Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

NIFEDIPINE 60 MG ER TAB

Facility

$15.34

Service Code	NDC 51079089620
Hospital Charge Code	6009823
Hospital Revenue Code	250
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$7.67
Rate for Payer: Aetna Commercial	$5.83
Rate for Payer: Aetna Medicare Advantage	$4.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.91
Rate for Payer: Cigna Commercial	$7.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.60
Rate for Payer: Oxford Commercial	$3.07
Rate for Payer: Qualcare PPO/HMO/WC	$2.30
Rate for Payer: UnitedHealthcare Commercial	$3.07
Rate for Payer: UnitedHealthcare Community & State	$0.37
Rate for Payer: Wellpoint Medicaid Managed Care	$0.41

NIFEDIPINE 60 MG ER TAB

Facility

$15.34

Service Code	NDC 51079089620
Hospital Charge Code	6009823
Hospital Revenue Code	250
Min. Negotiated Rate	$2.30
Max. Negotiated Rate	$2.30
Rate for Payer: Qualcare PPO/HMO/WC	$2.30

NIFEDIPINE CAP 10MG

Facility

$1.95

Hospital Charge Code	6022701
Hospital Revenue Code	251
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.98
Rate for Payer: Aetna Commercial	$0.74
Rate for Payer: Aetna Medicare Advantage	$0.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.50
Rate for Payer: Cigna Commercial	$0.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.59
Rate for Payer: Oxford Commercial	$0.39
Rate for Payer: Qualcare PPO/HMO/WC	$0.29
Rate for Payer: UnitedHealthcare Commercial	$0.39
Rate for Payer: UnitedHealthcare Community & State	$0.05
Rate for Payer: Wellpoint Medicaid Managed Care	$0.05

NIFEDIPINE CAP 10MG

Facility

$1.95

Hospital Charge Code	6022701
Hospital Revenue Code	251
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.29
Rate for Payer: Qualcare PPO/HMO/WC	$0.29

NIFEDIPINE CC (ADALAT)90MG TAB

Facility

$19.50

Service Code	NDC 378039001
Hospital Charge Code	60630140
Hospital Revenue Code	250
Min. Negotiated Rate	$0.47
Max. Negotiated Rate	$9.75
Rate for Payer: Aetna Commercial	$7.41
Rate for Payer: Aetna Medicare Advantage	$5.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.97
Rate for Payer: Cigna Commercial	$9.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.85
Rate for Payer: Oxford Commercial	$3.90
Rate for Payer: Qualcare PPO/HMO/WC	$2.92
Rate for Payer: UnitedHealthcare Commercial	$3.90
Rate for Payer: UnitedHealthcare Community & State	$0.47
Rate for Payer: Wellpoint Medicaid Managed Care	$0.52

NIFEDIPINE CC (ADALAT)90MG TAB

Facility

$19.50

Service Code	NDC 378039001
Hospital Charge Code	60630140
Hospital Revenue Code	250
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$2.92
Rate for Payer: Qualcare PPO/HMO/WC	$2.92

NIGHT DRAINAGE SYSTEM *******

Facility

$115.00

Hospital Charge Code	8003857
Hospital Revenue Code	272
Min. Negotiated Rate	$2.77
Max. Negotiated Rate	$57.50
Rate for Payer: Aetna Commercial	$43.70
Rate for Payer: Aetna Medicare Advantage	$34.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.32
Rate for Payer: Cigna Commercial	$57.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.50
Rate for Payer: Oxford Commercial	$23.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.25
Rate for Payer: UnitedHealthcare Commercial	$23.00
Rate for Payer: UnitedHealthcare Community & State	$2.77
Rate for Payer: Wellpoint Medicaid Managed Care	$3.05

NIGHT DRAINAGE SYSTEM *******

Facility

$115.00

Hospital Charge Code	8003857
Hospital Revenue Code	272
Min. Negotiated Rate	$17.25
Max. Negotiated Rate	$17.25
Rate for Payer: Qualcare PPO/HMO/WC	$17.25

NIMBEX 2MG/ML

Facility

$80.00

Hospital Charge Code	60635112
Hospital Revenue Code	250
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00

NIMBEX 2MG/ML

Facility

$80.00

Hospital Charge Code	60635112
Hospital Revenue Code	250
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$40.00
Rate for Payer: Aetna Commercial	$30.40
Rate for Payer: Aetna Medicare Advantage	$24.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.40
Rate for Payer: Cigna Commercial	$40.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.00
Rate for Payer: Oxford Commercial	$16.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00
Rate for Payer: UnitedHealthcare Commercial	$16.00
Rate for Payer: UnitedHealthcare Community & State	$1.93
Rate for Payer: Wellpoint Medicaid Managed Care	$2.12

NIMODIPINE 30 MG CAP

Facility

$128.84

Service Code	NDC 23155051230
Hospital Charge Code	60628536
Hospital Revenue Code	250
Min. Negotiated Rate	$3.11
Max. Negotiated Rate	$64.42
Rate for Payer: Aetna Commercial	$48.96
Rate for Payer: Aetna Medicare Advantage	$38.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.85
Rate for Payer: Cigna Commercial	$64.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.65
Rate for Payer: Oxford Commercial	$25.77
Rate for Payer: Qualcare PPO/HMO/WC	$19.33
Rate for Payer: UnitedHealthcare Commercial	$25.77
Rate for Payer: UnitedHealthcare Community & State	$3.11
Rate for Payer: Wellpoint Medicaid Managed Care	$3.41

NIMODIPINE 30 MG CAP

Facility

$128.84

Service Code	NDC 23155051230
Hospital Charge Code	60628536
Hospital Revenue Code	250
Min. Negotiated Rate	$19.33
Max. Negotiated Rate	$19.33
Rate for Payer: Qualcare PPO/HMO/WC	$19.33

NIMODIPINE CAP 30MG

Facility

$35.20

Hospital Charge Code	60628666
Hospital Revenue Code	250
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$17.60
Rate for Payer: Aetna Commercial	$13.38
Rate for Payer: Aetna Medicare Advantage	$10.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.98
Rate for Payer: Cigna Commercial	$17.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.56
Rate for Payer: Oxford Commercial	$7.04
Rate for Payer: Qualcare PPO/HMO/WC	$5.28
Rate for Payer: UnitedHealthcare Commercial	$7.04
Rate for Payer: UnitedHealthcare Community & State	$0.85
Rate for Payer: Wellpoint Medicaid Managed Care	$0.93

NIMODIPINE CAP 30MG

Facility

$35.20

Hospital Charge Code	60628666
Hospital Revenue Code	250
Min. Negotiated Rate	$5.28
Max. Negotiated Rate	$5.28
Rate for Payer: Qualcare PPO/HMO/WC	$5.28

NIMODIPINE ORAL SUSP 60MG/10ML

Facility

$683.40

Service Code	NDC 24338026010
Hospital Charge Code	606390450
Hospital Revenue Code	250
Min. Negotiated Rate	$16.47
Max. Negotiated Rate	$341.70
Rate for Payer: Aetna Commercial	$259.69
Rate for Payer: Aetna Medicare Advantage	$205.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.27
Rate for Payer: Cigna Commercial	$341.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.02
Rate for Payer: Oxford Commercial	$136.68
Rate for Payer: Qualcare PPO/HMO/WC	$102.51
Rate for Payer: UnitedHealthcare Commercial	$136.68
Rate for Payer: UnitedHealthcare Community & State	$16.47
Rate for Payer: Wellpoint Medicaid Managed Care	$18.11

NIMODIPINE ORAL SUSP 60MG/10ML

Facility

$683.40

Service Code	NDC 24338026010
Hospital Charge Code	606390450
Hospital Revenue Code	250
Min. Negotiated Rate	$102.51
Max. Negotiated Rate	$102.51
Rate for Payer: Qualcare PPO/HMO/WC	$102.51

NIPPLE/AREOLA RECONSTRUCTION

Facility

$35,786.50

Service Code	HCPCS 19350
Hospital Charge Code	16000666
Hospital Revenue Code	360
Min. Negotiated Rate	$5,367.98
Max. Negotiated Rate	$5,367.98
Rate for Payer: Qualcare PPO/HMO/WC	$5,367.98

NIPPLE/AREOLA RECONSTRUCTION

Facility

$35,786.50

Service Code	HCPCS 19350
Hospital Charge Code	16000666
Hospital Revenue Code	360
Min. Negotiated Rate	$862.45
Max. Negotiated Rate	$16,791.02
Rate for Payer: Aetna Commercial	$12,652.46
Rate for Payer: Aetna Medicare Advantage	$15,071.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,791.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,791.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,651.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16,791.02
Rate for Payer: Cigna Commercial	$9,324.19
Rate for Payer: Cigna Medicare Advantage	$4,651.64
Rate for Payer: Clover Medicare Advantage	$4,419.06
Rate for Payer: EmblemHealth Commercial	$13,954.92
Rate for Payer: Humana Medicare Advantage	$4,791.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,651.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,735.95
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,367.98
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$862.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,651.64
Rate for Payer: Wellcare Medicare Advantage	$4,651.64
Rate for Payer: Wellpoint Medicaid Managed Care	$948.34

NITINOL PILOT WIRE

Facility

$625.00

Service Code	HCPCS C1769
Hospital Charge Code	270700461
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

NITINOL PILOT WIRE

Facility

$625.00

Service Code	HCPCS C1769
Hospital Charge Code	270700461
Hospital Revenue Code	278
Min. Negotiated Rate	$15.06
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Community & State	$15.06
Rate for Payer: Wellpoint Medicaid Managed Care	$16.56

NITINOL STAPLE KIT 12X12MM

Facility

$5,515.00

Hospital Charge Code	270699042
Hospital Revenue Code	278
Min. Negotiated Rate	$132.91
Max. Negotiated Rate	$2,757.50
Rate for Payer: Aetna Commercial	$2,095.70
Rate for Payer: Aetna Medicare Advantage	$1,654.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,406.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,406.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,103.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,406.33
Rate for Payer: Cigna Commercial	$2,757.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,334.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,213.30
Rate for Payer: Qualcare PPO/HMO/WC	$827.25
Rate for Payer: UnitedHealthcare Community & State	$132.91
Rate for Payer: Wellpoint Medicaid Managed Care	$146.15

NITINOL STAPLE KIT 12X12MM

Facility

$5,515.00

Hospital Charge Code	270699042
Hospital Revenue Code	278
Min. Negotiated Rate	$827.25
Max. Negotiated Rate	$1,334.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,103.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,334.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,213.30
Rate for Payer: Qualcare PPO/HMO/WC	$827.25

NITINOL WIRES

Facility

$1,404.00

Hospital Charge Code	270704178
Hospital Revenue Code	279
Min. Negotiated Rate	$33.84
Max. Negotiated Rate	$702.00
Rate for Payer: Aetna Commercial	$533.52
Rate for Payer: Aetna Medicare Advantage	$421.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$358.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$358.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$358.02
Rate for Payer: Cigna Commercial	$702.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$421.20
Rate for Payer: Oxford Commercial	$280.80
Rate for Payer: Qualcare PPO/HMO/WC	$210.60
Rate for Payer: UnitedHealthcare Commercial	$280.80
Rate for Payer: UnitedHealthcare Community & State	$33.84
Rate for Payer: Wellpoint Medicaid Managed Care	$37.21

NITINOL WIRES

Facility

$1,404.00

Hospital Charge Code	270704178
Hospital Revenue Code	279
Min. Negotiated Rate	$210.60
Max. Negotiated Rate	$210.60
Rate for Payer: Qualcare PPO/HMO/WC	$210.60

NITRATE, URINE***

Facility

$22.00

Service Code	HCPCS 84311
Hospital Charge Code	3031325
Hospital Revenue Code	301
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$22.03
Rate for Payer: Aetna Medicare Advantage	$26.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.24
Rate for Payer: Cigna Commercial	$11.00
Rate for Payer: Cigna Medicare Advantage	$8.10
Rate for Payer: Clover Medicare Advantage	$7.70
Rate for Payer: EmblemHealth Commercial	$24.30
Rate for Payer: Humana Medicare Advantage	$8.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.30
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.10
Rate for Payer: Wellcare Medicare Advantage	$8.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.58

Know your out-of-pocket cost for care.

All Charges