Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

8MM 10DEG ZAVATION CAGE

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270705535
Hospital Revenue Code	278
Min. Negotiated Rate	$114.47
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,805.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,045.00
Rate for Payer: Qualcare PPO/HMO/WC	$712.50
Rate for Payer: UnitedHealthcare Community & State	$114.47
Rate for Payer: Wellpoint Medicaid Managed Care	$125.88

8MM MATISSE CAGE

Facility

$9,150.00

Service Code	HCPCS C1765
Hospital Charge Code	270703818
Hospital Revenue Code	278
Min. Negotiated Rate	$1,372.50
Max. Negotiated Rate	$2,214.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,830.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,214.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,013.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,372.50

8MM MATISSE CAGE

Facility

$9,150.00

Service Code	HCPCS C1765
Hospital Charge Code	270703818
Hospital Revenue Code	278
Min. Negotiated Rate	$220.51
Max. Negotiated Rate	$4,575.00
Rate for Payer: Aetna Commercial	$3,477.00
Rate for Payer: Aetna Medicare Advantage	$2,745.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,333.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,333.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,830.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,333.25
Rate for Payer: Cigna Commercial	$4,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,214.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,013.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,372.50
Rate for Payer: UnitedHealthcare Community & State	$220.51
Rate for Payer: Wellpoint Medicaid Managed Care	$242.47

8X150MM VELCTRAN ROD

Facility

$2,065.00

Hospital Charge Code	270656467
Hospital Revenue Code	278
Min. Negotiated Rate	$309.75
Max. Negotiated Rate	$499.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$413.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$499.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$454.30
Rate for Payer: Qualcare PPO/HMO/WC	$309.75

8X150MM VELCTRAN ROD

Facility

$2,065.00

Hospital Charge Code	270656467
Hospital Revenue Code	278
Min. Negotiated Rate	$49.77
Max. Negotiated Rate	$1,032.50
Rate for Payer: Aetna Commercial	$784.70
Rate for Payer: Aetna Medicare Advantage	$619.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$526.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$526.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$413.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$526.58
Rate for Payer: Cigna Commercial	$1,032.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$499.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$454.30
Rate for Payer: Qualcare PPO/HMO/WC	$309.75
Rate for Payer: UnitedHealthcare Community & State	$49.77
Rate for Payer: Wellpoint Medicaid Managed Care	$54.72

8X42X30MM 15DEGREE ALIF SPACER

Facility

$33,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270704085
Hospital Revenue Code	278
Min. Negotiated Rate	$4,968.75
Max. Negotiated Rate	$8,016.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,016.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,287.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,968.75

8X42X30MM 15DEGREE ALIF SPACER

Facility

$33,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270704085
Hospital Revenue Code	278
Min. Negotiated Rate	$798.31
Max. Negotiated Rate	$16,562.50
Rate for Payer: Aetna Commercial	$12,587.50
Rate for Payer: Aetna Medicare Advantage	$9,937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,446.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,446.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,446.88
Rate for Payer: Cigna Commercial	$16,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,016.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,287.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,968.75
Rate for Payer: UnitedHealthcare Community & State	$798.31
Rate for Payer: Wellpoint Medicaid Managed Care	$877.81

90 DEGREE POST

Facility

$1,085.00

Hospital Charge Code	270656470
Hospital Revenue Code	271
Min. Negotiated Rate	$26.15
Max. Negotiated Rate	$542.50
Rate for Payer: Aetna Commercial	$412.30
Rate for Payer: Aetna Medicare Advantage	$325.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$276.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$276.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$276.68
Rate for Payer: Cigna Commercial	$542.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$325.50
Rate for Payer: Oxford Commercial	$217.00
Rate for Payer: Qualcare PPO/HMO/WC	$162.75
Rate for Payer: UnitedHealthcare Commercial	$217.00
Rate for Payer: UnitedHealthcare Community & State	$26.15
Rate for Payer: Wellpoint Medicaid Managed Care	$28.75

90 DEGREE POST

Facility

$1,085.00

Hospital Charge Code	270656470
Hospital Revenue Code	271
Min. Negotiated Rate	$162.75
Max. Negotiated Rate	$162.75
Rate for Payer: Qualcare PPO/HMO/WC	$162.75

90 DEGREE QUICK PASS LASSO

Facility

$800.00

Hospital Charge Code	270656485
Hospital Revenue Code	271
Min. Negotiated Rate	$19.28
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.00
Rate for Payer: Oxford Commercial	$160.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Commercial	$160.00
Rate for Payer: UnitedHealthcare Community & State	$19.28
Rate for Payer: Wellpoint Medicaid Managed Care	$21.20

90 DEGREE QUICK PASS LASSO

Facility

$800.00

Hospital Charge Code	270656485
Hospital Revenue Code	271
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

90 DEGRESS ABLATOR

Facility

$1,075.00

Hospital Charge Code	270703224
Hospital Revenue Code	270
Min. Negotiated Rate	$25.91
Max. Negotiated Rate	$537.50
Rate for Payer: Aetna Commercial	$408.50
Rate for Payer: Aetna Medicare Advantage	$322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.12
Rate for Payer: Cigna Commercial	$537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$322.50
Rate for Payer: Oxford Commercial	$215.00
Rate for Payer: Qualcare PPO/HMO/WC	$161.25
Rate for Payer: UnitedHealthcare Commercial	$215.00
Rate for Payer: UnitedHealthcare Community & State	$25.91
Rate for Payer: Wellpoint Medicaid Managed Care	$28.49

90 DEGRESS ABLATOR

Facility

$1,075.00

Hospital Charge Code	270703224
Hospital Revenue Code	270
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$161.25
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

90 MM ROD

Facility

$875.00

Service Code	HCPCS C1773
Hospital Charge Code	270703977
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

90 MM ROD

Facility

$875.00

Service Code	HCPCS C1773
Hospital Charge Code	270703977
Hospital Revenue Code	278
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

90MM ROD

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270705000
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

90MM ROD

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270705000
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

9.0 MM X 2.0 MM STEM

Facility

$11,585.00

Service Code	HCPCS C1776
Hospital Charge Code	270686224
Hospital Revenue Code	278
Min. Negotiated Rate	$279.20
Max. Negotiated Rate	$5,792.50
Rate for Payer: Aetna Commercial	$4,402.30
Rate for Payer: Aetna Medicare Advantage	$3,475.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,954.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,954.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,317.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,954.18
Rate for Payer: Cigna Commercial	$5,792.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,803.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,548.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,737.75
Rate for Payer: UnitedHealthcare Community & State	$279.20
Rate for Payer: Wellpoint Medicaid Managed Care	$307.00

9.0 MM X 2.0 MM STEM

Facility

$11,585.00

Service Code	HCPCS C1776
Hospital Charge Code	270686224
Hospital Revenue Code	278
Min. Negotiated Rate	$1,737.75
Max. Negotiated Rate	$2,803.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,317.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,803.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,548.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,737.75

95X4.0 LOCKING SCREW

Facility

$875.00

Hospital Charge Code	270656472
Hospital Revenue Code	278
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

95X4.0 LOCKING SCREW

Facility

$875.00

Hospital Charge Code	270656472
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

9.5X55MM SI SCREW - DUAL

Facility

$16,950.00

Hospital Charge Code	270703185
Hospital Revenue Code	278
Min. Negotiated Rate	$408.50
Max. Negotiated Rate	$8,475.00
Rate for Payer: Aetna Commercial	$6,441.00
Rate for Payer: Aetna Medicare Advantage	$5,085.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,322.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,322.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,322.25
Rate for Payer: Cigna Commercial	$8,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,101.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,729.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,542.50
Rate for Payer: UnitedHealthcare Community & State	$408.50
Rate for Payer: Wellpoint Medicaid Managed Care	$449.18

9.5X55MM SI SCREW - DUAL

Facility

$16,950.00

Hospital Charge Code	270703185
Hospital Revenue Code	278
Min. Negotiated Rate	$2,542.50
Max. Negotiated Rate	$4,101.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,101.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,729.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,542.50

9.5X65MM SI SCREW DUAL THREAD

Facility

$16,752.00

Hospital Charge Code	270703186
Hospital Revenue Code	278
Min. Negotiated Rate	$403.72
Max. Negotiated Rate	$8,376.00
Rate for Payer: Aetna Commercial	$6,365.76
Rate for Payer: Aetna Medicare Advantage	$5,025.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,271.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,271.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,350.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,271.76
Rate for Payer: Cigna Commercial	$8,376.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,053.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,685.44
Rate for Payer: Qualcare PPO/HMO/WC	$2,512.80
Rate for Payer: UnitedHealthcare Community & State	$403.72
Rate for Payer: Wellpoint Medicaid Managed Care	$443.93

9.5X65MM SI SCREW DUAL THREAD

Facility

$16,752.00

Hospital Charge Code	270703186
Hospital Revenue Code	278
Min. Negotiated Rate	$2,512.80
Max. Negotiated Rate	$4,053.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,350.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,053.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,685.44
Rate for Payer: Qualcare PPO/HMO/WC	$2,512.80

Know your out-of-pocket cost for care.

All Charges