Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ARMOUR THYROID/120MG/TAB

Facility

$3.00

Hospital Charge Code	60632483
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

ARMOUR THYROID/120MG/TAB

Facility

$3.00

Hospital Charge Code	60632484
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

ARMOUR THYROID/120MG/TAB

Facility

$3.00

Hospital Charge Code	60632484
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

ARMOUR THYROID/120MG/TAB

Facility

$3.00

Hospital Charge Code	60632483
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

ARMOUR THYROID 30MG TAB

Facility

$4.00

Service Code	NDC 456045801
Hospital Charge Code	6063943058
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ARMOUR THYROID 30MG TAB

Facility

$4.00

Service Code	NDC 456045801
Hospital Charge Code	6063943058
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

ARMOUR THYROID 60MG TABLET

Facility

$4.00

Service Code	NDC 456045901
Hospital Charge Code	60632374
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

ARMOUR THYROID 60MG TABLET

Facility

$4.00

Service Code	NDC 456045901
Hospital Charge Code	60632374
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ARM SLING CHIEFTAIN LARGE

Facility

$10.90

Hospital Charge Code	270649889
Hospital Revenue Code	270
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$5.45
Rate for Payer: Aetna Commercial	$4.14
Rate for Payer: Aetna Medicare Advantage	$3.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.78
Rate for Payer: Cigna Commercial	$5.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.27
Rate for Payer: Oxford Commercial	$2.18
Rate for Payer: Qualcare PPO/HMO/WC	$1.64
Rate for Payer: UnitedHealthcare Commercial	$2.18
Rate for Payer: UnitedHealthcare Community & State	$0.26
Rate for Payer: Wellpoint Medicaid Managed Care	$0.29

ARM SLING CHIEFTAIN LARGE

Facility

$10.90

Hospital Charge Code	270649889
Hospital Revenue Code	270
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$1.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.64

ARM SLING CHIEFTAIN MEDIUM

Facility

$10.10

Hospital Charge Code	270649888
Hospital Revenue Code	270
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$5.05
Rate for Payer: Aetna Commercial	$3.84
Rate for Payer: Aetna Medicare Advantage	$3.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.58
Rate for Payer: Cigna Commercial	$5.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.03
Rate for Payer: Oxford Commercial	$2.02
Rate for Payer: Qualcare PPO/HMO/WC	$1.51
Rate for Payer: UnitedHealthcare Commercial	$2.02
Rate for Payer: UnitedHealthcare Community & State	$0.24
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

ARM SLING CHIEFTAIN MEDIUM

Facility

$10.10

Hospital Charge Code	270649888
Hospital Revenue Code	270
Min. Negotiated Rate	$1.51
Max. Negotiated Rate	$1.51
Rate for Payer: Qualcare PPO/HMO/WC	$1.51

ARM SLING CHIEFTAIN SMALL

Facility

$11.50

Hospital Charge Code	270649891
Hospital Revenue Code	270
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$5.75
Rate for Payer: Aetna Commercial	$4.37
Rate for Payer: Aetna Medicare Advantage	$3.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.93
Rate for Payer: Cigna Commercial	$5.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.45
Rate for Payer: Oxford Commercial	$2.30
Rate for Payer: Qualcare PPO/HMO/WC	$1.73
Rate for Payer: UnitedHealthcare Commercial	$2.30
Rate for Payer: UnitedHealthcare Community & State	$0.28
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

ARM SLING CHIEFTAIN SMALL

Facility

$11.50

Hospital Charge Code	270649891
Hospital Revenue Code	270
Min. Negotiated Rate	$1.73
Max. Negotiated Rate	$1.73
Rate for Payer: Qualcare PPO/HMO/WC	$1.73

ARM SLING LRG

Facility

$7.35

Hospital Charge Code	270649357S
Hospital Revenue Code	271
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.67
Rate for Payer: Aetna Commercial	$2.79
Rate for Payer: Aetna Medicare Advantage	$2.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.87
Rate for Payer: Cigna Commercial	$3.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.21
Rate for Payer: Oxford Commercial	$1.47
Rate for Payer: Qualcare PPO/HMO/WC	$1.10
Rate for Payer: UnitedHealthcare Commercial	$1.47
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

ARM SLING LRG

Facility

$7.35

Hospital Charge Code	270649357S
Hospital Revenue Code	271
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$1.10
Rate for Payer: Qualcare PPO/HMO/WC	$1.10

ARM SLING MED

Facility

$7.35

Hospital Charge Code	270649358S
Hospital Revenue Code	271
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$1.10
Rate for Payer: Qualcare PPO/HMO/WC	$1.10

ARM SLING MED

Facility

$7.35

Hospital Charge Code	270649358S
Hospital Revenue Code	271
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.67
Rate for Payer: Aetna Commercial	$2.79
Rate for Payer: Aetna Medicare Advantage	$2.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.87
Rate for Payer: Cigna Commercial	$3.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.21
Rate for Payer: Oxford Commercial	$1.47
Rate for Payer: Qualcare PPO/HMO/WC	$1.10
Rate for Payer: UnitedHealthcare Commercial	$1.47
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

ARMSTRONG V VENTILATION TUBE

Facility

$91.00

Hospital Charge Code	270657881
Hospital Revenue Code	272
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$45.50
Rate for Payer: Aetna Commercial	$34.58
Rate for Payer: Aetna Medicare Advantage	$27.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.20
Rate for Payer: Cigna Commercial	$45.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.30
Rate for Payer: Oxford Commercial	$18.20
Rate for Payer: Qualcare PPO/HMO/WC	$13.65
Rate for Payer: UnitedHealthcare Commercial	$18.20
Rate for Payer: UnitedHealthcare Community & State	$2.19
Rate for Payer: Wellpoint Medicaid Managed Care	$2.41

ARMSTRONG V VENTILATION TUBE

Facility

$91.00

Hospital Charge Code	270657881
Hospital Revenue Code	272
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$13.65
Rate for Payer: Qualcare PPO/HMO/WC	$13.65

ARROW MENISCAL 10mm 605625

Facility

$440.00

Hospital Charge Code	270605625
Hospital Revenue Code	279
Min. Negotiated Rate	$66.00
Max. Negotiated Rate	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.00

ARROW MENISCAL 10mm 605625

Facility

$440.00

Hospital Charge Code	270605625
Hospital Revenue Code	279
Min. Negotiated Rate	$10.60
Max. Negotiated Rate	$220.00
Rate for Payer: Aetna Commercial	$167.20
Rate for Payer: Aetna Medicare Advantage	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.20
Rate for Payer: Cigna Commercial	$220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.00
Rate for Payer: Oxford Commercial	$88.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.00
Rate for Payer: UnitedHealthcare Commercial	$88.00
Rate for Payer: UnitedHealthcare Community & State	$10.60
Rate for Payer: Wellpoint Medicaid Managed Care	$11.66

ARROW MENISCAL 13MM 605627

Facility

$440.00

Hospital Charge Code	270605627
Hospital Revenue Code	272
Min. Negotiated Rate	$66.00
Max. Negotiated Rate	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.00

ARROW MENISCAL 13MM 605627

Facility

$440.00

Hospital Charge Code	270605627
Hospital Revenue Code	272
Min. Negotiated Rate	$10.60
Max. Negotiated Rate	$220.00
Rate for Payer: Aetna Commercial	$167.20
Rate for Payer: Aetna Medicare Advantage	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.20
Rate for Payer: Cigna Commercial	$220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.00
Rate for Payer: Oxford Commercial	$88.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.00
Rate for Payer: UnitedHealthcare Commercial	$88.00
Rate for Payer: UnitedHealthcare Community & State	$10.60
Rate for Payer: Wellpoint Medicaid Managed Care	$11.66

ARROW MENISCAL 16MM 605628

Facility

$440.00

Hospital Charge Code	270605628
Hospital Revenue Code	272
Min. Negotiated Rate	$10.60
Max. Negotiated Rate	$220.00
Rate for Payer: Aetna Commercial	$167.20
Rate for Payer: Aetna Medicare Advantage	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.20
Rate for Payer: Cigna Commercial	$220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.00
Rate for Payer: Oxford Commercial	$88.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.00
Rate for Payer: UnitedHealthcare Commercial	$88.00
Rate for Payer: UnitedHealthcare Community & State	$10.60
Rate for Payer: Wellpoint Medicaid Managed Care	$11.66

Know your out-of-pocket cost for care.

All Charges