Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ROTOVIRUS AG

Facility

$75.65

Service Code	HCPCS 87425
Hospital Charge Code	39900450
Hospital Revenue Code	306
Min. Negotiated Rate	$11.35
Max. Negotiated Rate	$11.35
Rate for Payer: Qualcare PPO/HMO/WC	$11.35

ROTOVIRUS AG

Facility

$75.65

Service Code	HCPCS 87425
Hospital Charge Code	39900450
Hospital Revenue Code	306
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$32.59
Rate for Payer: Aetna Medicare Advantage	$38.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.24
Rate for Payer: Cigna Commercial	$37.83
Rate for Payer: Cigna Medicare Advantage	$11.98
Rate for Payer: Clover Medicare Advantage	$11.38
Rate for Payer: EmblemHealth Commercial	$35.94
Rate for Payer: Humana Medicare Advantage	$12.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.35
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.98
Rate for Payer: Wellcare Medicare Advantage	$11.98
Rate for Payer: Wellpoint Medicaid Managed Care	$2.00

ROUND CERAMIC BOXES

Facility

$64.95

Hospital Charge Code	270663157
Hospital Revenue Code	270
Min. Negotiated Rate	$9.74
Max. Negotiated Rate	$9.74
Rate for Payer: Qualcare PPO/HMO/WC	$9.74

ROUND CERAMIC BOXES

Facility

$64.95

Hospital Charge Code	270663157
Hospital Revenue Code	270
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$32.48
Rate for Payer: Aetna Commercial	$24.68
Rate for Payer: Aetna Medicare Advantage	$19.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.56
Rate for Payer: Cigna Commercial	$32.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.48
Rate for Payer: Oxford Commercial	$12.99
Rate for Payer: Qualcare PPO/HMO/WC	$9.74
Rate for Payer: UnitedHealthcare Commercial	$12.99
Rate for Payer: UnitedHealthcare Community & State	$1.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1.72

ROUTER ATK FEMORAL

Facility

$2,966.45

Hospital Charge Code	270621076
Hospital Revenue Code	272
Min. Negotiated Rate	$71.49
Max. Negotiated Rate	$1,483.22
Rate for Payer: Aetna Commercial	$1,127.25
Rate for Payer: Aetna Medicare Advantage	$889.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$756.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$756.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$756.44
Rate for Payer: Cigna Commercial	$1,483.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$889.93
Rate for Payer: Oxford Commercial	$593.29
Rate for Payer: Qualcare PPO/HMO/WC	$444.97
Rate for Payer: UnitedHealthcare Commercial	$593.29
Rate for Payer: UnitedHealthcare Community & State	$71.49
Rate for Payer: Wellpoint Medicaid Managed Care	$78.61

ROUTER ATK FEMORAL

Facility

$2,966.45

Hospital Charge Code	270621076
Hospital Revenue Code	272
Min. Negotiated Rate	$444.97
Max. Negotiated Rate	$444.97
Rate for Payer: Qualcare PPO/HMO/WC	$444.97

ROUTER STRAIGHT MED 1.2x6MM

Facility

$471.50

Hospital Charge Code	270673356
Hospital Revenue Code	272
Min. Negotiated Rate	$70.72
Max. Negotiated Rate	$70.72
Rate for Payer: Qualcare PPO/HMO/WC	$70.72

ROUTER STRAIGHT MED 1.2x6MM

Facility

$471.50

Hospital Charge Code	270673356
Hospital Revenue Code	272
Min. Negotiated Rate	$11.36
Max. Negotiated Rate	$235.75
Rate for Payer: Aetna Commercial	$179.17
Rate for Payer: Aetna Medicare Advantage	$141.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.23
Rate for Payer: Cigna Commercial	$235.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.45
Rate for Payer: Oxford Commercial	$94.30
Rate for Payer: Qualcare PPO/HMO/WC	$70.72
Rate for Payer: UnitedHealthcare Commercial	$94.30
Rate for Payer: UnitedHealthcare Community & State	$11.36
Rate for Payer: Wellpoint Medicaid Managed Care	$12.49

ROUTER TAPER

Facility

$640.00

Hospital Charge Code	270673070
Hospital Revenue Code	272
Min. Negotiated Rate	$15.42
Max. Negotiated Rate	$320.00
Rate for Payer: Aetna Commercial	$243.20
Rate for Payer: Aetna Medicare Advantage	$192.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$163.20
Rate for Payer: Cigna Commercial	$320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.00
Rate for Payer: Oxford Commercial	$128.00
Rate for Payer: Qualcare PPO/HMO/WC	$96.00
Rate for Payer: UnitedHealthcare Commercial	$128.00
Rate for Payer: UnitedHealthcare Community & State	$15.42
Rate for Payer: Wellpoint Medicaid Managed Care	$16.96

ROUTER TAPER

Facility

$640.00

Hospital Charge Code	270673070
Hospital Revenue Code	272
Min. Negotiated Rate	$96.00
Max. Negotiated Rate	$96.00
Rate for Payer: Qualcare PPO/HMO/WC	$96.00

ROUTER TAPER 1.5 MM

Facility

$560.00

Hospital Charge Code	270687582
Hospital Revenue Code	272
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$84.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

ROUTER TAPER 1.5 MM

Facility

$560.00

Hospital Charge Code	270687582
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$280.00
Rate for Payer: Aetna Commercial	$212.80
Rate for Payer: Aetna Medicare Advantage	$168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.80
Rate for Payer: Cigna Commercial	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.00
Rate for Payer: Oxford Commercial	$112.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.00
Rate for Payer: UnitedHealthcare Commercial	$112.00
Rate for Payer: UnitedHealthcare Community & State	$13.50
Rate for Payer: Wellpoint Medicaid Managed Care	$14.84

ROUTER TAPERED 2.3 MM

Facility

$577.55

Hospital Charge Code	270687583
Hospital Revenue Code	272
Min. Negotiated Rate	$13.92
Max. Negotiated Rate	$288.77
Rate for Payer: Aetna Commercial	$219.47
Rate for Payer: Aetna Medicare Advantage	$173.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.28
Rate for Payer: Cigna Commercial	$288.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.26
Rate for Payer: Oxford Commercial	$115.51
Rate for Payer: Qualcare PPO/HMO/WC	$86.63
Rate for Payer: UnitedHealthcare Commercial	$115.51
Rate for Payer: UnitedHealthcare Community & State	$13.92
Rate for Payer: Wellpoint Medicaid Managed Care	$15.31

ROUTER TAPERED 2.3 MM

Facility

$577.55

Hospital Charge Code	270687583
Hospital Revenue Code	272
Min. Negotiated Rate	$86.63
Max. Negotiated Rate	$86.63
Rate for Payer: Qualcare PPO/HMO/WC	$86.63

ROUTINE VENIPUNCTURE

Facility

$26.25

Service Code	HCPCS 36415
Hospital Charge Code	3400073
Hospital Revenue Code	300
Min. Negotiated Rate	$3.94
Max. Negotiated Rate	$3.94
Rate for Payer: Qualcare PPO/HMO/WC	$3.94

ROUTINE VENIPUNCTURE

Facility

$26.25

Service Code	HCPCS 36415
Hospital Charge Code	3400073
Hospital Revenue Code	300
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$25.40
Rate for Payer: Aetna Medicare Advantage	$30.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.71
Rate for Payer: Cigna Commercial	$13.12
Rate for Payer: Cigna Medicare Advantage	$9.34
Rate for Payer: Clover Medicare Advantage	$8.87
Rate for Payer: EmblemHealth Commercial	$28.02
Rate for Payer: Humana Medicare Advantage	$9.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.88
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.94
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.34
Rate for Payer: Wellcare Medicare Advantage	$9.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.70

ROUTINE VENIPUNCTURE

Facility

$390.00

Service Code	HCPCS 36415
Hospital Charge Code	412336415
Hospital Revenue Code	300
Min. Negotiated Rate	$3.83
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$25.40
Rate for Payer: Aetna Medicare Advantage	$30.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.71
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$9.34
Rate for Payer: Clover Medicare Advantage	$8.87
Rate for Payer: EmblemHealth Commercial	$28.02
Rate for Payer: Humana Medicare Advantage	$9.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.34
Rate for Payer: Wellcare Medicare Advantage	$9.34
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

ROUTINE VENIPUNCTURE

Facility

$390.00

Service Code	HCPCS 36415
Hospital Charge Code	412336415
Hospital Revenue Code	300
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ROWASA/4GM/60ML

Facility

$303.00

Hospital Charge Code	60633850
Hospital Revenue Code	250
Min. Negotiated Rate	$7.30
Max. Negotiated Rate	$151.50
Rate for Payer: Aetna Commercial	$115.14
Rate for Payer: Aetna Medicare Advantage	$90.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.27
Rate for Payer: Cigna Commercial	$151.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.90
Rate for Payer: Oxford Commercial	$60.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.45
Rate for Payer: UnitedHealthcare Commercial	$60.60
Rate for Payer: UnitedHealthcare Community & State	$7.30
Rate for Payer: Wellpoint Medicaid Managed Care	$8.03

ROWASA/4GM/60ML

Facility

$303.00

Hospital Charge Code	60633850
Hospital Revenue Code	250
Min. Negotiated Rate	$45.45
Max. Negotiated Rate	$45.45
Rate for Payer: Qualcare PPO/HMO/WC	$45.45

ROWASA SUPP

Facility

$15.00

Hospital Charge Code	60634990
Hospital Revenue Code	250
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

ROWASA SUPP

Facility

$15.00

Hospital Charge Code	60634990
Hospital Revenue Code	250
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$5.70
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.50
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$3.00
Rate for Payer: UnitedHealthcare Community & State	$0.36
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

ROXANOL-T ORAL SOL 20MG/M

Facility

$5.03

Service Code	NDC 406800330
Hospital Charge Code	60635311
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

ROXANOL-T ORAL SOL 20MG/M

Facility

$5.03

Service Code	NDC 406800330
Hospital Charge Code	60635311
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.52
Rate for Payer: Aetna Commercial	$1.91
Rate for Payer: Aetna Medicare Advantage	$1.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.28
Rate for Payer: Cigna Commercial	$2.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.51
Rate for Payer: Oxford Commercial	$1.01
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$1.01
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

RPLC GTUBE NO REVJ TRC

Facility

$1,286.08

Service Code	HCPCS 43762
Hospital Charge Code	16000344
Hospital Revenue Code	360
Min. Negotiated Rate	$192.91
Max. Negotiated Rate	$192.91
Rate for Payer: Qualcare PPO/HMO/WC	$192.91

Know your out-of-pocket cost for care.

All Charges