Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HYDROCORT OINT 0.2%

Facility

$276.00

Hospital Charge Code	60628399
Hospital Revenue Code	250
Min. Negotiated Rate	$6.65
Max. Negotiated Rate	$138.00
Rate for Payer: Aetna Commercial	$104.88
Rate for Payer: Aetna Medicare Advantage	$82.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.38
Rate for Payer: Cigna Commercial	$138.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.80
Rate for Payer: Oxford Commercial	$55.20
Rate for Payer: Qualcare PPO/HMO/WC	$41.40
Rate for Payer: UnitedHealthcare Commercial	$55.20
Rate for Payer: UnitedHealthcare Community & State	$6.65
Rate for Payer: Wellpoint Medicaid Managed Care	$7.31

HYDROCORT OINT 0.2%

Facility

$276.00

Hospital Charge Code	60628399
Hospital Revenue Code	250
Min. Negotiated Rate	$41.40
Max. Negotiated Rate	$41.40
Rate for Payer: Qualcare PPO/HMO/WC	$41.40

HYDROCORTONE/10G/TAB

Facility

$3.00

Hospital Charge Code	60634379
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

HYDROCORTONE/10G/TAB

Facility

$3.00

Hospital Charge Code	60634379
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

HYDROCORTONE/20MG/TAB

Facility

$3.00

Hospital Charge Code	60634378
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

HYDROCORTONE/20MG/TAB

Facility

$3.00

Hospital Charge Code	60634378
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

HYDROCORT POLY OTC SOL .5%10ML

Facility

$37.80

Hospital Charge Code	6002984
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

HYDROCORT POLY OTC SOL .5%10ML

Facility

$37.80

Hospital Charge Code	6002984
Hospital Revenue Code	251
Min. Negotiated Rate	$5.67
Max. Negotiated Rate	$5.67
Rate for Payer: Qualcare PPO/HMO/WC	$5.67

HYDROCORT SOD SUC INJ 250MG

Facility

$51.20

Hospital Charge Code	60628197
Hospital Revenue Code	250
Min. Negotiated Rate	$7.68
Max. Negotiated Rate	$7.68
Rate for Payer: Qualcare PPO/HMO/WC	$7.68

HYDROCORT SOD SUC INJ 250MG

Facility

$51.20

Hospital Charge Code	60628197
Hospital Revenue Code	250
Min. Negotiated Rate	$1.23
Max. Negotiated Rate	$25.60
Rate for Payer: Aetna Commercial	$19.46
Rate for Payer: Aetna Medicare Advantage	$15.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.06
Rate for Payer: Cigna Commercial	$25.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.36
Rate for Payer: Oxford Commercial	$10.24
Rate for Payer: Qualcare PPO/HMO/WC	$7.68
Rate for Payer: UnitedHealthcare Commercial	$10.24
Rate for Payer: UnitedHealthcare Community & State	$1.23
Rate for Payer: Wellpoint Medicaid Managed Care	$1.36

HYDROCORT SOD SUC INJ 500MG

Facility

$121.00

Hospital Charge Code	60628198
Hospital Revenue Code	250
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$18.15

HYDROCORT SOD SUC INJ 500MG

Facility

$121.00

Hospital Charge Code	60628198
Hospital Revenue Code	250
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$60.50
Rate for Payer: Aetna Commercial	$45.98
Rate for Payer: Aetna Medicare Advantage	$36.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.86
Rate for Payer: Cigna Commercial	$60.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.30
Rate for Payer: Oxford Commercial	$24.20
Rate for Payer: Qualcare PPO/HMO/WC	$18.15
Rate for Payer: UnitedHealthcare Commercial	$24.20
Rate for Payer: UnitedHealthcare Community & State	$2.92
Rate for Payer: Wellpoint Medicaid Managed Care	$3.21

HYDROCORT VALERATE .2% 60GM

Facility

$215.05

Hospital Charge Code	6008650
Hospital Revenue Code	251
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$107.53
Rate for Payer: Aetna Commercial	$81.72
Rate for Payer: Aetna Medicare Advantage	$64.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.84
Rate for Payer: Cigna Commercial	$107.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.52
Rate for Payer: Oxford Commercial	$43.01
Rate for Payer: Qualcare PPO/HMO/WC	$32.26
Rate for Payer: UnitedHealthcare Commercial	$43.01
Rate for Payer: UnitedHealthcare Community & State	$5.18
Rate for Payer: Wellpoint Medicaid Managed Care	$5.70

HYDROCORT VALERATE .2% 60GM

Facility

$215.05

Hospital Charge Code	6008650
Hospital Revenue Code	251
Min. Negotiated Rate	$32.26
Max. Negotiated Rate	$32.26
Rate for Payer: Qualcare PPO/HMO/WC	$32.26

HYDRO DISSECTION SUCTION

Facility

$372.52

Hospital Charge Code	270650793
Hospital Revenue Code	272
Min. Negotiated Rate	$55.88
Max. Negotiated Rate	$55.88
Rate for Payer: Qualcare PPO/HMO/WC	$55.88

HYDRO DISSECTION SUCTION

Facility

$372.52

Hospital Charge Code	270650793
Hospital Revenue Code	272
Min. Negotiated Rate	$8.98
Max. Negotiated Rate	$186.26
Rate for Payer: Aetna Commercial	$141.56
Rate for Payer: Aetna Medicare Advantage	$111.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.99
Rate for Payer: Cigna Commercial	$186.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.76
Rate for Payer: Oxford Commercial	$74.50
Rate for Payer: Qualcare PPO/HMO/WC	$55.88
Rate for Payer: UnitedHealthcare Commercial	$74.50
Rate for Payer: UnitedHealthcare Community & State	$8.98
Rate for Payer: Wellpoint Medicaid Managed Care	$9.87

HYDROFLEX HD HYSTER DIST TUBIN

Facility

$125.00

Hospital Charge Code	270339089
Hospital Revenue Code	272
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.50
Rate for Payer: Oxford Commercial	$25.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$25.00
Rate for Payer: UnitedHealthcare Community & State	$3.01
Rate for Payer: Wellpoint Medicaid Managed Care	$3.31

HYDROFLEX HD HYSTER DIST TUBIN

Facility

$125.00

Hospital Charge Code	270339089
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

HYDROGEL SKINTEGRITY 1 OZ

Facility

$5.19

Hospital Charge Code	270350290
Hospital Revenue Code	272
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$0.78
Rate for Payer: Qualcare PPO/HMO/WC	$0.78

HYDROGEL SKINTEGRITY 1 OZ

Facility

$5.19

Hospital Charge Code	270350290
Hospital Revenue Code	272
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$2.60
Rate for Payer: Aetna Commercial	$1.97
Rate for Payer: Aetna Medicare Advantage	$1.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.32
Rate for Payer: Cigna Commercial	$2.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.56
Rate for Payer: Oxford Commercial	$1.04
Rate for Payer: Qualcare PPO/HMO/WC	$0.78
Rate for Payer: UnitedHealthcare Commercial	$1.04
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

HYDROGEL WOUND DRESSING 8G

Facility

$30.10

Hospital Charge Code	60628890
Hospital Revenue Code	250
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

HYDROGEL WOUND DRESSING 8G

Facility

$30.10

Hospital Charge Code	60628890
Hospital Revenue Code	250
Min. Negotiated Rate	$4.51
Max. Negotiated Rate	$4.51
Rate for Payer: Qualcare PPO/HMO/WC	$4.51

HYDROGEN PEROXIDE 3% PINT

Facility

$3.85

Hospital Charge Code	6014096
Hospital Revenue Code	250
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$1.93
Rate for Payer: Aetna Commercial	$1.46
Rate for Payer: Aetna Medicare Advantage	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.98
Rate for Payer: Cigna Commercial	$1.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.16
Rate for Payer: Oxford Commercial	$0.77
Rate for Payer: Qualcare PPO/HMO/WC	$0.58
Rate for Payer: UnitedHealthcare Commercial	$0.77
Rate for Payer: UnitedHealthcare Community & State	$0.09
Rate for Payer: Wellpoint Medicaid Managed Care	$0.10

HYDROGEN PEROXIDE 3% PINT

Facility

$3.85

Hospital Charge Code	6014096
Hospital Revenue Code	250
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$0.58
Rate for Payer: Qualcare PPO/HMO/WC	$0.58

HYDROGEN PEROXIDE 3% SOLN

Facility

$105.26

Service Code	NDC 49348003138
Hospital Charge Code	60628351
Hospital Revenue Code	250
Min. Negotiated Rate	$2.54
Max. Negotiated Rate	$52.63
Rate for Payer: Aetna Commercial	$40.00
Rate for Payer: Aetna Medicare Advantage	$31.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.84
Rate for Payer: Cigna Commercial	$52.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.58
Rate for Payer: Oxford Commercial	$21.05
Rate for Payer: Qualcare PPO/HMO/WC	$15.79
Rate for Payer: UnitedHealthcare Commercial	$21.05
Rate for Payer: UnitedHealthcare Community & State	$2.54
Rate for Payer: Wellpoint Medicaid Managed Care	$2.79

Know your out-of-pocket cost for care.

All Charges