Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SPINAL NEEDLE 25G-3-1/2 BLUE

Facility

$15.00

Hospital Charge Code	270332213
Hospital Revenue Code	272
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$5.70
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.50
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$3.00
Rate for Payer: UnitedHealthcare Community & State	$0.36
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

SPINAL NEEDLE 25G-3-1/2 BLUE

Facility

$15.00

Hospital Charge Code	270332213
Hospital Revenue Code	272
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

SPINAL NEEDLE W/K-WIRE 150MM

Facility

$116.00

Hospital Charge Code	270339011
Hospital Revenue Code	272
Min. Negotiated Rate	$17.40
Max. Negotiated Rate	$17.40
Rate for Payer: Qualcare PPO/HMO/WC	$17.40

SPINAL NEEDLE W/K-WIRE 150MM

Facility

$116.00

Hospital Charge Code	270339011
Hospital Revenue Code	272
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$58.00
Rate for Payer: Aetna Commercial	$44.08
Rate for Payer: Aetna Medicare Advantage	$34.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.58
Rate for Payer: Cigna Commercial	$58.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.80
Rate for Payer: Oxford Commercial	$23.20
Rate for Payer: Qualcare PPO/HMO/WC	$17.40
Rate for Payer: UnitedHealthcare Commercial	$23.20
Rate for Payer: UnitedHealthcare Community & State	$2.80
Rate for Payer: Wellpoint Medicaid Managed Care	$3.07

SPINAL PROCEDURES

Facility

$19,828.57

Service Code	APR-DRG 0231
Min. Negotiated Rate	$19,439.77
Max. Negotiated Rate	$19,828.57
Rate for Payer: UnitedHealthcare Community & State	$19,439.77
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$19,828.57
Rate for Payer: Wellpoint Medicaid Managed Care	$19,439.77

SPINAL PROCEDURES

Facility

$45,305.31

Service Code	APR-DRG 0233
Min. Negotiated Rate	$44,416.97
Max. Negotiated Rate	$45,305.31
Rate for Payer: UnitedHealthcare Community & State	$44,416.97
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$45,305.31
Rate for Payer: Wellpoint Medicaid Managed Care	$44,416.97

SPINAL PROCEDURES

Facility

$71,574.87

Service Code	APR-DRG 0234
Min. Negotiated Rate	$70,171.44
Max. Negotiated Rate	$71,574.87
Rate for Payer: UnitedHealthcare Community & State	$70,171.44
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$71,574.87
Rate for Payer: Wellpoint Medicaid Managed Care	$70,171.44

SPINAL PROCEDURES

Facility

$26,923.27

Service Code	APR-DRG 0232
Min. Negotiated Rate	$26,395.36
Max. Negotiated Rate	$26,923.27
Rate for Payer: UnitedHealthcare Community & State	$26,395.36
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$26,923.27
Rate for Payer: Wellpoint Medicaid Managed Care	$26,395.36

SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS

Facility

$112,402.62

Service Code	MSDRG 029
Min. Negotiated Rate	$34,225.16
Max. Negotiated Rate	$112,402.62
Rate for Payer: Aetna Medicare Advantage	$112,402.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79,785.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79,785.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$36,026.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79,785.23
Rate for Payer: Cigna Commercial	$63,844.68
Rate for Payer: Cigna Medicare Advantage	$36,026.48
Rate for Payer: Clover Medicare Advantage	$34,225.16
Rate for Payer: EmblemHealth Commercial	$108,079.44
Rate for Payer: Humana Medicare Advantage	$37,107.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$36,026.48
Rate for Payer: Oxford Commercial	$45,886.02
Rate for Payer: UnitedHealthcare Commercial	$80,462.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$36,026.48
Rate for Payer: Wellcare Medicare Advantage	$36,026.48

SPINAL PROCEDURES WITH MCC

Facility

$196,332.30

Service Code	MSDRG 028
Min. Negotiated Rate	$59,780.67
Max. Negotiated Rate	$196,332.30
Rate for Payer: Aetna Medicare Advantage	$196,332.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140,263.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140,263.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$62,927.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140,263.83
Rate for Payer: Cigna Commercial	$112,439.33
Rate for Payer: Cigna Medicare Advantage	$62,927.02
Rate for Payer: Clover Medicare Advantage	$59,780.67
Rate for Payer: EmblemHealth Commercial	$188,781.06
Rate for Payer: Humana Medicare Advantage	$64,814.83
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$62,927.02
Rate for Payer: Oxford Commercial	$80,811.63
Rate for Payer: UnitedHealthcare Commercial	$141,705.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$62,927.02
Rate for Payer: Wellcare Medicare Advantage	$62,927.02

SPINAL PROCEDURES WITHOUT CC/MCC

Facility

$73,086.56

Service Code	MSDRG 030
Min. Negotiated Rate	$22,253.92
Max. Negotiated Rate	$73,086.56
Rate for Payer: Aetna Medicare Advantage	$73,086.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53,965.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53,965.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23,425.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53,965.52
Rate for Payer: Cigna Commercial	$41,080.97
Rate for Payer: Cigna Medicare Advantage	$23,425.18
Rate for Payer: Clover Medicare Advantage	$22,253.92
Rate for Payer: EmblemHealth Commercial	$70,275.54
Rate for Payer: Humana Medicare Advantage	$24,127.94
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$23,425.18
Rate for Payer: Oxford Commercial	$29,525.44
Rate for Payer: UnitedHealthcare Commercial	$51,773.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$23,425.18
Rate for Payer: Wellcare Medicare Advantage	$23,425.18

SPINAL STIM BATTERY

Facility

$120,000.00

Service Code	HCPCS C1778
Hospital Charge Code	270703698
Hospital Revenue Code	278
Min. Negotiated Rate	$18,000.00
Max. Negotiated Rate	$29,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29,040.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26,400.00
Rate for Payer: Qualcare PPO/HMO/WC	$18,000.00

SPINAL STIM BATTERY

Facility

$120,000.00

Service Code	HCPCS C1778
Hospital Charge Code	270703698
Hospital Revenue Code	278
Min. Negotiated Rate	$2,892.00
Max. Negotiated Rate	$60,000.00
Rate for Payer: Aetna Commercial	$45,600.00
Rate for Payer: Aetna Medicare Advantage	$36,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30,600.00
Rate for Payer: Cigna Commercial	$60,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29,040.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$26,400.00
Rate for Payer: Qualcare PPO/HMO/WC	$18,000.00
Rate for Payer: UnitedHealthcare Community & State	$2,892.00
Rate for Payer: Wellpoint Medicaid Managed Care	$3,180.00

SPINAL SYSTEM DTRAX

Facility

$14,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692492
Hospital Revenue Code	278
Min. Negotiated Rate	$2,100.00
Max. Negotiated Rate	$3,388.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,388.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,080.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,100.00

SPINAL SYSTEM DTRAX

Facility

$14,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692492
Hospital Revenue Code	278
Min. Negotiated Rate	$337.40
Max. Negotiated Rate	$7,000.00
Rate for Payer: Aetna Commercial	$5,320.00
Rate for Payer: Aetna Medicare Advantage	$4,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,570.00
Rate for Payer: Cigna Commercial	$7,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,388.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,080.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,100.00
Rate for Payer: UnitedHealthcare Community & State	$337.40
Rate for Payer: Wellpoint Medicaid Managed Care	$371.00

SPINE ACCESS KIT, DISPOSABLE

Facility

$375.00

Hospital Charge Code	270702072
Hospital Revenue Code	278
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

SPINE ACCESS KIT, DISPOSABLE

Facility

$375.00

Hospital Charge Code	270702072
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

SPINECATH INTADISCAL CATHETER

Facility

$10,500.00

Hospital Charge Code	270657285
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

SPINECATH INTADISCAL CATHETER

Facility

$10,500.00

Hospital Charge Code	270657285
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

SPINE ENTIRE 1 VIEW

Facility

$5,100.00

Service Code	HCPCS 72081
Hospital Charge Code	94061477
Hospital Revenue Code	320
Min. Negotiated Rate	$41.57
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	$41.57
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

SPINE ENTIRE 1 VIEW

Facility

$5,100.00

Service Code	HCPCS 72081
Hospital Charge Code	2011556
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

SPINE ENTIRE 1 VIEW

Facility

$5,100.00

Service Code	HCPCS 72081
Hospital Charge Code	2011556
Hospital Revenue Code	320
Min. Negotiated Rate	$41.57
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	$41.57
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

SPINE ENTIRE 1 VIEW

Facility

$5,100.00

Service Code	HCPCS 72081
Hospital Charge Code	94061477
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

SPINE ENTIRE 2-3 VIEWS

Facility

$5,100.00

Service Code	HCPCS 72082
Hospital Charge Code	2011557
Hospital Revenue Code	320
Min. Negotiated Rate	$67.12
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$86.94
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
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	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.88
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

SPINE ENTIRE 2-3 VIEWS

Facility

$5,100.00

Service Code	HCPCS 72082
Hospital Charge Code	2011557
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

Know your out-of-pocket cost for care.

All Charges