Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SOLUTION BSS 500 ML PLUS

Facility

$266.15

Hospital Charge Code	270684102
Hospital Revenue Code	272
Min. Negotiated Rate	$6.41
Max. Negotiated Rate	$133.07
Rate for Payer: Aetna Commercial	$101.14
Rate for Payer: Aetna Medicare Advantage	$79.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.87
Rate for Payer: Cigna Commercial	$133.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.84
Rate for Payer: Oxford Commercial	$53.23
Rate for Payer: Qualcare PPO/HMO/WC	$39.92
Rate for Payer: UnitedHealthcare Commercial	$53.23
Rate for Payer: UnitedHealthcare Community & State	$6.41
Rate for Payer: Wellpoint Medicaid Managed Care	$7.05

SOLUTION BSS 500 ML PLUS

Facility

$266.15

Hospital Charge Code	270684102
Hospital Revenue Code	272
Min. Negotiated Rate	$39.92
Max. Negotiated Rate	$39.92
Rate for Payer: Qualcare PPO/HMO/WC	$39.92

SOLUTION BSS SM 15ML BO

Facility

$16.85

Hospital Charge Code	270061250
Hospital Revenue Code	272
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$2.53
Rate for Payer: Qualcare PPO/HMO/WC	$2.53

SOLUTION BSS SM 15ML BO

Facility

$16.85

Hospital Charge Code	270061250
Hospital Revenue Code	272
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$8.43
Rate for Payer: Aetna Commercial	$6.40
Rate for Payer: Aetna Medicare Advantage	$5.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.30
Rate for Payer: Cigna Commercial	$8.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.05
Rate for Payer: Oxford Commercial	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$2.53
Rate for Payer: UnitedHealthcare Commercial	$3.37
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.45

SOLUTION DEX 10% INJ 500ml

Facility

$22.50

Hospital Charge Code	270649137
Hospital Revenue Code	258
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$11.25
Rate for Payer: Aetna Commercial	$8.55
Rate for Payer: Aetna Medicare Advantage	$6.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.74
Rate for Payer: Cigna Commercial	$11.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.75
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.38
Rate for Payer: UnitedHealthcare Commercial	$4.50
Rate for Payer: UnitedHealthcare Community & State	$0.54
Rate for Payer: Wellpoint Medicaid Managed Care	$0.60

SOLUTION DEX 10% INJ 500ml

Facility

$22.50

Hospital Charge Code	270649137
Hospital Revenue Code	258
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$3.38
Rate for Payer: Qualcare PPO/HMO/WC	$3.38

SOLUTION DEX 5% INJ 500ml

Facility

$22.50

Hospital Charge Code	270649139
Hospital Revenue Code	258
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$3.38
Rate for Payer: Qualcare PPO/HMO/WC	$3.38

SOLUTION DEX 5% INJ 500ml

Facility

$22.50

Hospital Charge Code	270649139
Hospital Revenue Code	258
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$11.25
Rate for Payer: Aetna Commercial	$8.55
Rate for Payer: Aetna Medicare Advantage	$6.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.74
Rate for Payer: Cigna Commercial	$11.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.75
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.38
Rate for Payer: UnitedHealthcare Commercial	$4.50
Rate for Payer: UnitedHealthcare Community & State	$0.54
Rate for Payer: Wellpoint Medicaid Managed Care	$0.60

SOLUTION DIANEAL PDIL 1.5% DEX

Facility

$154.58

Hospital Charge Code	270650533
Hospital Revenue Code	272
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$77.29
Rate for Payer: Aetna Commercial	$58.74
Rate for Payer: Aetna Medicare Advantage	$46.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.42
Rate for Payer: Cigna Commercial	$77.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.37
Rate for Payer: Oxford Commercial	$30.92
Rate for Payer: Qualcare PPO/HMO/WC	$23.19
Rate for Payer: UnitedHealthcare Commercial	$30.92
Rate for Payer: UnitedHealthcare Community & State	$3.73
Rate for Payer: Wellpoint Medicaid Managed Care	$4.10

SOLUTION DIANEAL PDIL 1.5% DEX

Facility

$154.58

Hospital Charge Code	270650533
Hospital Revenue Code	272
Min. Negotiated Rate	$23.19
Max. Negotiated Rate	$23.19
Rate for Payer: Qualcare PPO/HMO/WC	$23.19

SOLUTION DIANEAL PDIL 2.5% DEX

Facility

$177.65

Hospital Charge Code	270650534
Hospital Revenue Code	272
Min. Negotiated Rate	$4.28
Max. Negotiated Rate	$88.83
Rate for Payer: Aetna Commercial	$67.51
Rate for Payer: Aetna Medicare Advantage	$53.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.30
Rate for Payer: Cigna Commercial	$88.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.30
Rate for Payer: Oxford Commercial	$35.53
Rate for Payer: Qualcare PPO/HMO/WC	$26.65
Rate for Payer: UnitedHealthcare Commercial	$35.53
Rate for Payer: UnitedHealthcare Community & State	$4.28
Rate for Payer: Wellpoint Medicaid Managed Care	$4.71

SOLUTION DIANEAL PDIL 2.5% DEX

Facility

$177.65

Hospital Charge Code	270650534
Hospital Revenue Code	272
Min. Negotiated Rate	$26.65
Max. Negotiated Rate	$26.65
Rate for Payer: Qualcare PPO/HMO/WC	$26.65

SOLUTION EKG EXG-SOL 4 OZ

Facility

$55.00

Hospital Charge Code	270331297
Hospital Revenue Code	272
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

SOLUTION EKG EXG-SOL 4 OZ

Facility

$55.00

Hospital Charge Code	270331297
Hospital Revenue Code	272
Min. Negotiated Rate	$1.33
Max. Negotiated Rate	$27.50
Rate for Payer: Aetna Commercial	$20.90
Rate for Payer: Aetna Medicare Advantage	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.03
Rate for Payer: Cigna Commercial	$27.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.50
Rate for Payer: Oxford Commercial	$11.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.25
Rate for Payer: UnitedHealthcare Commercial	$11.00
Rate for Payer: UnitedHealthcare Community & State	$1.33
Rate for Payer: Wellpoint Medicaid Managed Care	$1.46

SOLUTION EYE IRRIGATING 15 ML

Facility

$9.00

Hospital Charge Code	6024228
Hospital Revenue Code	251
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$3.42
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.70
Rate for Payer: Oxford Commercial	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$1.80
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

SOLUTION EYE IRRIGATING 15 ML

Facility

$9.00

Hospital Charge Code	6024228
Hospital Revenue Code	251
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

SOLUTION GLYCINE 1.5% 3000ML

Facility

$60.45

Hospital Charge Code	270061490
Hospital Revenue Code	270
Min. Negotiated Rate	$9.07
Max. Negotiated Rate	$9.07
Rate for Payer: Qualcare PPO/HMO/WC	$9.07

SOLUTION GLYCINE 1.5% 3000ML

Facility

$60.45

Hospital Charge Code	270061490
Hospital Revenue Code	270
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$30.23
Rate for Payer: Aetna Commercial	$22.97
Rate for Payer: Aetna Medicare Advantage	$18.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.41
Rate for Payer: Cigna Commercial	$30.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.14
Rate for Payer: Oxford Commercial	$12.09
Rate for Payer: Qualcare PPO/HMO/WC	$9.07
Rate for Payer: UnitedHealthcare Commercial	$12.09
Rate for Payer: UnitedHealthcare Community & State	$1.46
Rate for Payer: Wellpoint Medicaid Managed Care	$1.60

SOLUTION HUMIDIFIER 500ml

Facility

$6.76

Hospital Charge Code	270649321
Hospital Revenue Code	270
Min. Negotiated Rate	$1.01
Max. Negotiated Rate	$1.01
Rate for Payer: Qualcare PPO/HMO/WC	$1.01

SOLUTION HUMIDIFIER 500ml

Facility

$6.76

Hospital Charge Code	270649321
Hospital Revenue Code	270
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$3.38
Rate for Payer: Aetna Commercial	$2.57
Rate for Payer: Aetna Medicare Advantage	$2.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.72
Rate for Payer: Cigna Commercial	$3.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.03
Rate for Payer: Oxford Commercial	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.01
Rate for Payer: UnitedHealthcare Commercial	$1.35
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

SOLUTION HYDROGEN PEROXIDE 3%

Facility

$55.45

Hospital Charge Code	270649477
Hospital Revenue Code	270
Min. Negotiated Rate	$1.34
Max. Negotiated Rate	$27.73
Rate for Payer: Aetna Commercial	$21.07
Rate for Payer: Aetna Medicare Advantage	$16.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.14
Rate for Payer: Cigna Commercial	$27.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.64
Rate for Payer: Oxford Commercial	$11.09
Rate for Payer: Qualcare PPO/HMO/WC	$8.32
Rate for Payer: UnitedHealthcare Commercial	$11.09
Rate for Payer: UnitedHealthcare Community & State	$1.34
Rate for Payer: Wellpoint Medicaid Managed Care	$1.47

SOLUTION HYDROGEN PEROXIDE 3%

Facility

$55.45

Hospital Charge Code	270649477
Hospital Revenue Code	270
Min. Negotiated Rate	$8.32
Max. Negotiated Rate	$8.32
Rate for Payer: Qualcare PPO/HMO/WC	$8.32

SOLUTION IRRIG 0.9% NACL 100ML

Facility

$2.48

Hospital Charge Code	270649322
Hospital Revenue Code	270
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.24
Rate for Payer: Aetna Commercial	$0.94
Rate for Payer: Aetna Medicare Advantage	$0.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.63
Rate for Payer: Cigna Commercial	$1.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.74
Rate for Payer: Oxford Commercial	$0.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.37
Rate for Payer: UnitedHealthcare Commercial	$0.50
Rate for Payer: UnitedHealthcare Community & State	$0.06
Rate for Payer: Wellpoint Medicaid Managed Care	$0.07

SOLUTION IRRIG 0.9% NACL 100ML

Facility

$2.48

Hospital Charge Code	270649322
Hospital Revenue Code	270
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.37
Rate for Payer: Qualcare PPO/HMO/WC	$0.37

SOLUTION POTASSIUM CHLORIDE

Facility

$83.00

Hospital Charge Code	270331404
Hospital Revenue Code	272
Min. Negotiated Rate	$12.45
Max. Negotiated Rate	$12.45
Rate for Payer: Qualcare PPO/HMO/WC	$12.45

Know your out-of-pocket cost for care.

All Charges