Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

NARCAN/0.4MG/1ML

Facility

$42.00

Hospital Charge Code	60633498
Hospital Revenue Code	250
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$6.30
Rate for Payer: Qualcare PPO/HMO/WC	$6.30

NARCAN/0.4MG/1ML

Facility

$42.00

Hospital Charge Code	60633498
Hospital Revenue Code	250
Min. Negotiated Rate	$1.01
Max. Negotiated Rate	$21.00
Rate for Payer: Aetna Commercial	$15.96
Rate for Payer: Aetna Medicare Advantage	$12.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.71
Rate for Payer: Cigna Commercial	$21.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.60
Rate for Payer: Oxford Commercial	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$6.30
Rate for Payer: UnitedHealthcare Commercial	$8.40
Rate for Payer: UnitedHealthcare Community & State	$1.01
Rate for Payer: Wellpoint Medicaid Managed Care	$1.11

NARCAN/1MG/1ML

Facility

$485.00

Hospital Charge Code	60633499
Hospital Revenue Code	250
Min. Negotiated Rate	$11.69
Max. Negotiated Rate	$242.50
Rate for Payer: Aetna Commercial	$184.30
Rate for Payer: Aetna Medicare Advantage	$145.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$123.67
Rate for Payer: Cigna Commercial	$242.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.50
Rate for Payer: Oxford Commercial	$97.00
Rate for Payer: Qualcare PPO/HMO/WC	$72.75
Rate for Payer: UnitedHealthcare Commercial	$97.00
Rate for Payer: UnitedHealthcare Community & State	$11.69
Rate for Payer: Wellpoint Medicaid Managed Care	$12.85

NARCAN/1MG/1ML

Facility

$485.00

Hospital Charge Code	60633499
Hospital Revenue Code	250
Min. Negotiated Rate	$72.75
Max. Negotiated Rate	$72.75
Rate for Payer: Qualcare PPO/HMO/WC	$72.75

NARCAN MULTIPLE DOSE/0.4M

Facility

$212.00

Hospital Charge Code	60633500
Hospital Revenue Code	250
Min. Negotiated Rate	$31.80
Max. Negotiated Rate	$31.80
Rate for Payer: Qualcare PPO/HMO/WC	$31.80

NARCAN MULTIPLE DOSE/0.4M

Facility

$212.00

Hospital Charge Code	60633500
Hospital Revenue Code	250
Min. Negotiated Rate	$5.11
Max. Negotiated Rate	$106.00
Rate for Payer: Aetna Commercial	$80.56
Rate for Payer: Aetna Medicare Advantage	$63.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.06
Rate for Payer: Cigna Commercial	$106.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.60
Rate for Payer: Oxford Commercial	$42.40
Rate for Payer: Qualcare PPO/HMO/WC	$31.80
Rate for Payer: UnitedHealthcare Commercial	$42.40
Rate for Payer: UnitedHealthcare Community & State	$5.11
Rate for Payer: Wellpoint Medicaid Managed Care	$5.62

NARCAN NEONATAL/0.02MG/1M

Facility

$38.00

Hospital Charge Code	60633501
Hospital Revenue Code	250
Min. Negotiated Rate	$5.70
Max. Negotiated Rate	$5.70
Rate for Payer: Qualcare PPO/HMO/WC	$5.70

NARCAN NEONATAL/0.02MG/1M

Facility

$38.00

Hospital Charge Code	60633501
Hospital Revenue Code	250
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$19.00
Rate for Payer: Aetna Commercial	$14.44
Rate for Payer: Aetna Medicare Advantage	$11.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.69
Rate for Payer: Cigna Commercial	$19.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.40
Rate for Payer: Oxford Commercial	$7.60
Rate for Payer: Qualcare PPO/HMO/WC	$5.70
Rate for Payer: UnitedHealthcare Commercial	$7.60
Rate for Payer: UnitedHealthcare Community & State	$0.92
Rate for Payer: Wellpoint Medicaid Managed Care	$1.01

NARDIL/15MG/TAB

Facility

$3.00

Hospital Charge Code	60633502
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

NARDIL/15MG/TAB

Facility

$3.00

Hospital Charge Code	60633502
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

NARROW HOOK 10 MM

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270687612
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

NARROW HOOK 10 MM

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270687612
Hospital Revenue Code	278
Min. Negotiated Rate	$96.40
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$96.40
Rate for Payer: Wellpoint Medicaid Managed Care	$106.00

NARROW HOOK 8 MM

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270687613
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

NARROW HOOK 8 MM

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270687613
Hospital Revenue Code	278
Min. Negotiated Rate	$96.40
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$96.40
Rate for Payer: Wellpoint Medicaid Managed Care	$106.00

NASAL BONES MIN 3 VW

Facility

$5,100.00

Service Code	HCPCS 70160
Hospital Charge Code	94061007
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

NASAL BONES MIN 3 VW

Facility

$5,100.00

Service Code	HCPCS 70160
Hospital Charge Code	94061007
Hospital Revenue Code	320
Min. Negotiated Rate	$31.94
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$281.22
Rate for Payer: Aetna Medicare Advantage	$334.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$373.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$373.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$103.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$373.21
Rate for Payer: Cigna Commercial	$207.24
Rate for Payer: Cigna Medicare Advantage	$72.37
Rate for Payer: Clover Medicare Advantage	$98.22
Rate for Payer: EmblemHealth Commercial	$310.17
Rate for Payer: Humana Medicare Advantage	$106.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$103.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,530.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$122.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$103.39
Rate for Payer: Wellcare Medicare Advantage	$103.39
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$216.59
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

NASALCROM 4%/13ML

Facility

$95.00

Hospital Charge Code	60633503
Hospital Revenue Code	250
Min. Negotiated Rate	$2.29
Max. Negotiated Rate	$47.50
Rate for Payer: Aetna Commercial	$36.10
Rate for Payer: Aetna Medicare Advantage	$28.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.23
Rate for Payer: Cigna Commercial	$47.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.50
Rate for Payer: Oxford Commercial	$19.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.25
Rate for Payer: UnitedHealthcare Commercial	$19.00
Rate for Payer: UnitedHealthcare Community & State	$2.29
Rate for Payer: Wellpoint Medicaid Managed Care	$2.52

NASALCROM 4%/13ML

Facility

$95.00

Hospital Charge Code	60633503
Hospital Revenue Code	250
Min. Negotiated Rate	$14.25
Max. Negotiated Rate	$14.25
Rate for Payer: Qualcare PPO/HMO/WC	$14.25

NASAL DORSUM DESIGN A 66MMX8MM

Facility

$975.00

Hospital Charge Code	270638534
Hospital Revenue Code	272
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$195.00
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

NASAL DORSUM DESIGN A 66MMX8MM

Facility

$975.00

Hospital Charge Code	270638534
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

NASAL DROPS/15ML

Facility

$2.00

Hospital Charge Code	60634602
Hospital Revenue Code	250
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$1.00
Rate for Payer: Aetna Commercial	$0.76
Rate for Payer: Aetna Medicare Advantage	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.51
Rate for Payer: Cigna Commercial	$1.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.60
Rate for Payer: Oxford Commercial	$0.40
Rate for Payer: Qualcare PPO/HMO/WC	$0.30
Rate for Payer: UnitedHealthcare Commercial	$0.40
Rate for Payer: UnitedHealthcare Community & State	$0.05
Rate for Payer: Wellpoint Medicaid Managed Care	$0.05

NASAL DROPS/15ML

Facility

$2.00

Hospital Charge Code	60634602
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.30

NASAL ENDO ETHMODIDECT,PATAL

Facility

$31,826.31

Service Code	HCPCS 31254
Hospital Charge Code	1600000610
Hospital Revenue Code	360
Min. Negotiated Rate	$4,773.95
Max. Negotiated Rate	$4,773.95
Rate for Payer: Qualcare PPO/HMO/WC	$4,773.95

NASAL ENDO ETHMODIDECT,PATAL

Facility

$31,826.31

Service Code	HCPCS 31254
Hospital Charge Code	1600000610
Hospital Revenue Code	360
Min. Negotiated Rate	$767.01
Max. Negotiated Rate	$30,265.35
Rate for Payer: Aetna Commercial	$22,805.70
Rate for Payer: Aetna Medicare Advantage	$27,165.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30,265.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30,265.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,384.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30,265.35
Rate for Payer: Cigna Commercial	$16,806.60
Rate for Payer: Cigna Medicare Advantage	$8,384.45
Rate for Payer: Clover Medicare Advantage	$7,965.23
Rate for Payer: EmblemHealth Commercial	$25,153.35
Rate for Payer: Humana Medicare Advantage	$8,635.98
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,384.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,547.89
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,773.95
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$767.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,384.45
Rate for Payer: Wellcare Medicare Advantage	$8,384.45
Rate for Payer: Wellpoint Medicaid Managed Care	$843.40

NASAL ENDOSCOPY-DX

Facility

$1,644.90

Service Code	HCPCS 31231
Hospital Charge Code	1600000347
Hospital Revenue Code	360
Min. Negotiated Rate	$39.64
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$645.02
Rate for Payer: Aetna Medicare Advantage	$768.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$856.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$856.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$237.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$856.00
Rate for Payer: Cigna Commercial	$475.34
Rate for Payer: Cigna Medicare Advantage	$237.14
Rate for Payer: Clover Medicare Advantage	$225.28
Rate for Payer: EmblemHealth Commercial	$711.42
Rate for Payer: Humana Medicare Advantage	$244.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$237.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$493.47
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$246.74
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$39.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$237.14
Rate for Payer: Wellcare Medicare Advantage	$237.14
Rate for Payer: Wellpoint Medicaid Managed Care	$43.59

Know your out-of-pocket cost for care.

All Charges