Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ALUM ACETATE CRM 30GM

Facility

$30.10

Hospital Charge Code	6005938
Hospital Revenue Code	251
Min. Negotiated Rate	$4.51
Max. Negotiated Rate	$4.51
Rate for Payer: Qualcare PPO/HMO/WC	$4.51

ALUM ACETATE CRM 30GM

Facility

$30.10

Hospital Charge Code	6005938
Hospital Revenue Code	251
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$15.05
Rate for Payer: Aetna Commercial	$11.44
Rate for Payer: Aetna Medicare Advantage	$9.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.68
Rate for Payer: Cigna Commercial	$15.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.03
Rate for Payer: Oxford Commercial	$6.02
Rate for Payer: Qualcare PPO/HMO/WC	$4.51
Rate for Payer: UnitedHealthcare Commercial	$6.02
Rate for Payer: UnitedHealthcare Community & State	$0.73
Rate for Payer: Wellpoint Medicaid Managed Care	$0.80

ALUM ACETATE CRM 454GM

Facility

$174.75

Hospital Charge Code	6005946
Hospital Revenue Code	250
Min. Negotiated Rate	$4.21
Max. Negotiated Rate	$87.38
Rate for Payer: Aetna Commercial	$66.41
Rate for Payer: Aetna Medicare Advantage	$52.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.56
Rate for Payer: Cigna Commercial	$87.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.42
Rate for Payer: Oxford Commercial	$34.95
Rate for Payer: Qualcare PPO/HMO/WC	$26.21
Rate for Payer: UnitedHealthcare Commercial	$34.95
Rate for Payer: UnitedHealthcare Community & State	$4.21
Rate for Payer: Wellpoint Medicaid Managed Care	$4.63

ALUM ACETATE CRM 454GM

Facility

$174.75

Hospital Charge Code	6005946
Hospital Revenue Code	250
Min. Negotiated Rate	$26.21
Max. Negotiated Rate	$26.21
Rate for Payer: Qualcare PPO/HMO/WC	$26.21

ALUM CARBONATE CAP 500MG

Facility

$1.95

Hospital Charge Code	60628564
Hospital Revenue Code	250
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

ALUM CARBONATE CAP 500MG

Facility

$1.95

Hospital Charge Code	60628564
Hospital Revenue Code	250
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.29
Rate for Payer: Qualcare PPO/HMO/WC	$0.29

ALUM HYDRO-MAG CARBONATE CHEW

Facility

$1.95

Hospital Charge Code	60628104
Hospital Revenue Code	250
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

ALUM HYDRO-MAG CARBONATE CHEW

Facility

$1.95

Hospital Charge Code	60628104
Hospital Revenue Code	250
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.29
Rate for Payer: Qualcare PPO/HMO/WC	$0.29

ALUM HYDROX ALGINATE 177ML

Facility

$30.10

Hospital Charge Code	6005953
Hospital Revenue Code	251
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$15.05
Rate for Payer: Aetna Commercial	$11.44
Rate for Payer: Aetna Medicare Advantage	$9.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.68
Rate for Payer: Cigna Commercial	$15.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.03
Rate for Payer: Oxford Commercial	$6.02
Rate for Payer: Qualcare PPO/HMO/WC	$4.51
Rate for Payer: UnitedHealthcare Commercial	$6.02
Rate for Payer: UnitedHealthcare Community & State	$0.73
Rate for Payer: Wellpoint Medicaid Managed Care	$0.80

ALUM HYDROX ALGINATE 177ML

Facility

$30.10

Hospital Charge Code	6005953
Hospital Revenue Code	251
Min. Negotiated Rate	$4.51
Max. Negotiated Rate	$4.51
Rate for Payer: Qualcare PPO/HMO/WC	$4.51

ALUM HYDROXIDE GEL 30ML

Facility

$3.20

Hospital Charge Code	6025092
Hospital Revenue Code	251
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$1.60
Rate for Payer: Aetna Commercial	$1.22
Rate for Payer: Aetna Medicare Advantage	$0.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.82
Rate for Payer: Cigna Commercial	$1.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.96
Rate for Payer: Oxford Commercial	$0.64
Rate for Payer: Qualcare PPO/HMO/WC	$0.48
Rate for Payer: UnitedHealthcare Commercial	$0.64
Rate for Payer: UnitedHealthcare Community & State	$0.08
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

ALUM HYDROXIDE GEL 30ML

Facility

$3.20

Hospital Charge Code	6025092
Hospital Revenue Code	251
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$0.48
Rate for Payer: Qualcare PPO/HMO/WC	$0.48

ALUM HYDROXIDE SSP 355ML

Facility

$37.80

Hospital Charge Code	6005961
Hospital Revenue Code	251
Min. Negotiated Rate	$5.67
Max. Negotiated Rate	$5.67
Rate for Payer: Qualcare PPO/HMO/WC	$5.67

ALUM HYDROXIDE SSP 355ML

Facility

$37.80

Hospital Charge Code	6005961
Hospital Revenue Code	251
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

ALUM HYDROXIDE TAB CHEW 600MG

Facility

$1.95

Hospital Charge Code	60628107
Hospital Revenue Code	250
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

ALUM HYDROXIDE TAB CHEW 600MG

Facility

$1.95

Hospital Charge Code	60628107
Hospital Revenue Code	250
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.29
Rate for Payer: Qualcare PPO/HMO/WC	$0.29

ALUMINUM

Facility

$280.00

Service Code	HCPCS 82108
Hospital Charge Code	38472071
Hospital Revenue Code	301
Min. Negotiated Rate	$7.42
Max. Negotiated Rate	$140.00
Rate for Payer: Aetna Commercial	$69.31
Rate for Payer: Aetna Medicare Advantage	$82.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.98
Rate for Payer: Cigna Commercial	$140.00
Rate for Payer: Cigna Medicare Advantage	$25.48
Rate for Payer: Clover Medicare Advantage	$24.21
Rate for Payer: EmblemHealth Commercial	$76.44
Rate for Payer: Humana Medicare Advantage	$26.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$25.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$20.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$25.48
Rate for Payer: Wellcare Medicare Advantage	$25.48
Rate for Payer: Wellpoint Medicaid Managed Care	$7.42

ALUMINUM

Facility

$280.00

Service Code	HCPCS 82108
Hospital Charge Code	38472071
Hospital Revenue Code	301
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00

ALUMINUM CANE

Facility

$87.00

Hospital Charge Code	84202095
Hospital Revenue Code	270
Min. Negotiated Rate	$13.05
Max. Negotiated Rate	$13.05
Rate for Payer: Qualcare PPO/HMO/WC	$13.05

ALUMINUM CANE

Facility

$87.00

Hospital Charge Code	84202095
Hospital Revenue Code	270
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$43.50
Rate for Payer: Aetna Commercial	$33.06
Rate for Payer: Aetna Medicare Advantage	$26.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.18
Rate for Payer: Cigna Commercial	$43.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.10
Rate for Payer: Oxford Commercial	$17.40
Rate for Payer: Qualcare PPO/HMO/WC	$13.05
Rate for Payer: UnitedHealthcare Commercial	$17.40
Rate for Payer: UnitedHealthcare Community & State	$2.10
Rate for Payer: Wellpoint Medicaid Managed Care	$2.31

ALUMINUM CHLORIDE 20% TOP SOLN

Facility

$16.65

Hospital Charge Code	60629144
Hospital Revenue Code	250
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$8.32
Rate for Payer: Aetna Commercial	$6.33
Rate for Payer: Aetna Medicare Advantage	$5.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.25
Rate for Payer: Cigna Commercial	$8.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.00
Rate for Payer: Oxford Commercial	$3.33
Rate for Payer: Qualcare PPO/HMO/WC	$2.50
Rate for Payer: UnitedHealthcare Commercial	$3.33
Rate for Payer: UnitedHealthcare Community & State	$0.40
Rate for Payer: Wellpoint Medicaid Managed Care	$0.44

ALUMINUM CHLORIDE 20% TOP SOLN

Facility

$16.65

Hospital Charge Code	60629144
Hospital Revenue Code	250
Min. Negotiated Rate	$2.50
Max. Negotiated Rate	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.50

ALUMINUM HYDROXIDE 300MG

Facility

$1.95

Hospital Charge Code	60628565
Hospital Revenue Code	250
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.29
Rate for Payer: Qualcare PPO/HMO/WC	$0.29

ALUMINUM HYDROXIDE 300MG

Facility

$1.95

Hospital Charge Code	60628565
Hospital Revenue Code	250
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

ALUMINUM HYDROXIDE GEL/40

Facility

$6.00

Hospital Charge Code	60632426
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

Know your out-of-pocket cost for care.

All Charges