Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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	$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 W20X16 6 DEG H8

Facility

$16,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270688702
Hospital Revenue Code	278
Min. Negotiated Rate	$397.05
Max. Negotiated Rate	$8,237.50
Rate for Payer: Aetna Commercial	$6,260.50
Rate for Payer: Aetna Medicare Advantage	$4,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,201.12
Rate for Payer: Cigna Commercial	$8,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,624.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25
Rate for Payer: UnitedHealthcare Community & State	$397.05
Rate for Payer: Wellpoint Medicaid Managed Care	$436.59

CAGE ACIF PEEK W20X16 6 DEG H8

Facility

$16,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270688702
Hospital Revenue Code	278
Min. Negotiated Rate	$2,471.25
Max. Negotiated Rate	$3,986.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,624.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25

CAGE ACIF TI COAT PEEK 10D 8MM

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270696724
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 TI COAT PEEK 10D 8MM

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270696724
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 ALEUTIAN 7D 11X11X8MM

Facility

$6,535.00

Service Code	HCPCS C1889
Hospital Charge Code	270648858
Hospital Revenue Code	278
Min. Negotiated Rate	$157.49
Max. Negotiated Rate	$3,267.50
Rate for Payer: Aetna Commercial	$2,483.30
Rate for Payer: Aetna Medicare Advantage	$1,960.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,666.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,666.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,307.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,666.42
Rate for Payer: Cigna Commercial	$3,267.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,581.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,437.70
Rate for Payer: Qualcare PPO/HMO/WC	$980.25
Rate for Payer: UnitedHealthcare Community & State	$157.49
Rate for Payer: Wellpoint Medicaid Managed Care	$173.18

CAGE ALEUTIAN 7D 11X11X8MM

Facility

$6,535.00

Service Code	HCPCS C1889
Hospital Charge Code	270648858
Hospital Revenue Code	278
Min. Negotiated Rate	$980.25
Max. Negotiated Rate	$1,581.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,307.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,581.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,437.70
Rate for Payer: Qualcare PPO/HMO/WC	$980.25

CAGE ALIF 13MM 8DEG

Facility

$25,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705781
Hospital Revenue Code	278
Min. Negotiated Rate	$602.50
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$9,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00
Rate for Payer: UnitedHealthcare Community & State	$602.50
Rate for Payer: Wellpoint Medicaid Managed Care	$662.50

CAGE ALIF 13MM 8DEG

Facility

$25,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705781
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

CAGE ALIF PC MAG 30X25X14MM12D

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697372
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

CAGE ALIF PC MAG 30X25X14MM12D

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697372
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

CAGE ALIGN LAT 18X60X11MM 12D

Facility

$40,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270696336
Hospital Revenue Code	278
Min. Negotiated Rate	$982.08
Max. Negotiated Rate	$20,375.00
Rate for Payer: Aetna Commercial	$15,485.00
Rate for Payer: Aetna Medicare Advantage	$12,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,391.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,391.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,391.25
Rate for Payer: Cigna Commercial	$20,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,861.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,965.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,112.50
Rate for Payer: UnitedHealthcare Community & State	$982.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1,079.88

CAGE ALIGN LAT 18X60X11MM 12D

Facility

$40,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270696336
Hospital Revenue Code	278
Min. Negotiated Rate	$6,112.50
Max. Negotiated Rate	$9,861.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,861.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,965.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,112.50

CAGE ANT LUMBAR MONTEREY

Facility

$44,975.00

Hospital Charge Code	270702924
Hospital Revenue Code	278
Min. Negotiated Rate	$1,083.90
Max. Negotiated Rate	$22,487.50
Rate for Payer: Aetna Commercial	$17,090.50
Rate for Payer: Aetna Medicare Advantage	$13,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,468.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,468.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,468.62
Rate for Payer: Cigna Commercial	$22,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,883.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,894.50
Rate for Payer: Qualcare PPO/HMO/WC	$6,746.25
Rate for Payer: UnitedHealthcare Community & State	$1,083.90
Rate for Payer: Wellpoint Medicaid Managed Care	$1,191.84

CAGE ANT LUMBAR MONTEREY

Facility

$44,975.00

Hospital Charge Code	270702924
Hospital Revenue Code	278
Min. Negotiated Rate	$6,746.25
Max. Negotiated Rate	$10,883.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,883.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,894.50
Rate for Payer: Qualcare PPO/HMO/WC	$6,746.25

CAGE BANGAL 28MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270686282
Hospital Revenue Code	278
Min. Negotiated Rate	$3,375.00
Max. Negotiated Rate	$5,445.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,950.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00

CAGE BANGAL 28MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270686282
Hospital Revenue Code	278
Min. Negotiated Rate	$542.25
Max. Negotiated Rate	$11,250.00
Rate for Payer: Aetna Commercial	$8,550.00
Rate for Payer: Aetna Medicare Advantage	$6,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,737.50
Rate for Payer: Cigna Commercial	$11,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,950.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00
Rate for Payer: UnitedHealthcare Community & State	$542.25
Rate for Payer: Wellpoint Medicaid Managed Care	$596.25

CAGE BENGAL 20MM

Facility

$20,140.00

Service Code	HCPCS C1713
Hospital Charge Code	270689202
Hospital Revenue Code	278
Min. Negotiated Rate	$485.37
Max. Negotiated Rate	$10,070.00
Rate for Payer: Aetna Commercial	$7,653.20
Rate for Payer: Aetna Medicare Advantage	$6,042.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,135.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,135.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,028.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,135.70
Rate for Payer: Cigna Commercial	$10,070.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,873.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,430.80
Rate for Payer: Qualcare PPO/HMO/WC	$3,021.00
Rate for Payer: UnitedHealthcare Community & State	$485.37
Rate for Payer: Wellpoint Medicaid Managed Care	$533.71

CAGE BENGAL 20MM

Facility

$20,140.00

Service Code	HCPCS C1713
Hospital Charge Code	270689202
Hospital Revenue Code	278
Min. Negotiated Rate	$3,021.00
Max. Negotiated Rate	$4,873.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,028.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,873.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,430.80
Rate for Payer: Qualcare PPO/HMO/WC	$3,021.00

CAGE BENGAL 26MM

Facility

$20,140.00

Service Code	HCPCS C1713
Hospital Charge Code	270689201
Hospital Revenue Code	278
Min. Negotiated Rate	$485.37
Max. Negotiated Rate	$10,070.00
Rate for Payer: Aetna Commercial	$7,653.20
Rate for Payer: Aetna Medicare Advantage	$6,042.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,135.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,135.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,028.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,135.70
Rate for Payer: Cigna Commercial	$10,070.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,873.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,430.80
Rate for Payer: Qualcare PPO/HMO/WC	$3,021.00
Rate for Payer: UnitedHealthcare Community & State	$485.37
Rate for Payer: Wellpoint Medicaid Managed Care	$533.71

CAGE BENGAL 26MM

Facility

$20,140.00

Service Code	HCPCS C1713
Hospital Charge Code	270689201
Hospital Revenue Code	278
Min. Negotiated Rate	$3,021.00
Max. Negotiated Rate	$4,873.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,028.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,873.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,430.80
Rate for Payer: Qualcare PPO/HMO/WC	$3,021.00

CAGE BENGAL 5MM

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270663294
Hospital Revenue Code	278
Min. Negotiated Rate	$156.65
Max. Negotiated Rate	$3,250.00
Rate for Payer: Aetna Commercial	$2,470.00
Rate for Payer: Aetna Medicare Advantage	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,657.50
Rate for Payer: Cigna Commercial	$3,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,430.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00
Rate for Payer: UnitedHealthcare Community & State	$156.65
Rate for Payer: Wellpoint Medicaid Managed Care	$172.25

CAGE BENGAL 5MM

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270663294
Hospital Revenue Code	278
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$1,573.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,430.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00

CAGE BENGAL7MM

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270680083
Hospital Revenue Code	278
Min. Negotiated Rate	$156.65
Max. Negotiated Rate	$3,250.00
Rate for Payer: Aetna Commercial	$2,470.00
Rate for Payer: Aetna Medicare Advantage	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,657.50
Rate for Payer: Cigna Commercial	$3,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,430.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00
Rate for Payer: UnitedHealthcare Community & State	$156.65
Rate for Payer: Wellpoint Medicaid Managed Care	$172.25

CAGE BENGAL7MM

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270680083
Hospital Revenue Code	278
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$1,573.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,430.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00

Know your out-of-pocket cost for care.

All Charges