Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CAGE ROI-C LORDOTIC 12X14MM10D

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270699663
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 LORDOTIC H8 12X14MM

Facility

$11,666.65

Service Code	HCPCS C1889
Hospital Charge Code	270691758
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 ROI-C LORDOTIC H8 12X14MM

Facility

$11,666.65

Service Code	HCPCS C1889
Hospital Charge Code	270691758
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 ROI-C PEEK TI 12X14 H8

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270692001
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 PEEK TI 12X14 H8

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270692001
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 TI 14x15.5Hmm

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270678600
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 ROI-C TI 14x15.5Hmm

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270678600
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 ROI-C TI LORDOT 14x15.5mm

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270678602
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 ROI-C TI LORDOT 14x15.5mm

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270678602
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 ROI-X CERVICAL 12x14H5MM

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270678598
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 ROI-X CERVICAL 12x14H5MM

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270678598
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

CAGES 7-9MM

Facility

$32,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270688388
Hospital Revenue Code	278
Min. Negotiated Rate	$4,875.00
Max. Negotiated Rate	$7,865.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,865.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,150.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,875.00

CAGES 7-9MM

Facility

$32,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270688388
Hospital Revenue Code	278
Min. Negotiated Rate	$783.25
Max. Negotiated Rate	$16,250.00
Rate for Payer: Aetna Commercial	$12,350.00
Rate for Payer: Aetna Medicare Advantage	$9,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,287.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,287.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,287.50
Rate for Payer: Cigna Commercial	$16,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,865.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,150.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,875.00
Rate for Payer: UnitedHealthcare Community & State	$783.25
Rate for Payer: Wellpoint Medicaid Managed Care	$861.25

CAGES 8-10MM

Facility

$32,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270688387
Hospital Revenue Code	278
Min. Negotiated Rate	$4,875.00
Max. Negotiated Rate	$7,865.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,865.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,150.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,875.00

CAGES 8-10MM

Facility

$32,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270688387
Hospital Revenue Code	278
Min. Negotiated Rate	$783.25
Max. Negotiated Rate	$16,250.00
Rate for Payer: Aetna Commercial	$12,350.00
Rate for Payer: Aetna Medicare Advantage	$9,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,287.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,287.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,287.50
Rate for Payer: Cigna Commercial	$16,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,865.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,150.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,875.00
Rate for Payer: UnitedHealthcare Community & State	$783.25
Rate for Payer: Wellpoint Medicaid Managed Care	$861.25

CAGES 9 MM X 12 MM X 23 MM

Facility

$24,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270683652
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

CAGES 9 MM X 12 MM X 23 MM

Facility

$24,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270683652
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

CAGES 9 X 11X 12

Facility

$19,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270679717
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

CAGES 9 X 11X 12

Facility

$19,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270679717
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

CAGES 9X 7 X 23

Facility

$24,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270687936
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

CAGES 9X 7 X 23

Facility

$24,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270687936
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 SCARLET C 12X15X8

Facility

$22,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697642
Hospital Revenue Code	278
Min. Negotiated Rate	$3,300.00
Max. Negotiated Rate	$5,324.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,324.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,300.00

CAGE SCARLET C 12X15X8

Facility

$22,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697642
Hospital Revenue Code	278
Min. Negotiated Rate	$530.20
Max. Negotiated Rate	$11,000.00
Rate for Payer: Aetna Commercial	$8,360.00
Rate for Payer: Aetna Medicare Advantage	$6,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,610.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,610.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,610.00
Rate for Payer: Cigna Commercial	$11,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,324.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,300.00
Rate for Payer: UnitedHealthcare Community & State	$530.20
Rate for Payer: Wellpoint Medicaid Managed Care	$583.00

CAGE SHURFIT 2CPEEK 12X29MM 2C

Facility

$36,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270696744
Hospital Revenue Code	278
Min. Negotiated Rate	$5,400.00
Max. Negotiated Rate	$8,712.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,712.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,920.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,400.00

CAGE SHURFIT 2CPEEK 12X29MM 2C

Facility

$36,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270696744
Hospital Revenue Code	278
Min. Negotiated Rate	$867.60
Max. Negotiated Rate	$18,000.00
Rate for Payer: Aetna Commercial	$13,680.00
Rate for Payer: Aetna Medicare Advantage	$10,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,180.00
Rate for Payer: Cigna Commercial	$18,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,712.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,920.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,400.00
Rate for Payer: UnitedHealthcare Community & State	$867.60
Rate for Payer: Wellpoint Medicaid Managed Care	$954.00

Know your out-of-pocket cost for care.

All Charges