Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

GLOVE SZ 7 TRIFLEX ORTHO

Facility

$203.80

Hospital Charge Code	270665431
Hospital Revenue Code	270
Min. Negotiated Rate	$4.91
Max. Negotiated Rate	$101.90
Rate for Payer: Aetna Commercial	$77.44
Rate for Payer: Aetna Medicare Advantage	$61.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.97
Rate for Payer: Cigna Commercial	$101.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.14
Rate for Payer: Oxford Commercial	$40.76
Rate for Payer: Qualcare PPO/HMO/WC	$30.57
Rate for Payer: UnitedHealthcare Commercial	$40.76
Rate for Payer: UnitedHealthcare Community & State	$4.91
Rate for Payer: Wellpoint Medicaid Managed Care	$5.40

GLOVE SZ 7 TRIFLEX ORTHO

Facility

$203.80

Hospital Charge Code	270665431
Hospital Revenue Code	270
Min. Negotiated Rate	$30.57
Max. Negotiated Rate	$30.57
Rate for Payer: Qualcare PPO/HMO/WC	$30.57

GLOVE TRIFLEX SURGICAL SZ 6.0

Facility

$13.17

Hospital Charge Code	270655995
Hospital Revenue Code	272
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$1.98
Rate for Payer: Qualcare PPO/HMO/WC	$1.98

GLOVE TRIFLEX SURGICAL SZ 6.0

Facility

$13.17

Hospital Charge Code	270655995
Hospital Revenue Code	272
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$6.58
Rate for Payer: Aetna Commercial	$5.00
Rate for Payer: Aetna Medicare Advantage	$3.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.36
Rate for Payer: Cigna Commercial	$6.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.95
Rate for Payer: Oxford Commercial	$2.63
Rate for Payer: Qualcare PPO/HMO/WC	$1.98
Rate for Payer: UnitedHealthcare Commercial	$2.63
Rate for Payer: UnitedHealthcare Community & State	$0.32
Rate for Payer: Wellpoint Medicaid Managed Care	$0.35

GLUCAGON

Facility

$98.20

Service Code	HCPCS 82943
Hospital Charge Code	39900085
Hospital Revenue Code	301
Min. Negotiated Rate	$14.73
Max. Negotiated Rate	$14.73
Rate for Payer: Qualcare PPO/HMO/WC	$14.73

GLUCAGON

Facility

$336.00

Service Code	HCPCS 82943
Hospital Charge Code	38472299
Hospital Revenue Code	301
Min. Negotiated Rate	$8.90
Max. Negotiated Rate	$168.00
Rate for Payer: Aetna Commercial	$38.87
Rate for Payer: Aetna Medicare Advantage	$46.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.58
Rate for Payer: Cigna Commercial	$168.00
Rate for Payer: Cigna Medicare Advantage	$14.29
Rate for Payer: Clover Medicare Advantage	$13.58
Rate for Payer: EmblemHealth Commercial	$42.87
Rate for Payer: Humana Medicare Advantage	$14.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.43
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.29
Rate for Payer: Wellcare Medicare Advantage	$14.29
Rate for Payer: Wellpoint Medicaid Managed Care	$8.90

GLUCAGON

Facility

$336.00

Service Code	HCPCS 82943
Hospital Charge Code	38472299
Hospital Revenue Code	301
Min. Negotiated Rate	$50.40
Max. Negotiated Rate	$50.40
Rate for Payer: Qualcare PPO/HMO/WC	$50.40

GLUCAGON

Facility

$98.20

Service Code	HCPCS 82943
Hospital Charge Code	39900085
Hospital Revenue Code	301
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$38.87
Rate for Payer: Aetna Medicare Advantage	$46.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.58
Rate for Payer: Cigna Commercial	$49.10
Rate for Payer: Cigna Medicare Advantage	$14.29
Rate for Payer: Clover Medicare Advantage	$13.58
Rate for Payer: EmblemHealth Commercial	$42.87
Rate for Payer: Humana Medicare Advantage	$14.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.46
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.73
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.43
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.29
Rate for Payer: Wellcare Medicare Advantage	$14.29
Rate for Payer: Wellpoint Medicaid Managed Care	$2.60

GLUCAGON, PLASMA

Facility

$179.25

Service Code	HCPCS 82943
Hospital Charge Code	3007416
Hospital Revenue Code	301
Min. Negotiated Rate	$26.89
Max. Negotiated Rate	$26.89
Rate for Payer: Qualcare PPO/HMO/WC	$26.89

GLUCAGON, PLASMA

Facility

$179.25

Service Code	HCPCS 82943
Hospital Charge Code	3007416
Hospital Revenue Code	301
Min. Negotiated Rate	$4.75
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$38.87
Rate for Payer: Aetna Medicare Advantage	$46.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.58
Rate for Payer: Cigna Commercial	$89.62
Rate for Payer: Cigna Medicare Advantage	$14.29
Rate for Payer: Clover Medicare Advantage	$13.58
Rate for Payer: EmblemHealth Commercial	$42.87
Rate for Payer: Humana Medicare Advantage	$14.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.77
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.89
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.43
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.29
Rate for Payer: Wellcare Medicare Advantage	$14.29
Rate for Payer: Wellpoint Medicaid Managed Care	$4.75

GLUCAGON RECOMBINANT 1 MG INJ

Facility

$1,379.66

Service Code	HCPCS J1610
Hospital Charge Code	6002638
Hospital Revenue Code	636
Min. Negotiated Rate	$206.95
Max. Negotiated Rate	$333.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.88
Rate for Payer: Qualcare PPO/HMO/WC	$206.95

GLUCAGON RECOMBINANT 1 MG INJ

Facility

$1,379.66

Service Code	HCPCS J1610
Hospital Charge Code	6002638
Hospital Revenue Code	636
Min. Negotiated Rate	$33.25
Max. Negotiated Rate	$528.21
Rate for Payer: Aetna Commercial	$398.02
Rate for Payer: Aetna Medicare Advantage	$474.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$528.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$528.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$146.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$528.21
Rate for Payer: Cigna Medicare Advantage	$146.33
Rate for Payer: Clover Medicare Advantage	$139.01
Rate for Payer: EmblemHealth Commercial	$438.99
Rate for Payer: Humana Medicare Advantage	$150.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$146.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.88
Rate for Payer: Qualcare PPO/HMO/WC	$206.95
Rate for Payer: UnitedHealthcare Community & State	$33.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$146.33
Rate for Payer: Wellcare Medicare Advantage	$146.33
Rate for Payer: Wellpoint Medicaid Managed Care	$36.56

GLUCERNA

Facility

$23.00

Hospital Charge Code	60634846
Hospital Revenue Code	250
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

GLUCERNA

Facility

$23.00

Hospital Charge Code	60634846
Hospital Revenue Code	250
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$11.50
Rate for Payer: Aetna Commercial	$8.74
Rate for Payer: Aetna Medicare Advantage	$6.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.87
Rate for Payer: Cigna Commercial	$11.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.90
Rate for Payer: Oxford Commercial	$4.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$4.60
Rate for Payer: UnitedHealthcare Community & State	$0.55
Rate for Payer: Wellpoint Medicaid Managed Care	$0.61

GLUCOMETER

Facility

$56.00

Service Code	HCPCS 82948
Hospital Charge Code	36540021
Hospital Revenue Code	301
Min. Negotiated Rate	$1.48
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$13.71
Rate for Payer: Aetna Medicare Advantage	$16.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.19
Rate for Payer: Cigna Commercial	$28.00
Rate for Payer: Cigna Medicare Advantage	$5.04
Rate for Payer: Clover Medicare Advantage	$4.79
Rate for Payer: EmblemHealth Commercial	$15.12
Rate for Payer: Humana Medicare Advantage	$5.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.04
Rate for Payer: Wellcare Medicare Advantage	$5.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.48

GLUCOMETER

Facility

$56.00

Service Code	HCPCS 82948
Hospital Charge Code	36540021
Hospital Revenue Code	301
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.40

GLUCOPHAGE 500MG

Facility

$4.00

Hospital Charge Code	60635048
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

GLUCOPHAGE 500MG

Facility

$4.00

Hospital Charge Code	60635048
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

GLUCOPHAGE 850MG/TAB

Facility

$5.00

Hospital Charge Code	60635102
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

GLUCOPHAGE 850MG/TAB

Facility

$5.00

Hospital Charge Code	60635102
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.90
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.50
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$1.00
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

GLUCOSAMINE-CHONDROITIN TAB

Facility

$1.65

Hospital Charge Code	60629203
Hospital Revenue Code	250
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$0.25
Rate for Payer: Qualcare PPO/HMO/WC	$0.25

GLUCOSAMINE-CHONDROITIN TAB

Facility

$1.65

Hospital Charge Code	60629203
Hospital Revenue Code	250
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.83
Rate for Payer: Aetna Commercial	$0.63
Rate for Payer: Aetna Medicare Advantage	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.42
Rate for Payer: Cigna Commercial	$0.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.50
Rate for Payer: Oxford Commercial	$0.33
Rate for Payer: Qualcare PPO/HMO/WC	$0.25
Rate for Payer: UnitedHealthcare Commercial	$0.33
Rate for Payer: UnitedHealthcare Community & State	$0.04
Rate for Payer: Wellpoint Medicaid Managed Care	$0.04

GLUCOSE

Facility

$156.00

Service Code	HCPCS 82947
Hospital Charge Code	38472302
Hospital Revenue Code	301
Min. Negotiated Rate	$23.40
Max. Negotiated Rate	$23.40
Rate for Payer: Qualcare PPO/HMO/WC	$23.40

GLUCOSE

Facility

$117.65

Service Code	HCPCS 82947CF
Hospital Charge Code	8200312RS
Hospital Revenue Code	301
Min. Negotiated Rate	$17.65
Max. Negotiated Rate	$17.65
Rate for Payer: Qualcare PPO/HMO/WC	$17.65

GLUCOSE

Facility

$117.65

Service Code	HCPCS 82947CF
Hospital Charge Code	8200312RS
Hospital Revenue Code	301
Min. Negotiated Rate	$2.84
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$44.71
Rate for Payer: Aetna Medicare Advantage	$35.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.00
Rate for Payer: Cigna Commercial	$58.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.84
Rate for Payer: Wellpoint Medicaid Managed Care	$3.12

Know your out-of-pocket cost for care.

All Charges