Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CAGE CERES-C 15X12X8MM 10D

Facility

$6,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270696388
Hospital Revenue Code	278
Min. Negotiated Rate	$930.00
Max. Negotiated Rate	$1,500.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,500.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,364.00
Rate for Payer: Qualcare PPO/HMO/WC	$930.00

CAGE CERV 14.5X12MM 7D

Facility

$42,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270698160
Hospital Revenue Code	278
Min. Negotiated Rate	$1,024.25
Max. Negotiated Rate	$21,250.00
Rate for Payer: Aetna Commercial	$16,150.00
Rate for Payer: Aetna Medicare Advantage	$12,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,837.50
Rate for Payer: Cigna Commercial	$21,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,285.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,350.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,375.00
Rate for Payer: UnitedHealthcare Community & State	$1,024.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1,126.25

CAGE CERV 14.5X12MM 7D

Facility

$42,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270698160
Hospital Revenue Code	278
Min. Negotiated Rate	$6,375.00
Max. Negotiated Rate	$10,285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,285.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,350.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,375.00

CAGE CERV DISC PRESTIGE 7X18MM

Facility

$44,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694698
Hospital Revenue Code	278
Min. Negotiated Rate	$1,072.45
Max. Negotiated Rate	$22,250.00
Rate for Payer: Aetna Commercial	$16,910.00
Rate for Payer: Aetna Medicare Advantage	$13,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,347.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,347.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,347.50
Rate for Payer: Cigna Commercial	$22,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,769.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,790.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,675.00
Rate for Payer: UnitedHealthcare Community & State	$1,072.45
Rate for Payer: Wellpoint Medicaid Managed Care	$1,179.25

CAGE CERV DISC PRESTIGE 7X18MM

Facility

$44,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694698
Hospital Revenue Code	278
Min. Negotiated Rate	$6,675.00
Max. Negotiated Rate	$10,769.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,769.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,790.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,675.00

CAGE CERV F3D 14.5X12X9MM 7D

Facility

$34,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270696269
Hospital Revenue Code	278
Min. Negotiated Rate	$825.42
Max. Negotiated Rate	$17,125.00
Rate for Payer: Aetna Commercial	$13,015.00
Rate for Payer: Aetna Medicare Advantage	$10,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,733.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,733.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,733.75
Rate for Payer: Cigna Commercial	$17,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,288.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,535.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,137.50
Rate for Payer: UnitedHealthcare Community & State	$825.42
Rate for Payer: Wellpoint Medicaid Managed Care	$907.62

CAGE CERV F3D 14.5X12X9MM 7D

Facility

$34,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270696269
Hospital Revenue Code	278
Min. Negotiated Rate	$5,137.50
Max. Negotiated Rate	$8,288.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,288.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,535.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,137.50

CAGE CERV H06 MM W14.5MM D12MM

Facility

$12,500.00

Hospital Charge Code	270701865
Hospital Revenue Code	278
Min. Negotiated Rate	$301.25
Max. Negotiated Rate	$6,250.00
Rate for Payer: Aetna Commercial	$4,750.00
Rate for Payer: Aetna Medicare Advantage	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,187.50
Rate for Payer: Cigna Commercial	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00
Rate for Payer: UnitedHealthcare Community & State	$301.25
Rate for Payer: Wellpoint Medicaid Managed Care	$331.25

CAGE CERV H06 MM W14.5MM D12MM

Facility

$12,500.00

Hospital Charge Code	270701865
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$3,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

CAGE CERV H0 MMW14.5MM D12MM

Facility

$12,500.00

Hospital Charge Code	270701862
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$3,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

CAGE CERV H0 MMW14.5MM D12MM

Facility

$12,500.00

Hospital Charge Code	270701862
Hospital Revenue Code	278
Min. Negotiated Rate	$301.25
Max. Negotiated Rate	$6,250.00
Rate for Payer: Aetna Commercial	$4,750.00
Rate for Payer: Aetna Medicare Advantage	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,187.50
Rate for Payer: Cigna Commercial	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00
Rate for Payer: UnitedHealthcare Community & State	$301.25
Rate for Payer: Wellpoint Medicaid Managed Care	$331.25

CAGECERV IBPEEK 7D 14.5X12X6MM

Facility

$42,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270697115
Hospital Revenue Code	278
Min. Negotiated Rate	$6,375.00
Max. Negotiated Rate	$10,285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,285.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,350.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,375.00

CAGECERV IBPEEK 7D 14.5X12X6MM

Facility

$42,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270697115
Hospital Revenue Code	278
Min. Negotiated Rate	$1,024.25
Max. Negotiated Rate	$21,250.00
Rate for Payer: Aetna Commercial	$16,150.00
Rate for Payer: Aetna Medicare Advantage	$12,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,837.50
Rate for Payer: Cigna Commercial	$21,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,285.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,350.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,375.00
Rate for Payer: UnitedHealthcare Community & State	$1,024.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1,126.25

CAGE CERVICAL 10MM 10 DEG

Facility

$9,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270691985
Hospital Revenue Code	278
Min. Negotiated Rate	$216.90
Max. Negotiated Rate	$4,500.00
Rate for Payer: Aetna Commercial	$3,420.00
Rate for Payer: Aetna Medicare Advantage	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,295.00
Rate for Payer: Cigna Commercial	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,178.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,980.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.00
Rate for Payer: UnitedHealthcare Community & State	$216.90
Rate for Payer: Wellpoint Medicaid Managed Care	$238.50

CAGE CERVICAL 10MM 10 DEG

Facility

$9,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270691985
Hospital Revenue Code	278
Min. Negotiated Rate	$1,350.00
Max. Negotiated Rate	$2,178.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,178.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,980.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.00

CAGE CERVICAL 14.5X12X7MM7D

Facility

$42,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270697762
Hospital Revenue Code	278
Min. Negotiated Rate	$6,375.00
Max. Negotiated Rate	$10,285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,285.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,350.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,375.00

CAGE CERVICAL 14.5X12X7MM7D

Facility

$42,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270697762
Hospital Revenue Code	278
Min. Negotiated Rate	$1,024.25
Max. Negotiated Rate	$21,250.00
Rate for Payer: Aetna Commercial	$16,150.00
Rate for Payer: Aetna Medicare Advantage	$12,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,837.50
Rate for Payer: Cigna Commercial	$21,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,285.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,350.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,375.00
Rate for Payer: UnitedHealthcare Community & State	$1,024.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1,126.25

CAGE CERVICAL 14mm x 15.5 mm H

Facility

$11,665.00

Service Code	HCPCS C1713
Hospital Charge Code	270688648
Hospital Revenue Code	278
Min. Negotiated Rate	$1,749.75
Max. Negotiated Rate	$2,822.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,822.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,566.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,749.75

CAGE CERVICAL 14mm x 15.5 mm H

Facility

$11,665.00

Service Code	HCPCS C1713
Hospital Charge Code	270688648
Hospital Revenue Code	278
Min. Negotiated Rate	$281.13
Max. Negotiated Rate	$5,832.50
Rate for Payer: Aetna Commercial	$4,432.70
Rate for Payer: Aetna Medicare Advantage	$3,499.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,974.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,974.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,974.57
Rate for Payer: Cigna Commercial	$5,832.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,822.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,566.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,749.75
Rate for Payer: UnitedHealthcare Community & State	$281.13
Rate for Payer: Wellpoint Medicaid Managed Care	$309.12

CAGE CERVICAL 14mm X 17mm

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270678668
Hospital Revenue Code	278
Min. Negotiated Rate	$1,750.00
Max. Negotiated Rate	$2,823.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,823.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,566.66
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.00

CAGE CERVICAL 14mm X 17mm

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270678668
Hospital Revenue Code	278
Min. Negotiated Rate	$281.17
Max. Negotiated Rate	$5,833.32
Rate for Payer: Aetna Commercial	$4,433.33
Rate for Payer: Aetna Medicare Advantage	$3,499.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,975.00
Rate for Payer: Cigna Commercial	$5,833.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,823.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,566.66
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.00
Rate for Payer: UnitedHealthcare Community & State	$281.17
Rate for Payer: Wellpoint Medicaid Managed Care	$309.17

CAGE CERVICAL 14MM X 17MM H6

Facility

$11,665.00

Service Code	HCPCS C1713
Hospital Charge Code	270679736
Hospital Revenue Code	278
Min. Negotiated Rate	$1,749.75
Max. Negotiated Rate	$2,822.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,822.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,566.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,749.75

CAGE CERVICAL 14MM X 17MM H6

Facility

$11,665.00

Service Code	HCPCS C1713
Hospital Charge Code	270679736
Hospital Revenue Code	278
Min. Negotiated Rate	$281.13
Max. Negotiated Rate	$5,832.50
Rate for Payer: Aetna Commercial	$4,432.70
Rate for Payer: Aetna Medicare Advantage	$3,499.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,974.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,974.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,974.57
Rate for Payer: Cigna Commercial	$5,832.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,822.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,566.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,749.75
Rate for Payer: UnitedHealthcare Community & State	$281.13
Rate for Payer: Wellpoint Medicaid Managed Care	$309.12

CAGE CERVICAL 14mmx17mm H7

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270680519
Hospital Revenue Code	278
Min. Negotiated Rate	$281.17
Max. Negotiated Rate	$5,833.32
Rate for Payer: Aetna Commercial	$4,433.33
Rate for Payer: Aetna Medicare Advantage	$3,499.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,975.00
Rate for Payer: Cigna Commercial	$5,833.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,823.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,566.66
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.00
Rate for Payer: UnitedHealthcare Community & State	$281.17
Rate for Payer: Wellpoint Medicaid Managed Care	$309.17

CAGE CERVICAL 14mmx17mm H7

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270680519
Hospital Revenue Code	278
Min. Negotiated Rate	$1,750.00
Max. Negotiated Rate	$2,823.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,823.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,566.66
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.00

Know your out-of-pocket cost for care.

All Charges