Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CAGE CERVICAL 14mmx17mm H8

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270680520
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 H8

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270680520
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 H8

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270678669
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 H8

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270678669
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 14X11X7MM 7D

Facility

$7,300.00

Service Code	HCPCS C1889
Hospital Charge Code	270695440
Hospital Revenue Code	278
Min. Negotiated Rate	$1,095.00
Max. Negotiated Rate	$1,766.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,766.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,606.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,095.00

CAGE CERVICAL 14X11X7MM 7D

Facility

$7,300.00

Service Code	HCPCS C1889
Hospital Charge Code	270695440
Hospital Revenue Code	278
Min. Negotiated Rate	$175.93
Max. Negotiated Rate	$3,650.00
Rate for Payer: Aetna Commercial	$2,774.00
Rate for Payer: Aetna Medicare Advantage	$2,190.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,861.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,861.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,460.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,861.50
Rate for Payer: Cigna Commercial	$3,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,766.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,606.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,095.00
Rate for Payer: UnitedHealthcare Community & State	$175.93
Rate for Payer: Wellpoint Medicaid Managed Care	$193.45

CAGE CERVICAL 7X16X13MM 6D

Facility

$11,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270694339
Hospital Revenue Code	278
Min. Negotiated Rate	$265.10
Max. Negotiated Rate	$5,500.00
Rate for Payer: Aetna Commercial	$4,180.00
Rate for Payer: Aetna Medicare Advantage	$3,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,805.00
Rate for Payer: Cigna Commercial	$5,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,662.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00
Rate for Payer: UnitedHealthcare Community & State	$265.10
Rate for Payer: Wellpoint Medicaid Managed Care	$291.50

CAGE CERVICAL 7X16X13MM 6D

Facility

$11,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270694339
Hospital Revenue Code	278
Min. Negotiated Rate	$1,650.00
Max. Negotiated Rate	$2,662.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,662.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00

CAGE CERVICAL CAVUX

Facility

$23,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270692493
Hospital Revenue Code	278
Min. Negotiated Rate	$554.30
Max. Negotiated Rate	$11,500.00
Rate for Payer: Aetna Commercial	$8,740.00
Rate for Payer: Aetna Medicare Advantage	$6,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,865.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,865.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,865.00
Rate for Payer: Cigna Commercial	$11,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,566.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,060.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,450.00
Rate for Payer: UnitedHealthcare Community & State	$554.30
Rate for Payer: Wellpoint Medicaid Managed Care	$609.50

CAGE CERVICAL CAVUX

Facility

$23,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270692493
Hospital Revenue Code	278
Min. Negotiated Rate	$3,450.00
Max. Negotiated Rate	$5,566.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,566.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,060.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,450.00

CAGE CERVICAL CAVUX X LTX

Facility

$9,025.00

Service Code	HCPCS C1889
Hospital Charge Code	270693673
Hospital Revenue Code	278
Min. Negotiated Rate	$1,353.75
Max. Negotiated Rate	$2,184.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,805.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,184.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,985.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,353.75

CAGE CERVICAL CAVUX X LTX

Facility

$9,025.00

Service Code	HCPCS C1889
Hospital Charge Code	270693673
Hospital Revenue Code	278
Min. Negotiated Rate	$217.50
Max. Negotiated Rate	$4,512.50
Rate for Payer: Aetna Commercial	$3,429.50
Rate for Payer: Aetna Medicare Advantage	$2,707.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,301.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,301.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,301.38
Rate for Payer: Cigna Commercial	$4,512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,184.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,985.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,353.75
Rate for Payer: UnitedHealthcare Community & State	$217.50
Rate for Payer: Wellpoint Medicaid Managed Care	$239.16

CAGE CERVICAL COHERE 12X14X8MM

Facility

$9,075.00

Service Code	HCPCS C1889
Hospital Charge Code	270692447
Hospital Revenue Code	278
Min. Negotiated Rate	$1,361.25
Max. Negotiated Rate	$2,196.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,815.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,196.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,996.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,361.25

CAGE CERVICAL COHERE 12X14X8MM

Facility

$9,075.00

Service Code	HCPCS C1889
Hospital Charge Code	270692447
Hospital Revenue Code	278
Min. Negotiated Rate	$218.71
Max. Negotiated Rate	$4,537.50
Rate for Payer: Aetna Commercial	$3,448.50
Rate for Payer: Aetna Medicare Advantage	$2,722.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,314.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,314.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,314.12
Rate for Payer: Cigna Commercial	$4,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,196.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,996.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,361.25
Rate for Payer: UnitedHealthcare Community & State	$218.71
Rate for Payer: Wellpoint Medicaid Managed Care	$240.49

CAGE CERVICAL PC 16X13X7MM 7D

Facility

$7,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270693521
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$1,694.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,540.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

CAGE CERVICAL PC 16X13X7MM 7D

Facility

$7,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270693521
Hospital Revenue Code	278
Min. Negotiated Rate	$168.70
Max. Negotiated Rate	$3,500.00
Rate for Payer: Aetna Commercial	$2,660.00
Rate for Payer: Aetna Medicare Advantage	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,785.00
Rate for Payer: Cigna Commercial	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,540.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00
Rate for Payer: UnitedHealthcare Community & State	$168.70
Rate for Payer: Wellpoint Medicaid Managed Care	$185.50

CAGE CERV INST KIT

Facility

$2,500.00

Hospital Charge Code	270701861
Hospital Revenue Code	278
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Community & State	$60.25
Rate for Payer: Wellpoint Medicaid Managed Care	$66.25

CAGE CERV INST KIT

Facility

$2,500.00

Hospital Charge Code	270701861
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

CAGE CERV INTERBD 16X13X8MM 7D

Facility

$5,600.00

Service Code	HCPCS C1889
Hospital Charge Code	270697100
Hospital Revenue Code	278
Min. Negotiated Rate	$134.96
Max. Negotiated Rate	$2,800.00
Rate for Payer: Aetna Commercial	$2,128.00
Rate for Payer: Aetna Medicare Advantage	$1,680.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,428.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,428.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,428.00
Rate for Payer: Cigna Commercial	$2,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,355.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,232.00
Rate for Payer: Qualcare PPO/HMO/WC	$840.00
Rate for Payer: UnitedHealthcare Community & State	$134.96
Rate for Payer: Wellpoint Medicaid Managed Care	$148.40

CAGE CERV INTERBD 16X13X8MM 7D

Facility

$5,600.00

Service Code	HCPCS C1889
Hospital Charge Code	270697100
Hospital Revenue Code	278
Min. Negotiated Rate	$840.00
Max. Negotiated Rate	$1,355.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,355.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,232.00
Rate for Payer: Qualcare PPO/HMO/WC	$840.00

CAGE CERV INTERBDY 9X28X9MM 5D

Facility

$34,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270693827
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 INTERBDY 9X28X9MM 5D

Facility

$34,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270693827
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 SHURF 5 DEG 6MM

Facility

$21,097.50

Service Code	HCPCS C1889
Hospital Charge Code	270698236
Hospital Revenue Code	278
Min. Negotiated Rate	$3,164.62
Max. Negotiated Rate	$5,105.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,219.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,105.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,641.45
Rate for Payer: Qualcare PPO/HMO/WC	$3,164.62

CAGE CERV SHURF 5 DEG 6MM

Facility

$21,097.50

Service Code	HCPCS C1889
Hospital Charge Code	270698236
Hospital Revenue Code	278
Min. Negotiated Rate	$508.45
Max. Negotiated Rate	$10,548.75
Rate for Payer: Aetna Commercial	$8,017.05
Rate for Payer: Aetna Medicare Advantage	$6,329.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,379.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,379.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,219.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,379.86
Rate for Payer: Cigna Commercial	$10,548.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,105.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,641.45
Rate for Payer: Qualcare PPO/HMO/WC	$3,164.62
Rate for Payer: UnitedHealthcare Community & State	$508.45
Rate for Payer: Wellpoint Medicaid Managed Care	$559.08

CAGE CERV SPACE NANO 18X14X8MM

Facility

$21,097.50

Service Code	HCPCS C1889
Hospital Charge Code	270698383
Hospital Revenue Code	278
Min. Negotiated Rate	$3,164.62
Max. Negotiated Rate	$5,105.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,219.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,105.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,641.45
Rate for Payer: Qualcare PPO/HMO/WC	$3,164.62

Know your out-of-pocket cost for care.

All Charges