Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

NITROSTAT/0.4MG/TAB

Facility

$4.00

Hospital Charge Code	60633537
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

NITROSTAT 0.6MG/SL/TAB

Facility

$3.00

Hospital Charge Code	60634331
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

NITROSTAT 0.6MG/SL/TAB

Facility

$3.00

Hospital Charge Code	60634331
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

NITROUS OXIDE 56LBS

Facility

$495.00

Hospital Charge Code	270653914
Hospital Revenue Code	272
Min. Negotiated Rate	$11.93
Max. Negotiated Rate	$247.50
Rate for Payer: Aetna Commercial	$188.10
Rate for Payer: Aetna Medicare Advantage	$148.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.22
Rate for Payer: Cigna Commercial	$247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.50
Rate for Payer: Oxford Commercial	$99.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.25
Rate for Payer: UnitedHealthcare Commercial	$99.00
Rate for Payer: UnitedHealthcare Community & State	$11.93
Rate for Payer: Wellpoint Medicaid Managed Care	$13.12

NITROUS OXIDE 56LBS

Facility

$495.00

Hospital Charge Code	270653914
Hospital Revenue Code	272
Min. Negotiated Rate	$74.25
Max. Negotiated Rate	$74.25
Rate for Payer: Qualcare PPO/HMO/WC	$74.25

NITROUS OXIDE ANALGESIA SUPPLY

Facility

$15.29

Hospital Charge Code	270999015
Hospital Revenue Code	270
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$7.64
Rate for Payer: Aetna Commercial	$5.81
Rate for Payer: Aetna Medicare Advantage	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.90
Rate for Payer: Cigna Commercial	$7.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.59
Rate for Payer: Oxford Commercial	$3.06
Rate for Payer: Qualcare PPO/HMO/WC	$2.29
Rate for Payer: UnitedHealthcare Commercial	$3.06
Rate for Payer: UnitedHealthcare Community & State	$0.37
Rate for Payer: Wellpoint Medicaid Managed Care	$0.41

NITROUS OXIDE ANALGESIA SUPPLY

Facility

$15.29

Hospital Charge Code	270999015
Hospital Revenue Code	270
Min. Negotiated Rate	$2.29
Max. Negotiated Rate	$2.29
Rate for Payer: Qualcare PPO/HMO/WC	$2.29

NIVEA LOTION

Facility

$28.80

Hospital Charge Code	60628868
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

NIVEA LOTION

Facility

$28.80

Hospital Charge Code	60628868
Hospital Revenue Code	250
Min. Negotiated Rate	$4.32
Max. Negotiated Rate	$4.32
Rate for Payer: Qualcare PPO/HMO/WC	$4.32

NIVEA SKIN CREAM

Facility

$17.95

Hospital Charge Code	60628427
Hospital Revenue Code	250
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$8.97
Rate for Payer: Aetna Commercial	$6.82
Rate for Payer: Aetna Medicare Advantage	$5.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.58
Rate for Payer: Cigna Commercial	$8.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.38
Rate for Payer: Oxford Commercial	$3.59
Rate for Payer: Qualcare PPO/HMO/WC	$2.69
Rate for Payer: UnitedHealthcare Commercial	$3.59
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

NIVEA SKIN CREAM

Facility

$17.95

Hospital Charge Code	60628427
Hospital Revenue Code	250
Min. Negotiated Rate	$2.69
Max. Negotiated Rate	$2.69
Rate for Payer: Qualcare PPO/HMO/WC	$2.69

NIVESTYM 480MCG/.8ML PER MCG

Facility

$1,599.22

Service Code	HCPCS Q5110
Hospital Charge Code	606390440
Hospital Revenue Code	636
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$387.01
Rate for Payer: Aetna Commercial	$0.76
Rate for Payer: Aetna Medicare Advantage	$0.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$0.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.01
Rate for Payer: Cigna Medicare Advantage	$0.28
Rate for Payer: Clover Medicare Advantage	$0.27
Rate for Payer: EmblemHealth Commercial	$0.84
Rate for Payer: Humana Medicare Advantage	$0.29
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$0.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.01
Rate for Payer: Qualcare PPO/HMO/WC	$239.88
Rate for Payer: UnitedHealthcare Community & State	$38.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$0.28
Rate for Payer: Wellcare Medicare Advantage	$0.28
Rate for Payer: Wellpoint Medicaid Managed Care	$42.38

NIVESTYM 480MCG/.8ML PER MCG

Facility

$1,599.22

Service Code	HCPCS Q5110
Hospital Charge Code	606390440
Hospital Revenue Code	636
Min. Negotiated Rate	$239.88
Max. Negotiated Rate	$387.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.01
Rate for Payer: Qualcare PPO/HMO/WC	$239.88

NIZATIDINE 150 MG

Facility

$1.95

Hospital Charge Code	6022818
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

NIZATIDINE 150 MG

Facility

$1.95

Hospital Charge Code	6022818
Hospital Revenue Code	251
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.29
Rate for Payer: Qualcare PPO/HMO/WC	$0.29

NIZATIDINE 150 MG CAP

Facility

$13.65

Hospital Charge Code	60628170
Hospital Revenue Code	250
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$2.05
Rate for Payer: Qualcare PPO/HMO/WC	$2.05

NIZATIDINE 150 MG CAP

Facility

$13.65

Hospital Charge Code	60628170
Hospital Revenue Code	250
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$6.83
Rate for Payer: Aetna Commercial	$5.19
Rate for Payer: Aetna Medicare Advantage	$4.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.48
Rate for Payer: Cigna Commercial	$6.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.09
Rate for Payer: Oxford Commercial	$2.73
Rate for Payer: Qualcare PPO/HMO/WC	$2.05
Rate for Payer: UnitedHealthcare Commercial	$2.73
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

NIZORAL/200MG/TAB

Facility

$9.00

Hospital Charge Code	60634702
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

NIZORAL/200MG/TAB

Facility

$9.00

Hospital Charge Code	60634702
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

NIZORAL 2%/15GM

Facility

$44.00

Hospital Charge Code	60633539
Hospital Revenue Code	250
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

NIZORAL 2%/15GM

Facility

$44.00

Hospital Charge Code	60633539
Hospital Revenue Code	250
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$22.00
Rate for Payer: Aetna Commercial	$16.72
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.20
Rate for Payer: Oxford Commercial	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$8.80
Rate for Payer: UnitedHealthcare Community & State	$1.06
Rate for Payer: Wellpoint Medicaid Managed Care	$1.17

NIZORAL SHAMPOO 4 OZ

Facility

$35.00

Hospital Charge Code	60635484
Hospital Revenue Code	250
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$5.25
Rate for Payer: Qualcare PPO/HMO/WC	$5.25

NIZORAL SHAMPOO 4 OZ

Facility

$35.00

Hospital Charge Code	60635484
Hospital Revenue Code	250
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$17.50
Rate for Payer: Aetna Commercial	$13.30
Rate for Payer: Aetna Medicare Advantage	$10.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.93
Rate for Payer: Cigna Commercial	$17.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.50
Rate for Payer: Oxford Commercial	$7.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.25
Rate for Payer: UnitedHealthcare Commercial	$7.00
Rate for Payer: UnitedHealthcare Community & State	$0.84
Rate for Payer: Wellpoint Medicaid Managed Care	$0.93

NJX AA&/STRD GNCLR NRV BRNCH

Facility

$3,865.20

Service Code	HCPCS 64454
Hospital Charge Code	411064454
Hospital Revenue Code	361
Min. Negotiated Rate	$93.15
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,281.02
Rate for Payer: Aetna Medicare Advantage	$2,717.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,027.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,027.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$838.61
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	$3,027.13
Rate for Payer: Cigna Commercial	$1,680.99
Rate for Payer: Cigna Medicare Advantage	$838.61
Rate for Payer: Clover Medicare Advantage	$796.68
Rate for Payer: EmblemHealth Commercial	$2,515.83
Rate for Payer: Humana Medicare Advantage	$863.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$838.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,159.56
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$579.78
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$93.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$838.61
Rate for Payer: Wellcare Medicare Advantage	$838.61
Rate for Payer: Wellpoint Medicaid Managed Care	$102.43

NJX AA&/STRD GNCLR NRV BRNCH

Facility

$2,930.12

Service Code	HCPCS 64454
Hospital Charge Code	1600000661
Hospital Revenue Code	360
Min. Negotiated Rate	$70.62
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,281.02
Rate for Payer: Aetna Medicare Advantage	$2,717.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,027.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,027.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$838.61
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	$3,027.13
Rate for Payer: Cigna Commercial	$1,680.99
Rate for Payer: Cigna Medicare Advantage	$838.61
Rate for Payer: Clover Medicare Advantage	$796.68
Rate for Payer: EmblemHealth Commercial	$2,515.83
Rate for Payer: Humana Medicare Advantage	$863.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$838.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$879.04
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$439.52
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$70.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$838.61
Rate for Payer: Wellcare Medicare Advantage	$838.61
Rate for Payer: Wellpoint Medicaid Managed Care	$77.65

Know your out-of-pocket cost for care.

All Charges