Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ENOXAPARIN 100 MG SYRINGE

Facility

$605.08

Service Code	HCPCS J1650
Hospital Charge Code	60628902
Hospital Revenue Code	636
Min. Negotiated Rate	$90.76
Max. Negotiated Rate	$146.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.43
Rate for Payer: Qualcare PPO/HMO/WC	$90.76

ENOXAPARIN 120 MG SYRINGE

Facility

$726.28

Service Code	HCPCS J1650
Hospital Charge Code	60629832
Hospital Revenue Code	636
Min. Negotiated Rate	$17.50
Max. Negotiated Rate	$363.14
Rate for Payer: Aetna Commercial	$275.99
Rate for Payer: Aetna Medicare Advantage	$217.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$185.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$185.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$185.20
Rate for Payer: Cigna Commercial	$363.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.76
Rate for Payer: Qualcare PPO/HMO/WC	$108.94
Rate for Payer: UnitedHealthcare Community & State	$17.50
Rate for Payer: Wellpoint Medicaid Managed Care	$19.25

ENOXAPARIN 120 MG SYRINGE

Facility

$726.28

Service Code	HCPCS J1650
Hospital Charge Code	60629832
Hospital Revenue Code	636
Min. Negotiated Rate	$108.94
Max. Negotiated Rate	$175.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.76
Rate for Payer: Qualcare PPO/HMO/WC	$108.94

ENOXAPARIN 150 MG SYRINGE

Facility

$677.60

Hospital Charge Code	60630052
Hospital Revenue Code	250
Min. Negotiated Rate	$101.64
Max. Negotiated Rate	$101.64
Rate for Payer: Qualcare PPO/HMO/WC	$101.64

ENOXAPARIN 150 MG SYRINGE

Facility

$677.60

Hospital Charge Code	60630052
Hospital Revenue Code	250
Min. Negotiated Rate	$16.33
Max. Negotiated Rate	$338.80
Rate for Payer: Aetna Commercial	$257.49
Rate for Payer: Aetna Medicare Advantage	$203.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.79
Rate for Payer: Cigna Commercial	$338.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$203.28
Rate for Payer: Oxford Commercial	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$101.64
Rate for Payer: UnitedHealthcare Commercial	$135.52
Rate for Payer: UnitedHealthcare Community & State	$16.33
Rate for Payer: Wellpoint Medicaid Managed Care	$17.96

ENOXAPARIN 150 MG SYRINGE

Facility

$998.77

Service Code	HCPCS J1650
Hospital Charge Code	60635382
Hospital Revenue Code	636
Min. Negotiated Rate	$24.07
Max. Negotiated Rate	$499.38
Rate for Payer: Aetna Commercial	$379.53
Rate for Payer: Aetna Medicare Advantage	$299.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$254.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$254.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$254.69
Rate for Payer: Cigna Commercial	$499.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$241.70
Rate for Payer: Qualcare PPO/HMO/WC	$149.82
Rate for Payer: UnitedHealthcare Community & State	$24.07
Rate for Payer: Wellpoint Medicaid Managed Care	$26.47

ENOXAPARIN 150 MG SYRINGE

Facility

$998.77

Service Code	HCPCS J1650
Hospital Charge Code	60635382
Hospital Revenue Code	636
Min. Negotiated Rate	$149.82
Max. Negotiated Rate	$241.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$241.70
Rate for Payer: Qualcare PPO/HMO/WC	$149.82

ENOXAPARIN 30 MG SYRINGE

Facility

$181.57

Service Code	HCPCS J1650
Hospital Charge Code	60627505
Hospital Revenue Code	636
Min. Negotiated Rate	$27.24
Max. Negotiated Rate	$43.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.94
Rate for Payer: Qualcare PPO/HMO/WC	$27.24

ENOXAPARIN 30 MG SYRINGE

Facility

$181.57

Service Code	HCPCS J1650
Hospital Charge Code	60627505
Hospital Revenue Code	636
Min. Negotiated Rate	$4.38
Max. Negotiated Rate	$90.78
Rate for Payer: Aetna Commercial	$69.00
Rate for Payer: Aetna Medicare Advantage	$54.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.30
Rate for Payer: Cigna Commercial	$90.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.94
Rate for Payer: Qualcare PPO/HMO/WC	$27.24
Rate for Payer: UnitedHealthcare Community & State	$4.38
Rate for Payer: Wellpoint Medicaid Managed Care	$4.81

ENOXAPARIN 40 MG SYRINGE

Facility

$241.87

Service Code	HCPCS J1650
Hospital Charge Code	60628889
Hospital Revenue Code	636
Min. Negotiated Rate	$5.83
Max. Negotiated Rate	$120.94
Rate for Payer: Aetna Commercial	$91.91
Rate for Payer: Aetna Medicare Advantage	$72.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.68
Rate for Payer: Cigna Commercial	$120.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.53
Rate for Payer: Qualcare PPO/HMO/WC	$36.28
Rate for Payer: UnitedHealthcare Community & State	$5.83
Rate for Payer: Wellpoint Medicaid Managed Care	$6.41

ENOXAPARIN 40 MG SYRINGE

Facility

$241.87

Service Code	HCPCS J1650
Hospital Charge Code	60628889
Hospital Revenue Code	636
Min. Negotiated Rate	$36.28
Max. Negotiated Rate	$58.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.53
Rate for Payer: Qualcare PPO/HMO/WC	$36.28

ENOXAPARIN 60 MG SYRINGE

Facility

$363.14

Service Code	HCPCS J1650
Hospital Charge Code	60628948
Hospital Revenue Code	636
Min. Negotiated Rate	$8.75
Max. Negotiated Rate	$181.57
Rate for Payer: Aetna Commercial	$137.99
Rate for Payer: Aetna Medicare Advantage	$108.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.60
Rate for Payer: Cigna Commercial	$181.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.88
Rate for Payer: Qualcare PPO/HMO/WC	$54.47
Rate for Payer: UnitedHealthcare Community & State	$8.75
Rate for Payer: Wellpoint Medicaid Managed Care	$9.62

ENOXAPARIN 60 MG SYRINGE

Facility

$363.14

Service Code	HCPCS J1650
Hospital Charge Code	60628948
Hospital Revenue Code	636
Min. Negotiated Rate	$54.47
Max. Negotiated Rate	$87.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.88
Rate for Payer: Qualcare PPO/HMO/WC	$54.47

ENOXAPARIN 80 MG SYRINGE

Facility

$484.41

Service Code	HCPCS J1650
Hospital Charge Code	60629000
Hospital Revenue Code	636
Min. Negotiated Rate	$11.67
Max. Negotiated Rate	$242.21
Rate for Payer: Aetna Commercial	$184.08
Rate for Payer: Aetna Medicare Advantage	$145.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$123.52
Rate for Payer: Cigna Commercial	$242.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.23
Rate for Payer: Qualcare PPO/HMO/WC	$72.66
Rate for Payer: UnitedHealthcare Community & State	$11.67
Rate for Payer: Wellpoint Medicaid Managed Care	$12.84

ENOXAPARIN 80 MG SYRINGE

Facility

$484.41

Service Code	HCPCS J1650
Hospital Charge Code	60629000
Hospital Revenue Code	636
Min. Negotiated Rate	$72.66
Max. Negotiated Rate	$117.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.23
Rate for Payer: Qualcare PPO/HMO/WC	$72.66

ENSARE SYST 7FR 18-30MM 120CM

Facility

$1,648.00

Hospital Charge Code	270645890
Hospital Revenue Code	272
Min. Negotiated Rate	$39.72
Max. Negotiated Rate	$824.00
Rate for Payer: Aetna Commercial	$626.24
Rate for Payer: Aetna Medicare Advantage	$494.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$420.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$420.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$420.24
Rate for Payer: Cigna Commercial	$824.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$494.40
Rate for Payer: Oxford Commercial	$329.60
Rate for Payer: Qualcare PPO/HMO/WC	$247.20
Rate for Payer: UnitedHealthcare Commercial	$329.60
Rate for Payer: UnitedHealthcare Community & State	$39.72
Rate for Payer: Wellpoint Medicaid Managed Care	$43.67

ENSARE SYST 7FR 18-30MM 120CM

Facility

$1,648.00

Hospital Charge Code	270645890
Hospital Revenue Code	272
Min. Negotiated Rate	$247.20
Max. Negotiated Rate	$247.20
Rate for Payer: Qualcare PPO/HMO/WC	$247.20

ENSEAL LAPARSCOPIC 35 CM

Facility

$2,469.79

Hospital Charge Code	270691431
Hospital Revenue Code	272
Min. Negotiated Rate	$59.52
Max. Negotiated Rate	$1,234.89
Rate for Payer: Aetna Commercial	$938.52
Rate for Payer: Aetna Medicare Advantage	$740.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$629.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$629.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$629.80
Rate for Payer: Cigna Commercial	$1,234.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.94
Rate for Payer: Oxford Commercial	$493.96
Rate for Payer: Qualcare PPO/HMO/WC	$370.47
Rate for Payer: UnitedHealthcare Commercial	$493.96
Rate for Payer: UnitedHealthcare Community & State	$59.52
Rate for Payer: Wellpoint Medicaid Managed Care	$65.45

ENSEAL LAPARSCOPIC 35 CM

Facility

$2,469.79

Hospital Charge Code	270691431
Hospital Revenue Code	272
Min. Negotiated Rate	$370.47
Max. Negotiated Rate	$370.47
Rate for Payer: Qualcare PPO/HMO/WC	$370.47

ENSEAL X1 CURVED

Facility

$4,187.78

Hospital Charge Code	270692880
Hospital Revenue Code	272
Min. Negotiated Rate	$100.93
Max. Negotiated Rate	$2,093.89
Rate for Payer: Aetna Commercial	$1,591.36
Rate for Payer: Aetna Medicare Advantage	$1,256.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,067.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,067.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,067.88
Rate for Payer: Cigna Commercial	$2,093.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,256.33
Rate for Payer: Oxford Commercial	$837.56
Rate for Payer: Qualcare PPO/HMO/WC	$628.17
Rate for Payer: UnitedHealthcare Commercial	$837.56
Rate for Payer: UnitedHealthcare Community & State	$100.93
Rate for Payer: Wellpoint Medicaid Managed Care	$110.98

ENSEAL X1 CURVED

Facility

$4,187.78

Hospital Charge Code	270692880
Hospital Revenue Code	272
Min. Negotiated Rate	$628.17
Max. Negotiated Rate	$628.17
Rate for Payer: Qualcare PPO/HMO/WC	$628.17

ENSEAL X1 LARGE JAW TISSUE SEA

Facility

$5,460.00

Hospital Charge Code	270680771
Hospital Revenue Code	272
Min. Negotiated Rate	$819.00
Max. Negotiated Rate	$819.00
Rate for Payer: Qualcare PPO/HMO/WC	$819.00

ENSEAL X1 LARGE JAW TISSUE SEA

Facility

$5,460.00

Hospital Charge Code	270680771
Hospital Revenue Code	272
Min. Negotiated Rate	$131.59
Max. Negotiated Rate	$2,730.00
Rate for Payer: Aetna Commercial	$2,074.80
Rate for Payer: Aetna Medicare Advantage	$1,638.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,392.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,392.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,392.30
Rate for Payer: Cigna Commercial	$2,730.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,638.00
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$819.00
Rate for Payer: UnitedHealthcare Commercial	$1,092.00
Rate for Payer: UnitedHealthcare Community & State	$131.59
Rate for Payer: Wellpoint Medicaid Managed Care	$144.69

ENSEAL X1 LG JAW TISSUE SEALER

Facility

$2,730.00

Hospital Charge Code	270680837
Hospital Revenue Code	272
Min. Negotiated Rate	$65.79
Max. Negotiated Rate	$1,365.00
Rate for Payer: Aetna Commercial	$1,037.40
Rate for Payer: Aetna Medicare Advantage	$819.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$696.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$696.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$696.15
Rate for Payer: Cigna Commercial	$1,365.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$819.00
Rate for Payer: Oxford Commercial	$546.00
Rate for Payer: Qualcare PPO/HMO/WC	$409.50
Rate for Payer: UnitedHealthcare Commercial	$546.00
Rate for Payer: UnitedHealthcare Community & State	$65.79
Rate for Payer: Wellpoint Medicaid Managed Care	$72.34

ENSEAL X1 LG JAW TISSUE SEALER

Facility

$2,730.00

Hospital Charge Code	270680837
Hospital Revenue Code	272
Min. Negotiated Rate	$409.50
Max. Negotiated Rate	$409.50
Rate for Payer: Qualcare PPO/HMO/WC	$409.50

Know your out-of-pocket cost for care.

All Charges