Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HEPARIN 100 UNITS/ML INJ

Facility

$45.36

Service Code	NDC 409128031
Hospital Charge Code	60627507
Hospital Revenue Code	250
Min. Negotiated Rate	$6.80
Max. Negotiated Rate	$6.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.80

HEPARIN 10 UNITS/ML (5 ML)

Facility

$1.70

Hospital Charge Code	60630233
Hospital Revenue Code	636
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.85
Rate for Payer: Aetna Commercial	$0.65
Rate for Payer: Aetna Medicare Advantage	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.43
Rate for Payer: Cigna Commercial	$0.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.41
Rate for Payer: Qualcare PPO/HMO/WC	$0.26
Rate for Payer: UnitedHealthcare Community & State	$0.04
Rate for Payer: Wellpoint Medicaid Managed Care	$0.05

HEPARIN 10 UNITS/ML (5 ML)

Facility

$1.70

Hospital Charge Code	60630233
Hospital Revenue Code	636
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$0.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.41
Rate for Payer: Qualcare PPO/HMO/WC	$0.26

HEPARIN 10 UNITS/ML INJ

Facility

$4.85

Hospital Charge Code	60628920
Hospital Revenue Code	636
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$1.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.17
Rate for Payer: Qualcare PPO/HMO/WC	$0.73

HEPARIN 10 UNITS/ML INJ

Facility

$4.85

Hospital Charge Code	60628920
Hospital Revenue Code	636
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.42
Rate for Payer: Aetna Commercial	$1.84
Rate for Payer: Aetna Medicare Advantage	$1.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.24
Rate for Payer: Cigna Commercial	$2.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.17
Rate for Payer: Qualcare PPO/HMO/WC	$0.73
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

HEPARIN 25000/250ML/D5W

Facility

$42.00

Hospital Charge Code	60634977
Hospital Revenue Code	636
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$10.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.16
Rate for Payer: Qualcare PPO/HMO/WC	$6.30

HEPARIN 25000/250ML/D5W

Facility

$42.00

Hospital Charge Code	60634977
Hospital Revenue Code	636
Min. Negotiated Rate	$1.01
Max. Negotiated Rate	$21.00
Rate for Payer: Aetna Commercial	$15.96
Rate for Payer: Aetna Medicare Advantage	$12.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.71
Rate for Payer: Cigna Commercial	$21.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.16
Rate for Payer: Qualcare PPO/HMO/WC	$6.30
Rate for Payer: UnitedHealthcare Community & State	$1.01
Rate for Payer: Wellpoint Medicaid Managed Care	$1.11

HEPARIN 25000/500ML/D5W

Facility

$36.00

Hospital Charge Code	60634978
Hospital Revenue Code	636
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$18.00
Rate for Payer: Aetna Commercial	$13.68
Rate for Payer: Aetna Medicare Advantage	$10.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.18
Rate for Payer: Cigna Commercial	$18.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.71
Rate for Payer: Qualcare PPO/HMO/WC	$5.40
Rate for Payer: UnitedHealthcare Community & State	$0.87
Rate for Payer: Wellpoint Medicaid Managed Care	$0.95

HEPARIN 25000/500ML/D5W

Facility

$36.00

Hospital Charge Code	60634978
Hospital Revenue Code	636
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$8.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.71
Rate for Payer: Qualcare PPO/HMO/WC	$5.40

HEPARIN 25000U/250ML BAGS

Facility

$59.23

Service Code	HCPCS J1644
Hospital Charge Code	60635054
Hospital Revenue Code	636
Min. Negotiated Rate	$8.88
Max. Negotiated Rate	$14.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.33
Rate for Payer: Qualcare PPO/HMO/WC	$8.88

HEPARIN 25000U/250ML BAGS

Facility

$59.23

Service Code	HCPCS J1644
Hospital Charge Code	60635054
Hospital Revenue Code	636
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$29.61
Rate for Payer: Aetna Commercial	$22.51
Rate for Payer: Aetna Medicare Advantage	$17.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.10
Rate for Payer: Cigna Commercial	$29.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.33
Rate for Payer: Qualcare PPO/HMO/WC	$8.88
Rate for Payer: UnitedHealthcare Community & State	$1.43
Rate for Payer: Wellpoint Medicaid Managed Care	$1.57

HEPARIN 5000 UNITS/ML INJ

Facility

$6.70

Service Code	HCPCS J1644
Hospital Charge Code	60627511
Hospital Revenue Code	636
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$3.35
Rate for Payer: Aetna Commercial	$2.55
Rate for Payer: Aetna Medicare Advantage	$2.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.71
Rate for Payer: Cigna Commercial	$3.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.00
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

HEPARIN 5000 UNITS/ML INJ

Facility

$6.70

Service Code	HCPCS J1644
Hospital Charge Code	60627511
Hospital Revenue Code	636
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$1.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.00

Heparin, Anti-Xa

Facility

$480.85

Service Code	HCPCS 85520
Hospital Charge Code	401085520
Hospital Revenue Code	305
Min. Negotiated Rate	$10.47
Max. Negotiated Rate	$240.43
Rate for Payer: Aetna Commercial	$35.60
Rate for Payer: Aetna Medicare Advantage	$42.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.25
Rate for Payer: Cigna Commercial	$240.43
Rate for Payer: Cigna Medicare Advantage	$13.09
Rate for Payer: Clover Medicare Advantage	$12.44
Rate for Payer: EmblemHealth Commercial	$39.27
Rate for Payer: Humana Medicare Advantage	$13.48
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$72.13
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.09
Rate for Payer: Wellcare Medicare Advantage	$13.09
Rate for Payer: Wellpoint Medicaid Managed Care	$12.74

Heparin, Anti-Xa

Facility

$480.85

Service Code	HCPCS 85520
Hospital Charge Code	401085520
Hospital Revenue Code	305
Min. Negotiated Rate	$72.13
Max. Negotiated Rate	$72.13
Rate for Payer: Qualcare PPO/HMO/WC	$72.13

HEPARIN ANTI-XA

Facility

$65.45

Service Code	HCPCS 85520
Hospital Charge Code	38476001
Hospital Revenue Code	305
Min. Negotiated Rate	$1.73
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$35.60
Rate for Payer: Aetna Medicare Advantage	$42.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.25
Rate for Payer: Cigna Commercial	$32.73
Rate for Payer: Cigna Medicare Advantage	$13.09
Rate for Payer: Clover Medicare Advantage	$12.44
Rate for Payer: EmblemHealth Commercial	$39.27
Rate for Payer: Humana Medicare Advantage	$13.48
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.64
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.82
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.09
Rate for Payer: Wellcare Medicare Advantage	$13.09
Rate for Payer: Wellpoint Medicaid Managed Care	$1.73

HEPARIN ANTI-XA

Facility

$65.45

Service Code	HCPCS 85520
Hospital Charge Code	38476001
Hospital Revenue Code	305
Min. Negotiated Rate	$9.82
Max. Negotiated Rate	$9.82
Rate for Payer: Qualcare PPO/HMO/WC	$9.82

HEPARIN ASSAY

Facility

$305.00

Service Code	HCPCS 85520
Hospital Charge Code	38477112
Hospital Revenue Code	305
Min. Negotiated Rate	$8.08
Max. Negotiated Rate	$152.50
Rate for Payer: Aetna Commercial	$35.60
Rate for Payer: Aetna Medicare Advantage	$42.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.25
Rate for Payer: Cigna Commercial	$152.50
Rate for Payer: Cigna Medicare Advantage	$13.09
Rate for Payer: Clover Medicare Advantage	$12.44
Rate for Payer: EmblemHealth Commercial	$39.27
Rate for Payer: Humana Medicare Advantage	$13.48
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.75
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.09
Rate for Payer: Wellcare Medicare Advantage	$13.09
Rate for Payer: Wellpoint Medicaid Managed Care	$8.08

HEPARIN ASSAY

Facility

$305.00

Service Code	HCPCS 85520
Hospital Charge Code	38477112
Hospital Revenue Code	305
Min. Negotiated Rate	$45.75
Max. Negotiated Rate	$45.75
Rate for Payer: Qualcare PPO/HMO/WC	$45.75

HEPARIN BEEF 1000U/ML 10ML VL

Facility

$4.00

Hospital Charge Code	6010169
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

HEPARIN BEEF 1000U/ML 10ML VL

Facility

$4.00

Hospital Charge Code	6010169
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

HEPARIN BEEF INJ 10000U/10ML

Facility

$12.20

Hospital Charge Code	60629164
Hospital Revenue Code	250
Min. Negotiated Rate	$1.83
Max. Negotiated Rate	$1.83
Rate for Payer: Qualcare PPO/HMO/WC	$1.83

HEPARIN BEEF INJ 10000U/10ML

Facility

$12.20

Hospital Charge Code	60629164
Hospital Revenue Code	250
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$6.10
Rate for Payer: Aetna Commercial	$4.64
Rate for Payer: Aetna Medicare Advantage	$3.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.11
Rate for Payer: Cigna Commercial	$6.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.66
Rate for Payer: Oxford Commercial	$2.44
Rate for Payer: Qualcare PPO/HMO/WC	$1.83
Rate for Payer: UnitedHealthcare Commercial	$2.44
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

HEPARIN FLS 100U/1 ML INJ 3 ML

Facility

$38.12

Service Code	HCPCS J1642
Hospital Charge Code	6012595
Hospital Revenue Code	636
Min. Negotiated Rate	$5.72
Max. Negotiated Rate	$9.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.23
Rate for Payer: Qualcare PPO/HMO/WC	$5.72

HEPARIN FLS 100U/1 ML INJ 3 ML

Facility

$38.12

Service Code	HCPCS J1642
Hospital Charge Code	6012595
Hospital Revenue Code	636
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$19.06
Rate for Payer: Aetna Commercial	$14.49
Rate for Payer: Aetna Medicare Advantage	$11.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.72
Rate for Payer: Cigna Commercial	$19.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.23
Rate for Payer: Qualcare PPO/HMO/WC	$5.72
Rate for Payer: UnitedHealthcare Community & State	$0.92
Rate for Payer: Wellpoint Medicaid Managed Care	$1.01

Know your out-of-pocket cost for care.

All Charges