Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SPINE ENTIRE 2-3 VIEWS

Facility

$5,100.00

Service Code	HCPCS 72082
Hospital Charge Code	94061476
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	94061476
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 4-5 VIEWS

Facility

$1,131.07

Service Code	HCPCS 72083
Hospital Charge Code	94061478
Hospital Revenue Code	320
Min. Negotiated Rate	$27.26
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	$72.83
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	$339.32
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$169.66
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$27.26
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	$1,837.41
Rate for Payer: Wellpoint Medicaid Managed Care	$29.97

SPINE ENTIRE 4-5 VIEWS

Facility

$1,131.07

Service Code	HCPCS 72083
Hospital Charge Code	94061478
Hospital Revenue Code	320
Min. Negotiated Rate	$169.66
Max. Negotiated Rate	$169.66
Rate for Payer: Qualcare PPO/HMO/WC	$169.66

SPINE ENTIRE 4-5 VIEWS

Facility

$5,100.00

Service Code	HCPCS 72083
Hospital Charge Code	2011558
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 4-5 VIEWS

Facility

$5,100.00

Service Code	HCPCS 72083
Hospital Charge Code	2011558
Hospital Revenue Code	320
Min. Negotiated Rate	$72.83
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	$72.83
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	$1,837.41
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

SPINE ENTIRE MIN 6 VIEWS

Facility

$5,100.00

Service Code	HCPCS 72084
Hospital Charge Code	2011559
Hospital Revenue Code	320
Min. Negotiated Rate	$86.94
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	$87.06
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	$817.38
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

SPINE ENTIRE MIN 6 VIEWS

Facility

$5,100.00

Service Code	HCPCS 72084
Hospital Charge Code	2011559
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 MIN 6 VIEWS

Facility

$1,131.07

Service Code	HCPCS 72084
Hospital Charge Code	94061479
Hospital Revenue Code	320
Min. Negotiated Rate	$27.26
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	$87.06
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	$339.32
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$169.66
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$27.26
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	$817.38
Rate for Payer: Wellpoint Medicaid Managed Care	$29.97

SPINE ENTIRE MIN 6 VIEWS

Facility

$1,131.07

Service Code	HCPCS 72084
Hospital Charge Code	94061479
Hospital Revenue Code	320
Min. Negotiated Rate	$169.66
Max. Negotiated Rate	$169.66
Rate for Payer: Qualcare PPO/HMO/WC	$169.66

SPINE FUSE&REMV CERV BEL C2,SG

Facility

$44,286.00

Service Code	HCPCS 22551
Hospital Charge Code	1620001
Hospital Revenue Code	360
Min. Negotiated Rate	$1,067.29
Max. Negotiated Rate	$55,057.64
Rate for Payer: Aetna Commercial	$41,487.32
Rate for Payer: Aetna Medicare Advantage	$49,418.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55,057.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55,057.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,252.69
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	$55,057.64
Rate for Payer: Cigna Commercial	$30,573.98
Rate for Payer: Cigna Medicare Advantage	$15,252.69
Rate for Payer: Clover Medicare Advantage	$14,490.06
Rate for Payer: EmblemHealth Commercial	$45,758.07
Rate for Payer: Humana Medicare Advantage	$15,710.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,252.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,285.80
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,642.90
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,067.29
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,252.69
Rate for Payer: Wellcare Medicare Advantage	$15,252.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1,173.58

SPINE FUSE&REMV CERV BEL C2,SG

Facility

$44,286.00

Service Code	HCPCS 22551
Hospital Charge Code	1620001
Hospital Revenue Code	360
Min. Negotiated Rate	$6,642.90
Max. Negotiated Rate	$6,642.90
Rate for Payer: Qualcare PPO/HMO/WC	$6,642.90

SPINE FUSE&REMV CERV BEL C2,SG

Facility

$44,286.00

Service Code	HCPCS 22551
Hospital Charge Code	16000384
Hospital Revenue Code	360
Min. Negotiated Rate	$6,642.90
Max. Negotiated Rate	$6,642.90
Rate for Payer: Qualcare PPO/HMO/WC	$6,642.90

SPINE FUSE&REMV CERV BEL C2,SG

Facility

$44,286.00

Service Code	HCPCS 22551
Hospital Charge Code	16000384
Hospital Revenue Code	360
Min. Negotiated Rate	$1,067.29
Max. Negotiated Rate	$55,057.64
Rate for Payer: Aetna Commercial	$41,487.32
Rate for Payer: Aetna Medicare Advantage	$49,418.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55,057.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55,057.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,252.69
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	$55,057.64
Rate for Payer: Cigna Commercial	$30,573.98
Rate for Payer: Cigna Medicare Advantage	$15,252.69
Rate for Payer: Clover Medicare Advantage	$14,490.06
Rate for Payer: EmblemHealth Commercial	$45,758.07
Rate for Payer: Humana Medicare Advantage	$15,710.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,252.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,285.80
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,642.90
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,067.29
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,252.69
Rate for Payer: Wellcare Medicare Advantage	$15,252.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1,173.58

SPINE FUSION EXTRA SEGMENT

Facility

$23,739.75

Service Code	HCPCS 22632
Hospital Charge Code	16000608
Hospital Revenue Code	360
Min. Negotiated Rate	$572.13
Max. Negotiated Rate	$11,869.88
Rate for Payer: Aetna Commercial	$9,021.10
Rate for Payer: Aetna Medicare Advantage	$7,121.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,053.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,053.64
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	$6,053.64
Rate for Payer: Cigna Commercial	$11,869.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,121.93
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,560.96
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$572.13

SPINE FUSION EXTRA SEGMENT

Facility

$23,739.75

Service Code	HCPCS 22632
Hospital Charge Code	16000608
Hospital Revenue Code	360
Min. Negotiated Rate	$3,560.96
Max. Negotiated Rate	$3,560.96
Rate for Payer: Qualcare PPO/HMO/WC	$3,560.96

SPINE FUSION EXTRA SEGMENT

Facility

$20,716.40

Service Code	HCPCS 22634
Hospital Charge Code	16000609
Hospital Revenue Code	360
Min. Negotiated Rate	$499.27
Max. Negotiated Rate	$10,358.20
Rate for Payer: Aetna Commercial	$7,872.23
Rate for Payer: Aetna Medicare Advantage	$6,214.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,282.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,282.68
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	$5,282.68
Rate for Payer: Cigna Commercial	$10,358.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,214.92
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,107.46
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$499.27

SPINE FUSION EXTRA SEGMENT

Facility

$20,716.40

Service Code	HCPCS 22634
Hospital Charge Code	16000609
Hospital Revenue Code	360
Min. Negotiated Rate	$3,107.46
Max. Negotiated Rate	$3,107.46
Rate for Payer: Qualcare PPO/HMO/WC	$3,107.46

SPINE JET QUICK CONNECTOR

Facility

$638.00

Hospital Charge Code	270335916
Hospital Revenue Code	272
Min. Negotiated Rate	$95.70
Max. Negotiated Rate	$95.70
Rate for Payer: Qualcare PPO/HMO/WC	$95.70

SPINE JET QUICK CONNECTOR

Facility

$638.00

Hospital Charge Code	270335916
Hospital Revenue Code	272
Min. Negotiated Rate	$15.38
Max. Negotiated Rate	$319.00
Rate for Payer: Aetna Commercial	$242.44
Rate for Payer: Aetna Medicare Advantage	$191.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$162.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$162.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$162.69
Rate for Payer: Cigna Commercial	$319.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.40
Rate for Payer: Oxford Commercial	$127.60
Rate for Payer: Qualcare PPO/HMO/WC	$95.70
Rate for Payer: UnitedHealthcare Commercial	$127.60
Rate for Payer: UnitedHealthcare Community & State	$15.38
Rate for Payer: Wellpoint Medicaid Managed Care	$16.91

SPINL NEEDL 18G 3.5INCH TOUHEY

Facility

$447.00

Hospital Charge Code	270325403
Hospital Revenue Code	272
Min. Negotiated Rate	$67.05
Max. Negotiated Rate	$67.05
Rate for Payer: Qualcare PPO/HMO/WC	$67.05

SPINL NEEDL 18G 3.5INCH TOUHEY

Facility

$447.00

Hospital Charge Code	270325403
Hospital Revenue Code	272
Min. Negotiated Rate	$10.77
Max. Negotiated Rate	$223.50
Rate for Payer: Aetna Commercial	$169.86
Rate for Payer: Aetna Medicare Advantage	$134.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.98
Rate for Payer: Cigna Commercial	$223.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.10
Rate for Payer: Oxford Commercial	$89.40
Rate for Payer: Qualcare PPO/HMO/WC	$67.05
Rate for Payer: UnitedHealthcare Commercial	$89.40
Rate for Payer: UnitedHealthcare Community & State	$10.77
Rate for Payer: Wellpoint Medicaid Managed Care	$11.85

SPINT FINGER 3 11202

Facility

$48.65

Hospital Charge Code	270649341
Hospital Revenue Code	270
Min. Negotiated Rate	$7.30
Max. Negotiated Rate	$7.30
Rate for Payer: Qualcare PPO/HMO/WC	$7.30

SPINT FINGER 3 11202

Facility

$48.65

Hospital Charge Code	270649341
Hospital Revenue Code	270
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$24.32
Rate for Payer: Aetna Commercial	$18.49
Rate for Payer: Aetna Medicare Advantage	$14.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.41
Rate for Payer: Cigna Commercial	$24.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.60
Rate for Payer: Oxford Commercial	$9.73
Rate for Payer: Qualcare PPO/HMO/WC	$7.30
Rate for Payer: UnitedHealthcare Commercial	$9.73
Rate for Payer: UnitedHealthcare Community & State	$1.17
Rate for Payer: Wellpoint Medicaid Managed Care	$1.29

SPIRAL ELECTRODE

Facility

$51.00

Hospital Charge Code	270331667
Hospital Revenue Code	272
Min. Negotiated Rate	$7.65
Max. Negotiated Rate	$7.65
Rate for Payer: Qualcare PPO/HMO/WC	$7.65

Know your out-of-pocket cost for care.

All Charges