Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CISCO CATAKYST 24 ETHERNET

Facility

$5,838.75

Hospital Charge Code	270659108
Hospital Revenue Code	278
Min. Negotiated Rate	$140.71
Max. Negotiated Rate	$2,919.38
Rate for Payer: Aetna Commercial	$2,218.72
Rate for Payer: Aetna Medicare Advantage	$1,751.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,488.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,488.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,167.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,488.88
Rate for Payer: Cigna Commercial	$2,919.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,412.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,284.53
Rate for Payer: Qualcare PPO/HMO/WC	$875.81
Rate for Payer: UnitedHealthcare Community & State	$140.71
Rate for Payer: Wellpoint Medicaid Managed Care	$154.73

CISPLATIN 100 MG/100ML INJ

Facility

$576.00

Hospital Charge Code	6001226
Hospital Revenue Code	636
Min. Negotiated Rate	$13.88
Max. Negotiated Rate	$288.00
Rate for Payer: Aetna Commercial	$218.88
Rate for Payer: Aetna Medicare Advantage	$172.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.88
Rate for Payer: Cigna Commercial	$288.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.39
Rate for Payer: Qualcare PPO/HMO/WC	$86.40
Rate for Payer: UnitedHealthcare Community & State	$13.88
Rate for Payer: Wellpoint Medicaid Managed Care	$15.26

CISPLATIN 100 MG/100ML INJ

Facility

$576.00

Hospital Charge Code	6001226
Hospital Revenue Code	636
Min. Negotiated Rate	$86.40
Max. Negotiated Rate	$139.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.39
Rate for Payer: Qualcare PPO/HMO/WC	$86.40

CISPLATIN INJ 10 MG

Facility

$250.25

Hospital Charge Code	6001218
Hospital Revenue Code	250
Min. Negotiated Rate	$37.54
Max. Negotiated Rate	$37.54
Rate for Payer: Qualcare PPO/HMO/WC	$37.54

CISPLATIN INJ 10 MG

Facility

$250.25

Hospital Charge Code	6001218
Hospital Revenue Code	250
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$125.12
Rate for Payer: Aetna Commercial	$95.09
Rate for Payer: Aetna Medicare Advantage	$75.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.81
Rate for Payer: Cigna Commercial	$125.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.08
Rate for Payer: Oxford Commercial	$50.05
Rate for Payer: Qualcare PPO/HMO/WC	$37.54
Rate for Payer: UnitedHealthcare Commercial	$50.05
Rate for Payer: UnitedHealthcare Community & State	$6.03
Rate for Payer: Wellpoint Medicaid Managed Care	$6.63

CITALOPRAM 20 MG TAB

Facility

$17.15

Service Code	NDC 65162005350
Hospital Charge Code	60628873
Hospital Revenue Code	250
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$8.57
Rate for Payer: Aetna Commercial	$6.52
Rate for Payer: Aetna Medicare Advantage	$5.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.37
Rate for Payer: Cigna Commercial	$8.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.14
Rate for Payer: Oxford Commercial	$3.43
Rate for Payer: Qualcare PPO/HMO/WC	$2.57
Rate for Payer: UnitedHealthcare Commercial	$3.43
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.45

CITALOPRAM 20 MG TAB

Facility

$17.15

Service Code	NDC 65162005350
Hospital Charge Code	60628873
Hospital Revenue Code	250
Min. Negotiated Rate	$2.57
Max. Negotiated Rate	$2.57
Rate for Payer: Qualcare PPO/HMO/WC	$2.57

CITALOPRAM (CELEXA)10MG TAB

Facility

$16.42

Service Code	NDC 378623101
Hospital Charge Code	60630129
Hospital Revenue Code	250
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$8.21
Rate for Payer: Aetna Commercial	$6.24
Rate for Payer: Aetna Medicare Advantage	$4.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.19
Rate for Payer: Cigna Commercial	$8.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.93
Rate for Payer: Oxford Commercial	$3.28
Rate for Payer: Qualcare PPO/HMO/WC	$2.46
Rate for Payer: UnitedHealthcare Commercial	$3.28
Rate for Payer: UnitedHealthcare Community & State	$0.40
Rate for Payer: Wellpoint Medicaid Managed Care	$0.44

CITALOPRAM (CELEXA)10MG TAB

Facility

$16.42

Service Code	NDC 378623101
Hospital Charge Code	60630129
Hospital Revenue Code	250
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$2.46
Rate for Payer: Qualcare PPO/HMO/WC	$2.46

CITRACAL D TAB

Facility

$4.00

Service Code	NDC 904546061
Hospital Charge Code	6063943080
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

CITRACAL D TAB

Facility

$4.00

Service Code	NDC 904546061
Hospital Charge Code	6063943080
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

CITRATE

Facility

$390.00

Service Code	HCPCS 82507
Hospital Charge Code	39990241C
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CITRATE

Facility

$390.00

Service Code	HCPCS 82507
Hospital Charge Code	39990241C
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$75.62
Rate for Payer: Aetna Medicare Advantage	$90.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.35
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$27.80
Rate for Payer: Clover Medicare Advantage	$26.41
Rate for Payer: EmblemHealth Commercial	$83.40
Rate for Payer: Humana Medicare Advantage	$28.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27.80
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	$22.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.80
Rate for Payer: Wellcare Medicare Advantage	$27.80
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

CITRATE,24HR URINE

Facility

$390.00

Service Code	HCPCS 82507
Hospital Charge Code	39900062
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CITRATE,24HR URINE

Facility

$390.00

Service Code	HCPCS 82507
Hospital Charge Code	39900062
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$75.62
Rate for Payer: Aetna Medicare Advantage	$90.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.35
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$27.80
Rate for Payer: Clover Medicare Advantage	$26.41
Rate for Payer: EmblemHealth Commercial	$83.40
Rate for Payer: Humana Medicare Advantage	$28.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27.80
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	$22.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.80
Rate for Payer: Wellcare Medicare Advantage	$27.80
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

CITRATE DEXT SOL FORM A 500ML

Facility

$82.60

Hospital Charge Code	6010268
Hospital Revenue Code	250
Min. Negotiated Rate	$12.39
Max. Negotiated Rate	$12.39
Rate for Payer: Qualcare PPO/HMO/WC	$12.39

CITRATE DEXT SOL FORM A 500ML

Facility

$82.60

Hospital Charge Code	6010268
Hospital Revenue Code	250
Min. Negotiated Rate	$1.99
Max. Negotiated Rate	$41.30
Rate for Payer: Aetna Commercial	$31.39
Rate for Payer: Aetna Medicare Advantage	$24.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.06
Rate for Payer: Cigna Commercial	$41.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.78
Rate for Payer: Oxford Commercial	$16.52
Rate for Payer: Qualcare PPO/HMO/WC	$12.39
Rate for Payer: UnitedHealthcare Commercial	$16.52
Rate for Payer: UnitedHealthcare Community & State	$1.99
Rate for Payer: Wellpoint Medicaid Managed Care	$2.19

CITRATE DEXT SOL FORM B 500ML

Facility

$82.60

Hospital Charge Code	6010250
Hospital Revenue Code	250
Min. Negotiated Rate	$1.99
Max. Negotiated Rate	$41.30
Rate for Payer: Aetna Commercial	$31.39
Rate for Payer: Aetna Medicare Advantage	$24.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.06
Rate for Payer: Cigna Commercial	$41.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.78
Rate for Payer: Oxford Commercial	$16.52
Rate for Payer: Qualcare PPO/HMO/WC	$12.39
Rate for Payer: UnitedHealthcare Commercial	$16.52
Rate for Payer: UnitedHealthcare Community & State	$1.99
Rate for Payer: Wellpoint Medicaid Managed Care	$2.19

CITRATE DEXT SOL FORM B 500ML

Facility

$82.60

Hospital Charge Code	6010250
Hospital Revenue Code	250
Min. Negotiated Rate	$12.39
Max. Negotiated Rate	$12.39
Rate for Payer: Qualcare PPO/HMO/WC	$12.39

CITRATE OF MAGNESIA/296ML

Facility

$3.00

Hospital Charge Code	60632706
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

CITRATE OF MAGNESIA/296ML

Facility

$3.00

Hospital Charge Code	60632706
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

CITRATE (URINE)

Facility

$338.45

Service Code	HCPCS 82507
Hospital Charge Code	3009172
Hospital Revenue Code	301
Min. Negotiated Rate	$8.97
Max. Negotiated Rate	$169.22
Rate for Payer: Aetna Commercial	$75.62
Rate for Payer: Aetna Medicare Advantage	$90.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.35
Rate for Payer: Cigna Commercial	$169.22
Rate for Payer: Cigna Medicare Advantage	$27.80
Rate for Payer: Clover Medicare Advantage	$26.41
Rate for Payer: EmblemHealth Commercial	$83.40
Rate for Payer: Humana Medicare Advantage	$28.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.53
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.77
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$22.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.80
Rate for Payer: Wellcare Medicare Advantage	$27.80
Rate for Payer: Wellpoint Medicaid Managed Care	$8.97

CITRATE (URINE)

Facility

$338.45

Service Code	HCPCS 82507
Hospital Charge Code	3009172
Hospital Revenue Code	301
Min. Negotiated Rate	$50.77
Max. Negotiated Rate	$50.77
Rate for Payer: Qualcare PPO/HMO/WC	$50.77

CITRATE URINE

Facility

$431.00

Service Code	HCPCS 82507
Hospital Charge Code	38473125
Hospital Revenue Code	301
Min. Negotiated Rate	$64.65
Max. Negotiated Rate	$64.65
Rate for Payer: Qualcare PPO/HMO/WC	$64.65

CITRATE URINE

Facility

$431.00

Service Code	HCPCS 82507
Hospital Charge Code	38473125
Hospital Revenue Code	301
Min. Negotiated Rate	$11.42
Max. Negotiated Rate	$215.50
Rate for Payer: Aetna Commercial	$75.62
Rate for Payer: Aetna Medicare Advantage	$90.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.35
Rate for Payer: Cigna Commercial	$215.50
Rate for Payer: Cigna Medicare Advantage	$27.80
Rate for Payer: Clover Medicare Advantage	$26.41
Rate for Payer: EmblemHealth Commercial	$83.40
Rate for Payer: Humana Medicare Advantage	$28.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$64.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$22.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.80
Rate for Payer: Wellcare Medicare Advantage	$27.80
Rate for Payer: Wellpoint Medicaid Managed Care	$11.42

Know your out-of-pocket cost for care.

All Charges