Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PAPARELA TY 1.02 VNT TB 510041

Facility

$66.00

Hospital Charge Code	270639205
Hospital Revenue Code	272
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$33.00
Rate for Payer: Aetna Commercial	$25.08
Rate for Payer: Aetna Medicare Advantage	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.83
Rate for Payer: Cigna Commercial	$33.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.80
Rate for Payer: Oxford Commercial	$13.20
Rate for Payer: Qualcare PPO/HMO/WC	$9.90
Rate for Payer: UnitedHealthcare Commercial	$13.20
Rate for Payer: UnitedHealthcare Community & State	$1.59
Rate for Payer: Wellpoint Medicaid Managed Care	$1.75

PAPARELA TY 1.14 VT TBE 510061

Facility

$66.00

Hospital Charge Code	270639206
Hospital Revenue Code	272
Min. Negotiated Rate	$9.90
Max. Negotiated Rate	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$9.90

PAPARELA TY 1.14 VT TBE 510061

Facility

$66.00

Hospital Charge Code	270639206
Hospital Revenue Code	272
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$33.00
Rate for Payer: Aetna Commercial	$25.08
Rate for Payer: Aetna Medicare Advantage	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.83
Rate for Payer: Cigna Commercial	$33.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.80
Rate for Payer: Oxford Commercial	$13.20
Rate for Payer: Qualcare PPO/HMO/WC	$9.90
Rate for Payer: UnitedHealthcare Commercial	$13.20
Rate for Payer: UnitedHealthcare Community & State	$1.59
Rate for Payer: Wellpoint Medicaid Managed Care	$1.75

PAPAVERINE 150 MG ER CAP

Facility

$2.45

Hospital Charge Code	60627661
Hospital Revenue Code	250
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.37
Rate for Payer: Qualcare PPO/HMO/WC	$0.37

PAPAVERINE 150 MG ER CAP

Facility

$2.45

Hospital Charge Code	60627661
Hospital Revenue Code	250
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.23
Rate for Payer: Aetna Commercial	$0.93
Rate for Payer: Aetna Medicare Advantage	$0.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.62
Rate for Payer: Cigna Commercial	$1.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.74
Rate for Payer: Oxford Commercial	$0.49
Rate for Payer: Qualcare PPO/HMO/WC	$0.37
Rate for Payer: UnitedHealthcare Commercial	$0.49
Rate for Payer: UnitedHealthcare Community & State	$0.06
Rate for Payer: Wellpoint Medicaid Managed Care	$0.06

PAPAVERINE 300MG/10ML INJ

Facility

$1,438.16

Service Code	HCPCS J2440
Hospital Charge Code	60627662
Hospital Revenue Code	636
Min. Negotiated Rate	$34.66
Max. Negotiated Rate	$719.08
Rate for Payer: Aetna Commercial	$546.50
Rate for Payer: Aetna Medicare Advantage	$431.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$366.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$366.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$366.73
Rate for Payer: Cigna Commercial	$719.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$348.03
Rate for Payer: Qualcare PPO/HMO/WC	$215.72
Rate for Payer: UnitedHealthcare Community & State	$34.66
Rate for Payer: Wellpoint Medicaid Managed Care	$38.11

PAPAVERINE 300MG/10ML INJ

Facility

$1,438.16

Service Code	HCPCS J2440
Hospital Charge Code	60627662
Hospital Revenue Code	636
Min. Negotiated Rate	$215.72
Max. Negotiated Rate	$348.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$348.03
Rate for Payer: Qualcare PPO/HMO/WC	$215.72

Papaverine 30mg/1ml 2ml vial

Facility

$10.72

Hospital Charge Code	6000429
Hospital Revenue Code	636
Min. Negotiated Rate	$1.61
Max. Negotiated Rate	$2.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.59
Rate for Payer: Qualcare PPO/HMO/WC	$1.61

Papaverine 30mg/1ml 2ml vial

Facility

$10.72

Hospital Charge Code	6000429
Hospital Revenue Code	636
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$5.36
Rate for Payer: Aetna Commercial	$4.07
Rate for Payer: Aetna Medicare Advantage	$3.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.73
Rate for Payer: Cigna Commercial	$5.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.59
Rate for Payer: Qualcare PPO/HMO/WC	$1.61
Rate for Payer: UnitedHealthcare Community & State	$0.26
Rate for Payer: Wellpoint Medicaid Managed Care	$0.28

PAPAVERINE 30MG/ML VIAL

Facility

$287.63

Service Code	HCPCS J2440
Hospital Charge Code	60631898
Hospital Revenue Code	636
Min. Negotiated Rate	$43.14
Max. Negotiated Rate	$69.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.61
Rate for Payer: Qualcare PPO/HMO/WC	$43.14

PAPAVERINE 30MG/ML VIAL

Facility

$287.63

Service Code	HCPCS J2440
Hospital Charge Code	60631898
Hospital Revenue Code	636
Min. Negotiated Rate	$6.93
Max. Negotiated Rate	$143.81
Rate for Payer: Aetna Commercial	$109.30
Rate for Payer: Aetna Medicare Advantage	$86.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.35
Rate for Payer: Cigna Commercial	$143.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.61
Rate for Payer: Qualcare PPO/HMO/WC	$43.14
Rate for Payer: UnitedHealthcare Community & State	$6.93
Rate for Payer: Wellpoint Medicaid Managed Care	$7.62

PAPAVERINE 39MG/ML 10ML

Facility

$34.60

Hospital Charge Code	6006464
Hospital Revenue Code	250
Min. Negotiated Rate	$0.83
Max. Negotiated Rate	$17.30
Rate for Payer: Aetna Commercial	$13.15
Rate for Payer: Aetna Medicare Advantage	$10.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.82
Rate for Payer: Cigna Commercial	$17.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.38
Rate for Payer: Oxford Commercial	$6.92
Rate for Payer: Qualcare PPO/HMO/WC	$5.19
Rate for Payer: UnitedHealthcare Commercial	$6.92
Rate for Payer: UnitedHealthcare Community & State	$0.83
Rate for Payer: Wellpoint Medicaid Managed Care	$0.92

PAPAVERINE 39MG/ML 10ML

Facility

$34.60

Hospital Charge Code	6006464
Hospital Revenue Code	250
Min. Negotiated Rate	$5.19
Max. Negotiated Rate	$5.19
Rate for Payer: Qualcare PPO/HMO/WC	$5.19

PAPER COPY WHITE8-1/2 X 11

Facility

$15.45

Hospital Charge Code	270650856
Hospital Revenue Code	272
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$7.72
Rate for Payer: Aetna Commercial	$5.87
Rate for Payer: Aetna Medicare Advantage	$4.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.94
Rate for Payer: Cigna Commercial	$7.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.63
Rate for Payer: Oxford Commercial	$3.09
Rate for Payer: Qualcare PPO/HMO/WC	$2.32
Rate for Payer: UnitedHealthcare Commercial	$3.09
Rate for Payer: UnitedHealthcare Community & State	$0.37
Rate for Payer: Wellpoint Medicaid Managed Care	$0.41

PAPER COPY WHITE8-1/2 X 11

Facility

$15.45

Hospital Charge Code	270650856
Hospital Revenue Code	272
Min. Negotiated Rate	$2.32
Max. Negotiated Rate	$2.32
Rate for Payer: Qualcare PPO/HMO/WC	$2.32

PAPERED ROUTER 1.7MMx16MM

Facility

$577.55

Hospital Charge Code	270673034
Hospital Revenue Code	272
Min. Negotiated Rate	$86.63
Max. Negotiated Rate	$86.63
Rate for Payer: Qualcare PPO/HMO/WC	$86.63

PAPERED ROUTER 1.7MMx16MM

Facility

$577.55

Hospital Charge Code	270673034
Hospital Revenue Code	272
Min. Negotiated Rate	$13.92
Max. Negotiated Rate	$288.77
Rate for Payer: Aetna Commercial	$219.47
Rate for Payer: Aetna Medicare Advantage	$173.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.28
Rate for Payer: Cigna Commercial	$288.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.26
Rate for Payer: Oxford Commercial	$115.51
Rate for Payer: Qualcare PPO/HMO/WC	$86.63
Rate for Payer: UnitedHealthcare Commercial	$115.51
Rate for Payer: UnitedHealthcare Community & State	$13.92
Rate for Payer: Wellpoint Medicaid Managed Care	$15.31

PAPERED ROUTER 1.7x25MM

Facility

$603.75

Hospital Charge Code	270673204
Hospital Revenue Code	272
Min. Negotiated Rate	$14.55
Max. Negotiated Rate	$301.88
Rate for Payer: Aetna Commercial	$229.43
Rate for Payer: Aetna Medicare Advantage	$181.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.96
Rate for Payer: Cigna Commercial	$301.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.12
Rate for Payer: Oxford Commercial	$120.75
Rate for Payer: Qualcare PPO/HMO/WC	$90.56
Rate for Payer: UnitedHealthcare Commercial	$120.75
Rate for Payer: UnitedHealthcare Community & State	$14.55
Rate for Payer: Wellpoint Medicaid Managed Care	$16.00

PAPERED ROUTER 1.7x25MM

Facility

$603.75

Hospital Charge Code	270673204
Hospital Revenue Code	272
Min. Negotiated Rate	$90.56
Max. Negotiated Rate	$90.56
Rate for Payer: Qualcare PPO/HMO/WC	$90.56

PAPER RECORDER RED

Facility

$10.59

Hospital Charge Code	270649472
Hospital Revenue Code	270
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$1.59
Rate for Payer: Qualcare PPO/HMO/WC	$1.59

PAPER RECORDER RED

Facility

$10.59

Hospital Charge Code	270649472
Hospital Revenue Code	270
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$5.29
Rate for Payer: Aetna Commercial	$4.02
Rate for Payer: Aetna Medicare Advantage	$3.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.70
Rate for Payer: Cigna Commercial	$5.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.18
Rate for Payer: Oxford Commercial	$2.12
Rate for Payer: Qualcare PPO/HMO/WC	$1.59
Rate for Payer: UnitedHealthcare Commercial	$2.12
Rate for Payer: UnitedHealthcare Community & State	$0.26
Rate for Payer: Wellpoint Medicaid Managed Care	$0.28

PAPER STRYKER ENDOSCOPY

Facility

$3.00

Hospital Charge Code	270657633
Hospital Revenue Code	270
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

PAPER STRYKER ENDOSCOPY

Facility

$3.00

Hospital Charge Code	270657633
Hospital Revenue Code	270
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

PAPER WASP IGE

Facility

$52.00

Service Code	HCPCS 86003
Hospital Charge Code	3035141
Hospital Revenue Code	305
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

PAPER WASP IGE

Facility

$52.00

Service Code	HCPCS 86003
Hospital Charge Code	3035141
Hospital Revenue Code	305
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.84
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$1.38

Know your out-of-pocket cost for care.

All Charges