Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CLAMP SYN EXT FIX 4/2.5 395.54

Facility

$1,689.65

Hospital Charge Code	270601815
Hospital Revenue Code	278
Min. Negotiated Rate	$253.45
Max. Negotiated Rate	$408.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$337.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$408.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$371.72
Rate for Payer: Qualcare PPO/HMO/WC	$253.45

CLAMP SYN HOLD 1.25 K 395.125

Facility

$2,376.00

Hospital Charge Code	270622481
Hospital Revenue Code	272
Min. Negotiated Rate	$356.40
Max. Negotiated Rate	$356.40
Rate for Payer: Qualcare PPO/HMO/WC	$356.40

CLAMP SYN HOLD 1.25 K 395.125

Facility

$2,376.00

Hospital Charge Code	270622481
Hospital Revenue Code	272
Min. Negotiated Rate	$57.26
Max. Negotiated Rate	$1,188.00
Rate for Payer: Aetna Commercial	$902.88
Rate for Payer: Aetna Medicare Advantage	$712.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$605.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$605.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$605.88
Rate for Payer: Cigna Commercial	$1,188.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$712.80
Rate for Payer: Oxford Commercial	$475.20
Rate for Payer: Qualcare PPO/HMO/WC	$356.40
Rate for Payer: UnitedHealthcare Commercial	$475.20
Rate for Payer: UnitedHealthcare Community & State	$57.26
Rate for Payer: Wellpoint Medicaid Managed Care	$62.96

CLAMP TRANSVERSE

Facility

$3,021.00

Hospital Charge Code	270656307
Hospital Revenue Code	272
Min. Negotiated Rate	$72.81
Max. Negotiated Rate	$1,510.50
Rate for Payer: Aetna Commercial	$1,147.98
Rate for Payer: Aetna Medicare Advantage	$906.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$770.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$770.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$770.36
Rate for Payer: Cigna Commercial	$1,510.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$906.30
Rate for Payer: Oxford Commercial	$604.20
Rate for Payer: Qualcare PPO/HMO/WC	$453.15
Rate for Payer: UnitedHealthcare Commercial	$604.20
Rate for Payer: UnitedHealthcare Community & State	$72.81
Rate for Payer: Wellpoint Medicaid Managed Care	$80.06

CLAMP TRANSVERSE

Facility

$3,021.00

Hospital Charge Code	270656307
Hospital Revenue Code	272
Min. Negotiated Rate	$453.15
Max. Negotiated Rate	$453.15
Rate for Payer: Qualcare PPO/HMO/WC	$453.15

CLAMP TUBE TO TUBE 390.007

Facility

$880.00

Hospital Charge Code	270648948
Hospital Revenue Code	272
Min. Negotiated Rate	$132.00
Max. Negotiated Rate	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$132.00

CLAMP TUBE TO TUBE 390.007

Facility

$880.00

Hospital Charge Code	270648948
Hospital Revenue Code	272
Min. Negotiated Rate	$21.21
Max. Negotiated Rate	$440.00
Rate for Payer: Aetna Commercial	$334.40
Rate for Payer: Aetna Medicare Advantage	$264.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.40
Rate for Payer: Cigna Commercial	$440.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$264.00
Rate for Payer: Oxford Commercial	$176.00
Rate for Payer: Qualcare PPO/HMO/WC	$132.00
Rate for Payer: UnitedHealthcare Commercial	$176.00
Rate for Payer: UnitedHealthcare Community & State	$21.21
Rate for Payer: Wellpoint Medicaid Managed Care	$23.32

CLAMP UMBILICAL CORD

Facility

$11.25

Hospital Charge Code	270130050
Hospital Revenue Code	272
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

CLAMP UMBILICAL CORD

Facility

$11.25

Hospital Charge Code	270130050
Hospital Revenue Code	272
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$4.28
Rate for Payer: Aetna Medicare Advantage	$3.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.87
Rate for Payer: Cigna Commercial	$5.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.38
Rate for Payer: Oxford Commercial	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.69
Rate for Payer: UnitedHealthcare Commercial	$2.25
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

CLAMP VACUSTAT ANG 1001-501

Facility

$50.50

Hospital Charge Code	270612954
Hospital Revenue Code	272
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$25.25
Rate for Payer: Aetna Commercial	$19.19
Rate for Payer: Aetna Medicare Advantage	$15.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.88
Rate for Payer: Cigna Commercial	$25.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.15
Rate for Payer: Oxford Commercial	$10.10
Rate for Payer: Qualcare PPO/HMO/WC	$7.58
Rate for Payer: UnitedHealthcare Commercial	$10.10
Rate for Payer: UnitedHealthcare Community & State	$1.22
Rate for Payer: Wellpoint Medicaid Managed Care	$1.34

CLAMP VACUSTAT ANG 1001-501

Facility

$50.50

Hospital Charge Code	270612954
Hospital Revenue Code	272
Min. Negotiated Rate	$7.58
Max. Negotiated Rate	$7.58
Rate for Payer: Qualcare PPO/HMO/WC	$7.58

CLAMP VACUSTAT STR 1001-500

Facility

$34.70

Hospital Charge Code	270612953
Hospital Revenue Code	272
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$17.35
Rate for Payer: Aetna Commercial	$13.19
Rate for Payer: Aetna Medicare Advantage	$10.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.85
Rate for Payer: Cigna Commercial	$17.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.41
Rate for Payer: Oxford Commercial	$6.94
Rate for Payer: Qualcare PPO/HMO/WC	$5.21
Rate for Payer: UnitedHealthcare Commercial	$6.94
Rate for Payer: UnitedHealthcare Community & State	$0.84
Rate for Payer: Wellpoint Medicaid Managed Care	$0.92

CLAMP VACUSTAT STR 1001-500

Facility

$34.70

Hospital Charge Code	270612953
Hospital Revenue Code	272
Min. Negotiated Rate	$5.21
Max. Negotiated Rate	$5.21
Rate for Payer: Qualcare PPO/HMO/WC	$5.21

CLAMP W/CRIMP 1.0x750MM

Facility

$2,145.15

Hospital Charge Code	270674357
Hospital Revenue Code	272
Min. Negotiated Rate	$51.70
Max. Negotiated Rate	$1,072.58
Rate for Payer: Aetna Commercial	$815.16
Rate for Payer: Aetna Medicare Advantage	$643.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$547.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$547.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$547.01
Rate for Payer: Cigna Commercial	$1,072.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$643.54
Rate for Payer: Oxford Commercial	$429.03
Rate for Payer: Qualcare PPO/HMO/WC	$321.77
Rate for Payer: UnitedHealthcare Commercial	$429.03
Rate for Payer: UnitedHealthcare Community & State	$51.70
Rate for Payer: Wellpoint Medicaid Managed Care	$56.85

CLAMP W/CRIMP 1.0x750MM

Facility

$2,145.15

Hospital Charge Code	270674357
Hospital Revenue Code	272
Min. Negotiated Rate	$321.77
Max. Negotiated Rate	$321.77
Rate for Payer: Qualcare PPO/HMO/WC	$321.77

CLAMP W/CRIMP 1.0X750MM

Facility

$2,940.55

Hospital Charge Code	674357
Hospital Revenue Code	278
Min. Negotiated Rate	$70.87
Max. Negotiated Rate	$1,470.28
Rate for Payer: Aetna Commercial	$1,117.41
Rate for Payer: Aetna Medicare Advantage	$882.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$749.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$749.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$588.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$749.84
Rate for Payer: Cigna Commercial	$1,470.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$711.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$646.92
Rate for Payer: Qualcare PPO/HMO/WC	$441.08
Rate for Payer: UnitedHealthcare Community & State	$70.87
Rate for Payer: Wellpoint Medicaid Managed Care	$77.92

CLAMP W/CRIMP 1.0X750MM

Facility

$2,940.55

Hospital Charge Code	674357
Hospital Revenue Code	278
Min. Negotiated Rate	$441.08
Max. Negotiated Rate	$711.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$588.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$711.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$646.92
Rate for Payer: Qualcare PPO/HMO/WC	$441.08

CLARITHROMYCIN 250 MG TAB

Facility

$40.33

Service Code	NDC 781196160
Hospital Charge Code	6016505
Hospital Revenue Code	250
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$20.16
Rate for Payer: Aetna Commercial	$15.33
Rate for Payer: Aetna Medicare Advantage	$12.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.28
Rate for Payer: Cigna Commercial	$20.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.10
Rate for Payer: Oxford Commercial	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$6.05
Rate for Payer: UnitedHealthcare Commercial	$8.07
Rate for Payer: UnitedHealthcare Community & State	$0.97
Rate for Payer: Wellpoint Medicaid Managed Care	$1.07

CLARITHROMYCIN 250 MG TAB

Facility

$40.33

Service Code	NDC 781196160
Hospital Charge Code	6016505
Hospital Revenue Code	250
Min. Negotiated Rate	$6.05
Max. Negotiated Rate	$6.05
Rate for Payer: Qualcare PPO/HMO/WC	$6.05

CLARITHROMYCIN 500 MG TAB UD

Facility

$30.28

Service Code	NDC 68382076214
Hospital Charge Code	6016513
Hospital Revenue Code	250
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$15.14
Rate for Payer: Aetna Commercial	$11.51
Rate for Payer: Aetna Medicare Advantage	$9.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.72
Rate for Payer: Cigna Commercial	$15.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.08
Rate for Payer: Oxford Commercial	$6.06
Rate for Payer: Qualcare PPO/HMO/WC	$4.54
Rate for Payer: UnitedHealthcare Commercial	$6.06
Rate for Payer: UnitedHealthcare Community & State	$0.73
Rate for Payer: Wellpoint Medicaid Managed Care	$0.80

CLARITHROMYCIN 500 MG TAB UD

Facility

$30.28

Service Code	NDC 68382076214
Hospital Charge Code	6016513
Hospital Revenue Code	250
Min. Negotiated Rate	$4.54
Max. Negotiated Rate	$4.54
Rate for Payer: Qualcare PPO/HMO/WC	$4.54

CLARITHROMYCN SSP .125MG/5ML

Facility

$62.10

Hospital Charge Code	6017412
Hospital Revenue Code	252
Min. Negotiated Rate	$9.31
Max. Negotiated Rate	$9.31
Rate for Payer: Qualcare PPO/HMO/WC	$9.31

CLARITHROMYCN SSP .125MG/5ML

Facility

$62.10

Hospital Charge Code	6017412
Hospital Revenue Code	252
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$31.05
Rate for Payer: Aetna Commercial	$23.60
Rate for Payer: Aetna Medicare Advantage	$18.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.84
Rate for Payer: Cigna Commercial	$31.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.63
Rate for Payer: Oxford Commercial	$12.42
Rate for Payer: Qualcare PPO/HMO/WC	$9.31
Rate for Payer: UnitedHealthcare Commercial	$12.42
Rate for Payer: UnitedHealthcare Community & State	$1.50
Rate for Payer: Wellpoint Medicaid Managed Care	$1.65

CLARITHROMYCN SSP .250MG/5ML

Facility

$115.85

Hospital Charge Code	6017404
Hospital Revenue Code	252
Min. Negotiated Rate	$17.38
Max. Negotiated Rate	$17.38
Rate for Payer: Qualcare PPO/HMO/WC	$17.38

CLARITHROMYCN SSP .250MG/5ML

Facility

$115.85

Hospital Charge Code	6017404
Hospital Revenue Code	252
Min. Negotiated Rate	$2.79
Max. Negotiated Rate	$57.92
Rate for Payer: Aetna Commercial	$44.02
Rate for Payer: Aetna Medicare Advantage	$34.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.54
Rate for Payer: Cigna Commercial	$57.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.76
Rate for Payer: Oxford Commercial	$23.17
Rate for Payer: Qualcare PPO/HMO/WC	$17.38
Rate for Payer: UnitedHealthcare Commercial	$23.17
Rate for Payer: UnitedHealthcare Community & State	$2.79
Rate for Payer: Wellpoint Medicaid Managed Care	$3.07

Know your out-of-pocket cost for care.

All Charges