Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SPECULUM VAGINAL ER-SPEC S

Facility

$1,404.00

Hospital Charge Code	270665603
Hospital Revenue Code	270
Min. Negotiated Rate	$210.60
Max. Negotiated Rate	$210.60
Rate for Payer: Qualcare PPO/HMO/WC	$210.60

SPECULUM VAGINAL ER-SPEC S

Facility

$1,404.00

Hospital Charge Code	270665603
Hospital Revenue Code	270
Min. Negotiated Rate	$33.84
Max. Negotiated Rate	$702.00
Rate for Payer: Aetna Commercial	$533.52
Rate for Payer: Aetna Medicare Advantage	$421.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$358.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$358.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$358.02
Rate for Payer: Cigna Commercial	$702.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$421.20
Rate for Payer: Oxford Commercial	$280.80
Rate for Payer: Qualcare PPO/HMO/WC	$210.60
Rate for Payer: UnitedHealthcare Commercial	$280.80
Rate for Payer: UnitedHealthcare Community & State	$33.84
Rate for Payer: Wellpoint Medicaid Managed Care	$37.21

SPECULUM VAGINAL LARGE DISP.

Facility

$8.64

Hospital Charge Code	270658820
Hospital Revenue Code	270
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$4.32
Rate for Payer: Aetna Commercial	$3.28
Rate for Payer: Aetna Medicare Advantage	$2.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.20
Rate for Payer: Cigna Commercial	$4.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.59
Rate for Payer: Oxford Commercial	$1.73
Rate for Payer: Qualcare PPO/HMO/WC	$1.30
Rate for Payer: UnitedHealthcare Commercial	$1.73
Rate for Payer: UnitedHealthcare Community & State	$0.21
Rate for Payer: Wellpoint Medicaid Managed Care	$0.23

SPECULUM VAGINAL LARGE DISP.

Facility

$8.64

Hospital Charge Code	270658820
Hospital Revenue Code	270
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$1.30
Rate for Payer: Qualcare PPO/HMO/WC	$1.30

SPECULUM VAGINAL SMALL DISP

Facility

$6.90

Hospital Charge Code	270652828
Hospital Revenue Code	270
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.45
Rate for Payer: Aetna Commercial	$2.62
Rate for Payer: Aetna Medicare Advantage	$2.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.76
Rate for Payer: Cigna Commercial	$3.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.07
Rate for Payer: Oxford Commercial	$1.38
Rate for Payer: Qualcare PPO/HMO/WC	$1.03
Rate for Payer: UnitedHealthcare Commercial	$1.38
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

SPECULUM VAGINAL SMALL DISP

Facility

$6.90

Hospital Charge Code	270652828
Hospital Revenue Code	270
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$1.03
Rate for Payer: Qualcare PPO/HMO/WC	$1.03

SPECULUM VAGINAL SMALL DISP.

Facility

$6.51

Hospital Charge Code	270658819
Hospital Revenue Code	270
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$0.98
Rate for Payer: Qualcare PPO/HMO/WC	$0.98

SPECULUM VAGINAL SMALL DISP.

Facility

$6.51

Hospital Charge Code	270658819
Hospital Revenue Code	270
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$3.25
Rate for Payer: Aetna Commercial	$2.47
Rate for Payer: Aetna Medicare Advantage	$1.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.66
Rate for Payer: Cigna Commercial	$3.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.95
Rate for Payer: Oxford Commercial	$1.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.98
Rate for Payer: UnitedHealthcare Commercial	$1.30
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.17

SPECULUUM VAG AUVARD WEIGHTED

Facility

$2,469.30

Hospital Charge Code	270611251
Hospital Revenue Code	270
Min. Negotiated Rate	$370.39
Max. Negotiated Rate	$370.39
Rate for Payer: Qualcare PPO/HMO/WC	$370.39

SPECULUUM VAG AUVARD WEIGHTED

Facility

$2,469.30

Hospital Charge Code	270611251
Hospital Revenue Code	270
Min. Negotiated Rate	$59.51
Max. Negotiated Rate	$1,234.65
Rate for Payer: Aetna Commercial	$938.33
Rate for Payer: Aetna Medicare Advantage	$740.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$629.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$629.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$629.67
Rate for Payer: Cigna Commercial	$1,234.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.79
Rate for Payer: Oxford Commercial	$493.86
Rate for Payer: Qualcare PPO/HMO/WC	$370.39
Rate for Payer: UnitedHealthcare Commercial	$493.86
Rate for Payer: UnitedHealthcare Community & State	$59.51
Rate for Payer: Wellpoint Medicaid Managed Care	$65.44

SPEECH LANG CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G9174GN
Hospital Charge Code	84201177
Hospital Revenue Code	449
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

SPEECH LANG CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G9174GN
Hospital Charge Code	84201177
Hospital Revenue Code	449
Max. Negotiated Rate	$1,060.00
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) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

SPEECH LANG CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G9174GN
Hospital Charge Code	84201095
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
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) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

SPEECH LANG CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G9174GN
Hospital Charge Code	84201095
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

SPEECH LANG D/C STATUS

Facility

$0.01

Service Code	HCPCS G9178GN
Hospital Charge Code	84201179
Hospital Revenue Code	449
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

SPEECH LANG D/C STATUS

Facility

$0.01

Service Code	HCPCS G9176GN
Hospital Charge Code	84201105
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

SPEECH LANG D/C STATUS

Facility

$0.01

Service Code	HCPCS G9178GN
Hospital Charge Code	84201179
Hospital Revenue Code	449
Max. Negotiated Rate	$1,060.00
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) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

SPEECH LANG D/C STATUS

Facility

$0.01

Service Code	HCPCS G9176GN
Hospital Charge Code	84201105
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
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) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

SPEECH LANG GOAL STATUS

Facility

$0.01

Service Code	HCPCS G9175GN
Hospital Charge Code	84201100
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
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) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

SPEECH LANG GOAL STATUS

Facility

$0.01

Service Code	HCPCS G9175GN
Hospital Charge Code	84201100
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

SPEECH LANG GOAL STATUS

Facility

$0.01

Service Code	HCPCS G9175GN
Hospital Charge Code	84201178
Hospital Revenue Code	449
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

SPEECH LANG GOAL STATUS

Facility

$0.01

Service Code	HCPCS G9175GN
Hospital Charge Code	84201178
Hospital Revenue Code	449
Max. Negotiated Rate	$1,060.00
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) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

SPEECH THERAPY/CHILD STUDY****

Facility

$65.00

Service Code	HCPCS 92507
Hospital Charge Code	9000472
Hospital Revenue Code	449
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$9.75
Rate for Payer: Qualcare PPO/HMO/WC	$9.75

SPEECH THERAPY/CHILD STUDY****

Facility

$65.00

Service Code	HCPCS 92507
Hospital Charge Code	9000472
Hospital Revenue Code	449
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$24.70
Rate for Payer: Aetna Medicare Advantage	$19.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.57
Rate for Payer: Cigna Commercial	$32.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.75
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$1.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1.72

SPEECH THERAPY SESSION DBL****

Facility

$65.00

Service Code	HCPCS 92507GN
Hospital Charge Code	9000324
Hospital Revenue Code	449
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$9.75
Rate for Payer: Qualcare PPO/HMO/WC	$9.75

Know your out-of-pocket cost for care.

All Charges