Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PAMELOR/50MG/CAP

Facility

$12.00

Hospital Charge Code	60633601
Hospital Revenue Code	250
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$4.56
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.60
Rate for Payer: Oxford Commercial	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$2.40
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

PAMELOR/50MG/CAP

Facility

$12.00

Hospital Charge Code	60633601
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

PAMELOR/75MG/CAP

Facility

$9.00

Hospital Charge Code	60633606
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

PAMELOR/75MG/CAP

Facility

$9.00

Hospital Charge Code	60633606
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

PAMIDRONATE 30 MG/10 ML INJ

Facility

$217.08

Service Code	HCPCS J2430
Hospital Charge Code	60628541
Hospital Revenue Code	636
Min. Negotiated Rate	$5.23
Max. Negotiated Rate	$108.54
Rate for Payer: Aetna Commercial	$82.49
Rate for Payer: Aetna Medicare Advantage	$65.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.36
Rate for Payer: Cigna Commercial	$108.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.53
Rate for Payer: Qualcare PPO/HMO/WC	$32.56
Rate for Payer: UnitedHealthcare Community & State	$5.23
Rate for Payer: Wellpoint Medicaid Managed Care	$5.75

PAMIDRONATE 30 MG/10 ML INJ

Facility

$217.08

Service Code	HCPCS J2430
Hospital Charge Code	60628541
Hospital Revenue Code	636
Min. Negotiated Rate	$32.56
Max. Negotiated Rate	$52.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.53
Rate for Payer: Qualcare PPO/HMO/WC	$32.56

PAMIDRONATE 90 MG/10 ML INJ

Facility

$288.23

Service Code	HCPCS J2430
Hospital Charge Code	60628543
Hospital Revenue Code	636
Min. Negotiated Rate	$6.95
Max. Negotiated Rate	$144.12
Rate for Payer: Aetna Commercial	$109.53
Rate for Payer: Aetna Medicare Advantage	$86.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.50
Rate for Payer: Cigna Commercial	$144.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.75
Rate for Payer: Qualcare PPO/HMO/WC	$43.23
Rate for Payer: UnitedHealthcare Community & State	$6.95
Rate for Payer: Wellpoint Medicaid Managed Care	$7.64

PAMIDRONATE 90 MG/10 ML INJ

Facility

$288.23

Service Code	HCPCS J2430
Hospital Charge Code	60628543
Hospital Revenue Code	636
Min. Negotiated Rate	$43.23
Max. Negotiated Rate	$69.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.75
Rate for Payer: Qualcare PPO/HMO/WC	$43.23

PAMIDRONATE DISODIUM VL 30MG

Facility

$1,763.85

Hospital Charge Code	6007637
Hospital Revenue Code	636
Min. Negotiated Rate	$264.58
Max. Negotiated Rate	$426.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$426.85
Rate for Payer: Qualcare PPO/HMO/WC	$264.58

PAMIDRONATE DISODIUM VL 30MG

Facility

$1,763.85

Hospital Charge Code	6007637
Hospital Revenue Code	636
Min. Negotiated Rate	$42.51
Max. Negotiated Rate	$881.92
Rate for Payer: Aetna Commercial	$670.26
Rate for Payer: Aetna Medicare Advantage	$529.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$449.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$449.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$449.78
Rate for Payer: Cigna Commercial	$881.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$426.85
Rate for Payer: Qualcare PPO/HMO/WC	$264.58
Rate for Payer: UnitedHealthcare Community & State	$42.51
Rate for Payer: Wellpoint Medicaid Managed Care	$46.74

PAMIDRONATE INJ 30MG

Facility

$1,175.70

Hospital Charge Code	60628674
Hospital Revenue Code	636
Min. Negotiated Rate	$28.33
Max. Negotiated Rate	$587.85
Rate for Payer: Aetna Commercial	$446.77
Rate for Payer: Aetna Medicare Advantage	$352.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.80
Rate for Payer: Cigna Commercial	$587.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.52
Rate for Payer: Qualcare PPO/HMO/WC	$176.35
Rate for Payer: UnitedHealthcare Community & State	$28.33
Rate for Payer: Wellpoint Medicaid Managed Care	$31.16

PAMIDRONATE INJ 30MG

Facility

$1,175.70

Hospital Charge Code	60628674
Hospital Revenue Code	636
Min. Negotiated Rate	$176.35
Max. Negotiated Rate	$284.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.52
Rate for Payer: Qualcare PPO/HMO/WC	$176.35

PAMIDRONATE IV 90MG/IL NS

Facility

$3,525.15

Hospital Charge Code	60628676
Hospital Revenue Code	636
Min. Negotiated Rate	$528.77
Max. Negotiated Rate	$853.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$853.09
Rate for Payer: Qualcare PPO/HMO/WC	$528.77

PAMIDRONATE IV 90MG/IL NS

Facility

$3,525.15

Hospital Charge Code	60628676
Hospital Revenue Code	636
Min. Negotiated Rate	$84.96
Max. Negotiated Rate	$1,762.58
Rate for Payer: Aetna Commercial	$1,339.56
Rate for Payer: Aetna Medicare Advantage	$1,057.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$898.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$898.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$898.91
Rate for Payer: Cigna Commercial	$1,762.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$853.09
Rate for Payer: Qualcare PPO/HMO/WC	$528.77
Rate for Payer: UnitedHealthcare Community & State	$84.96
Rate for Payer: Wellpoint Medicaid Managed Care	$93.42

PAMPERS DIAPERS 16-28LBS SZ 3

Facility

$4.00

Hospital Charge Code	270624537
Hospital Revenue Code	270
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

PAMPERS DIAPERS 16-28LBS SZ 3

Facility

$4.00

Hospital Charge Code	270624537
Hospital Revenue Code	270
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PAMPERS DIAPERS 21-37LBS SZ 4

Facility

$4.00

Hospital Charge Code	270601000
Hospital Revenue Code	270
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

PAMPERS DIAPERS 21-37LBS SZ 4

Facility

$4.00

Hospital Charge Code	270601000
Hospital Revenue Code	270
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PAMPERS DIAPERS 8-14LBS SZ 1

Facility

$4.00

Hospital Charge Code	270623178
Hospital Revenue Code	270
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

PAMPERS DIAPERS 8-14LBS SZ 1

Facility

$4.00

Hospital Charge Code	270623178
Hospital Revenue Code	270
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PANAFIL 1OZ

Facility

$389.00

Hospital Charge Code	60635547
Hospital Revenue Code	250
Min. Negotiated Rate	$58.35
Max. Negotiated Rate	$58.35
Rate for Payer: Qualcare PPO/HMO/WC	$58.35

PANAFIL 1OZ

Facility

$389.00

Hospital Charge Code	60635547
Hospital Revenue Code	250
Min. Negotiated Rate	$9.37
Max. Negotiated Rate	$194.50
Rate for Payer: Aetna Commercial	$147.82
Rate for Payer: Aetna Medicare Advantage	$116.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.19
Rate for Payer: Cigna Commercial	$194.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.70
Rate for Payer: Oxford Commercial	$77.80
Rate for Payer: Qualcare PPO/HMO/WC	$58.35
Rate for Payer: UnitedHealthcare Commercial	$77.80
Rate for Payer: UnitedHealthcare Community & State	$9.37
Rate for Payer: Wellpoint Medicaid Managed Care	$10.31

PANA SPRAY AIR MOTOR LUBRICANT

Facility

$265.00

Hospital Charge Code	270664999
Hospital Revenue Code	270
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$132.50
Rate for Payer: Aetna Commercial	$100.70
Rate for Payer: Aetna Medicare Advantage	$79.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.58
Rate for Payer: Cigna Commercial	$132.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.50
Rate for Payer: Oxford Commercial	$53.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.75
Rate for Payer: UnitedHealthcare Commercial	$53.00
Rate for Payer: UnitedHealthcare Community & State	$6.39
Rate for Payer: Wellpoint Medicaid Managed Care	$7.02

PANA SPRAY AIR MOTOR LUBRICANT

Facility

$265.00

Hospital Charge Code	270664999
Hospital Revenue Code	270
Min. Negotiated Rate	$39.75
Max. Negotiated Rate	$39.75
Rate for Payer: Qualcare PPO/HMO/WC	$39.75

PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC

Facility

$95,873.29

Service Code	MSDRG 406
Min. Negotiated Rate	$29,192.19
Max. Negotiated Rate	$95,873.29
Rate for Payer: Aetna Commercial	$66,133.22
Rate for Payer: Aetna Medicare Advantage	$95,873.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67,224.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67,224.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$30,728.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67,224.29
Rate for Payer: Cigna Commercial	$54,274.34
Rate for Payer: Cigna Medicare Advantage	$30,728.62
Rate for Payer: Clover Medicare Advantage	$29,192.19
Rate for Payer: EmblemHealth Commercial	$92,185.86
Rate for Payer: Humana Medicare Advantage	$31,650.48
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$30,728.62
Rate for Payer: Oxford Commercial	$39,007.69
Rate for Payer: UnitedHealthcare Commercial	$68,401.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$30,728.62
Rate for Payer: Wellcare Medicare Advantage	$30,728.62

Know your out-of-pocket cost for care.

All Charges