Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

QUETIAPINE XR 150MG TAB

Facility

$31.48

Hospital Charge Code	60635782
Hospital Revenue Code	250
Min. Negotiated Rate	$4.72
Max. Negotiated Rate	$4.72
Rate for Payer: Qualcare PPO/HMO/WC	$4.72

QUETIAPINE XR 150MG TAB

Facility

$31.48

Hospital Charge Code	60635782
Hospital Revenue Code	250
Min. Negotiated Rate	$0.76
Max. Negotiated Rate	$15.74
Rate for Payer: Aetna Commercial	$11.96
Rate for Payer: Aetna Medicare Advantage	$9.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.03
Rate for Payer: Cigna Commercial	$15.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.44
Rate for Payer: Oxford Commercial	$6.30
Rate for Payer: Qualcare PPO/HMO/WC	$4.72
Rate for Payer: UnitedHealthcare Commercial	$6.30
Rate for Payer: UnitedHealthcare Community & State	$0.76
Rate for Payer: Wellpoint Medicaid Managed Care	$0.83

QUETIAPINE XR 200 MG TAB

Facility

$120.80

Service Code	NDC 310028239
Hospital Charge Code	60630020
Hospital Revenue Code	250
Min. Negotiated Rate	$18.12
Max. Negotiated Rate	$18.12
Rate for Payer: Qualcare PPO/HMO/WC	$18.12

QUETIAPINE XR 200 MG TAB

Facility

$120.80

Service Code	NDC 310028239
Hospital Charge Code	60630020
Hospital Revenue Code	250
Min. Negotiated Rate	$2.91
Max. Negotiated Rate	$60.40
Rate for Payer: Aetna Commercial	$45.90
Rate for Payer: Aetna Medicare Advantage	$36.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.80
Rate for Payer: Cigna Commercial	$60.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.24
Rate for Payer: Oxford Commercial	$24.16
Rate for Payer: Qualcare PPO/HMO/WC	$18.12
Rate for Payer: UnitedHealthcare Commercial	$24.16
Rate for Payer: UnitedHealthcare Community & State	$2.91
Rate for Payer: Wellpoint Medicaid Managed Care	$3.20

QUETIAPINE XR 50 MG TAB

Facility

$61.10

Service Code	NDC 310028060
Hospital Charge Code	60630018
Hospital Revenue Code	250
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$30.55
Rate for Payer: Aetna Commercial	$23.22
Rate for Payer: Aetna Medicare Advantage	$18.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.58
Rate for Payer: Cigna Commercial	$30.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.33
Rate for Payer: Oxford Commercial	$12.22
Rate for Payer: Qualcare PPO/HMO/WC	$9.16
Rate for Payer: UnitedHealthcare Commercial	$12.22
Rate for Payer: UnitedHealthcare Community & State	$1.47
Rate for Payer: Wellpoint Medicaid Managed Care	$1.62

QUETIAPINE XR 50 MG TAB

Facility

$61.10

Service Code	NDC 310028060
Hospital Charge Code	60630018
Hospital Revenue Code	250
Min. Negotiated Rate	$9.16
Max. Negotiated Rate	$9.16
Rate for Payer: Qualcare PPO/HMO/WC	$9.16

QUIBRON/CAP

Facility

$3.00

Hospital Charge Code	60633796
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

QUIBRON/CAP

Facility

$3.00

Hospital Charge Code	60633796
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

QUICKANCHOR MINI PLUS

Facility

$2,310.00

Hospital Charge Code	270671154
Hospital Revenue Code	278
Min. Negotiated Rate	$55.67
Max. Negotiated Rate	$1,155.00
Rate for Payer: Aetna Commercial	$877.80
Rate for Payer: Aetna Medicare Advantage	$693.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$589.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$589.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$462.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$589.05
Rate for Payer: Cigna Commercial	$1,155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$559.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$508.20
Rate for Payer: Qualcare PPO/HMO/WC	$346.50
Rate for Payer: UnitedHealthcare Community & State	$55.67
Rate for Payer: Wellpoint Medicaid Managed Care	$61.22

QUICKANCHOR MINI PLUS

Facility

$2,310.00

Hospital Charge Code	270671154
Hospital Revenue Code	278
Min. Negotiated Rate	$346.50
Max. Negotiated Rate	$559.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$462.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$559.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$508.20
Rate for Payer: Qualcare PPO/HMO/WC	$346.50

QUICKANCHOR MIRO PLUS #4/0 SUT

Facility

$2,335.00

Service Code	HCPCS C1713
Hospital Charge Code	270680084
Hospital Revenue Code	278
Min. Negotiated Rate	$350.25
Max. Negotiated Rate	$565.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$467.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$565.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$513.70
Rate for Payer: Qualcare PPO/HMO/WC	$350.25

QUICKANCHOR MIRO PLUS #4/0 SUT

Facility

$2,335.00

Service Code	HCPCS C1713
Hospital Charge Code	270680084
Hospital Revenue Code	278
Min. Negotiated Rate	$56.27
Max. Negotiated Rate	$1,167.50
Rate for Payer: Aetna Commercial	$887.30
Rate for Payer: Aetna Medicare Advantage	$700.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$595.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$595.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$467.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$595.42
Rate for Payer: Cigna Commercial	$1,167.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$565.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$513.70
Rate for Payer: Qualcare PPO/HMO/WC	$350.25
Rate for Payer: UnitedHealthcare Community & State	$56.27
Rate for Payer: Wellpoint Medicaid Managed Care	$61.88

QUICK ANCHOR MITEK SZ 2

Facility

$1,449.65

Hospital Charge Code	270605201
Hospital Revenue Code	278
Min. Negotiated Rate	$34.94
Max. Negotiated Rate	$724.83
Rate for Payer: Aetna Commercial	$550.87
Rate for Payer: Aetna Medicare Advantage	$434.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$369.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$369.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$289.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$369.66
Rate for Payer: Cigna Commercial	$724.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$318.92
Rate for Payer: Qualcare PPO/HMO/WC	$217.45
Rate for Payer: UnitedHealthcare Community & State	$34.94
Rate for Payer: Wellpoint Medicaid Managed Care	$38.42

QUICK ANCHOR MITEK SZ 2

Facility

$1,449.65

Hospital Charge Code	270605201
Hospital Revenue Code	278
Min. Negotiated Rate	$217.45
Max. Negotiated Rate	$350.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$289.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$318.92
Rate for Payer: Qualcare PPO/HMO/WC	$217.45

QUICKANCHOR W/0 ORTHOCORD,BIT

Facility

$2,335.00

Hospital Charge Code	270669931
Hospital Revenue Code	278
Min. Negotiated Rate	$350.25
Max. Negotiated Rate	$565.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$467.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$565.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$513.70
Rate for Payer: Qualcare PPO/HMO/WC	$350.25

QUICKANCHOR W/0 ORTHOCORD,BIT

Facility

$2,335.00

Hospital Charge Code	270669931
Hospital Revenue Code	278
Min. Negotiated Rate	$56.27
Max. Negotiated Rate	$1,167.50
Rate for Payer: Aetna Commercial	$887.30
Rate for Payer: Aetna Medicare Advantage	$700.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$595.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$595.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$467.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$595.42
Rate for Payer: Cigna Commercial	$1,167.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$565.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$513.70
Rate for Payer: Qualcare PPO/HMO/WC	$350.25
Rate for Payer: UnitedHealthcare Community & State	$56.27
Rate for Payer: Wellpoint Medicaid Managed Care	$61.88

QUICKCROSS .035X135cm

Facility

$167.00

Hospital Charge Code	270636735
Hospital Revenue Code	278
Min. Negotiated Rate	$25.05
Max. Negotiated Rate	$40.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$36.74
Rate for Payer: Qualcare PPO/HMO/WC	$25.05

QUICKCROSS .035X135cm

Facility

$167.00

Hospital Charge Code	270636735
Hospital Revenue Code	278
Min. Negotiated Rate	$4.02
Max. Negotiated Rate	$83.50
Rate for Payer: Aetna Commercial	$63.46
Rate for Payer: Aetna Medicare Advantage	$50.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.59
Rate for Payer: Cigna Commercial	$83.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$36.74
Rate for Payer: Qualcare PPO/HMO/WC	$25.05
Rate for Payer: UnitedHealthcare Community & State	$4.02
Rate for Payer: Wellpoint Medicaid Managed Care	$4.43

QUICK FILL TUBE(SYRINGE)

Facility

$11.00

Hospital Charge Code	270331483
Hospital Revenue Code	272
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$5.50
Rate for Payer: Aetna Commercial	$4.18
Rate for Payer: Aetna Medicare Advantage	$3.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.81
Rate for Payer: Cigna Commercial	$5.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.30
Rate for Payer: Oxford Commercial	$2.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.65
Rate for Payer: UnitedHealthcare Commercial	$2.20
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.29

QUICK FILL TUBE(SYRINGE)

Facility

$11.00

Hospital Charge Code	270331483
Hospital Revenue Code	272
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$1.65
Rate for Payer: Qualcare PPO/HMO/WC	$1.65

QUICKFIX 10MM SCREW

Facility

$550.00

Hospital Charge Code	270339443
Hospital Revenue Code	278
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

QUICKFIX 10MM SCREW

Facility

$550.00

Hospital Charge Code	270339443
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$133.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

QUICK RELEASE KIT

Facility

$2,000.00

Hospital Charge Code	270678322
Hospital Revenue Code	272
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

QUICK RELEASE KIT

Facility

$2,000.00

Hospital Charge Code	270678322
Hospital Revenue Code	272
Min. Negotiated Rate	$48.20
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.00
Rate for Payer: Oxford Commercial	$400.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Commercial	$400.00
Rate for Payer: UnitedHealthcare Community & State	$48.20
Rate for Payer: Wellpoint Medicaid Managed Care	$53.00

QUICKSET 16CC

Facility

$14,962.50

Hospital Charge Code	270667209
Hospital Revenue Code	272
Min. Negotiated Rate	$360.60
Max. Negotiated Rate	$7,481.25
Rate for Payer: Aetna Commercial	$5,685.75
Rate for Payer: Aetna Medicare Advantage	$4,488.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,815.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,815.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,815.44
Rate for Payer: Cigna Commercial	$7,481.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,488.75
Rate for Payer: Oxford Commercial	$2,992.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,244.38
Rate for Payer: UnitedHealthcare Commercial	$2,992.50
Rate for Payer: UnitedHealthcare Community & State	$360.60
Rate for Payer: Wellpoint Medicaid Managed Care	$396.51

Know your out-of-pocket cost for care.

All Charges