Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

OXISENSOR NEONATAL

Facility

$50.61

Hospital Charge Code	270649675
Hospital Revenue Code	270
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$25.30
Rate for Payer: Aetna Commercial	$19.23
Rate for Payer: Aetna Medicare Advantage	$15.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.91
Rate for Payer: Cigna Commercial	$25.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.18
Rate for Payer: Oxford Commercial	$10.12
Rate for Payer: Qualcare PPO/HMO/WC	$7.59
Rate for Payer: UnitedHealthcare Commercial	$10.12
Rate for Payer: UnitedHealthcare Community & State	$1.22
Rate for Payer: Wellpoint Medicaid Managed Care	$1.34

OXISENSOR OXIMAX ADULT

Facility

$39.80

Hospital Charge Code	270649182N
Hospital Revenue Code	270
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$19.90
Rate for Payer: Aetna Commercial	$15.12
Rate for Payer: Aetna Medicare Advantage	$11.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.15
Rate for Payer: Cigna Commercial	$19.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.94
Rate for Payer: Oxford Commercial	$7.96
Rate for Payer: Qualcare PPO/HMO/WC	$5.97
Rate for Payer: UnitedHealthcare Commercial	$7.96
Rate for Payer: UnitedHealthcare Community & State	$0.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1.05

OXISENSOR OXIMAX ADULT

Facility

$28.75

Hospital Charge Code	270649182S
Hospital Revenue Code	270
Min. Negotiated Rate	$0.69
Max. Negotiated Rate	$14.38
Rate for Payer: Aetna Commercial	$10.93
Rate for Payer: Aetna Medicare Advantage	$8.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.33
Rate for Payer: Cigna Commercial	$14.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.62
Rate for Payer: Oxford Commercial	$5.75
Rate for Payer: Qualcare PPO/HMO/WC	$4.31
Rate for Payer: UnitedHealthcare Commercial	$5.75
Rate for Payer: UnitedHealthcare Community & State	$0.69
Rate for Payer: Wellpoint Medicaid Managed Care	$0.76

OXISENSOR OXIMAX ADULT

Facility

$28.95

Hospital Charge Code	270649182
Hospital Revenue Code	270
Min. Negotiated Rate	$4.34
Max. Negotiated Rate	$4.34
Rate for Payer: Qualcare PPO/HMO/WC	$4.34

OXISENSOR OXIMAX ADULT

Facility

$28.75

Hospital Charge Code	270649182S
Hospital Revenue Code	270
Min. Negotiated Rate	$4.31
Max. Negotiated Rate	$4.31
Rate for Payer: Qualcare PPO/HMO/WC	$4.31

OXISENSOR OXIMAX ADULT

Facility

$39.80

Hospital Charge Code	270649182N
Hospital Revenue Code	270
Min. Negotiated Rate	$5.97
Max. Negotiated Rate	$5.97
Rate for Payer: Qualcare PPO/HMO/WC	$5.97

OXISENSOR OXIMAX ADULT

Facility

$28.95

Hospital Charge Code	270649182
Hospital Revenue Code	270
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$14.47
Rate for Payer: Aetna Commercial	$11.00
Rate for Payer: Aetna Medicare Advantage	$8.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.38
Rate for Payer: Cigna Commercial	$14.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.69
Rate for Payer: Oxford Commercial	$5.79
Rate for Payer: Qualcare PPO/HMO/WC	$4.34
Rate for Payer: UnitedHealthcare Commercial	$5.79
Rate for Payer: UnitedHealthcare Community & State	$0.70
Rate for Payer: Wellpoint Medicaid Managed Care	$0.77

OXISENSOR OXIMAX PED

Facility

$47.90

Hospital Charge Code	270649183
Hospital Revenue Code	272
Min. Negotiated Rate	$1.15
Max. Negotiated Rate	$23.95
Rate for Payer: Aetna Commercial	$18.20
Rate for Payer: Aetna Medicare Advantage	$14.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.21
Rate for Payer: Cigna Commercial	$23.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.37
Rate for Payer: Oxford Commercial	$9.58
Rate for Payer: Qualcare PPO/HMO/WC	$7.18
Rate for Payer: UnitedHealthcare Commercial	$9.58
Rate for Payer: UnitedHealthcare Community & State	$1.15
Rate for Payer: Wellpoint Medicaid Managed Care	$1.27

OXISENSOR OXIMAX PED

Facility

$47.90

Hospital Charge Code	270649183
Hospital Revenue Code	272
Min. Negotiated Rate	$7.18
Max. Negotiated Rate	$7.18
Rate for Payer: Qualcare PPO/HMO/WC	$7.18

OXISENSOR PEDIATRIC DIGIT DISP

Facility

$70.54

Hospital Charge Code	270649676
Hospital Revenue Code	270
Min. Negotiated Rate	$1.70
Max. Negotiated Rate	$35.27
Rate for Payer: Aetna Commercial	$26.81
Rate for Payer: Aetna Medicare Advantage	$21.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.99
Rate for Payer: Cigna Commercial	$35.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.16
Rate for Payer: Oxford Commercial	$14.11
Rate for Payer: Qualcare PPO/HMO/WC	$10.58
Rate for Payer: UnitedHealthcare Commercial	$14.11
Rate for Payer: UnitedHealthcare Community & State	$1.70
Rate for Payer: Wellpoint Medicaid Managed Care	$1.87

OXISENSOR PEDIATRIC DIGIT DISP

Facility

$70.54

Hospital Charge Code	270649676
Hospital Revenue Code	270
Min. Negotiated Rate	$10.58
Max. Negotiated Rate	$10.58
Rate for Payer: Qualcare PPO/HMO/WC	$10.58

OXISENSOR PULSE PEDIATRIC

Facility

$6.55

Hospital Charge Code	270600746
Hospital Revenue Code	270
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$0.98
Rate for Payer: Qualcare PPO/HMO/WC	$0.98

OXISENSOR PULSE PEDIATRIC

Facility

$6.55

Hospital Charge Code	270600746
Hospital Revenue Code	270
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$3.27
Rate for Payer: Aetna Commercial	$2.49
Rate for Payer: Aetna Medicare Advantage	$1.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.67
Rate for Payer: Cigna Commercial	$3.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.97
Rate for Payer: Oxford Commercial	$1.31
Rate for Payer: Qualcare PPO/HMO/WC	$0.98
Rate for Payer: UnitedHealthcare Commercial	$1.31
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.17

OXISENSORS***

Facility

$69.00

Hospital Charge Code	2300721
Hospital Revenue Code	279
Min. Negotiated Rate	$1.66
Max. Negotiated Rate	$34.50
Rate for Payer: Aetna Commercial	$26.22
Rate for Payer: Aetna Medicare Advantage	$20.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.59
Rate for Payer: Cigna Commercial	$34.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.70
Rate for Payer: Oxford Commercial	$13.80
Rate for Payer: Qualcare PPO/HMO/WC	$10.35
Rate for Payer: UnitedHealthcare Commercial	$13.80
Rate for Payer: UnitedHealthcare Community & State	$1.66
Rate for Payer: Wellpoint Medicaid Managed Care	$1.83

OXISENSORS***

Facility

$69.00

Hospital Charge Code	2300721
Hospital Revenue Code	279
Min. Negotiated Rate	$10.35
Max. Negotiated Rate	$10.35
Rate for Payer: Qualcare PPO/HMO/WC	$10.35

OXYBUTYNIN 2.5 MG/0.5 TAB

Facility

$3.20

Hospital Charge Code	60628924
Hospital Revenue Code	250
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$0.48
Rate for Payer: Qualcare PPO/HMO/WC	$0.48

OXYBUTYNIN 2.5 MG/0.5 TAB

Facility

$3.20

Hospital Charge Code	60628924
Hospital Revenue Code	250
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$1.60
Rate for Payer: Aetna Commercial	$1.22
Rate for Payer: Aetna Medicare Advantage	$0.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.82
Rate for Payer: Cigna Commercial	$1.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.96
Rate for Payer: Oxford Commercial	$0.64
Rate for Payer: Qualcare PPO/HMO/WC	$0.48
Rate for Payer: UnitedHealthcare Commercial	$0.64
Rate for Payer: UnitedHealthcare Community & State	$0.08
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

OXYBUTYNIN 5 MG TAB

Facility

$5.09

Service Code	NDC 60687067001
Hospital Charge Code	60628468
Hospital Revenue Code	250
Min. Negotiated Rate	$0.76
Max. Negotiated Rate	$0.76
Rate for Payer: Qualcare PPO/HMO/WC	$0.76

OXYBUTYNIN 5 MG TAB

Facility

$5.09

Service Code	NDC 60687067001
Hospital Charge Code	60628468
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.54
Rate for Payer: Aetna Commercial	$1.93
Rate for Payer: Aetna Medicare Advantage	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.30
Rate for Payer: Cigna Commercial	$2.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.53
Rate for Payer: Oxford Commercial	$1.02
Rate for Payer: Qualcare PPO/HMO/WC	$0.76
Rate for Payer: UnitedHealthcare Commercial	$1.02
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

OXYBUTYNIN SOL 5MG/5ML 16 OZ

Facility

$299.55

Hospital Charge Code	6004048
Hospital Revenue Code	251
Min. Negotiated Rate	$7.22
Max. Negotiated Rate	$149.78
Rate for Payer: Aetna Commercial	$113.83
Rate for Payer: Aetna Medicare Advantage	$89.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.39
Rate for Payer: Cigna Commercial	$149.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.86
Rate for Payer: Oxford Commercial	$59.91
Rate for Payer: Qualcare PPO/HMO/WC	$44.93
Rate for Payer: UnitedHealthcare Commercial	$59.91
Rate for Payer: UnitedHealthcare Community & State	$7.22
Rate for Payer: Wellpoint Medicaid Managed Care	$7.94

OXYBUTYNIN SOL 5MG/5ML 16 OZ

Facility

$299.55

Hospital Charge Code	6004048
Hospital Revenue Code	251
Min. Negotiated Rate	$44.93
Max. Negotiated Rate	$44.93
Rate for Payer: Qualcare PPO/HMO/WC	$44.93

OXYBUTYNIN SYRP 5MG/5ML

Facility

$4.00

Service Code	NDC 60432009216
Hospital Charge Code	60628469
Hospital Revenue Code	250
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

OXYBUTYNIN SYRP 5MG/5ML

Facility

$4.00

Service Code	NDC 60432009216
Hospital Charge Code	60628469
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

OXYBUTYNIN SYRP 5MG/5ML 480ML

Facility

$419.85

Hospital Charge Code	6010318
Hospital Revenue Code	251
Min. Negotiated Rate	$10.12
Max. Negotiated Rate	$209.93
Rate for Payer: Aetna Commercial	$159.54
Rate for Payer: Aetna Medicare Advantage	$125.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.06
Rate for Payer: Cigna Commercial	$209.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.95
Rate for Payer: Oxford Commercial	$83.97
Rate for Payer: Qualcare PPO/HMO/WC	$62.98
Rate for Payer: UnitedHealthcare Commercial	$83.97
Rate for Payer: UnitedHealthcare Community & State	$10.12
Rate for Payer: Wellpoint Medicaid Managed Care	$11.13

OXYBUTYNIN SYRP 5MG/5ML 480ML

Facility

$419.85

Hospital Charge Code	6010318
Hospital Revenue Code	251
Min. Negotiated Rate	$62.98
Max. Negotiated Rate	$62.98
Rate for Payer: Qualcare PPO/HMO/WC	$62.98

Know your out-of-pocket cost for care.

All Charges