Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ALDACTAZIDE 25/25/TAB

Facility

$3.00

Hospital Charge Code	60632409
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

ALDACTAZIDE/UD

Facility

$4.00

Hospital Charge Code	60634653
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

ALDACTAZIDE/UD

Facility

$4.00

Hospital Charge Code	60634653
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ALDACTONE/100MG/TAB

Facility

$9.72

Service Code	NDC 53489032907
Hospital Charge Code	60632412
Hospital Revenue Code	250
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$4.86
Rate for Payer: Aetna Commercial	$3.69
Rate for Payer: Aetna Medicare Advantage	$2.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.48
Rate for Payer: Cigna Commercial	$4.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.92
Rate for Payer: Oxford Commercial	$1.94
Rate for Payer: Qualcare PPO/HMO/WC	$1.46
Rate for Payer: UnitedHealthcare Commercial	$1.94
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

ALDACTONE/100MG/TAB

Facility

$9.72

Service Code	NDC 53489032907
Hospital Charge Code	60632412
Hospital Revenue Code	250
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$1.46
Rate for Payer: Qualcare PPO/HMO/WC	$1.46

ALDACTONE/25MG/TAB

Facility

$4.00

Hospital Charge Code	60632411
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

ALDACTONE/25MG/TAB

Facility

$4.00

Hospital Charge Code	60632411
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ALDACTONE/50MG/TAB

Facility

$5.76

Service Code	NDC 68084020701
Hospital Charge Code	60632413
Hospital Revenue Code	250
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$0.86
Rate for Payer: Qualcare PPO/HMO/WC	$0.86

ALDACTONE/50MG/TAB

Facility

$5.76

Service Code	NDC 68084020701
Hospital Charge Code	60632413
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.88
Rate for Payer: Aetna Commercial	$2.19
Rate for Payer: Aetna Medicare Advantage	$1.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.47
Rate for Payer: Cigna Commercial	$2.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.73
Rate for Payer: Oxford Commercial	$1.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.86
Rate for Payer: UnitedHealthcare Commercial	$1.15
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

ALDESLEUKIN INJ 22MU

Facility

$4,507.70

Hospital Charge Code	60628563
Hospital Revenue Code	636
Min. Negotiated Rate	$108.64
Max. Negotiated Rate	$2,253.85
Rate for Payer: Aetna Commercial	$1,712.93
Rate for Payer: Aetna Medicare Advantage	$1,352.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,149.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,149.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,149.46
Rate for Payer: Cigna Commercial	$2,253.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,090.86
Rate for Payer: Qualcare PPO/HMO/WC	$676.15
Rate for Payer: UnitedHealthcare Community & State	$108.64
Rate for Payer: Wellpoint Medicaid Managed Care	$119.45

ALDESLEUKIN INJ 22MU

Facility

$3,868.20

Hospital Charge Code	6010466
Hospital Revenue Code	636
Min. Negotiated Rate	$93.22
Max. Negotiated Rate	$1,934.10
Rate for Payer: Aetna Commercial	$1,469.92
Rate for Payer: Aetna Medicare Advantage	$1,160.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$986.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$986.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$986.39
Rate for Payer: Cigna Commercial	$1,934.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$936.10
Rate for Payer: Qualcare PPO/HMO/WC	$580.23
Rate for Payer: UnitedHealthcare Community & State	$93.22
Rate for Payer: Wellpoint Medicaid Managed Care	$102.51

ALDESLEUKIN INJ 22MU

Facility

$4,507.70

Hospital Charge Code	60628563
Hospital Revenue Code	636
Min. Negotiated Rate	$676.15
Max. Negotiated Rate	$1,090.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,090.86
Rate for Payer: Qualcare PPO/HMO/WC	$676.15

ALDESLEUKIN INJ 22MU

Facility

$3,868.20

Hospital Charge Code	6010466
Hospital Revenue Code	636
Min. Negotiated Rate	$580.23
Max. Negotiated Rate	$936.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$936.10
Rate for Payer: Qualcare PPO/HMO/WC	$580.23

ALDOLASE

Facility

$390.00

Service Code	HCPCS 82085
Hospital Charge Code	39900036
Hospital Revenue Code	307
Min. Negotiated Rate	$7.77
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$26.41
Rate for Payer: Aetna Medicare Advantage	$31.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.05
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$9.71
Rate for Payer: Clover Medicare Advantage	$9.22
Rate for Payer: EmblemHealth Commercial	$29.13
Rate for Payer: Humana Medicare Advantage	$10.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$7.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.71
Rate for Payer: Wellcare Medicare Advantage	$9.71
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

ALDOLASE

Facility

$390.00

Service Code	HCPCS 82085
Hospital Charge Code	39900036
Hospital Revenue Code	307
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ALDOLASE

Facility

$274.00

Service Code	HCPCS 82085
Hospital Charge Code	38472044
Hospital Revenue Code	307
Min. Negotiated Rate	$7.26
Max. Negotiated Rate	$137.00
Rate for Payer: Aetna Commercial	$26.41
Rate for Payer: Aetna Medicare Advantage	$31.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.05
Rate for Payer: Cigna Commercial	$137.00
Rate for Payer: Cigna Medicare Advantage	$9.71
Rate for Payer: Clover Medicare Advantage	$9.22
Rate for Payer: EmblemHealth Commercial	$29.13
Rate for Payer: Humana Medicare Advantage	$10.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.10
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$7.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.71
Rate for Payer: Wellcare Medicare Advantage	$9.71
Rate for Payer: Wellpoint Medicaid Managed Care	$7.26

ALDOLASE

Facility

$103.25

Service Code	HCPCS 82085
Hospital Charge Code	3000155
Hospital Revenue Code	307
Min. Negotiated Rate	$2.74
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$26.41
Rate for Payer: Aetna Medicare Advantage	$31.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.05
Rate for Payer: Cigna Commercial	$51.62
Rate for Payer: Cigna Medicare Advantage	$9.71
Rate for Payer: Clover Medicare Advantage	$9.22
Rate for Payer: EmblemHealth Commercial	$29.13
Rate for Payer: Humana Medicare Advantage	$10.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.98
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.49
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$7.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.71
Rate for Payer: Wellcare Medicare Advantage	$9.71
Rate for Payer: Wellpoint Medicaid Managed Care	$2.74

ALDOLASE

Facility

$103.25

Service Code	HCPCS 82085
Hospital Charge Code	3000155
Hospital Revenue Code	307
Min. Negotiated Rate	$15.49
Max. Negotiated Rate	$15.49
Rate for Payer: Qualcare PPO/HMO/WC	$15.49

ALDOLASE

Facility

$274.00

Service Code	HCPCS 82085
Hospital Charge Code	38472044
Hospital Revenue Code	307
Min. Negotiated Rate	$41.10
Max. Negotiated Rate	$41.10
Rate for Payer: Qualcare PPO/HMO/WC	$41.10

ALDOLASE***

Facility

$38.00

Hospital Charge Code	3010154
Hospital Revenue Code	309
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$14.44
Rate for Payer: Aetna Medicare Advantage	$11.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.69
Rate for Payer: Cigna Commercial	$19.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.70
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$0.92
Rate for Payer: Wellpoint Medicaid Managed Care	$1.01

ALDOLASE***

Facility

$38.00

Hospital Charge Code	3010154
Hospital Revenue Code	309
Min. Negotiated Rate	$5.70
Max. Negotiated Rate	$5.70
Rate for Payer: Qualcare PPO/HMO/WC	$5.70

ALDOMET/250MG/5ML

Facility

$4.00

Hospital Charge Code	60632414
Hospital Revenue Code	636
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.97
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ALDOMET/250MG/5ML

Facility

$4.00

Hospital Charge Code	60632414
Hospital Revenue Code	636
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	$0.97
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

ALDORIL-25/TAB

Facility

$3.00

Hospital Charge Code	60632415
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

ALDORIL-25/TAB

Facility

$3.00

Hospital Charge Code	60632415
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

Know your out-of-pocket cost for care.

All Charges