Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

E-STIM UNATTENDED CQ

Facility

$91.25

Service Code	HCPCS G0281GP
Hospital Charge Code	904170281Q
Hospital Revenue Code	420
Min. Negotiated Rate	$2.20
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$34.67
Rate for Payer: Aetna Medicare Advantage	$27.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.27
Rate for Payer: Cigna Commercial	$45.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.38
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.69
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$2.20
Rate for Payer: Wellpoint Medicaid Managed Care	$2.42

E-STIM UNATTENDED NON WND CQ

Facility

$91.25

Service Code	HCPCS G0283GP
Hospital Charge Code	904170283Q
Hospital Revenue Code	420
Min. Negotiated Rate	$2.20
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$34.67
Rate for Payer: Aetna Medicare Advantage	$27.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.27
Rate for Payer: Cigna Commercial	$45.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.38
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.69
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$2.20
Rate for Payer: Wellpoint Medicaid Managed Care	$2.42

E-STIM UNATTENDED NON WND CQ

Facility

$91.25

Service Code	HCPCS G0283GP
Hospital Charge Code	904170283Q
Hospital Revenue Code	420
Min. Negotiated Rate	$13.69
Max. Negotiated Rate	$13.69
Rate for Payer: Qualcare PPO/HMO/WC	$13.69

ESTRADERM/0.05MG/EACH

Facility

$84.00

Hospital Charge Code	60632961
Hospital Revenue Code	250
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.60

ESTRADERM/0.05MG/EACH

Facility

$84.00

Hospital Charge Code	60632961
Hospital Revenue Code	250
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$42.00
Rate for Payer: Aetna Commercial	$31.92
Rate for Payer: Aetna Medicare Advantage	$25.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.42
Rate for Payer: Cigna Commercial	$42.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.20
Rate for Payer: Oxford Commercial	$16.80
Rate for Payer: Qualcare PPO/HMO/WC	$12.60
Rate for Payer: UnitedHealthcare Commercial	$16.80
Rate for Payer: UnitedHealthcare Community & State	$2.02
Rate for Payer: Wellpoint Medicaid Managed Care	$2.23

ESTRADERM 0.1

Facility

$8.00

Hospital Charge Code	60634878
Hospital Revenue Code	250
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

ESTRADERM 0.1

Facility

$8.00

Hospital Charge Code	60634878
Hospital Revenue Code	250
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$3.04
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.40
Rate for Payer: Oxford Commercial	$1.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$1.60
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

ESTRADIOL

Facility

$941.00

Service Code	HCPCS 82670
Hospital Charge Code	38472260
Hospital Revenue Code	301
Min. Negotiated Rate	$22.35
Max. Negotiated Rate	$470.50
Rate for Payer: Aetna Commercial	$76.00
Rate for Payer: Aetna Medicare Advantage	$90.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.86
Rate for Payer: Cigna Commercial	$470.50
Rate for Payer: Cigna Medicare Advantage	$27.94
Rate for Payer: Clover Medicare Advantage	$26.54
Rate for Payer: EmblemHealth Commercial	$83.82
Rate for Payer: Humana Medicare Advantage	$28.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$282.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$141.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$22.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.94
Rate for Payer: Wellcare Medicare Advantage	$27.94
Rate for Payer: Wellpoint Medicaid Managed Care	$24.94

ESTRADIOL

Facility

$941.00

Service Code	HCPCS 82670
Hospital Charge Code	38472260
Hospital Revenue Code	301
Min. Negotiated Rate	$141.15
Max. Negotiated Rate	$141.15
Rate for Payer: Qualcare PPO/HMO/WC	$141.15

ESTRADIOL 1 MG TAB

Facility

$10.45

Hospital Charge Code	60627475
Hospital Revenue Code	252
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$5.22
Rate for Payer: Aetna Commercial	$3.97
Rate for Payer: Aetna Medicare Advantage	$3.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.66
Rate for Payer: Cigna Commercial	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.13
Rate for Payer: Oxford Commercial	$2.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.57
Rate for Payer: UnitedHealthcare Commercial	$2.09
Rate for Payer: UnitedHealthcare Community & State	$0.25
Rate for Payer: Wellpoint Medicaid Managed Care	$0.28

ESTRADIOL 1 MG TAB

Facility

$10.45

Hospital Charge Code	60627475
Hospital Revenue Code	252
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$1.57
Rate for Payer: Qualcare PPO/HMO/WC	$1.57

ESTRADIOL INJ CYP 5MG/ML 5ML

Facility

$61.45

Hospital Charge Code	6002281
Hospital Revenue Code	250
Min. Negotiated Rate	$1.48
Max. Negotiated Rate	$30.73
Rate for Payer: Aetna Commercial	$23.35
Rate for Payer: Aetna Medicare Advantage	$18.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.67
Rate for Payer: Cigna Commercial	$30.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.43
Rate for Payer: Oxford Commercial	$12.29
Rate for Payer: Qualcare PPO/HMO/WC	$9.22
Rate for Payer: UnitedHealthcare Commercial	$12.29
Rate for Payer: UnitedHealthcare Community & State	$1.48
Rate for Payer: Wellpoint Medicaid Managed Care	$1.63

ESTRADIOL INJ CYP 5MG/ML 5ML

Facility

$61.45

Hospital Charge Code	6002281
Hospital Revenue Code	250
Min. Negotiated Rate	$9.22
Max. Negotiated Rate	$9.22
Rate for Payer: Qualcare PPO/HMO/WC	$9.22

ESTRADIOL INJ VAL 20MG/ML 5ML

Facility

$362.90

Hospital Charge Code	6002307
Hospital Revenue Code	250
Min. Negotiated Rate	$8.75
Max. Negotiated Rate	$181.45
Rate for Payer: Aetna Commercial	$137.90
Rate for Payer: Aetna Medicare Advantage	$108.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.54
Rate for Payer: Cigna Commercial	$181.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.87
Rate for Payer: Oxford Commercial	$72.58
Rate for Payer: Qualcare PPO/HMO/WC	$54.44
Rate for Payer: UnitedHealthcare Commercial	$72.58
Rate for Payer: UnitedHealthcare Community & State	$8.75
Rate for Payer: Wellpoint Medicaid Managed Care	$9.62

ESTRADIOL INJ VAL 20MG/ML 5ML

Facility

$362.90

Hospital Charge Code	6002307
Hospital Revenue Code	250
Min. Negotiated Rate	$54.44
Max. Negotiated Rate	$54.44
Rate for Payer: Qualcare PPO/HMO/WC	$54.44

ESTRADIOL INJ VAL 40MG/ML 5ML

Facility

$604.20

Hospital Charge Code	6002299
Hospital Revenue Code	250
Min. Negotiated Rate	$14.56
Max. Negotiated Rate	$302.10
Rate for Payer: Aetna Commercial	$229.60
Rate for Payer: Aetna Medicare Advantage	$181.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.07
Rate for Payer: Cigna Commercial	$302.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.26
Rate for Payer: Oxford Commercial	$120.84
Rate for Payer: Qualcare PPO/HMO/WC	$90.63
Rate for Payer: UnitedHealthcare Commercial	$120.84
Rate for Payer: UnitedHealthcare Community & State	$14.56
Rate for Payer: Wellpoint Medicaid Managed Care	$16.01

ESTRADIOL INJ VAL 40MG/ML 5ML

Facility

$604.20

Hospital Charge Code	6002299
Hospital Revenue Code	250
Min. Negotiated Rate	$90.63
Max. Negotiated Rate	$90.63
Rate for Payer: Qualcare PPO/HMO/WC	$90.63

ESTRADIOL-NORETHI 0.05/0.14 MG

Facility

$22.45

Hospital Charge Code	60629168
Hospital Revenue Code	250
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$11.22
Rate for Payer: Aetna Commercial	$8.53
Rate for Payer: Aetna Medicare Advantage	$6.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.72
Rate for Payer: Cigna Commercial	$11.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.74
Rate for Payer: Oxford Commercial	$4.49
Rate for Payer: Qualcare PPO/HMO/WC	$3.37
Rate for Payer: UnitedHealthcare Commercial	$4.49
Rate for Payer: UnitedHealthcare Community & State	$0.54
Rate for Payer: Wellpoint Medicaid Managed Care	$0.59

ESTRADIOL-NORETHI 0.05/0.14 MG

Facility

$22.45

Hospital Charge Code	60629168
Hospital Revenue Code	250
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$3.37

ESTRADIOL, SERUM

Facility

$205.65

Service Code	HCPCS 82670
Hospital Charge Code	3006236
Hospital Revenue Code	301
Min. Negotiated Rate	$30.85
Max. Negotiated Rate	$30.85
Rate for Payer: Qualcare PPO/HMO/WC	$30.85

ESTRADIOL, SERUM

Facility

$205.65

Service Code	HCPCS 82670
Hospital Charge Code	3006236
Hospital Revenue Code	301
Min. Negotiated Rate	$5.45
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$76.00
Rate for Payer: Aetna Medicare Advantage	$90.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.86
Rate for Payer: Cigna Commercial	$102.83
Rate for Payer: Cigna Medicare Advantage	$27.94
Rate for Payer: Clover Medicare Advantage	$26.54
Rate for Payer: EmblemHealth Commercial	$83.82
Rate for Payer: Humana Medicare Advantage	$28.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.85
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$22.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.94
Rate for Payer: Wellcare Medicare Advantage	$27.94
Rate for Payer: Wellpoint Medicaid Managed Care	$5.45

ESTRADIOL TAB 1MG

Facility

$3.85

Hospital Charge Code	60628218
Hospital Revenue Code	250
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$0.58
Rate for Payer: Qualcare PPO/HMO/WC	$0.58

ESTRADIOL TAB 1MG

Facility

$3.85

Hospital Charge Code	60628218
Hospital Revenue Code	250
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$1.93
Rate for Payer: Aetna Commercial	$1.46
Rate for Payer: Aetna Medicare Advantage	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.98
Rate for Payer: Cigna Commercial	$1.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.16
Rate for Payer: Oxford Commercial	$0.77
Rate for Payer: Qualcare PPO/HMO/WC	$0.58
Rate for Payer: UnitedHealthcare Commercial	$0.77
Rate for Payer: UnitedHealthcare Community & State	$0.09
Rate for Payer: Wellpoint Medicaid Managed Care	$0.10

ESTRADIOL TOP .05MG/24HR

Facility

$37.80

Hospital Charge Code	6002265
Hospital Revenue Code	252
Min. Negotiated Rate	$5.67
Max. Negotiated Rate	$5.67
Rate for Payer: Qualcare PPO/HMO/WC	$5.67

ESTRADIOL TOP .05MG/24HR

Facility

$37.80

Hospital Charge Code	6002265
Hospital Revenue Code	252
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$18.90
Rate for Payer: Aetna Commercial	$14.36
Rate for Payer: Aetna Medicare Advantage	$11.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.64
Rate for Payer: Cigna Commercial	$18.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.34
Rate for Payer: Oxford Commercial	$7.56
Rate for Payer: Qualcare PPO/HMO/WC	$5.67
Rate for Payer: UnitedHealthcare Commercial	$7.56
Rate for Payer: UnitedHealthcare Community & State	$0.91
Rate for Payer: Wellpoint Medicaid Managed Care	$1.00

Know your out-of-pocket cost for care.

All Charges