Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ISONIAZIO INJ 100MG/1ML 10ML

Facility

$2,358.80

Service Code	NDC 781305670
Hospital Charge Code	60628844
Hospital Revenue Code	250
Min. Negotiated Rate	$56.85
Max. Negotiated Rate	$1,179.40
Rate for Payer: Aetna Commercial	$896.34
Rate for Payer: Aetna Medicare Advantage	$707.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$601.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$601.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$601.49
Rate for Payer: Cigna Commercial	$1,179.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$707.64
Rate for Payer: Oxford Commercial	$471.76
Rate for Payer: Qualcare PPO/HMO/WC	$353.82
Rate for Payer: UnitedHealthcare Commercial	$471.76
Rate for Payer: UnitedHealthcare Community & State	$56.85
Rate for Payer: Wellpoint Medicaid Managed Care	$62.51

ISO OR EXTC OF HIGH PURI NUCLE

Facility

$8.00

Service Code	HCPCS 83891
Hospital Charge Code	3035164
Hospital Revenue Code	301
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

ISO OR EXTC OF HIGH PURI NUCLE

Facility

$8.00

Service Code	HCPCS 83891
Hospital Charge Code	3035164
Hospital Revenue Code	301
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$3.04
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

ISOPROPANOL

Facility

$667.59

Service Code	HCPCS 80320
Hospital Charge Code	3037072
Hospital Revenue Code	306
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

ISOPROPANOL

Facility

$667.59

Service Code	HCPCS 80320
Hospital Charge Code	3037072
Hospital Revenue Code	306
Min. Negotiated Rate	$16.66
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$253.68
Rate for Payer: Aetna Medicare Advantage	$200.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.24
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.66
Rate for Payer: Wellpoint Medicaid Managed Care	$17.69

ISOPROPYL ALCOHOL 70%

Facility

$7.64

Service Code	NDC 869081043
Hospital Charge Code	6063943120
Hospital Revenue Code	270
Min. Negotiated Rate	$1.15
Max. Negotiated Rate	$1.15
Rate for Payer: Qualcare PPO/HMO/WC	$1.15

ISOPROPYL ALCOHOL 70%

Facility

$7.64

Service Code	NDC 869081043
Hospital Charge Code	6063943120
Hospital Revenue Code	270
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.82
Rate for Payer: Aetna Commercial	$2.90
Rate for Payer: Aetna Medicare Advantage	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.95
Rate for Payer: Cigna Commercial	$3.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.29
Rate for Payer: Oxford Commercial	$1.53
Rate for Payer: Qualcare PPO/HMO/WC	$1.15
Rate for Payer: UnitedHealthcare Commercial	$1.53
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

ISOPROPYL ALCOHOL 70% 473ML

Facility

$9.00

Hospital Charge Code	60628314
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

ISOPROPYL ALCOHOL 70% 473ML

Facility

$9.00

Hospital Charge Code	60628314
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

ISOPROPYL ALCOHOL 70% PINT

Facility

$10.25

Hospital Charge Code	6012694
Hospital Revenue Code	250
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$5.12
Rate for Payer: Aetna Commercial	$3.90
Rate for Payer: Aetna Medicare Advantage	$3.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.61
Rate for Payer: Cigna Commercial	$5.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.08
Rate for Payer: Oxford Commercial	$2.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.54
Rate for Payer: UnitedHealthcare Commercial	$2.05
Rate for Payer: UnitedHealthcare Community & State	$0.25
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

ISOPROPYL ALCOHOL 70% PINT

Facility

$10.25

Hospital Charge Code	6012694
Hospital Revenue Code	250
Min. Negotiated Rate	$1.54
Max. Negotiated Rate	$1.54
Rate for Payer: Qualcare PPO/HMO/WC	$1.54

ISOPROTERENOL 0.2% AEROSOL

Facility

$199.05

Hospital Charge Code	60627455
Hospital Revenue Code	250
Min. Negotiated Rate	$29.86
Max. Negotiated Rate	$29.86
Rate for Payer: Qualcare PPO/HMO/WC	$29.86

ISOPROTERENOL 0.2% AEROSOL

Facility

$199.05

Hospital Charge Code	60627455
Hospital Revenue Code	250
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$99.53
Rate for Payer: Aetna Commercial	$75.64
Rate for Payer: Aetna Medicare Advantage	$59.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.76
Rate for Payer: Cigna Commercial	$99.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.72
Rate for Payer: Oxford Commercial	$39.81
Rate for Payer: Qualcare PPO/HMO/WC	$29.86
Rate for Payer: UnitedHealthcare Commercial	$39.81
Rate for Payer: UnitedHealthcare Community & State	$4.80
Rate for Payer: Wellpoint Medicaid Managed Care	$5.27

ISOPROTERENOL ABBO/1MG/5M

Facility

$13.00

Hospital Charge Code	60634420
Hospital Revenue Code	250
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$4.94
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$2.60
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

ISOPROTERENOL ABBO/1MG/5M

Facility

$13.00

Hospital Charge Code	60634420
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

ISOPROTERENOL INJ 1:5000

Facility

$240.65

Hospital Charge Code	6003198
Hospital Revenue Code	250
Min. Negotiated Rate	$36.10
Max. Negotiated Rate	$36.10
Rate for Payer: Qualcare PPO/HMO/WC	$36.10

ISOPROTERENOL INJ 1:5000

Facility

$240.65

Hospital Charge Code	6003198
Hospital Revenue Code	250
Min. Negotiated Rate	$5.80
Max. Negotiated Rate	$120.33
Rate for Payer: Aetna Commercial	$91.45
Rate for Payer: Aetna Medicare Advantage	$72.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.37
Rate for Payer: Cigna Commercial	$120.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.19
Rate for Payer: Oxford Commercial	$48.13
Rate for Payer: Qualcare PPO/HMO/WC	$36.10
Rate for Payer: UnitedHealthcare Commercial	$48.13
Rate for Payer: UnitedHealthcare Community & State	$5.80
Rate for Payer: Wellpoint Medicaid Managed Care	$6.38

ISOPROTERENOL SYRG 2MG/10ML

Facility

$152.35

Hospital Charge Code	60627454
Hospital Revenue Code	250
Min. Negotiated Rate	$3.67
Max. Negotiated Rate	$76.17
Rate for Payer: Aetna Commercial	$57.89
Rate for Payer: Aetna Medicare Advantage	$45.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.85
Rate for Payer: Cigna Commercial	$76.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.70
Rate for Payer: Oxford Commercial	$30.47
Rate for Payer: Qualcare PPO/HMO/WC	$22.85
Rate for Payer: UnitedHealthcare Commercial	$30.47
Rate for Payer: UnitedHealthcare Community & State	$3.67
Rate for Payer: Wellpoint Medicaid Managed Care	$4.04

ISOPROTERENOL SYRG 2MG/10ML

Facility

$152.35

Hospital Charge Code	60627454
Hospital Revenue Code	250
Min. Negotiated Rate	$22.85
Max. Negotiated Rate	$22.85
Rate for Payer: Qualcare PPO/HMO/WC	$22.85

ISOPTIN/120MG/TAB

Facility

$3.00

Hospital Charge Code	60633201
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

ISOPTIN/120MG/TAB

Facility

$3.00

Hospital Charge Code	60633199
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

ISOPTIN/120MG/TAB

Facility

$3.00

Hospital Charge Code	60633199
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

ISOPTIN/120MG/TAB

Facility

$3.00

Hospital Charge Code	60633197
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

ISOPTIN/120MG/TAB

Facility

$3.00

Hospital Charge Code	60633201
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

ISOPTIN/120MG/TAB

Facility

$3.00

Hospital Charge Code	60633197
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

Know your out-of-pocket cost for care.

All Charges