Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TERAZOSIN 1 MG CAP

Facility

$10.79

Service Code	NDC 51079093601
Hospital Charge Code	6027106
Hospital Revenue Code	251
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$5.39
Rate for Payer: Aetna Commercial	$4.10
Rate for Payer: Aetna Medicare Advantage	$3.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.75
Rate for Payer: Cigna Commercial	$5.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.24
Rate for Payer: Oxford Commercial	$2.16
Rate for Payer: Qualcare PPO/HMO/WC	$1.62
Rate for Payer: UnitedHealthcare Commercial	$2.16
Rate for Payer: UnitedHealthcare Community & State	$0.26
Rate for Payer: Wellpoint Medicaid Managed Care	$0.29

TERAZOSIN 5 MG CAP

Facility

$10.79

Service Code	NDC 51079093820
Hospital Charge Code	6027098
Hospital Revenue Code	251
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$5.39
Rate for Payer: Aetna Commercial	$4.10
Rate for Payer: Aetna Medicare Advantage	$3.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.75
Rate for Payer: Cigna Commercial	$5.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.24
Rate for Payer: Oxford Commercial	$2.16
Rate for Payer: Qualcare PPO/HMO/WC	$1.62
Rate for Payer: UnitedHealthcare Commercial	$2.16
Rate for Payer: UnitedHealthcare Community & State	$0.26
Rate for Payer: Wellpoint Medicaid Managed Care	$0.29

TERAZOSIN 5 MG CAP

Facility

$10.79

Service Code	NDC 51079093820
Hospital Charge Code	6027098
Hospital Revenue Code	251
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$1.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.62

TERBINAFINE 250 MG TAB

Facility

$49.65

Hospital Charge Code	60628767
Hospital Revenue Code	250
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$24.82
Rate for Payer: Aetna Commercial	$18.87
Rate for Payer: Aetna Medicare Advantage	$14.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.66
Rate for Payer: Cigna Commercial	$24.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.89
Rate for Payer: Oxford Commercial	$9.93
Rate for Payer: Qualcare PPO/HMO/WC	$7.45
Rate for Payer: UnitedHealthcare Commercial	$9.93
Rate for Payer: UnitedHealthcare Community & State	$1.20
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

TERBINAFINE 250 MG TAB

Facility

$49.65

Hospital Charge Code	60628767
Hospital Revenue Code	250
Min. Negotiated Rate	$7.45
Max. Negotiated Rate	$7.45
Rate for Payer: Qualcare PPO/HMO/WC	$7.45

TERBUTALINE 1 MG/ML INJ

Facility

$150.68

Service Code	HCPCS J3105
Hospital Charge Code	60627471
Hospital Revenue Code	636
Min. Negotiated Rate	$22.60
Max. Negotiated Rate	$36.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.46
Rate for Payer: Qualcare PPO/HMO/WC	$22.60

TERBUTALINE 1 MG/ML INJ

Facility

$150.68

Service Code	HCPCS J3105
Hospital Charge Code	60627471
Hospital Revenue Code	636
Min. Negotiated Rate	$3.63
Max. Negotiated Rate	$75.34
Rate for Payer: Aetna Commercial	$57.26
Rate for Payer: Aetna Medicare Advantage	$45.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.42
Rate for Payer: Cigna Commercial	$75.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.46
Rate for Payer: Qualcare PPO/HMO/WC	$22.60
Rate for Payer: UnitedHealthcare Community & State	$3.63
Rate for Payer: Wellpoint Medicaid Managed Care	$3.99

TERBUTALINE 2.5 MG TAB

Facility

$36.45

Service Code	NDC 115261101
Hospital Charge Code	60627472
Hospital Revenue Code	250
Min. Negotiated Rate	$5.47
Max. Negotiated Rate	$5.47
Rate for Payer: Qualcare PPO/HMO/WC	$5.47

TERBUTALINE 2.5 MG TAB

Facility

$36.45

Service Code	NDC 115261101
Hospital Charge Code	60627472
Hospital Revenue Code	250
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$18.23
Rate for Payer: Aetna Commercial	$13.85
Rate for Payer: Aetna Medicare Advantage	$10.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.29
Rate for Payer: Cigna Commercial	$18.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.94
Rate for Payer: Oxford Commercial	$7.29
Rate for Payer: Qualcare PPO/HMO/WC	$5.47
Rate for Payer: UnitedHealthcare Commercial	$7.29
Rate for Payer: UnitedHealthcare Community & State	$0.88
Rate for Payer: Wellpoint Medicaid Managed Care	$0.97

TERBUTALINE INJ 1MG

Facility

$15.40

Hospital Charge Code	6009070
Hospital Revenue Code	250
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$2.31
Rate for Payer: Qualcare PPO/HMO/WC	$2.31

TERBUTALINE INJ 1MG

Facility

$15.40

Hospital Charge Code	6009070
Hospital Revenue Code	250
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

TERBUTALINE ORL INH 0.2MG

Facility

$185.00

Hospital Charge Code	60627470
Hospital Revenue Code	250
Min. Negotiated Rate	$27.75
Max. Negotiated Rate	$27.75
Rate for Payer: Qualcare PPO/HMO/WC	$27.75

TERBUTALINE ORL INH 0.2MG

Facility

$185.00

Hospital Charge Code	60627470
Hospital Revenue Code	250
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$92.50
Rate for Payer: Aetna Commercial	$70.30
Rate for Payer: Aetna Medicare Advantage	$55.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.17
Rate for Payer: Cigna Commercial	$92.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.50
Rate for Payer: Oxford Commercial	$37.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.75
Rate for Payer: UnitedHealthcare Commercial	$37.00
Rate for Payer: UnitedHealthcare Community & State	$4.46
Rate for Payer: Wellpoint Medicaid Managed Care	$4.90

TERCONAZOLE 0.4% VAG CREAM 45G

Facility

$274.23

Service Code	NDC 591319689
Hospital Charge Code	6063943314
Hospital Revenue Code	250
Min. Negotiated Rate	$41.13
Max. Negotiated Rate	$41.13
Rate for Payer: Qualcare PPO/HMO/WC	$41.13

TERCONAZOLE 0.4% VAG CREAM 45G

Facility

$274.23

Service Code	NDC 591319689
Hospital Charge Code	6063943314
Hospital Revenue Code	250
Min. Negotiated Rate	$6.61
Max. Negotiated Rate	$137.12
Rate for Payer: Aetna Commercial	$104.21
Rate for Payer: Aetna Medicare Advantage	$82.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.93
Rate for Payer: Cigna Commercial	$137.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.27
Rate for Payer: Oxford Commercial	$54.85
Rate for Payer: Qualcare PPO/HMO/WC	$41.13
Rate for Payer: UnitedHealthcare Commercial	$54.85
Rate for Payer: UnitedHealthcare Community & State	$6.61
Rate for Payer: Wellpoint Medicaid Managed Care	$7.27

TERCONAZOLE 0.8% VAG CRM 20GM

Facility

$436.17

Service Code	NDC 50458053601
Hospital Charge Code	606361042
Hospital Revenue Code	250
Min. Negotiated Rate	$65.43
Max. Negotiated Rate	$65.43
Rate for Payer: Qualcare PPO/HMO/WC	$65.43

TERCONAZOLE 0.8% VAG CRM 20GM

Facility

$436.17

Service Code	NDC 50458053601
Hospital Charge Code	606361042
Hospital Revenue Code	250
Min. Negotiated Rate	$10.51
Max. Negotiated Rate	$218.09
Rate for Payer: Aetna Commercial	$165.74
Rate for Payer: Aetna Medicare Advantage	$130.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.22
Rate for Payer: Cigna Commercial	$218.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.85
Rate for Payer: Oxford Commercial	$87.23
Rate for Payer: Qualcare PPO/HMO/WC	$65.43
Rate for Payer: UnitedHealthcare Commercial	$87.23
Rate for Payer: UnitedHealthcare Community & State	$10.51
Rate for Payer: Wellpoint Medicaid Managed Care	$11.56

TERIPARATIDE 750MCG/3ML

Facility

$3,804.50

Hospital Charge Code	60629880
Hospital Revenue Code	250
Min. Negotiated Rate	$570.67
Max. Negotiated Rate	$570.67
Rate for Payer: Qualcare PPO/HMO/WC	$570.67

TERIPARATIDE 750MCG/3ML

Facility

$3,804.50

Hospital Charge Code	60629880
Hospital Revenue Code	250
Min. Negotiated Rate	$91.69
Max. Negotiated Rate	$1,902.25
Rate for Payer: Aetna Commercial	$1,445.71
Rate for Payer: Aetna Medicare Advantage	$1,141.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$970.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$970.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$970.15
Rate for Payer: Cigna Commercial	$1,902.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,141.35
Rate for Payer: Oxford Commercial	$760.90
Rate for Payer: Qualcare PPO/HMO/WC	$570.67
Rate for Payer: UnitedHealthcare Commercial	$760.90
Rate for Payer: UnitedHealthcare Community & State	$91.69
Rate for Payer: Wellpoint Medicaid Managed Care	$100.82

TERM.DEOXYNUCLEOTIDYL TRANSFER

Facility

$218.74

Service Code	HCPCS 88346
Hospital Charge Code	38476180
Hospital Revenue Code	312
Min. Negotiated Rate	$5.80
Max. Negotiated Rate	$730.60
Rate for Payer: Aetna Commercial	$550.53
Rate for Payer: Aetna Medicare Advantage	$655.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$730.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$730.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$202.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$730.60
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$202.40
Rate for Payer: Clover Medicare Advantage	$192.28
Rate for Payer: EmblemHealth Commercial	$607.20
Rate for Payer: Humana Medicare Advantage	$208.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$202.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.62
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.81
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$122.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$202.40
Rate for Payer: Wellcare Medicare Advantage	$202.40
Rate for Payer: Wellpoint Medicaid Managed Care	$5.80

TERM.DEOXYNUCLEOTIDYL TRANSFER

Facility

$218.74

Service Code	HCPCS 88346
Hospital Charge Code	38476180
Hospital Revenue Code	312
Min. Negotiated Rate	$32.81
Max. Negotiated Rate	$32.81
Rate for Payer: Qualcare PPO/HMO/WC	$32.81

TERMINAL DEOXYNUCLEOTIDL STN**

Facility

$250.00

Service Code	HCPCS 85999
Hospital Charge Code	3008281
Hospital Revenue Code	306
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$95.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.03
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

TERMINAL DEOXYNUCLEOTIDL STN**

Facility

$250.00

Service Code	HCPCS 85999
Hospital Charge Code	3008281
Hospital Revenue Code	306
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

TERPIN HYDRATE/COD LIQ 4 OZ

Facility

$122.90

Hospital Charge Code	6005151
Hospital Revenue Code	251
Min. Negotiated Rate	$18.43
Max. Negotiated Rate	$18.43
Rate for Payer: Qualcare PPO/HMO/WC	$18.43

TERPIN HYDRATE/COD LIQ 4 OZ

Facility

$122.90

Hospital Charge Code	6005151
Hospital Revenue Code	251
Min. Negotiated Rate	$2.96
Max. Negotiated Rate	$61.45
Rate for Payer: Aetna Commercial	$46.70
Rate for Payer: Aetna Medicare Advantage	$36.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.34
Rate for Payer: Cigna Commercial	$61.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.87
Rate for Payer: Oxford Commercial	$24.58
Rate for Payer: Qualcare PPO/HMO/WC	$18.43
Rate for Payer: UnitedHealthcare Commercial	$24.58
Rate for Payer: UnitedHealthcare Community & State	$2.96
Rate for Payer: Wellpoint Medicaid Managed Care	$3.26

Know your out-of-pocket cost for care.

All Charges