Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TALWIN/30MG/ML

Facility

$53.00

Hospital Charge Code	60634415
Hospital Revenue Code	250
Min. Negotiated Rate	$1.28
Max. Negotiated Rate	$26.50
Rate for Payer: Aetna Commercial	$20.14
Rate for Payer: Aetna Medicare Advantage	$15.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.52
Rate for Payer: Cigna Commercial	$26.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.90
Rate for Payer: Oxford Commercial	$10.60
Rate for Payer: Qualcare PPO/HMO/WC	$7.95
Rate for Payer: UnitedHealthcare Commercial	$10.60
Rate for Payer: UnitedHealthcare Community & State	$1.28
Rate for Payer: Wellpoint Medicaid Managed Care	$1.40

TALWIN/30MG/ML

Facility

$53.00

Hospital Charge Code	60634415
Hospital Revenue Code	250
Min. Negotiated Rate	$7.95
Max. Negotiated Rate	$7.95
Rate for Payer: Qualcare PPO/HMO/WC	$7.95

TALWIN NX/TAB

Facility

$3.00

Hospital Charge Code	60633963
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

TALWIN NX/TAB

Facility

$3.00

Hospital Charge Code	60633963
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

TAMIFLU 12MG/ML

Facility

$215.00

Hospital Charge Code	60635729
Hospital Revenue Code	250
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$107.50
Rate for Payer: Aetna Commercial	$81.70
Rate for Payer: Aetna Medicare Advantage	$64.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.83
Rate for Payer: Cigna Commercial	$107.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.50
Rate for Payer: Oxford Commercial	$43.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.25
Rate for Payer: UnitedHealthcare Commercial	$43.00
Rate for Payer: UnitedHealthcare Community & State	$5.18
Rate for Payer: Wellpoint Medicaid Managed Care	$5.70

TAMIFLU 12MG/ML

Facility

$215.00

Hospital Charge Code	60635729
Hospital Revenue Code	250
Min. Negotiated Rate	$32.25
Max. Negotiated Rate	$32.25
Rate for Payer: Qualcare PPO/HMO/WC	$32.25

TAMIFLU ORAL SUSP

Facility

$16.15

Service Code	NDC 4082205
Hospital Charge Code	60635754
Hospital Revenue Code	250
Min. Negotiated Rate	$2.42
Max. Negotiated Rate	$2.42
Rate for Payer: Qualcare PPO/HMO/WC	$2.42

TAMIFLU ORAL SUSP

Facility

$16.15

Service Code	NDC 4082205
Hospital Charge Code	60635754
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$8.07
Rate for Payer: Aetna Commercial	$6.14
Rate for Payer: Aetna Medicare Advantage	$4.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.12
Rate for Payer: Cigna Commercial	$8.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.84
Rate for Payer: Oxford Commercial	$3.23
Rate for Payer: Qualcare PPO/HMO/WC	$2.42
Rate for Payer: UnitedHealthcare Commercial	$3.23
Rate for Payer: UnitedHealthcare Community & State	$0.39
Rate for Payer: Wellpoint Medicaid Managed Care	$0.43

TAMOXIFEN 10 MG TAB

Facility

$15.88

Service Code	NDC 63739026910
Hospital Charge Code	6010086
Hospital Revenue Code	250
Min. Negotiated Rate	$0.38
Max. Negotiated Rate	$7.94
Rate for Payer: Aetna Commercial	$6.03
Rate for Payer: Aetna Medicare Advantage	$4.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.05
Rate for Payer: Cigna Commercial	$7.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.76
Rate for Payer: Oxford Commercial	$3.18
Rate for Payer: Qualcare PPO/HMO/WC	$2.38
Rate for Payer: UnitedHealthcare Commercial	$3.18
Rate for Payer: UnitedHealthcare Community & State	$0.38
Rate for Payer: Wellpoint Medicaid Managed Care	$0.42

TAMOXIFEN 10 MG TAB

Facility

$15.88

Service Code	NDC 63739026910
Hospital Charge Code	6010086
Hospital Revenue Code	250
Min. Negotiated Rate	$2.38
Max. Negotiated Rate	$2.38
Rate for Payer: Qualcare PPO/HMO/WC	$2.38

TAMOXIFEN TAB 10MG

Facility

$15.40

Hospital Charge Code	6008692
Hospital Revenue Code	251
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$2.31
Rate for Payer: Qualcare PPO/HMO/WC	$2.31

TAMOXIFEN TAB 10MG

Facility

$15.40

Hospital Charge Code	6008692
Hospital Revenue Code	251
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$7.70
Rate for Payer: Aetna Commercial	$5.85
Rate for Payer: Aetna Medicare Advantage	$4.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.93
Rate for Payer: Cigna Commercial	$7.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.62
Rate for Payer: Oxford Commercial	$3.08
Rate for Payer: Qualcare PPO/HMO/WC	$2.31
Rate for Payer: UnitedHealthcare Commercial	$3.08
Rate for Payer: UnitedHealthcare Community & State	$0.37
Rate for Payer: Wellpoint Medicaid Managed Care	$0.41

TAMP BONE INFLATABLE

Facility

$6,475.00

Hospital Charge Code	270636280
Hospital Revenue Code	272
Min. Negotiated Rate	$156.05
Max. Negotiated Rate	$3,237.50
Rate for Payer: Aetna Commercial	$2,460.50
Rate for Payer: Aetna Medicare Advantage	$1,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,651.12
Rate for Payer: Cigna Commercial	$3,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,942.50
Rate for Payer: Oxford Commercial	$1,295.00
Rate for Payer: Qualcare PPO/HMO/WC	$971.25
Rate for Payer: UnitedHealthcare Commercial	$1,295.00
Rate for Payer: UnitedHealthcare Community & State	$156.05
Rate for Payer: Wellpoint Medicaid Managed Care	$171.59

TAMP BONE INFLATABLE

Facility

$6,475.00

Hospital Charge Code	270636280
Hospital Revenue Code	272
Min. Negotiated Rate	$971.25
Max. Negotiated Rate	$971.25
Rate for Payer: Qualcare PPO/HMO/WC	$971.25

TAMP BONE INFLATABLE 10/2 K15A

Facility

$5,975.00

Hospital Charge Code	270637758
Hospital Revenue Code	272
Min. Negotiated Rate	$896.25
Max. Negotiated Rate	$896.25
Rate for Payer: Qualcare PPO/HMO/WC	$896.25

TAMP BONE INFLATABLE 10/2 K15A

Facility

$5,975.00

Hospital Charge Code	270637758
Hospital Revenue Code	272
Min. Negotiated Rate	$144.00
Max. Negotiated Rate	$2,987.50
Rate for Payer: Aetna Commercial	$2,270.50
Rate for Payer: Aetna Medicare Advantage	$1,792.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,523.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,523.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,523.62
Rate for Payer: Cigna Commercial	$2,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,792.50
Rate for Payer: Oxford Commercial	$1,195.00
Rate for Payer: Qualcare PPO/HMO/WC	$896.25
Rate for Payer: UnitedHealthcare Commercial	$1,195.00
Rate for Payer: UnitedHealthcare Community & State	$144.00
Rate for Payer: Wellpoint Medicaid Managed Care	$158.34

TAMP BONE INFLATABLE 10/3

Facility

$6,475.00

Hospital Charge Code	270640794
Hospital Revenue Code	272
Min. Negotiated Rate	$971.25
Max. Negotiated Rate	$971.25
Rate for Payer: Qualcare PPO/HMO/WC	$971.25

TAMP BONE INFLATABLE 10/3

Facility

$6,475.00

Hospital Charge Code	270640794
Hospital Revenue Code	272
Min. Negotiated Rate	$156.05
Max. Negotiated Rate	$3,237.50
Rate for Payer: Aetna Commercial	$2,460.50
Rate for Payer: Aetna Medicare Advantage	$1,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,651.12
Rate for Payer: Cigna Commercial	$3,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,942.50
Rate for Payer: Oxford Commercial	$1,295.00
Rate for Payer: Qualcare PPO/HMO/WC	$971.25
Rate for Payer: UnitedHealthcare Commercial	$1,295.00
Rate for Payer: UnitedHealthcare Community & State	$156.05
Rate for Payer: Wellpoint Medicaid Managed Care	$171.59

TAMP OAT SZ 10

Facility

$970.00

Hospital Charge Code	270677743
Hospital Revenue Code	272
Min. Negotiated Rate	$23.38
Max. Negotiated Rate	$485.00
Rate for Payer: Aetna Commercial	$368.60
Rate for Payer: Aetna Medicare Advantage	$291.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.35
Rate for Payer: Cigna Commercial	$485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.00
Rate for Payer: Oxford Commercial	$194.00
Rate for Payer: Qualcare PPO/HMO/WC	$145.50
Rate for Payer: UnitedHealthcare Commercial	$194.00
Rate for Payer: UnitedHealthcare Community & State	$23.38
Rate for Payer: Wellpoint Medicaid Managed Care	$25.70

TAMP OAT SZ 10

Facility

$970.00

Hospital Charge Code	270677743
Hospital Revenue Code	272
Min. Negotiated Rate	$145.50
Max. Negotiated Rate	$145.50
Rate for Payer: Qualcare PPO/HMO/WC	$145.50

TAMP OAT SZ 5

Facility

$970.00

Hospital Charge Code	270677738
Hospital Revenue Code	272
Min. Negotiated Rate	$145.50
Max. Negotiated Rate	$145.50
Rate for Payer: Qualcare PPO/HMO/WC	$145.50

TAMP OAT SZ 5

Facility

$970.00

Hospital Charge Code	270677738
Hospital Revenue Code	272
Min. Negotiated Rate	$23.38
Max. Negotiated Rate	$485.00
Rate for Payer: Aetna Commercial	$368.60
Rate for Payer: Aetna Medicare Advantage	$291.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.35
Rate for Payer: Cigna Commercial	$485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.00
Rate for Payer: Oxford Commercial	$194.00
Rate for Payer: Qualcare PPO/HMO/WC	$145.50
Rate for Payer: UnitedHealthcare Commercial	$194.00
Rate for Payer: UnitedHealthcare Community & State	$23.38
Rate for Payer: Wellpoint Medicaid Managed Care	$25.70

TAMP OAT SZ 6

Facility

$970.00

Hospital Charge Code	270677739
Hospital Revenue Code	272
Min. Negotiated Rate	$145.50
Max. Negotiated Rate	$145.50
Rate for Payer: Qualcare PPO/HMO/WC	$145.50

TAMP OAT SZ 6

Facility

$970.00

Hospital Charge Code	270677739
Hospital Revenue Code	272
Min. Negotiated Rate	$23.38
Max. Negotiated Rate	$485.00
Rate for Payer: Aetna Commercial	$368.60
Rate for Payer: Aetna Medicare Advantage	$291.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.35
Rate for Payer: Cigna Commercial	$485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.00
Rate for Payer: Oxford Commercial	$194.00
Rate for Payer: Qualcare PPO/HMO/WC	$145.50
Rate for Payer: UnitedHealthcare Commercial	$194.00
Rate for Payer: UnitedHealthcare Community & State	$23.38
Rate for Payer: Wellpoint Medicaid Managed Care	$25.70

TAMP OAT SZ 7

Facility

$970.00

Hospital Charge Code	270677740
Hospital Revenue Code	272
Min. Negotiated Rate	$145.50
Max. Negotiated Rate	$145.50
Rate for Payer: Qualcare PPO/HMO/WC	$145.50

Know your out-of-pocket cost for care.

All Charges