Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

NAIL ZIM HUMRL 8 22 225422508

Facility

$4,208.00

Hospital Charge Code	270625007
Hospital Revenue Code	278
Min. Negotiated Rate	$631.20
Max. Negotiated Rate	$1,018.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$841.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,018.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$925.76
Rate for Payer: Qualcare PPO/HMO/WC	$631.20

NAIL ZIM HUMRL 8 22 225422508

Facility

$4,208.00

Hospital Charge Code	270625007
Hospital Revenue Code	278
Min. Negotiated Rate	$101.41
Max. Negotiated Rate	$2,104.00
Rate for Payer: Aetna Commercial	$1,599.04
Rate for Payer: Aetna Medicare Advantage	$1,262.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,073.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,073.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$841.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,073.04
Rate for Payer: Cigna Commercial	$2,104.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,018.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$925.76
Rate for Payer: Qualcare PPO/HMO/WC	$631.20
Rate for Payer: UnitedHealthcare Community & State	$101.41
Rate for Payer: Wellpoint Medicaid Managed Care	$111.51

NAIL ZIM HUMRL 8 24 224724008

Facility

$4,800.85

Hospital Charge Code	270610832
Hospital Revenue Code	278
Min. Negotiated Rate	$115.70
Max. Negotiated Rate	$2,400.43
Rate for Payer: Aetna Commercial	$1,824.32
Rate for Payer: Aetna Medicare Advantage	$1,440.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,224.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,224.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$960.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,224.22
Rate for Payer: Cigna Commercial	$2,400.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,161.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,056.19
Rate for Payer: Qualcare PPO/HMO/WC	$720.13
Rate for Payer: UnitedHealthcare Community & State	$115.70
Rate for Payer: Wellpoint Medicaid Managed Care	$127.22

NAIL ZIM HUMRL 8 24 224724008

Facility

$4,800.85

Hospital Charge Code	270610832
Hospital Revenue Code	278
Min. Negotiated Rate	$720.13
Max. Negotiated Rate	$1,161.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$960.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,161.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,056.19
Rate for Payer: Qualcare PPO/HMO/WC	$720.13

NAIL ZIM HUMRL 8 24 225421009

Facility

$4,689.65

Hospital Charge Code	270618073
Hospital Revenue Code	278
Min. Negotiated Rate	$703.45
Max. Negotiated Rate	$1,134.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$937.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,134.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,031.72
Rate for Payer: Qualcare PPO/HMO/WC	$703.45

NAIL ZIM HUMRL 8 24 225421009

Facility

$4,689.65

Hospital Charge Code	270618073
Hospital Revenue Code	278
Min. Negotiated Rate	$113.02
Max. Negotiated Rate	$2,344.82
Rate for Payer: Aetna Commercial	$1,782.07
Rate for Payer: Aetna Medicare Advantage	$1,406.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,195.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,195.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$937.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,195.86
Rate for Payer: Cigna Commercial	$2,344.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,134.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,031.72
Rate for Payer: Qualcare PPO/HMO/WC	$703.45
Rate for Payer: UnitedHealthcare Community & State	$113.02
Rate for Payer: Wellpoint Medicaid Managed Care	$124.28

NAIL ZIM IM FEM 12 40 22401240

Facility

$4,196.00

Hospital Charge Code	270628469
Hospital Revenue Code	278
Min. Negotiated Rate	$101.12
Max. Negotiated Rate	$2,098.00
Rate for Payer: Aetna Commercial	$1,594.48
Rate for Payer: Aetna Medicare Advantage	$1,258.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,069.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,069.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$839.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,069.98
Rate for Payer: Cigna Commercial	$2,098.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,015.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$923.12
Rate for Payer: Qualcare PPO/HMO/WC	$629.40
Rate for Payer: UnitedHealthcare Community & State	$101.12
Rate for Payer: Wellpoint Medicaid Managed Care	$111.19

NAIL ZIM IM FEM 12 40 22401240

Facility

$4,196.00

Hospital Charge Code	270628469
Hospital Revenue Code	278
Min. Negotiated Rate	$629.40
Max. Negotiated Rate	$1,015.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$839.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,015.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$923.12
Rate for Payer: Qualcare PPO/HMO/WC	$629.40

NAIL ZIM IM FEM 14 32 22401432

Facility

$4,188.85

Hospital Charge Code	270625723
Hospital Revenue Code	278
Min. Negotiated Rate	$100.95
Max. Negotiated Rate	$2,094.43
Rate for Payer: Aetna Commercial	$1,591.76
Rate for Payer: Aetna Medicare Advantage	$1,256.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,068.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,068.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$837.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,068.16
Rate for Payer: Cigna Commercial	$2,094.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,013.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$921.55
Rate for Payer: Qualcare PPO/HMO/WC	$628.33
Rate for Payer: UnitedHealthcare Community & State	$100.95
Rate for Payer: Wellpoint Medicaid Managed Care	$111.00

NAIL ZIM IM FEM 14 32 22401432

Facility

$4,188.85

Hospital Charge Code	270625723
Hospital Revenue Code	278
Min. Negotiated Rate	$628.33
Max. Negotiated Rate	$1,013.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$837.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,013.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$921.55
Rate for Payer: Qualcare PPO/HMO/WC	$628.33

NAIL ZIM IM FEM 9 36 225236009

Facility

$2,912.00

Hospital Charge Code	270620526
Hospital Revenue Code	278
Min. Negotiated Rate	$70.18
Max. Negotiated Rate	$1,456.00
Rate for Payer: Aetna Commercial	$1,106.56
Rate for Payer: Aetna Medicare Advantage	$873.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$742.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$742.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$582.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$742.56
Rate for Payer: Cigna Commercial	$1,456.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$704.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$640.64
Rate for Payer: Qualcare PPO/HMO/WC	$436.80
Rate for Payer: UnitedHealthcare Community & State	$70.18
Rate for Payer: Wellpoint Medicaid Managed Care	$77.17

NAIL ZIM IM FEM 9 36 225236009

Facility

$2,912.00

Hospital Charge Code	270620526
Hospital Revenue Code	278
Min. Negotiated Rate	$436.80
Max. Negotiated Rate	$704.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$582.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$704.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$640.64
Rate for Payer: Qualcare PPO/HMO/WC	$436.80

NAIL ZIM IM TIB 11 32 22533211

Facility

$2,940.85

Hospital Charge Code	270624447
Hospital Revenue Code	278
Min. Negotiated Rate	$70.87
Max. Negotiated Rate	$1,470.42
Rate for Payer: Aetna Commercial	$1,117.52
Rate for Payer: Aetna Medicare Advantage	$882.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$749.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$749.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$588.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$749.92
Rate for Payer: Cigna Commercial	$1,470.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$711.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$646.99
Rate for Payer: Qualcare PPO/HMO/WC	$441.13
Rate for Payer: UnitedHealthcare Community & State	$70.87
Rate for Payer: Wellpoint Medicaid Managed Care	$77.93

NAIL ZIM IM TIB 11 32 22533211

Facility

$2,940.85

Hospital Charge Code	270624447
Hospital Revenue Code	278
Min. Negotiated Rate	$441.13
Max. Negotiated Rate	$711.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$588.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$711.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$646.99
Rate for Payer: Qualcare PPO/HMO/WC	$441.13

NAIL ZIM IM TIB 12 30 22533001

Facility

$3,113.65

Hospital Charge Code	270623245
Hospital Revenue Code	278
Min. Negotiated Rate	$75.04
Max. Negotiated Rate	$1,556.83
Rate for Payer: Aetna Commercial	$1,183.19
Rate for Payer: Aetna Medicare Advantage	$934.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$793.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$793.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$622.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$793.98
Rate for Payer: Cigna Commercial	$1,556.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$753.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$685.00
Rate for Payer: Qualcare PPO/HMO/WC	$467.05
Rate for Payer: UnitedHealthcare Community & State	$75.04
Rate for Payer: Wellpoint Medicaid Managed Care	$82.51

NAIL ZIM IM TIB 12 30 22533001

Facility

$3,113.65

Hospital Charge Code	270623245
Hospital Revenue Code	278
Min. Negotiated Rate	$467.05
Max. Negotiated Rate	$753.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$622.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$753.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$685.00
Rate for Payer: Qualcare PPO/HMO/WC	$467.05

NAIL ZIM IM TIB 9 36 22533609

Facility

$2,940.85

Hospital Charge Code	270624283
Hospital Revenue Code	278
Min. Negotiated Rate	$70.87
Max. Negotiated Rate	$1,470.42
Rate for Payer: Aetna Commercial	$1,117.52
Rate for Payer: Aetna Medicare Advantage	$882.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$749.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$749.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$588.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$749.92
Rate for Payer: Cigna Commercial	$1,470.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$711.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$646.99
Rate for Payer: Qualcare PPO/HMO/WC	$441.13
Rate for Payer: UnitedHealthcare Community & State	$70.87
Rate for Payer: Wellpoint Medicaid Managed Care	$77.93

NAIL ZIM IM TIB 9 36 22533609

Facility

$2,940.85

Hospital Charge Code	270624283
Hospital Revenue Code	278
Min. Negotiated Rate	$441.13
Max. Negotiated Rate	$711.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$588.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$711.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$646.99
Rate for Payer: Qualcare PPO/HMO/WC	$441.13

NAI M/DN R-F IM 14m30c22401430

Facility

$5,620.65

Hospital Charge Code	270639516
Hospital Revenue Code	278
Min. Negotiated Rate	$135.46
Max. Negotiated Rate	$2,810.32
Rate for Payer: Aetna Commercial	$2,135.85
Rate for Payer: Aetna Medicare Advantage	$1,686.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,433.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,433.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,124.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,433.27
Rate for Payer: Cigna Commercial	$2,810.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,360.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,236.54
Rate for Payer: Qualcare PPO/HMO/WC	$843.10
Rate for Payer: UnitedHealthcare Community & State	$135.46
Rate for Payer: Wellpoint Medicaid Managed Care	$148.95

NAI M/DN R-F IM 14m30c22401430

Facility

$5,620.65

Hospital Charge Code	270639516
Hospital Revenue Code	278
Min. Negotiated Rate	$843.10
Max. Negotiated Rate	$1,360.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,124.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,360.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,236.54
Rate for Payer: Qualcare PPO/HMO/WC	$843.10

NAI TROCH LNG 11mmX30cmRT28330

Facility

$7,800.00

Hospital Charge Code	270640203
Hospital Revenue Code	278
Min. Negotiated Rate	$1,170.00
Max. Negotiated Rate	$1,887.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,887.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,716.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,170.00

NAI TROCH LNG 11mmX30cmRT28330

Facility

$7,800.00

Hospital Charge Code	270640203
Hospital Revenue Code	278
Min. Negotiated Rate	$187.98
Max. Negotiated Rate	$3,900.00
Rate for Payer: Aetna Commercial	$2,964.00
Rate for Payer: Aetna Medicare Advantage	$2,340.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,989.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,989.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,560.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,989.00
Rate for Payer: Cigna Commercial	$3,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,887.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,716.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,170.00
Rate for Payer: UnitedHealthcare Community & State	$187.98
Rate for Payer: Wellpoint Medicaid Managed Care	$206.70

NALBUPHINE 10MG/ML AMPUL

Facility

$26.40

Service Code	HCPCS J2300
Hospital Charge Code	60631804
Hospital Revenue Code	636
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$13.20
Rate for Payer: Aetna Commercial	$10.03
Rate for Payer: Aetna Medicare Advantage	$7.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.73
Rate for Payer: Cigna Commercial	$13.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.39
Rate for Payer: Qualcare PPO/HMO/WC	$3.96
Rate for Payer: UnitedHealthcare Community & State	$0.64
Rate for Payer: Wellpoint Medicaid Managed Care	$0.70

NALBUPHINE 10MG/ML AMPUL

Facility

$26.40

Service Code	HCPCS J2300
Hospital Charge Code	60631804
Hospital Revenue Code	636
Min. Negotiated Rate	$3.96
Max. Negotiated Rate	$6.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.39
Rate for Payer: Qualcare PPO/HMO/WC	$3.96

NALBUPHINE 10 MG/ML INJ

Facility

$10.45

Hospital Charge Code	6008965
Hospital Revenue Code	250
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$5.22
Rate for Payer: Aetna Commercial	$3.97
Rate for Payer: Aetna Medicare Advantage	$3.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.66
Rate for Payer: Cigna Commercial	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.13
Rate for Payer: Oxford Commercial	$2.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.57
Rate for Payer: UnitedHealthcare Commercial	$2.09
Rate for Payer: UnitedHealthcare Community & State	$0.25
Rate for Payer: Wellpoint Medicaid Managed Care	$0.28

Know your out-of-pocket cost for care.

All Charges