Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

NAFCIL/500MG

Facility

$32.00

Hospital Charge Code	60633484
Hospital Revenue Code	250
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna Commercial	$12.16
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.60
Rate for Payer: Oxford Commercial	$6.40
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$6.40
Rate for Payer: UnitedHealthcare Community & State	$0.77
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

NAFCIL/500MG

Facility

$32.00

Hospital Charge Code	60633484
Hospital Revenue Code	250
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

NAFCILLIN 1 G INJ

Facility

$52.60

Service Code	NDC 703909501
Hospital Charge Code	6012884
Hospital Revenue Code	250
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$26.30
Rate for Payer: Aetna Commercial	$19.99
Rate for Payer: Aetna Medicare Advantage	$15.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.41
Rate for Payer: Cigna Commercial	$26.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.78
Rate for Payer: Oxford Commercial	$10.52
Rate for Payer: Qualcare PPO/HMO/WC	$7.89
Rate for Payer: UnitedHealthcare Commercial	$10.52
Rate for Payer: UnitedHealthcare Community & State	$1.27
Rate for Payer: Wellpoint Medicaid Managed Care	$1.39

NAFCILLIN 1 G INJ

Facility

$52.60

Service Code	NDC 703909501
Hospital Charge Code	6012884
Hospital Revenue Code	250
Min. Negotiated Rate	$7.89
Max. Negotiated Rate	$7.89
Rate for Payer: Qualcare PPO/HMO/WC	$7.89

NAFCILLIN 2 G INJ

Facility

$102.04

Service Code	NDC 703910501
Hospital Charge Code	60627303
Hospital Revenue Code	250
Min. Negotiated Rate	$15.31
Max. Negotiated Rate	$15.31
Rate for Payer: Qualcare PPO/HMO/WC	$15.31

NAFCILLIN 2 G INJ

Facility

$102.04

Service Code	NDC 703910501
Hospital Charge Code	60627303
Hospital Revenue Code	250
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$51.02
Rate for Payer: Aetna Commercial	$38.78
Rate for Payer: Aetna Medicare Advantage	$30.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.02
Rate for Payer: Cigna Commercial	$51.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.61
Rate for Payer: Oxford Commercial	$20.41
Rate for Payer: Qualcare PPO/HMO/WC	$15.31
Rate for Payer: UnitedHealthcare Commercial	$20.41
Rate for Payer: UnitedHealthcare Community & State	$2.46
Rate for Payer: Wellpoint Medicaid Managed Care	$2.70

NAFCILLIN INJ 2GM

Facility

$247.70

Hospital Charge Code	6003842
Hospital Revenue Code	250
Min. Negotiated Rate	$5.97
Max. Negotiated Rate	$123.85
Rate for Payer: Aetna Commercial	$94.13
Rate for Payer: Aetna Medicare Advantage	$74.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.16
Rate for Payer: Cigna Commercial	$123.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.31
Rate for Payer: Oxford Commercial	$49.54
Rate for Payer: Qualcare PPO/HMO/WC	$37.16
Rate for Payer: UnitedHealthcare Commercial	$49.54
Rate for Payer: UnitedHealthcare Community & State	$5.97
Rate for Payer: Wellpoint Medicaid Managed Care	$6.56

NAFCILLIN INJ 2GM

Facility

$247.70

Hospital Charge Code	6003842
Hospital Revenue Code	250
Min. Negotiated Rate	$37.16
Max. Negotiated Rate	$37.16
Rate for Payer: Qualcare PPO/HMO/WC	$37.16

NAFCILLIN IVPB 2GM/NS 100ML

Facility

$28.80

Hospital Charge Code	60627302
Hospital Revenue Code	250
Min. Negotiated Rate	$4.32
Max. Negotiated Rate	$4.32
Rate for Payer: Qualcare PPO/HMO/WC	$4.32

NAFCILLIN IVPB 2GM/NS 100ML

Facility

$28.80

Hospital Charge Code	60627302
Hospital Revenue Code	250
Min. Negotiated Rate	$0.69
Max. Negotiated Rate	$14.40
Rate for Payer: Aetna Commercial	$10.94
Rate for Payer: Aetna Medicare Advantage	$8.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.34
Rate for Payer: Cigna Commercial	$14.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.64
Rate for Payer: Oxford Commercial	$5.76
Rate for Payer: Qualcare PPO/HMO/WC	$4.32
Rate for Payer: UnitedHealthcare Commercial	$5.76
Rate for Payer: UnitedHealthcare Community & State	$0.69
Rate for Payer: Wellpoint Medicaid Managed Care	$0.76

NAFCILLIN IVPB ODD DOSE >1GM

Facility

$28.80

Hospital Charge Code	60627304
Hospital Revenue Code	250
Min. Negotiated Rate	$4.32
Max. Negotiated Rate	$4.32
Rate for Payer: Qualcare PPO/HMO/WC	$4.32

NAFCILLIN IVPB ODD DOSE >1GM

Facility

$28.80

Hospital Charge Code	60627304
Hospital Revenue Code	250
Min. Negotiated Rate	$0.69
Max. Negotiated Rate	$14.40
Rate for Payer: Aetna Commercial	$10.94
Rate for Payer: Aetna Medicare Advantage	$8.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.34
Rate for Payer: Cigna Commercial	$14.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.64
Rate for Payer: Oxford Commercial	$5.76
Rate for Payer: Qualcare PPO/HMO/WC	$4.32
Rate for Payer: UnitedHealthcare Commercial	$5.76
Rate for Payer: UnitedHealthcare Community & State	$0.69
Rate for Payer: Wellpoint Medicaid Managed Care	$0.76

NAFCILLIN SODIUM/10GM

Facility

$258.00

Hospital Charge Code	60633488
Hospital Revenue Code	250
Min. Negotiated Rate	$6.22
Max. Negotiated Rate	$129.00
Rate for Payer: Aetna Commercial	$98.04
Rate for Payer: Aetna Medicare Advantage	$77.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.79
Rate for Payer: Cigna Commercial	$129.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.40
Rate for Payer: Oxford Commercial	$51.60
Rate for Payer: Qualcare PPO/HMO/WC	$38.70
Rate for Payer: UnitedHealthcare Commercial	$51.60
Rate for Payer: UnitedHealthcare Community & State	$6.22
Rate for Payer: Wellpoint Medicaid Managed Care	$6.84

NAFCILLIN SODIUM/10GM

Facility

$258.00

Hospital Charge Code	60633488
Hospital Revenue Code	250
Min. Negotiated Rate	$38.70
Max. Negotiated Rate	$38.70
Rate for Payer: Qualcare PPO/HMO/WC	$38.70

NAFCILLIN SODIUM/500MG

Facility

$13.00

Hospital Charge Code	60633487
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

NAFCILLIN SODIUM/500MG

Facility

$13.00

Hospital Charge Code	60633487
Hospital Revenue Code	250
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$4.94
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$2.60
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

NAI FEM IM 11mDia40cm225740011

Facility

$5,562.95

Hospital Charge Code	270636138
Hospital Revenue Code	278
Min. Negotiated Rate	$134.07
Max. Negotiated Rate	$2,781.47
Rate for Payer: Aetna Commercial	$2,113.92
Rate for Payer: Aetna Medicare Advantage	$1,668.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,418.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,418.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,112.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,418.55
Rate for Payer: Cigna Commercial	$2,781.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,346.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,223.85
Rate for Payer: Qualcare PPO/HMO/WC	$834.44
Rate for Payer: UnitedHealthcare Community & State	$134.07
Rate for Payer: Wellpoint Medicaid Managed Care	$147.42

NAI FEM IM 11mDia40cm225740011

Facility

$5,562.95

Hospital Charge Code	270636138
Hospital Revenue Code	278
Min. Negotiated Rate	$834.44
Max. Negotiated Rate	$1,346.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,112.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,346.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,223.85
Rate for Payer: Qualcare PPO/HMO/WC	$834.44

NAI FEM IM 12m 36c LT225736002

Facility

$5,832.05

Hospital Charge Code	270639365
Hospital Revenue Code	278
Min. Negotiated Rate	$874.81
Max. Negotiated Rate	$1,411.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,166.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,411.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,283.05
Rate for Payer: Qualcare PPO/HMO/WC	$874.81

NAI FEM IM 12m 36c LT225736002

Facility

$5,832.05

Hospital Charge Code	270639365
Hospital Revenue Code	278
Min. Negotiated Rate	$140.55
Max. Negotiated Rate	$2,916.03
Rate for Payer: Aetna Commercial	$2,216.18
Rate for Payer: Aetna Medicare Advantage	$1,749.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,487.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,487.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,166.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,487.17
Rate for Payer: Cigna Commercial	$2,916.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,411.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,283.05
Rate for Payer: Qualcare PPO/HMO/WC	$874.81
Rate for Payer: UnitedHealthcare Community & State	$140.55
Rate for Payer: Wellpoint Medicaid Managed Care	$154.55

NAI FEM IM13mD36cmLFT225736003

Facility

$5,607.75

Hospital Charge Code	270637324
Hospital Revenue Code	278
Min. Negotiated Rate	$135.15
Max. Negotiated Rate	$2,803.88
Rate for Payer: Aetna Commercial	$2,130.95
Rate for Payer: Aetna Medicare Advantage	$1,682.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,429.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,429.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,121.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,429.98
Rate for Payer: Cigna Commercial	$2,803.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,357.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,233.70
Rate for Payer: Qualcare PPO/HMO/WC	$841.16
Rate for Payer: UnitedHealthcare Community & State	$135.15
Rate for Payer: Wellpoint Medicaid Managed Care	$148.61

NAI FEM IM13mD36cmLFT225736003

Facility

$5,607.75

Hospital Charge Code	270637324
Hospital Revenue Code	278
Min. Negotiated Rate	$841.16
Max. Negotiated Rate	$1,357.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,121.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,357.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,233.70
Rate for Payer: Qualcare PPO/HMO/WC	$841.16

NAI HUM 9 Ti CAN 150 04001410S

Facility

$7,965.00

Hospital Charge Code	270637801
Hospital Revenue Code	278
Min. Negotiated Rate	$191.96
Max. Negotiated Rate	$3,982.50
Rate for Payer: Aetna Commercial	$3,026.70
Rate for Payer: Aetna Medicare Advantage	$2,389.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,031.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,031.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,593.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,031.08
Rate for Payer: Cigna Commercial	$3,982.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,927.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,752.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,194.75
Rate for Payer: UnitedHealthcare Community & State	$191.96
Rate for Payer: Wellpoint Medicaid Managed Care	$211.07

NAI HUM 9 Ti CAN 150 04001410S

Facility

$7,965.00

Hospital Charge Code	270637801
Hospital Revenue Code	278
Min. Negotiated Rate	$1,194.75
Max. Negotiated Rate	$1,927.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,593.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,927.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,752.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,194.75

NAIL 10.5X90MM

Facility

$2,750.00

Hospital Charge Code	270702477
Hospital Revenue Code	278
Min. Negotiated Rate	$66.28
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$1,045.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50
Rate for Payer: UnitedHealthcare Community & State	$66.28
Rate for Payer: Wellpoint Medicaid Managed Care	$72.88

Know your out-of-pocket cost for care.

All Charges