Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PIPRACIL 3G ADV

Facility

$122.00

Hospital Charge Code	60635042
Hospital Revenue Code	636
Min. Negotiated Rate	$18.30
Max. Negotiated Rate	$29.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.52
Rate for Payer: Qualcare PPO/HMO/WC	$18.30

PIPRACIL 3G ADV

Facility

$122.00

Hospital Charge Code	60635042
Hospital Revenue Code	636
Min. Negotiated Rate	$2.94
Max. Negotiated Rate	$61.00
Rate for Payer: Aetna Commercial	$46.36
Rate for Payer: Aetna Medicare Advantage	$36.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.11
Rate for Payer: Cigna Commercial	$61.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.52
Rate for Payer: Qualcare PPO/HMO/WC	$18.30
Rate for Payer: UnitedHealthcare Community & State	$2.94
Rate for Payer: Wellpoint Medicaid Managed Care	$3.23

PIPRACIL 3GM (ADD VANT)

Facility

$122.00

Hospital Charge Code	60635040
Hospital Revenue Code	636
Min. Negotiated Rate	$18.30
Max. Negotiated Rate	$29.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.52
Rate for Payer: Qualcare PPO/HMO/WC	$18.30

PIPRACIL 3GM (ADD VANT)

Facility

$122.00

Hospital Charge Code	60635040
Hospital Revenue Code	636
Min. Negotiated Rate	$2.94
Max. Negotiated Rate	$61.00
Rate for Payer: Aetna Commercial	$46.36
Rate for Payer: Aetna Medicare Advantage	$36.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.11
Rate for Payer: Cigna Commercial	$61.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.52
Rate for Payer: Qualcare PPO/HMO/WC	$18.30
Rate for Payer: UnitedHealthcare Community & State	$2.94
Rate for Payer: Wellpoint Medicaid Managed Care	$3.23

PIPRACIL/3GM/VIAL

Facility

$89.00

Hospital Charge Code	60634503
Hospital Revenue Code	636
Min. Negotiated Rate	$2.14
Max. Negotiated Rate	$44.50
Rate for Payer: Aetna Commercial	$33.82
Rate for Payer: Aetna Medicare Advantage	$26.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.70
Rate for Payer: Cigna Commercial	$44.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.54
Rate for Payer: Qualcare PPO/HMO/WC	$13.35
Rate for Payer: UnitedHealthcare Community & State	$2.14
Rate for Payer: Wellpoint Medicaid Managed Care	$2.36

PIPRACIL/3GM/VIAL

Facility

$89.00

Hospital Charge Code	60634503
Hospital Revenue Code	636
Min. Negotiated Rate	$13.35
Max. Negotiated Rate	$21.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.54
Rate for Payer: Qualcare PPO/HMO/WC	$13.35

PIPRACIL/40GM

Facility

$110.00

Hospital Charge Code	60633665
Hospital Revenue Code	636
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$55.00
Rate for Payer: Aetna Commercial	$41.80
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.62
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Community & State	$2.65
Rate for Payer: Wellpoint Medicaid Managed Care	$2.92

PIPRACIL/40GM

Facility

$110.00

Hospital Charge Code	60633665
Hospital Revenue Code	636
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$26.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.62
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

PIPRACIL 4G ADV

Facility

$195.00

Hospital Charge Code	60635043
Hospital Revenue Code	636
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$47.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.19
Rate for Payer: Qualcare PPO/HMO/WC	$29.25

PIPRACIL 4G ADV

Facility

$195.00

Hospital Charge Code	60635043
Hospital Revenue Code	636
Min. Negotiated Rate	$4.70
Max. Negotiated Rate	$97.50
Rate for Payer: Aetna Commercial	$74.10
Rate for Payer: Aetna Medicare Advantage	$58.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.73
Rate for Payer: Cigna Commercial	$97.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.19
Rate for Payer: Qualcare PPO/HMO/WC	$29.25
Rate for Payer: UnitedHealthcare Community & State	$4.70
Rate for Payer: Wellpoint Medicaid Managed Care	$5.17

PIPRACIL 4GM (ADD VANT)

Facility

$195.00

Hospital Charge Code	60635041
Hospital Revenue Code	636
Min. Negotiated Rate	$4.70
Max. Negotiated Rate	$97.50
Rate for Payer: Aetna Commercial	$74.10
Rate for Payer: Aetna Medicare Advantage	$58.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.73
Rate for Payer: Cigna Commercial	$97.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.19
Rate for Payer: Qualcare PPO/HMO/WC	$29.25
Rate for Payer: UnitedHealthcare Community & State	$4.70
Rate for Payer: Wellpoint Medicaid Managed Care	$5.17

PIPRACIL 4GM (ADD VANT)

Facility

$195.00

Hospital Charge Code	60635041
Hospital Revenue Code	636
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$47.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.19
Rate for Payer: Qualcare PPO/HMO/WC	$29.25

PIPRACIL/4GM/VIAL

Facility

$127.00

Hospital Charge Code	60634504
Hospital Revenue Code	636
Min. Negotiated Rate	$19.05
Max. Negotiated Rate	$30.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.73
Rate for Payer: Qualcare PPO/HMO/WC	$19.05

PIPRACIL/4GM/VIAL

Facility

$127.00

Hospital Charge Code	60634504
Hospital Revenue Code	636
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$63.50
Rate for Payer: Aetna Commercial	$48.26
Rate for Payer: Aetna Medicare Advantage	$38.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.38
Rate for Payer: Cigna Commercial	$63.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.73
Rate for Payer: Qualcare PPO/HMO/WC	$19.05
Rate for Payer: UnitedHealthcare Community & State	$3.06
Rate for Payer: Wellpoint Medicaid Managed Care	$3.37

PIRBUTEROL ACETATE MDI 25.6G

Facility

$62.75

Hospital Charge Code	6008767
Hospital Revenue Code	252
Min. Negotiated Rate	$9.41
Max. Negotiated Rate	$9.41
Rate for Payer: Qualcare PPO/HMO/WC	$9.41

PIRBUTEROL ACETATE MDI 25.6G

Facility

$62.75

Hospital Charge Code	6008767
Hospital Revenue Code	252
Min. Negotiated Rate	$1.51
Max. Negotiated Rate	$31.38
Rate for Payer: Aetna Commercial	$23.84
Rate for Payer: Aetna Medicare Advantage	$18.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.00
Rate for Payer: Cigna Commercial	$31.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.82
Rate for Payer: Oxford Commercial	$12.55
Rate for Payer: Qualcare PPO/HMO/WC	$9.41
Rate for Payer: UnitedHealthcare Commercial	$12.55
Rate for Payer: UnitedHealthcare Community & State	$1.51
Rate for Payer: Wellpoint Medicaid Managed Care	$1.66

PIRIFORMIS FOSSA FEMORAL NAIL

Facility

$9,904.20

Hospital Charge Code	270657838
Hospital Revenue Code	278
Min. Negotiated Rate	$238.69
Max. Negotiated Rate	$4,952.10
Rate for Payer: Aetna Commercial	$3,763.60
Rate for Payer: Aetna Medicare Advantage	$2,971.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,525.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,525.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,980.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,525.57
Rate for Payer: Cigna Commercial	$4,952.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,396.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,178.92
Rate for Payer: Qualcare PPO/HMO/WC	$1,485.63
Rate for Payer: UnitedHealthcare Community & State	$238.69
Rate for Payer: Wellpoint Medicaid Managed Care	$262.46

PIRIFORMIS FOSSA FEMORAL NAIL

Facility

$9,904.20

Hospital Charge Code	270657838
Hospital Revenue Code	278
Min. Negotiated Rate	$1,485.63
Max. Negotiated Rate	$2,396.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,980.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,396.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,178.92
Rate for Payer: Qualcare PPO/HMO/WC	$1,485.63

PIRIFORMIS FOSSS FEMORAL NAIL

Facility

$9,904.20

Hospital Charge Code	270657837
Hospital Revenue Code	278
Min. Negotiated Rate	$238.69
Max. Negotiated Rate	$4,952.10
Rate for Payer: Aetna Commercial	$3,763.60
Rate for Payer: Aetna Medicare Advantage	$2,971.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,525.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,525.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,980.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,525.57
Rate for Payer: Cigna Commercial	$4,952.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,396.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,178.92
Rate for Payer: Qualcare PPO/HMO/WC	$1,485.63
Rate for Payer: UnitedHealthcare Community & State	$238.69
Rate for Payer: Wellpoint Medicaid Managed Care	$262.46

PIRIFORMIS FOSSS FEMORAL NAIL

Facility

$9,904.20

Hospital Charge Code	270657837
Hospital Revenue Code	278
Min. Negotiated Rate	$1,485.63
Max. Negotiated Rate	$2,396.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,980.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,396.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,178.92
Rate for Payer: Qualcare PPO/HMO/WC	$1,485.63

PIROXICAM 20 MG CAP

Facility

$24.00

Hospital Charge Code	60627695
Hospital Revenue Code	250
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$12.00
Rate for Payer: Aetna Commercial	$9.12
Rate for Payer: Aetna Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.12
Rate for Payer: Cigna Commercial	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.20
Rate for Payer: Oxford Commercial	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$3.60
Rate for Payer: UnitedHealthcare Commercial	$4.80
Rate for Payer: UnitedHealthcare Community & State	$0.58
Rate for Payer: Wellpoint Medicaid Managed Care	$0.64

PIROXICAM 20 MG CAP

Facility

$24.00

Hospital Charge Code	60627695
Hospital Revenue Code	250
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.60

PISTON SCHK WIRE EAR .6 140129

Facility

$708.00

Hospital Charge Code	270620114
Hospital Revenue Code	278
Min. Negotiated Rate	$106.20
Max. Negotiated Rate	$171.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$155.76
Rate for Payer: Qualcare PPO/HMO/WC	$106.20

PISTON SCHK WIRE EAR .6 140129

Facility

$708.00

Hospital Charge Code	270620114
Hospital Revenue Code	278
Min. Negotiated Rate	$17.06
Max. Negotiated Rate	$354.00
Rate for Payer: Aetna Commercial	$269.04
Rate for Payer: Aetna Medicare Advantage	$212.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$180.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$180.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$180.54
Rate for Payer: Cigna Commercial	$354.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$155.76
Rate for Payer: Qualcare PPO/HMO/WC	$106.20
Rate for Payer: UnitedHealthcare Community & State	$17.06
Rate for Payer: Wellpoint Medicaid Managed Care	$18.76

PISTONS SCHUKT 0.6X4.75 140127

Facility

$457.15

Hospital Charge Code	270620112
Hospital Revenue Code	278
Min. Negotiated Rate	$68.57
Max. Negotiated Rate	$110.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$100.57
Rate for Payer: Qualcare PPO/HMO/WC	$68.57

Know your out-of-pocket cost for care.

All Charges