Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PAREGORIC LIQ 4 OZ

Facility

$53.80

Hospital Charge Code	6004071
Hospital Revenue Code	251
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$26.90
Rate for Payer: Aetna Commercial	$20.44
Rate for Payer: Aetna Medicare Advantage	$16.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.72
Rate for Payer: Cigna Commercial	$26.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.14
Rate for Payer: Oxford Commercial	$10.76
Rate for Payer: Qualcare PPO/HMO/WC	$8.07
Rate for Payer: UnitedHealthcare Commercial	$10.76
Rate for Payer: UnitedHealthcare Community & State	$1.30
Rate for Payer: Wellpoint Medicaid Managed Care	$1.43

PAREGORIC LIQ 4 OZ

Facility

$53.80

Hospital Charge Code	6004071
Hospital Revenue Code	251
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$8.07

PARENTAL NUTRITION INFUSION

Facility

$2,046.73

Hospital Charge Code	8200522
Hospital Revenue Code	272
Min. Negotiated Rate	$307.01
Max. Negotiated Rate	$307.01
Rate for Payer: Qualcare PPO/HMO/WC	$307.01

PARENTAL NUTRITION INFUSION

Facility

$2,046.73

Hospital Charge Code	8200522
Hospital Revenue Code	272
Min. Negotiated Rate	$49.33
Max. Negotiated Rate	$1,023.37
Rate for Payer: Aetna Commercial	$777.76
Rate for Payer: Aetna Medicare Advantage	$614.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$521.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$521.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$521.92
Rate for Payer: Cigna Commercial	$1,023.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$614.02
Rate for Payer: Oxford Commercial	$409.35
Rate for Payer: Qualcare PPO/HMO/WC	$307.01
Rate for Payer: UnitedHealthcare Commercial	$409.35
Rate for Payer: UnitedHealthcare Community & State	$49.33
Rate for Payer: Wellpoint Medicaid Managed Care	$54.24

PARIATEX MESH 12 CM

Facility

$829.00

Hospital Charge Code	270339118
Hospital Revenue Code	278
Min. Negotiated Rate	$124.35
Max. Negotiated Rate	$200.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$182.38
Rate for Payer: Qualcare PPO/HMO/WC	$124.35

PARIATEX MESH 12 CM

Facility

$829.00

Hospital Charge Code	270339118
Hospital Revenue Code	278
Min. Negotiated Rate	$19.98
Max. Negotiated Rate	$414.50
Rate for Payer: Aetna Commercial	$315.02
Rate for Payer: Aetna Medicare Advantage	$248.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.40
Rate for Payer: Cigna Commercial	$414.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$182.38
Rate for Payer: Qualcare PPO/HMO/WC	$124.35
Rate for Payer: UnitedHealthcare Community & State	$19.98
Rate for Payer: Wellpoint Medicaid Managed Care	$21.97

PARIATEX MESH 9 CM

Facility

$615.00

Hospital Charge Code	270339117
Hospital Revenue Code	278
Min. Negotiated Rate	$92.25
Max. Negotiated Rate	$148.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$135.30
Rate for Payer: Qualcare PPO/HMO/WC	$92.25

PARIATEX MESH 9 CM

Facility

$615.00

Hospital Charge Code	270339117
Hospital Revenue Code	278
Min. Negotiated Rate	$14.82
Max. Negotiated Rate	$307.50
Rate for Payer: Aetna Commercial	$233.70
Rate for Payer: Aetna Medicare Advantage	$184.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.82
Rate for Payer: Cigna Commercial	$307.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$135.30
Rate for Payer: Qualcare PPO/HMO/WC	$92.25
Rate for Payer: UnitedHealthcare Community & State	$14.82
Rate for Payer: Wellpoint Medicaid Managed Care	$16.30

PARICALCITOL 2 MCG/ML INJ

Facility

$48.71

Service Code	HCPCS J2501
Hospital Charge Code	60635723
Hospital Revenue Code	636
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$24.36
Rate for Payer: Aetna Commercial	$18.51
Rate for Payer: Aetna Medicare Advantage	$14.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.42
Rate for Payer: Cigna Commercial	$24.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.79
Rate for Payer: Qualcare PPO/HMO/WC	$7.31
Rate for Payer: UnitedHealthcare Community & State	$1.17
Rate for Payer: Wellpoint Medicaid Managed Care	$1.29

PARICALCITOL 2 MCG/ML INJ

Facility

$48.71

Service Code	HCPCS J2501
Hospital Charge Code	60635723
Hospital Revenue Code	636
Min. Negotiated Rate	$7.31
Max. Negotiated Rate	$11.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.79
Rate for Payer: Qualcare PPO/HMO/WC	$7.31

PARICALCITOL 5 MCG/ML INJ

Facility

$121.81

Service Code	HCPCS J2501
Hospital Charge Code	60629008
Hospital Revenue Code	636
Min. Negotiated Rate	$2.94
Max. Negotiated Rate	$60.91
Rate for Payer: Aetna Commercial	$46.29
Rate for Payer: Aetna Medicare Advantage	$36.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.06
Rate for Payer: Cigna Commercial	$60.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.48
Rate for Payer: Qualcare PPO/HMO/WC	$18.27
Rate for Payer: UnitedHealthcare Community & State	$2.94
Rate for Payer: Wellpoint Medicaid Managed Care	$3.23

PARICALCITOL 5 MCG/ML INJ

Facility

$121.81

Service Code	HCPCS J2501
Hospital Charge Code	60629008
Hospital Revenue Code	636
Min. Negotiated Rate	$18.27
Max. Negotiated Rate	$29.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.48
Rate for Payer: Qualcare PPO/HMO/WC	$18.27

PARIETAL CELL AB

Facility

$390.00

Service Code	HCPCS 86255
Hospital Charge Code	39900364
Hospital Revenue Code	302
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.50
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

PARIETAL CELL AB

Facility

$390.00

Service Code	HCPCS 86255
Hospital Charge Code	39900364
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PARIETAL CELL ANTIBODIES

Facility

$280.00

Service Code	HCPCS 86255
Hospital Charge Code	38476184
Hospital Revenue Code	302
Min. Negotiated Rate	$7.42
Max. Negotiated Rate	$140.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.50
Rate for Payer: Cigna Commercial	$140.00
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$7.42

PARIETAL CELL ANTIBODIES

Facility

$280.00

Service Code	HCPCS 86255
Hospital Charge Code	38476184
Hospital Revenue Code	302
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00

PARIETEX 30X20

Facility

$8,443.45

Hospital Charge Code	270656081
Hospital Revenue Code	278
Min. Negotiated Rate	$203.49
Max. Negotiated Rate	$4,221.73
Rate for Payer: Aetna Commercial	$3,208.51
Rate for Payer: Aetna Medicare Advantage	$2,533.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,153.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,153.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,688.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,153.08
Rate for Payer: Cigna Commercial	$4,221.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,043.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,857.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,266.52
Rate for Payer: UnitedHealthcare Community & State	$203.49
Rate for Payer: Wellpoint Medicaid Managed Care	$223.75

PARIETEX 30X20

Facility

$8,443.45

Hospital Charge Code	270655621
Hospital Revenue Code	278
Min. Negotiated Rate	$203.49
Max. Negotiated Rate	$4,221.73
Rate for Payer: Aetna Commercial	$3,208.51
Rate for Payer: Aetna Medicare Advantage	$2,533.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,153.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,153.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,688.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,153.08
Rate for Payer: Cigna Commercial	$4,221.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,043.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,857.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,266.52
Rate for Payer: UnitedHealthcare Community & State	$203.49
Rate for Payer: Wellpoint Medicaid Managed Care	$223.75

PARIETEX 30X20

Facility

$8,443.45

Hospital Charge Code	270655621
Hospital Revenue Code	278
Min. Negotiated Rate	$1,266.52
Max. Negotiated Rate	$2,043.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,688.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,043.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,857.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,266.52

PARIETEX 30X20

Facility

$8,443.45

Hospital Charge Code	270656081
Hospital Revenue Code	278
Min. Negotiated Rate	$1,266.52
Max. Negotiated Rate	$2,043.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,688.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,043.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,857.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,266.52

PARIETEX 30X20 OPEN

Facility

$8,800.00

Hospital Charge Code	270656086
Hospital Revenue Code	278
Min. Negotiated Rate	$212.08
Max. Negotiated Rate	$4,400.00
Rate for Payer: Aetna Commercial	$3,344.00
Rate for Payer: Aetna Medicare Advantage	$2,640.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,244.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,244.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,760.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,244.00
Rate for Payer: Cigna Commercial	$4,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,129.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,320.00
Rate for Payer: UnitedHealthcare Community & State	$212.08
Rate for Payer: Wellpoint Medicaid Managed Care	$233.20

PARIETEX 30X20 OPEN

Facility

$8,800.00

Hospital Charge Code	270656086
Hospital Revenue Code	278
Min. Negotiated Rate	$1,320.00
Max. Negotiated Rate	$2,129.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,760.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,129.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,320.00

PARIETEX OPEN PCO12X

Facility

$21.40

Hospital Charge Code	270659390
Hospital Revenue Code	272
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$10.70
Rate for Payer: Aetna Commercial	$8.13
Rate for Payer: Aetna Medicare Advantage	$6.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.46
Rate for Payer: Cigna Commercial	$10.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.42
Rate for Payer: Oxford Commercial	$4.28
Rate for Payer: Qualcare PPO/HMO/WC	$3.21
Rate for Payer: UnitedHealthcare Commercial	$4.28
Rate for Payer: UnitedHealthcare Community & State	$0.52
Rate for Payer: Wellpoint Medicaid Managed Care	$0.57

PARIETEX OPEN PCO12X

Facility

$21.40

Hospital Charge Code	270659390
Hospital Revenue Code	272
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$3.21
Rate for Payer: Qualcare PPO/HMO/WC	$3.21

PARIETEX PLUG 6.5 CM ROUND

Facility

$507.65

Service Code	HCPCS C1781
Hospital Charge Code	270689837
Hospital Revenue Code	278
Min. Negotiated Rate	$12.23
Max. Negotiated Rate	$253.82
Rate for Payer: Aetna Commercial	$192.91
Rate for Payer: Aetna Medicare Advantage	$152.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$129.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$129.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$129.45
Rate for Payer: Cigna Commercial	$253.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.68
Rate for Payer: Qualcare PPO/HMO/WC	$76.15
Rate for Payer: UnitedHealthcare Community & State	$12.23
Rate for Payer: Wellpoint Medicaid Managed Care	$13.45

Know your out-of-pocket cost for care.

All Charges