Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

NAL IM RF M/DN 12x30 224001230

Facility

$5,353.00

Hospital Charge Code	270639190
Hospital Revenue Code	278
Min. Negotiated Rate	$802.95
Max. Negotiated Rate	$1,295.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,070.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,295.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,177.66
Rate for Payer: Qualcare PPO/HMO/WC	$802.95

NALOXONE 0.4 MG/ML INJ

Facility

$294.80

Service Code	HCPCS 2312
Hospital Charge Code	60627734
Hospital Revenue Code	636
Min. Negotiated Rate	$7.10
Max. Negotiated Rate	$147.40
Rate for Payer: Aetna Commercial	$112.02
Rate for Payer: Aetna Medicare Advantage	$88.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.17
Rate for Payer: Cigna Commercial	$147.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.34
Rate for Payer: Qualcare PPO/HMO/WC	$44.22
Rate for Payer: UnitedHealthcare Community & State	$7.10
Rate for Payer: Wellpoint Medicaid Managed Care	$7.81

NALOXONE 0.4 MG/ML INJ

Facility

$294.80

Service Code	HCPCS 2312
Hospital Charge Code	60627734
Hospital Revenue Code	636
Min. Negotiated Rate	$44.22
Max. Negotiated Rate	$71.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.34
Rate for Payer: Qualcare PPO/HMO/WC	$44.22

NALOXONE 0.4 MG/ML INJ (ADULT)

Facility

$127.30

Service Code	HCPCS J2312
Hospital Charge Code	60627733
Hospital Revenue Code	636
Min. Negotiated Rate	$19.09
Max. Negotiated Rate	$30.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.81
Rate for Payer: Qualcare PPO/HMO/WC	$19.09

NALOXONE 0.4 MG/ML INJ (ADULT)

Facility

$127.30

Service Code	HCPCS J2312
Hospital Charge Code	60627733
Hospital Revenue Code	636
Min. Negotiated Rate	$3.07
Max. Negotiated Rate	$63.65
Rate for Payer: Aetna Commercial	$48.37
Rate for Payer: Aetna Medicare Advantage	$38.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.46
Rate for Payer: Cigna Commercial	$63.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.81
Rate for Payer: Qualcare PPO/HMO/WC	$19.09
Rate for Payer: UnitedHealthcare Community & State	$3.07
Rate for Payer: Wellpoint Medicaid Managed Care	$3.37

NALOXONE HCL 2MG/2ML SYRUP

Facility

$132.66

Service Code	NDC 76329336901
Hospital Charge Code	6063943143
Hospital Revenue Code	250
Min. Negotiated Rate	$3.20
Max. Negotiated Rate	$66.33
Rate for Payer: Aetna Commercial	$50.41
Rate for Payer: Aetna Medicare Advantage	$39.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.83
Rate for Payer: Cigna Commercial	$66.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.80
Rate for Payer: Oxford Commercial	$26.53
Rate for Payer: Qualcare PPO/HMO/WC	$19.90
Rate for Payer: UnitedHealthcare Commercial	$26.53
Rate for Payer: UnitedHealthcare Community & State	$3.20
Rate for Payer: Wellpoint Medicaid Managed Care	$3.52

NALOXONE HCL 2MG/2ML SYRUP

Facility

$132.66

Service Code	NDC 76329336901
Hospital Charge Code	6063943143
Hospital Revenue Code	250
Min. Negotiated Rate	$19.90
Max. Negotiated Rate	$19.90
Rate for Payer: Qualcare PPO/HMO/WC	$19.90

NALOXONE INJ 1.0MG/ML 2ML

Facility

$19.85

Hospital Charge Code	6003859
Hospital Revenue Code	250
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$9.93
Rate for Payer: Aetna Commercial	$7.54
Rate for Payer: Aetna Medicare Advantage	$5.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.06
Rate for Payer: Cigna Commercial	$9.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.96
Rate for Payer: Oxford Commercial	$3.97
Rate for Payer: Qualcare PPO/HMO/WC	$2.98
Rate for Payer: UnitedHealthcare Commercial	$3.97
Rate for Payer: UnitedHealthcare Community & State	$0.48
Rate for Payer: Wellpoint Medicaid Managed Care	$0.53

NALOXONE INJ 1.0MG/ML 2ML

Facility

$19.85

Hospital Charge Code	6003859
Hospital Revenue Code	250
Min. Negotiated Rate	$2.98
Max. Negotiated Rate	$2.98
Rate for Payer: Qualcare PPO/HMO/WC	$2.98

NALOXONE VIAL 0.4MG

Facility

$3.85

Hospital Charge Code	6012900
Hospital Revenue Code	250
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$1.93
Rate for Payer: Aetna Commercial	$1.46
Rate for Payer: Aetna Medicare Advantage	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.98
Rate for Payer: Cigna Commercial	$1.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.16
Rate for Payer: Oxford Commercial	$0.77
Rate for Payer: Qualcare PPO/HMO/WC	$0.58
Rate for Payer: UnitedHealthcare Commercial	$0.77
Rate for Payer: UnitedHealthcare Community & State	$0.09
Rate for Payer: Wellpoint Medicaid Managed Care	$0.10

NALOXONE VIAL 0.4MG

Facility

$3.85

Hospital Charge Code	6012900
Hospital Revenue Code	250
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$0.58
Rate for Payer: Qualcare PPO/HMO/WC	$0.58

NALOXONE VIAL 4 MG

Facility

$9.00

Hospital Charge Code	6013007
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

NALOXONE VIAL 4 MG

Facility

$9.00

Hospital Charge Code	6013007
Hospital Revenue Code	250
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$3.42
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.70
Rate for Payer: Oxford Commercial	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$1.80
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

NALTREXONE 50 MG TAB

Facility

$28.61

Service Code	NDC 16729008101
Hospital Charge Code	60628852
Hospital Revenue Code	250
Min. Negotiated Rate	$0.69
Max. Negotiated Rate	$14.30
Rate for Payer: Aetna Commercial	$10.87
Rate for Payer: Aetna Medicare Advantage	$8.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.30
Rate for Payer: Cigna Commercial	$14.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.58
Rate for Payer: Oxford Commercial	$5.72
Rate for Payer: Qualcare PPO/HMO/WC	$4.29
Rate for Payer: UnitedHealthcare Commercial	$5.72
Rate for Payer: UnitedHealthcare Community & State	$0.69
Rate for Payer: Wellpoint Medicaid Managed Care	$0.76

NALTREXONE 50 MG TAB

Facility

$28.61

Service Code	NDC 16729008101
Hospital Charge Code	60628852
Hospital Revenue Code	250
Min. Negotiated Rate	$4.29
Max. Negotiated Rate	$4.29
Rate for Payer: Qualcare PPO/HMO/WC	$4.29

NANDROL DEC INJ 50MG/ML 1 ML

Facility

$48.00

Hospital Charge Code	6003867
Hospital Revenue Code	250
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$24.00
Rate for Payer: Aetna Commercial	$18.24
Rate for Payer: Aetna Medicare Advantage	$14.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.24
Rate for Payer: Cigna Commercial	$24.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.40
Rate for Payer: Oxford Commercial	$9.60
Rate for Payer: Qualcare PPO/HMO/WC	$7.20
Rate for Payer: UnitedHealthcare Commercial	$9.60
Rate for Payer: UnitedHealthcare Community & State	$1.16
Rate for Payer: Wellpoint Medicaid Managed Care	$1.27

NANDROL DEC INJ 50MG/ML 1 ML

Facility

$48.00

Hospital Charge Code	6003867
Hospital Revenue Code	250
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$7.20

NANDROL DE VL 1CMG/ML 2ML VIAL

Facility

$64.00

Hospital Charge Code	60629361
Hospital Revenue Code	250
Min. Negotiated Rate	$1.54
Max. Negotiated Rate	$32.00
Rate for Payer: Aetna Commercial	$24.32
Rate for Payer: Aetna Medicare Advantage	$19.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.32
Rate for Payer: Cigna Commercial	$32.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.20
Rate for Payer: Oxford Commercial	$12.80
Rate for Payer: Qualcare PPO/HMO/WC	$9.60
Rate for Payer: UnitedHealthcare Commercial	$12.80
Rate for Payer: UnitedHealthcare Community & State	$1.54
Rate for Payer: Wellpoint Medicaid Managed Care	$1.70

NANDROL DE VL 1CMG/ML 2ML VIAL

Facility

$64.00

Hospital Charge Code	60629361
Hospital Revenue Code	250
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$9.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.60

NanoCross .014 Long 150mm -210

Facility

$1,852.20

Service Code	HCPCS C1725
Hospital Charge Code	270686204
Hospital Revenue Code	278
Min. Negotiated Rate	$277.83
Max. Negotiated Rate	$448.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$407.48
Rate for Payer: Qualcare PPO/HMO/WC	$277.83

NanoCross .014 Long 150mm -210

Facility

$1,852.20

Service Code	HCPCS C1725
Hospital Charge Code	270686204
Hospital Revenue Code	278
Min. Negotiated Rate	$44.64
Max. Negotiated Rate	$926.10
Rate for Payer: Aetna Commercial	$703.84
Rate for Payer: Aetna Medicare Advantage	$555.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$472.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$472.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$472.31
Rate for Payer: Cigna Commercial	$926.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$407.48
Rate for Payer: Qualcare PPO/HMO/WC	$277.83
Rate for Payer: UnitedHealthcare Community & State	$44.64
Rate for Payer: Wellpoint Medicaid Managed Care	$49.08

NANONEEDLE SCOPE 180MM

Facility

$1,750.00

Hospital Charge Code	270704957
Hospital Revenue Code	279
Min. Negotiated Rate	$42.17
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$525.00
Rate for Payer: Oxford Commercial	$350.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Commercial	$350.00
Rate for Payer: UnitedHealthcare Community & State	$42.17
Rate for Payer: Wellpoint Medicaid Managed Care	$46.38

NANONEEDLE SCOPE 180MM

Facility

$1,750.00

Hospital Charge Code	270704957
Hospital Revenue Code	279
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

NANONEEDLE SCOPE HFLO KIT 180

Facility

$425.00

Hospital Charge Code	270704958
Hospital Revenue Code	279
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

NANONEEDLE SCOPE HFLO KIT 180

Facility

$425.00

Hospital Charge Code	270704958
Hospital Revenue Code	279
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.50
Rate for Payer: Oxford Commercial	$85.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Commercial	$85.00
Rate for Payer: UnitedHealthcare Community & State	$10.24
Rate for Payer: Wellpoint Medicaid Managed Care	$11.26

Know your out-of-pocket cost for care.

All Charges