Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ATHERECTOMY-FEM POP-LT

Facility

$47,711.75

Service Code	HCPCS 37225LT
Hospital Charge Code	2709012
Hospital Revenue Code	361
Min. Negotiated Rate	$1,149.85
Max. Negotiated Rate	$23,855.88
Rate for Payer: Aetna Commercial	$18,130.47
Rate for Payer: Aetna Medicare Advantage	$14,313.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,166.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,166.50
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	$12,166.50
Rate for Payer: Cigna Commercial	$23,855.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,313.52
Rate for Payer: Qualcare PPO/HMO/WC	$7,156.76
Rate for Payer: UnitedHealthcare Community & State	$1,149.85
Rate for Payer: Wellpoint Medicaid Managed Care	$1,264.36

ATHERECTOMY-FEM POP-LT

Facility

$47,711.75

Service Code	HCPCS 37225LT
Hospital Charge Code	2709012
Hospital Revenue Code	361
Min. Negotiated Rate	$7,156.76
Max. Negotiated Rate	$7,156.76
Rate for Payer: Qualcare PPO/HMO/WC	$7,156.76

ATHERECTOMY-FEM POP-RT

Facility

$47,711.75

Service Code	HCPCS 37225RT
Hospital Charge Code	2709014
Hospital Revenue Code	361
Min. Negotiated Rate	$1,149.85
Max. Negotiated Rate	$23,855.88
Rate for Payer: Aetna Commercial	$18,130.47
Rate for Payer: Aetna Medicare Advantage	$14,313.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,166.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,166.50
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	$12,166.50
Rate for Payer: Cigna Commercial	$23,855.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,313.52
Rate for Payer: Qualcare PPO/HMO/WC	$7,156.76
Rate for Payer: UnitedHealthcare Community & State	$1,149.85
Rate for Payer: Wellpoint Medicaid Managed Care	$1,264.36

ATHERECTOMY-FEM POP-RT

Facility

$47,711.75

Service Code	HCPCS 37225RT
Hospital Charge Code	2709014
Hospital Revenue Code	361
Min. Negotiated Rate	$7,156.76
Max. Negotiated Rate	$7,156.76
Rate for Payer: Qualcare PPO/HMO/WC	$7,156.76

ATHEROSCLEROSIS WITH MCC

Facility

$40,810.22

Service Code	MSDRG 302
Min. Negotiated Rate	$12,426.19
Max. Negotiated Rate	$40,810.22
Rate for Payer: Aetna Commercial	$28,298.59
Rate for Payer: Aetna Medicare Advantage	$40,810.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26,052.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26,052.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,080.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26,052.32
Rate for Payer: Cigna Commercial	$22,393.17
Rate for Payer: Cigna Medicare Advantage	$13,080.20
Rate for Payer: Clover Medicare Advantage	$12,426.19
Rate for Payer: EmblemHealth Commercial	$39,240.60
Rate for Payer: Humana Medicare Advantage	$13,472.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,080.20
Rate for Payer: Oxford Commercial	$16,094.27
Rate for Payer: UnitedHealthcare Commercial	$28,221.81
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,080.20
Rate for Payer: Wellcare Medicare Advantage	$13,080.20

ATHEROSCLEROSIS WITHOUT MCC

Facility

$23,893.05

Service Code	MSDRG 303
Min. Negotiated Rate	$7,275.13
Max. Negotiated Rate	$23,893.05
Rate for Payer: Aetna Commercial	$16,674.56
Rate for Payer: Aetna Medicare Advantage	$23,893.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,352.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,352.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,658.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,352.26
Rate for Payer: Cigna Commercial	$12,598.26
Rate for Payer: Cigna Medicare Advantage	$7,658.03
Rate for Payer: Clover Medicare Advantage	$7,275.13
Rate for Payer: EmblemHealth Commercial	$22,974.09
Rate for Payer: Humana Medicare Advantage	$7,887.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,658.03
Rate for Payer: Oxford Commercial	$9,054.54
Rate for Payer: UnitedHealthcare Commercial	$15,877.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,658.03
Rate for Payer: Wellcare Medicare Advantage	$7,658.03

ATIVAN/0.5MG/TAB

Facility

$3.00

Hospital Charge Code	60632498
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

ATIVAN/0.5MG/TAB

Facility

$4.00

Hospital Charge Code	60632501
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ATIVAN/0.5MG/TAB

Facility

$4.00

Hospital Charge Code	60632501
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

ATIVAN/0.5MG/TAB

Facility

$3.00

Hospital Charge Code	60632498
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

ATIVAN/1MG/TAB

Facility

$3.00

Hospital Charge Code	60632500
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

ATIVAN/1MG/TAB

Facility

$3.00

Hospital Charge Code	60632500
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

ATIVAN/1MG/TAB

Facility

$4.00

Hospital Charge Code	60632496
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ATIVAN/1MG/TAB

Facility

$4.00

Hospital Charge Code	60632496
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

ATIVAN/2MG/1ML

Facility

$80.00

Hospital Charge Code	60632502
Hospital Revenue Code	636
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$19.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.36
Rate for Payer: Qualcare PPO/HMO/WC	$12.00

ATIVAN/2MG/1ML

Facility

$80.00

Hospital Charge Code	60632502
Hospital Revenue Code	636
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$40.00
Rate for Payer: Aetna Commercial	$30.40
Rate for Payer: Aetna Medicare Advantage	$24.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.40
Rate for Payer: Cigna Commercial	$40.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.36
Rate for Payer: Qualcare PPO/HMO/WC	$12.00
Rate for Payer: UnitedHealthcare Community & State	$1.93
Rate for Payer: Wellpoint Medicaid Managed Care	$2.12

ATIVAN/2MG/TAB

Facility

$4.00

Hospital Charge Code	60632497
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ATIVAN/2MG/TAB

Facility

$4.00

Hospital Charge Code	60632497
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

ATIVAN/2MG/TAB

Facility

$3.00

Hospital Charge Code	60632499
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

ATIVAN/2MG/TAB

Facility

$3.00

Hospital Charge Code	60632499
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

ATLAS TOPAZ WAND

Facility

$475.00

Hospital Charge Code	270332603
Hospital Revenue Code	272
Min. Negotiated Rate	$11.45
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$180.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.50
Rate for Payer: Oxford Commercial	$95.00
Rate for Payer: Qualcare PPO/HMO/WC	$71.25
Rate for Payer: UnitedHealthcare Commercial	$95.00
Rate for Payer: UnitedHealthcare Community & State	$11.45
Rate for Payer: Wellpoint Medicaid Managed Care	$12.59

ATLAS TOPAZ WAND

Facility

$475.00

Hospital Charge Code	270332603
Hospital Revenue Code	272
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$71.25
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

ATOMOXETINE HYDROCHLORIDE 10 M

Facility

$74.71

Service Code	NDC 2322730
Hospital Charge Code	6063943180
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$37.35
Rate for Payer: Aetna Commercial	$28.39
Rate for Payer: Aetna Medicare Advantage	$22.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.05
Rate for Payer: Cigna Commercial	$37.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.41
Rate for Payer: Oxford Commercial	$14.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.21
Rate for Payer: UnitedHealthcare Commercial	$14.94
Rate for Payer: UnitedHealthcare Community & State	$1.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1.98

ATOMOXETINE HYDROCHLORIDE 10 M

Facility

$74.71

Service Code	NDC 2322730
Hospital Charge Code	6063943180
Hospital Revenue Code	250
Min. Negotiated Rate	$11.21
Max. Negotiated Rate	$11.21
Rate for Payer: Qualcare PPO/HMO/WC	$11.21

ATOMOXETINE HYDROCHLORIDE 18 M

Facility

$74.71

Service Code	NDC 2323830
Hospital Charge Code	6063943181
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$37.35
Rate for Payer: Aetna Commercial	$28.39
Rate for Payer: Aetna Medicare Advantage	$22.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.05
Rate for Payer: Cigna Commercial	$37.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.41
Rate for Payer: Oxford Commercial	$14.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.21
Rate for Payer: UnitedHealthcare Commercial	$14.94
Rate for Payer: UnitedHealthcare Community & State	$1.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1.98

Know your out-of-pocket cost for care.

All Charges