Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

COLLAGENASE OINT 30GM

Facility

$1,493.56

Service Code	NDC 64501090
Hospital Charge Code	60628876
Hospital Revenue Code	250
Min. Negotiated Rate	$224.03
Max. Negotiated Rate	$224.03
Rate for Payer: Qualcare PPO/HMO/WC	$224.03

COLLAGENASE OINT 30GM

Facility

$1,493.56

Service Code	NDC 64501090
Hospital Charge Code	60628876
Hospital Revenue Code	250
Min. Negotiated Rate	$35.99
Max. Negotiated Rate	$746.78
Rate for Payer: Aetna Commercial	$567.55
Rate for Payer: Aetna Medicare Advantage	$448.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$380.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$380.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$380.86
Rate for Payer: Cigna Commercial	$746.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.07
Rate for Payer: Oxford Commercial	$298.71
Rate for Payer: Qualcare PPO/HMO/WC	$224.03
Rate for Payer: UnitedHealthcare Commercial	$298.71
Rate for Payer: UnitedHealthcare Community & State	$35.99
Rate for Payer: Wellpoint Medicaid Managed Care	$39.58

COLLAGEN CROSS LINKED N-TELO

Facility

$194.00

Service Code	HCPCS 82523
Hospital Charge Code	38472931
Hospital Revenue Code	301
Min. Negotiated Rate	$29.10
Max. Negotiated Rate	$29.10
Rate for Payer: Qualcare PPO/HMO/WC	$29.10

COLLAGEN CROSS LINKED N-TELO

Facility

$194.00

Service Code	HCPCS 82523
Hospital Charge Code	38472931
Hospital Revenue Code	301
Min. Negotiated Rate	$5.14
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$50.81
Rate for Payer: Aetna Medicare Advantage	$60.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.43
Rate for Payer: Cigna Commercial	$97.00
Rate for Payer: Cigna Medicare Advantage	$18.68
Rate for Payer: Clover Medicare Advantage	$17.75
Rate for Payer: EmblemHealth Commercial	$56.04
Rate for Payer: Humana Medicare Advantage	$19.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.10
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.68
Rate for Payer: Wellcare Medicare Advantage	$18.68
Rate for Payer: Wellpoint Medicaid Managed Care	$5.14

COLLAGEN MATRIX 6cmX8cm TISSUE

Facility

$4,935.25

Hospital Charge Code	270630693
Hospital Revenue Code	278
Min. Negotiated Rate	$118.94
Max. Negotiated Rate	$2,467.62
Rate for Payer: Aetna Commercial	$1,875.39
Rate for Payer: Aetna Medicare Advantage	$1,480.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,258.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,258.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$987.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,258.49
Rate for Payer: Cigna Commercial	$2,467.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,194.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,085.76
Rate for Payer: Qualcare PPO/HMO/WC	$740.29
Rate for Payer: UnitedHealthcare Community & State	$118.94
Rate for Payer: Wellpoint Medicaid Managed Care	$130.78

COLLAGEN MATRIX 6cmX8cm TISSUE

Facility

$4,935.25

Hospital Charge Code	270630693
Hospital Revenue Code	278
Min. Negotiated Rate	$740.29
Max. Negotiated Rate	$1,194.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$987.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,194.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,085.76
Rate for Payer: Qualcare PPO/HMO/WC	$740.29

COLLAGEN MICROFIB TOP 1 GM

Facility

$1,045.15

Hospital Charge Code	6001341
Hospital Revenue Code	250
Min. Negotiated Rate	$25.19
Max. Negotiated Rate	$522.58
Rate for Payer: Aetna Commercial	$397.16
Rate for Payer: Aetna Medicare Advantage	$313.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$266.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$266.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$266.51
Rate for Payer: Cigna Commercial	$522.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.55
Rate for Payer: Oxford Commercial	$209.03
Rate for Payer: Qualcare PPO/HMO/WC	$156.77
Rate for Payer: UnitedHealthcare Commercial	$209.03
Rate for Payer: UnitedHealthcare Community & State	$25.19
Rate for Payer: Wellpoint Medicaid Managed Care	$27.70

COLLAGEN MICROFIB TOP 1 GM

Facility

$1,045.15

Hospital Charge Code	6001341
Hospital Revenue Code	250
Min. Negotiated Rate	$156.77
Max. Negotiated Rate	$156.77
Rate for Payer: Qualcare PPO/HMO/WC	$156.77

COLLAGEN POWDER 1 GRAM

Facility

$45.00

Service Code	HCPCS A6010
Hospital Charge Code	270678861
Hospital Revenue Code	272
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$22.50
Rate for Payer: Aetna Commercial	$17.10
Rate for Payer: Aetna Medicare Advantage	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.47
Rate for Payer: Cigna Commercial	$22.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.50
Rate for Payer: Oxford Commercial	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.75
Rate for Payer: UnitedHealthcare Commercial	$9.00
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

COLLAGEN POWDER 1 GRAM

Facility

$45.00

Service Code	HCPCS A6010
Hospital Charge Code	270678861
Hospital Revenue Code	272
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$6.75
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

COLLAGEN TYPE 1 CTX

Facility

$729.75

Service Code	HCPCS 82523
Hospital Charge Code	401082523
Hospital Revenue Code	301
Min. Negotiated Rate	$11.91
Max. Negotiated Rate	$364.88
Rate for Payer: Aetna Commercial	$50.81
Rate for Payer: Aetna Medicare Advantage	$60.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.43
Rate for Payer: Cigna Commercial	$364.88
Rate for Payer: Cigna Medicare Advantage	$18.68
Rate for Payer: Clover Medicare Advantage	$17.75
Rate for Payer: EmblemHealth Commercial	$56.04
Rate for Payer: Humana Medicare Advantage	$19.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.93
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$109.46
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.68
Rate for Payer: Wellcare Medicare Advantage	$18.68
Rate for Payer: Wellpoint Medicaid Managed Care	$19.34

COLLAGEN TYPE 1 CTX

Facility

$390.00

Service Code	HCPCS 82523
Hospital Charge Code	397071387
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$50.81
Rate for Payer: Aetna Medicare Advantage	$60.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.43
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$18.68
Rate for Payer: Clover Medicare Advantage	$17.75
Rate for Payer: EmblemHealth Commercial	$56.04
Rate for Payer: Humana Medicare Advantage	$19.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.68
Rate for Payer: Wellcare Medicare Advantage	$18.68
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

COLLAGEN TYPE 1 CTX

Facility

$390.00

Service Code	HCPCS 82523
Hospital Charge Code	397071387
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

COLLAGEN TYPE 1 CTX

Facility

$729.75

Service Code	HCPCS 82523
Hospital Charge Code	401082523
Hospital Revenue Code	301
Min. Negotiated Rate	$109.46
Max. Negotiated Rate	$109.46
Rate for Payer: Qualcare PPO/HMO/WC	$109.46

COLLAGEN X-LINK NTX

Facility

$92.85

Service Code	HCPCS 82523
Hospital Charge Code	3032752
Hospital Revenue Code	301
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$50.81
Rate for Payer: Aetna Medicare Advantage	$60.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.43
Rate for Payer: Cigna Commercial	$46.42
Rate for Payer: Cigna Medicare Advantage	$18.68
Rate for Payer: Clover Medicare Advantage	$17.75
Rate for Payer: EmblemHealth Commercial	$56.04
Rate for Payer: Humana Medicare Advantage	$19.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.86
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.93
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.68
Rate for Payer: Wellcare Medicare Advantage	$18.68
Rate for Payer: Wellpoint Medicaid Managed Care	$2.46

COLLAGEN X-LINK NTX

Facility

$92.85

Service Code	HCPCS 82523
Hospital Charge Code	3032752
Hospital Revenue Code	301
Min. Negotiated Rate	$13.93
Max. Negotiated Rate	$13.93
Rate for Payer: Qualcare PPO/HMO/WC	$13.93

COLLAR CERV

Facility

$24.00

Hospital Charge Code	8001919
Hospital Revenue Code	279
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$12.00
Rate for Payer: Aetna Commercial	$9.12
Rate for Payer: Aetna Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.12
Rate for Payer: Cigna Commercial	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.20
Rate for Payer: Oxford Commercial	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$3.60
Rate for Payer: UnitedHealthcare Commercial	$4.80
Rate for Payer: UnitedHealthcare Community & State	$0.58
Rate for Payer: Wellpoint Medicaid Managed Care	$0.64

COLLAR CERV

Facility

$24.00

Hospital Charge Code	8001919
Hospital Revenue Code	279
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.60

COLLAR CERV LGE SERP 737-04

Facility

$31.80

Hospital Charge Code	270302775
Hospital Revenue Code	270
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$15.90
Rate for Payer: Aetna Commercial	$12.08
Rate for Payer: Aetna Medicare Advantage	$9.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.11
Rate for Payer: Cigna Commercial	$15.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.54
Rate for Payer: Oxford Commercial	$6.36
Rate for Payer: Qualcare PPO/HMO/WC	$4.77
Rate for Payer: UnitedHealthcare Commercial	$6.36
Rate for Payer: UnitedHealthcare Community & State	$0.77
Rate for Payer: Wellpoint Medicaid Managed Care	$0.84

COLLAR CERV LGE SERP 737-04

Facility

$31.80

Hospital Charge Code	270302775
Hospital Revenue Code	270
Min. Negotiated Rate	$4.77
Max. Negotiated Rate	$4.77
Rate for Payer: Qualcare PPO/HMO/WC	$4.77

COLLAR CERV LRG SERP 737-04

Facility

$19.25

Hospital Charge Code	270600220
Hospital Revenue Code	272
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$9.62
Rate for Payer: Aetna Commercial	$7.32
Rate for Payer: Aetna Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.91
Rate for Payer: Cigna Commercial	$9.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.78
Rate for Payer: Oxford Commercial	$3.85
Rate for Payer: Qualcare PPO/HMO/WC	$2.89
Rate for Payer: UnitedHealthcare Commercial	$3.85
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.51

COLLAR CERV LRG SERP 737-04

Facility

$19.25

Hospital Charge Code	270600220
Hospital Revenue Code	272
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$2.89
Rate for Payer: Qualcare PPO/HMO/WC	$2.89

COLLAR CERV MED SERP 737-03

Facility

$19.25

Hospital Charge Code	270600219
Hospital Revenue Code	272
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$2.89
Rate for Payer: Qualcare PPO/HMO/WC	$2.89

COLLAR CERV MED SERP 737-03

Facility

$19.25

Hospital Charge Code	270600219
Hospital Revenue Code	272
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$9.62
Rate for Payer: Aetna Commercial	$7.32
Rate for Payer: Aetna Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.91
Rate for Payer: Cigna Commercial	$9.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.78
Rate for Payer: Oxford Commercial	$3.85
Rate for Payer: Qualcare PPO/HMO/WC	$2.89
Rate for Payer: UnitedHealthcare Commercial	$3.85
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.51

COLLAR CERV MED SERP LNG 73705

Facility

$31.80

Hospital Charge Code	270302770
Hospital Revenue Code	270
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$15.90
Rate for Payer: Aetna Commercial	$12.08
Rate for Payer: Aetna Medicare Advantage	$9.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.11
Rate for Payer: Cigna Commercial	$15.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.54
Rate for Payer: Oxford Commercial	$6.36
Rate for Payer: Qualcare PPO/HMO/WC	$4.77
Rate for Payer: UnitedHealthcare Commercial	$6.36
Rate for Payer: UnitedHealthcare Community & State	$0.77
Rate for Payer: Wellpoint Medicaid Managed Care	$0.84

Know your out-of-pocket cost for care.

All Charges