Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ERGOCALCIFEROL 400 IU/0.05 ML

Facility

$9.60

Hospital Charge Code	6063943197
Hospital Revenue Code	250
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$1.44
Rate for Payer: Qualcare PPO/HMO/WC	$1.44

ERGOCALCIFEROL 50000 IU SGL

Facility

$13.20

Service Code	NDC 64380073706
Hospital Charge Code	60628493
Hospital Revenue Code	250
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$1.98
Rate for Payer: Qualcare PPO/HMO/WC	$1.98

ERGOCALCIFEROL 50000 IU SGL

Facility

$13.20

Service Code	NDC 64380073706
Hospital Charge Code	60628493
Hospital Revenue Code	250
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$6.60
Rate for Payer: Aetna Commercial	$5.02
Rate for Payer: Aetna Medicare Advantage	$3.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.37
Rate for Payer: Cigna Commercial	$6.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.96
Rate for Payer: Oxford Commercial	$2.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.98
Rate for Payer: UnitedHealthcare Commercial	$2.64
Rate for Payer: UnitedHealthcare Community & State	$0.32
Rate for Payer: Wellpoint Medicaid Managed Care	$0.35

ERGOCALCIFEROL LQ 0.2MG/ML

Facility

$684.85

Hospital Charge Code	60628492
Hospital Revenue Code	250
Min. Negotiated Rate	$102.73
Max. Negotiated Rate	$102.73
Rate for Payer: Qualcare PPO/HMO/WC	$102.73

ERGOCALCIFEROL LQ 0.2MG/ML

Facility

$684.85

Hospital Charge Code	60628492
Hospital Revenue Code	250
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$342.43
Rate for Payer: Aetna Commercial	$260.24
Rate for Payer: Aetna Medicare Advantage	$205.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.64
Rate for Payer: Cigna Commercial	$342.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.46
Rate for Payer: Oxford Commercial	$136.97
Rate for Payer: Qualcare PPO/HMO/WC	$102.73
Rate for Payer: UnitedHealthcare Commercial	$136.97
Rate for Payer: UnitedHealthcare Community & State	$16.50
Rate for Payer: Wellpoint Medicaid Managed Care	$18.15

ERGOCALCIFEROL LQ 200MCG 60ML

Facility

$442.90

Hospital Charge Code	6002232
Hospital Revenue Code	252
Min. Negotiated Rate	$66.44
Max. Negotiated Rate	$66.44
Rate for Payer: Qualcare PPO/HMO/WC	$66.44

ERGOCALCIFEROL LQ 200MCG 60ML

Facility

$442.90

Hospital Charge Code	6002232
Hospital Revenue Code	252
Min. Negotiated Rate	$10.67
Max. Negotiated Rate	$221.45
Rate for Payer: Aetna Commercial	$168.30
Rate for Payer: Aetna Medicare Advantage	$132.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.94
Rate for Payer: Cigna Commercial	$221.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.87
Rate for Payer: Oxford Commercial	$88.58
Rate for Payer: Qualcare PPO/HMO/WC	$66.44
Rate for Payer: UnitedHealthcare Commercial	$88.58
Rate for Payer: UnitedHealthcare Community & State	$10.67
Rate for Payer: Wellpoint Medicaid Managed Care	$11.74

ERGOLOID MESYLATES/1MG/TA

Facility

$3.00

Hospital Charge Code	60632942
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

ERGOLOID MESYLATES/1MG/TA

Facility

$3.00

Hospital Charge Code	60632942
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

ERGONOVINE 0.2 MG/ML INJ

Facility

$23.70

Hospital Charge Code	60628282
Hospital Revenue Code	636
Min. Negotiated Rate	$3.56
Max. Negotiated Rate	$5.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.74
Rate for Payer: Qualcare PPO/HMO/WC	$3.56

ERGONOVINE 0.2 MG/ML INJ

Facility

$23.70

Hospital Charge Code	60628282
Hospital Revenue Code	636
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$11.85
Rate for Payer: Aetna Commercial	$9.01
Rate for Payer: Aetna Medicare Advantage	$7.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.04
Rate for Payer: Cigna Commercial	$11.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.74
Rate for Payer: Qualcare PPO/HMO/WC	$3.56
Rate for Payer: UnitedHealthcare Community & State	$0.57
Rate for Payer: Wellpoint Medicaid Managed Care	$0.63

ERGONOVINE PROVOCATION TEST***

Facility

$424.00

Service Code	HCPCS 93024
Hospital Charge Code	5100029
Hospital Revenue Code	481
Min. Negotiated Rate	$63.60
Max. Negotiated Rate	$63.60
Rate for Payer: Qualcare PPO/HMO/WC	$63.60

ERGONOVINE PROVOCATION TEST***

Facility

$424.00

Service Code	HCPCS 93024
Hospital Charge Code	5100029
Hospital Revenue Code	481
Min. Negotiated Rate	$10.22
Max. Negotiated Rate	$6,600.00
Rate for Payer: Aetna Commercial	$1,443.56
Rate for Payer: Aetna Medicare Advantage	$1,719.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,915.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,915.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$530.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,915.74
Rate for Payer: Cigna Commercial	$1,063.82
Rate for Payer: Cigna Medicare Advantage	$530.72
Rate for Payer: Clover Medicare Advantage	$504.18
Rate for Payer: EmblemHealth Commercial	$1,592.16
Rate for Payer: Humana Medicare Advantage	$546.64
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$530.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.60
Rate for Payer: UnitedHealthcare Community & State	$10.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$530.72
Rate for Payer: Wellcare Medicare Advantage	$530.72
Rate for Payer: Wellpoint Medicaid Managed Care	$11.24

ERGOTRATE MALEATE/0.2MG/1

Facility

$13.00

Hospital Charge Code	60632943
Hospital Revenue Code	250
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$4.94
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$2.60
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

ERGOTRATE MALEATE/0.2MG/1

Facility

$13.00

Hospital Charge Code	60632943
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

ER-GREAT TOE FRACTURE-BIL

Facility

$612.00

Hospital Charge Code	5790645
Hospital Revenue Code	450
Min. Negotiated Rate	$16.22
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$232.56
Rate for Payer: Aetna Medicare Advantage	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.06
Rate for Payer: Cigna Commercial	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.80
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$16.22

ER-GREAT TOE FRACTURE-BIL

Facility

$612.00

Hospital Charge Code	5790645
Hospital Revenue Code	450
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

ER HEMOCCULT STOOL

Facility

$32.05

Service Code	HCPCS 82272
Hospital Charge Code	5700809
Hospital Revenue Code	300
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$11.51
Rate for Payer: Aetna Medicare Advantage	$13.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.27
Rate for Payer: Cigna Commercial	$16.02
Rate for Payer: Cigna Medicare Advantage	$4.23
Rate for Payer: Clover Medicare Advantage	$4.02
Rate for Payer: EmblemHealth Commercial	$12.69
Rate for Payer: Humana Medicare Advantage	$4.36
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.62
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.81
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.23
Rate for Payer: Wellcare Medicare Advantage	$4.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

ER HEMOCCULT STOOL

Facility

$32.05

Service Code	HCPCS 82272
Hospital Charge Code	5700809
Hospital Revenue Code	300
Min. Negotiated Rate	$4.81
Max. Negotiated Rate	$4.81
Rate for Payer: Qualcare PPO/HMO/WC	$4.81

ER HEP LOCK SETUP PROCEDURE***

Facility

$46.00

Hospital Charge Code	8004079
Hospital Revenue Code	272
Min. Negotiated Rate	$6.90
Max. Negotiated Rate	$6.90
Rate for Payer: Qualcare PPO/HMO/WC	$6.90

ER HEP LOCK SETUP PROCEDURE***

Facility

$46.00

Hospital Charge Code	8004079
Hospital Revenue Code	272
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$23.00
Rate for Payer: Aetna Commercial	$17.48
Rate for Payer: Aetna Medicare Advantage	$13.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.73
Rate for Payer: Cigna Commercial	$23.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.80
Rate for Payer: Oxford Commercial	$9.20
Rate for Payer: Qualcare PPO/HMO/WC	$6.90
Rate for Payer: UnitedHealthcare Commercial	$9.20
Rate for Payer: UnitedHealthcare Community & State	$1.11
Rate for Payer: Wellpoint Medicaid Managed Care	$1.22

ER-HIP DISLOC TRAMATIC-BI

Facility

$453.00

Hospital Charge Code	5790550
Hospital Revenue Code	450
Min. Negotiated Rate	$67.95
Max. Negotiated Rate	$67.95
Rate for Payer: Qualcare PPO/HMO/WC	$67.95

ER-HIP DISLOC TRAMATIC-BI

Facility

$453.00

Hospital Charge Code	5790550
Hospital Revenue Code	450
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$172.14
Rate for Payer: Aetna Medicare Advantage	$135.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$115.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$115.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$115.52
Rate for Payer: Cigna Commercial	$226.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.95
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$12.00

ER-HUMERAL CONDYLAR FX-BI

Facility

$458.00

Hospital Charge Code	5790395
Hospital Revenue Code	450
Min. Negotiated Rate	$68.70
Max. Negotiated Rate	$68.70
Rate for Payer: Qualcare PPO/HMO/WC	$68.70

ER-HUMERAL CONDYLAR FX-BI

Facility

$458.00

Hospital Charge Code	5790395
Hospital Revenue Code	450
Min. Negotiated Rate	$12.14
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$174.04
Rate for Payer: Aetna Medicare Advantage	$137.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.79
Rate for Payer: Cigna Commercial	$229.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$68.70
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$12.14

Know your out-of-pocket cost for care.

All Charges