Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ASSY HOSE OXYGEN 33FT

Facility

$816.00

Hospital Charge Code	270634528
Hospital Revenue Code	270
Min. Negotiated Rate	$19.67
Max. Negotiated Rate	$408.00
Rate for Payer: Aetna Commercial	$310.08
Rate for Payer: Aetna Medicare Advantage	$244.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$208.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$208.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$208.08
Rate for Payer: Cigna Commercial	$408.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$244.80
Rate for Payer: Oxford Commercial	$163.20
Rate for Payer: Qualcare PPO/HMO/WC	$122.40
Rate for Payer: UnitedHealthcare Commercial	$163.20
Rate for Payer: UnitedHealthcare Community & State	$19.67
Rate for Payer: Wellpoint Medicaid Managed Care	$21.62

ASSY HOSE OXYGEN 33FT

Facility

$816.00

Hospital Charge Code	270634528
Hospital Revenue Code	270
Min. Negotiated Rate	$122.40
Max. Negotiated Rate	$122.40
Rate for Payer: Qualcare PPO/HMO/WC	$122.40

ASSY HOSE VACUUM 33FT

Facility

$869.50

Hospital Charge Code	270634527
Hospital Revenue Code	270
Min. Negotiated Rate	$20.95
Max. Negotiated Rate	$434.75
Rate for Payer: Aetna Commercial	$330.41
Rate for Payer: Aetna Medicare Advantage	$260.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$221.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$221.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$221.72
Rate for Payer: Cigna Commercial	$434.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.85
Rate for Payer: Oxford Commercial	$173.90
Rate for Payer: Qualcare PPO/HMO/WC	$130.43
Rate for Payer: UnitedHealthcare Commercial	$173.90
Rate for Payer: UnitedHealthcare Community & State	$20.95
Rate for Payer: Wellpoint Medicaid Managed Care	$23.04

ASSY HOSE VACUUM 33FT

Facility

$869.50

Hospital Charge Code	270634527
Hospital Revenue Code	270
Min. Negotiated Rate	$130.43
Max. Negotiated Rate	$130.43
Rate for Payer: Qualcare PPO/HMO/WC	$130.43

ASSY S/S CABL 1.8/559 22320118

Facility

$1,866.25

Hospital Charge Code	270606981
Hospital Revenue Code	278
Min. Negotiated Rate	$44.98
Max. Negotiated Rate	$933.12
Rate for Payer: Aetna Commercial	$709.17
Rate for Payer: Aetna Medicare Advantage	$559.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$475.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$475.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$373.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$475.89
Rate for Payer: Cigna Commercial	$933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$451.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$410.57
Rate for Payer: Qualcare PPO/HMO/WC	$279.94
Rate for Payer: UnitedHealthcare Community & State	$44.98
Rate for Payer: Wellpoint Medicaid Managed Care	$49.46

ASSY S/S CABL 1.8/559 22320118

Facility

$1,866.25

Hospital Charge Code	270606981
Hospital Revenue Code	278
Min. Negotiated Rate	$279.94
Max. Negotiated Rate	$451.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$373.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$451.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$410.57
Rate for Payer: Qualcare PPO/HMO/WC	$279.94

ASTHMA

Facility

$4,834.91

Service Code	APR-DRG 1411
Min. Negotiated Rate	$4,740.11
Max. Negotiated Rate	$4,834.91
Rate for Payer: UnitedHealthcare Community & State	$4,740.11
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,834.91
Rate for Payer: Wellpoint Medicaid Managed Care	$4,740.11

ASTHMA

Facility

$8,399.47

Service Code	APR-DRG 1413
Min. Negotiated Rate	$8,234.77
Max. Negotiated Rate	$8,399.47
Rate for Payer: UnitedHealthcare Community & State	$8,234.77
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,399.47
Rate for Payer: Wellpoint Medicaid Managed Care	$8,234.77

ASTHMA

Facility

$7,080.60

Service Code	APR-DRG 1412
Min. Negotiated Rate	$6,941.76
Max. Negotiated Rate	$7,080.60
Rate for Payer: UnitedHealthcare Community & State	$6,941.76
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,080.60
Rate for Payer: Wellpoint Medicaid Managed Care	$6,941.76

ASTHMA

Facility

$16,396.77

Service Code	APR-DRG 1414
Min. Negotiated Rate	$16,075.26
Max. Negotiated Rate	$16,396.77
Rate for Payer: UnitedHealthcare Community & State	$16,075.26
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$16,396.77
Rate for Payer: Wellpoint Medicaid Managed Care	$16,075.26

ASTRIN GYN FERRIC SUBSULFUTE

Facility

$61.86

Hospital Charge Code	270650773
Hospital Revenue Code	272
Min. Negotiated Rate	$9.28
Max. Negotiated Rate	$9.28
Rate for Payer: Qualcare PPO/HMO/WC	$9.28

ASTRIN GYN FERRIC SUBSULFUTE

Facility

$61.86

Hospital Charge Code	270650773
Hospital Revenue Code	272
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$30.93
Rate for Payer: Aetna Commercial	$23.51
Rate for Payer: Aetna Medicare Advantage	$18.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.77
Rate for Payer: Cigna Commercial	$30.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.56
Rate for Payer: Oxford Commercial	$12.37
Rate for Payer: Qualcare PPO/HMO/WC	$9.28
Rate for Payer: UnitedHealthcare Commercial	$12.37
Rate for Payer: UnitedHealthcare Community & State	$1.49
Rate for Payer: Wellpoint Medicaid Managed Care	$1.64

AST - SGOT

Facility

$667.59

Service Code	HCPCS 84450
Hospital Charge Code	3002441
Hospital Revenue Code	301
Min. Negotiated Rate	$4.14
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$14.09
Rate for Payer: Aetna Medicare Advantage	$16.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.70
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$5.18
Rate for Payer: Clover Medicare Advantage	$4.92
Rate for Payer: EmblemHealth Commercial	$15.54
Rate for Payer: Humana Medicare Advantage	$5.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.18
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	$4.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.18
Rate for Payer: Wellcare Medicare Advantage	$5.18
Rate for Payer: Wellpoint Medicaid Managed Care	$17.69

AST - SGOT

Facility

$667.59

Service Code	HCPCS 84450
Hospital Charge Code	3002441
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

AST - SGOT PANEL***

Facility

$25.20

Service Code	HCPCS 84450
Hospital Charge Code	3002441P
Hospital Revenue Code	301
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$14.09
Rate for Payer: Aetna Medicare Advantage	$16.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.70
Rate for Payer: Cigna Commercial	$12.60
Rate for Payer: Cigna Medicare Advantage	$5.18
Rate for Payer: Clover Medicare Advantage	$4.92
Rate for Payer: EmblemHealth Commercial	$15.54
Rate for Payer: Humana Medicare Advantage	$5.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.56
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.78
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.18
Rate for Payer: Wellcare Medicare Advantage	$5.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.67

AST - SGOT PANEL***

Facility

$25.20

Service Code	HCPCS 84450
Hospital Charge Code	3002441P
Hospital Revenue Code	301
Min. Negotiated Rate	$3.78
Max. Negotiated Rate	$3.78
Rate for Payer: Qualcare PPO/HMO/WC	$3.78

ASYMETRIC PATELLAA-29MMX9MM

Facility

$2,678.00

Service Code	HCPCS C1776
Hospital Charge Code	270690854
Hospital Revenue Code	278
Min. Negotiated Rate	$64.54
Max. Negotiated Rate	$1,339.00
Rate for Payer: Aetna Commercial	$1,017.64
Rate for Payer: Aetna Medicare Advantage	$803.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$682.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$682.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$535.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$682.89
Rate for Payer: Cigna Commercial	$1,339.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$648.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$589.16
Rate for Payer: Qualcare PPO/HMO/WC	$401.70
Rate for Payer: UnitedHealthcare Community & State	$64.54
Rate for Payer: Wellpoint Medicaid Managed Care	$70.97

ASYMETRIC PATELLAA-29MMX9MM

Facility

$2,678.00

Service Code	HCPCS C1776
Hospital Charge Code	270690854
Hospital Revenue Code	278
Min. Negotiated Rate	$401.70
Max. Negotiated Rate	$648.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$535.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$648.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$589.16
Rate for Payer: Qualcare PPO/HMO/WC	$401.70

ATARAX/25MG/TAB

Facility

$7.00

Hospital Charge Code	60632494
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

ATARAX/25MG/TAB

Facility

$6.00

Hospital Charge Code	60632495
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

ATARAX/25MG/TAB

Facility

$6.00

Hospital Charge Code	60632495
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$2.28
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.80
Rate for Payer: Oxford Commercial	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.20
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

ATARAX/25MG/TAB

Facility

$7.00

Hospital Charge Code	60632494
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.66
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.10
Rate for Payer: Oxford Commercial	$1.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$1.40
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

ATAZANAVIR 100 MG CAP

Facility

$147.27

Service Code	NDC 3363810
Hospital Charge Code	60632255
Hospital Revenue Code	250
Min. Negotiated Rate	$22.09
Max. Negotiated Rate	$22.09
Rate for Payer: Qualcare PPO/HMO/WC	$22.09

ATAZANAVIR 100 MG CAP

Facility

$147.27

Service Code	NDC 3363810
Hospital Charge Code	60632255
Hospital Revenue Code	250
Min. Negotiated Rate	$3.55
Max. Negotiated Rate	$73.64
Rate for Payer: Aetna Commercial	$55.96
Rate for Payer: Aetna Medicare Advantage	$44.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.55
Rate for Payer: Cigna Commercial	$73.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.18
Rate for Payer: Oxford Commercial	$29.45
Rate for Payer: Qualcare PPO/HMO/WC	$22.09
Rate for Payer: UnitedHealthcare Commercial	$29.45
Rate for Payer: UnitedHealthcare Community & State	$3.55
Rate for Payer: Wellpoint Medicaid Managed Care	$3.90

ATAZANAVIR 150 MG CAPSULE

Facility

$171.45

Service Code	NDC 3362412
Hospital Charge Code	60630010
Hospital Revenue Code	250
Min. Negotiated Rate	$25.72
Max. Negotiated Rate	$25.72
Rate for Payer: Qualcare PPO/HMO/WC	$25.72

Know your out-of-pocket cost for care.

All Charges