Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CLINDAMYCIN 1% TOP SOLN

Facility

$120.75

Hospital Charge Code	60628594
Hospital Revenue Code	250
Min. Negotiated Rate	$2.91
Max. Negotiated Rate	$60.38
Rate for Payer: Aetna Commercial	$45.88
Rate for Payer: Aetna Medicare Advantage	$36.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.79
Rate for Payer: Cigna Commercial	$60.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.23
Rate for Payer: Oxford Commercial	$24.15
Rate for Payer: Qualcare PPO/HMO/WC	$18.11
Rate for Payer: UnitedHealthcare Commercial	$24.15
Rate for Payer: UnitedHealthcare Community & State	$2.91
Rate for Payer: Wellpoint Medicaid Managed Care	$3.20

CLINDAMYCIN 300MG/2ML

Facility

$50.79

Service Code	NDC 9087026
Hospital Charge Code	60632361
Hospital Revenue Code	250
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$25.39
Rate for Payer: Aetna Commercial	$19.30
Rate for Payer: Aetna Medicare Advantage	$15.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.95
Rate for Payer: Cigna Commercial	$25.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.24
Rate for Payer: Oxford Commercial	$10.16
Rate for Payer: Qualcare PPO/HMO/WC	$7.62
Rate for Payer: UnitedHealthcare Commercial	$10.16
Rate for Payer: UnitedHealthcare Community & State	$1.22
Rate for Payer: Wellpoint Medicaid Managed Care	$1.35

CLINDAMYCIN 300MG/2ML

Facility

$50.79

Service Code	NDC 9087026
Hospital Charge Code	60632361
Hospital Revenue Code	250
Min. Negotiated Rate	$7.62
Max. Negotiated Rate	$7.62
Rate for Payer: Qualcare PPO/HMO/WC	$7.62

CLINDAMYCIN 300MG/50ML

Facility

$67.00

Service Code	NDC 338954524
Hospital Charge Code	60627323
Hospital Revenue Code	250
Min. Negotiated Rate	$1.61
Max. Negotiated Rate	$33.50
Rate for Payer: Aetna Commercial	$25.46
Rate for Payer: Aetna Medicare Advantage	$20.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.09
Rate for Payer: Cigna Commercial	$33.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.10
Rate for Payer: Oxford Commercial	$13.40
Rate for Payer: Qualcare PPO/HMO/WC	$10.05
Rate for Payer: UnitedHealthcare Commercial	$13.40
Rate for Payer: UnitedHealthcare Community & State	$1.61
Rate for Payer: Wellpoint Medicaid Managed Care	$1.78

CLINDAMYCIN 300MG/50ML

Facility

$67.00

Service Code	NDC 338954524
Hospital Charge Code	60627323
Hospital Revenue Code	250
Min. Negotiated Rate	$10.05
Max. Negotiated Rate	$10.05
Rate for Payer: Qualcare PPO/HMO/WC	$10.05

CLINDAMYCIN 300MG/50ML D5W

Facility

$65.93

Service Code	NDC 781922009
Hospital Charge Code	606390188
Hospital Revenue Code	250
Min. Negotiated Rate	$9.89
Max. Negotiated Rate	$9.89
Rate for Payer: Qualcare PPO/HMO/WC	$9.89

CLINDAMYCIN 300MG/50ML D5W

Facility

$65.93

Service Code	NDC 781922009
Hospital Charge Code	606390188
Hospital Revenue Code	250
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$32.97
Rate for Payer: Aetna Commercial	$25.05
Rate for Payer: Aetna Medicare Advantage	$19.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.81
Rate for Payer: Cigna Commercial	$32.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.78
Rate for Payer: Oxford Commercial	$13.19
Rate for Payer: Qualcare PPO/HMO/WC	$9.89
Rate for Payer: UnitedHealthcare Commercial	$13.19
Rate for Payer: UnitedHealthcare Community & State	$1.59
Rate for Payer: Wellpoint Medicaid Managed Care	$1.75

CLINDAMYCIN 300MG PREMIX

Facility

$39.40

Hospital Charge Code	60635747
Hospital Revenue Code	250
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$19.70
Rate for Payer: Aetna Commercial	$14.97
Rate for Payer: Aetna Medicare Advantage	$11.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.05
Rate for Payer: Cigna Commercial	$19.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.82
Rate for Payer: Oxford Commercial	$7.88
Rate for Payer: Qualcare PPO/HMO/WC	$5.91
Rate for Payer: UnitedHealthcare Commercial	$7.88
Rate for Payer: UnitedHealthcare Community & State	$0.95
Rate for Payer: Wellpoint Medicaid Managed Care	$1.04

CLINDAMYCIN 300MG PREMIX

Facility

$39.40

Hospital Charge Code	60635747
Hospital Revenue Code	250
Min. Negotiated Rate	$5.91
Max. Negotiated Rate	$5.91
Rate for Payer: Qualcare PPO/HMO/WC	$5.91

CLINDAMYCIN 600MG/50ML

Facility

$50.59

Service Code	NDC 781328991
Hospital Charge Code	6006324
Hospital Revenue Code	250
Min. Negotiated Rate	$7.59
Max. Negotiated Rate	$7.59
Rate for Payer: Qualcare PPO/HMO/WC	$7.59

CLINDAMYCIN 600MG/50ML

Facility

$50.59

Service Code	NDC 781328991
Hospital Charge Code	6006324
Hospital Revenue Code	250
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$25.30
Rate for Payer: Aetna Commercial	$19.22
Rate for Payer: Aetna Medicare Advantage	$15.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.90
Rate for Payer: Cigna Commercial	$25.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.18
Rate for Payer: Oxford Commercial	$10.12
Rate for Payer: Qualcare PPO/HMO/WC	$7.59
Rate for Payer: UnitedHealthcare Commercial	$10.12
Rate for Payer: UnitedHealthcare Community & State	$1.22
Rate for Payer: Wellpoint Medicaid Managed Care	$1.34

CLINDAMYCIN 75 MG/5 ML INJ

Facility

$2.45

Hospital Charge Code	60627322
Hospital Revenue Code	252
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.37
Rate for Payer: Qualcare PPO/HMO/WC	$0.37

CLINDAMYCIN 75 MG/5 ML INJ

Facility

$2.45

Hospital Charge Code	60627322
Hospital Revenue Code	252
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.23
Rate for Payer: Aetna Commercial	$0.93
Rate for Payer: Aetna Medicare Advantage	$0.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.62
Rate for Payer: Cigna Commercial	$1.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.74
Rate for Payer: Oxford Commercial	$0.49
Rate for Payer: Qualcare PPO/HMO/WC	$0.37
Rate for Payer: UnitedHealthcare Commercial	$0.49
Rate for Payer: UnitedHealthcare Community & State	$0.06
Rate for Payer: Wellpoint Medicaid Managed Care	$0.06

CLINDAMYCIN 75 MG/5 ML SUSP

Facility

$9.85

Service Code	NDC 574012901
Hospital Charge Code	6063943326
Hospital Revenue Code	250
Min. Negotiated Rate	$1.48
Max. Negotiated Rate	$1.48
Rate for Payer: Qualcare PPO/HMO/WC	$1.48

CLINDAMYCIN 75 MG/5 ML SUSP

Facility

$9.85

Service Code	NDC 574012901
Hospital Charge Code	6063943326
Hospital Revenue Code	250
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$4.92
Rate for Payer: Aetna Commercial	$3.74
Rate for Payer: Aetna Medicare Advantage	$2.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.51
Rate for Payer: Cigna Commercial	$4.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.96
Rate for Payer: Oxford Commercial	$1.97
Rate for Payer: Qualcare PPO/HMO/WC	$1.48
Rate for Payer: UnitedHealthcare Commercial	$1.97
Rate for Payer: UnitedHealthcare Community & State	$0.24
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

CLINDAMYCIN 900MG/D5W 50ML

Facility

$121.40

Service Code	NDC 781922209
Hospital Charge Code	606390397
Hospital Revenue Code	250
Min. Negotiated Rate	$18.21
Max. Negotiated Rate	$18.21
Rate for Payer: Qualcare PPO/HMO/WC	$18.21

CLINDAMYCIN 900MG/D5W 50ML

Facility

$121.40

Service Code	NDC 781922209
Hospital Charge Code	606390397
Hospital Revenue Code	250
Min. Negotiated Rate	$2.93
Max. Negotiated Rate	$60.70
Rate for Payer: Aetna Commercial	$46.13
Rate for Payer: Aetna Medicare Advantage	$36.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.96
Rate for Payer: Cigna Commercial	$60.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.42
Rate for Payer: Oxford Commercial	$24.28
Rate for Payer: Qualcare PPO/HMO/WC	$18.21
Rate for Payer: UnitedHealthcare Commercial	$24.28
Rate for Payer: UnitedHealthcare Community & State	$2.93
Rate for Payer: Wellpoint Medicaid Managed Care	$3.22

CLINDAMYCIN 90 MG/NS 50 ML

Facility

$104.92

Service Code	NDC 338955350
Hospital Charge Code	606390277
Hospital Revenue Code	250
Min. Negotiated Rate	$15.74
Max. Negotiated Rate	$15.74
Rate for Payer: Qualcare PPO/HMO/WC	$15.74

CLINDAMYCIN 90 MG/NS 50 ML

Facility

$104.92

Service Code	NDC 338955350
Hospital Charge Code	606390277
Hospital Revenue Code	250
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$52.46
Rate for Payer: Aetna Commercial	$39.87
Rate for Payer: Aetna Medicare Advantage	$31.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.75
Rate for Payer: Cigna Commercial	$52.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.48
Rate for Payer: Oxford Commercial	$20.98
Rate for Payer: Qualcare PPO/HMO/WC	$15.74
Rate for Payer: UnitedHealthcare Commercial	$20.98
Rate for Payer: UnitedHealthcare Community & State	$2.53
Rate for Payer: Wellpoint Medicaid Managed Care	$2.78

CLINDAMYCIN ADDV/300MG

Facility

$61.00

Hospital Charge Code	60634455
Hospital Revenue Code	250
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$30.50
Rate for Payer: Aetna Commercial	$23.18
Rate for Payer: Aetna Medicare Advantage	$18.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.55
Rate for Payer: Cigna Commercial	$30.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.30
Rate for Payer: Oxford Commercial	$12.20
Rate for Payer: Qualcare PPO/HMO/WC	$9.15
Rate for Payer: UnitedHealthcare Commercial	$12.20
Rate for Payer: UnitedHealthcare Community & State	$1.47
Rate for Payer: Wellpoint Medicaid Managed Care	$1.62

CLINDAMYCIN ADDV/300MG

Facility

$61.00

Hospital Charge Code	60634455
Hospital Revenue Code	250
Min. Negotiated Rate	$9.15
Max. Negotiated Rate	$9.15
Rate for Payer: Qualcare PPO/HMO/WC	$9.15

CLINDAMYCIN ADDV/600MG

Facility

$65.00

Hospital Charge Code	60634456
Hospital Revenue Code	250
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$9.75
Rate for Payer: Qualcare PPO/HMO/WC	$9.75

CLINDAMYCIN ADDV/600MG

Facility

$65.00

Hospital Charge Code	60634456
Hospital Revenue Code	250
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$32.50
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) 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	$13.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.75
Rate for Payer: UnitedHealthcare Commercial	$13.00
Rate for Payer: UnitedHealthcare Community & State	$1.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1.72

CLINDAMYCIN ADDV/900MG

Facility

$122.00

Hospital Charge Code	60634457
Hospital Revenue Code	250
Min. Negotiated Rate	$18.30
Max. Negotiated Rate	$18.30
Rate for Payer: Qualcare PPO/HMO/WC	$18.30

CLINDAMYCIN ADDV/900MG

Facility

$122.00

Hospital Charge Code	60634457
Hospital Revenue Code	250
Min. Negotiated Rate	$2.94
Max. Negotiated Rate	$61.00
Rate for Payer: Aetna Commercial	$46.36
Rate for Payer: Aetna Medicare Advantage	$36.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.11
Rate for Payer: Cigna Commercial	$61.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.60
Rate for Payer: Oxford Commercial	$24.40
Rate for Payer: Qualcare PPO/HMO/WC	$18.30
Rate for Payer: UnitedHealthcare Commercial	$24.40
Rate for Payer: UnitedHealthcare Community & State	$2.94
Rate for Payer: Wellpoint Medicaid Managed Care	$3.23

Know your out-of-pocket cost for care.

All Charges