Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PATTIES NEURO 1/4X1/4

Facility

$44.00

Hospital Charge Code	270600400
Hospital Revenue Code	272
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$22.00
Rate for Payer: Aetna Commercial	$16.72
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.20
Rate for Payer: Oxford Commercial	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$8.80
Rate for Payer: UnitedHealthcare Community & State	$1.06
Rate for Payer: Wellpoint Medicaid Managed Care	$1.17

PATTIES NEURO 1/4X1/4

Facility

$44.00

Hospital Charge Code	270600400
Hospital Revenue Code	272
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

PATTIES NEURO 1/6

Facility

$23.75

Hospital Charge Code	270600201
Hospital Revenue Code	272
Min. Negotiated Rate	$3.56
Max. Negotiated Rate	$3.56
Rate for Payer: Qualcare PPO/HMO/WC	$3.56

PATTIES NEURO 1/6

Facility

$23.75

Hospital Charge Code	270600201
Hospital Revenue Code	272
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$11.88
Rate for Payer: Aetna Commercial	$9.03
Rate for Payer: Aetna Medicare Advantage	$7.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.06
Rate for Payer: Cigna Commercial	$11.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.12
Rate for Payer: Oxford Commercial	$4.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.56
Rate for Payer: UnitedHealthcare Commercial	$4.75
Rate for Payer: UnitedHealthcare Community & State	$0.57
Rate for Payer: Wellpoint Medicaid Managed Care	$0.63

PATTIES NEURO 2/6

Facility

$39.25

Hospital Charge Code	270600403
Hospital Revenue Code	272
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$19.62
Rate for Payer: Aetna Commercial	$14.91
Rate for Payer: Aetna Medicare Advantage	$11.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.01
Rate for Payer: Cigna Commercial	$19.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.78
Rate for Payer: Oxford Commercial	$7.85
Rate for Payer: Qualcare PPO/HMO/WC	$5.89
Rate for Payer: UnitedHealthcare Commercial	$7.85
Rate for Payer: UnitedHealthcare Community & State	$0.95
Rate for Payer: Wellpoint Medicaid Managed Care	$1.04

PATTIES NEURO 2/6

Facility

$39.25

Hospital Charge Code	270600403
Hospital Revenue Code	272
Min. Negotiated Rate	$5.89
Max. Negotiated Rate	$5.89
Rate for Payer: Qualcare PPO/HMO/WC	$5.89

PATTIES NEURO 3 1/2X6

Facility

$39.25

Hospital Charge Code	270600405
Hospital Revenue Code	272
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$19.62
Rate for Payer: Aetna Commercial	$14.91
Rate for Payer: Aetna Medicare Advantage	$11.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.01
Rate for Payer: Cigna Commercial	$19.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.78
Rate for Payer: Oxford Commercial	$7.85
Rate for Payer: Qualcare PPO/HMO/WC	$5.89
Rate for Payer: UnitedHealthcare Commercial	$7.85
Rate for Payer: UnitedHealthcare Community & State	$0.95
Rate for Payer: Wellpoint Medicaid Managed Care	$1.04

PATTIES NEURO 3 1/2X6

Facility

$39.25

Hospital Charge Code	270600405
Hospital Revenue Code	272
Min. Negotiated Rate	$5.89
Max. Negotiated Rate	$5.89
Rate for Payer: Qualcare PPO/HMO/WC	$5.89

PATTIES NEURO 3/4X6

Facility

$41.80

Hospital Charge Code	270600378
Hospital Revenue Code	272
Min. Negotiated Rate	$6.27
Max. Negotiated Rate	$6.27
Rate for Payer: Qualcare PPO/HMO/WC	$6.27

PATTIES NEURO 3/4X6

Facility

$41.80

Hospital Charge Code	270600378
Hospital Revenue Code	272
Min. Negotiated Rate	$1.01
Max. Negotiated Rate	$20.90
Rate for Payer: Aetna Commercial	$15.88
Rate for Payer: Aetna Medicare Advantage	$12.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.66
Rate for Payer: Cigna Commercial	$20.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.54
Rate for Payer: Oxford Commercial	$8.36
Rate for Payer: Qualcare PPO/HMO/WC	$6.27
Rate for Payer: UnitedHealthcare Commercial	$8.36
Rate for Payer: UnitedHealthcare Community & State	$1.01
Rate for Payer: Wellpoint Medicaid Managed Care	$1.11

PATTIES SURGICAL 1/2 X 1/2

Facility

$6.80

Hospital Charge Code	270660041
Hospital Revenue Code	270
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$1.02
Rate for Payer: Qualcare PPO/HMO/WC	$1.02

PATTIES SURGICAL 1/2 X 1/2

Facility

$6.80

Hospital Charge Code	270660041
Hospital Revenue Code	270
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$3.40
Rate for Payer: Aetna Commercial	$2.58
Rate for Payer: Aetna Medicare Advantage	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.73
Rate for Payer: Cigna Commercial	$3.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.04
Rate for Payer: Oxford Commercial	$1.36
Rate for Payer: Qualcare PPO/HMO/WC	$1.02
Rate for Payer: UnitedHealthcare Commercial	$1.36
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

PATTIES SURGICAL 5x5 in

Facility

$72.50

Hospital Charge Code	270664335
Hospital Revenue Code	272
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$36.25
Rate for Payer: Aetna Commercial	$27.55
Rate for Payer: Aetna Medicare Advantage	$21.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.49
Rate for Payer: Cigna Commercial	$36.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.75
Rate for Payer: Oxford Commercial	$14.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.88
Rate for Payer: UnitedHealthcare Commercial	$14.50
Rate for Payer: UnitedHealthcare Community & State	$1.75
Rate for Payer: Wellpoint Medicaid Managed Care	$1.92

PATTIES SURGICAL 5x5 in

Facility

$72.50

Hospital Charge Code	270664335
Hospital Revenue Code	272
Min. Negotiated Rate	$10.88
Max. Negotiated Rate	$10.88
Rate for Payer: Qualcare PPO/HMO/WC	$10.88

PATTIES SURGICAL .75IN X.75IN

Facility

$67.90

Hospital Charge Code	270664336
Hospital Revenue Code	270
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$33.95
Rate for Payer: Aetna Commercial	$25.80
Rate for Payer: Aetna Medicare Advantage	$20.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.31
Rate for Payer: Cigna Commercial	$33.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.37
Rate for Payer: Oxford Commercial	$13.58
Rate for Payer: Qualcare PPO/HMO/WC	$10.19
Rate for Payer: UnitedHealthcare Commercial	$13.58
Rate for Payer: UnitedHealthcare Community & State	$1.64
Rate for Payer: Wellpoint Medicaid Managed Care	$1.80

PATTIES SURGICAL .75IN X.75IN

Facility

$67.90

Hospital Charge Code	270664336
Hospital Revenue Code	270
Min. Negotiated Rate	$10.19
Max. Negotiated Rate	$10.19
Rate for Payer: Qualcare PPO/HMO/WC	$10.19

PATTIES SURG X-RAY 1/2x3 10/PK

Facility

$72.50

Hospital Charge Code	270656088
Hospital Revenue Code	271
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$36.25
Rate for Payer: Aetna Commercial	$27.55
Rate for Payer: Aetna Medicare Advantage	$21.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.49
Rate for Payer: Cigna Commercial	$36.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.75
Rate for Payer: Oxford Commercial	$14.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.88
Rate for Payer: UnitedHealthcare Commercial	$14.50
Rate for Payer: UnitedHealthcare Community & State	$1.75
Rate for Payer: Wellpoint Medicaid Managed Care	$1.92

PATTIES SURG X-RAY 1/2x3 10/PK

Facility

$72.50

Hospital Charge Code	270656088
Hospital Revenue Code	271
Min. Negotiated Rate	$10.88
Max. Negotiated Rate	$10.88
Rate for Payer: Qualcare PPO/HMO/WC	$10.88

PAVABID/150MG/CAP

Facility

$9.00

Hospital Charge Code	60633615
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

PAVABID/150MG/CAP

Facility

$3.00

Hospital Charge Code	60633614
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

PAVABID/150MG/CAP

Facility

$9.00

Hospital Charge Code	60633615
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

PAVABID/150MG/CAP

Facility

$3.00

Hospital Charge Code	60633614
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

PAVULON/1MG/1ML

Facility

$81.00

Hospital Charge Code	60633616
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$40.50
Rate for Payer: Aetna Commercial	$30.78
Rate for Payer: Aetna Medicare Advantage	$24.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.66
Rate for Payer: Cigna Commercial	$40.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.30
Rate for Payer: Oxford Commercial	$16.20
Rate for Payer: Qualcare PPO/HMO/WC	$12.15
Rate for Payer: UnitedHealthcare Commercial	$16.20
Rate for Payer: UnitedHealthcare Community & State	$1.95
Rate for Payer: Wellpoint Medicaid Managed Care	$2.15

PAVULON/1MG/1ML

Facility

$81.00

Hospital Charge Code	60633616
Hospital Revenue Code	250
Min. Negotiated Rate	$12.15
Max. Negotiated Rate	$12.15
Rate for Payer: Qualcare PPO/HMO/WC	$12.15

PAXIL 12.5MG TAB

Facility

$37.39

Service Code	NDC 60505367303
Hospital Charge Code	60635469
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$18.70
Rate for Payer: Aetna Commercial	$14.21
Rate for Payer: Aetna Medicare Advantage	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.53
Rate for Payer: Cigna Commercial	$18.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.22
Rate for Payer: Oxford Commercial	$7.48
Rate for Payer: Qualcare PPO/HMO/WC	$5.61
Rate for Payer: UnitedHealthcare Commercial	$7.48
Rate for Payer: UnitedHealthcare Community & State	$0.90
Rate for Payer: Wellpoint Medicaid Managed Care	$0.99

Know your out-of-pocket cost for care.

All Charges