Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

NACL .9% 1000ML

Facility

$10.35

Hospital Charge Code	270649314S
Hospital Revenue Code	258
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$5.17
Rate for Payer: Aetna Commercial	$3.93
Rate for Payer: Aetna Medicare Advantage	$3.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.64
Rate for Payer: Cigna Commercial	$5.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.10
Rate for Payer: Oxford Commercial	$2.07
Rate for Payer: Qualcare PPO/HMO/WC	$1.55
Rate for Payer: UnitedHealthcare Commercial	$2.07
Rate for Payer: UnitedHealthcare Community & State	$0.25
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

NACL .9% 50ML

Facility

$8.50

Hospital Charge Code	270649316
Hospital Revenue Code	258
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 .9% 50ML

Facility

$8.50

Hospital Charge Code	270649316
Hospital Revenue Code	258
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$1.27
Rate for Payer: Qualcare PPO/HMO/WC	$1.27

NACL INJ 23.4% 30ML/VL

Facility

$15.40

Hospital Charge Code	6010136
Hospital Revenue Code	250
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$2.31
Rate for Payer: Qualcare PPO/HMO/WC	$2.31

NACL INJ 23.4% 30ML/VL

Facility

$15.40

Hospital Charge Code	6010136
Hospital Revenue Code	250
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$7.70
Rate for Payer: Aetna Commercial	$5.85
Rate for Payer: Aetna Medicare Advantage	$4.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.93
Rate for Payer: Cigna Commercial	$7.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.62
Rate for Payer: Oxford Commercial	$3.08
Rate for Payer: Qualcare PPO/HMO/WC	$2.31
Rate for Payer: UnitedHealthcare Commercial	$3.08
Rate for Payer: UnitedHealthcare Community & State	$0.37
Rate for Payer: Wellpoint Medicaid Managed Care	$0.41

NADOLOL 20 MG TAB

Facility

$41.47

Service Code	NDC 51079081220
Hospital Charge Code	60627586
Hospital Revenue Code	250
Min. Negotiated Rate	$6.22
Max. Negotiated Rate	$6.22
Rate for Payer: Qualcare PPO/HMO/WC	$6.22

NADOLOL 20 MG TAB

Facility

$41.47

Service Code	NDC 51079081220
Hospital Charge Code	60627586
Hospital Revenue Code	250
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$20.73
Rate for Payer: Aetna Commercial	$15.76
Rate for Payer: Aetna Medicare Advantage	$12.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.57
Rate for Payer: Cigna Commercial	$20.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.44
Rate for Payer: Oxford Commercial	$8.29
Rate for Payer: Qualcare PPO/HMO/WC	$6.22
Rate for Payer: UnitedHealthcare Commercial	$8.29
Rate for Payer: UnitedHealthcare Community & State	$1.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1.10

NADOLOL 40 MG TAB

Facility

$48.44

Service Code	NDC 51079081320
Hospital Charge Code	60627587
Hospital Revenue Code	250
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$24.22
Rate for Payer: Aetna Commercial	$18.41
Rate for Payer: Aetna Medicare Advantage	$14.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.35
Rate for Payer: Cigna Commercial	$24.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.53
Rate for Payer: Oxford Commercial	$9.69
Rate for Payer: Qualcare PPO/HMO/WC	$7.27
Rate for Payer: UnitedHealthcare Commercial	$9.69
Rate for Payer: UnitedHealthcare Community & State	$1.17
Rate for Payer: Wellpoint Medicaid Managed Care	$1.28

NADOLOL 40 MG TAB

Facility

$48.44

Service Code	NDC 51079081320
Hospital Charge Code	60627587
Hospital Revenue Code	250
Min. Negotiated Rate	$7.27
Max. Negotiated Rate	$7.27
Rate for Payer: Qualcare PPO/HMO/WC	$7.27

NADOLOL TAB 40MG

Facility

$10.90

Hospital Charge Code	6009724
Hospital Revenue Code	251
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$1.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.64

NADOLOL TAB 40MG

Facility

$10.90

Hospital Charge Code	6009724
Hospital Revenue Code	251
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

NADROXEN SSP 125MG/5ML 474ML

Facility

$346.90

Hospital Charge Code	6009864
Hospital Revenue Code	252
Min. Negotiated Rate	$8.36
Max. Negotiated Rate	$173.45
Rate for Payer: Aetna Commercial	$131.82
Rate for Payer: Aetna Medicare Advantage	$104.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.46
Rate for Payer: Cigna Commercial	$173.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.07
Rate for Payer: Oxford Commercial	$69.38
Rate for Payer: Qualcare PPO/HMO/WC	$52.03
Rate for Payer: UnitedHealthcare Commercial	$69.38
Rate for Payer: UnitedHealthcare Community & State	$8.36
Rate for Payer: Wellpoint Medicaid Managed Care	$9.19

NADROXEN SSP 125MG/5ML 474ML

Facility

$346.90

Hospital Charge Code	6009864
Hospital Revenue Code	252
Min. Negotiated Rate	$52.03
Max. Negotiated Rate	$52.03
Rate for Payer: Qualcare PPO/HMO/WC	$52.03

NAFAZAIR 0.1% OPHTH/15ML

Facility

$18.00

Hospital Charge Code	60633481
Hospital Revenue Code	250
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

NAFAZAIR 0.1% OPHTH/15ML

Facility

$18.00

Hospital Charge Code	60633481
Hospital Revenue Code	250
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

NAFCIL/10GM

Facility

$84.00

Hospital Charge Code	60633483
Hospital Revenue Code	250
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.60

NAFCIL/10GM

Facility

$84.00

Hospital Charge Code	60633483
Hospital Revenue Code	250
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$42.00
Rate for Payer: Aetna Commercial	$31.92
Rate for Payer: Aetna Medicare Advantage	$25.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.42
Rate for Payer: Cigna Commercial	$42.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.20
Rate for Payer: Oxford Commercial	$16.80
Rate for Payer: Qualcare PPO/HMO/WC	$12.60
Rate for Payer: UnitedHealthcare Commercial	$16.80
Rate for Payer: UnitedHealthcare Community & State	$2.02
Rate for Payer: Wellpoint Medicaid Managed Care	$2.23

NAFCIL/1GM

Facility

$44.00

Hospital Charge Code	60633485
Hospital Revenue Code	250
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$22.00
Rate for Payer: Aetna Commercial	$16.72
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.20
Rate for Payer: Oxford Commercial	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$8.80
Rate for Payer: UnitedHealthcare Community & State	$1.06
Rate for Payer: Wellpoint Medicaid Managed Care	$1.17

NAFCIL/1GM

Facility

$44.00

Hospital Charge Code	60633485
Hospital Revenue Code	250
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

NAFCIL/2GM

Facility

$122.00

Hospital Charge Code	60633486
Hospital Revenue Code	250
Min. Negotiated Rate	$18.30
Max. Negotiated Rate	$18.30
Rate for Payer: Qualcare PPO/HMO/WC	$18.30

NAFCIL/2GM

Facility

$101.00

Hospital Charge Code	60633482
Hospital Revenue Code	250
Min. Negotiated Rate	$2.43
Max. Negotiated Rate	$50.50
Rate for Payer: Aetna Commercial	$38.38
Rate for Payer: Aetna Medicare Advantage	$30.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.75
Rate for Payer: Cigna Commercial	$50.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.30
Rate for Payer: Oxford Commercial	$20.20
Rate for Payer: Qualcare PPO/HMO/WC	$15.15
Rate for Payer: UnitedHealthcare Commercial	$20.20
Rate for Payer: UnitedHealthcare Community & State	$2.43
Rate for Payer: Wellpoint Medicaid Managed Care	$2.68

NAFCIL/2GM

Facility

$101.00

Hospital Charge Code	60633482
Hospital Revenue Code	250
Min. Negotiated Rate	$15.15
Max. Negotiated Rate	$15.15
Rate for Payer: Qualcare PPO/HMO/WC	$15.15

NAFCIL/2GM

Facility

$122.00

Hospital Charge Code	60633486
Hospital Revenue Code	250
Min. Negotiated Rate	$2.94
Max. Negotiated Rate	$61.00
Rate for Payer: Aetna Commercial	$46.36
Rate for Payer: Aetna Medicare Advantage	$36.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.11
Rate for Payer: Cigna Commercial	$61.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.60
Rate for Payer: Oxford Commercial	$24.40
Rate for Payer: Qualcare PPO/HMO/WC	$18.30
Rate for Payer: UnitedHealthcare Commercial	$24.40
Rate for Payer: UnitedHealthcare Community & State	$2.94
Rate for Payer: Wellpoint Medicaid Managed Care	$3.23

NAFCIL 2GM PREMIX

Facility

$138.00

Hospital Charge Code	60635572
Hospital Revenue Code	250
Min. Negotiated Rate	$3.33
Max. Negotiated Rate	$69.00
Rate for Payer: Aetna Commercial	$52.44
Rate for Payer: Aetna Medicare Advantage	$41.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.19
Rate for Payer: Cigna Commercial	$69.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.40
Rate for Payer: Oxford Commercial	$27.60
Rate for Payer: Qualcare PPO/HMO/WC	$20.70
Rate for Payer: UnitedHealthcare Commercial	$27.60
Rate for Payer: UnitedHealthcare Community & State	$3.33
Rate for Payer: Wellpoint Medicaid Managed Care	$3.66

NAFCIL 2GM PREMIX

Facility

$138.00

Hospital Charge Code	60635572
Hospital Revenue Code	250
Min. Negotiated Rate	$20.70
Max. Negotiated Rate	$20.70
Rate for Payer: Qualcare PPO/HMO/WC	$20.70

Know your out-of-pocket cost for care.

All Charges