Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

THIMOLOL OPH .25% 5ML

Facility

$19.85

Hospital Charge Code	6006134
Hospital Revenue Code	251
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$9.93
Rate for Payer: Aetna Commercial	$7.54
Rate for Payer: Aetna Medicare Advantage	$5.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.06
Rate for Payer: Cigna Commercial	$9.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.96
Rate for Payer: Oxford Commercial	$3.97
Rate for Payer: Qualcare PPO/HMO/WC	$2.98
Rate for Payer: UnitedHealthcare Commercial	$3.97
Rate for Payer: UnitedHealthcare Community & State	$0.48
Rate for Payer: Wellpoint Medicaid Managed Care	$0.53

THIN LONG BLADE 8MM

Facility

$1,062.00

Hospital Charge Code	270685392
Hospital Revenue Code	272
Min. Negotiated Rate	$159.30
Max. Negotiated Rate	$159.30
Rate for Payer: Qualcare PPO/HMO/WC	$159.30

THIN LONG BLADE 8MM

Facility

$1,062.00

Hospital Charge Code	270685392
Hospital Revenue Code	272
Min. Negotiated Rate	$25.59
Max. Negotiated Rate	$531.00
Rate for Payer: Aetna Commercial	$403.56
Rate for Payer: Aetna Medicare Advantage	$318.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$270.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$270.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$270.81
Rate for Payer: Cigna Commercial	$531.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.60
Rate for Payer: Oxford Commercial	$212.40
Rate for Payer: Qualcare PPO/HMO/WC	$159.30
Rate for Payer: UnitedHealthcare Commercial	$212.40
Rate for Payer: UnitedHealthcare Community & State	$25.59
Rate for Payer: Wellpoint Medicaid Managed Care	$28.14

THINPREP -TIS

Facility

$176.15

Service Code	HCPCS 88175
Hospital Charge Code	39900313
Hospital Revenue Code	311
Min. Negotiated Rate	$26.42
Max. Negotiated Rate	$26.42
Rate for Payer: Qualcare PPO/HMO/WC	$26.42

THINPREP -TIS

Facility

$176.15

Service Code	HCPCS 88175
Hospital Charge Code	39900313
Hospital Revenue Code	311
Min. Negotiated Rate	$4.67
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$72.38
Rate for Payer: Aetna Medicare Advantage	$86.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.05
Rate for Payer: Cigna Commercial	$88.08
Rate for Payer: Cigna Medicare Advantage	$26.61
Rate for Payer: Clover Medicare Advantage	$25.28
Rate for Payer: EmblemHealth Commercial	$79.83
Rate for Payer: Humana Medicare Advantage	$27.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.84
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.42
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$21.29
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.61
Rate for Payer: Wellcare Medicare Advantage	$26.61
Rate for Payer: Wellpoint Medicaid Managed Care	$4.67

THIOCYANATE (SERUM)

Facility

$205.65

Service Code	HCPCS 84430
Hospital Charge Code	3009099
Hospital Revenue Code	301
Min. Negotiated Rate	$30.85
Max. Negotiated Rate	$30.85
Rate for Payer: Qualcare PPO/HMO/WC	$30.85

THIOCYANATE (SERUM)

Facility

$205.65

Service Code	HCPCS 84430
Hospital Charge Code	3009099
Hospital Revenue Code	301
Min. Negotiated Rate	$5.45
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$31.63
Rate for Payer: Aetna Medicare Advantage	$37.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.98
Rate for Payer: Cigna Commercial	$102.83
Rate for Payer: Cigna Medicare Advantage	$11.63
Rate for Payer: Clover Medicare Advantage	$11.05
Rate for Payer: EmblemHealth Commercial	$34.89
Rate for Payer: Humana Medicare Advantage	$11.98
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.85
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.63
Rate for Payer: Wellcare Medicare Advantage	$11.63
Rate for Payer: Wellpoint Medicaid Managed Care	$5.45

THIOCYANATE, SERUM

Facility

$259.00

Service Code	HCPCS 84430
Hospital Charge Code	38472034
Hospital Revenue Code	301
Min. Negotiated Rate	$38.85
Max. Negotiated Rate	$38.85
Rate for Payer: Qualcare PPO/HMO/WC	$38.85

THIOCYANATE, SERUM

Facility

$259.00

Service Code	HCPCS 84430
Hospital Charge Code	38472034
Hospital Revenue Code	301
Min. Negotiated Rate	$6.86
Max. Negotiated Rate	$129.50
Rate for Payer: Aetna Commercial	$31.63
Rate for Payer: Aetna Medicare Advantage	$37.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.98
Rate for Payer: Cigna Commercial	$129.50
Rate for Payer: Cigna Medicare Advantage	$11.63
Rate for Payer: Clover Medicare Advantage	$11.05
Rate for Payer: EmblemHealth Commercial	$34.89
Rate for Payer: Humana Medicare Advantage	$11.98
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.85
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.63
Rate for Payer: Wellcare Medicare Advantage	$11.63
Rate for Payer: Wellpoint Medicaid Managed Care	$6.86

THIOCYANATE,URINE

Facility

$259.00

Service Code	HCPCS 84430
Hospital Charge Code	38472633
Hospital Revenue Code	301
Min. Negotiated Rate	$6.86
Max. Negotiated Rate	$129.50
Rate for Payer: Aetna Commercial	$31.63
Rate for Payer: Aetna Medicare Advantage	$37.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.98
Rate for Payer: Cigna Commercial	$129.50
Rate for Payer: Cigna Medicare Advantage	$11.63
Rate for Payer: Clover Medicare Advantage	$11.05
Rate for Payer: EmblemHealth Commercial	$34.89
Rate for Payer: Humana Medicare Advantage	$11.98
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.85
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.63
Rate for Payer: Wellcare Medicare Advantage	$11.63
Rate for Payer: Wellpoint Medicaid Managed Care	$6.86

THIOCYANATE,URINE

Facility

$259.00

Service Code	HCPCS 84430
Hospital Charge Code	38472633
Hospital Revenue Code	301
Min. Negotiated Rate	$38.85
Max. Negotiated Rate	$38.85
Rate for Payer: Qualcare PPO/HMO/WC	$38.85

THIOGUANINE/40MG/TAB

Facility

$13.00

Hospital Charge Code	60634019
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

THIOGUANINE/40MG/TAB

Facility

$13.00

Hospital Charge Code	60634019
Hospital Revenue Code	250
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$4.94
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$2.60
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

THIOPENTAL 400 MG INJ

Facility

$119.25

Hospital Charge Code	60627674
Hospital Revenue Code	250
Min. Negotiated Rate	$17.89
Max. Negotiated Rate	$17.89
Rate for Payer: Qualcare PPO/HMO/WC	$17.89

THIOPENTAL 400 MG INJ

Facility

$119.25

Hospital Charge Code	60627674
Hospital Revenue Code	250
Min. Negotiated Rate	$2.87
Max. Negotiated Rate	$59.62
Rate for Payer: Aetna Commercial	$45.31
Rate for Payer: Aetna Medicare Advantage	$35.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.41
Rate for Payer: Cigna Commercial	$59.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.77
Rate for Payer: Oxford Commercial	$23.85
Rate for Payer: Qualcare PPO/HMO/WC	$17.89
Rate for Payer: UnitedHealthcare Commercial	$23.85
Rate for Payer: UnitedHealthcare Community & State	$2.87
Rate for Payer: Wellpoint Medicaid Managed Care	$3.16

THIOPENTAL 500 MG REC

Facility

$13.20

Hospital Charge Code	60629879
Hospital Revenue Code	250
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$1.98
Rate for Payer: Qualcare PPO/HMO/WC	$1.98

THIOPENTAL 500 MG REC

Facility

$13.20

Hospital Charge Code	60629879
Hospital Revenue Code	250
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$6.60
Rate for Payer: Aetna Commercial	$5.02
Rate for Payer: Aetna Medicare Advantage	$3.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.37
Rate for Payer: Cigna Commercial	$6.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.96
Rate for Payer: Oxford Commercial	$2.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.98
Rate for Payer: UnitedHealthcare Commercial	$2.64
Rate for Payer: UnitedHealthcare Community & State	$0.32
Rate for Payer: Wellpoint Medicaid Managed Care	$0.35

THIOPENTAL SOD INJ 25MG/ML 20M

Facility

$74.90

Hospital Charge Code	6005318
Hospital Revenue Code	250
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$37.45
Rate for Payer: Aetna Commercial	$28.46
Rate for Payer: Aetna Medicare Advantage	$22.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.10
Rate for Payer: Cigna Commercial	$37.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.47
Rate for Payer: Oxford Commercial	$14.98
Rate for Payer: Qualcare PPO/HMO/WC	$11.23
Rate for Payer: UnitedHealthcare Commercial	$14.98
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.98

THIOPENTAL SOD INJ 25MG/ML 20M

Facility

$74.90

Hospital Charge Code	6005318
Hospital Revenue Code	250
Min. Negotiated Rate	$11.23
Max. Negotiated Rate	$11.23
Rate for Payer: Qualcare PPO/HMO/WC	$11.23

THIOPURINE METABOLITES

Facility

$390.00

Service Code	HCPCS 83789
Hospital Charge Code	397080007
Hospital Revenue Code	306
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$65.58
Rate for Payer: Aetna Medicare Advantage	$78.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.03
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$24.11
Rate for Payer: Clover Medicare Advantage	$22.90
Rate for Payer: EmblemHealth Commercial	$72.33
Rate for Payer: Humana Medicare Advantage	$24.83
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$19.29
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.11
Rate for Payer: Wellcare Medicare Advantage	$24.11
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

THIOPURINE METABOLITES

Facility

$390.00

Service Code	HCPCS 83789
Hospital Charge Code	397080007
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

THIOPURINE METABOLOTES

Facility

$376.33

Hospital Charge Code	397073690
Hospital Revenue Code	306
Min. Negotiated Rate	$9.07
Max. Negotiated Rate	$188.16
Rate for Payer: Aetna Commercial	$143.01
Rate for Payer: Aetna Medicare Advantage	$112.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.96
Rate for Payer: Cigna Commercial	$188.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.45
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.07
Rate for Payer: Wellpoint Medicaid Managed Care	$9.97

THIOPURINE METABOLOTES

Facility

$376.33

Hospital Charge Code	397073690
Hospital Revenue Code	306
Min. Negotiated Rate	$56.45
Max. Negotiated Rate	$56.45
Rate for Payer: Qualcare PPO/HMO/WC	$56.45

THIORIDAZINE 100 MG TAB

Facility

$4.00

Hospital Charge Code	60627818
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

THIORIDAZINE 100 MG TAB

Facility

$4.00

Hospital Charge Code	60627818
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

Know your out-of-pocket cost for care.

All Charges