Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

NOREPINEPHRINE 4 MG / 4 ML INJ

Facility

$70.35

Service Code	NDC 36000016210
Hospital Charge Code	60627463
Hospital Revenue Code	250
Min. Negotiated Rate	$10.55
Max. Negotiated Rate	$10.55
Rate for Payer: Qualcare PPO/HMO/WC	$10.55

NOREPINEPHRINE PLASMA

Facility

$123.15

Service Code	HCPCS 82542
Hospital Charge Code	39708033
Hospital Revenue Code	301
Min. Negotiated Rate	$3.26
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$65.52
Rate for Payer: Aetna Medicare Advantage	$78.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.96
Rate for Payer: Cigna Commercial	$61.58
Rate for Payer: Cigna Medicare Advantage	$24.09
Rate for Payer: Clover Medicare Advantage	$22.89
Rate for Payer: EmblemHealth Commercial	$72.27
Rate for Payer: Humana Medicare Advantage	$24.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.95
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.47
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$19.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.09
Rate for Payer: Wellcare Medicare Advantage	$24.09
Rate for Payer: Wellpoint Medicaid Managed Care	$3.26

NOREPINEPHRINE PLASMA

Facility

$123.15

Service Code	HCPCS 82542
Hospital Charge Code	39708033
Hospital Revenue Code	301
Min. Negotiated Rate	$18.47
Max. Negotiated Rate	$18.47
Rate for Payer: Qualcare PPO/HMO/WC	$18.47

NOREPINEPHRN BITAR 8MG/NS250ML

Facility

$150.75

Service Code	NDC 69374050425
Hospital Charge Code	606390290
Hospital Revenue Code	250
Min. Negotiated Rate	$3.63
Max. Negotiated Rate	$75.38
Rate for Payer: Aetna Commercial	$57.28
Rate for Payer: Aetna Medicare Advantage	$45.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.44
Rate for Payer: Cigna Commercial	$75.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.23
Rate for Payer: Oxford Commercial	$30.15
Rate for Payer: Qualcare PPO/HMO/WC	$22.61
Rate for Payer: UnitedHealthcare Commercial	$30.15
Rate for Payer: UnitedHealthcare Community & State	$3.63
Rate for Payer: Wellpoint Medicaid Managed Care	$3.99

NOREPINEPHRN BITAR 8MG/NS250ML

Facility

$150.75

Service Code	NDC 69374050425
Hospital Charge Code	606390290
Hospital Revenue Code	250
Min. Negotiated Rate	$22.61
Max. Negotiated Rate	$22.61
Rate for Payer: Qualcare PPO/HMO/WC	$22.61

NORFLEX/100MG/TAB

Facility

$7.00

Hospital Charge Code	60634388
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

NORFLEX/100MG/TAB

Facility

$7.00

Hospital Charge Code	60634388
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.66
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.10
Rate for Payer: Oxford Commercial	$1.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$1.40
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

NORGESIC FORTE/TAB

Facility

$6.00

Hospital Charge Code	60633542
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$2.28
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.80
Rate for Payer: Oxford Commercial	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.20
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

NORGESIC FORTE/TAB

Facility

$6.00

Hospital Charge Code	60633543
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$2.28
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.80
Rate for Payer: Oxford Commercial	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.20
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

NORGESIC FORTE/TAB

Facility

$6.00

Hospital Charge Code	60633543
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

NORGESIC FORTE/TAB

Facility

$6.00

Hospital Charge Code	60633542
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

NORGESTREL ETHINYL ESTRADIOL

Facility

$13.45

Hospital Charge Code	60628742
Hospital Revenue Code	250
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$2.02
Rate for Payer: Qualcare PPO/HMO/WC	$2.02

NORGESTREL ETHINYL ESTRADIOL

Facility

$13.45

Hospital Charge Code	60628742
Hospital Revenue Code	250
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$6.72
Rate for Payer: Aetna Commercial	$5.11
Rate for Payer: Aetna Medicare Advantage	$4.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.43
Rate for Payer: Cigna Commercial	$6.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.04
Rate for Payer: Oxford Commercial	$2.69
Rate for Payer: Qualcare PPO/HMO/WC	$2.02
Rate for Payer: UnitedHealthcare Commercial	$2.69
Rate for Payer: UnitedHealthcare Community & State	$0.32
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

NORIAN SRS ROTARY MIX 10cc

Facility

$15,435.00

Hospital Charge Code	270645731
Hospital Revenue Code	278
Min. Negotiated Rate	$2,315.25
Max. Negotiated Rate	$3,735.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,087.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,735.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,395.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,315.25

NORIAN SRS ROTARY MIX 10cc

Facility

$15,435.00

Hospital Charge Code	270645731
Hospital Revenue Code	278
Min. Negotiated Rate	$371.98
Max. Negotiated Rate	$7,717.50
Rate for Payer: Aetna Commercial	$5,865.30
Rate for Payer: Aetna Medicare Advantage	$4,630.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,935.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,935.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,087.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,935.93
Rate for Payer: Cigna Commercial	$7,717.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,735.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,395.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,315.25
Rate for Payer: UnitedHealthcare Community & State	$371.98
Rate for Payer: Wellpoint Medicaid Managed Care	$409.03

NORLUTATE/5MG/TAB

Facility

$3.00

Hospital Charge Code	60633544
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

NORLUTATE/5MG/TAB

Facility

$3.00

Hospital Charge Code	60633544
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

NORLUTIN/5MG/TAB

Facility

$3.00

Hospital Charge Code	60634231
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

NORLUTIN/5MG/TAB

Facility

$3.00

Hospital Charge Code	60634231
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

NORMAL NEWBORN

Facility

$8,591.89

Service Code	MSDRG 795
Min. Negotiated Rate	$2,523.00
Max. Negotiated Rate	$8,591.89
Rate for Payer: Aetna Commercial	$6,160.95
Rate for Payer: Aetna Medicare Advantage	$8,591.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,652.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,652.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,753.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,652.20
Rate for Payer: Cigna Commercial	$3,739.06
Rate for Payer: Cigna Medicare Advantage	$2,753.81
Rate for Payer: Clover Medicare Advantage	$2,616.12
Rate for Payer: EmblemHealth Commercial	$8,261.43
Rate for Payer: Humana Medicare Advantage	$2,836.42
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,753.81
Rate for Payer: Oxford Commercial	$2,523.00
Rate for Payer: UnitedHealthcare Commercial	$4,425.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,753.81
Rate for Payer: Wellcare Medicare Advantage	$2,753.81

NORMAL SALINE FLUSH 2.5ML

Facility

$4.00

Service Code	NDC 63807010030
Hospital Charge Code	6063943150
Hospital Revenue Code	258
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

NORMAL SALINE FLUSH 2.5ML

Facility

$4.00

Service Code	NDC 63807010030
Hospital Charge Code	6063943150
Hospital Revenue Code	258
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

NORMEPERIDINE RANDOM URINE

Facility

$588.25

Service Code	HCPCS 80349
Hospital Charge Code	39708047
Hospital Revenue Code	306
Min. Negotiated Rate	$15.59
Max. Negotiated Rate	$294.12
Rate for Payer: Aetna Commercial	$223.53
Rate for Payer: Aetna Medicare Advantage	$176.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$150.00
Rate for Payer: Cigna Commercial	$294.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.47
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$88.24
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$22.05
Rate for Payer: Wellpoint Medicaid Managed Care	$15.59

NORMEPERIDINE RANDOM URINE

Facility

$588.25

Service Code	HCPCS 80349
Hospital Charge Code	39708047
Hospital Revenue Code	306
Min. Negotiated Rate	$88.24
Max. Negotiated Rate	$88.24
Rate for Payer: Qualcare PPO/HMO/WC	$88.24

NORMODYNE/100MG/TAB

Facility

$3.00

Hospital Charge Code	60633547
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

Know your out-of-pocket cost for care.

All Charges