Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PROGESTERONE 50 MG/ML INJ

Facility

$16.00

Hospital Charge Code	6004675
Hospital Revenue Code	250
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$2.40

PROGESTERONE 50 MG/ML INJ

Facility

$16.00

Hospital Charge Code	6004675
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$8.00
Rate for Payer: Aetna Commercial	$6.08
Rate for Payer: Aetna Medicare Advantage	$4.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.08
Rate for Payer: Cigna Commercial	$8.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.80
Rate for Payer: Oxford Commercial	$3.20
Rate for Payer: Qualcare PPO/HMO/WC	$2.40
Rate for Payer: UnitedHealthcare Commercial	$3.20
Rate for Payer: UnitedHealthcare Community & State	$0.39
Rate for Payer: Wellpoint Medicaid Managed Care	$0.42

PROGESTERONE INJ

Facility

$89.00

Hospital Charge Code	60635063
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

PROGESTERONE INJ

Facility

$89.00

Hospital Charge Code	60635063
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

PROGESTERONE OIL MDV 50MG/10ML

Facility

$14.85

Hospital Charge Code	60629834
Hospital Revenue Code	250
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$7.42
Rate for Payer: Aetna Commercial	$5.64
Rate for Payer: Aetna Medicare Advantage	$4.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.79
Rate for Payer: Cigna Commercial	$7.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.46
Rate for Payer: Oxford Commercial	$2.97
Rate for Payer: Qualcare PPO/HMO/WC	$2.23
Rate for Payer: UnitedHealthcare Commercial	$2.97
Rate for Payer: UnitedHealthcare Community & State	$0.36
Rate for Payer: Wellpoint Medicaid Managed Care	$0.39

PROGESTERONE OIL MDV 50MG/10ML

Facility

$14.85

Hospital Charge Code	60629834
Hospital Revenue Code	250
Min. Negotiated Rate	$2.23
Max. Negotiated Rate	$2.23
Rate for Payer: Qualcare PPO/HMO/WC	$2.23

PROGESTERONE RECEPTOR ASSAY

Facility

$770.00

Service Code	HCPCS 84234
Hospital Charge Code	38474007
Hospital Revenue Code	301
Min. Negotiated Rate	$20.41
Max. Negotiated Rate	$385.00
Rate for Payer: Aetna Commercial	$176.47
Rate for Payer: Aetna Medicare Advantage	$210.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$234.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$234.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$64.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$234.20
Rate for Payer: Cigna Commercial	$385.00
Rate for Payer: Cigna Medicare Advantage	$64.88
Rate for Payer: Clover Medicare Advantage	$61.64
Rate for Payer: EmblemHealth Commercial	$194.64
Rate for Payer: Humana Medicare Advantage	$66.83
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$64.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$115.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$51.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$64.88
Rate for Payer: Wellcare Medicare Advantage	$64.88
Rate for Payer: Wellpoint Medicaid Managed Care	$20.41

PROGESTERONE RECEPTOR ASSAY

Facility

$770.00

Service Code	HCPCS 84234
Hospital Charge Code	38474007
Hospital Revenue Code	301
Min. Negotiated Rate	$115.50
Max. Negotiated Rate	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$115.50

PROGESTERONE, SERUM

Facility

$103.25

Service Code	HCPCS 84144
Hospital Charge Code	3002193
Hospital Revenue Code	301
Min. Negotiated Rate	$15.49
Max. Negotiated Rate	$15.49
Rate for Payer: Qualcare PPO/HMO/WC	$15.49

PROGESTERONE, SERUM

Facility

$103.25

Service Code	HCPCS 84144
Hospital Charge Code	3002193
Hospital Revenue Code	301
Min. Negotiated Rate	$2.74
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$56.74
Rate for Payer: Aetna Medicare Advantage	$67.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.30
Rate for Payer: Cigna Commercial	$51.62
Rate for Payer: Cigna Medicare Advantage	$20.86
Rate for Payer: Clover Medicare Advantage	$19.82
Rate for Payer: EmblemHealth Commercial	$62.58
Rate for Payer: Humana Medicare Advantage	$21.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.98
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.49
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.86
Rate for Payer: Wellcare Medicare Advantage	$20.86
Rate for Payer: Wellpoint Medicaid Managed Care	$2.74

PROGESTRONE***

Facility

$78.00

Hospital Charge Code	3012192
Hospital Revenue Code	309
Min. Negotiated Rate	$1.88
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$29.64
Rate for Payer: Aetna Medicare Advantage	$23.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.89
Rate for Payer: Cigna Commercial	$39.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.70
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.88
Rate for Payer: Wellpoint Medicaid Managed Care	$2.07

PROGESTRONE***

Facility

$78.00

Hospital Charge Code	3012192
Hospital Revenue Code	309
Min. Negotiated Rate	$11.70
Max. Negotiated Rate	$11.70
Rate for Payer: Qualcare PPO/HMO/WC	$11.70

PROGESTRONE/50MG/ML

Facility

$56.00

Hospital Charge Code	60634417
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$28.00
Rate for Payer: Aetna Commercial	$21.28
Rate for Payer: Aetna Medicare Advantage	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.28
Rate for Payer: Cigna Commercial	$28.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.80
Rate for Payer: Oxford Commercial	$11.20
Rate for Payer: Qualcare PPO/HMO/WC	$8.40
Rate for Payer: UnitedHealthcare Commercial	$11.20
Rate for Payer: UnitedHealthcare Community & State	$1.35
Rate for Payer: Wellpoint Medicaid Managed Care	$1.48

PROGESTRONE/50MG/ML

Facility

$56.00

Hospital Charge Code	60634417
Hospital Revenue Code	250
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.40

PROGRAF GRANULES 1MG/PKT

Facility

$63.65

Service Code	HCPCS J7507
Hospital Charge Code	606390478
Hospital Revenue Code	636
Min. Negotiated Rate	$9.55
Max. Negotiated Rate	$15.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.40
Rate for Payer: Qualcare PPO/HMO/WC	$9.55

PROGRAF GRANULES 1MG/PKT

Facility

$63.65

Service Code	HCPCS J7507
Hospital Charge Code	606390478
Hospital Revenue Code	636
Min. Negotiated Rate	$1.53
Max. Negotiated Rate	$31.82
Rate for Payer: Aetna Commercial	$24.19
Rate for Payer: Aetna Medicare Advantage	$19.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.23
Rate for Payer: Cigna Commercial	$31.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.40
Rate for Payer: Qualcare PPO/HMO/WC	$9.55
Rate for Payer: UnitedHealthcare Community & State	$1.53
Rate for Payer: Wellpoint Medicaid Managed Care	$1.69

PROGRAMMER

Facility

$8,125.00

Service Code	HCPCS C1787
Hospital Charge Code	270675088
Hospital Revenue Code	272
Min. Negotiated Rate	$195.81
Max. Negotiated Rate	$4,062.50
Rate for Payer: Aetna Commercial	$3,087.50
Rate for Payer: Aetna Medicare Advantage	$2,437.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,071.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,071.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,071.88
Rate for Payer: Cigna Commercial	$4,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,437.50
Rate for Payer: Oxford Commercial	$1,625.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,218.75
Rate for Payer: UnitedHealthcare Commercial	$1,625.00
Rate for Payer: UnitedHealthcare Community & State	$195.81
Rate for Payer: Wellpoint Medicaid Managed Care	$215.31

PROGRAMMER

Facility

$8,125.00

Service Code	HCPCS C1787
Hospital Charge Code	270675088
Hospital Revenue Code	272
Min. Negotiated Rate	$1,218.75
Max. Negotiated Rate	$1,218.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,218.75

PROGRAMMER PATIENT

Facility

$4,500.00

Hospital Charge Code	270648830
Hospital Revenue Code	272
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$675.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

PROGRAMMER PATIENT

Facility

$4,500.00

Hospital Charge Code	270648830
Hospital Revenue Code	272
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,350.00
Rate for Payer: Oxford Commercial	$900.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Commercial	$900.00
Rate for Payer: UnitedHealthcare Community & State	$108.45
Rate for Payer: Wellpoint Medicaid Managed Care	$119.25

PROGRAMMER PATIENT

Facility

$11,975.00

Service Code	HCPCS C1787
Hospital Charge Code	270683893
Hospital Revenue Code	272
Min. Negotiated Rate	$288.60
Max. Negotiated Rate	$5,987.50
Rate for Payer: Aetna Commercial	$4,550.50
Rate for Payer: Aetna Medicare Advantage	$3,592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,053.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,053.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,053.62
Rate for Payer: Cigna Commercial	$5,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,592.50
Rate for Payer: Oxford Commercial	$2,395.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,796.25
Rate for Payer: UnitedHealthcare Commercial	$2,395.00
Rate for Payer: UnitedHealthcare Community & State	$288.60
Rate for Payer: Wellpoint Medicaid Managed Care	$317.34

PROGRAMMER PATIENT

Facility

$11,975.00

Service Code	HCPCS C1787
Hospital Charge Code	270683893
Hospital Revenue Code	272
Min. Negotiated Rate	$1,796.25
Max. Negotiated Rate	$1,796.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,796.25

PROGRAMMER PATIENT 37744

Facility

$4,500.00

Hospital Charge Code	270647430
Hospital Revenue Code	272
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$675.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

PROGRAMMER PATIENT 37744

Facility

$4,500.00

Hospital Charge Code	270647430
Hospital Revenue Code	272
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,350.00
Rate for Payer: Oxford Commercial	$900.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Commercial	$900.00
Rate for Payer: UnitedHealthcare Community & State	$108.45
Rate for Payer: Wellpoint Medicaid Managed Care	$119.25

PROGRAMMER PATIENT EON MINI

Facility

$8,125.00

Service Code	HCPCS C1787
Hospital Charge Code	270642325
Hospital Revenue Code	278
Min. Negotiated Rate	$195.81
Max. Negotiated Rate	$4,062.50
Rate for Payer: Aetna Commercial	$3,087.50
Rate for Payer: Aetna Medicare Advantage	$2,437.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,071.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,071.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,071.88
Rate for Payer: Cigna Commercial	$4,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,966.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,787.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,218.75
Rate for Payer: UnitedHealthcare Community & State	$195.81
Rate for Payer: Wellpoint Medicaid Managed Care	$215.31

Know your out-of-pocket cost for care.

All Charges