
Rate for Payer: Aetna Commercial	$12,114.40
Rate for Payer: Aetna Medicare Advantage	$9,564.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,129.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,129.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,376.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,129.40
Rate for Payer: Cigna Commercial	$15,940.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,714.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,013.60
Rate for Payer: Qualcare PPO/HMO/WC	$4,782.00
Rate for Payer: UnitedHealthcare Community & State	$768.31
Rate for Payer: Wellpoint Medicaid Managed Care	$844.82

SPACER COALIT 12X14 O D 6MM

Facility

$31,880.00

Service Code	HCPCS C1889
Hospital Charge Code	270694202
Hospital Revenue Code	278
Min. Negotiated Rate	$4,782.00
Max. Negotiated Rate	$7,714.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,376.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,714.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,013.60
Rate for Payer: Qualcare PPO/HMO/WC	$4,782.00

SPACERCOALITIONMIS12X14X7MM0D

Facility

$31,880.00

Service Code	HCPCS C1889
Hospital Charge Code	270694453
Hospital Revenue Code	278
Min. Negotiated Rate	$768.31
Max. Negotiated Rate	$15,940.00
Rate for Payer: Aetna Commercial	$12,114.40
Rate for Payer: Aetna Medicare Advantage	$9,564.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,129.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,129.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,376.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,129.40
Rate for Payer: Cigna Commercial	$15,940.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,714.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,013.60
Rate for Payer: Qualcare PPO/HMO/WC	$4,782.00
Rate for Payer: UnitedHealthcare Community & State	$768.31
Rate for Payer: Wellpoint Medicaid Managed Care	$844.82

SPACERCOALITIONMIS12X14X7MM0D

Facility

$31,880.00

Service Code	HCPCS C1889
Hospital Charge Code	270694453
Hospital Revenue Code	278
Min. Negotiated Rate	$4,782.00
Max. Negotiated Rate	$7,714.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,376.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,714.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,013.60
Rate for Payer: Qualcare PPO/HMO/WC	$4,782.00

SPACER COALITION MIS TI 12X14

Facility

$31,880.00

Service Code	HCPCS C1889
Hospital Charge Code	270694414
Hospital Revenue Code	278
Min. Negotiated Rate	$4,782.00
Max. Negotiated Rate	$7,714.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,376.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,714.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,013.60
Rate for Payer: Qualcare PPO/HMO/WC	$4,782.00

SPACER COALITION MIS TI 12X14

Facility

$31,880.00

Service Code	HCPCS C1889
Hospital Charge Code	278694414
Hospital Revenue Code	278
Min. Negotiated Rate	$768.31
Max. Negotiated Rate	$15,940.00
Rate for Payer: Aetna Commercial	$12,114.40
Rate for Payer: Aetna Medicare Advantage	$9,564.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,129.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,129.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,376.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,129.40
Rate for Payer: Cigna Commercial	$15,940.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,714.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,013.60
Rate for Payer: Qualcare PPO/HMO/WC	$4,782.00
Rate for Payer: UnitedHealthcare Community & State	$768.31
Rate for Payer: Wellpoint Medicaid Managed Care	$844.82

SPACER COALITION MIS TI 12X14

Facility

$31,880.00

Service Code	HCPCS C1889
Hospital Charge Code	270694414
Hospital Revenue Code	278
Min. Negotiated Rate	$768.31
Max. Negotiated Rate	$15,940.00
Rate for Payer: Aetna Commercial	$12,114.40
Rate for Payer: Aetna Medicare Advantage	$9,564.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,129.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,129.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,376.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,129.40
Rate for Payer: Cigna Commercial	$15,940.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,714.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,013.60
Rate for Payer: Qualcare PPO/HMO/WC	$4,782.00
Rate for Payer: UnitedHealthcare Community & State	$768.31
Rate for Payer: Wellpoint Medicaid Managed Care	$844.82

SPACER COALITION MIS TI 12X14

Facility

$31,880.00

Service Code	HCPCS C1889
Hospital Charge Code	278694414
Hospital Revenue Code	278
Min. Negotiated Rate	$4,782.00
Max. Negotiated Rate	$7,714.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,376.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,714.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,013.60
Rate for Payer: Qualcare PPO/HMO/WC	$4,782.00

SPACER COALIT TI 14X16 7D 8MM

Facility

$31,880.00

Service Code	HCPCS C1889
Hospital Charge Code	270695928
Hospital Revenue Code	278
Min. Negotiated Rate	$768.31
Max. Negotiated Rate	$15,940.00
Rate for Payer: Aetna Commercial	$12,114.40
Rate for Payer: Aetna Medicare Advantage	$9,564.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,129.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,129.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,376.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,129.40
Rate for Payer: Cigna Commercial	$15,940.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,714.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,013.60
Rate for Payer: Qualcare PPO/HMO/WC	$4,782.00
Rate for Payer: UnitedHealthcare Community & State	$768.31
Rate for Payer: Wellpoint Medicaid Managed Care	$844.82

SPACER COALIT TI 14X16 7D 8MM

Facility

$31,880.00

Service Code	HCPCS C1889
Hospital Charge Code	270695928
Hospital Revenue Code	278
Min. Negotiated Rate	$4,782.00
Max. Negotiated Rate	$7,714.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,376.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,714.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,013.60
Rate for Payer: Qualcare PPO/HMO/WC	$4,782.00

SPACER DISTAL MED

Facility

$790.00

Service Code	HCPCS C1713
Hospital Charge Code	270660303
Hospital Revenue Code	278
Min. Negotiated Rate	$19.04
Max. Negotiated Rate	$395.00
Rate for Payer: Aetna Commercial	$300.20
Rate for Payer: Aetna Medicare Advantage	$237.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.45
Rate for Payer: Cigna Commercial	$395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$173.80
Rate for Payer: Qualcare PPO/HMO/WC	$118.50
Rate for Payer: UnitedHealthcare Community & State	$19.04
Rate for Payer: Wellpoint Medicaid Managed Care	$20.93

SPACER DISTAL MED

Facility

$790.00

Service Code	HCPCS C1713
Hospital Charge Code	270660303
Hospital Revenue Code	278
Min. Negotiated Rate	$118.50
Max. Negotiated Rate	$191.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$173.80
Rate for Payer: Qualcare PPO/HMO/WC	$118.50

SPACER DPY W/BOLT 2.5MM 10492

Facility

$147.25

Hospital Charge Code	270612486
Hospital Revenue Code	272
Min. Negotiated Rate	$22.09
Max. Negotiated Rate	$22.09
Rate for Payer: Qualcare PPO/HMO/WC	$22.09

SPACER DPY W/BOLT 2.5MM 10492

Facility

$147.25

Hospital Charge Code	270612486
Hospital Revenue Code	272
Min. Negotiated Rate	$3.55
Max. Negotiated Rate	$73.62
Rate for Payer: Aetna Commercial	$55.95
Rate for Payer: Aetna Medicare Advantage	$44.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.55
Rate for Payer: Cigna Commercial	$73.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.17
Rate for Payer: Oxford Commercial	$29.45
Rate for Payer: Qualcare PPO/HMO/WC	$22.09
Rate for Payer: UnitedHealthcare Commercial	$29.45
Rate for Payer: UnitedHealthcare Community & State	$3.55
Rate for Payer: Wellpoint Medicaid Managed Care	$3.90

SPACER EVO SYNFIX 10.5MM 10D

Facility

$45,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270698975
Hospital Revenue Code	278
Min. Negotiated Rate	$1,084.50
Max. Negotiated Rate	$22,500.00
Rate for Payer: Aetna Commercial	$17,100.00
Rate for Payer: Aetna Medicare Advantage	$13,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,475.00
Rate for Payer: Cigna Commercial	$22,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,890.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,900.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,750.00
Rate for Payer: UnitedHealthcare Community & State	$1,084.50
Rate for Payer: Wellpoint Medicaid Managed Care	$1,192.50

SPACER EVO SYNFIX 10.5MM 10D

Facility

$45,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270698975
Hospital Revenue Code	278
Min. Negotiated Rate	$6,750.00
Max. Negotiated Rate	$10,890.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,890.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,900.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,750.00

SPACER FLAT CERV 14X12X5MM 6D

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270698828
Hospital Revenue Code	278
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,400.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

SPACER FLAT CERV 14X12X5MM 6D

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270698828
Hospital Revenue Code	278
Min. Negotiated Rate	$482.00
Max. Negotiated Rate	$10,000.00
Rate for Payer: Aetna Commercial	$7,600.00
Rate for Payer: Aetna Medicare Advantage	$6,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,100.00
Rate for Payer: Cigna Commercial	$10,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,400.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00
Rate for Payer: UnitedHealthcare Community & State	$482.00
Rate for Payer: Wellpoint Medicaid Managed Care	$530.00

SPACER FLAT CERVICAL 14X12X6MM

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697657
Hospital Revenue Code	278
Min. Negotiated Rate	$482.00
Max. Negotiated Rate	$10,000.00
Rate for Payer: Aetna Commercial	$7,600.00
Rate for Payer: Aetna Medicare Advantage	$6,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,100.00
Rate for Payer: Cigna Commercial	$10,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,400.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00
Rate for Payer: UnitedHealthcare Community & State	$482.00
Rate for Payer: Wellpoint Medicaid Managed Care	$530.00

SPACER FLAT CERVICAL 14X12X6MM

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697657
Hospital Revenue Code	278
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,400.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

SPACER FORTICORE 14X12X7MM 6D

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697215
Hospital Revenue Code	278
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,400.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

SPACER FORTICORE 14X12X7MM 6D

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697215
Hospital Revenue Code	278
Min. Negotiated Rate	$482.00
Max. Negotiated Rate	$10,000.00
Rate for Payer: Aetna Commercial	$7,600.00
Rate for Payer: Aetna Medicare Advantage	$6,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,100.00
Rate for Payer: Cigna Commercial	$10,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,400.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00
Rate for Payer: UnitedHealthcare Community & State	$482.00
Rate for Payer: Wellpoint Medicaid Managed Care	$530.00

Know your out-of-pocket cost for care.

All Charges