Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

NACL 0.9% 250ML*****

Facility

$10.00

Hospital Charge Code	7000185
Hospital Revenue Code	258
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$5.00
Rate for Payer: Aetna Commercial	$3.80
Rate for Payer: Aetna Medicare Advantage	$3.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.55
Rate for Payer: Cigna Commercial	$5.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.00
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.50
Rate for Payer: UnitedHealthcare Commercial	$2.00
Rate for Payer: UnitedHealthcare Community & State	$0.24
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

NACL 0.9% 250ML GLASS ******

Facility

$16.00

Hospital Charge Code	7000508
Hospital Revenue Code	279
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$2.40

NACL 0.9% 250ML GLASS ******

Facility

$16.00

Hospital Charge Code	7000508
Hospital Revenue Code	279
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$8.00
Rate for Payer: Aetna Commercial	$6.08
Rate for Payer: Aetna Medicare Advantage	$4.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.08
Rate for Payer: Cigna Commercial	$8.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.80
Rate for Payer: Oxford Commercial	$3.20
Rate for Payer: Qualcare PPO/HMO/WC	$2.40
Rate for Payer: UnitedHealthcare Commercial	$3.20
Rate for Payer: UnitedHealthcare Community & State	$0.39
Rate for Payer: Wellpoint Medicaid Managed Care	$0.42

NACL 0.9% 3000ML ******

Facility

$23.00

Hospital Charge Code	1608231
Hospital Revenue Code	272
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

NACL 0.9% 3000ML ******

Facility

$23.00

Hospital Charge Code	1608231
Hospital Revenue Code	272
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$11.50
Rate for Payer: Aetna Commercial	$8.74
Rate for Payer: Aetna Medicare Advantage	$6.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.87
Rate for Payer: Cigna Commercial	$11.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.90
Rate for Payer: Oxford Commercial	$4.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$4.60
Rate for Payer: UnitedHealthcare Community & State	$0.55
Rate for Payer: Wellpoint Medicaid Managed Care	$0.61

NACL .09% 3000ml CBI

Facility

$35.00

Hospital Charge Code	270650080
Hospital Revenue Code	272
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$17.50
Rate for Payer: Aetna Commercial	$13.30
Rate for Payer: Aetna Medicare Advantage	$10.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.93
Rate for Payer: Cigna Commercial	$17.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.50
Rate for Payer: Oxford Commercial	$7.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.25
Rate for Payer: UnitedHealthcare Commercial	$7.00
Rate for Payer: UnitedHealthcare Community & State	$0.84
Rate for Payer: Wellpoint Medicaid Managed Care	$0.93

NACL .09% 3000ml CBI

Facility

$35.00

Hospital Charge Code	270650080
Hospital Revenue Code	272
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$5.25
Rate for Payer: Qualcare PPO/HMO/WC	$5.25

NACL 0.9% 40 KCL 1000cc

Facility

$9.95

Hospital Charge Code	270650114
Hospital Revenue Code	258
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$1.49
Rate for Payer: Qualcare PPO/HMO/WC	$1.49

NACL 0.9% 40 KCL 1000cc

Facility

$9.95

Hospital Charge Code	270650114
Hospital Revenue Code	258
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$4.97
Rate for Payer: Aetna Commercial	$3.78
Rate for Payer: Aetna Medicare Advantage	$2.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.54
Rate for Payer: Cigna Commercial	$4.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.98
Rate for Payer: Oxford Commercial	$1.99
Rate for Payer: Qualcare PPO/HMO/WC	$1.49
Rate for Payer: UnitedHealthcare Commercial	$1.99
Rate for Payer: UnitedHealthcare Community & State	$0.24
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

NACL .09% 500ml

Facility

$6.10

Hospital Charge Code	270650051
Hospital Revenue Code	258
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$0.92
Rate for Payer: Qualcare PPO/HMO/WC	$0.92

NACL .09% 500ml

Facility

$6.10

Hospital Charge Code	270650051
Hospital Revenue Code	258
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$3.05
Rate for Payer: Aetna Commercial	$2.32
Rate for Payer: Aetna Medicare Advantage	$1.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.56
Rate for Payer: Cigna Commercial	$3.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.83
Rate for Payer: Oxford Commercial	$1.22
Rate for Payer: Qualcare PPO/HMO/WC	$0.92
Rate for Payer: UnitedHealthcare Commercial	$1.22
Rate for Payer: UnitedHealthcare Community & State	$0.15
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

NACL .09% 500ML

Facility

$8.61

Hospital Charge Code	270649315S
Hospital Revenue Code	258
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$4.30
Rate for Payer: Aetna Commercial	$3.27
Rate for Payer: Aetna Medicare Advantage	$2.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.20
Rate for Payer: Cigna Commercial	$4.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.58
Rate for Payer: Oxford Commercial	$1.72
Rate for Payer: Qualcare PPO/HMO/WC	$1.29
Rate for Payer: UnitedHealthcare Commercial	$1.72
Rate for Payer: UnitedHealthcare Community & State	$0.21
Rate for Payer: Wellpoint Medicaid Managed Care	$0.23

NACL .09% 500ML

Facility

$8.61

Hospital Charge Code	270649315S
Hospital Revenue Code	258
Min. Negotiated Rate	$1.29
Max. Negotiated Rate	$1.29
Rate for Payer: Qualcare PPO/HMO/WC	$1.29

NACL 0.9% 500ML

Facility

$4.04

Hospital Charge Code	270040195
Hospital Revenue Code	258
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$0.61
Rate for Payer: Qualcare PPO/HMO/WC	$0.61

NACL 0.9% 500ML

Facility

$4.04

Hospital Charge Code	270040195
Hospital Revenue Code	258
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.02
Rate for Payer: Aetna Commercial	$1.54
Rate for Payer: Aetna Medicare Advantage	$1.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.03
Rate for Payer: Cigna Commercial	$2.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.21
Rate for Payer: Oxford Commercial	$0.81
Rate for Payer: Qualcare PPO/HMO/WC	$0.61
Rate for Payer: UnitedHealthcare Commercial	$0.81
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

NACL 0.9% 500ML ******

Facility

$3.00

Hospital Charge Code	7000789
Hospital Revenue Code	258
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

NACL 0.9% 500ML ******

Facility

$3.00

Hospital Charge Code	7000789
Hospital Revenue Code	258
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

NACL 0.9% 500ML GLASS****

Facility

$18.00

Hospital Charge Code	7000516
Hospital Revenue Code	279
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$9.00
Rate for Payer: Aetna Commercial	$6.84
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.40
Rate for Payer: Oxford Commercial	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$3.60
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

NACL 0.9% 500ML GLASS****

Facility

$18.00

Hospital Charge Code	7000516
Hospital Revenue Code	279
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

NACL 0.9% 50ML

Facility

$5.12

Hospital Charge Code	270040205
Hospital Revenue Code	258
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$0.77
Rate for Payer: Qualcare PPO/HMO/WC	$0.77

NACL 0.9% 50ML

Facility

$5.12

Hospital Charge Code	270040205
Hospital Revenue Code	258
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.56
Rate for Payer: Aetna Commercial	$1.95
Rate for Payer: Aetna Medicare Advantage	$1.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.31
Rate for Payer: Cigna Commercial	$2.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.54
Rate for Payer: Oxford Commercial	$1.02
Rate for Payer: Qualcare PPO/HMO/WC	$0.77
Rate for Payer: UnitedHealthcare Commercial	$1.02
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

NACL 0.9% 50ML *******

Facility

$4.00

Hospital Charge Code	7000854
Hospital Revenue Code	258
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

NACL 0.9% 50ML *******

Facility

$4.00

Hospital Charge Code	7000854
Hospital Revenue Code	258
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

NACL 0.9% 50ML ********

Facility

$4.00

Hospital Charge Code	7000797
Hospital Revenue Code	258
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

NACL 0.9% 50ML ********

Facility

$4.00

Hospital Charge Code	7000797
Hospital Revenue Code	258
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

Know your out-of-pocket cost for care.

All Charges