Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

GENIUS PRP SYSTEM

Facility

$4,000.00

Hospital Charge Code	270679233
Hospital Revenue Code	272
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$600.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

GENIUS PRP SYSTEM 60ML

Facility

$1,975.00

Hospital Charge Code	270685399
Hospital Revenue Code	272
Min. Negotiated Rate	$296.25
Max. Negotiated Rate	$296.25
Rate for Payer: Qualcare PPO/HMO/WC	$296.25

GENIUS PRP SYSTEM 60ML

Facility

$1,975.00

Hospital Charge Code	270685399
Hospital Revenue Code	272
Min. Negotiated Rate	$47.60
Max. Negotiated Rate	$987.50
Rate for Payer: Aetna Commercial	$750.50
Rate for Payer: Aetna Medicare Advantage	$592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$503.62
Rate for Payer: Cigna Commercial	$987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$592.50
Rate for Payer: Oxford Commercial	$395.00
Rate for Payer: Qualcare PPO/HMO/WC	$296.25
Rate for Payer: UnitedHealthcare Commercial	$395.00
Rate for Payer: UnitedHealthcare Community & State	$47.60
Rate for Payer: Wellpoint Medicaid Managed Care	$52.34

GEN LAP KIT

Facility

$352.00

Hospital Charge Code	270338736
Hospital Revenue Code	272
Min. Negotiated Rate	$52.80
Max. Negotiated Rate	$52.80
Rate for Payer: Qualcare PPO/HMO/WC	$52.80

GEN LAP KIT

Facility

$352.00

Hospital Charge Code	270338736
Hospital Revenue Code	272
Min. Negotiated Rate	$8.48
Max. Negotiated Rate	$176.00
Rate for Payer: Aetna Commercial	$133.76
Rate for Payer: Aetna Medicare Advantage	$105.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.76
Rate for Payer: Cigna Commercial	$176.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.60
Rate for Payer: Oxford Commercial	$70.40
Rate for Payer: Qualcare PPO/HMO/WC	$52.80
Rate for Payer: UnitedHealthcare Commercial	$70.40
Rate for Payer: UnitedHealthcare Community & State	$8.48
Rate for Payer: Wellpoint Medicaid Managed Care	$9.33

GENOPTIC OPHTH/5ML

Facility

$53.00

Hospital Charge Code	60633039
Hospital Revenue Code	250
Min. Negotiated Rate	$1.28
Max. Negotiated Rate	$26.50
Rate for Payer: Aetna Commercial	$20.14
Rate for Payer: Aetna Medicare Advantage	$15.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.52
Rate for Payer: Cigna Commercial	$26.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.90
Rate for Payer: Oxford Commercial	$10.60
Rate for Payer: Qualcare PPO/HMO/WC	$7.95
Rate for Payer: UnitedHealthcare Commercial	$10.60
Rate for Payer: UnitedHealthcare Community & State	$1.28
Rate for Payer: Wellpoint Medicaid Managed Care	$1.40

GENOPTIC OPHTH/5ML

Facility

$53.00

Hospital Charge Code	60633039
Hospital Revenue Code	250
Min. Negotiated Rate	$7.95
Max. Negotiated Rate	$7.95
Rate for Payer: Qualcare PPO/HMO/WC	$7.95

GENOPTIC SOLUTION

Facility

$43.55

Hospital Charge Code	6008452
Hospital Revenue Code	252
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$21.77
Rate for Payer: Aetna Commercial	$16.55
Rate for Payer: Aetna Medicare Advantage	$13.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.11
Rate for Payer: Cigna Commercial	$21.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.06
Rate for Payer: Oxford Commercial	$8.71
Rate for Payer: Qualcare PPO/HMO/WC	$6.53
Rate for Payer: UnitedHealthcare Commercial	$8.71
Rate for Payer: UnitedHealthcare Community & State	$1.05
Rate for Payer: Wellpoint Medicaid Managed Care	$1.15

GENOPTIC SOLUTION

Facility

$43.55

Hospital Charge Code	6008452
Hospital Revenue Code	252
Min. Negotiated Rate	$6.53
Max. Negotiated Rate	$6.53
Rate for Payer: Qualcare PPO/HMO/WC	$6.53

GENTACIDIN OPHTH/3MG/1ML

Facility

$41.00

Hospital Charge Code	60633040
Hospital Revenue Code	250
Min. Negotiated Rate	$6.15
Max. Negotiated Rate	$6.15
Rate for Payer: Qualcare PPO/HMO/WC	$6.15

GENTACIDIN OPHTH/3MG/1ML

Facility

$41.00

Hospital Charge Code	60633040
Hospital Revenue Code	250
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$20.50
Rate for Payer: Aetna Commercial	$15.58
Rate for Payer: Aetna Medicare Advantage	$12.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.46
Rate for Payer: Cigna Commercial	$20.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.30
Rate for Payer: Oxford Commercial	$8.20
Rate for Payer: Qualcare PPO/HMO/WC	$6.15
Rate for Payer: UnitedHealthcare Commercial	$8.20
Rate for Payer: UnitedHealthcare Community & State	$0.99
Rate for Payer: Wellpoint Medicaid Managed Care	$1.09

GENTAMICIN 0.3% OPHTH OINT

Facility

$28.10

Hospital Charge Code	6002562
Hospital Revenue Code	251
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$14.05
Rate for Payer: Aetna Commercial	$10.68
Rate for Payer: Aetna Medicare Advantage	$8.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.17
Rate for Payer: Cigna Commercial	$14.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.43
Rate for Payer: Oxford Commercial	$5.62
Rate for Payer: Qualcare PPO/HMO/WC	$4.21
Rate for Payer: UnitedHealthcare Commercial	$5.62
Rate for Payer: UnitedHealthcare Community & State	$0.68
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

GENTAMICIN 0.3% OPHTH OINT

Facility

$28.10

Hospital Charge Code	6002562
Hospital Revenue Code	251
Min. Negotiated Rate	$4.21
Max. Negotiated Rate	$4.21
Rate for Payer: Qualcare PPO/HMO/WC	$4.21

GENTAMICIN 0.3% OPHTH SOLN

Facility

$32.00

Hospital Charge Code	60628013
Hospital Revenue Code	250
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna Commercial	$12.16
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.60
Rate for Payer: Oxford Commercial	$6.40
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$6.40
Rate for Payer: UnitedHealthcare Community & State	$0.77
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

GENTAMICIN 0.3% OPHTH SOLN

Facility

$32.00

Hospital Charge Code	60628013
Hospital Revenue Code	250
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

GENTAMICIN 0.3%/PREDN 0.6% UNG

Facility

$472.25

Hospital Charge Code	606390043
Hospital Revenue Code	250
Min. Negotiated Rate	$11.38
Max. Negotiated Rate	$236.12
Rate for Payer: Aetna Commercial	$179.46
Rate for Payer: Aetna Medicare Advantage	$141.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.42
Rate for Payer: Cigna Commercial	$236.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.68
Rate for Payer: Oxford Commercial	$94.45
Rate for Payer: Qualcare PPO/HMO/WC	$70.84
Rate for Payer: UnitedHealthcare Commercial	$94.45
Rate for Payer: UnitedHealthcare Community & State	$11.38
Rate for Payer: Wellpoint Medicaid Managed Care	$12.51

GENTAMICIN 0.3%/PREDN 0.6% UNG

Facility

$472.25

Hospital Charge Code	606390043
Hospital Revenue Code	250
Min. Negotiated Rate	$70.84
Max. Negotiated Rate	$70.84
Rate for Payer: Qualcare PPO/HMO/WC	$70.84

GENTAMICIN 60MG/50ML NS IVPB**

Facility

$27.90

Service Code	HCPCS J1580
Hospital Charge Code	606272236
Hospital Revenue Code	259
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$13.95
Rate for Payer: Aetna Commercial	$10.60
Rate for Payer: Aetna Medicare Advantage	$8.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.11
Rate for Payer: Cigna Commercial	$13.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.37
Rate for Payer: Oxford Commercial	$5.58
Rate for Payer: Qualcare PPO/HMO/WC	$4.18
Rate for Payer: UnitedHealthcare Commercial	$5.58
Rate for Payer: UnitedHealthcare Community & State	$0.67
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

GENTAMICIN 60MG/50ML NS IVPB**

Facility

$27.90

Service Code	HCPCS J1580
Hospital Charge Code	606272236
Hospital Revenue Code	259
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$4.18
Rate for Payer: Qualcare PPO/HMO/WC	$4.18

GENTAMICIN 80 MG/2ML INJ.

Facility

$5.43

Service Code	HCPCS J1580
Hospital Charge Code	60627238
Hospital Revenue Code	636
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$2.71
Rate for Payer: Aetna Commercial	$2.06
Rate for Payer: Aetna Medicare Advantage	$1.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.38
Rate for Payer: Cigna Commercial	$2.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.31
Rate for Payer: Qualcare PPO/HMO/WC	$0.81
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

GENTAMICIN 80 MG/2ML INJ.

Facility

$5.43

Service Code	HCPCS J1580
Hospital Charge Code	60627238
Hospital Revenue Code	636
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$1.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.31
Rate for Payer: Qualcare PPO/HMO/WC	$0.81

GENTAMICIN FORTIFIED 13.6MG/ML

Facility

$62.10

Hospital Charge Code	60629022
Hospital Revenue Code	250
Min. Negotiated Rate	$9.31
Max. Negotiated Rate	$9.31
Rate for Payer: Qualcare PPO/HMO/WC	$9.31

GENTAMICIN FORTIFIED 13.6MG/ML

Facility

$62.10

Hospital Charge Code	60629022
Hospital Revenue Code	250
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$31.05
Rate for Payer: Aetna Commercial	$23.60
Rate for Payer: Aetna Medicare Advantage	$18.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.84
Rate for Payer: Cigna Commercial	$31.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.63
Rate for Payer: Oxford Commercial	$12.42
Rate for Payer: Qualcare PPO/HMO/WC	$9.31
Rate for Payer: UnitedHealthcare Commercial	$12.42
Rate for Payer: UnitedHealthcare Community & State	$1.50
Rate for Payer: Wellpoint Medicaid Managed Care	$1.65

GENTAMICIN (GARAMYCIN)

Facility

$179.00

Service Code	HCPCS 80170
Hospital Charge Code	38472296
Hospital Revenue Code	301
Min. Negotiated Rate	$26.85
Max. Negotiated Rate	$26.85
Rate for Payer: Qualcare PPO/HMO/WC	$26.85

GENTAMICIN (GARAMYCIN)

Facility

$179.00

Service Code	HCPCS 80170
Hospital Charge Code	38472296
Hospital Revenue Code	301
Min. Negotiated Rate	$4.74
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$44.55
Rate for Payer: Aetna Medicare Advantage	$53.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.13
Rate for Payer: Cigna Commercial	$89.50
Rate for Payer: Cigna Medicare Advantage	$16.38
Rate for Payer: Clover Medicare Advantage	$15.56
Rate for Payer: EmblemHealth Commercial	$49.14
Rate for Payer: Humana Medicare Advantage	$16.87
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.85
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.38
Rate for Payer: Wellcare Medicare Advantage	$16.38
Rate for Payer: Wellpoint Medicaid Managed Care	$4.74

Know your out-of-pocket cost for care.

All Charges