Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CLINDAMYCIN HCL 150MG CAPSULE

Facility

$4.89

Service Code	NDC 904595961
Hospital Charge Code	60632362
Hospital Revenue Code	250
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$0.73
Rate for Payer: Qualcare PPO/HMO/WC	$0.73

CLINDAMYCIN HCL 150MG CAPSULE

Facility

$4.89

Service Code	NDC 904595961
Hospital Charge Code	60632362
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.44
Rate for Payer: Aetna Commercial	$1.86
Rate for Payer: Aetna Medicare Advantage	$1.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.25
Rate for Payer: Cigna Commercial	$2.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.47
Rate for Payer: Oxford Commercial	$0.98
Rate for Payer: Qualcare PPO/HMO/WC	$0.73
Rate for Payer: UnitedHealthcare Commercial	$0.98
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

CLINDAMYCIN INJ OPH 150MG/ML

Facility

$53.80

Hospital Charge Code	6001234
Hospital Revenue Code	250
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$8.07

CLINDAMYCIN INJ OPH 150MG/ML

Facility

$53.80

Hospital Charge Code	6001234
Hospital Revenue Code	250
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$26.90
Rate for Payer: Aetna Commercial	$20.44
Rate for Payer: Aetna Medicare Advantage	$16.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.72
Rate for Payer: Cigna Commercial	$26.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.14
Rate for Payer: Oxford Commercial	$10.76
Rate for Payer: Qualcare PPO/HMO/WC	$8.07
Rate for Payer: UnitedHealthcare Commercial	$10.76
Rate for Payer: UnitedHealthcare Community & State	$1.30
Rate for Payer: Wellpoint Medicaid Managed Care	$1.43

CLINDAMYCIN IVPB 300MG/D5W50ML

Facility

$31.40

Hospital Charge Code	60627324
Hospital Revenue Code	250
Min. Negotiated Rate	$0.76
Max. Negotiated Rate	$15.70
Rate for Payer: Aetna Commercial	$11.93
Rate for Payer: Aetna Medicare Advantage	$9.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.01
Rate for Payer: Cigna Commercial	$15.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.42
Rate for Payer: Oxford Commercial	$6.28
Rate for Payer: Qualcare PPO/HMO/WC	$4.71
Rate for Payer: UnitedHealthcare Commercial	$6.28
Rate for Payer: UnitedHealthcare Community & State	$0.76
Rate for Payer: Wellpoint Medicaid Managed Care	$0.83

CLINDAMYCIN IVPB 300MG/D5W50ML

Facility

$31.40

Hospital Charge Code	60627324
Hospital Revenue Code	250
Min. Negotiated Rate	$4.71
Max. Negotiated Rate	$4.71
Rate for Payer: Qualcare PPO/HMO/WC	$4.71

CLINDAMYCIN IVPB 900MG/D5W100M

Facility

$70.40

Hospital Charge Code	60627326
Hospital Revenue Code	250
Min. Negotiated Rate	$1.70
Max. Negotiated Rate	$35.20
Rate for Payer: Aetna Commercial	$26.75
Rate for Payer: Aetna Medicare Advantage	$21.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.95
Rate for Payer: Cigna Commercial	$35.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.12
Rate for Payer: Oxford Commercial	$14.08
Rate for Payer: Qualcare PPO/HMO/WC	$10.56
Rate for Payer: UnitedHealthcare Commercial	$14.08
Rate for Payer: UnitedHealthcare Community & State	$1.70
Rate for Payer: Wellpoint Medicaid Managed Care	$1.87

CLINDAMYCIN IVPB 900MG/D5W100M

Facility

$70.40

Hospital Charge Code	60627326
Hospital Revenue Code	250
Min. Negotiated Rate	$10.56
Max. Negotiated Rate	$10.56
Rate for Payer: Qualcare PPO/HMO/WC	$10.56

CLINDAMYCIN IVPB 900MG/NS100ML

Facility

$21.80

Hospital Charge Code	60627325
Hospital Revenue Code	250
Min. Negotiated Rate	$0.53
Max. Negotiated Rate	$10.90
Rate for Payer: Aetna Commercial	$8.28
Rate for Payer: Aetna Medicare Advantage	$6.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.56
Rate for Payer: Cigna Commercial	$10.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.54
Rate for Payer: Oxford Commercial	$4.36
Rate for Payer: Qualcare PPO/HMO/WC	$3.27
Rate for Payer: UnitedHealthcare Commercial	$4.36
Rate for Payer: UnitedHealthcare Community & State	$0.53
Rate for Payer: Wellpoint Medicaid Managed Care	$0.58

CLINDAMYCIN IVPB 900MG/NS100ML

Facility

$21.80

Hospital Charge Code	60627325
Hospital Revenue Code	250
Min. Negotiated Rate	$3.27
Max. Negotiated Rate	$3.27
Rate for Payer: Qualcare PPO/HMO/WC	$3.27

CLINDAMYCIN LEVEL

Facility

$376.00

Service Code	HCPCS 80299
Hospital Charge Code	38473067
Hospital Revenue Code	301
Min. Negotiated Rate	$56.40
Max. Negotiated Rate	$56.40
Rate for Payer: Qualcare PPO/HMO/WC	$56.40

CLINDAMYCIN LEVEL

Facility

$376.00

Service Code	HCPCS 80299
Hospital Charge Code	38473067
Hospital Revenue Code	301
Min. Negotiated Rate	$9.96
Max. Negotiated Rate	$188.00
Rate for Payer: Aetna Commercial	$50.70
Rate for Payer: Aetna Medicare Advantage	$60.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.28
Rate for Payer: Cigna Commercial	$188.00
Rate for Payer: Cigna Medicare Advantage	$18.64
Rate for Payer: Clover Medicare Advantage	$17.71
Rate for Payer: EmblemHealth Commercial	$55.92
Rate for Payer: Humana Medicare Advantage	$19.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Medicare Advantage	$18.64
Rate for Payer: Wellpoint Medicaid Managed Care	$9.96

CLINDAMYCIN PHOS ADDV/300

Facility

$18.00

Hospital Charge Code	60634316
Hospital Revenue Code	250
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$9.00
Rate for Payer: Aetna Commercial	$6.84
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.40
Rate for Payer: Oxford Commercial	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$3.60
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

CLINDAMYCIN PHOS ADDV/300

Facility

$18.00

Hospital Charge Code	60634316
Hospital Revenue Code	250
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

CLINDAMYCIN PHOS ADDV/600

Facility

$24.00

Hospital Charge Code	60634317
Hospital Revenue Code	250
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.60

CLINDAMYCIN PHOS ADDV/600

Facility

$24.00

Hospital Charge Code	60634317
Hospital Revenue Code	250
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$12.00
Rate for Payer: Aetna Commercial	$9.12
Rate for Payer: Aetna Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.12
Rate for Payer: Cigna Commercial	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.20
Rate for Payer: Oxford Commercial	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$3.60
Rate for Payer: UnitedHealthcare Commercial	$4.80
Rate for Payer: UnitedHealthcare Community & State	$0.58
Rate for Payer: Wellpoint Medicaid Managed Care	$0.64

CLINDAMYCIN PHOS ADDV/900

Facility

$28.00

Hospital Charge Code	60634318
Hospital Revenue Code	250
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

CLINDAMYCIN PHOS ADDV/900

Facility

$28.00

Hospital Charge Code	60634318
Hospital Revenue Code	250
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$14.00
Rate for Payer: Aetna Commercial	$10.64
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.40
Rate for Payer: Oxford Commercial	$5.60
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$5.60
Rate for Payer: UnitedHealthcare Community & State	$0.67
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

CLINDAMYCIN PHOSPHATE/150

Facility

$28.00

Hospital Charge Code	60632709
Hospital Revenue Code	250
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$14.00
Rate for Payer: Aetna Commercial	$10.64
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.40
Rate for Payer: Oxford Commercial	$5.60
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$5.60
Rate for Payer: UnitedHealthcare Community & State	$0.67
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

CLINDAMYCIN PHOSPHATE/150

Facility

$28.00

Hospital Charge Code	60632709
Hospital Revenue Code	250
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

CLINDAMYCIN PHOSPHATE 2 % CRE

Facility

$900.35

Service Code	NDC 9344801
Hospital Charge Code	6011068
Hospital Revenue Code	250
Min. Negotiated Rate	$135.05
Max. Negotiated Rate	$135.05
Rate for Payer: Qualcare PPO/HMO/WC	$135.05

CLINDAMYCIN PHOSPHATE 2 % CRE

Facility

$900.35

Service Code	NDC 9344801
Hospital Charge Code	6011068
Hospital Revenue Code	250
Min. Negotiated Rate	$21.70
Max. Negotiated Rate	$450.18
Rate for Payer: Aetna Commercial	$342.13
Rate for Payer: Aetna Medicare Advantage	$270.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.59
Rate for Payer: Cigna Commercial	$450.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$270.11
Rate for Payer: Oxford Commercial	$180.07
Rate for Payer: Qualcare PPO/HMO/WC	$135.05
Rate for Payer: UnitedHealthcare Commercial	$180.07
Rate for Payer: UnitedHealthcare Community & State	$21.70
Rate for Payer: Wellpoint Medicaid Managed Care	$23.86

CLINDAMYCIN VAG CRM 2% 40G

Facility

$309.15

Hospital Charge Code	6010284
Hospital Revenue Code	252
Min. Negotiated Rate	$46.37
Max. Negotiated Rate	$46.37
Rate for Payer: Qualcare PPO/HMO/WC	$46.37

CLINDAMYCIN VAG CRM 2% 40G

Facility

$309.15

Hospital Charge Code	6010284
Hospital Revenue Code	252
Min. Negotiated Rate	$7.45
Max. Negotiated Rate	$154.57
Rate for Payer: Aetna Commercial	$117.48
Rate for Payer: Aetna Medicare Advantage	$92.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.83
Rate for Payer: Cigna Commercial	$154.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.75
Rate for Payer: Oxford Commercial	$61.83
Rate for Payer: Qualcare PPO/HMO/WC	$46.37
Rate for Payer: UnitedHealthcare Commercial	$61.83
Rate for Payer: UnitedHealthcare Community & State	$7.45
Rate for Payer: Wellpoint Medicaid Managed Care	$8.19

CLINICAL CHEMISTRY TEST

Facility

$760.50

Service Code	HCPCS 84999
Hospital Charge Code	401084999
Hospital Revenue Code	301
Min. Negotiated Rate	$114.08
Max. Negotiated Rate	$114.08
Rate for Payer: Qualcare PPO/HMO/WC	$114.08

Know your out-of-pocket cost for care.

All Charges