Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SENNA 8.8 MG/5 ML SYRUP

Facility

$4.00

Service Code	NDC 59390012541
Hospital Charge Code	60629038
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

SENNA CONCENTR 218MG/5ML SYRUP

Facility

$62.10

Hospital Charge Code	6009922
Hospital Revenue Code	250
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$31.05
Rate for Payer: Aetna Commercial	$23.60
Rate for Payer: Aetna Medicare Advantage	$18.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.84
Rate for Payer: Cigna Commercial	$31.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.63
Rate for Payer: Oxford Commercial	$12.42
Rate for Payer: Qualcare PPO/HMO/WC	$9.31
Rate for Payer: UnitedHealthcare Commercial	$12.42
Rate for Payer: UnitedHealthcare Community & State	$1.50
Rate for Payer: Wellpoint Medicaid Managed Care	$1.65

SENNA CONCENTR 218MG/5ML SYRUP

Facility

$62.10

Hospital Charge Code	6009922
Hospital Revenue Code	250
Min. Negotiated Rate	$9.31
Max. Negotiated Rate	$9.31
Rate for Payer: Qualcare PPO/HMO/WC	$9.31

SENNA CONCENTRATE 56GM GRANULE

Facility

$62.10

Hospital Charge Code	6009914
Hospital Revenue Code	250
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$31.05
Rate for Payer: Aetna Commercial	$23.60
Rate for Payer: Aetna Medicare Advantage	$18.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.84
Rate for Payer: Cigna Commercial	$31.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.63
Rate for Payer: Oxford Commercial	$12.42
Rate for Payer: Qualcare PPO/HMO/WC	$9.31
Rate for Payer: UnitedHealthcare Commercial	$12.42
Rate for Payer: UnitedHealthcare Community & State	$1.50
Rate for Payer: Wellpoint Medicaid Managed Care	$1.65

SENNA CONCENTRATE 56GM GRANULE

Facility

$62.10

Hospital Charge Code	6009914
Hospital Revenue Code	250
Min. Negotiated Rate	$9.31
Max. Negotiated Rate	$9.31
Rate for Payer: Qualcare PPO/HMO/WC	$9.31

SENNA TAB 374MG

Facility

$3.85

Hospital Charge Code	60628703
Hospital Revenue Code	250
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$1.93
Rate for Payer: Aetna Commercial	$1.46
Rate for Payer: Aetna Medicare Advantage	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.98
Rate for Payer: Cigna Commercial	$1.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.16
Rate for Payer: Oxford Commercial	$0.77
Rate for Payer: Qualcare PPO/HMO/WC	$0.58
Rate for Payer: UnitedHealthcare Commercial	$0.77
Rate for Payer: UnitedHealthcare Community & State	$0.09
Rate for Payer: Wellpoint Medicaid Managed Care	$0.10

SENNA TAB 374MG

Facility

$3.85

Hospital Charge Code	60628703
Hospital Revenue Code	250
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$0.58
Rate for Payer: Qualcare PPO/HMO/WC	$0.58

SENOKOT SUPPOSITORY

Facility

$3.00

Hospital Charge Code	60634528
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

SENOKOT SUPPOSITORY

Facility

$3.00

Hospital Charge Code	60634528
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

SENOKOT/TAB

Facility

$1.00

Hospital Charge Code	60633861
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.15

SENOKOT/TAB

Facility

$1.00

Hospital Charge Code	60633861
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.50
Rate for Payer: Aetna Commercial	$0.38
Rate for Payer: Aetna Medicare Advantage	$0.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.26
Rate for Payer: Cigna Commercial	$0.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.30
Rate for Payer: Oxford Commercial	$0.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.15
Rate for Payer: UnitedHealthcare Commercial	$0.20
Rate for Payer: UnitedHealthcare Community & State	$0.02
Rate for Payer: Wellpoint Medicaid Managed Care	$0.03

SENOR PULSE OX

Facility

$1,076.75

Hospital Charge Code	270665806
Hospital Revenue Code	270
Min. Negotiated Rate	$161.51
Max. Negotiated Rate	$161.51
Rate for Payer: Qualcare PPO/HMO/WC	$161.51

SENOR PULSE OX

Facility

$1,076.75

Hospital Charge Code	270665806
Hospital Revenue Code	270
Min. Negotiated Rate	$25.95
Max. Negotiated Rate	$538.38
Rate for Payer: Aetna Commercial	$409.17
Rate for Payer: Aetna Medicare Advantage	$323.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.57
Rate for Payer: Cigna Commercial	$538.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$323.02
Rate for Payer: Oxford Commercial	$215.35
Rate for Payer: Qualcare PPO/HMO/WC	$161.51
Rate for Payer: UnitedHealthcare Commercial	$215.35
Rate for Payer: UnitedHealthcare Community & State	$25.95
Rate for Payer: Wellpoint Medicaid Managed Care	$28.53

SENSATION STANDARD OVAL

Facility

$4.25

Hospital Charge Code	270654279
Hospital Revenue Code	272
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$0.64
Rate for Payer: Qualcare PPO/HMO/WC	$0.64

SENSATION STANDARD OVAL

Facility

$4.25

Hospital Charge Code	270654279
Hospital Revenue Code	272
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.12
Rate for Payer: Aetna Commercial	$1.61
Rate for Payer: Aetna Medicare Advantage	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.08
Rate for Payer: Cigna Commercial	$2.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.27
Rate for Payer: Oxford Commercial	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.64
Rate for Payer: UnitedHealthcare Commercial	$0.85
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

SENSIPAR 60MG TAB

Facility

$294.26

Service Code	NDC 55513007430
Hospital Charge Code	606361030
Hospital Revenue Code	250
Min. Negotiated Rate	$7.09
Max. Negotiated Rate	$147.13
Rate for Payer: Aetna Commercial	$111.82
Rate for Payer: Aetna Medicare Advantage	$88.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.04
Rate for Payer: Cigna Commercial	$147.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.28
Rate for Payer: Oxford Commercial	$58.85
Rate for Payer: Qualcare PPO/HMO/WC	$44.14
Rate for Payer: UnitedHealthcare Commercial	$58.85
Rate for Payer: UnitedHealthcare Community & State	$7.09
Rate for Payer: Wellpoint Medicaid Managed Care	$7.80

SENSIPAR 60MG TAB

Facility

$294.26

Service Code	NDC 55513007430
Hospital Charge Code	606361030
Hospital Revenue Code	250
Min. Negotiated Rate	$44.14
Max. Negotiated Rate	$44.14
Rate for Payer: Qualcare PPO/HMO/WC	$44.14

SENSITIVITY

Facility

$66.25

Service Code	HCPCS 87184
Hospital Charge Code	3008746
Hospital Revenue Code	309
Min. Negotiated Rate	$1.76
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$20.35
Rate for Payer: Aetna Medicare Advantage	$24.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.00
Rate for Payer: Cigna Commercial	$33.12
Rate for Payer: Cigna Medicare Advantage	$7.48
Rate for Payer: Clover Medicare Advantage	$7.11
Rate for Payer: EmblemHealth Commercial	$22.44
Rate for Payer: Humana Medicare Advantage	$7.70
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.88
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.94
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.98
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.48
Rate for Payer: Wellcare Medicare Advantage	$7.48
Rate for Payer: Wellpoint Medicaid Managed Care	$1.76

SENSITIVITY

Facility

$66.25

Service Code	HCPCS 87184
Hospital Charge Code	3008746
Hospital Revenue Code	309
Min. Negotiated Rate	$9.94
Max. Negotiated Rate	$9.94
Rate for Payer: Qualcare PPO/HMO/WC	$9.94

SENSITIVITY, FUNGUS

Facility

$111.25

Service Code	HCPCS 87107
Hospital Charge Code	3008778
Hospital Revenue Code	309
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$28.07
Rate for Payer: Aetna Medicare Advantage	$33.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.25
Rate for Payer: Cigna Commercial	$55.62
Rate for Payer: Cigna Medicare Advantage	$10.32
Rate for Payer: Clover Medicare Advantage	$9.80
Rate for Payer: EmblemHealth Commercial	$30.96
Rate for Payer: Humana Medicare Advantage	$10.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.69
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$8.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.32
Rate for Payer: Wellcare Medicare Advantage	$10.32
Rate for Payer: Wellpoint Medicaid Managed Care	$2.95

SENSITIVITY, FUNGUS

Facility

$111.25

Service Code	HCPCS 87107
Hospital Charge Code	3008778
Hospital Revenue Code	309
Min. Negotiated Rate	$16.69
Max. Negotiated Rate	$16.69
Rate for Payer: Qualcare PPO/HMO/WC	$16.69

SENSITIVITY - MIC

Facility

$196.35

Service Code	HCPCS 87186
Hospital Charge Code	3001047
Hospital Revenue Code	309
Min. Negotiated Rate	$29.45
Max. Negotiated Rate	$29.45
Rate for Payer: Qualcare PPO/HMO/WC	$29.45

SENSITIVITY - MIC

Facility

$196.35

Service Code	HCPCS 87186
Hospital Charge Code	3001047
Hospital Revenue Code	309
Min. Negotiated Rate	$5.20
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$23.53
Rate for Payer: Aetna Medicare Advantage	$28.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.22
Rate for Payer: Cigna Commercial	$98.17
Rate for Payer: Cigna Medicare Advantage	$8.65
Rate for Payer: Clover Medicare Advantage	$8.22
Rate for Payer: EmblemHealth Commercial	$25.95
Rate for Payer: Humana Medicare Advantage	$8.91
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.91
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.45
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.92
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.65
Rate for Payer: Wellcare Medicare Advantage	$8.65
Rate for Payer: Wellpoint Medicaid Managed Care	$5.20

SENSITIV/KIRBY-BAUER PER PLATI

Facility

$33.00

Service Code	HCPCS 87184
Hospital Charge Code	3008745
Hospital Revenue Code	306
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$20.35
Rate for Payer: Aetna Medicare Advantage	$24.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.00
Rate for Payer: Cigna Commercial	$16.50
Rate for Payer: Cigna Medicare Advantage	$7.48
Rate for Payer: Clover Medicare Advantage	$7.11
Rate for Payer: EmblemHealth Commercial	$22.44
Rate for Payer: Humana Medicare Advantage	$7.70
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.95
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.98
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.48
Rate for Payer: Wellcare Medicare Advantage	$7.48
Rate for Payer: Wellpoint Medicaid Managed Care	$0.87

SENSITIV/KIRBY-BAUER PER PLATI

Facility

$33.00

Service Code	HCPCS 87184
Hospital Charge Code	3008745
Hospital Revenue Code	306
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$4.95
Rate for Payer: Qualcare PPO/HMO/WC	$4.95

Know your out-of-pocket cost for care.

All Charges