Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

INJECT,AMPHOTERICIN B LIP 10MG

Facility

$691.85

Hospital Charge Code	6016571
Hospital Revenue Code	636
Min. Negotiated Rate	$16.67
Max. Negotiated Rate	$345.93
Rate for Payer: Aetna Commercial	$262.90
Rate for Payer: Aetna Medicare Advantage	$207.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$176.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$176.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$176.42
Rate for Payer: Cigna Commercial	$345.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.43
Rate for Payer: Qualcare PPO/HMO/WC	$103.78
Rate for Payer: UnitedHealthcare Community & State	$16.67
Rate for Payer: Wellpoint Medicaid Managed Care	$18.33

INJECT,DEXAMETHASONE ACETO 1MG

Facility

$9.00

Hospital Charge Code	6012440
Hospital Revenue Code	250
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$3.42
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.70
Rate for Payer: Oxford Commercial	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$1.80
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

INJECT,DEXAMETHASONE ACETO 1MG

Facility

$9.00

Hospital Charge Code	6012440
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

INJECT-IM/SQ DURING INFUS

Facility

$343.00

Service Code	HCPCS 9637259
Hospital Charge Code	93500053
Hospital Revenue Code	260
Min. Negotiated Rate	$8.27
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$130.34
Rate for Payer: Aetna Medicare Advantage	$102.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.47
Rate for Payer: Cigna Commercial	$171.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.90
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.45
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$8.27
Rate for Payer: Wellpoint Medicaid Managed Care	$9.09

INJECT-IM/SQ DURING INFUS

Facility

$343.00

Service Code	HCPCS 9637259
Hospital Charge Code	93500053
Hospital Revenue Code	260
Min. Negotiated Rate	$51.45
Max. Negotiated Rate	$51.45
Rate for Payer: Qualcare PPO/HMO/WC	$51.45

INJECT-INTRA-ART DUR INF

Facility

$257.00

Service Code	HCPCS 96373
Hospital Charge Code	93500059
Hospital Revenue Code	260
Min. Negotiated Rate	$6.19
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$687.34
Rate for Payer: Aetna Medicare Advantage	$818.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$912.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$912.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$252.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$912.17
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: Cigna Medicare Advantage	$252.70
Rate for Payer: Clover Medicare Advantage	$240.06
Rate for Payer: EmblemHealth Commercial	$758.10
Rate for Payer: Humana Medicare Advantage	$260.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$252.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.10
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.55
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$6.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$252.70
Rate for Payer: Wellcare Medicare Advantage	$252.70
Rate for Payer: Wellpoint Medicaid Managed Care	$6.81

INJECT-INTRA-ART DUR INF

Facility

$257.00

Service Code	HCPCS 96373
Hospital Charge Code	3409025
Hospital Revenue Code	260
Min. Negotiated Rate	$6.19
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$687.34
Rate for Payer: Aetna Medicare Advantage	$818.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$912.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$912.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$252.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$912.17
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: Cigna Medicare Advantage	$252.70
Rate for Payer: Clover Medicare Advantage	$240.06
Rate for Payer: EmblemHealth Commercial	$758.10
Rate for Payer: Humana Medicare Advantage	$260.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$252.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.10
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.55
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$6.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$252.70
Rate for Payer: Wellcare Medicare Advantage	$252.70
Rate for Payer: Wellpoint Medicaid Managed Care	$6.81

INJECT-INTRA-ART DUR INF

Facility

$257.00

Service Code	HCPCS 96373
Hospital Charge Code	93500059
Hospital Revenue Code	260
Min. Negotiated Rate	$38.55
Max. Negotiated Rate	$38.55
Rate for Payer: Qualcare PPO/HMO/WC	$38.55

INJECT-INTRA-ART DUR INF

Facility

$257.00

Service Code	HCPCS 96373
Hospital Charge Code	3409025
Hospital Revenue Code	260
Min. Negotiated Rate	$38.55
Max. Negotiated Rate	$38.55
Rate for Payer: Qualcare PPO/HMO/WC	$38.55

INJECT-INTRA-ARTERIL ONLY

Facility

$257.00

Service Code	HCPCS 96373
Hospital Charge Code	93500057
Hospital Revenue Code	260
Min. Negotiated Rate	$38.55
Max. Negotiated Rate	$38.55
Rate for Payer: Qualcare PPO/HMO/WC	$38.55

INJECT-INTRA-ARTERIL ONLY

Facility

$257.00

Service Code	HCPCS 96373
Hospital Charge Code	93500057
Hospital Revenue Code	260
Min. Negotiated Rate	$6.19
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$687.34
Rate for Payer: Aetna Medicare Advantage	$818.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$912.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$912.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$252.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$912.17
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: Cigna Medicare Advantage	$252.70
Rate for Payer: Clover Medicare Advantage	$240.06
Rate for Payer: EmblemHealth Commercial	$758.10
Rate for Payer: Humana Medicare Advantage	$260.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$252.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.10
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.55
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$6.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$252.70
Rate for Payer: Wellcare Medicare Advantage	$252.70
Rate for Payer: Wellpoint Medicaid Managed Care	$6.81

INJECTION CEFRIAXONE*****

Facility

$11.26

Service Code	HCPCS J0696
Hospital Charge Code	9600027
Hospital Revenue Code	636
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$5.63
Rate for Payer: Aetna Commercial	$4.28
Rate for Payer: Aetna Medicare Advantage	$3.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.87
Rate for Payer: Cigna Commercial	$5.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.72
Rate for Payer: Qualcare PPO/HMO/WC	$1.69
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

INJECTION CEFRIAXONE*****

Facility

$11.26

Service Code	HCPCS J0696
Hospital Charge Code	9600027
Hospital Revenue Code	636
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$2.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.72
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

INJECTION CORTICOTROPIN 500 MG

Facility

$154.25

Hospital Charge Code	6001358
Hospital Revenue Code	636
Min. Negotiated Rate	$23.14
Max. Negotiated Rate	$37.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.33
Rate for Payer: Qualcare PPO/HMO/WC	$23.14

INJECTION CORTICOTROPIN 500 MG

Facility

$154.25

Hospital Charge Code	6001358
Hospital Revenue Code	636
Min. Negotiated Rate	$3.72
Max. Negotiated Rate	$77.12
Rate for Payer: Aetna Commercial	$58.62
Rate for Payer: Aetna Medicare Advantage	$46.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.33
Rate for Payer: Cigna Commercial	$77.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.33
Rate for Payer: Qualcare PPO/HMO/WC	$23.14
Rate for Payer: UnitedHealthcare Community & State	$3.72
Rate for Payer: Wellpoint Medicaid Managed Care	$4.09

INJECTION CORTICOTROPIN 80 U/M

Facility

$229.80

Hospital Charge Code	6001366
Hospital Revenue Code	636
Min. Negotiated Rate	$34.47
Max. Negotiated Rate	$55.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.61
Rate for Payer: Qualcare PPO/HMO/WC	$34.47

INJECTION CORTICOTROPIN 80 U/M

Facility

$229.80

Hospital Charge Code	6001366
Hospital Revenue Code	636
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$114.90
Rate for Payer: Aetna Commercial	$87.32
Rate for Payer: Aetna Medicare Advantage	$68.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.60
Rate for Payer: Cigna Commercial	$114.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.61
Rate for Payer: Qualcare PPO/HMO/WC	$34.47
Rate for Payer: UnitedHealthcare Community & State	$5.54
Rate for Payer: Wellpoint Medicaid Managed Care	$6.09

INJECTION DIAZOXIDE 300MG/2ML

Facility

$666.90

Hospital Charge Code	6001887
Hospital Revenue Code	636
Min. Negotiated Rate	$16.07
Max. Negotiated Rate	$333.45
Rate for Payer: Aetna Commercial	$253.42
Rate for Payer: Aetna Medicare Advantage	$200.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.06
Rate for Payer: Cigna Commercial	$333.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.39
Rate for Payer: Qualcare PPO/HMO/WC	$100.03
Rate for Payer: UnitedHealthcare Community & State	$16.07
Rate for Payer: Wellpoint Medicaid Managed Care	$17.67

INJECTION DIAZOXIDE 300MG/2ML

Facility

$666.90

Hospital Charge Code	6001887
Hospital Revenue Code	636
Min. Negotiated Rate	$100.03
Max. Negotiated Rate	$161.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.39
Rate for Payer: Qualcare PPO/HMO/WC	$100.03

INJECTION ENOXAPARIN 30MG

Facility

$97.30

Hospital Charge Code	6010599
Hospital Revenue Code	250
Min. Negotiated Rate	$14.60
Max. Negotiated Rate	$14.60
Rate for Payer: Qualcare PPO/HMO/WC	$14.60

INJECTION ENOXAPARIN 30MG

Facility

$97.30

Hospital Charge Code	6010599
Hospital Revenue Code	250
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$48.65
Rate for Payer: Aetna Commercial	$36.97
Rate for Payer: Aetna Medicare Advantage	$29.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.81
Rate for Payer: Cigna Commercial	$48.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.19
Rate for Payer: Oxford Commercial	$19.46
Rate for Payer: Qualcare PPO/HMO/WC	$14.60
Rate for Payer: UnitedHealthcare Commercial	$19.46
Rate for Payer: UnitedHealthcare Community & State	$2.34
Rate for Payer: Wellpoint Medicaid Managed Care	$2.58

INJECTION FOR CHOLANGIOGRAM

Facility

$14,313.70

Service Code	HCPCS 47531
Hospital Charge Code	366847531
Hospital Revenue Code	361
Min. Negotiated Rate	$344.96
Max. Negotiated Rate	$15,354.26
Rate for Payer: Aetna Commercial	$11,569.82
Rate for Payer: Aetna Medicare Advantage	$13,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,253.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,354.26
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: Cigna Medicare Advantage	$4,253.61
Rate for Payer: Clover Medicare Advantage	$4,040.93
Rate for Payer: EmblemHealth Commercial	$12,760.83
Rate for Payer: Humana Medicare Advantage	$4,381.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,253.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,294.11
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,147.05
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$344.96
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,253.61
Rate for Payer: Wellcare Medicare Advantage	$4,253.61
Rate for Payer: Wellpoint Medicaid Managed Care	$379.31

INJECTION FOR CHOLANGIOGRAM

Facility

$14,313.70

Service Code	HCPCS 47531
Hospital Charge Code	2011600
Hospital Revenue Code	361
Min. Negotiated Rate	$2,147.05
Max. Negotiated Rate	$2,147.05
Rate for Payer: Qualcare PPO/HMO/WC	$2,147.05

INJECTION FOR CHOLANGIOGRAM

Facility

$14,313.70

Service Code	HCPCS 47531
Hospital Charge Code	2011600
Hospital Revenue Code	361
Min. Negotiated Rate	$344.96
Max. Negotiated Rate	$15,354.26
Rate for Payer: Aetna Commercial	$11,569.82
Rate for Payer: Aetna Medicare Advantage	$13,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,253.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,354.26
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: Cigna Medicare Advantage	$4,253.61
Rate for Payer: Clover Medicare Advantage	$4,040.93
Rate for Payer: EmblemHealth Commercial	$12,760.83
Rate for Payer: Humana Medicare Advantage	$4,381.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,253.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,294.11
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,147.05
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$344.96
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,253.61
Rate for Payer: Wellcare Medicare Advantage	$4,253.61
Rate for Payer: Wellpoint Medicaid Managed Care	$379.31

INJECTION FOR CHOLANGIOGRAM

Facility

$11,644.64

Service Code	HCPCS 47531
Hospital Charge Code	16000982
Hospital Revenue Code	360
Min. Negotiated Rate	$280.64
Max. Negotiated Rate	$15,354.26
Rate for Payer: Aetna Commercial	$11,569.82
Rate for Payer: Aetna Medicare Advantage	$13,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,253.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,354.26
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: Cigna Medicare Advantage	$4,253.61
Rate for Payer: Clover Medicare Advantage	$4,040.93
Rate for Payer: EmblemHealth Commercial	$12,760.83
Rate for Payer: Humana Medicare Advantage	$4,381.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,253.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,493.39
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,746.70
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$280.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,253.61
Rate for Payer: Wellcare Medicare Advantage	$4,253.61
Rate for Payer: Wellpoint Medicaid Managed Care	$308.58

Know your out-of-pocket cost for care.

All Charges