Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CORTOSS CARTRIDGE 10 CC

Facility

$7,500.00

Hospital Charge Code	2709006357
Hospital Revenue Code	272
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$1,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

CORTOSS CARTRIDGE 10 CC

Facility

$7,500.00

Hospital Charge Code	2709006357
Hospital Revenue Code	272
Min. Negotiated Rate	$180.75
Max. Negotiated Rate	$3,750.00
Rate for Payer: Aetna Commercial	$2,850.00
Rate for Payer: Aetna Medicare Advantage	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,912.50
Rate for Payer: Cigna Commercial	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,250.00
Rate for Payer: Oxford Commercial	$1,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00
Rate for Payer: UnitedHealthcare Commercial	$1,500.00
Rate for Payer: UnitedHealthcare Community & State	$180.75
Rate for Payer: Wellpoint Medicaid Managed Care	$198.75

CORTOSS DELIVERY GUN

Facility

$500.00

Hospital Charge Code	2709006358
Hospital Revenue Code	272
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$100.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

CORTOSS DELIVERY GUN

Facility

$500.00

Hospital Charge Code	2709006358
Hospital Revenue Code	272
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

CORTOSS FLEXIBLE EXTENSION

Facility

$40.00

Hospital Charge Code	270906360
Hospital Revenue Code	272
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

CORTOSS FLEXIBLE EXTENSION

Facility

$40.00

Hospital Charge Code	270906360
Hospital Revenue Code	272
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$20.00
Rate for Payer: Aetna Commercial	$15.20
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.00
Rate for Payer: Oxford Commercial	$8.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$8.00
Rate for Payer: UnitedHealthcare Community & State	$0.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

CORTOSS PLUNGER 6

Facility

$200.00

Hospital Charge Code	2706006362
Hospital Revenue Code	272
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

CORTOSS PLUNGER 6

Facility

$200.00

Hospital Charge Code	2706006362
Hospital Revenue Code	272
Min. Negotiated Rate	$4.82
Max. Negotiated Rate	$100.00
Rate for Payer: Aetna Commercial	$76.00
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.00
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.00
Rate for Payer: Oxford Commercial	$40.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00
Rate for Payer: UnitedHealthcare Commercial	$40.00
Rate for Payer: UnitedHealthcare Community & State	$4.82
Rate for Payer: Wellpoint Medicaid Managed Care	$5.30

CORTOSS SYRINGE DELIVERY SYS

Facility

$2,100.00

Hospital Charge Code	2709006359
Hospital Revenue Code	272
Min. Negotiated Rate	$50.61
Max. Negotiated Rate	$1,050.00
Rate for Payer: Aetna Commercial	$798.00
Rate for Payer: Aetna Medicare Advantage	$630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$535.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$535.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$535.50
Rate for Payer: Cigna Commercial	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$630.00
Rate for Payer: Oxford Commercial	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$315.00
Rate for Payer: UnitedHealthcare Commercial	$420.00
Rate for Payer: UnitedHealthcare Community & State	$50.61
Rate for Payer: Wellpoint Medicaid Managed Care	$55.65

CORTOSS SYRINGE DELIVERY SYS

Facility

$2,100.00

Hospital Charge Code	2709006359
Hospital Revenue Code	272
Min. Negotiated Rate	$315.00
Max. Negotiated Rate	$315.00
Rate for Payer: Qualcare PPO/HMO/WC	$315.00

CORUS PCSS IMPLANT 4MM

Facility

$19,000.00

Hospital Charge Code	270703456
Hospital Revenue Code	278
Min. Negotiated Rate	$2,850.00
Max. Negotiated Rate	$4,598.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,598.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,180.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00

CORUS PCSS IMPLANT 4MM

Facility

$19,000.00

Hospital Charge Code	270703456
Hospital Revenue Code	278
Min. Negotiated Rate	$457.90
Max. Negotiated Rate	$9,500.00
Rate for Payer: Aetna Commercial	$7,220.00
Rate for Payer: Aetna Medicare Advantage	$5,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,845.00
Rate for Payer: Cigna Commercial	$9,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,598.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,180.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00
Rate for Payer: UnitedHealthcare Community & State	$457.90
Rate for Payer: Wellpoint Medicaid Managed Care	$503.50

CORUS PCSS L1 4MM

Facility

$41,500.00

Hospital Charge Code	270703455
Hospital Revenue Code	278
Min. Negotiated Rate	$1,000.15
Max. Negotiated Rate	$20,750.00
Rate for Payer: Aetna Commercial	$15,770.00
Rate for Payer: Aetna Medicare Advantage	$12,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,582.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,582.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,582.50
Rate for Payer: Cigna Commercial	$20,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,043.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,130.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,225.00
Rate for Payer: UnitedHealthcare Community & State	$1,000.15
Rate for Payer: Wellpoint Medicaid Managed Care	$1,099.75

CORUS PCSS L1 4MM

Facility

$41,500.00

Hospital Charge Code	270703455
Hospital Revenue Code	278
Min. Negotiated Rate	$6,225.00
Max. Negotiated Rate	$10,043.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,043.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,130.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,225.00

COSEAL PREMIX 2mL 934070

Facility

$1,463.25

Hospital Charge Code	270635991
Hospital Revenue Code	272
Min. Negotiated Rate	$35.26
Max. Negotiated Rate	$731.62
Rate for Payer: Aetna Commercial	$556.03
Rate for Payer: Aetna Medicare Advantage	$438.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$373.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$373.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$373.13
Rate for Payer: Cigna Commercial	$731.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$438.98
Rate for Payer: Oxford Commercial	$292.65
Rate for Payer: Qualcare PPO/HMO/WC	$219.49
Rate for Payer: UnitedHealthcare Commercial	$292.65
Rate for Payer: UnitedHealthcare Community & State	$35.26
Rate for Payer: Wellpoint Medicaid Managed Care	$38.78

COSEAL PREMIX 2mL 934070

Facility

$1,463.25

Hospital Charge Code	270635991
Hospital Revenue Code	272
Min. Negotiated Rate	$219.49
Max. Negotiated Rate	$219.49
Rate for Payer: Qualcare PPO/HMO/WC	$219.49

COSEAL PREMIX 4ml 934071

Facility

$2,375.90

Hospital Charge Code	270636142
Hospital Revenue Code	272
Min. Negotiated Rate	$356.38
Max. Negotiated Rate	$356.38
Rate for Payer: Qualcare PPO/HMO/WC	$356.38

COSEAL PREMIX 4ml 934071

Facility

$2,375.90

Hospital Charge Code	270636142
Hospital Revenue Code	272
Min. Negotiated Rate	$57.26
Max. Negotiated Rate	$1,187.95
Rate for Payer: Aetna Commercial	$902.84
Rate for Payer: Aetna Medicare Advantage	$712.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$605.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$605.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$605.85
Rate for Payer: Cigna Commercial	$1,187.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$712.77
Rate for Payer: Oxford Commercial	$475.18
Rate for Payer: Qualcare PPO/HMO/WC	$356.38
Rate for Payer: UnitedHealthcare Commercial	$475.18
Rate for Payer: UnitedHealthcare Community & State	$57.26
Rate for Payer: Wellpoint Medicaid Managed Care	$62.96

COSYNTROPIN 0.25 MG PDS

Facility

$856.93

Service Code	HCPCS J0834
Hospital Charge Code	6001382
Hospital Revenue Code	636
Min. Negotiated Rate	$20.65
Max. Negotiated Rate	$428.46
Rate for Payer: Aetna Commercial	$325.63
Rate for Payer: Aetna Medicare Advantage	$257.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$218.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$218.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$218.52
Rate for Payer: Cigna Commercial	$428.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.38
Rate for Payer: Qualcare PPO/HMO/WC	$128.54
Rate for Payer: UnitedHealthcare Community & State	$20.65
Rate for Payer: Wellpoint Medicaid Managed Care	$22.71

COSYNTROPIN 0.25 MG PDS

Facility

$856.93

Service Code	HCPCS J0834
Hospital Charge Code	6001382
Hospital Revenue Code	636
Min. Negotiated Rate	$128.54
Max. Negotiated Rate	$207.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.38
Rate for Payer: Qualcare PPO/HMO/WC	$128.54

CO-T2318

Facility

$470.00

Hospital Charge Code	270656024
Hospital Revenue Code	271
Min. Negotiated Rate	$11.33
Max. Negotiated Rate	$235.00
Rate for Payer: Aetna Commercial	$178.60
Rate for Payer: Aetna Medicare Advantage	$141.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.85
Rate for Payer: Cigna Commercial	$235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.00
Rate for Payer: Oxford Commercial	$94.00
Rate for Payer: Qualcare PPO/HMO/WC	$70.50
Rate for Payer: UnitedHealthcare Commercial	$94.00
Rate for Payer: UnitedHealthcare Community & State	$11.33
Rate for Payer: Wellpoint Medicaid Managed Care	$12.46

CO-T2318

Facility

$470.00

Hospital Charge Code	270656024
Hospital Revenue Code	271
Min. Negotiated Rate	$70.50
Max. Negotiated Rate	$70.50
Rate for Payer: Qualcare PPO/HMO/WC	$70.50

CO-T2324

Facility

$470.00

Hospital Charge Code	270656025
Hospital Revenue Code	271
Min. Negotiated Rate	$70.50
Max. Negotiated Rate	$70.50
Rate for Payer: Qualcare PPO/HMO/WC	$70.50

CO-T2324

Facility

$470.00

Hospital Charge Code	270656025
Hospital Revenue Code	271
Min. Negotiated Rate	$11.33
Max. Negotiated Rate	$235.00
Rate for Payer: Aetna Commercial	$178.60
Rate for Payer: Aetna Medicare Advantage	$141.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.85
Rate for Payer: Cigna Commercial	$235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.00
Rate for Payer: Oxford Commercial	$94.00
Rate for Payer: Qualcare PPO/HMO/WC	$70.50
Rate for Payer: UnitedHealthcare Commercial	$94.00
Rate for Payer: UnitedHealthcare Community & State	$11.33
Rate for Payer: Wellpoint Medicaid Managed Care	$12.46

COTAZYM/CAP

Facility

$3.00

Hospital Charge Code	60632754
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

Know your out-of-pocket cost for care.

All Charges