Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

COLLAR CERV MED SERP LNG 73705

Facility

$31.80

Hospital Charge Code	270302770
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 SML 737-02

Facility

$31.80

Hospital Charge Code	270302765
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 SML 737-02

Facility

$31.80

Hospital Charge Code	270302765
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 SML LO CNTR 737-07

Facility

$43.25

Hospital Charge Code	270600321
Hospital Revenue Code	272
Min. Negotiated Rate	$6.49
Max. Negotiated Rate	$6.49
Rate for Payer: Qualcare PPO/HMO/WC	$6.49

COLLAR CERV SML LO CNTR 737-07

Facility

$43.25

Hospital Charge Code	270600321
Hospital Revenue Code	272
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.62
Rate for Payer: Aetna Commercial	$16.43
Rate for Payer: Aetna Medicare Advantage	$12.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.03
Rate for Payer: Cigna Commercial	$21.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.97
Rate for Payer: Oxford Commercial	$8.65
Rate for Payer: Qualcare PPO/HMO/WC	$6.49
Rate for Payer: UnitedHealthcare Commercial	$8.65
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.15

COLLAR CERV SML SERP 737-02

Facility

$43.25

Hospital Charge Code	270600218
Hospital Revenue Code	272
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.62
Rate for Payer: Aetna Commercial	$16.43
Rate for Payer: Aetna Medicare Advantage	$12.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.03
Rate for Payer: Cigna Commercial	$21.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.97
Rate for Payer: Oxford Commercial	$8.65
Rate for Payer: Qualcare PPO/HMO/WC	$6.49
Rate for Payer: UnitedHealthcare Commercial	$8.65
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.15

COLLAR CERV SML SERP 737-02

Facility

$43.25

Hospital Charge Code	270600218
Hospital Revenue Code	272
Min. Negotiated Rate	$6.49
Max. Negotiated Rate	$6.49
Rate for Payer: Qualcare PPO/HMO/WC	$6.49

COLLAR CERV SML XLONG 737-06

Facility

$135.00

Hospital Charge Code	270600224
Hospital Revenue Code	272
Min. Negotiated Rate	$20.25
Max. Negotiated Rate	$20.25
Rate for Payer: Qualcare PPO/HMO/WC	$20.25

COLLAR CERV SML XLONG 737-06

Facility

$135.00

Hospital Charge Code	270600224
Hospital Revenue Code	272
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$67.50
Rate for Payer: Aetna Commercial	$51.30
Rate for Payer: Aetna Medicare Advantage	$40.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.42
Rate for Payer: Cigna Commercial	$67.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.50
Rate for Payer: Oxford Commercial	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.25
Rate for Payer: UnitedHealthcare Commercial	$27.00
Rate for Payer: UnitedHealthcare Community & State	$3.25
Rate for Payer: Wellpoint Medicaid Managed Care	$3.58

COLLAR CERV SML XWIDE 737-01

Facility

$43.25

Hospital Charge Code	270600217
Hospital Revenue Code	272
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.62
Rate for Payer: Aetna Commercial	$16.43
Rate for Payer: Aetna Medicare Advantage	$12.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.03
Rate for Payer: Cigna Commercial	$21.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.97
Rate for Payer: Oxford Commercial	$8.65
Rate for Payer: Qualcare PPO/HMO/WC	$6.49
Rate for Payer: UnitedHealthcare Commercial	$8.65
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.15

COLLAR CERV SML XWIDE 737-01

Facility

$43.25

Hospital Charge Code	270600217
Hospital Revenue Code	272
Min. Negotiated Rate	$6.49
Max. Negotiated Rate	$6.49
Rate for Payer: Qualcare PPO/HMO/WC	$6.49

COLLAR CERV SM/MED/LG SERP****

Facility

$7.00

Hospital Charge Code	1608082
Hospital Revenue Code	270
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

COLLAR CERV SM/MED/LG SERP****

Facility

$7.00

Hospital Charge Code	1608082
Hospital Revenue Code	270
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.66
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.10
Rate for Payer: Oxford Commercial	$1.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$1.40
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

COLLARD INTEGRAL POROUS STEM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270683753
Hospital Revenue Code	278
Min. Negotiated Rate	$253.05
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,990.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00
Rate for Payer: UnitedHealthcare Community & State	$253.05
Rate for Payer: Wellpoint Medicaid Managed Care	$278.25

COLLARD INTEGRAL POROUS STEM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270683753
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

COLLAR EXTRCATION ADLT 281-000

Facility

$44.95

Hospital Charge Code	270644286
Hospital Revenue Code	272
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$22.48
Rate for Payer: Aetna Commercial	$17.08
Rate for Payer: Aetna Medicare Advantage	$13.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.46
Rate for Payer: Cigna Commercial	$22.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.48
Rate for Payer: Oxford Commercial	$8.99
Rate for Payer: Qualcare PPO/HMO/WC	$6.74
Rate for Payer: UnitedHealthcare Commercial	$8.99
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

COLLAR EXTRCATION ADLT 281-000

Facility

$44.95

Hospital Charge Code	270644286
Hospital Revenue Code	272
Min. Negotiated Rate	$6.74
Max. Negotiated Rate	$6.74
Rate for Payer: Qualcare PPO/HMO/WC	$6.74

COLLAR FOAM SERPENTINE LARGE

Facility

$19.05

Hospital Charge Code	270649375
Hospital Revenue Code	272
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$9.53
Rate for Payer: Aetna Commercial	$7.24
Rate for Payer: Aetna Medicare Advantage	$5.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.86
Rate for Payer: Cigna Commercial	$9.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.71
Rate for Payer: Oxford Commercial	$3.81
Rate for Payer: Qualcare PPO/HMO/WC	$2.86
Rate for Payer: UnitedHealthcare Commercial	$3.81
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.50

COLLAR FOAM SERPENTINE LARGE

Facility

$19.05

Hospital Charge Code	270649375
Hospital Revenue Code	272
Min. Negotiated Rate	$2.86
Max. Negotiated Rate	$2.86
Rate for Payer: Qualcare PPO/HMO/WC	$2.86

COLLAR FOAM SERPENTINE MEDIUM

Facility

$19.05

Hospital Charge Code	270649376
Hospital Revenue Code	272
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$9.53
Rate for Payer: Aetna Commercial	$7.24
Rate for Payer: Aetna Medicare Advantage	$5.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.86
Rate for Payer: Cigna Commercial	$9.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.71
Rate for Payer: Oxford Commercial	$3.81
Rate for Payer: Qualcare PPO/HMO/WC	$2.86
Rate for Payer: UnitedHealthcare Commercial	$3.81
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.50

COLLAR FOAM SERPENTINE MEDIUM

Facility

$19.05

Hospital Charge Code	270649376
Hospital Revenue Code	272
Min. Negotiated Rate	$2.86
Max. Negotiated Rate	$2.86
Rate for Payer: Qualcare PPO/HMO/WC	$2.86

COLLAR FOAM SERPENTINE SMALL

Facility

$18.50

Hospital Charge Code	270649377
Hospital Revenue Code	272
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$9.25
Rate for Payer: Aetna Commercial	$7.03
Rate for Payer: Aetna Medicare Advantage	$5.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.72
Rate for Payer: Cigna Commercial	$9.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.55
Rate for Payer: Oxford Commercial	$3.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.77
Rate for Payer: UnitedHealthcare Commercial	$3.70
Rate for Payer: UnitedHealthcare Community & State	$0.45
Rate for Payer: Wellpoint Medicaid Managed Care	$0.49

COLLAR FOAM SERPENTINE SMALL

Facility

$18.50

Hospital Charge Code	270649377
Hospital Revenue Code	272
Min. Negotiated Rate	$2.77
Max. Negotiated Rate	$2.77
Rate for Payer: Qualcare PPO/HMO/WC	$2.77

COLLAR FOAM SERPENTINE X-LG

Facility

$19.05

Hospital Charge Code	270649378
Hospital Revenue Code	272
Min. Negotiated Rate	$2.86
Max. Negotiated Rate	$2.86
Rate for Payer: Qualcare PPO/HMO/WC	$2.86

COLLAR FOAM SERPENTINE X-LG

Facility

$19.05

Hospital Charge Code	270649378
Hospital Revenue Code	272
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$9.53
Rate for Payer: Aetna Commercial	$7.24
Rate for Payer: Aetna Medicare Advantage	$5.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.86
Rate for Payer: Cigna Commercial	$9.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.71
Rate for Payer: Oxford Commercial	$3.81
Rate for Payer: Qualcare PPO/HMO/WC	$2.86
Rate for Payer: UnitedHealthcare Commercial	$3.81
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.50

Know your out-of-pocket cost for care.

All Charges