Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PERFORATOR AMNIHOOK

Facility

$16.85

Hospital Charge Code	270130010
Hospital Revenue Code	272
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$8.43
Rate for Payer: Aetna Commercial	$6.40
Rate for Payer: Aetna Medicare Advantage	$5.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.30
Rate for Payer: Cigna Commercial	$8.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.05
Rate for Payer: Oxford Commercial	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$2.53
Rate for Payer: UnitedHealthcare Commercial	$3.37
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.45

PERFORATOR CRANIAL 14MM 261221

Facility

$890.45

Hospital Charge Code	270061175
Hospital Revenue Code	272
Min. Negotiated Rate	$133.57
Max. Negotiated Rate	$133.57
Rate for Payer: Qualcare PPO/HMO/WC	$133.57

PERFORATOR CRANIAL 14MM 261221

Facility

$1,200.00

Hospital Charge Code	270625223
Hospital Revenue Code	272
Min. Negotiated Rate	$28.92
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$456.00
Rate for Payer: Aetna Medicare Advantage	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$306.00
Rate for Payer: Cigna Commercial	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$360.00
Rate for Payer: Oxford Commercial	$240.00
Rate for Payer: Qualcare PPO/HMO/WC	$180.00
Rate for Payer: UnitedHealthcare Commercial	$240.00
Rate for Payer: UnitedHealthcare Community & State	$28.92
Rate for Payer: Wellpoint Medicaid Managed Care	$31.80

PERFORATOR CRANIAL 14MM 261221

Facility

$1,200.00

Hospital Charge Code	270625223
Hospital Revenue Code	272
Min. Negotiated Rate	$180.00
Max. Negotiated Rate	$180.00
Rate for Payer: Qualcare PPO/HMO/WC	$180.00

PERFORATOR CRANIAL 14MM 261221

Facility

$890.45

Hospital Charge Code	270061175
Hospital Revenue Code	272
Min. Negotiated Rate	$21.46
Max. Negotiated Rate	$445.23
Rate for Payer: Aetna Commercial	$338.37
Rate for Payer: Aetna Medicare Advantage	$267.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$227.06
Rate for Payer: Cigna Commercial	$445.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$267.13
Rate for Payer: Oxford Commercial	$178.09
Rate for Payer: Qualcare PPO/HMO/WC	$133.57
Rate for Payer: UnitedHealthcare Commercial	$178.09
Rate for Payer: UnitedHealthcare Community & State	$21.46
Rate for Payer: Wellpoint Medicaid Managed Care	$23.60

PERFORMAX EE LEAK 2 SU XS

Facility

$1,330.10

Hospital Charge Code	270684816
Hospital Revenue Code	272
Min. Negotiated Rate	$199.51
Max. Negotiated Rate	$199.51
Rate for Payer: Qualcare PPO/HMO/WC	$199.51

PERFORMAX EE LEAK 2 SU XS

Facility

$1,330.10

Hospital Charge Code	270684816
Hospital Revenue Code	272
Min. Negotiated Rate	$32.06
Max. Negotiated Rate	$665.05
Rate for Payer: Aetna Commercial	$505.44
Rate for Payer: Aetna Medicare Advantage	$399.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$339.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$339.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$339.18
Rate for Payer: Cigna Commercial	$665.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$399.03
Rate for Payer: Oxford Commercial	$266.02
Rate for Payer: Qualcare PPO/HMO/WC	$199.51
Rate for Payer: UnitedHealthcare Commercial	$266.02
Rate for Payer: UnitedHealthcare Community & State	$32.06
Rate for Payer: Wellpoint Medicaid Managed Care	$35.25

PERFOROMIST 20MCG/2ML NEB VIAL

Facility

$190.28

Service Code	NDC 49502060530
Hospital Charge Code	606390223
Hospital Revenue Code	250
Min. Negotiated Rate	$28.54
Max. Negotiated Rate	$28.54
Rate for Payer: Qualcare PPO/HMO/WC	$28.54

PERFOROMIST 20MCG/2ML NEB VIAL

Facility

$190.28

Service Code	NDC 49502060530
Hospital Charge Code	606390223
Hospital Revenue Code	250
Min. Negotiated Rate	$4.59
Max. Negotiated Rate	$95.14
Rate for Payer: Aetna Commercial	$72.31
Rate for Payer: Aetna Medicare Advantage	$57.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.52
Rate for Payer: Cigna Commercial	$95.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.08
Rate for Payer: Oxford Commercial	$38.06
Rate for Payer: Qualcare PPO/HMO/WC	$28.54
Rate for Payer: UnitedHealthcare Commercial	$38.06
Rate for Payer: UnitedHealthcare Community & State	$4.59
Rate for Payer: Wellpoint Medicaid Managed Care	$5.04

PERGOLIDE 0.05 MG TAB

Facility

$7.25

Hospital Charge Code	60628680
Hospital Revenue Code	250
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

PERGOLIDE 0.05 MG TAB

Facility

$7.25

Hospital Charge Code	60628680
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.62
Rate for Payer: Aetna Commercial	$2.75
Rate for Payer: Aetna Medicare Advantage	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.85
Rate for Payer: Cigna Commercial	$3.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.17
Rate for Payer: Oxford Commercial	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.09
Rate for Payer: UnitedHealthcare Commercial	$1.45
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

PERGOLIDE 0.25 MG TAB

Facility

$10.45

Hospital Charge Code	60628678
Hospital Revenue Code	250
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$1.57
Rate for Payer: Qualcare PPO/HMO/WC	$1.57

PERGOLIDE 0.25 MG TAB

Facility

$10.45

Hospital Charge Code	60628678
Hospital Revenue Code	250
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$5.22
Rate for Payer: Aetna Commercial	$3.97
Rate for Payer: Aetna Medicare Advantage	$3.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.66
Rate for Payer: Cigna Commercial	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.13
Rate for Payer: Oxford Commercial	$2.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.57
Rate for Payer: UnitedHealthcare Commercial	$2.09
Rate for Payer: UnitedHealthcare Community & State	$0.25
Rate for Payer: Wellpoint Medicaid Managed Care	$0.28

PERGOLIDE 1 MG TAB

Facility

$30.45

Hospital Charge Code	60628679
Hospital Revenue Code	250
Min. Negotiated Rate	$4.57
Max. Negotiated Rate	$4.57
Rate for Payer: Qualcare PPO/HMO/WC	$4.57

PERGOLIDE 1 MG TAB

Facility

$30.45

Hospital Charge Code	60628679
Hospital Revenue Code	250
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$15.22
Rate for Payer: Aetna Commercial	$11.57
Rate for Payer: Aetna Medicare Advantage	$9.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.76
Rate for Payer: Cigna Commercial	$15.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.13
Rate for Payer: Oxford Commercial	$6.09
Rate for Payer: Qualcare PPO/HMO/WC	$4.57
Rate for Payer: UnitedHealthcare Commercial	$6.09
Rate for Payer: UnitedHealthcare Community & State	$0.73
Rate for Payer: Wellpoint Medicaid Managed Care	$0.81

PERGONAL/75U

Facility

$310.00

Hospital Charge Code	60633630
Hospital Revenue Code	250
Min. Negotiated Rate	$46.50
Max. Negotiated Rate	$46.50
Rate for Payer: Qualcare PPO/HMO/WC	$46.50

PERGONAL/75U

Facility

$310.00

Hospital Charge Code	60633630
Hospital Revenue Code	250
Min. Negotiated Rate	$7.47
Max. Negotiated Rate	$155.00
Rate for Payer: Aetna Commercial	$117.80
Rate for Payer: Aetna Medicare Advantage	$93.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.05
Rate for Payer: Cigna Commercial	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.00
Rate for Payer: Oxford Commercial	$62.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.50
Rate for Payer: UnitedHealthcare Commercial	$62.00
Rate for Payer: UnitedHealthcare Community & State	$7.47
Rate for Payer: Wellpoint Medicaid Managed Care	$8.21

PERI ACCUCHECK (EACH TIME)

Facility

$56.00

Service Code	HCPCS 82948
Hospital Charge Code	74308200
Hospital Revenue Code	301
Min. Negotiated Rate	$1.48
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$13.71
Rate for Payer: Aetna Medicare Advantage	$16.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.19
Rate for Payer: Cigna Commercial	$28.00
Rate for Payer: Cigna Medicare Advantage	$5.04
Rate for Payer: Clover Medicare Advantage	$4.79
Rate for Payer: EmblemHealth Commercial	$15.12
Rate for Payer: Humana Medicare Advantage	$5.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.04
Rate for Payer: Wellcare Medicare Advantage	$5.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.48

PERI ACCUCHECK (EACH TIME)

Facility

$56.00

Service Code	HCPCS 82948
Hospital Charge Code	74308200
Hospital Revenue Code	301
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.40

PERIACTIN/2MG/5ML

Facility

$114.00

Hospital Charge Code	60633631
Hospital Revenue Code	250
Min. Negotiated Rate	$17.10
Max. Negotiated Rate	$17.10
Rate for Payer: Qualcare PPO/HMO/WC	$17.10

PERIACTIN/2MG/5ML

Facility

$114.00

Hospital Charge Code	60633631
Hospital Revenue Code	250
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$57.00
Rate for Payer: Aetna Commercial	$43.32
Rate for Payer: Aetna Medicare Advantage	$34.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.07
Rate for Payer: Cigna Commercial	$57.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.20
Rate for Payer: Oxford Commercial	$22.80
Rate for Payer: Qualcare PPO/HMO/WC	$17.10
Rate for Payer: UnitedHealthcare Commercial	$22.80
Rate for Payer: UnitedHealthcare Community & State	$2.75
Rate for Payer: Wellpoint Medicaid Managed Care	$3.02

PERIACTIN/4MG/TAB

Facility

$4.00

Hospital Charge Code	60633632
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PERIACTIN/4MG/TAB

Facility

$4.00

Hospital Charge Code	60633632
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

PERI AMNIOCENTESIS

Facility

$591.00

Service Code	HCPCS 59000
Hospital Charge Code	74308030
Hospital Revenue Code	514
Min. Negotiated Rate	$14.24
Max. Negotiated Rate	$3,949.84
Rate for Payer: Aetna Commercial	$2,976.31
Rate for Payer: Aetna Medicare Advantage	$3,545.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,949.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,949.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,094.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,949.84
Rate for Payer: Cigna Commercial	$2,193.38
Rate for Payer: Cigna Medicare Advantage	$1,094.23
Rate for Payer: Clover Medicare Advantage	$1,039.52
Rate for Payer: EmblemHealth Commercial	$3,282.69
Rate for Payer: Humana Medicare Advantage	$1,127.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,094.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.30
Rate for Payer: Qualcare PPO/HMO/WC	$88.65
Rate for Payer: UnitedHealthcare Community & State	$14.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,094.23
Rate for Payer: Wellcare Medicare Advantage	$1,094.23
Rate for Payer: Wellpoint Medicaid Managed Care	$15.66

PERI AMNIOCENTESIS

Facility

$591.00

Service Code	HCPCS 59000
Hospital Charge Code	74308030
Hospital Revenue Code	514
Min. Negotiated Rate	$88.65
Max. Negotiated Rate	$88.65
Rate for Payer: Qualcare PPO/HMO/WC	$88.65

Know your out-of-pocket cost for care.

All Charges