Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ROMIPLOSTIM 10MCG VIAL

Facility

$11,258.81

Service Code	HCPCS J2796
Hospital Charge Code	60630031
Hospital Revenue Code	636
Min. Negotiated Rate	$271.34
Max. Negotiated Rate	$5,629.40
Rate for Payer: Aetna Commercial	$4,278.35
Rate for Payer: Aetna Medicare Advantage	$3,377.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,871.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,871.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,871.00
Rate for Payer: Cigna Commercial	$5,629.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,724.63
Rate for Payer: Qualcare PPO/HMO/WC	$1,688.82
Rate for Payer: UnitedHealthcare Community & State	$271.34
Rate for Payer: Wellpoint Medicaid Managed Care	$298.36

ROMIPLOSTIM 10MCG VIAL

Facility

$11,258.81

Service Code	HCPCS J2796
Hospital Charge Code	60630031
Hospital Revenue Code	636
Min. Negotiated Rate	$1,688.82
Max. Negotiated Rate	$2,724.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,724.63
Rate for Payer: Qualcare PPO/HMO/WC	$1,688.82

RONDEC/30ML

Facility

$89.00

Hospital Charge Code	60633846
Hospital Revenue Code	250
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	$26.70
Rate for Payer: Oxford Commercial	$17.80
Rate for Payer: Qualcare PPO/HMO/WC	$13.35
Rate for Payer: UnitedHealthcare Commercial	$17.80
Rate for Payer: UnitedHealthcare Community & State	$2.14
Rate for Payer: Wellpoint Medicaid Managed Care	$2.36

RONDEC/30ML

Facility

$89.00

Hospital Charge Code	60633846
Hospital Revenue Code	250
Min. Negotiated Rate	$13.35
Max. Negotiated Rate	$13.35
Rate for Payer: Qualcare PPO/HMO/WC	$13.35

RONDEC/480ML

Facility

$110.00

Hospital Charge Code	60633845
Hospital Revenue Code	250
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	$33.00
Rate for Payer: Oxford Commercial	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$22.00
Rate for Payer: UnitedHealthcare Community & State	$2.65
Rate for Payer: Wellpoint Medicaid Managed Care	$2.92

RONDEC/480ML

Facility

$110.00

Hospital Charge Code	60633845
Hospital Revenue Code	250
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

RONDEC-DM/120ML

Facility

$13.00

Hospital Charge Code	60633847
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

RONDEC-DM/120ML

Facility

$13.00

Hospital Charge Code	60633847
Hospital Revenue Code	250
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$4.94
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$2.60
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

RONDEC DM 30ML

Facility

$4.00

Hospital Charge Code	60635482
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

RONDEC DM 30ML

Facility

$4.00

Hospital Charge Code	60635482
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

RONDEC-DM/30ML

Facility

$125.00

Hospital Charge Code	60633849
Hospital Revenue Code	250
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.50
Rate for Payer: Oxford Commercial	$25.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$25.00
Rate for Payer: UnitedHealthcare Community & State	$3.01
Rate for Payer: Wellpoint Medicaid Managed Care	$3.31

RONDEC-DM/30ML

Facility

$125.00

Hospital Charge Code	60633849
Hospital Revenue Code	250
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

RONDEC-DM/480ML

Facility

$172.00

Hospital Charge Code	60633848
Hospital Revenue Code	250
Min. Negotiated Rate	$4.15
Max. Negotiated Rate	$86.00
Rate for Payer: Aetna Commercial	$65.36
Rate for Payer: Aetna Medicare Advantage	$51.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.86
Rate for Payer: Cigna Commercial	$86.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.60
Rate for Payer: Oxford Commercial	$34.40
Rate for Payer: Qualcare PPO/HMO/WC	$25.80
Rate for Payer: UnitedHealthcare Commercial	$34.40
Rate for Payer: UnitedHealthcare Community & State	$4.15
Rate for Payer: Wellpoint Medicaid Managed Care	$4.56

RONDEC-DM/480ML

Facility

$172.00

Hospital Charge Code	60633848
Hospital Revenue Code	250
Min. Negotiated Rate	$25.80
Max. Negotiated Rate	$25.80
Rate for Payer: Qualcare PPO/HMO/WC	$25.80

RONGEURS LEMPERT

Facility

$2,652.02

Hospital Charge Code	270659124
Hospital Revenue Code	278
Min. Negotiated Rate	$397.80
Max. Negotiated Rate	$641.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$530.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$641.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$583.44
Rate for Payer: Qualcare PPO/HMO/WC	$397.80

RONGEURS LEMPERT

Facility

$2,652.02

Hospital Charge Code	270659124
Hospital Revenue Code	278
Min. Negotiated Rate	$63.91
Max. Negotiated Rate	$1,326.01
Rate for Payer: Aetna Commercial	$1,007.77
Rate for Payer: Aetna Medicare Advantage	$795.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$676.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$676.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$530.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$676.27
Rate for Payer: Cigna Commercial	$1,326.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$641.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$583.44
Rate for Payer: Qualcare PPO/HMO/WC	$397.80
Rate for Payer: UnitedHealthcare Community & State	$63.91
Rate for Payer: Wellpoint Medicaid Managed Care	$70.28

RONGEURS STRAIGHT LOVE-GRUENWA

Facility

$2,680.40

Hospital Charge Code	270665978
Hospital Revenue Code	270
Min. Negotiated Rate	$64.60
Max. Negotiated Rate	$1,340.20
Rate for Payer: Aetna Commercial	$1,018.55
Rate for Payer: Aetna Medicare Advantage	$804.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$683.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$683.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$683.50
Rate for Payer: Cigna Commercial	$1,340.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.12
Rate for Payer: Oxford Commercial	$536.08
Rate for Payer: Qualcare PPO/HMO/WC	$402.06
Rate for Payer: UnitedHealthcare Commercial	$536.08
Rate for Payer: UnitedHealthcare Community & State	$64.60
Rate for Payer: Wellpoint Medicaid Managed Care	$71.03

RONGEURS STRAIGHT LOVE-GRUENWA

Facility

$2,680.40

Hospital Charge Code	270665978
Hospital Revenue Code	270
Min. Negotiated Rate	$402.06
Max. Negotiated Rate	$402.06
Rate for Payer: Qualcare PPO/HMO/WC	$402.06

RONGEURS STRAIGHT SPURLING

Facility

$2,680.40

Hospital Charge Code	270665977
Hospital Revenue Code	270
Min. Negotiated Rate	$64.60
Max. Negotiated Rate	$1,340.20
Rate for Payer: Aetna Commercial	$1,018.55
Rate for Payer: Aetna Medicare Advantage	$804.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$683.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$683.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$683.50
Rate for Payer: Cigna Commercial	$1,340.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.12
Rate for Payer: Oxford Commercial	$536.08
Rate for Payer: Qualcare PPO/HMO/WC	$402.06
Rate for Payer: UnitedHealthcare Commercial	$536.08
Rate for Payer: UnitedHealthcare Community & State	$64.60
Rate for Payer: Wellpoint Medicaid Managed Care	$71.03

RONGEURS STRAIGHT SPURLING

Facility

$2,680.40

Hospital Charge Code	270665977
Hospital Revenue Code	270
Min. Negotiated Rate	$402.06
Max. Negotiated Rate	$402.06
Rate for Payer: Qualcare PPO/HMO/WC	$402.06

RONGUER 2X10MM, 7IN

Facility

$2,680.40

Hospital Charge Code	270659125
Hospital Revenue Code	278
Min. Negotiated Rate	$64.60
Max. Negotiated Rate	$1,340.20
Rate for Payer: Aetna Commercial	$1,018.55
Rate for Payer: Aetna Medicare Advantage	$804.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$683.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$683.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$536.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$683.50
Rate for Payer: Cigna Commercial	$1,340.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$648.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$589.69
Rate for Payer: Qualcare PPO/HMO/WC	$402.06
Rate for Payer: UnitedHealthcare Community & State	$64.60
Rate for Payer: Wellpoint Medicaid Managed Care	$71.03

RONGUER 2X10MM, 7IN

Facility

$2,680.40

Hospital Charge Code	270659125
Hospital Revenue Code	278
Min. Negotiated Rate	$402.06
Max. Negotiated Rate	$648.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$536.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$648.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$589.69
Rate for Payer: Qualcare PPO/HMO/WC	$402.06

RONGUER 6X12MM

Facility

$3,200.00

Hospital Charge Code	270659123
Hospital Revenue Code	278
Min. Negotiated Rate	$480.00
Max. Negotiated Rate	$774.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$640.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$774.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$704.00
Rate for Payer: Qualcare PPO/HMO/WC	$480.00

RONGUER 6X12MM

Facility

$3,200.00

Hospital Charge Code	270659123
Hospital Revenue Code	278
Min. Negotiated Rate	$77.12
Max. Negotiated Rate	$1,600.00
Rate for Payer: Aetna Commercial	$1,216.00
Rate for Payer: Aetna Medicare Advantage	$960.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$816.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$816.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$640.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$816.00
Rate for Payer: Cigna Commercial	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$774.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$704.00
Rate for Payer: Qualcare PPO/HMO/WC	$480.00
Rate for Payer: UnitedHealthcare Community & State	$77.12
Rate for Payer: Wellpoint Medicaid Managed Care	$84.80

RONGUER KERRISON 3M

Facility

$5,439.75

Hospital Charge Code	270664164
Hospital Revenue Code	270
Min. Negotiated Rate	$131.10
Max. Negotiated Rate	$2,719.88
Rate for Payer: Aetna Commercial	$2,067.11
Rate for Payer: Aetna Medicare Advantage	$1,631.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,387.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,387.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,387.14
Rate for Payer: Cigna Commercial	$2,719.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.92
Rate for Payer: Oxford Commercial	$1,087.95
Rate for Payer: Qualcare PPO/HMO/WC	$815.96
Rate for Payer: UnitedHealthcare Commercial	$1,087.95
Rate for Payer: UnitedHealthcare Community & State	$131.10
Rate for Payer: Wellpoint Medicaid Managed Care	$144.15

Know your out-of-pocket cost for care.

All Charges