Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ROSIDIAL SSB 6X

Facility

$26.85

Hospital Charge Code	270636424
Hospital Revenue Code	271
Min. Negotiated Rate	$4.03
Max. Negotiated Rate	$4.03
Rate for Payer: Qualcare PPO/HMO/WC	$4.03

ROSIDIAL SSB 6X

Facility

$26.85

Hospital Charge Code	270636424
Hospital Revenue Code	271
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$13.43
Rate for Payer: Aetna Commercial	$10.20
Rate for Payer: Aetna Medicare Advantage	$8.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.85
Rate for Payer: Cigna Commercial	$13.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.05
Rate for Payer: Oxford Commercial	$5.37
Rate for Payer: Qualcare PPO/HMO/WC	$4.03
Rate for Payer: UnitedHealthcare Commercial	$5.37
Rate for Payer: UnitedHealthcare Community & State	$0.65
Rate for Payer: Wellpoint Medicaid Managed Care	$0.71

ROSIDIAL SSB 6X

Facility

$33.95

Hospital Charge Code	270636425
Hospital Revenue Code	271
Min. Negotiated Rate	$5.09
Max. Negotiated Rate	$5.09
Rate for Payer: Qualcare PPO/HMO/WC	$5.09

ROSIDIAL SSB 6X

Facility

$33.95

Hospital Charge Code	270636425
Hospital Revenue Code	271
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$16.98
Rate for Payer: Aetna Commercial	$12.90
Rate for Payer: Aetna Medicare Advantage	$10.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.66
Rate for Payer: Cigna Commercial	$16.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.19
Rate for Payer: Oxford Commercial	$6.79
Rate for Payer: Qualcare PPO/HMO/WC	$5.09
Rate for Payer: UnitedHealthcare Commercial	$6.79
Rate for Payer: UnitedHealthcare Community & State	$0.82
Rate for Payer: Wellpoint Medicaid Managed Care	$0.90

ROSIGLITAZONE 2 MG TAB

Facility

$9.65

Hospital Charge Code	60629180
Hospital Revenue Code	250
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$4.83
Rate for Payer: Aetna Commercial	$3.67
Rate for Payer: Aetna Medicare Advantage	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.46
Rate for Payer: Cigna Commercial	$4.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.90
Rate for Payer: Oxford Commercial	$1.93
Rate for Payer: Qualcare PPO/HMO/WC	$1.45
Rate for Payer: UnitedHealthcare Commercial	$1.93
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

ROSIGLITAZONE 2 MG TAB

Facility

$9.65

Hospital Charge Code	60629180
Hospital Revenue Code	250
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.45

ROSIGLITAZONE 4 MG TAB

Facility

$20.85

Hospital Charge Code	60629053
Hospital Revenue Code	250
Min. Negotiated Rate	$3.13
Max. Negotiated Rate	$3.13
Rate for Payer: Qualcare PPO/HMO/WC	$3.13

ROSIGLITAZONE 4 MG TAB

Facility

$20.85

Hospital Charge Code	60629053
Hospital Revenue Code	250
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$10.43
Rate for Payer: Aetna Commercial	$7.92
Rate for Payer: Aetna Medicare Advantage	$6.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.32
Rate for Payer: Cigna Commercial	$10.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.25
Rate for Payer: Oxford Commercial	$4.17
Rate for Payer: Qualcare PPO/HMO/WC	$3.13
Rate for Payer: UnitedHealthcare Commercial	$4.17
Rate for Payer: UnitedHealthcare Community & State	$0.50
Rate for Payer: Wellpoint Medicaid Managed Care	$0.55

ROSIGLITAZONE 8 MG TAB

Facility

$37.65

Hospital Charge Code	60629056
Hospital Revenue Code	250
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$18.82
Rate for Payer: Aetna Commercial	$14.31
Rate for Payer: Aetna Medicare Advantage	$11.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.60
Rate for Payer: Cigna Commercial	$18.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.29
Rate for Payer: Oxford Commercial	$7.53
Rate for Payer: Qualcare PPO/HMO/WC	$5.65
Rate for Payer: UnitedHealthcare Commercial	$7.53
Rate for Payer: UnitedHealthcare Community & State	$0.91
Rate for Payer: Wellpoint Medicaid Managed Care	$1.00

ROSIGLITAZONE 8 MG TAB

Facility

$37.65

Hospital Charge Code	60629056
Hospital Revenue Code	250
Min. Negotiated Rate	$5.65
Max. Negotiated Rate	$5.65
Rate for Payer: Qualcare PPO/HMO/WC	$5.65

ROSS REPLCMNT GASTROST TUBE***

Facility

$348.00

Hospital Charge Code	2300655
Hospital Revenue Code	279
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	$104.40
Rate for Payer: Oxford Commercial	$69.60
Rate for Payer: Qualcare PPO/HMO/WC	$52.20
Rate for Payer: UnitedHealthcare Commercial	$69.60
Rate for Payer: UnitedHealthcare Community & State	$8.39
Rate for Payer: Wellpoint Medicaid Managed Care	$9.22

ROSS REPLCMNT GASTROST TUBE***

Facility

$348.00

Hospital Charge Code	2300655
Hospital Revenue Code	279
Min. Negotiated Rate	$52.20
Max. Negotiated Rate	$52.20
Rate for Payer: Qualcare PPO/HMO/WC	$52.20

ROSUVASTATIN CALCIUM 40MG TAB

Facility

$59.90

Service Code	NDC 16729028715
Hospital Charge Code	606390536
Hospital Revenue Code	250
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$29.95
Rate for Payer: Aetna Commercial	$22.76
Rate for Payer: Aetna Medicare Advantage	$17.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.27
Rate for Payer: Cigna Commercial	$29.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.97
Rate for Payer: Oxford Commercial	$11.98
Rate for Payer: Qualcare PPO/HMO/WC	$8.98
Rate for Payer: UnitedHealthcare Commercial	$11.98
Rate for Payer: UnitedHealthcare Community & State	$1.44
Rate for Payer: Wellpoint Medicaid Managed Care	$1.59

ROSUVASTATIN CALCIUM 40MG TAB

Facility

$59.90

Service Code	NDC 16729028715
Hospital Charge Code	606390536
Hospital Revenue Code	250
Min. Negotiated Rate	$8.98
Max. Negotiated Rate	$8.98
Rate for Payer: Qualcare PPO/HMO/WC	$8.98

ROTABLE SNARES

Facility

$90.66

Hospital Charge Code	270663898
Hospital Revenue Code	272
Min. Negotiated Rate	$13.60
Max. Negotiated Rate	$13.60
Rate for Payer: Qualcare PPO/HMO/WC	$13.60

ROTABLE SNARES

Facility

$90.66

Hospital Charge Code	270663898
Hospital Revenue Code	272
Min. Negotiated Rate	$2.18
Max. Negotiated Rate	$45.33
Rate for Payer: Aetna Commercial	$34.45
Rate for Payer: Aetna Medicare Advantage	$27.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.12
Rate for Payer: Cigna Commercial	$45.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.20
Rate for Payer: Oxford Commercial	$18.13
Rate for Payer: Qualcare PPO/HMO/WC	$13.60
Rate for Payer: UnitedHealthcare Commercial	$18.13
Rate for Payer: UnitedHealthcare Community & State	$2.18
Rate for Payer: Wellpoint Medicaid Managed Care	$2.40

ROTARIX 2ML(ROTAVIRUS)2 D ORAL

Facility

$672.14

Service Code	HCPCS 90681
Hospital Charge Code	83652615
Hospital Revenue Code	636
Min. Negotiated Rate	$100.82
Max. Negotiated Rate	$162.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.66
Rate for Payer: Qualcare PPO/HMO/WC	$100.82

ROTARIX 2ML(ROTAVIRUS)2 D ORAL

Facility

$672.14

Service Code	HCPCS 90681
Hospital Charge Code	83652615
Hospital Revenue Code	636
Min. Negotiated Rate	$16.20
Max. Negotiated Rate	$336.07
Rate for Payer: Aetna Commercial	$255.41
Rate for Payer: Aetna Medicare Advantage	$201.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$171.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$171.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$171.40
Rate for Payer: Cigna Commercial	$336.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.66
Rate for Payer: Qualcare PPO/HMO/WC	$100.82
Rate for Payer: UnitedHealthcare Community & State	$16.20
Rate for Payer: Wellpoint Medicaid Managed Care	$17.81

ROTATABLE RETRIEVAL DEVICE

Facility

$360.05

Hospital Charge Code	270663899
Hospital Revenue Code	272
Min. Negotiated Rate	$8.68
Max. Negotiated Rate	$180.03
Rate for Payer: Aetna Commercial	$136.82
Rate for Payer: Aetna Medicare Advantage	$108.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.81
Rate for Payer: Cigna Commercial	$180.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.02
Rate for Payer: Oxford Commercial	$72.01
Rate for Payer: Qualcare PPO/HMO/WC	$54.01
Rate for Payer: UnitedHealthcare Commercial	$72.01
Rate for Payer: UnitedHealthcare Community & State	$8.68
Rate for Payer: Wellpoint Medicaid Managed Care	$9.54

ROTATABLE RETRIEVAL DEVICE

Facility

$360.05

Hospital Charge Code	270663899
Hospital Revenue Code	272
Min. Negotiated Rate	$54.01
Max. Negotiated Rate	$54.01
Rate for Payer: Qualcare PPO/HMO/WC	$54.01

ROTA TEQ 2ML(ROTAVIRUS)

Facility

$227.73

Service Code	HCPCS 90680
Hospital Charge Code	83652589
Hospital Revenue Code	636
Min. Negotiated Rate	$5.49
Max. Negotiated Rate	$113.86
Rate for Payer: Aetna Commercial	$86.54
Rate for Payer: Aetna Medicare Advantage	$68.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.07
Rate for Payer: Cigna Commercial	$113.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.11
Rate for Payer: Qualcare PPO/HMO/WC	$34.16
Rate for Payer: UnitedHealthcare Community & State	$5.49
Rate for Payer: Wellpoint Medicaid Managed Care	$6.03

ROTA TEQ 2ML(ROTAVIRUS)

Facility

$227.73

Service Code	HCPCS 90680
Hospital Charge Code	83652589
Hospital Revenue Code	636
Min. Negotiated Rate	$34.16
Max. Negotiated Rate	$55.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.11
Rate for Payer: Qualcare PPO/HMO/WC	$34.16

ROTATIONAL PLATE 2.0

Facility

$4,095.00

Service Code	HCPCS C1713
Hospital Charge Code	270702062
Hospital Revenue Code	278
Min. Negotiated Rate	$614.25
Max. Negotiated Rate	$990.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$819.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$990.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$900.90
Rate for Payer: Qualcare PPO/HMO/WC	$614.25

ROTATIONAL PLATE 2.0

Facility

$4,095.00

Service Code	HCPCS C1713
Hospital Charge Code	270702062
Hospital Revenue Code	278
Min. Negotiated Rate	$98.69
Max. Negotiated Rate	$2,047.50
Rate for Payer: Aetna Commercial	$1,556.10
Rate for Payer: Aetna Medicare Advantage	$1,228.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,044.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,044.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$819.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,044.22
Rate for Payer: Cigna Commercial	$2,047.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$990.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$900.90
Rate for Payer: Qualcare PPO/HMO/WC	$614.25
Rate for Payer: UnitedHealthcare Community & State	$98.69
Rate for Payer: Wellpoint Medicaid Managed Care	$108.52

ROTATOR CUFF GRASPER

Facility

$4,975.00

Hospital Charge Code	270656555
Hospital Revenue Code	272
Min. Negotiated Rate	$119.90
Max. Negotiated Rate	$2,487.50
Rate for Payer: Aetna Commercial	$1,890.50
Rate for Payer: Aetna Medicare Advantage	$1,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,268.62
Rate for Payer: Cigna Commercial	$2,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,492.50
Rate for Payer: Oxford Commercial	$995.00
Rate for Payer: Qualcare PPO/HMO/WC	$746.25
Rate for Payer: UnitedHealthcare Commercial	$995.00
Rate for Payer: UnitedHealthcare Community & State	$119.90
Rate for Payer: Wellpoint Medicaid Managed Care	$131.84

Know your out-of-pocket cost for care.

All Charges