Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BEBTELOVIMAB INJ AND MONITOR

Facility

$2,250.00

Service Code	HCPCS M0222
Hospital Charge Code	3035M0222
Hospital Revenue Code	771
Min. Negotiated Rate	$54.23
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$675.00
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$54.23
Rate for Payer: Wellpoint Medicaid Managed Care	$59.62

BEBTELOVIMAB INJ AND MONITOR

Facility

$2,250.00

Service Code	HCPCS M0222
Hospital Charge Code	3024M0222
Hospital Revenue Code	771
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

BEBTELOVIMAB INJ AND MONITOR

Facility

$2,250.00

Service Code	HCPCS M0222
Hospital Charge Code	3042M0222
Hospital Revenue Code	771
Min. Negotiated Rate	$54.23
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$675.00
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$54.23
Rate for Payer: Wellpoint Medicaid Managed Care	$59.62

BECLOMETHASONE DIPRO INH

Facility

$64.00

Hospital Charge Code	6000558
Hospital Revenue Code	252
Min. Negotiated Rate	$1.54
Max. Negotiated Rate	$32.00
Rate for Payer: Aetna Commercial	$24.32
Rate for Payer: Aetna Medicare Advantage	$19.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.32
Rate for Payer: Cigna Commercial	$32.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.20
Rate for Payer: Oxford Commercial	$12.80
Rate for Payer: Qualcare PPO/HMO/WC	$9.60
Rate for Payer: UnitedHealthcare Commercial	$12.80
Rate for Payer: UnitedHealthcare Community & State	$1.54
Rate for Payer: Wellpoint Medicaid Managed Care	$1.70

BECLOMETHASONE DIPRO INH

Facility

$64.00

Hospital Charge Code	6000558
Hospital Revenue Code	252
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$9.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.60

BECLOMETHASONE NSL 42MCG AQUE

Facility

$362.45

Hospital Charge Code	60628034
Hospital Revenue Code	250
Min. Negotiated Rate	$54.37
Max. Negotiated Rate	$54.37
Rate for Payer: Qualcare PPO/HMO/WC	$54.37

BECLOMETHASONE NSL 42MCG AQUE

Facility

$362.45

Hospital Charge Code	60628034
Hospital Revenue Code	250
Min. Negotiated Rate	$8.74
Max. Negotiated Rate	$181.22
Rate for Payer: Aetna Commercial	$137.73
Rate for Payer: Aetna Medicare Advantage	$108.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.42
Rate for Payer: Cigna Commercial	$181.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.73
Rate for Payer: Oxford Commercial	$72.49
Rate for Payer: Qualcare PPO/HMO/WC	$54.37
Rate for Payer: UnitedHealthcare Commercial	$72.49
Rate for Payer: UnitedHealthcare Community & State	$8.74
Rate for Payer: Wellpoint Medicaid Managed Care	$9.60

BECLOMETHASONE NSL INH 42MCG

Facility

$268.80

Hospital Charge Code	60628035
Hospital Revenue Code	250
Min. Negotiated Rate	$6.48
Max. Negotiated Rate	$134.40
Rate for Payer: Aetna Commercial	$102.14
Rate for Payer: Aetna Medicare Advantage	$80.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.54
Rate for Payer: Cigna Commercial	$134.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.64
Rate for Payer: Oxford Commercial	$53.76
Rate for Payer: Qualcare PPO/HMO/WC	$40.32
Rate for Payer: UnitedHealthcare Commercial	$53.76
Rate for Payer: UnitedHealthcare Community & State	$6.48
Rate for Payer: Wellpoint Medicaid Managed Care	$7.12

BECLOMETHASONE NSL INH 42MCG

Facility

$268.80

Hospital Charge Code	60628035
Hospital Revenue Code	250
Min. Negotiated Rate	$40.32
Max. Negotiated Rate	$40.32
Rate for Payer: Qualcare PPO/HMO/WC	$40.32

BECLOMETHASONE ORL INH 42MCG

Facility

$321.65

Hospital Charge Code	60628180
Hospital Revenue Code	250
Min. Negotiated Rate	$48.25
Max. Negotiated Rate	$48.25
Rate for Payer: Qualcare PPO/HMO/WC	$48.25

BECLOMETHASONE ORL INH 42MCG

Facility

$321.65

Hospital Charge Code	60628180
Hospital Revenue Code	250
Min. Negotiated Rate	$7.75
Max. Negotiated Rate	$160.82
Rate for Payer: Aetna Commercial	$122.23
Rate for Payer: Aetna Medicare Advantage	$96.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.02
Rate for Payer: Cigna Commercial	$160.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.50
Rate for Payer: Oxford Commercial	$64.33
Rate for Payer: Qualcare PPO/HMO/WC	$48.25
Rate for Payer: UnitedHealthcare Commercial	$64.33
Rate for Payer: UnitedHealthcare Community & State	$7.75
Rate for Payer: Wellpoint Medicaid Managed Care	$8.52

BECLOMETHASONE ORL INH 84MCG

Facility

$272.00

Hospital Charge Code	60628181
Hospital Revenue Code	250
Min. Negotiated Rate	$40.80
Max. Negotiated Rate	$40.80
Rate for Payer: Qualcare PPO/HMO/WC	$40.80

BECLOMETHASONE ORL INH 84MCG

Facility

$272.00

Hospital Charge Code	60628181
Hospital Revenue Code	250
Min. Negotiated Rate	$6.56
Max. Negotiated Rate	$136.00
Rate for Payer: Aetna Commercial	$103.36
Rate for Payer: Aetna Medicare Advantage	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.36
Rate for Payer: Cigna Commercial	$136.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.60
Rate for Payer: Oxford Commercial	$54.40
Rate for Payer: Qualcare PPO/HMO/WC	$40.80
Rate for Payer: UnitedHealthcare Commercial	$54.40
Rate for Payer: UnitedHealthcare Community & State	$6.56
Rate for Payer: Wellpoint Medicaid Managed Care	$7.21

BECLOVENT/16.8GM

Facility

$149.00

Hospital Charge Code	60632534
Hospital Revenue Code	250
Min. Negotiated Rate	$22.35
Max. Negotiated Rate	$22.35
Rate for Payer: Qualcare PPO/HMO/WC	$22.35

BECLOVENT/16.8GM

Facility

$149.00

Hospital Charge Code	60632534
Hospital Revenue Code	250
Min. Negotiated Rate	$3.59
Max. Negotiated Rate	$74.50
Rate for Payer: Aetna Commercial	$56.62
Rate for Payer: Aetna Medicare Advantage	$44.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.99
Rate for Payer: Cigna Commercial	$74.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.70
Rate for Payer: Oxford Commercial	$29.80
Rate for Payer: Qualcare PPO/HMO/WC	$22.35
Rate for Payer: UnitedHealthcare Commercial	$29.80
Rate for Payer: UnitedHealthcare Community & State	$3.59
Rate for Payer: Wellpoint Medicaid Managed Care	$3.95

BECLOVENT/BECONASE/16.8GM

Facility

$100.00

Hospital Charge Code	60632535
Hospital Revenue Code	250
Min. Negotiated Rate	$2.41
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Commercial	$38.00
Rate for Payer: Aetna Medicare Advantage	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.50
Rate for Payer: Cigna Commercial	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.00
Rate for Payer: Oxford Commercial	$20.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$20.00
Rate for Payer: UnitedHealthcare Community & State	$2.41
Rate for Payer: Wellpoint Medicaid Managed Care	$2.65

BECLOVENT/BECONASE/16.8GM

Facility

$100.00

Hospital Charge Code	60632535
Hospital Revenue Code	250
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

BECONASE/16.8GM

Facility

$108.00

Hospital Charge Code	60632536
Hospital Revenue Code	250
Min. Negotiated Rate	$16.20
Max. Negotiated Rate	$16.20
Rate for Payer: Qualcare PPO/HMO/WC	$16.20

BECONASE/16.8GM

Facility

$108.00

Hospital Charge Code	60632536
Hospital Revenue Code	250
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$54.00
Rate for Payer: Aetna Commercial	$41.04
Rate for Payer: Aetna Medicare Advantage	$32.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.54
Rate for Payer: Cigna Commercial	$54.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.40
Rate for Payer: Oxford Commercial	$21.60
Rate for Payer: Qualcare PPO/HMO/WC	$16.20
Rate for Payer: UnitedHealthcare Commercial	$21.60
Rate for Payer: UnitedHealthcare Community & State	$2.60
Rate for Payer: Wellpoint Medicaid Managed Care	$2.86

BECONASE AQ 0.042% NASAL

Facility

$158.00

Hospital Charge Code	60632537
Hospital Revenue Code	250
Min. Negotiated Rate	$23.70
Max. Negotiated Rate	$23.70
Rate for Payer: Qualcare PPO/HMO/WC	$23.70

BECONASE AQ 0.042% NASAL

Facility

$158.00

Hospital Charge Code	60632537
Hospital Revenue Code	250
Min. Negotiated Rate	$3.81
Max. Negotiated Rate	$79.00
Rate for Payer: Aetna Commercial	$60.04
Rate for Payer: Aetna Medicare Advantage	$47.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.29
Rate for Payer: Cigna Commercial	$79.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.40
Rate for Payer: Oxford Commercial	$31.60
Rate for Payer: Qualcare PPO/HMO/WC	$23.70
Rate for Payer: UnitedHealthcare Commercial	$31.60
Rate for Payer: UnitedHealthcare Community & State	$3.81
Rate for Payer: Wellpoint Medicaid Managed Care	$4.19

BEDPAN FRACTURE DISP

Facility

$7.25

Hospital Charge Code	270300325
Hospital Revenue Code	272
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

BEDPAN FRACTURE DISP

Facility

$7.25

Hospital Charge Code	270300325
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.62
Rate for Payer: Aetna Commercial	$2.75
Rate for Payer: Aetna Medicare Advantage	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.85
Rate for Payer: Cigna Commercial	$3.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.17
Rate for Payer: Oxford Commercial	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.09
Rate for Payer: UnitedHealthcare Commercial	$1.45
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

BEDPAN REGULAR DISP

Facility

$9.65

Hospital Charge Code	270300330
Hospital Revenue Code	270
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$4.83
Rate for Payer: Aetna Commercial	$3.67
Rate for Payer: Aetna Medicare Advantage	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.46
Rate for Payer: Cigna Commercial	$4.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.90
Rate for Payer: Oxford Commercial	$1.93
Rate for Payer: Qualcare PPO/HMO/WC	$1.45
Rate for Payer: UnitedHealthcare Commercial	$1.93
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

BEDPAN REGULAR DISP

Facility

$9.65

Hospital Charge Code	270300330
Hospital Revenue Code	270
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.45

Know your out-of-pocket cost for care.

All Charges