Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ADRENALIN CHLOR 1:1000 NA

Facility

$60.00

Hospital Charge Code	60632402
Hospital Revenue Code	250
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$30.00
Rate for Payer: Aetna Commercial	$22.80
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.00
Rate for Payer: Oxford Commercial	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Commercial	$12.00
Rate for Payer: UnitedHealthcare Community & State	$1.45
Rate for Payer: Wellpoint Medicaid Managed Care	$1.59

ADRENALIN CHLOR 1:1000 NA

Facility

$60.00

Hospital Charge Code	60632402
Hospital Revenue Code	250
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

ADRENALIN CHLORIDE

Facility

$74.90

Hospital Charge Code	6008437
Hospital Revenue Code	250
Min. Negotiated Rate	$11.23
Max. Negotiated Rate	$11.23
Rate for Payer: Qualcare PPO/HMO/WC	$11.23

ADRENALIN CHLORIDE

Facility

$74.90

Hospital Charge Code	6008437
Hospital Revenue Code	250
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$37.45
Rate for Payer: Aetna Commercial	$28.46
Rate for Payer: Aetna Medicare Advantage	$22.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.10
Rate for Payer: Cigna Commercial	$37.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.47
Rate for Payer: Oxford Commercial	$14.98
Rate for Payer: Qualcare PPO/HMO/WC	$11.23
Rate for Payer: UnitedHealthcare Commercial	$14.98
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.98

ADRENALIN CHLORIDE 1:1000

Facility

$60.00

Hospital Charge Code	60632403
Hospital Revenue Code	250
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$30.00
Rate for Payer: Aetna Commercial	$22.80
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.00
Rate for Payer: Oxford Commercial	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Commercial	$12.00
Rate for Payer: UnitedHealthcare Community & State	$1.45
Rate for Payer: Wellpoint Medicaid Managed Care	$1.59

ADRENALIN CHLORIDE 1:1000

Facility

$60.00

Hospital Charge Code	60632403
Hospital Revenue Code	250
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

ADRENALIN CHLORIDE 1:1000

Facility

$83.00

Hospital Charge Code	60632404
Hospital Revenue Code	250
Min. Negotiated Rate	$12.45
Max. Negotiated Rate	$12.45
Rate for Payer: Qualcare PPO/HMO/WC	$12.45

ADRENALIN CHLORIDE 1:1000

Facility

$83.00

Hospital Charge Code	60632404
Hospital Revenue Code	250
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$41.50
Rate for Payer: Aetna Commercial	$31.54
Rate for Payer: Aetna Medicare Advantage	$24.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.16
Rate for Payer: Cigna Commercial	$41.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.90
Rate for Payer: Oxford Commercial	$16.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.45
Rate for Payer: UnitedHealthcare Commercial	$16.60
Rate for Payer: UnitedHealthcare Community & State	$2.00
Rate for Payer: Wellpoint Medicaid Managed Care	$2.20

ADRENAL PROCEDURES

Facility

$28,185.87

Service Code	APR-DRG 4012
Min. Negotiated Rate	$27,633.21
Max. Negotiated Rate	$28,185.87
Rate for Payer: UnitedHealthcare Community & State	$27,633.21
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$28,185.87
Rate for Payer: Wellpoint Medicaid Managed Care	$27,633.21

ADRENAL PROCEDURES

Facility

$61,178.61

Service Code	APR-DRG 4014
Min. Negotiated Rate	$59,979.03
Max. Negotiated Rate	$61,178.61
Rate for Payer: UnitedHealthcare Community & State	$59,979.03
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$61,178.61
Rate for Payer: Wellpoint Medicaid Managed Care	$59,979.03

ADRENAL PROCEDURES

Facility

$16,286.98

Service Code	APR-DRG 4011
Min. Negotiated Rate	$15,967.63
Max. Negotiated Rate	$16,286.98
Rate for Payer: UnitedHealthcare Community & State	$15,967.63
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$16,286.98
Rate for Payer: Wellpoint Medicaid Managed Care	$15,967.63

ADRENAL PROCEDURES

Facility

$36,978.58

Service Code	APR-DRG 4013
Min. Negotiated Rate	$36,253.51
Max. Negotiated Rate	$36,978.58
Rate for Payer: UnitedHealthcare Community & State	$36,253.51
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$36,978.58
Rate for Payer: Wellpoint Medicaid Managed Care	$36,253.51

ADRENOCORTITROPHIC HORMONE ACT

Facility

$383.00

Service Code	HCPCS 82024
Hospital Charge Code	38472035
Hospital Revenue Code	309
Min. Negotiated Rate	$57.45
Max. Negotiated Rate	$57.45
Rate for Payer: Qualcare PPO/HMO/WC	$57.45

ADRENOCORTITROPHIC HORMONE ACT

Facility

$383.00

Service Code	HCPCS 82024
Hospital Charge Code	38472035
Hospital Revenue Code	309
Min. Negotiated Rate	$10.15
Max. Negotiated Rate	$191.50
Rate for Payer: Aetna Commercial	$105.05
Rate for Payer: Aetna Medicare Advantage	$125.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$139.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$139.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$38.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$139.41
Rate for Payer: Cigna Commercial	$191.50
Rate for Payer: Cigna Medicare Advantage	$38.62
Rate for Payer: Clover Medicare Advantage	$36.69
Rate for Payer: EmblemHealth Commercial	$115.86
Rate for Payer: Humana Medicare Advantage	$39.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$38.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.45
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$30.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$38.62
Rate for Payer: Wellcare Medicare Advantage	$38.62
Rate for Payer: Wellpoint Medicaid Managed Care	$10.15

ADRIAMYCIN PFS/10MG

Facility

$214.00

Hospital Charge Code	60634323
Hospital Revenue Code	250
Min. Negotiated Rate	$32.10
Max. Negotiated Rate	$32.10
Rate for Payer: Qualcare PPO/HMO/WC	$32.10

ADRIAMYCIN PFS/10MG

Facility

$214.00

Hospital Charge Code	60634323
Hospital Revenue Code	250
Min. Negotiated Rate	$5.16
Max. Negotiated Rate	$107.00
Rate for Payer: Aetna Commercial	$81.32
Rate for Payer: Aetna Medicare Advantage	$64.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.57
Rate for Payer: Cigna Commercial	$107.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.20
Rate for Payer: Oxford Commercial	$42.80
Rate for Payer: Qualcare PPO/HMO/WC	$32.10
Rate for Payer: UnitedHealthcare Commercial	$42.80
Rate for Payer: UnitedHealthcare Community & State	$5.16
Rate for Payer: Wellpoint Medicaid Managed Care	$5.67

ADRIAMYCIN PFS/50MG

Facility

$1,430.00

Hospital Charge Code	60634324
Hospital Revenue Code	250
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$214.50
Rate for Payer: Qualcare PPO/HMO/WC	$214.50

ADRIAMYCIN PFS/50MG

Facility

$1,430.00

Hospital Charge Code	60634324
Hospital Revenue Code	250
Min. Negotiated Rate	$34.46
Max. Negotiated Rate	$715.00
Rate for Payer: Aetna Commercial	$543.40
Rate for Payer: Aetna Medicare Advantage	$429.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$364.65
Rate for Payer: Cigna Commercial	$715.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$429.00
Rate for Payer: Oxford Commercial	$286.00
Rate for Payer: Qualcare PPO/HMO/WC	$214.50
Rate for Payer: UnitedHealthcare Commercial	$286.00
Rate for Payer: UnitedHealthcare Community & State	$34.46
Rate for Payer: Wellpoint Medicaid Managed Care	$37.90

ADULT PULSE OXIMETER SENSOR

Facility

$28.75

Hospital Charge Code	270652476
Hospital Revenue Code	270
Min. Negotiated Rate	$4.31
Max. Negotiated Rate	$4.31
Rate for Payer: Qualcare PPO/HMO/WC	$4.31

ADULT PULSE OXIMETER SENSOR

Facility

$28.75

Hospital Charge Code	270652476
Hospital Revenue Code	270
Min. Negotiated Rate	$0.69
Max. Negotiated Rate	$14.38
Rate for Payer: Aetna Commercial	$10.93
Rate for Payer: Aetna Medicare Advantage	$8.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.33
Rate for Payer: Cigna Commercial	$14.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.62
Rate for Payer: Oxford Commercial	$5.75
Rate for Payer: Qualcare PPO/HMO/WC	$4.31
Rate for Payer: UnitedHealthcare Commercial	$5.75
Rate for Payer: UnitedHealthcare Community & State	$0.69
Rate for Payer: Wellpoint Medicaid Managed Care	$0.76

ADVAIR 115/21 INH

Facility

$1,291.96

Service Code	NDC 173071622
Hospital Charge Code	6063943050
Hospital Revenue Code	250
Min. Negotiated Rate	$193.79
Max. Negotiated Rate	$193.79
Rate for Payer: Qualcare PPO/HMO/WC	$193.79

ADVAIR 115/21 INH

Facility

$1,291.96

Service Code	NDC 173071622
Hospital Charge Code	6063943050
Hospital Revenue Code	250
Min. Negotiated Rate	$31.14
Max. Negotiated Rate	$645.98
Rate for Payer: Aetna Commercial	$490.94
Rate for Payer: Aetna Medicare Advantage	$387.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$329.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$329.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$329.45
Rate for Payer: Cigna Commercial	$645.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.59
Rate for Payer: Oxford Commercial	$258.39
Rate for Payer: Qualcare PPO/HMO/WC	$193.79
Rate for Payer: UnitedHealthcare Commercial	$258.39
Rate for Payer: UnitedHealthcare Community & State	$31.14
Rate for Payer: Wellpoint Medicaid Managed Care	$34.24

ADVAIR 230/21 INH

Facility

$1,916.07

Service Code	NDC 173071722
Hospital Charge Code	6063943051
Hospital Revenue Code	250
Min. Negotiated Rate	$287.41
Max. Negotiated Rate	$287.41
Rate for Payer: Qualcare PPO/HMO/WC	$287.41

ADVAIR 230/21 INH

Facility

$1,916.07

Service Code	NDC 173071722
Hospital Charge Code	6063943051
Hospital Revenue Code	250
Min. Negotiated Rate	$46.18
Max. Negotiated Rate	$958.03
Rate for Payer: Aetna Commercial	$728.11
Rate for Payer: Aetna Medicare Advantage	$574.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$488.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$488.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$488.60
Rate for Payer: Cigna Commercial	$958.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$574.82
Rate for Payer: Oxford Commercial	$383.21
Rate for Payer: Qualcare PPO/HMO/WC	$287.41
Rate for Payer: UnitedHealthcare Commercial	$383.21
Rate for Payer: UnitedHealthcare Community & State	$46.18
Rate for Payer: Wellpoint Medicaid Managed Care	$50.78

ADVAIR 45/21 INH

Facility

$1,291.96

Service Code	NDC 173071522
Hospital Charge Code	6063943052
Hospital Revenue Code	250
Min. Negotiated Rate	$193.79
Max. Negotiated Rate	$193.79
Rate for Payer: Qualcare PPO/HMO/WC	$193.79

Know your out-of-pocket cost for care.

All Charges