Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ATROPINE 0.8MG/2ML

Facility

$4.00

Service Code	HCPCS J0461
Hospital Charge Code	6063943061
Hospital Revenue Code	636
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.97
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ATROPINE 1% OPHTHALMIN SOLN 2M

Facility

$320.66

Service Code	NDC 17478021502
Hospital Charge Code	6063943291
Hospital Revenue Code	250
Min. Negotiated Rate	$7.73
Max. Negotiated Rate	$160.33
Rate for Payer: Aetna Commercial	$121.85
Rate for Payer: Aetna Medicare Advantage	$96.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.77
Rate for Payer: Cigna Commercial	$160.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.20
Rate for Payer: Oxford Commercial	$64.13
Rate for Payer: Qualcare PPO/HMO/WC	$48.10
Rate for Payer: UnitedHealthcare Commercial	$64.13
Rate for Payer: UnitedHealthcare Community & State	$7.73
Rate for Payer: Wellpoint Medicaid Managed Care	$8.50

ATROPINE 1% OPHTHALMIN SOLN 2M

Facility

$320.66

Service Code	NDC 17478021502
Hospital Charge Code	6063943291
Hospital Revenue Code	250
Min. Negotiated Rate	$48.10
Max. Negotiated Rate	$48.10
Rate for Payer: Qualcare PPO/HMO/WC	$48.10

ATROPINE 1% OPHTH SOLN UD

Facility

$2,404.97

Service Code	NDC 17478021505
Hospital Charge Code	60628064
Hospital Revenue Code	250
Min. Negotiated Rate	$360.75
Max. Negotiated Rate	$360.75
Rate for Payer: Qualcare PPO/HMO/WC	$360.75

ATROPINE 1% OPHTH SOLN UD

Facility

$2,404.97

Service Code	NDC 17478021505
Hospital Charge Code	60628064
Hospital Revenue Code	250
Min. Negotiated Rate	$57.96
Max. Negotiated Rate	$1,202.48
Rate for Payer: Aetna Commercial	$913.89
Rate for Payer: Aetna Medicare Advantage	$721.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$613.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$613.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$613.27
Rate for Payer: Cigna Commercial	$1,202.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$721.49
Rate for Payer: Oxford Commercial	$480.99
Rate for Payer: Qualcare PPO/HMO/WC	$360.75
Rate for Payer: UnitedHealthcare Commercial	$480.99
Rate for Payer: UnitedHealthcare Community & State	$57.96
Rate for Payer: Wellpoint Medicaid Managed Care	$63.73

ATROPINE 20ML

Facility

$10.90

Hospital Charge Code	6012231
Hospital Revenue Code	250
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

ATROPINE 20ML

Facility

$10.90

Hospital Charge Code	6012231
Hospital Revenue Code	250
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$1.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.64

ATROPINE 400MCG/ML 20ML

Facility

$6.00

Hospital Charge Code	60635269
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

ATROPINE 400MCG/ML 20ML

Facility

$6.00

Hospital Charge Code	60635269
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

ATROPINE SULFATE/0.1MG/1M

Facility

$48.00

Hospital Charge Code	60632506
Hospital Revenue Code	250
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$24.00
Rate for Payer: Aetna Commercial	$18.24
Rate for Payer: Aetna Medicare Advantage	$14.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.24
Rate for Payer: Cigna Commercial	$24.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.40
Rate for Payer: Oxford Commercial	$9.60
Rate for Payer: Qualcare PPO/HMO/WC	$7.20
Rate for Payer: UnitedHealthcare Commercial	$9.60
Rate for Payer: UnitedHealthcare Community & State	$1.16
Rate for Payer: Wellpoint Medicaid Managed Care	$1.27

ATROPINE SULFATE/0.1MG/1M

Facility

$48.00

Hospital Charge Code	60632506
Hospital Revenue Code	250
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$7.20

ATROPINE SULFATE/0.4MG/1M

Facility

$4.00

Service Code	NDC 10019025012
Hospital Charge Code	60632505
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

ATROPINE SULFATE/0.4MG/1M

Facility

$4.00

Service Code	NDC 10019025012
Hospital Charge Code	60632505
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ATROPINE SULFATE 0.5MG/5ML SYR

Facility

$4.00

Service Code	NDC 70121170501
Hospital Charge Code	606390568
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

ATROPINE SULFATE 0.5MG/5ML SYR

Facility

$4.00

Service Code	NDC 70121170501
Hospital Charge Code	606390568
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ATROPINE SULFATE 0.5% OPH

Facility

$28.00

Hospital Charge Code	60632507
Hospital Revenue Code	250
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

ATROPINE SULFATE 0.5% OPH

Facility

$28.00

Hospital Charge Code	60632507
Hospital Revenue Code	250
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$14.00
Rate for Payer: Aetna Commercial	$10.64
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.40
Rate for Payer: Oxford Commercial	$5.60
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$5.60
Rate for Payer: UnitedHealthcare Community & State	$0.67
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

ATROPINE SULFATE/1MG/1ML

Facility

$92.13

Service Code	NDC 517101025
Hospital Charge Code	60632504
Hospital Revenue Code	250
Min. Negotiated Rate	$2.22
Max. Negotiated Rate	$46.06
Rate for Payer: Aetna Commercial	$35.01
Rate for Payer: Aetna Medicare Advantage	$27.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.49
Rate for Payer: Cigna Commercial	$46.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.64
Rate for Payer: Oxford Commercial	$18.43
Rate for Payer: Qualcare PPO/HMO/WC	$13.82
Rate for Payer: UnitedHealthcare Commercial	$18.43
Rate for Payer: UnitedHealthcare Community & State	$2.22
Rate for Payer: Wellpoint Medicaid Managed Care	$2.44

ATROPINE SULFATE/1MG/1ML

Facility

$92.13

Service Code	NDC 517101025
Hospital Charge Code	60632504
Hospital Revenue Code	250
Min. Negotiated Rate	$13.82
Max. Negotiated Rate	$13.82
Rate for Payer: Qualcare PPO/HMO/WC	$13.82

ATROPINE SULF OPHT SOL 1%

Facility

$73.00

Hospital Charge Code	6000483
Hospital Revenue Code	251
Min. Negotiated Rate	$10.95
Max. Negotiated Rate	$10.95
Rate for Payer: Qualcare PPO/HMO/WC	$10.95

ATROPINE SULF OPHT SOL 1%

Facility

$73.00

Hospital Charge Code	6000483
Hospital Revenue Code	251
Min. Negotiated Rate	$1.76
Max. Negotiated Rate	$36.50
Rate for Payer: Aetna Commercial	$27.74
Rate for Payer: Aetna Medicare Advantage	$21.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.61
Rate for Payer: Cigna Commercial	$36.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.90
Rate for Payer: Oxford Commercial	$14.60
Rate for Payer: Qualcare PPO/HMO/WC	$10.95
Rate for Payer: UnitedHealthcare Commercial	$14.60
Rate for Payer: UnitedHealthcare Community & State	$1.76
Rate for Payer: Wellpoint Medicaid Managed Care	$1.93

ATROPINE SULF SYRN 1MG/10ML

Facility

$25.59

Service Code	NDC 10019025012
Hospital Charge Code	60627425
Hospital Revenue Code	250
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$12.79
Rate for Payer: Aetna Commercial	$9.72
Rate for Payer: Aetna Medicare Advantage	$7.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.53
Rate for Payer: Cigna Commercial	$12.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.68
Rate for Payer: Oxford Commercial	$5.12
Rate for Payer: Qualcare PPO/HMO/WC	$3.84
Rate for Payer: UnitedHealthcare Commercial	$5.12
Rate for Payer: UnitedHealthcare Community & State	$0.62
Rate for Payer: Wellpoint Medicaid Managed Care	$0.68

ATROPINE SULF SYRN 1MG/10ML

Facility

$25.59

Service Code	NDC 10019025012
Hospital Charge Code	60627425
Hospital Revenue Code	250
Min. Negotiated Rate	$3.84
Max. Negotiated Rate	$3.84
Rate for Payer: Qualcare PPO/HMO/WC	$3.84

ATROPINE SULF VL 0.RMG/ML 20ML

Facility

$10.90

Hospital Charge Code	6006829
Hospital Revenue Code	250
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

ATROPINE SULF VL 0.RMG/ML 20ML

Facility

$10.90

Hospital Charge Code	6006829
Hospital Revenue Code	250
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$1.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.64

Know your out-of-pocket cost for care.

All Charges