Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CAGE TLX20 11X11X26MM 20D

Facility

$39,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270699307
Hospital Revenue Code	278
Min. Negotiated Rate	$5,850.00
Max. Negotiated Rate	$9,438.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,438.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,850.00

CAGE TLX20 11X11X26MM 20D

Facility

$39,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270699307
Hospital Revenue Code	278
Min. Negotiated Rate	$939.90
Max. Negotiated Rate	$19,500.00
Rate for Payer: Aetna Commercial	$14,820.00
Rate for Payer: Aetna Medicare Advantage	$11,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,945.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,945.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,945.00
Rate for Payer: Cigna Commercial	$19,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,438.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,850.00
Rate for Payer: UnitedHealthcare Community & State	$939.90
Rate for Payer: Wellpoint Medicaid Managed Care	$1,033.50

CAGE TLX20 11X11X31 MM

Facility

$32,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270691826
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

CAGE TLX20 11X11X31 MM

Facility

$32,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270691826
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

CAGE TLX20 12X11X26MM 20D

Facility

$39,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270699308
Hospital Revenue Code	278
Min. Negotiated Rate	$939.90
Max. Negotiated Rate	$19,500.00
Rate for Payer: Aetna Commercial	$14,820.00
Rate for Payer: Aetna Medicare Advantage	$11,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,945.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,945.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,945.00
Rate for Payer: Cigna Commercial	$19,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,438.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,850.00
Rate for Payer: UnitedHealthcare Community & State	$939.90
Rate for Payer: Wellpoint Medicaid Managed Care	$1,033.50

CAGE TLX20 12X11X26MM 20D

Facility

$39,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270699308
Hospital Revenue Code	278
Min. Negotiated Rate	$5,850.00
Max. Negotiated Rate	$9,438.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,438.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,850.00

CAGE TLX20 9X11X26MM 20 DEG

Facility

$31,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270691369
Hospital Revenue Code	278
Min. Negotiated Rate	$4,650.00
Max. Negotiated Rate	$7,502.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,502.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,820.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,650.00

CAGE TLX20 9X11X26MM 20 DEG

Facility

$31,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270691369
Hospital Revenue Code	278
Min. Negotiated Rate	$747.10
Max. Negotiated Rate	$15,500.00
Rate for Payer: Aetna Commercial	$11,780.00
Rate for Payer: Aetna Medicare Advantage	$9,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,905.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,905.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,905.00
Rate for Payer: Cigna Commercial	$15,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,502.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,820.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,650.00
Rate for Payer: UnitedHealthcare Community & State	$747.10
Rate for Payer: Wellpoint Medicaid Managed Care	$821.50

CAGE TRANQUIL-C IBD 7X18X14 6D

Facility

$11,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270693713
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 TRANQUIL-C IBD 7X18X14 6D

Facility

$11,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270693713
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 TRANQUIL-C IBD 8X16X3MM

Facility

$11,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270696676
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 TRANQUIL-C IBD 8X16X3MM

Facility

$11,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270696676
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 VARILIFT LX IBFD 28X10MM

Facility

$25,000.00

Service Code	HCPCS L8699
Hospital Charge Code	270693006
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 VARILIFT LX IBFD 28X10MM

Facility

$25,000.00

Service Code	HCPCS L8699
Hospital Charge Code	270693006
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 VBR INCORP 14X12X20MM 10D

Facility

$15,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270696994
Hospital Revenue Code	278
Min. Negotiated Rate	$371.14
Max. Negotiated Rate	$7,700.00
Rate for Payer: Aetna Commercial	$5,852.00
Rate for Payer: Aetna Medicare Advantage	$4,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,927.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,927.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,927.00
Rate for Payer: Cigna Commercial	$7,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,726.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,388.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,310.00
Rate for Payer: UnitedHealthcare Community & State	$371.14
Rate for Payer: Wellpoint Medicaid Managed Care	$408.10

CAGE VBR INCORP 14X12X20MM 10D

Facility

$15,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270696994
Hospital Revenue Code	278
Min. Negotiated Rate	$2,310.00
Max. Negotiated Rate	$3,726.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,726.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,388.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,310.00

CAGE VBR INCORP 14X12X26MM 10D

Facility

$15,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270696945
Hospital Revenue Code	278
Min. Negotiated Rate	$371.14
Max. Negotiated Rate	$7,700.00
Rate for Payer: Aetna Commercial	$5,852.00
Rate for Payer: Aetna Medicare Advantage	$4,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,927.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,927.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,927.00
Rate for Payer: Cigna Commercial	$7,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,726.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,388.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,310.00
Rate for Payer: UnitedHealthcare Community & State	$371.14
Rate for Payer: Wellpoint Medicaid Managed Care	$408.10

CAGE VBR INCORP 14X12X26MM 10D

Facility

$15,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270696845
Hospital Revenue Code	278
Min. Negotiated Rate	$371.14
Max. Negotiated Rate	$7,700.00
Rate for Payer: Aetna Commercial	$5,852.00
Rate for Payer: Aetna Medicare Advantage	$4,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,927.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,927.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,927.00
Rate for Payer: Cigna Commercial	$7,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,726.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,388.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,310.00
Rate for Payer: UnitedHealthcare Community & State	$371.14
Rate for Payer: Wellpoint Medicaid Managed Care	$408.10

CAGE VBR INCORP 14X12X26MM 10D

Facility

$15,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270696845
Hospital Revenue Code	278
Min. Negotiated Rate	$2,310.00
Max. Negotiated Rate	$3,726.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,726.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,388.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,310.00

CAGE VBR INCORP 14X12X26MM 10D

Facility

$15,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270696945
Hospital Revenue Code	278
Min. Negotiated Rate	$2,310.00
Max. Negotiated Rate	$3,726.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,726.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,388.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,310.00

CAGE VEO LATERAL 6D 17X11X55MM

Facility

$36,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270695256
Hospital Revenue Code	278
Min. Negotiated Rate	$873.62
Max. Negotiated Rate	$18,125.00
Rate for Payer: Aetna Commercial	$13,775.00
Rate for Payer: Aetna Medicare Advantage	$10,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,243.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,243.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,243.75
Rate for Payer: Cigna Commercial	$18,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,772.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,975.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,437.50
Rate for Payer: UnitedHealthcare Community & State	$873.62
Rate for Payer: Wellpoint Medicaid Managed Care	$960.62

CAGE VEO LATERAL 6D 17X11X55MM

Facility

$36,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270695256
Hospital Revenue Code	278
Min. Negotiated Rate	$5,437.50
Max. Negotiated Rate	$8,772.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,772.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,975.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,437.50

CAGE WIDE 7MM

Facility

$0.01

Service Code	HCPCS C1889
Hospital Charge Code	270690708
Hospital Revenue Code	278
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

CAGE WIDE 7MM

Facility

$0.01

Service Code	HCPCS C1889
Hospital Charge Code	270690708
Hospital Revenue Code	278
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

CAGE ZERO PVA 7 MM LORD

Facility

$16,267.25

Service Code	HCPCS C1889
Hospital Charge Code	270692398
Hospital Revenue Code	278
Min. Negotiated Rate	$392.04
Max. Negotiated Rate	$8,133.62
Rate for Payer: Aetna Commercial	$6,181.56
Rate for Payer: Aetna Medicare Advantage	$4,880.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,148.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,148.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,253.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,148.15
Rate for Payer: Cigna Commercial	$8,133.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,936.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,578.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,440.09
Rate for Payer: UnitedHealthcare Community & State	$392.04
Rate for Payer: Wellpoint Medicaid Managed Care	$431.08

Know your out-of-pocket cost for care.

All Charges