Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CAGE 9MM X 11MM X 23 MM

Facility

$24,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270688260
Hospital Revenue Code	278
Min. Negotiated Rate	$3,600.00
Max. Negotiated Rate	$5,808.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,808.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,280.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,600.00

CAGE 9MM X 11MM X 23 MM

Facility

$24,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270688260
Hospital Revenue Code	278
Min. Negotiated Rate	$578.40
Max. Negotiated Rate	$12,000.00
Rate for Payer: Aetna Commercial	$9,120.00
Rate for Payer: Aetna Medicare Advantage	$7,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,120.00
Rate for Payer: Cigna Commercial	$12,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,808.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,280.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,600.00
Rate for Payer: UnitedHealthcare Community & State	$578.40
Rate for Payer: Wellpoint Medicaid Managed Care	$636.00

CAGE 9MM X11 MM X 23 MM

Facility

$24,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270683546
Hospital Revenue Code	278
Min. Negotiated Rate	$3,600.00
Max. Negotiated Rate	$5,808.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,808.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,280.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,600.00

CAGE 9MM X11 MM X 23 MM

Facility

$24,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270683546
Hospital Revenue Code	278
Min. Negotiated Rate	$578.40
Max. Negotiated Rate	$12,000.00
Rate for Payer: Aetna Commercial	$9,120.00
Rate for Payer: Aetna Medicare Advantage	$7,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,120.00
Rate for Payer: Cigna Commercial	$12,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,808.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,280.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,600.00
Rate for Payer: UnitedHealthcare Community & State	$578.40
Rate for Payer: Wellpoint Medicaid Managed Care	$636.00

CAGE 9MM X11 MM X 23 MM

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270688471
Hospital Revenue Code	278
Min. Negotiated Rate	$3,637.50
Max. Negotiated Rate	$5,868.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,335.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50

CAGE 9MM X11 MM X 23 MM

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270688471
Hospital Revenue Code	278
Min. Negotiated Rate	$584.42
Max. Negotiated Rate	$12,125.00
Rate for Payer: Aetna Commercial	$9,215.00
Rate for Payer: Aetna Medicare Advantage	$7,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,183.75
Rate for Payer: Cigna Commercial	$12,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,335.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50
Rate for Payer: UnitedHealthcare Community & State	$584.42
Rate for Payer: Wellpoint Medicaid Managed Care	$642.62

CAGE 9MM X-WIDE TI

Facility

$9,175.00

Hospital Charge Code	270703142
Hospital Revenue Code	278
Min. Negotiated Rate	$1,376.25
Max. Negotiated Rate	$2,220.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,835.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,220.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,018.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,376.25

CAGE 9MM X-WIDE TI

Facility

$9,175.00

Hospital Charge Code	270703142
Hospital Revenue Code	278
Min. Negotiated Rate	$221.12
Max. Negotiated Rate	$4,587.50
Rate for Payer: Aetna Commercial	$3,486.50
Rate for Payer: Aetna Medicare Advantage	$2,752.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,339.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,339.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,835.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,339.62
Rate for Payer: Cigna Commercial	$4,587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,220.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,018.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,376.25
Rate for Payer: UnitedHealthcare Community & State	$221.12
Rate for Payer: Wellpoint Medicaid Managed Care	$243.14

CAGE 9X 10 X 27 MM

Facility

$20,273.00

Service Code	HCPCS C1889
Hospital Charge Code	270690581
Hospital Revenue Code	278
Min. Negotiated Rate	$488.58
Max. Negotiated Rate	$10,136.50
Rate for Payer: Aetna Commercial	$7,703.74
Rate for Payer: Aetna Medicare Advantage	$6,081.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,169.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,169.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,054.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,169.61
Rate for Payer: Cigna Commercial	$10,136.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,906.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,460.06
Rate for Payer: Qualcare PPO/HMO/WC	$3,040.95
Rate for Payer: UnitedHealthcare Community & State	$488.58
Rate for Payer: Wellpoint Medicaid Managed Care	$537.23

CAGE 9X 10 X 27 MM

Facility

$20,273.00

Service Code	HCPCS C1889
Hospital Charge Code	270690581
Hospital Revenue Code	278
Min. Negotiated Rate	$3,040.95
Max. Negotiated Rate	$4,906.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,054.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,906.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,460.06
Rate for Payer: Qualcare PPO/HMO/WC	$3,040.95

CAGE 9 X 11 X 22

Facility

$30,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270693960
Hospital Revenue Code	278
Min. Negotiated Rate	$4,500.00
Max. Negotiated Rate	$7,260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,260.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,500.00

CAGE 9 X 11 X 22

Facility

$30,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270693960
Hospital Revenue Code	278
Min. Negotiated Rate	$723.00
Max. Negotiated Rate	$15,000.00
Rate for Payer: Aetna Commercial	$11,400.00
Rate for Payer: Aetna Medicare Advantage	$9,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,650.00
Rate for Payer: Cigna Commercial	$15,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,260.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,500.00
Rate for Payer: UnitedHealthcare Community & State	$723.00
Rate for Payer: Wellpoint Medicaid Managed Care	$795.00

CAGE 9X11X27

Facility

$19,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270685133
Hospital Revenue Code	278
Min. Negotiated Rate	$2,887.50
Max. Negotiated Rate	$4,658.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.50

CAGE 9X11X27

Facility

$19,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270685133
Hospital Revenue Code	278
Min. Negotiated Rate	$463.93
Max. Negotiated Rate	$9,625.00
Rate for Payer: Aetna Commercial	$7,315.00
Rate for Payer: Aetna Medicare Advantage	$5,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,908.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,908.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,908.75
Rate for Payer: Cigna Commercial	$9,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.50
Rate for Payer: UnitedHealthcare Community & State	$463.93
Rate for Payer: Wellpoint Medicaid Managed Care	$510.12

CAGE 9X13

Facility

$23,755.80

Service Code	HCPCS C1889
Hospital Charge Code	270692141
Hospital Revenue Code	278
Min. Negotiated Rate	$572.51
Max. Negotiated Rate	$11,877.90
Rate for Payer: Aetna Commercial	$9,027.20
Rate for Payer: Aetna Medicare Advantage	$7,126.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,057.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,057.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,751.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,057.73
Rate for Payer: Cigna Commercial	$11,877.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,748.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,226.28
Rate for Payer: Qualcare PPO/HMO/WC	$3,563.37
Rate for Payer: UnitedHealthcare Community & State	$572.51
Rate for Payer: Wellpoint Medicaid Managed Care	$629.53

CAGE 9X13

Facility

$23,755.80

Service Code	HCPCS C1889
Hospital Charge Code	270692141
Hospital Revenue Code	278
Min. Negotiated Rate	$3,563.37
Max. Negotiated Rate	$5,748.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,751.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,748.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,226.28
Rate for Payer: Qualcare PPO/HMO/WC	$3,563.37

CAGE ACDF 16X14X7MM 7D

Facility

$32,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270697641
Hospital Revenue Code	278
Min. Negotiated Rate	$4,837.50
Max. Negotiated Rate	$7,804.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,804.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,095.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,837.50

CAGE ACDF 16X14X7MM 7D

Facility

$32,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270697641
Hospital Revenue Code	278
Min. Negotiated Rate	$777.23
Max. Negotiated Rate	$16,125.00
Rate for Payer: Aetna Commercial	$12,255.00
Rate for Payer: Aetna Medicare Advantage	$9,675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,223.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,223.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,223.75
Rate for Payer: Cigna Commercial	$16,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,804.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,095.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,837.50
Rate for Payer: UnitedHealthcare Community & State	$777.23
Rate for Payer: Wellpoint Medicaid Managed Care	$854.62

CAGE ACDF DAKOTA 16X14X6MM 7D

Facility

$32,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270697644
Hospital Revenue Code	278
Min. Negotiated Rate	$777.23
Max. Negotiated Rate	$16,125.00
Rate for Payer: Aetna Commercial	$12,255.00
Rate for Payer: Aetna Medicare Advantage	$9,675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,223.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,223.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,223.75
Rate for Payer: Cigna Commercial	$16,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,804.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,095.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,837.50
Rate for Payer: UnitedHealthcare Community & State	$777.23
Rate for Payer: Wellpoint Medicaid Managed Care	$854.62

CAGE ACDF DAKOTA 16X14X6MM 7D

Facility

$32,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270697644
Hospital Revenue Code	278
Min. Negotiated Rate	$4,837.50
Max. Negotiated Rate	$7,804.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,804.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,095.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,837.50

CAGE ACIF 2C PEEK 5D 8MM

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270696038
Hospital Revenue Code	278
Min. Negotiated Rate	$3,637.50
Max. Negotiated Rate	$5,868.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,335.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50

CAGE ACIF 2C PEEK 5D 8MM

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270696038
Hospital Revenue Code	278
Min. Negotiated Rate	$584.42
Max. Negotiated Rate	$12,125.00
Rate for Payer: Aetna Commercial	$9,215.00
Rate for Payer: Aetna Medicare Advantage	$7,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,183.75
Rate for Payer: Cigna Commercial	$12,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,335.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50
Rate for Payer: UnitedHealthcare Community & State	$584.42
Rate for Payer: Wellpoint Medicaid Managed Care	$642.62

CAGE ACIF 2C PEEK WIDE 5D 8MM

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270696037
Hospital Revenue Code	278
Min. Negotiated Rate	$3,637.50
Max. Negotiated Rate	$5,868.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,335.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50

CAGE ACIF 2C PEEK WIDE 5D 8MM

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270696037
Hospital Revenue Code	278
Min. Negotiated Rate	$584.42
Max. Negotiated Rate	$12,125.00
Rate for Payer: Aetna Commercial	$9,215.00
Rate for Payer: Aetna Medicare Advantage	$7,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,183.75
Rate for Payer: Cigna Commercial	$12,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,335.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50
Rate for Payer: UnitedHealthcare Community & State	$584.42
Rate for Payer: Wellpoint Medicaid Managed Care	$642.62

CAGE ACIF PEEK TI HA 5D 9MM

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270696322
Hospital Revenue Code	278
Min. Negotiated Rate	$3,637.50
Max. Negotiated Rate	$5,868.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,335.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50

Know your out-of-pocket cost for care.

All Charges