Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ROCEPHIN/10GM

Facility

$344.00

Hospital Charge Code	60633842
Hospital Revenue Code	636
Min. Negotiated Rate	$51.60
Max. Negotiated Rate	$83.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.25
Rate for Payer: Qualcare PPO/HMO/WC	$51.60

ROCEPHIN/1GM

Facility

$196.00

Hospital Charge Code	60633841
Hospital Revenue Code	636
Min. Negotiated Rate	$29.40
Max. Negotiated Rate	$47.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.43
Rate for Payer: Qualcare PPO/HMO/WC	$29.40

ROCEPHIN/1GM

Facility

$196.00

Hospital Charge Code	60633841
Hospital Revenue Code	636
Min. Negotiated Rate	$4.72
Max. Negotiated Rate	$98.00
Rate for Payer: Aetna Commercial	$74.48
Rate for Payer: Aetna Medicare Advantage	$58.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.98
Rate for Payer: Cigna Commercial	$98.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.43
Rate for Payer: Qualcare PPO/HMO/WC	$29.40
Rate for Payer: UnitedHealthcare Community & State	$4.72
Rate for Payer: Wellpoint Medicaid Managed Care	$5.19

ROCEPHIN 1GM/50ML

Facility

$200.00

Hospital Charge Code	60635028
Hospital Revenue Code	636
Min. Negotiated Rate	$4.82
Max. Negotiated Rate	$100.00
Rate for Payer: Aetna Commercial	$76.00
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.00
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.40
Rate for Payer: Qualcare PPO/HMO/WC	$30.00
Rate for Payer: UnitedHealthcare Community & State	$4.82
Rate for Payer: Wellpoint Medicaid Managed Care	$5.30

ROCEPHIN 1GM/50ML

Facility

$200.00

Hospital Charge Code	60635028
Hospital Revenue Code	636
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$48.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.40
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

ROCEPHIN 1GM ADD/D5W

Facility

$348.00

Hospital Charge Code	60635004
Hospital Revenue Code	636
Min. Negotiated Rate	$52.20
Max. Negotiated Rate	$84.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.22
Rate for Payer: Qualcare PPO/HMO/WC	$52.20

ROCEPHIN 1GM ADD/D5W

Facility

$348.00

Hospital Charge Code	60635004
Hospital Revenue Code	636
Min. Negotiated Rate	$8.39
Max. Negotiated Rate	$174.00
Rate for Payer: Aetna Commercial	$132.24
Rate for Payer: Aetna Medicare Advantage	$104.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.74
Rate for Payer: Cigna Commercial	$174.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.22
Rate for Payer: Qualcare PPO/HMO/WC	$52.20
Rate for Payer: UnitedHealthcare Community & State	$8.39
Rate for Payer: Wellpoint Medicaid Managed Care	$9.22

ROCEPHIN 1 GM ADD/NS

Facility

$379.00

Hospital Charge Code	60635007
Hospital Revenue Code	636
Min. Negotiated Rate	$9.13
Max. Negotiated Rate	$189.50
Rate for Payer: Aetna Commercial	$144.02
Rate for Payer: Aetna Medicare Advantage	$113.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.64
Rate for Payer: Cigna Commercial	$189.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.72
Rate for Payer: Qualcare PPO/HMO/WC	$56.85
Rate for Payer: UnitedHealthcare Community & State	$9.13
Rate for Payer: Wellpoint Medicaid Managed Care	$10.04

ROCEPHIN 1 GM ADD/NS

Facility

$379.00

Hospital Charge Code	60635007
Hospital Revenue Code	636
Min. Negotiated Rate	$56.85
Max. Negotiated Rate	$91.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.72
Rate for Payer: Qualcare PPO/HMO/WC	$56.85

ROCEPHIN 2GM/50ML

Facility

$379.00

Hospital Charge Code	60635029
Hospital Revenue Code	636
Min. Negotiated Rate	$56.85
Max. Negotiated Rate	$91.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.72
Rate for Payer: Qualcare PPO/HMO/WC	$56.85

ROCEPHIN 2GM/50ML

Facility

$379.00

Hospital Charge Code	60635029
Hospital Revenue Code	636
Min. Negotiated Rate	$9.13
Max. Negotiated Rate	$189.50
Rate for Payer: Aetna Commercial	$144.02
Rate for Payer: Aetna Medicare Advantage	$113.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.64
Rate for Payer: Cigna Commercial	$189.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.72
Rate for Payer: Qualcare PPO/HMO/WC	$56.85
Rate for Payer: UnitedHealthcare Community & State	$9.13
Rate for Payer: Wellpoint Medicaid Managed Care	$10.04

ROCEPHIN 2GM ADD/D5W

Facility

$348.00

Hospital Charge Code	60635005
Hospital Revenue Code	636
Min. Negotiated Rate	$52.20
Max. Negotiated Rate	$84.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.22
Rate for Payer: Qualcare PPO/HMO/WC	$52.20

ROCEPHIN 2GM ADD/D5W

Facility

$348.00

Hospital Charge Code	60635005
Hospital Revenue Code	636
Min. Negotiated Rate	$8.39
Max. Negotiated Rate	$174.00
Rate for Payer: Aetna Commercial	$132.24
Rate for Payer: Aetna Medicare Advantage	$104.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.74
Rate for Payer: Cigna Commercial	$174.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.22
Rate for Payer: Qualcare PPO/HMO/WC	$52.20
Rate for Payer: UnitedHealthcare Community & State	$8.39
Rate for Payer: Wellpoint Medicaid Managed Care	$9.22

ROCEPHIN/500MG

Facility

$110.00

Hospital Charge Code	60633840
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

ROCEPHIN/500MG

Facility

$110.00

Hospital Charge Code	60633840
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

ROCKY MOUNTAIN SPOT IGG,IGM

Facility

$184.00

Service Code	HCPCS 86757
Hospital Charge Code	3000367
Hospital Revenue Code	300
Min. Negotiated Rate	$27.60
Max. Negotiated Rate	$27.60
Rate for Payer: Qualcare PPO/HMO/WC	$27.60

ROCKY MOUNTAIN SPOT IGG,IGM

Facility

$184.00

Service Code	HCPCS 86757
Hospital Charge Code	3000367
Hospital Revenue Code	300
Min. Negotiated Rate	$4.88
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$52.63
Rate for Payer: Aetna Medicare Advantage	$62.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.85
Rate for Payer: Cigna Commercial	$92.00
Rate for Payer: Cigna Medicare Advantage	$19.35
Rate for Payer: Clover Medicare Advantage	$18.38
Rate for Payer: EmblemHealth Commercial	$58.05
Rate for Payer: Humana Medicare Advantage	$19.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$15.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.35
Rate for Payer: Wellcare Medicare Advantage	$19.35
Rate for Payer: Wellpoint Medicaid Managed Care	$4.88

ROCKY MOUNTAIN SPOTTED FEVER

Facility

$128.00

Service Code	HCPCS 86000
Hospital Charge Code	3006889
Hospital Revenue Code	305
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

ROCKY MOUNTAIN SPOTTED FEVER

Facility

$128.00

Service Code	HCPCS 86000
Hospital Charge Code	3006889
Hospital Revenue Code	305
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$18.99
Rate for Payer: Aetna Medicare Advantage	$22.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.20
Rate for Payer: Cigna Commercial	$64.00
Rate for Payer: Cigna Medicare Advantage	$6.98
Rate for Payer: Clover Medicare Advantage	$6.63
Rate for Payer: EmblemHealth Commercial	$20.94
Rate for Payer: Humana Medicare Advantage	$7.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.98
Rate for Payer: Wellcare Medicare Advantage	$6.98
Rate for Payer: Wellpoint Medicaid Managed Care	$3.39

ROCKY MTN SPOTTED FEV IGG RN

Facility

$100.00

Service Code	HCPCS 86757
Hospital Charge Code	3006895
Hospital Revenue Code	302
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$52.63
Rate for Payer: Aetna Medicare Advantage	$62.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.85
Rate for Payer: Cigna Commercial	$50.00
Rate for Payer: Cigna Medicare Advantage	$19.35
Rate for Payer: Clover Medicare Advantage	$18.38
Rate for Payer: EmblemHealth Commercial	$58.05
Rate for Payer: Humana Medicare Advantage	$19.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$15.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.35
Rate for Payer: Wellcare Medicare Advantage	$19.35
Rate for Payer: Wellpoint Medicaid Managed Care	$2.65

ROCKY MTN SPOTTED FEV IGG RN

Facility

$100.00

Service Code	HCPCS 86757
Hospital Charge Code	3006895
Hospital Revenue Code	302
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

ROCKY MTN SPOTTED FEV IGM

Facility

$100.00

Service Code	HCPCS 86757
Hospital Charge Code	3006890
Hospital Revenue Code	302
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

ROCKY MTN SPOTTED FEV IGM

Facility

$100.00

Service Code	HCPCS 86757
Hospital Charge Code	3006890
Hospital Revenue Code	302
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$52.63
Rate for Payer: Aetna Medicare Advantage	$62.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.85
Rate for Payer: Cigna Commercial	$50.00
Rate for Payer: Cigna Medicare Advantage	$19.35
Rate for Payer: Clover Medicare Advantage	$18.38
Rate for Payer: EmblemHealth Commercial	$58.05
Rate for Payer: Humana Medicare Advantage	$19.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$15.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.35
Rate for Payer: Wellcare Medicare Advantage	$19.35
Rate for Payer: Wellpoint Medicaid Managed Care	$2.65

ROCURONIUM 50 MG/5ML INJ

Facility

$170.25

Service Code	NDC 52045015
Hospital Charge Code	60627490
Hospital Revenue Code	250
Min. Negotiated Rate	$25.54
Max. Negotiated Rate	$25.54
Rate for Payer: Qualcare PPO/HMO/WC	$25.54

ROCURONIUM 50 MG/5ML INJ

Facility

$170.25

Service Code	NDC 52045015
Hospital Charge Code	60627490
Hospital Revenue Code	250
Min. Negotiated Rate	$4.10
Max. Negotiated Rate	$85.12
Rate for Payer: Aetna Commercial	$64.69
Rate for Payer: Aetna Medicare Advantage	$51.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.41
Rate for Payer: Cigna Commercial	$85.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.08
Rate for Payer: Oxford Commercial	$34.05
Rate for Payer: Qualcare PPO/HMO/WC	$25.54
Rate for Payer: UnitedHealthcare Commercial	$34.05
Rate for Payer: UnitedHealthcare Community & State	$4.10
Rate for Payer: Wellpoint Medicaid Managed Care	$4.51

Know your out-of-pocket cost for care.

All Charges