Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PIOGLITAZONE 15 MG TAB

Facility

$83.68

Service Code	NDC 64764015104
Hospital Charge Code	60629054
Hospital Revenue Code	250
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$41.84
Rate for Payer: Aetna Commercial	$31.80
Rate for Payer: Aetna Medicare Advantage	$25.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.34
Rate for Payer: Cigna Commercial	$41.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.10
Rate for Payer: Oxford Commercial	$16.74
Rate for Payer: Qualcare PPO/HMO/WC	$12.55
Rate for Payer: UnitedHealthcare Commercial	$16.74
Rate for Payer: UnitedHealthcare Community & State	$2.02
Rate for Payer: Wellpoint Medicaid Managed Care	$2.22

PIOGLITAZONE 30 MG TAB

Facility

$127.90

Service Code	NDC 64764030114
Hospital Charge Code	60629055
Hospital Revenue Code	250
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$63.95
Rate for Payer: Aetna Commercial	$48.60
Rate for Payer: Aetna Medicare Advantage	$38.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.61
Rate for Payer: Cigna Commercial	$63.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.37
Rate for Payer: Oxford Commercial	$25.58
Rate for Payer: Qualcare PPO/HMO/WC	$19.18
Rate for Payer: UnitedHealthcare Commercial	$25.58
Rate for Payer: UnitedHealthcare Community & State	$3.08
Rate for Payer: Wellpoint Medicaid Managed Care	$3.39

PIOGLITAZONE 30 MG TAB

Facility

$127.90

Service Code	NDC 64764030114
Hospital Charge Code	60629055
Hospital Revenue Code	250
Min. Negotiated Rate	$19.18
Max. Negotiated Rate	$19.18
Rate for Payer: Qualcare PPO/HMO/WC	$19.18

PIOGLITAZONE 45 MG TAB

Facility

$138.76

Service Code	NDC 64764045124
Hospital Charge Code	60629060
Hospital Revenue Code	250
Min. Negotiated Rate	$3.34
Max. Negotiated Rate	$69.38
Rate for Payer: Aetna Commercial	$52.73
Rate for Payer: Aetna Medicare Advantage	$41.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.38
Rate for Payer: Cigna Commercial	$69.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.63
Rate for Payer: Oxford Commercial	$27.75
Rate for Payer: Qualcare PPO/HMO/WC	$20.81
Rate for Payer: UnitedHealthcare Commercial	$27.75
Rate for Payer: UnitedHealthcare Community & State	$3.34
Rate for Payer: Wellpoint Medicaid Managed Care	$3.68

PIOGLITAZONE 45 MG TAB

Facility

$138.76

Service Code	NDC 64764045124
Hospital Charge Code	60629060
Hospital Revenue Code	250
Min. Negotiated Rate	$20.81
Max. Negotiated Rate	$20.81
Rate for Payer: Qualcare PPO/HMO/WC	$20.81

PIPELINE EMBOLIZATION 4.5X20MM

Facility

$89,300.00

Service Code	HCPCS C1889
Hospital Charge Code	270697151S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,152.13
Max. Negotiated Rate	$44,650.00
Rate for Payer: Aetna Commercial	$33,934.00
Rate for Payer: Aetna Medicare Advantage	$26,790.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,771.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,771.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,860.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,771.50
Rate for Payer: Cigna Commercial	$44,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21,610.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$19,646.00
Rate for Payer: Qualcare PPO/HMO/WC	$13,395.00
Rate for Payer: UnitedHealthcare Community & State	$2,152.13
Rate for Payer: Wellpoint Medicaid Managed Care	$2,366.45

PIPELINE EMBOLIZATION 4.5X20MM

Facility

$89,300.00

Service Code	HCPCS C1889
Hospital Charge Code	270697151S
Hospital Revenue Code	278
Min. Negotiated Rate	$13,395.00
Max. Negotiated Rate	$21,610.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21,610.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$19,646.00
Rate for Payer: Qualcare PPO/HMO/WC	$13,395.00

PIPELLE 3.1 MM O.D

Facility

$29.72

Hospital Charge Code	270662678
Hospital Revenue Code	270
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$4.46
Rate for Payer: Qualcare PPO/HMO/WC	$4.46

PIPELLE 3.1 MM O.D

Facility

$29.72

Hospital Charge Code	270662678
Hospital Revenue Code	270
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$14.86
Rate for Payer: Aetna Commercial	$11.29
Rate for Payer: Aetna Medicare Advantage	$8.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.58
Rate for Payer: Cigna Commercial	$14.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.92
Rate for Payer: Oxford Commercial	$5.94
Rate for Payer: Qualcare PPO/HMO/WC	$4.46
Rate for Payer: UnitedHealthcare Commercial	$5.94
Rate for Payer: UnitedHealthcare Community & State	$0.72
Rate for Payer: Wellpoint Medicaid Managed Care	$0.79

PIPERACILLIN DROP OPH 100MG/ML

Facility

$207.40

Hospital Charge Code	6004444
Hospital Revenue Code	252
Min. Negotiated Rate	$5.00
Max. Negotiated Rate	$103.70
Rate for Payer: Aetna Commercial	$78.81
Rate for Payer: Aetna Medicare Advantage	$62.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.89
Rate for Payer: Cigna Commercial	$103.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.22
Rate for Payer: Oxford Commercial	$41.48
Rate for Payer: Qualcare PPO/HMO/WC	$31.11
Rate for Payer: UnitedHealthcare Commercial	$41.48
Rate for Payer: UnitedHealthcare Community & State	$5.00
Rate for Payer: Wellpoint Medicaid Managed Care	$5.50

PIPERACILLIN DROP OPH 100MG/ML

Facility

$207.40

Hospital Charge Code	6004444
Hospital Revenue Code	252
Min. Negotiated Rate	$31.11
Max. Negotiated Rate	$31.11
Rate for Payer: Qualcare PPO/HMO/WC	$31.11

PIPERACILLIN SBCN OPH 200MG/ML

Facility

$53.80

Hospital Charge Code	6004436
Hospital Revenue Code	252
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

PIPERACILLIN SBCN OPH 200MG/ML

Facility

$53.80

Hospital Charge Code	6004436
Hospital Revenue Code	252
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$8.07

PIPERACILLIN VL 2GM

Facility

$90.90

Hospital Charge Code	6007082
Hospital Revenue Code	250
Min. Negotiated Rate	$13.63
Max. Negotiated Rate	$13.63
Rate for Payer: Qualcare PPO/HMO/WC	$13.63

PIPERACILLIN VL 2GM

Facility

$90.90

Hospital Charge Code	6007082
Hospital Revenue Code	250
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$45.45
Rate for Payer: Aetna Commercial	$34.54
Rate for Payer: Aetna Medicare Advantage	$27.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.18
Rate for Payer: Cigna Commercial	$45.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.27
Rate for Payer: Oxford Commercial	$18.18
Rate for Payer: Qualcare PPO/HMO/WC	$13.63
Rate for Payer: UnitedHealthcare Commercial	$18.18
Rate for Payer: UnitedHealthcare Community & State	$2.19
Rate for Payer: Wellpoint Medicaid Managed Care	$2.41

PIPERACILLIN VL 3GM

Facility

$136.85

Hospital Charge Code	6006563
Hospital Revenue Code	250
Min. Negotiated Rate	$20.53
Max. Negotiated Rate	$20.53
Rate for Payer: Qualcare PPO/HMO/WC	$20.53

PIPERACILLIN VL 3GM

Facility

$136.85

Hospital Charge Code	6006563
Hospital Revenue Code	250
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$68.42
Rate for Payer: Aetna Commercial	$52.00
Rate for Payer: Aetna Medicare Advantage	$41.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.90
Rate for Payer: Cigna Commercial	$68.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.05
Rate for Payer: Oxford Commercial	$27.37
Rate for Payer: Qualcare PPO/HMO/WC	$20.53
Rate for Payer: UnitedHealthcare Commercial	$27.37
Rate for Payer: UnitedHealthcare Community & State	$3.30
Rate for Payer: Wellpoint Medicaid Managed Care	$3.63

PIPERACILLN/TAZOBACT 4.5GM INJ

Facility

$200.87

Service Code	HCPCS J2543
Hospital Charge Code	60632212
Hospital Revenue Code	636
Min. Negotiated Rate	$30.13
Max. Negotiated Rate	$48.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.61
Rate for Payer: Qualcare PPO/HMO/WC	$30.13

PIPERACILLN/TAZOBACT 4.5GM INJ

Facility

$200.87

Service Code	HCPCS J2543
Hospital Charge Code	60632212
Hospital Revenue Code	636
Min. Negotiated Rate	$4.84
Max. Negotiated Rate	$100.44
Rate for Payer: Aetna Commercial	$76.33
Rate for Payer: Aetna Medicare Advantage	$60.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.22
Rate for Payer: Cigna Commercial	$100.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.61
Rate for Payer: Qualcare PPO/HMO/WC	$30.13
Rate for Payer: UnitedHealthcare Community & State	$4.84
Rate for Payer: Wellpoint Medicaid Managed Care	$5.32

PIPERACLLN/TAZOBACT 2.25GM INJ

Facility

$233.23

Service Code	HCPCS J2543
Hospital Charge Code	60627314
Hospital Revenue Code	636
Min. Negotiated Rate	$5.62
Max. Negotiated Rate	$116.61
Rate for Payer: Aetna Commercial	$88.63
Rate for Payer: Aetna Medicare Advantage	$69.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.47
Rate for Payer: Cigna Commercial	$116.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.44
Rate for Payer: Qualcare PPO/HMO/WC	$34.98
Rate for Payer: UnitedHealthcare Community & State	$5.62
Rate for Payer: Wellpoint Medicaid Managed Care	$6.18

PIPERACLLN/TAZOBACT 2.25GM INJ

Facility

$233.23

Service Code	HCPCS J2543
Hospital Charge Code	60627314
Hospital Revenue Code	636
Min. Negotiated Rate	$34.98
Max. Negotiated Rate	$56.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.44
Rate for Payer: Qualcare PPO/HMO/WC	$34.98

PIPERCILL/TAZO 3.375GM NS100ML

Facility

$147.07

Service Code	HCPCS J2543
Hospital Charge Code	6010391
Hospital Revenue Code	636
Min. Negotiated Rate	$22.06
Max. Negotiated Rate	$35.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.59
Rate for Payer: Qualcare PPO/HMO/WC	$22.06

PIPERCILL/TAZO 3.375GM NS100ML

Facility

$147.07

Service Code	HCPCS J2543
Hospital Charge Code	6010391
Hospital Revenue Code	636
Min. Negotiated Rate	$3.54
Max. Negotiated Rate	$73.53
Rate for Payer: Aetna Commercial	$55.89
Rate for Payer: Aetna Medicare Advantage	$44.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.50
Rate for Payer: Cigna Commercial	$73.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.59
Rate for Payer: Qualcare PPO/HMO/WC	$22.06
Rate for Payer: UnitedHealthcare Community & State	$3.54
Rate for Payer: Wellpoint Medicaid Managed Care	$3.90

PIPRACIL/2GM/VIAL

Facility

$61.00

Hospital Charge Code	60634502
Hospital Revenue Code	636
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$30.50
Rate for Payer: Aetna Commercial	$23.18
Rate for Payer: Aetna Medicare Advantage	$18.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.55
Rate for Payer: Cigna Commercial	$30.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.76
Rate for Payer: Qualcare PPO/HMO/WC	$9.15
Rate for Payer: UnitedHealthcare Community & State	$1.47
Rate for Payer: Wellpoint Medicaid Managed Care	$1.62

PIPRACIL/2GM/VIAL

Facility

$61.00

Hospital Charge Code	60634502
Hospital Revenue Code	636
Min. Negotiated Rate	$9.15
Max. Negotiated Rate	$14.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.76
Rate for Payer: Qualcare PPO/HMO/WC	$9.15

Know your out-of-pocket cost for care.

All Charges