Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ERYTHROMYCIN SSP 200MG/5ML 5ML

Facility

$1.95

Hospital Charge Code	60627277
Hospital Revenue Code	251
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.98
Rate for Payer: Aetna Commercial	$0.74
Rate for Payer: Aetna Medicare Advantage	$0.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.50
Rate for Payer: Cigna Commercial	$0.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.59
Rate for Payer: Oxford Commercial	$0.39
Rate for Payer: Qualcare PPO/HMO/WC	$0.29
Rate for Payer: UnitedHealthcare Commercial	$0.39
Rate for Payer: UnitedHealthcare Community & State	$0.05
Rate for Payer: Wellpoint Medicaid Managed Care	$0.05

ERYTHROMYCIN SSP 200MG/5ML 5ML

Facility

$1.95

Hospital Charge Code	60627277
Hospital Revenue Code	251
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.29
Rate for Payer: Qualcare PPO/HMO/WC	$0.29

ERYTHROMYCIN STEARATE/250

Facility

$3.00

Hospital Charge Code	60632959
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

ERYTHROMYCIN STEARATE/250

Facility

$3.00

Hospital Charge Code	60632959
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

ERYTHROMYCIN STEARATE/500

Facility

$4.00

Hospital Charge Code	60632958
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

ERYTHROMYCIN STEARATE/500

Facility

$4.00

Hospital Charge Code	60632958
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ERYTHROMYCIN TAB EC 250MG

Facility

$4.00

Service Code	NDC 24338010213
Hospital Charge Code	60627273
Hospital Revenue Code	251
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

ERYTHROMYCIN TAB EC 250MG

Facility

$4.00

Service Code	NDC 24338010213
Hospital Charge Code	60627273
Hospital Revenue Code	251
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ERYTHROMYCIN TAB PC 500MG

Facility

$15.15

Hospital Charge Code	60627275
Hospital Revenue Code	251
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$7.58
Rate for Payer: Aetna Commercial	$5.76
Rate for Payer: Aetna Medicare Advantage	$4.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.86
Rate for Payer: Cigna Commercial	$7.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.54
Rate for Payer: Oxford Commercial	$3.03
Rate for Payer: Qualcare PPO/HMO/WC	$2.27
Rate for Payer: UnitedHealthcare Commercial	$3.03
Rate for Payer: UnitedHealthcare Community & State	$0.37
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

ERYTHROMYCIN TAB PC 500MG

Facility

$15.15

Hospital Charge Code	60627275
Hospital Revenue Code	251
Min. Negotiated Rate	$2.27
Max. Negotiated Rate	$2.27
Rate for Payer: Qualcare PPO/HMO/WC	$2.27

ERYTHROMYCIN TOPICAL 2%/6

Facility

$21.00

Hospital Charge Code	60632960
Hospital Revenue Code	250
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$10.50
Rate for Payer: Aetna Commercial	$7.98
Rate for Payer: Aetna Medicare Advantage	$6.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.36
Rate for Payer: Cigna Commercial	$10.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.30
Rate for Payer: Oxford Commercial	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$3.15
Rate for Payer: UnitedHealthcare Commercial	$4.20
Rate for Payer: UnitedHealthcare Community & State	$0.51
Rate for Payer: Wellpoint Medicaid Managed Care	$0.56

ERYTHROMYCIN TOPICAL 2%/6

Facility

$21.00

Hospital Charge Code	60632960
Hospital Revenue Code	250
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$3.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.15

ERYTHROMYCIN VL 1GM

Facility

$109.45

Hospital Charge Code	6006522
Hospital Revenue Code	250
Min. Negotiated Rate	$2.64
Max. Negotiated Rate	$54.73
Rate for Payer: Aetna Commercial	$41.59
Rate for Payer: Aetna Medicare Advantage	$32.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.91
Rate for Payer: Cigna Commercial	$54.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.84
Rate for Payer: Oxford Commercial	$21.89
Rate for Payer: Qualcare PPO/HMO/WC	$16.42
Rate for Payer: UnitedHealthcare Commercial	$21.89
Rate for Payer: UnitedHealthcare Community & State	$2.64
Rate for Payer: Wellpoint Medicaid Managed Care	$2.90

ERYTHROMYCIN VL 1GM

Facility

$109.45

Hospital Charge Code	6006522
Hospital Revenue Code	250
Min. Negotiated Rate	$16.42
Max. Negotiated Rate	$16.42
Rate for Payer: Qualcare PPO/HMO/WC	$16.42

ERYTHROPOIETIN

Facility

$390.00

Service Code	HCPCS 82668
Hospital Charge Code	39900074
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ERYTHROPOIETIN

Facility

$440.00

Service Code	HCPCS 82668
Hospital Charge Code	38472257
Hospital Revenue Code	301
Min. Negotiated Rate	$66.00
Max. Negotiated Rate	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.00

ERYTHROPOIETIN

Facility

$390.00

Service Code	HCPCS 82668
Hospital Charge Code	39900074
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$51.11
Rate for Payer: Aetna Medicare Advantage	$60.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.83
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$18.79
Rate for Payer: Clover Medicare Advantage	$17.85
Rate for Payer: EmblemHealth Commercial	$56.37
Rate for Payer: Humana Medicare Advantage	$19.35
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.79
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	$15.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.79
Rate for Payer: Wellcare Medicare Advantage	$18.79
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

ERYTHROPOIETIN

Facility

$440.00

Service Code	HCPCS 82668
Hospital Charge Code	38472257
Hospital Revenue Code	301
Min. Negotiated Rate	$11.66
Max. Negotiated Rate	$220.00
Rate for Payer: Aetna Commercial	$51.11
Rate for Payer: Aetna Medicare Advantage	$60.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.83
Rate for Payer: Cigna Commercial	$220.00
Rate for Payer: Cigna Medicare Advantage	$18.79
Rate for Payer: Clover Medicare Advantage	$17.85
Rate for Payer: EmblemHealth Commercial	$56.37
Rate for Payer: Humana Medicare Advantage	$19.35
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$15.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.79
Rate for Payer: Wellcare Medicare Advantage	$18.79
Rate for Payer: Wellpoint Medicaid Managed Care	$11.66

ERYTHROPOIETIN 2000 UNITS

Facility

$105.00

Hospital Charge Code	6000384
Hospital Revenue Code	634
Min. Negotiated Rate	$15.75
Max. Negotiated Rate	$15.75
Rate for Payer: Qualcare PPO/HMO/WC	$15.75

ERYTHROPOIETIN 2000 UNITS

Facility

$105.00

Hospital Charge Code	6000384
Hospital Revenue Code	634
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$52.50
Rate for Payer: Aetna Commercial	$39.90
Rate for Payer: Aetna Medicare Advantage	$31.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.77
Rate for Payer: Cigna Commercial	$52.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.50
Rate for Payer: Oxford Commercial	$21.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.75
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Community & State	$2.53
Rate for Payer: Wellpoint Medicaid Managed Care	$2.78

ERYTHROPOIETIN 4000U

Facility

$211.00

Hospital Charge Code	6007009
Hospital Revenue Code	634
Min. Negotiated Rate	$5.09
Max. Negotiated Rate	$105.50
Rate for Payer: Aetna Commercial	$80.18
Rate for Payer: Aetna Medicare Advantage	$63.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.80
Rate for Payer: Cigna Commercial	$105.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.30
Rate for Payer: Oxford Commercial	$42.20
Rate for Payer: Qualcare PPO/HMO/WC	$31.65
Rate for Payer: UnitedHealthcare Commercial	$42.20
Rate for Payer: UnitedHealthcare Community & State	$5.09
Rate for Payer: Wellpoint Medicaid Managed Care	$5.59

ERYTHROPOIETIN 4000U

Facility

$211.00

Hospital Charge Code	6007009
Hospital Revenue Code	634
Min. Negotiated Rate	$31.65
Max. Negotiated Rate	$31.65
Rate for Payer: Qualcare PPO/HMO/WC	$31.65

ERYTHROPOIETIN INJ 10,000***

Facility

$218.00

Service Code	HCPCS Q0136
Hospital Charge Code	6017362
Hospital Revenue Code	634
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$109.00
Rate for Payer: Aetna Commercial	$82.84
Rate for Payer: Aetna Medicare Advantage	$65.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.59
Rate for Payer: Cigna Commercial	$109.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.40
Rate for Payer: Oxford Commercial	$43.60
Rate for Payer: Qualcare PPO/HMO/WC	$32.70
Rate for Payer: UnitedHealthcare Commercial	$43.60
Rate for Payer: UnitedHealthcare Community & State	$5.25
Rate for Payer: Wellpoint Medicaid Managed Care	$5.78

ERYTHROPOIETIN INJ 10,000***

Facility

$218.00

Service Code	HCPCS Q0136
Hospital Charge Code	6017362
Hospital Revenue Code	634
Min. Negotiated Rate	$32.70
Max. Negotiated Rate	$32.70
Rate for Payer: Qualcare PPO/HMO/WC	$32.70

ERYTHROPOIETIN INJ 1,000U

Facility

$48.00

Hospital Charge Code	6017420
Hospital Revenue Code	636
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$24.00
Rate for Payer: Aetna Commercial	$18.24
Rate for Payer: Aetna Medicare Advantage	$14.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.24
Rate for Payer: Cigna Commercial	$24.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.62
Rate for Payer: Qualcare PPO/HMO/WC	$7.20
Rate for Payer: UnitedHealthcare Community & State	$1.16
Rate for Payer: Wellpoint Medicaid Managed Care	$1.27

Know your out-of-pocket cost for care.

All Charges