Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PROCAINAMIDE & NAPA

Facility

$115.15

Service Code	HCPCS 80192
Hospital Charge Code	39900009
Hospital Revenue Code	301
Min. Negotiated Rate	$17.27
Max. Negotiated Rate	$17.27
Rate for Payer: Qualcare PPO/HMO/WC	$17.27

PROCAINAMIDE & NAPA

Facility

$115.15

Service Code	HCPCS 80192
Hospital Charge Code	39900009
Hospital Revenue Code	301
Min. Negotiated Rate	$3.05
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$45.56
Rate for Payer: Aetna Medicare Advantage	$54.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.46
Rate for Payer: Cigna Commercial	$57.58
Rate for Payer: Cigna Medicare Advantage	$16.75
Rate for Payer: Clover Medicare Advantage	$15.91
Rate for Payer: EmblemHealth Commercial	$50.25
Rate for Payer: Humana Medicare Advantage	$17.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.55
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.27
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.40
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.75
Rate for Payer: Wellcare Medicare Advantage	$16.75
Rate for Payer: Wellpoint Medicaid Managed Care	$3.05

PROCAINAMIDE (PRONESTYL)

Facility

$217.00

Service Code	HCPCS 80192
Hospital Charge Code	38472560
Hospital Revenue Code	301
Min. Negotiated Rate	$5.75
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$45.56
Rate for Payer: Aetna Medicare Advantage	$54.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.46
Rate for Payer: Cigna Commercial	$108.50
Rate for Payer: Cigna Medicare Advantage	$16.75
Rate for Payer: Clover Medicare Advantage	$15.91
Rate for Payer: EmblemHealth Commercial	$50.25
Rate for Payer: Humana Medicare Advantage	$17.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.55
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.40
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.75
Rate for Payer: Wellcare Medicare Advantage	$16.75
Rate for Payer: Wellpoint Medicaid Managed Care	$5.75

PROCAINAMIDE (PRONESTYL)

Facility

$217.00

Service Code	HCPCS 80192
Hospital Charge Code	38472560
Hospital Revenue Code	301
Min. Negotiated Rate	$32.55
Max. Negotiated Rate	$32.55
Rate for Payer: Qualcare PPO/HMO/WC	$32.55

PROCAINAMIDE TAB 500 MG CR

Facility

$4.50

Hospital Charge Code	60629035
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.25
Rate for Payer: Aetna Commercial	$1.71
Rate for Payer: Aetna Medicare Advantage	$1.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.15
Rate for Payer: Cigna Commercial	$2.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.35
Rate for Payer: Oxford Commercial	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.68
Rate for Payer: UnitedHealthcare Commercial	$0.90
Rate for Payer: UnitedHealthcare Community & State	$0.11
Rate for Payer: Wellpoint Medicaid Managed Care	$0.12

PROCAINAMIDE TAB 500 MG CR

Facility

$4.50

Hospital Charge Code	60629035
Hospital Revenue Code	250
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$0.68
Rate for Payer: Qualcare PPO/HMO/WC	$0.68

PROCAINAMIDE TAB SR 750MG

Facility

$5.65

Hospital Charge Code	60627596
Hospital Revenue Code	250
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.85

PROCAINAMIDE TAB SR 750MG

Facility

$5.65

Hospital Charge Code	60627596
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.83
Rate for Payer: Aetna Commercial	$2.15
Rate for Payer: Aetna Medicare Advantage	$1.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.44
Rate for Payer: Cigna Commercial	$2.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.70
Rate for Payer: Oxford Commercial	$1.13
Rate for Payer: Qualcare PPO/HMO/WC	$0.85
Rate for Payer: UnitedHealthcare Commercial	$1.13
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

PROCAINE HYDROCH INJ 1% 30ML

Facility

$2.45

Hospital Charge Code	6004659
Hospital Revenue Code	250
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.23
Rate for Payer: Aetna Commercial	$0.93
Rate for Payer: Aetna Medicare Advantage	$0.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.62
Rate for Payer: Cigna Commercial	$1.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.74
Rate for Payer: Oxford Commercial	$0.49
Rate for Payer: Qualcare PPO/HMO/WC	$0.37
Rate for Payer: UnitedHealthcare Commercial	$0.49
Rate for Payer: UnitedHealthcare Community & State	$0.06
Rate for Payer: Wellpoint Medicaid Managed Care	$0.06

PROCAINE HYDROCH INJ 1% 30ML

Facility

$2.45

Hospital Charge Code	6004659
Hospital Revenue Code	250
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.37
Rate for Payer: Qualcare PPO/HMO/WC	$0.37

PROCAINE HYDROCH INJ 2% 30ML

Facility

$109.45

Hospital Charge Code	6004667
Hospital Revenue Code	250
Min. Negotiated Rate	$16.42
Max. Negotiated Rate	$16.42
Rate for Payer: Qualcare PPO/HMO/WC	$16.42

PROCAINE HYDROCH INJ 2% 30ML

Facility

$109.45

Hospital Charge Code	6004667
Hospital Revenue Code	250
Min. Negotiated Rate	$2.64
Max. Negotiated Rate	$54.73
Rate for Payer: Aetna Commercial	$41.59
Rate for Payer: Aetna Medicare Advantage	$32.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.91
Rate for Payer: Cigna Commercial	$54.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.84
Rate for Payer: Oxford Commercial	$21.89
Rate for Payer: Qualcare PPO/HMO/WC	$16.42
Rate for Payer: UnitedHealthcare Commercial	$21.89
Rate for Payer: UnitedHealthcare Community & State	$2.64
Rate for Payer: Wellpoint Medicaid Managed Care	$2.90

PROCAINE INJ 2%

Facility

$38.45

Hospital Charge Code	60628279
Hospital Revenue Code	250
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$19.23
Rate for Payer: Aetna Commercial	$14.61
Rate for Payer: Aetna Medicare Advantage	$11.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.80
Rate for Payer: Cigna Commercial	$19.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.54
Rate for Payer: Oxford Commercial	$7.69
Rate for Payer: Qualcare PPO/HMO/WC	$5.77
Rate for Payer: UnitedHealthcare Commercial	$7.69
Rate for Payer: UnitedHealthcare Community & State	$0.93
Rate for Payer: Wellpoint Medicaid Managed Care	$1.02

PROCAINE INJ 2%

Facility

$38.45

Hospital Charge Code	60628279
Hospital Revenue Code	250
Min. Negotiated Rate	$5.77
Max. Negotiated Rate	$5.77
Rate for Payer: Qualcare PPO/HMO/WC	$5.77

PROCAINE VL 1% 30ML

Facility

$4.50

Hospital Charge Code	6013163
Hospital Revenue Code	250
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$0.68
Rate for Payer: Qualcare PPO/HMO/WC	$0.68

PROCAINE VL 1% 30ML

Facility

$4.50

Hospital Charge Code	6013163
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.25
Rate for Payer: Aetna Commercial	$1.71
Rate for Payer: Aetna Medicare Advantage	$1.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.15
Rate for Payer: Cigna Commercial	$2.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.35
Rate for Payer: Oxford Commercial	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.68
Rate for Payer: UnitedHealthcare Commercial	$0.90
Rate for Payer: UnitedHealthcare Community & State	$0.11
Rate for Payer: Wellpoint Medicaid Managed Care	$0.12

PROCALAMINE/1000ML

Facility

$131.00

Hospital Charge Code	60634539
Hospital Revenue Code	250
Min. Negotiated Rate	$3.16
Max. Negotiated Rate	$65.50
Rate for Payer: Aetna Commercial	$49.78
Rate for Payer: Aetna Medicare Advantage	$39.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.41
Rate for Payer: Cigna Commercial	$65.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.30
Rate for Payer: Oxford Commercial	$26.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.65
Rate for Payer: UnitedHealthcare Commercial	$26.20
Rate for Payer: UnitedHealthcare Community & State	$3.16
Rate for Payer: Wellpoint Medicaid Managed Care	$3.47

PROCALAMINE/1000ML

Facility

$131.00

Hospital Charge Code	60634539
Hospital Revenue Code	250
Min. Negotiated Rate	$19.65
Max. Negotiated Rate	$19.65
Rate for Payer: Qualcare PPO/HMO/WC	$19.65

PROCALCITONIN

Facility

$184.10

Service Code	HCPCS 84145
Hospital Charge Code	3038135
Hospital Revenue Code	301
Min. Negotiated Rate	$4.88
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$74.04
Rate for Payer: Aetna Medicare Advantage	$88.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.26
Rate for Payer: Cigna Commercial	$92.05
Rate for Payer: Cigna Medicare Advantage	$27.22
Rate for Payer: Clover Medicare Advantage	$25.86
Rate for Payer: EmblemHealth Commercial	$81.66
Rate for Payer: Humana Medicare Advantage	$28.04
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.23
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.61
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$21.78
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.22
Rate for Payer: Wellcare Medicare Advantage	$27.22
Rate for Payer: Wellpoint Medicaid Managed Care	$4.88

PROCALCITONIN

Facility

$184.10

Service Code	HCPCS 84145
Hospital Charge Code	39900123
Hospital Revenue Code	301
Min. Negotiated Rate	$27.61
Max. Negotiated Rate	$27.61
Rate for Payer: Qualcare PPO/HMO/WC	$27.61

PROCALCITONIN

Facility

$184.10

Service Code	HCPCS 84145
Hospital Charge Code	3038135
Hospital Revenue Code	301
Min. Negotiated Rate	$27.61
Max. Negotiated Rate	$27.61
Rate for Payer: Qualcare PPO/HMO/WC	$27.61

PROCALCITONIN

Facility

$189.65

Service Code	HCPCS 84145
Hospital Charge Code	38472078
Hospital Revenue Code	301
Min. Negotiated Rate	$28.45
Max. Negotiated Rate	$28.45
Rate for Payer: Qualcare PPO/HMO/WC	$28.45

PROCALCITONIN

Facility

$189.65

Service Code	HCPCS 84145
Hospital Charge Code	38472078
Hospital Revenue Code	301
Min. Negotiated Rate	$5.03
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$74.04
Rate for Payer: Aetna Medicare Advantage	$88.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.26
Rate for Payer: Cigna Commercial	$94.83
Rate for Payer: Cigna Medicare Advantage	$27.22
Rate for Payer: Clover Medicare Advantage	$25.86
Rate for Payer: EmblemHealth Commercial	$81.66
Rate for Payer: Humana Medicare Advantage	$28.04
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.45
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$21.78
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.22
Rate for Payer: Wellcare Medicare Advantage	$27.22
Rate for Payer: Wellpoint Medicaid Managed Care	$5.03

PROCALCITONIN

Facility

$184.10

Service Code	HCPCS 84145
Hospital Charge Code	39900123
Hospital Revenue Code	301
Min. Negotiated Rate	$4.88
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$74.04
Rate for Payer: Aetna Medicare Advantage	$88.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.26
Rate for Payer: Cigna Commercial	$92.05
Rate for Payer: Cigna Medicare Advantage	$27.22
Rate for Payer: Clover Medicare Advantage	$25.86
Rate for Payer: EmblemHealth Commercial	$81.66
Rate for Payer: Humana Medicare Advantage	$28.04
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.23
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.61
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$21.78
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.22
Rate for Payer: Wellcare Medicare Advantage	$27.22
Rate for Payer: Wellpoint Medicaid Managed Care	$4.88

PROCALCITONIN IN HOUSE TEST

Facility

$377.00

Service Code	HCPCS 84145
Hospital Charge Code	401116223
Hospital Revenue Code	301
Min. Negotiated Rate	$56.55
Max. Negotiated Rate	$56.55
Rate for Payer: Qualcare PPO/HMO/WC	$56.55

Know your out-of-pocket cost for care.

All Charges