Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

COIL TARGET TETRA 2.0MMX45CM

Facility

$11,113.50

Service Code	HCPCS C1889
Hospital Charge Code	270699562S
Hospital Revenue Code	278
Min. Negotiated Rate	$267.84
Max. Negotiated Rate	$5,556.75
Rate for Payer: Aetna Commercial	$4,223.13
Rate for Payer: Aetna Medicare Advantage	$3,334.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,833.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,833.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,222.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,833.94
Rate for Payer: Cigna Commercial	$5,556.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,689.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,444.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,667.03
Rate for Payer: UnitedHealthcare Community & State	$267.84
Rate for Payer: Wellpoint Medicaid Managed Care	$294.51

COIL TARGET TETRA 2MMX2.5CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270699390S
Hospital Revenue Code	278
Min. Negotiated Rate	$253.44
Max. Negotiated Rate	$5,258.00
Rate for Payer: Aetna Commercial	$3,996.08
Rate for Payer: Aetna Medicare Advantage	$3,154.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,681.58
Rate for Payer: Cigna Commercial	$5,258.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,313.52
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40
Rate for Payer: UnitedHealthcare Community & State	$253.44
Rate for Payer: Wellpoint Medicaid Managed Care	$278.67

COIL TARGET TETRA 2MMX2.5CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270699390S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.40
Max. Negotiated Rate	$2,544.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,313.52
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40

COIL TARGET TETRA 3.5MMX8CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270699418S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.40
Max. Negotiated Rate	$2,544.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,313.52
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40

COIL TARGET TETRA 3.5MMX8CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270699418S
Hospital Revenue Code	278
Min. Negotiated Rate	$253.44
Max. Negotiated Rate	$5,258.00
Rate for Payer: Aetna Commercial	$3,996.08
Rate for Payer: Aetna Medicare Advantage	$3,154.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,681.58
Rate for Payer: Cigna Commercial	$5,258.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,313.52
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40
Rate for Payer: UnitedHealthcare Community & State	$253.44
Rate for Payer: Wellpoint Medicaid Managed Care	$278.67

COIL TARG XL 360 SOFT 10X40CM

Facility

$15,205.50

Service Code	HCPCS C1889
Hospital Charge Code	270698372S
Hospital Revenue Code	278
Min. Negotiated Rate	$366.45
Max. Negotiated Rate	$7,602.75
Rate for Payer: Aetna Commercial	$5,778.09
Rate for Payer: Aetna Medicare Advantage	$4,561.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,877.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,877.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,041.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,877.40
Rate for Payer: Cigna Commercial	$7,602.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,679.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,345.21
Rate for Payer: Qualcare PPO/HMO/WC	$2,280.82
Rate for Payer: UnitedHealthcare Community & State	$366.45
Rate for Payer: Wellpoint Medicaid Managed Care	$402.95

COIL TARG XL 360 SOFT 10X40CM

Facility

$15,205.50

Service Code	HCPCS C1889
Hospital Charge Code	270698372S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,280.82
Max. Negotiated Rate	$3,679.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,041.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,679.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,345.21
Rate for Payer: Qualcare PPO/HMO/WC	$2,280.82

COIL TARG XL 360 SOFT 12X45CM

Facility

$15,205.50

Service Code	HCPCS C1889
Hospital Charge Code	270698373S
Hospital Revenue Code	278
Min. Negotiated Rate	$366.45
Max. Negotiated Rate	$7,602.75
Rate for Payer: Aetna Commercial	$5,778.09
Rate for Payer: Aetna Medicare Advantage	$4,561.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,877.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,877.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,041.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,877.40
Rate for Payer: Cigna Commercial	$7,602.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,679.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,345.21
Rate for Payer: Qualcare PPO/HMO/WC	$2,280.82
Rate for Payer: UnitedHealthcare Community & State	$366.45
Rate for Payer: Wellpoint Medicaid Managed Care	$402.95

COIL TARG XL 360 SOFT 12X45CM

Facility

$15,205.50

Service Code	HCPCS C1889
Hospital Charge Code	270698373S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,280.82
Max. Negotiated Rate	$3,679.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,041.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,679.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,345.21
Rate for Payer: Qualcare PPO/HMO/WC	$2,280.82

COIL TARG XL 360 SOFT 9X30CM

Facility

$15,205.50

Service Code	HCPCS C1889
Hospital Charge Code	270698374S
Hospital Revenue Code	278
Min. Negotiated Rate	$366.45
Max. Negotiated Rate	$7,602.75
Rate for Payer: Aetna Commercial	$5,778.09
Rate for Payer: Aetna Medicare Advantage	$4,561.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,877.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,877.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,041.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,877.40
Rate for Payer: Cigna Commercial	$7,602.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,679.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,345.21
Rate for Payer: Qualcare PPO/HMO/WC	$2,280.82
Rate for Payer: UnitedHealthcare Community & State	$366.45
Rate for Payer: Wellpoint Medicaid Managed Care	$402.95

COIL TARG XL 360 SOFT 9X30CM

Facility

$15,205.50

Service Code	HCPCS C1889
Hospital Charge Code	270698374S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,280.82
Max. Negotiated Rate	$3,679.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,041.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,679.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,345.21
Rate for Payer: Qualcare PPO/HMO/WC	$2,280.82

COIL ULTRASOUND ENHANCE17X10CM

Facility

$360.00

Service Code	HCPCS A4648
Hospital Charge Code	270654054
Hospital Revenue Code	278
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$87.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$79.20
Rate for Payer: Qualcare PPO/HMO/WC	$54.00

COIL ULTRASOUND ENHANCE17X10CM

Facility

$360.00

Service Code	HCPCS A4648
Hospital Charge Code	270654054
Hospital Revenue Code	278
Min. Negotiated Rate	$8.68
Max. Negotiated Rate	$180.00
Rate for Payer: Aetna Commercial	$136.80
Rate for Payer: Aetna Medicare Advantage	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.80
Rate for Payer: Cigna Commercial	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$79.20
Rate for Payer: Qualcare PPO/HMO/WC	$54.00
Rate for Payer: UnitedHealthcare Community & State	$8.68
Rate for Payer: Wellpoint Medicaid Managed Care	$9.54

COLACE SOLN 1%/30ML

Facility

$25.00

Hospital Charge Code	60634582
Hospital Revenue Code	250
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

COLACE SOLN 1%/30ML

Facility

$25.00

Hospital Charge Code	60634582
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$12.50
Rate for Payer: Aetna Commercial	$9.50
Rate for Payer: Aetna Medicare Advantage	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.38
Rate for Payer: Cigna Commercial	$12.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.50
Rate for Payer: Oxford Commercial	$5.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$5.00
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

COLAPINTO RING TIPS SET

Facility

$469.70

Hospital Charge Code	270658308O
Hospital Revenue Code	272
Min. Negotiated Rate	$70.45
Max. Negotiated Rate	$70.45
Rate for Payer: Qualcare PPO/HMO/WC	$70.45

COLAPINTO RING TIPS SET

Facility

$469.70

Hospital Charge Code	270658308
Hospital Revenue Code	272
Min. Negotiated Rate	$70.45
Max. Negotiated Rate	$70.45
Rate for Payer: Qualcare PPO/HMO/WC	$70.45

COLAPINTO RING TIPS SET

Facility

$469.70

Hospital Charge Code	270658308O
Hospital Revenue Code	272
Min. Negotiated Rate	$11.32
Max. Negotiated Rate	$234.85
Rate for Payer: Aetna Commercial	$178.49
Rate for Payer: Aetna Medicare Advantage	$140.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.77
Rate for Payer: Cigna Commercial	$234.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.91
Rate for Payer: Oxford Commercial	$93.94
Rate for Payer: Qualcare PPO/HMO/WC	$70.45
Rate for Payer: UnitedHealthcare Commercial	$93.94
Rate for Payer: UnitedHealthcare Community & State	$11.32
Rate for Payer: Wellpoint Medicaid Managed Care	$12.45

COLAPINTO RING TIPS SET

Facility

$2,348.50

Hospital Charge Code	2706000329
Hospital Revenue Code	272
Min. Negotiated Rate	$56.60
Max. Negotiated Rate	$1,174.25
Rate for Payer: Aetna Commercial	$892.43
Rate for Payer: Aetna Medicare Advantage	$704.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$598.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$598.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$598.87
Rate for Payer: Cigna Commercial	$1,174.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$704.55
Rate for Payer: Oxford Commercial	$469.70
Rate for Payer: Qualcare PPO/HMO/WC	$352.27
Rate for Payer: UnitedHealthcare Commercial	$469.70
Rate for Payer: UnitedHealthcare Community & State	$56.60
Rate for Payer: Wellpoint Medicaid Managed Care	$62.24

COLAPINTO RING TIPS SET

Facility

$469.70

Hospital Charge Code	270658308
Hospital Revenue Code	272
Min. Negotiated Rate	$11.32
Max. Negotiated Rate	$234.85
Rate for Payer: Aetna Commercial	$178.49
Rate for Payer: Aetna Medicare Advantage	$140.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.77
Rate for Payer: Cigna Commercial	$234.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.91
Rate for Payer: Oxford Commercial	$93.94
Rate for Payer: Qualcare PPO/HMO/WC	$70.45
Rate for Payer: UnitedHealthcare Commercial	$93.94
Rate for Payer: UnitedHealthcare Community & State	$11.32
Rate for Payer: Wellpoint Medicaid Managed Care	$12.45

COLAPINTO RING TIPS SET

Facility

$2,348.50

Hospital Charge Code	2706000329
Hospital Revenue Code	272
Min. Negotiated Rate	$352.27
Max. Negotiated Rate	$352.27
Rate for Payer: Qualcare PPO/HMO/WC	$352.27

COLBENEMID TAB

Facility

$3.00

Hospital Charge Code	60632726
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

COLBENEMID TAB

Facility

$3.00

Hospital Charge Code	60632726
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

COLCHICINE 0.6 MG TAB

Facility

$50.25

Service Code	NDC 66993016502
Hospital Charge Code	60628521
Hospital Revenue Code	250
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$25.12
Rate for Payer: Aetna Commercial	$19.09
Rate for Payer: Aetna Medicare Advantage	$15.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.81
Rate for Payer: Cigna Commercial	$25.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.07
Rate for Payer: Oxford Commercial	$10.05
Rate for Payer: Qualcare PPO/HMO/WC	$7.54
Rate for Payer: UnitedHealthcare Commercial	$10.05
Rate for Payer: UnitedHealthcare Community & State	$1.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.33

COLCHICINE 0.6 MG TAB

Facility

$50.25

Service Code	NDC 66993016502
Hospital Charge Code	60628521
Hospital Revenue Code	250
Min. Negotiated Rate	$7.54
Max. Negotiated Rate	$7.54
Rate for Payer: Qualcare PPO/HMO/WC	$7.54

Know your out-of-pocket cost for care.

All Charges