Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HUMULIN R/100U/1ML

Facility

$43.00

Hospital Charge Code	60633097
Hospital Revenue Code	250
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

HUMULIN R/100U/1ML

Facility

$43.00

Hospital Charge Code	60633097
Hospital Revenue Code	250
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$16.34
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.90
Rate for Payer: Oxford Commercial	$8.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$8.60
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.14

HUMULIN R 100U/ML 10ML VIAL

Facility

$267.65

Hospital Charge Code	606390570
Hospital Revenue Code	250
Min. Negotiated Rate	$40.15
Max. Negotiated Rate	$40.15
Rate for Payer: Qualcare PPO/HMO/WC	$40.15

HUMULIN R 100U/ML 10ML VIAL

Facility

$267.65

Hospital Charge Code	606390570
Hospital Revenue Code	250
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$133.82
Rate for Payer: Aetna Commercial	$101.71
Rate for Payer: Aetna Medicare Advantage	$80.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.25
Rate for Payer: Cigna Commercial	$133.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.30
Rate for Payer: Oxford Commercial	$53.53
Rate for Payer: Qualcare PPO/HMO/WC	$40.15
Rate for Payer: UnitedHealthcare Commercial	$53.53
Rate for Payer: UnitedHealthcare Community & State	$6.45
Rate for Payer: Wellpoint Medicaid Managed Care	$7.09

HUMULIN R (U100)

Facility

$80.65

Hospital Charge Code	6008338
Hospital Revenue Code	250
Min. Negotiated Rate	$1.94
Max. Negotiated Rate	$40.33
Rate for Payer: Aetna Commercial	$30.65
Rate for Payer: Aetna Medicare Advantage	$24.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.57
Rate for Payer: Cigna Commercial	$40.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.20
Rate for Payer: Oxford Commercial	$16.13
Rate for Payer: Qualcare PPO/HMO/WC	$12.10
Rate for Payer: UnitedHealthcare Commercial	$16.13
Rate for Payer: UnitedHealthcare Community & State	$1.94
Rate for Payer: Wellpoint Medicaid Managed Care	$2.14

HUMULIN R (U100)

Facility

$80.65

Hospital Charge Code	6008338
Hospital Revenue Code	250
Min. Negotiated Rate	$12.10
Max. Negotiated Rate	$12.10
Rate for Payer: Qualcare PPO/HMO/WC	$12.10

HUMULIN U HI-610 ULTRALEN

Facility

$89.00

Hospital Charge Code	60633098
Hospital Revenue Code	250
Min. Negotiated Rate	$2.14
Max. Negotiated Rate	$44.50
Rate for Payer: Aetna Commercial	$33.82
Rate for Payer: Aetna Medicare Advantage	$26.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.70
Rate for Payer: Cigna Commercial	$44.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.70
Rate for Payer: Oxford Commercial	$17.80
Rate for Payer: Qualcare PPO/HMO/WC	$13.35
Rate for Payer: UnitedHealthcare Commercial	$17.80
Rate for Payer: UnitedHealthcare Community & State	$2.14
Rate for Payer: Wellpoint Medicaid Managed Care	$2.36

HUMULIN U HI-610 ULTRALEN

Facility

$89.00

Hospital Charge Code	60633098
Hospital Revenue Code	250
Min. Negotiated Rate	$13.35
Max. Negotiated Rate	$13.35
Rate for Payer: Qualcare PPO/HMO/WC	$13.35

HUNTER ACTIVE TENDON IMPLANT P

Facility

$7,150.00

Service Code	HCPCS C1762
Hospital Charge Code	270679623
Hospital Revenue Code	278
Min. Negotiated Rate	$1,072.50
Max. Negotiated Rate	$1,730.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,730.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,072.50

HUNTER ACTIVE TENDON IMPLANT P

Facility

$7,150.00

Service Code	HCPCS C1762
Hospital Charge Code	270679623
Hospital Revenue Code	278
Min. Negotiated Rate	$172.31
Max. Negotiated Rate	$3,575.00
Rate for Payer: Aetna Commercial	$2,717.00
Rate for Payer: Aetna Medicare Advantage	$2,145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,823.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,823.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,430.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,823.25
Rate for Payer: Cigna Commercial	$3,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,730.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,072.50
Rate for Payer: UnitedHealthcare Community & State	$172.31
Rate for Payer: Wellpoint Medicaid Managed Care	$189.47

HUNTER ROD 4x24.5CM

Facility

$7,150.00

Service Code	HCPCS C1713
Hospital Charge Code	270671369
Hospital Revenue Code	278
Min. Negotiated Rate	$1,072.50
Max. Negotiated Rate	$1,730.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,730.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,072.50

HUNTER ROD 4x24.5CM

Facility

$7,150.00

Service Code	HCPCS C1713
Hospital Charge Code	270671369
Hospital Revenue Code	278
Min. Negotiated Rate	$172.31
Max. Negotiated Rate	$3,575.00
Rate for Payer: Aetna Commercial	$2,717.00
Rate for Payer: Aetna Medicare Advantage	$2,145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,823.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,823.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,430.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,823.25
Rate for Payer: Cigna Commercial	$3,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,730.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,072.50
Rate for Payer: UnitedHealthcare Community & State	$172.31
Rate for Payer: Wellpoint Medicaid Managed Care	$189.47

HUNTINGTON DISEASE MUTATI

Facility

$2,375.00

Service Code	HCPCS 81401
Hospital Charge Code	39900026
Hospital Revenue Code	310
Min. Negotiated Rate	$62.94
Max. Negotiated Rate	$1,187.50
Rate for Payer: Aetna Commercial	$372.64
Rate for Payer: Aetna Medicare Advantage	$443.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$494.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$494.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$137.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$494.53
Rate for Payer: Cigna Commercial	$1,187.50
Rate for Payer: Cigna Medicare Advantage	$137.00
Rate for Payer: Clover Medicare Advantage	$130.15
Rate for Payer: EmblemHealth Commercial	$411.00
Rate for Payer: Humana Medicare Advantage	$141.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$137.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$712.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$356.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$109.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$137.00
Rate for Payer: Wellcare Medicare Advantage	$137.00
Rate for Payer: Wellpoint Medicaid Managed Care	$62.94

HUNTINGTON DISEASE MUTATI

Facility

$2,375.00

Service Code	HCPCS 81401
Hospital Charge Code	39900026
Hospital Revenue Code	310
Min. Negotiated Rate	$356.25
Max. Negotiated Rate	$356.25
Rate for Payer: Qualcare PPO/HMO/WC	$356.25

HURRICANE ONE SPRAY 0.5ML

Facility

$92.66

Service Code	NDC 283061026
Hospital Charge Code	60635735
Hospital Revenue Code	250
Min. Negotiated Rate	$13.90
Max. Negotiated Rate	$13.90
Rate for Payer: Qualcare PPO/HMO/WC	$13.90

HURRICANE ONE SPRAY 0.5ML

Facility

$92.66

Service Code	NDC 283061026
Hospital Charge Code	60635735
Hospital Revenue Code	250
Min. Negotiated Rate	$2.23
Max. Negotiated Rate	$46.33
Rate for Payer: Aetna Commercial	$35.21
Rate for Payer: Aetna Medicare Advantage	$27.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.63
Rate for Payer: Cigna Commercial	$46.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.80
Rate for Payer: Oxford Commercial	$18.53
Rate for Payer: Qualcare PPO/HMO/WC	$13.90
Rate for Payer: UnitedHealthcare Commercial	$18.53
Rate for Payer: UnitedHealthcare Community & State	$2.23
Rate for Payer: Wellpoint Medicaid Managed Care	$2.46

HURRICANE SPRAY 20%

Facility

$39.00

Hospital Charge Code	60635349
Hospital Revenue Code	250
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$19.50
Rate for Payer: Aetna Commercial	$14.82
Rate for Payer: Aetna Medicare Advantage	$11.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.95
Rate for Payer: Cigna Commercial	$19.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.70
Rate for Payer: Oxford Commercial	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$5.85
Rate for Payer: UnitedHealthcare Commercial	$7.80
Rate for Payer: UnitedHealthcare Community & State	$0.94
Rate for Payer: Wellpoint Medicaid Managed Care	$1.03

HURRICANE SPRAY 20%

Facility

$39.00

Hospital Charge Code	60635349
Hospital Revenue Code	250
Min. Negotiated Rate	$5.85
Max. Negotiated Rate	$5.85
Rate for Payer: Qualcare PPO/HMO/WC	$5.85

HX DRIV N-FORCE 4.0

Facility

$520.00

Hospital Charge Code	270687090
Hospital Revenue Code	272
Min. Negotiated Rate	$78.00
Max. Negotiated Rate	$78.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.00

HX DRIV N-FORCE 4.0

Facility

$520.00

Hospital Charge Code	270687090
Hospital Revenue Code	272
Min. Negotiated Rate	$12.53
Max. Negotiated Rate	$260.00
Rate for Payer: Aetna Commercial	$197.60
Rate for Payer: Aetna Medicare Advantage	$156.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.60
Rate for Payer: Cigna Commercial	$260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.00
Rate for Payer: Oxford Commercial	$104.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.00
Rate for Payer: UnitedHealthcare Commercial	$104.00
Rate for Payer: UnitedHealthcare Community & State	$12.53
Rate for Payer: Wellpoint Medicaid Managed Care	$13.78

HYALURONAN FOR IA INJ

Facility

$1,026.64

Service Code	HCPCS J7323
Hospital Charge Code	412317323
Hospital Revenue Code	636
Min. Negotiated Rate	$154.00
Max. Negotiated Rate	$248.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.45
Rate for Payer: Qualcare PPO/HMO/WC	$154.00

HYALURONAN FOR IA INJ

Facility

$1,026.64

Service Code	HCPCS J7323
Hospital Charge Code	412317323
Hospital Revenue Code	636
Min. Negotiated Rate	$24.74
Max. Negotiated Rate	$381.11
Rate for Payer: Aetna Commercial	$287.18
Rate for Payer: Aetna Medicare Advantage	$342.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$381.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$381.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$105.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$381.11
Rate for Payer: Cigna Medicare Advantage	$105.58
Rate for Payer: Clover Medicare Advantage	$100.30
Rate for Payer: EmblemHealth Commercial	$316.74
Rate for Payer: Humana Medicare Advantage	$108.75
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$105.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.45
Rate for Payer: Qualcare PPO/HMO/WC	$154.00
Rate for Payer: UnitedHealthcare Community & State	$24.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$105.58
Rate for Payer: Wellcare Medicare Advantage	$105.58
Rate for Payer: Wellpoint Medicaid Managed Care	$27.21

HYALURONIDASE 200 U/ML VIAL

Facility

$446.15

Service Code	HCPCS J3470
Hospital Charge Code	60630065
Hospital Revenue Code	636
Min. Negotiated Rate	$10.75
Max. Negotiated Rate	$223.07
Rate for Payer: Aetna Commercial	$169.54
Rate for Payer: Aetna Medicare Advantage	$133.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.77
Rate for Payer: Cigna Commercial	$223.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.97
Rate for Payer: Qualcare PPO/HMO/WC	$66.92
Rate for Payer: UnitedHealthcare Community & State	$10.75
Rate for Payer: Wellpoint Medicaid Managed Care	$11.82

HYALURONIDASE 200 U/ML VIAL

Facility

$446.15

Service Code	HCPCS J3470
Hospital Charge Code	60630065
Hospital Revenue Code	636
Min. Negotiated Rate	$66.92
Max. Negotiated Rate	$107.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.97
Rate for Payer: Qualcare PPO/HMO/WC	$66.92

HYALURONIDASE INJ 150U/1ML****

Facility

$79.00

Service Code	HCPCS J3470
Hospital Charge Code	60627983
Hospital Revenue Code	636
Min. Negotiated Rate	$11.85
Max. Negotiated Rate	$19.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.12
Rate for Payer: Qualcare PPO/HMO/WC	$11.85

Know your out-of-pocket cost for care.

All Charges