Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CORTISOL,TOTAL

Facility

$746.00

Service Code	HCPCS 82533
Hospital Charge Code	38472224
Hospital Revenue Code	301
Min. Negotiated Rate	$111.90
Max. Negotiated Rate	$111.90
Rate for Payer: Qualcare PPO/HMO/WC	$111.90

CORTISOL, URINARY FREE

Facility

$139.25

Service Code	HCPCS 82530
Hospital Charge Code	3009214
Hospital Revenue Code	301
Min. Negotiated Rate	$20.89
Max. Negotiated Rate	$20.89
Rate for Payer: Qualcare PPO/HMO/WC	$20.89

CORTISOL, URINARY FREE

Facility

$139.25

Service Code	HCPCS 82530
Hospital Charge Code	3009214
Hospital Revenue Code	301
Min. Negotiated Rate	$3.69
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$45.45
Rate for Payer: Aetna Medicare Advantage	$54.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.32
Rate for Payer: Cigna Commercial	$69.62
Rate for Payer: Cigna Medicare Advantage	$16.71
Rate for Payer: Clover Medicare Advantage	$15.87
Rate for Payer: EmblemHealth Commercial	$50.13
Rate for Payer: Humana Medicare Advantage	$17.21
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.77
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.89
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.71
Rate for Payer: Wellcare Medicare Advantage	$16.71
Rate for Payer: Wellpoint Medicaid Managed Care	$3.69

CORTISONE 25 MG TAB

Facility

$4.00

Service Code	NDC 143120201
Hospital Charge Code	60628183
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

CORTISONE 25 MG TAB

Facility

$4.00

Service Code	NDC 143120201
Hospital Charge Code	60628183
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

CORTISONE ACETATE INJ 50MG/ML

Facility

$54.00

Service Code	HCPCS J0810
Hospital Charge Code	6001374
Hospital Revenue Code	250
Min. Negotiated Rate	$8.10
Max. Negotiated Rate	$8.10
Rate for Payer: Qualcare PPO/HMO/WC	$8.10

CORTISONE ACETATE INJ 50MG/ML

Facility

$54.00

Service Code	HCPCS J0810
Hospital Charge Code	6001374
Hospital Revenue Code	250
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$27.00
Rate for Payer: Aetna Commercial	$20.52
Rate for Payer: Aetna Medicare Advantage	$16.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.77
Rate for Payer: Cigna Commercial	$27.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.20
Rate for Payer: Oxford Commercial	$10.80
Rate for Payer: Qualcare PPO/HMO/WC	$8.10
Rate for Payer: UnitedHealthcare Commercial	$10.80
Rate for Payer: UnitedHealthcare Community & State	$1.30
Rate for Payer: Wellpoint Medicaid Managed Care	$1.43

CORTISPORIN

Facility

$152.35

Hospital Charge Code	6008387
Hospital Revenue Code	251
Min. Negotiated Rate	$22.85
Max. Negotiated Rate	$22.85
Rate for Payer: Qualcare PPO/HMO/WC	$22.85

CORTISPORIN

Facility

$152.35

Hospital Charge Code	6008387
Hospital Revenue Code	251
Min. Negotiated Rate	$3.67
Max. Negotiated Rate	$76.17
Rate for Payer: Aetna Commercial	$57.89
Rate for Payer: Aetna Medicare Advantage	$45.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.85
Rate for Payer: Cigna Commercial	$76.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.70
Rate for Payer: Oxford Commercial	$30.47
Rate for Payer: Qualcare PPO/HMO/WC	$22.85
Rate for Payer: UnitedHealthcare Commercial	$30.47
Rate for Payer: UnitedHealthcare Community & State	$3.67
Rate for Payer: Wellpoint Medicaid Managed Care	$4.04

CORTISPORIN/15GM

Facility

$83.00

Hospital Charge Code	60632747
Hospital Revenue Code	250
Min. Negotiated Rate	$12.45
Max. Negotiated Rate	$12.45
Rate for Payer: Qualcare PPO/HMO/WC	$12.45

CORTISPORIN/15GM

Facility

$83.00

Hospital Charge Code	60632747
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

CORTISPORIN/7.5GM

Facility

$75.00

Hospital Charge Code	60632748
Hospital Revenue Code	250
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

CORTISPORIN/7.5GM

Facility

$75.00

Hospital Charge Code	60632748
Hospital Revenue Code	250
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

CORTISPORIN OPHTH/3.5GM

Facility

$83.00

Hospital Charge Code	60632749
Hospital Revenue Code	250
Min. Negotiated Rate	$12.45
Max. Negotiated Rate	$12.45
Rate for Payer: Qualcare PPO/HMO/WC	$12.45

CORTISPORIN OPHTH/3.5GM

Facility

$83.00

Hospital Charge Code	60632749
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

CORTISPORIN OTIC/10ML

Facility

$674.56

Service Code	NDC 61314064610
Hospital Charge Code	60632752
Hospital Revenue Code	250
Min. Negotiated Rate	$101.18
Max. Negotiated Rate	$101.18
Rate for Payer: Qualcare PPO/HMO/WC	$101.18

CORTISPORIN OTIC/10ML

Facility

$104.00

Hospital Charge Code	60632751
Hospital Revenue Code	250
Min. Negotiated Rate	$2.51
Max. Negotiated Rate	$52.00
Rate for Payer: Aetna Commercial	$39.52
Rate for Payer: Aetna Medicare Advantage	$31.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.52
Rate for Payer: Cigna Commercial	$52.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.20
Rate for Payer: Oxford Commercial	$20.80
Rate for Payer: Qualcare PPO/HMO/WC	$15.60
Rate for Payer: UnitedHealthcare Commercial	$20.80
Rate for Payer: UnitedHealthcare Community & State	$2.51
Rate for Payer: Wellpoint Medicaid Managed Care	$2.76

CORTISPORIN OTIC/10ML

Facility

$104.00

Hospital Charge Code	60632751
Hospital Revenue Code	250
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$15.60
Rate for Payer: Qualcare PPO/HMO/WC	$15.60

CORTISPORIN OTIC/10ML

Facility

$674.56

Service Code	NDC 61314064610
Hospital Charge Code	60632752
Hospital Revenue Code	250
Min. Negotiated Rate	$16.26
Max. Negotiated Rate	$337.28
Rate for Payer: Aetna Commercial	$256.33
Rate for Payer: Aetna Medicare Advantage	$202.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.01
Rate for Payer: Cigna Commercial	$337.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$202.37
Rate for Payer: Oxford Commercial	$134.91
Rate for Payer: Qualcare PPO/HMO/WC	$101.18
Rate for Payer: UnitedHealthcare Commercial	$134.91
Rate for Payer: UnitedHealthcare Community & State	$16.26
Rate for Payer: Wellpoint Medicaid Managed Care	$17.88

CORTISPORIN SOL

Facility

$125.45

Hospital Charge Code	6008411
Hospital Revenue Code	251
Min. Negotiated Rate	$18.82
Max. Negotiated Rate	$18.82
Rate for Payer: Qualcare PPO/HMO/WC	$18.82

CORTISPORIN SOL

Facility

$125.45

Hospital Charge Code	6008411
Hospital Revenue Code	251
Min. Negotiated Rate	$3.02
Max. Negotiated Rate	$62.73
Rate for Payer: Aetna Commercial	$47.67
Rate for Payer: Aetna Medicare Advantage	$37.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.99
Rate for Payer: Cigna Commercial	$62.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.63
Rate for Payer: Oxford Commercial	$25.09
Rate for Payer: Qualcare PPO/HMO/WC	$18.82
Rate for Payer: UnitedHealthcare Commercial	$25.09
Rate for Payer: UnitedHealthcare Community & State	$3.02
Rate for Payer: Wellpoint Medicaid Managed Care	$3.32

CORTISPORIN UNG OINT

Facility

$125.45

Hospital Charge Code	6008429
Hospital Revenue Code	251
Min. Negotiated Rate	$3.02
Max. Negotiated Rate	$62.73
Rate for Payer: Aetna Commercial	$47.67
Rate for Payer: Aetna Medicare Advantage	$37.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.99
Rate for Payer: Cigna Commercial	$62.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.63
Rate for Payer: Oxford Commercial	$25.09
Rate for Payer: Qualcare PPO/HMO/WC	$18.82
Rate for Payer: UnitedHealthcare Commercial	$25.09
Rate for Payer: UnitedHealthcare Community & State	$3.02
Rate for Payer: Wellpoint Medicaid Managed Care	$3.32

CORTISPORIN UNG OINT

Facility

$125.45

Hospital Charge Code	6008429
Hospital Revenue Code	251
Min. Negotiated Rate	$18.82
Max. Negotiated Rate	$18.82
Rate for Payer: Qualcare PPO/HMO/WC	$18.82

CORTONE/25MG/TAB

Facility

$4.00

Hospital Charge Code	60634362
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

CORTONE/25MG/TAB

Facility

$4.00

Hospital Charge Code	60634362
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

Know your out-of-pocket cost for care.

All Charges