Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TAVIST I/TAB

Facility

$1.00

Hospital Charge Code	60634398
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.15

TAVIST I/TAB

Facility

$1.00

Hospital Charge Code	60634398
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

TAXOL 300MG/50ML INJ

Facility

$9,928.00

Hospital Charge Code	60635234
Hospital Revenue Code	636
Min. Negotiated Rate	$239.26
Max. Negotiated Rate	$4,964.00
Rate for Payer: Aetna Commercial	$3,772.64
Rate for Payer: Aetna Medicare Advantage	$2,978.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,531.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,531.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,531.64
Rate for Payer: Cigna Commercial	$4,964.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,402.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,489.20
Rate for Payer: UnitedHealthcare Community & State	$239.26
Rate for Payer: Wellpoint Medicaid Managed Care	$263.09

TAXOL 300MG/50ML INJ

Facility

$9,928.00

Hospital Charge Code	60635234
Hospital Revenue Code	636
Min. Negotiated Rate	$1,489.20
Max. Negotiated Rate	$2,402.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,402.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,489.20

TAXOL 30MG VIALS

Facility

$2,407.00

Hospital Charge Code	60635082
Hospital Revenue Code	636
Min. Negotiated Rate	$58.01
Max. Negotiated Rate	$1,203.50
Rate for Payer: Aetna Commercial	$914.66
Rate for Payer: Aetna Medicare Advantage	$722.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$613.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$613.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$613.78
Rate for Payer: Cigna Commercial	$1,203.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$582.49
Rate for Payer: Qualcare PPO/HMO/WC	$361.05
Rate for Payer: UnitedHealthcare Community & State	$58.01
Rate for Payer: Wellpoint Medicaid Managed Care	$63.79

TAXOL 30MG VIALS

Facility

$2,407.00

Hospital Charge Code	60635082
Hospital Revenue Code	636
Min. Negotiated Rate	$361.05
Max. Negotiated Rate	$582.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$582.49
Rate for Payer: Qualcare PPO/HMO/WC	$361.05

*****TAY SACHS

Facility

$150.00

Service Code	HCPCS 84311
Hospital Charge Code	30006748
Hospital Revenue Code	301
Min. Negotiated Rate	$3.98
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$22.03
Rate for Payer: Aetna Medicare Advantage	$26.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.24
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: Cigna Medicare Advantage	$8.10
Rate for Payer: Clover Medicare Advantage	$7.70
Rate for Payer: EmblemHealth Commercial	$24.30
Rate for Payer: Humana Medicare Advantage	$8.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.10
Rate for Payer: Wellcare Medicare Advantage	$8.10
Rate for Payer: Wellpoint Medicaid Managed Care	$3.98

*****TAY SACHS

Facility

$150.00

Service Code	HCPCS 84311
Hospital Charge Code	30006748
Hospital Revenue Code	301
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

TAY-SACHS CAR SCN,LEUK AND DNA

Facility

$193.75

Service Code	HCPCS 83080
Hospital Charge Code	3006745
Hospital Revenue Code	301
Min. Negotiated Rate	$5.13
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$45.89
Rate for Payer: Aetna Medicare Advantage	$54.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.90
Rate for Payer: Cigna Commercial	$96.88
Rate for Payer: Cigna Medicare Advantage	$16.87
Rate for Payer: Clover Medicare Advantage	$16.03
Rate for Payer: EmblemHealth Commercial	$50.61
Rate for Payer: Humana Medicare Advantage	$17.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.12
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.06
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.87
Rate for Payer: Wellcare Medicare Advantage	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$5.13

TAY-SACHS CAR SCN,LEUK AND DNA

Facility

$193.75

Service Code	HCPCS 83080
Hospital Charge Code	3006745
Hospital Revenue Code	301
Min. Negotiated Rate	$29.06
Max. Negotiated Rate	$29.06
Rate for Payer: Qualcare PPO/HMO/WC	$29.06

TAY SACHS (SPECT)

Facility

$383.25

Service Code	HCPCS 84311
Hospital Charge Code	3006748
Hospital Revenue Code	301
Min. Negotiated Rate	$57.49
Max. Negotiated Rate	$57.49
Rate for Payer: Qualcare PPO/HMO/WC	$57.49

TAY SACHS (SPECT)

Facility

$383.25

Service Code	HCPCS 84311
Hospital Charge Code	3006748
Hospital Revenue Code	301
Min. Negotiated Rate	$6.48
Max. Negotiated Rate	$191.62
Rate for Payer: Aetna Commercial	$22.03
Rate for Payer: Aetna Medicare Advantage	$26.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.24
Rate for Payer: Cigna Commercial	$191.62
Rate for Payer: Cigna Medicare Advantage	$8.10
Rate for Payer: Clover Medicare Advantage	$7.70
Rate for Payer: EmblemHealth Commercial	$24.30
Rate for Payer: Humana Medicare Advantage	$8.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.49
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.10
Rate for Payer: Wellcare Medicare Advantage	$8.10
Rate for Payer: Wellpoint Medicaid Managed Care	$10.16

TAZIDIME/1GM

Facility

$84.00

Hospital Charge Code	60633969
Hospital Revenue Code	250
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.60

TAZIDIME/1GM

Facility

$84.00

Hospital Charge Code	60633969
Hospital Revenue Code	250
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$42.00
Rate for Payer: Aetna Commercial	$31.92
Rate for Payer: Aetna Medicare Advantage	$25.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.42
Rate for Payer: Cigna Commercial	$42.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.20
Rate for Payer: Oxford Commercial	$16.80
Rate for Payer: Qualcare PPO/HMO/WC	$12.60
Rate for Payer: UnitedHealthcare Commercial	$16.80
Rate for Payer: UnitedHealthcare Community & State	$2.02
Rate for Payer: Wellpoint Medicaid Managed Care	$2.23

TAZIDIME/500MG

Facility

$48.00

Hospital Charge Code	60633968
Hospital Revenue Code	250
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$24.00
Rate for Payer: Aetna Commercial	$18.24
Rate for Payer: Aetna Medicare Advantage	$14.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.24
Rate for Payer: Cigna Commercial	$24.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.40
Rate for Payer: Oxford Commercial	$9.60
Rate for Payer: Qualcare PPO/HMO/WC	$7.20
Rate for Payer: UnitedHealthcare Commercial	$9.60
Rate for Payer: UnitedHealthcare Community & State	$1.16
Rate for Payer: Wellpoint Medicaid Managed Care	$1.27

TAZIDIME/500MG

Facility

$48.00

Hospital Charge Code	60633968
Hospital Revenue Code	250
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$7.20

TAZIDIME/6GM

Facility

$482.00

Hospital Charge Code	60633970
Hospital Revenue Code	250
Min. Negotiated Rate	$11.62
Max. Negotiated Rate	$241.00
Rate for Payer: Aetna Commercial	$183.16
Rate for Payer: Aetna Medicare Advantage	$144.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.91
Rate for Payer: Cigna Commercial	$241.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.60
Rate for Payer: Oxford Commercial	$96.40
Rate for Payer: Qualcare PPO/HMO/WC	$72.30
Rate for Payer: UnitedHealthcare Commercial	$96.40
Rate for Payer: UnitedHealthcare Community & State	$11.62
Rate for Payer: Wellpoint Medicaid Managed Care	$12.77

TAZIDIME/6GM

Facility

$482.00

Hospital Charge Code	60633970
Hospital Revenue Code	250
Min. Negotiated Rate	$72.30
Max. Negotiated Rate	$72.30
Rate for Payer: Qualcare PPO/HMO/WC	$72.30

TBA 1ST ARTERY (NOT DIALYSIS)

Facility

$24,115.80

Service Code	HCPCS 37248
Hospital Charge Code	5100846
Hospital Revenue Code	361
Min. Negotiated Rate	$3,617.37
Max. Negotiated Rate	$3,617.37
Rate for Payer: Qualcare PPO/HMO/WC	$3,617.37

TBA 1ST ARTERY (NOT DIALYSIS)

Facility

$24,115.80

Service Code	HCPCS 37248
Hospital Charge Code	366837248
Hospital Revenue Code	361
Min. Negotiated Rate	$581.19
Max. Negotiated Rate	$24,407.82
Rate for Payer: Aetna Commercial	$18,391.91
Rate for Payer: Aetna Medicare Advantage	$21,908.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24,407.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24,407.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,761.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24,407.82
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: Cigna Medicare Advantage	$6,761.73
Rate for Payer: Clover Medicare Advantage	$6,423.64
Rate for Payer: EmblemHealth Commercial	$20,285.19
Rate for Payer: Humana Medicare Advantage	$6,964.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,761.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,234.74
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,617.37
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$581.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,761.73
Rate for Payer: Wellcare Medicare Advantage	$6,761.73
Rate for Payer: Wellpoint Medicaid Managed Care	$639.07

TBA 1ST ARTERY (NOT DIALYSIS)

Facility

$24,115.80

Service Code	HCPCS 37248
Hospital Charge Code	2692138
Hospital Revenue Code	361
Min. Negotiated Rate	$3,617.37
Max. Negotiated Rate	$3,617.37
Rate for Payer: Qualcare PPO/HMO/WC	$3,617.37

TBA 1ST ARTERY (NOT DIALYSIS)

Facility

$24,115.80

Service Code	HCPCS 37248
Hospital Charge Code	5100846
Hospital Revenue Code	361
Min. Negotiated Rate	$581.19
Max. Negotiated Rate	$24,407.82
Rate for Payer: Aetna Commercial	$18,391.91
Rate for Payer: Aetna Medicare Advantage	$21,908.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24,407.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24,407.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,761.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24,407.82
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: Cigna Medicare Advantage	$6,761.73
Rate for Payer: Clover Medicare Advantage	$6,423.64
Rate for Payer: EmblemHealth Commercial	$20,285.19
Rate for Payer: Humana Medicare Advantage	$6,964.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,761.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,234.74
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,617.37
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$581.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,761.73
Rate for Payer: Wellcare Medicare Advantage	$6,761.73
Rate for Payer: Wellpoint Medicaid Managed Care	$639.07

TBA 1ST ARTERY (NOT DIALYSIS)

Facility

$24,115.80

Service Code	HCPCS 37248
Hospital Charge Code	366837248
Hospital Revenue Code	361
Min. Negotiated Rate	$3,617.37
Max. Negotiated Rate	$3,617.37
Rate for Payer: Qualcare PPO/HMO/WC	$3,617.37

TBA 1ST ARTERY (NOT DIALYSIS)

Facility

$24,115.80

Service Code	HCPCS 37248
Hospital Charge Code	2709033
Hospital Revenue Code	361
Min. Negotiated Rate	$3,617.37
Max. Negotiated Rate	$3,617.37
Rate for Payer: Qualcare PPO/HMO/WC	$3,617.37

TBA 1ST ARTERY (NOT DIALYSIS)

Facility

$27,397.00

Service Code	HCPCS 37248
Hospital Charge Code	321037248
Hospital Revenue Code	361
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

Know your out-of-pocket cost for care.

All Charges