Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

NACL 0.9% GU 1000 ML*****

Facility

$7.00

Hospital Charge Code	7000227
Hospital Revenue Code	258
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

NACL 0.9% GU 1000 ML*****

Facility

$7.00

Hospital Charge Code	7000227
Hospital Revenue Code	258
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

NACL 0.9% INJ 1000ML 7983-02

Facility

$4.40

Service Code	HCPCS J7030
Hospital Charge Code	270649314
Hospital Revenue Code	258
Min. Negotiated Rate	$0.66
Max. Negotiated Rate	$0.66
Rate for Payer: Qualcare PPO/HMO/WC	$0.66

NACL 0.9% INJ 1000ML 7983-02

Facility

$4.40

Service Code	HCPCS J7030
Hospital Charge Code	270649314
Hospital Revenue Code	258
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.20
Rate for Payer: Aetna Commercial	$1.67
Rate for Payer: Aetna Medicare Advantage	$1.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.12
Rate for Payer: Cigna Commercial	$2.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.32
Rate for Payer: Oxford Commercial	$0.88
Rate for Payer: Qualcare PPO/HMO/WC	$0.66
Rate for Payer: UnitedHealthcare Commercial	$0.88
Rate for Payer: UnitedHealthcare Community & State	$0.11
Rate for Payer: Wellpoint Medicaid Managed Care	$0.12

NACL 0.9% INJ 100ml

Facility

$8.50

Hospital Charge Code	270649318
Hospital Revenue Code	272
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$4.25
Rate for Payer: Aetna Commercial	$3.23
Rate for Payer: Aetna Medicare Advantage	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.17
Rate for Payer: Cigna Commercial	$4.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.55
Rate for Payer: Oxford Commercial	$1.70
Rate for Payer: Qualcare PPO/HMO/WC	$1.27
Rate for Payer: UnitedHealthcare Commercial	$1.70
Rate for Payer: UnitedHealthcare Community & State	$0.20
Rate for Payer: Wellpoint Medicaid Managed Care	$0.23

NACL 0.9% INJ 100ml

Facility

$8.50

Hospital Charge Code	270649318
Hospital Revenue Code	272
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$1.27
Rate for Payer: Qualcare PPO/HMO/WC	$1.27

NACL 0.9% INJ 250ML 7983-02

Facility

$3.89

Hospital Charge Code	270649313
Hospital Revenue Code	258
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$0.58
Rate for Payer: Qualcare PPO/HMO/WC	$0.58

NACL 0.9% INJ 250ML 7983-02

Facility

$3.89

Hospital Charge Code	270649313
Hospital Revenue Code	258
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$1.95
Rate for Payer: Aetna Commercial	$1.48
Rate for Payer: Aetna Medicare Advantage	$1.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.99
Rate for Payer: Cigna Commercial	$1.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.17
Rate for Payer: Oxford Commercial	$0.78
Rate for Payer: Qualcare PPO/HMO/WC	$0.58
Rate for Payer: UnitedHealthcare Commercial	$0.78
Rate for Payer: UnitedHealthcare Community & State	$0.09
Rate for Payer: Wellpoint Medicaid Managed Care	$0.10

NACL 0.9% INJ 500ML 7983-03

Facility

$4.70

Service Code	HCPCS J7040
Hospital Charge Code	270649315
Hospital Revenue Code	258
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.35
Rate for Payer: Aetna Commercial	$1.79
Rate for Payer: Aetna Medicare Advantage	$1.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.20
Rate for Payer: Cigna Commercial	$2.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.41
Rate for Payer: Oxford Commercial	$0.94
Rate for Payer: Qualcare PPO/HMO/WC	$0.71
Rate for Payer: UnitedHealthcare Commercial	$0.94
Rate for Payer: UnitedHealthcare Community & State	$0.11
Rate for Payer: Wellpoint Medicaid Managed Care	$0.12

NACL 0.9% INJ 500ML 7983-03

Facility

$4.70

Service Code	HCPCS J7040
Hospital Charge Code	270649315
Hospital Revenue Code	258
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$0.71
Rate for Payer: Qualcare PPO/HMO/WC	$0.71

NACL 0.9% INK 100ML 7984-23

Facility

$7.72

Hospital Charge Code	2700649318
Hospital Revenue Code	270
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.86
Rate for Payer: Aetna Commercial	$2.93
Rate for Payer: Aetna Medicare Advantage	$2.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.97
Rate for Payer: Cigna Commercial	$3.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.32
Rate for Payer: Oxford Commercial	$1.54
Rate for Payer: Qualcare PPO/HMO/WC	$1.16
Rate for Payer: UnitedHealthcare Commercial	$1.54
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

NACL 0.9% INK 100ML 7984-23

Facility

$7.72

Hospital Charge Code	2700649318
Hospital Revenue Code	270
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$1.16
Rate for Payer: Qualcare PPO/HMO/WC	$1.16

NACL 15ML DOSE 116

Facility

$33.65

Hospital Charge Code	270600600
Hospital Revenue Code	272
Min. Negotiated Rate	$5.05
Max. Negotiated Rate	$5.05
Rate for Payer: Qualcare PPO/HMO/WC	$5.05

NACL 15ML DOSE 116

Facility

$33.65

Hospital Charge Code	270600600
Hospital Revenue Code	272
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$16.82
Rate for Payer: Aetna Commercial	$12.79
Rate for Payer: Aetna Medicare Advantage	$10.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.58
Rate for Payer: Cigna Commercial	$16.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.10
Rate for Payer: Oxford Commercial	$6.73
Rate for Payer: Qualcare PPO/HMO/WC	$5.05
Rate for Payer: UnitedHealthcare Commercial	$6.73
Rate for Payer: UnitedHealthcare Community & State	$0.81
Rate for Payer: Wellpoint Medicaid Managed Care	$0.89

NACL 3% 500ML

Facility

$9.65

Hospital Charge Code	270040100
Hospital Revenue Code	272
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$4.83
Rate for Payer: Aetna Commercial	$3.67
Rate for Payer: Aetna Medicare Advantage	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.46
Rate for Payer: Cigna Commercial	$4.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.90
Rate for Payer: Oxford Commercial	$1.93
Rate for Payer: Qualcare PPO/HMO/WC	$1.45
Rate for Payer: UnitedHealthcare Commercial	$1.93
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

NACL 3% 500ML

Facility

$9.65

Hospital Charge Code	270040100
Hospital Revenue Code	272
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.45

NACL 3% 500ML ********

Facility

$16.00

Hospital Charge Code	7000219
Hospital Revenue Code	258
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 3% 500ML ********

Facility

$16.00

Hospital Charge Code	7000219
Hospital Revenue Code	258
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$2.40

NACL .45% 1000cc

Facility

$15.95

Hospital Charge Code	270650119
Hospital Revenue Code	258
Min. Negotiated Rate	$0.38
Max. Negotiated Rate	$7.97
Rate for Payer: Aetna Commercial	$6.06
Rate for Payer: Aetna Medicare Advantage	$4.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.07
Rate for Payer: Cigna Commercial	$7.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.79
Rate for Payer: Oxford Commercial	$3.19
Rate for Payer: Qualcare PPO/HMO/WC	$2.39
Rate for Payer: UnitedHealthcare Commercial	$3.19
Rate for Payer: UnitedHealthcare Community & State	$0.38
Rate for Payer: Wellpoint Medicaid Managed Care	$0.42

NACL .45% 1000cc

Facility

$15.95

Hospital Charge Code	270650119
Hospital Revenue Code	258
Min. Negotiated Rate	$2.39
Max. Negotiated Rate	$2.39
Rate for Payer: Qualcare PPO/HMO/WC	$2.39

NACL .45% 1000ML

Facility

$22.50

Hospital Charge Code	270649311S
Hospital Revenue Code	258
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$11.25
Rate for Payer: Aetna Commercial	$8.55
Rate for Payer: Aetna Medicare Advantage	$6.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.74
Rate for Payer: Cigna Commercial	$11.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.75
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.38
Rate for Payer: UnitedHealthcare Commercial	$4.50
Rate for Payer: UnitedHealthcare Community & State	$0.54
Rate for Payer: Wellpoint Medicaid Managed Care	$0.60

NACL .45% 1000ML

Facility

$22.50

Hospital Charge Code	270649311S
Hospital Revenue Code	258
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$3.38
Rate for Payer: Qualcare PPO/HMO/WC	$3.38

NACL .45% 500cc

Facility

$20.71

Hospital Charge Code	270650128
Hospital Revenue Code	258
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$10.36
Rate for Payer: Aetna Commercial	$7.87
Rate for Payer: Aetna Medicare Advantage	$6.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.28
Rate for Payer: Cigna Commercial	$10.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.21
Rate for Payer: Oxford Commercial	$4.14
Rate for Payer: Qualcare PPO/HMO/WC	$3.11
Rate for Payer: UnitedHealthcare Commercial	$4.14
Rate for Payer: UnitedHealthcare Community & State	$0.50
Rate for Payer: Wellpoint Medicaid Managed Care	$0.55

NACL .45% 500cc

Facility

$20.71

Hospital Charge Code	270650128
Hospital Revenue Code	258
Min. Negotiated Rate	$3.11
Max. Negotiated Rate	$3.11
Rate for Payer: Qualcare PPO/HMO/WC	$3.11

NACL .9% 1000ML

Facility

$10.35

Hospital Charge Code	270649314S
Hospital Revenue Code	258
Min. Negotiated Rate	$1.55
Max. Negotiated Rate	$1.55
Rate for Payer: Qualcare PPO/HMO/WC	$1.55

Know your out-of-pocket cost for care.

All Charges