Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CAGE PROLIFT 10X28X8-13MM

Facility

$35,000.00

Hospital Charge Code	270703131
Hospital Revenue Code	278
Min. Negotiated Rate	$843.50
Max. Negotiated Rate	$17,500.00
Rate for Payer: Aetna Commercial	$13,300.00
Rate for Payer: Aetna Medicare Advantage	$10,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,925.00
Rate for Payer: Cigna Commercial	$17,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,470.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,700.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,250.00
Rate for Payer: UnitedHealthcare Community & State	$843.50
Rate for Payer: Wellpoint Medicaid Managed Care	$927.50

CAGE PROLIFT 10X28X8-13MM

Facility

$35,000.00

Hospital Charge Code	270703131
Hospital Revenue Code	278
Min. Negotiated Rate	$5,250.00
Max. Negotiated Rate	$8,470.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,470.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,700.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,250.00

CAGE PROLIFT 10X28X8 15 DEG

Facility

$30,000.00

Hospital Charge Code	270701777
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 PROLIFT 10X28X8 15 DEG

Facility

$30,000.00

Hospital Charge Code	270701777
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 PROLINK 16X13X7MM 7D

Facility

$17,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270698823
Hospital Revenue Code	278
Min. Negotiated Rate	$421.75
Max. Negotiated Rate	$8,750.00
Rate for Payer: Aetna Commercial	$6,650.00
Rate for Payer: Aetna Medicare Advantage	$5,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,462.50
Rate for Payer: Cigna Commercial	$8,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00
Rate for Payer: UnitedHealthcare Community & State	$421.75
Rate for Payer: Wellpoint Medicaid Managed Care	$463.75

CAGE PROLINK 16X13X7MM 7D

Facility

$17,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270698823
Hospital Revenue Code	278
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$4,235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

CAGE PROLINK 16X13X8MM 7D

Facility

$17,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270698879
Hospital Revenue Code	278
Min. Negotiated Rate	$421.75
Max. Negotiated Rate	$8,750.00
Rate for Payer: Aetna Commercial	$6,650.00
Rate for Payer: Aetna Medicare Advantage	$5,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,462.50
Rate for Payer: Cigna Commercial	$8,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00
Rate for Payer: UnitedHealthcare Community & State	$421.75
Rate for Payer: Wellpoint Medicaid Managed Care	$463.75

CAGE PROLINK 16X13X8MM 7D

Facility

$17,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270698879
Hospital Revenue Code	278
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$4,235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

CAGE PROLINK TI 16X13X6MM 7D

Facility

$17,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270698822
Hospital Revenue Code	278
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$4,235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

CAGE PROLINK TI 16X13X6MM 7D

Facility

$17,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270698822
Hospital Revenue Code	278
Min. Negotiated Rate	$421.75
Max. Negotiated Rate	$8,750.00
Rate for Payer: Aetna Commercial	$6,650.00
Rate for Payer: Aetna Medicare Advantage	$5,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,462.50
Rate for Payer: Cigna Commercial	$8,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00
Rate for Payer: UnitedHealthcare Community & State	$421.75
Rate for Payer: Wellpoint Medicaid Managed Care	$463.75

CAGE PSR

Facility

$8,225.00

Service Code	HCPCS C1889
Hospital Charge Code	270691792
Hospital Revenue Code	278
Min. Negotiated Rate	$1,233.75
Max. Negotiated Rate	$1,990.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,990.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,809.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,233.75

CAGE PSR

Facility

$8,225.00

Service Code	HCPCS C1889
Hospital Charge Code	270691792
Hospital Revenue Code	278
Min. Negotiated Rate	$198.22
Max. Negotiated Rate	$4,112.50
Rate for Payer: Aetna Commercial	$3,125.50
Rate for Payer: Aetna Medicare Advantage	$2,467.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,097.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,097.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,645.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,097.38
Rate for Payer: Cigna Commercial	$4,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,990.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,809.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,233.75
Rate for Payer: UnitedHealthcare Community & State	$198.22
Rate for Payer: Wellpoint Medicaid Managed Care	$217.96

CAGE PSX EXPAND 7X10X25MM 20D

Facility

$35,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270699536
Hospital Revenue Code	278
Min. Negotiated Rate	$5,287.50
Max. Negotiated Rate	$8,530.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,530.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,755.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,287.50

CAGE PSX EXPAND 7X10X25MM 20D

Facility

$35,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270699536
Hospital Revenue Code	278
Min. Negotiated Rate	$849.52
Max. Negotiated Rate	$17,625.00
Rate for Payer: Aetna Commercial	$13,395.00
Rate for Payer: Aetna Medicare Advantage	$10,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,988.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,988.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,988.75
Rate for Payer: Cigna Commercial	$17,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,530.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,755.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,287.50
Rate for Payer: UnitedHealthcare Community & State	$849.52
Rate for Payer: Wellpoint Medicaid Managed Care	$934.12

CAGEPSXLORDOTEXP10X10X25MM20D

Facility

$35,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270698057
Hospital Revenue Code	278
Min. Negotiated Rate	$5,287.50
Max. Negotiated Rate	$8,530.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,530.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,755.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,287.50

CAGEPSXLORDOTEXP10X10X25MM20D

Facility

$35,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270698057
Hospital Revenue Code	278
Min. Negotiated Rate	$849.52
Max. Negotiated Rate	$17,625.00
Rate for Payer: Aetna Commercial	$13,395.00
Rate for Payer: Aetna Medicare Advantage	$10,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,988.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,988.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,988.75
Rate for Payer: Cigna Commercial	$17,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,530.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,755.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,287.50
Rate for Payer: UnitedHealthcare Community & State	$849.52
Rate for Payer: Wellpoint Medicaid Managed Care	$934.12

CAGE REG 8MM

Facility

$16,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270688430
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 REG 8MM

Facility

$16,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270688430
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 RISE-L 22X60MM 10D

Facility

$39,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694591
Hospital Revenue Code	278
Min. Negotiated Rate	$5,925.00
Max. Negotiated Rate	$9,559.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,559.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,690.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,925.00

CAGE RISE-L 22X60MM 10D

Facility

$39,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694591
Hospital Revenue Code	278
Min. Negotiated Rate	$951.95
Max. Negotiated Rate	$19,750.00
Rate for Payer: Aetna Commercial	$15,010.00
Rate for Payer: Aetna Medicare Advantage	$11,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,072.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,072.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,072.50
Rate for Payer: Cigna Commercial	$19,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,559.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,690.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,925.00
Rate for Payer: UnitedHealthcare Community & State	$951.95
Rate for Payer: Wellpoint Medicaid Managed Care	$1,046.75

CAGE ROI-C 12X14X9 H9

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270692184
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 ROI-C 12X14X9 H9

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270692184
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 ROI-C LOR CERV 12x 14H5mm

Facility

$11,665.00

Service Code	HCPCS C1713
Hospital Charge Code	270678599
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 ROI-C LOR CERV 12x 14H5mm

Facility

$11,665.00

Service Code	HCPCS C1713
Hospital Charge Code	270678599
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 ROI-C LORDOTIC 12X14MM10D

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270699663
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

Know your out-of-pocket cost for care.

All Charges