Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BENTSON WIRE 180

Facility

$650.00

Hospital Charge Code	270683079
Hospital Revenue Code	272
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.00
Rate for Payer: Oxford Commercial	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Commercial	$130.00
Rate for Payer: UnitedHealthcare Community & State	$15.66
Rate for Payer: Wellpoint Medicaid Managed Care	$17.23

BENTSON WIRE 180

Facility

$650.00

Hospital Charge Code	270683079S
Hospital Revenue Code	272
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.00
Rate for Payer: Oxford Commercial	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Commercial	$130.00
Rate for Payer: UnitedHealthcare Community & State	$15.66
Rate for Payer: Wellpoint Medicaid Managed Care	$17.23

BENTSON WIRE 180

Facility

$650.00

Hospital Charge Code	270683079S
Hospital Revenue Code	272
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

BENTSON WIRE 180

Facility

$650.00

Hospital Charge Code	270683079N
Hospital Revenue Code	272
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.00
Rate for Payer: Oxford Commercial	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Commercial	$130.00
Rate for Payer: UnitedHealthcare Community & State	$15.66
Rate for Payer: Wellpoint Medicaid Managed Care	$17.23

BENTSON WIRE 180

Facility

$650.00

Hospital Charge Code	270683079N
Hospital Revenue Code	272
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

BENTSON WIRE 180

Facility

$650.00

Hospital Charge Code	270683079
Hospital Revenue Code	272
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

BENTSON WIRE GUIGE 80CM

Facility

$132.45

Hospital Charge Code	270704889
Hospital Revenue Code	279
Min. Negotiated Rate	$3.19
Max. Negotiated Rate	$66.22
Rate for Payer: Aetna Commercial	$50.33
Rate for Payer: Aetna Medicare Advantage	$39.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.77
Rate for Payer: Cigna Commercial	$66.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.73
Rate for Payer: Oxford Commercial	$26.49
Rate for Payer: Qualcare PPO/HMO/WC	$19.87
Rate for Payer: UnitedHealthcare Commercial	$26.49
Rate for Payer: UnitedHealthcare Community & State	$3.19
Rate for Payer: Wellpoint Medicaid Managed Care	$3.51

BENTSON WIRE GUIGE 80CM

Facility

$132.45

Hospital Charge Code	270704889
Hospital Revenue Code	279
Min. Negotiated Rate	$19.87
Max. Negotiated Rate	$19.87
Rate for Payer: Qualcare PPO/HMO/WC	$19.87

BENYLIN COUGH/4OZ

Facility

$8.00

Hospital Charge Code	60634516
Hospital Revenue Code	250
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$3.04
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.40
Rate for Payer: Oxford Commercial	$1.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$1.60
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

BENYLIN COUGH/4OZ

Facility

$8.00

Hospital Charge Code	60634516
Hospital Revenue Code	250
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

BENZALKONIUM CHLOR SOL .13%

Facility

$73.00

Hospital Charge Code	6000574
Hospital Revenue Code	251
Min. Negotiated Rate	$1.76
Max. Negotiated Rate	$36.50
Rate for Payer: Aetna Commercial	$27.74
Rate for Payer: Aetna Medicare Advantage	$21.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.61
Rate for Payer: Cigna Commercial	$36.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.90
Rate for Payer: Oxford Commercial	$14.60
Rate for Payer: Qualcare PPO/HMO/WC	$10.95
Rate for Payer: UnitedHealthcare Commercial	$14.60
Rate for Payer: UnitedHealthcare Community & State	$1.76
Rate for Payer: Wellpoint Medicaid Managed Care	$1.93

BENZALKONIUM CHLOR SOL .13%

Facility

$73.00

Hospital Charge Code	6000574
Hospital Revenue Code	251
Min. Negotiated Rate	$10.95
Max. Negotiated Rate	$10.95
Rate for Payer: Qualcare PPO/HMO/WC	$10.95

BENZENE,SERUM

Facility

$111.25

Service Code	HCPCS 84600
Hospital Charge Code	3000410
Hospital Revenue Code	301
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$46.54
Rate for Payer: Aetna Medicare Advantage	$55.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.76
Rate for Payer: Cigna Commercial	$55.62
Rate for Payer: Cigna Medicare Advantage	$17.11
Rate for Payer: Clover Medicare Advantage	$16.25
Rate for Payer: EmblemHealth Commercial	$51.33
Rate for Payer: Humana Medicare Advantage	$17.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.69
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.11
Rate for Payer: Wellcare Medicare Advantage	$17.11
Rate for Payer: Wellpoint Medicaid Managed Care	$2.95

BENZENE,SERUM

Facility

$111.25

Service Code	HCPCS 84600
Hospital Charge Code	3000410
Hospital Revenue Code	301
Min. Negotiated Rate	$16.69
Max. Negotiated Rate	$16.69
Rate for Payer: Qualcare PPO/HMO/WC	$16.69

BENZOCAINE 20 % SPR

Facility

$9.65

Hospital Charge Code	6000582
Hospital Revenue Code	251
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.45

BENZOCAINE 20 % SPR

Facility

$9.65

Hospital Charge Code	6000582
Hospital Revenue Code	251
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

BENZOCAINE5%-RESORCINOL2% CREA

Facility

$3.80

Hospital Charge Code	60629957
Hospital Revenue Code	250
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$0.57
Rate for Payer: Qualcare PPO/HMO/WC	$0.57

BENZOCAINE5%-RESORCINOL2% CREA

Facility

$3.80

Hospital Charge Code	60629957
Hospital Revenue Code	250
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$1.90
Rate for Payer: Aetna Commercial	$1.44
Rate for Payer: Aetna Medicare Advantage	$1.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.97
Rate for Payer: Cigna Commercial	$1.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.14
Rate for Payer: Oxford Commercial	$0.76
Rate for Payer: Qualcare PPO/HMO/WC	$0.57
Rate for Payer: UnitedHealthcare Commercial	$0.76
Rate for Payer: UnitedHealthcare Community & State	$0.09
Rate for Payer: Wellpoint Medicaid Managed Care	$0.10

BENZOCAINE ANTIPY OTIC 10ML

Facility

$64.00

Hospital Charge Code	6000590
Hospital Revenue Code	251
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

BENZOCAINE ANTIPY OTIC 10ML

Facility

$64.00

Hospital Charge Code	6000590
Hospital Revenue Code	251
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$9.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.60

BENZOCAINE GEL

Facility

$4.89

Service Code	NDC 10310031840
Hospital Charge Code	606390415
Hospital Revenue Code	250
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$0.73
Rate for Payer: Qualcare PPO/HMO/WC	$0.73

BENZOCAINE GEL

Facility

$4.89

Service Code	NDC 10310031840
Hospital Charge Code	606390415
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.44
Rate for Payer: Aetna Commercial	$1.86
Rate for Payer: Aetna Medicare Advantage	$1.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.25
Rate for Payer: Cigna Commercial	$2.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.47
Rate for Payer: Oxford Commercial	$0.98
Rate for Payer: Qualcare PPO/HMO/WC	$0.73
Rate for Payer: UnitedHealthcare Commercial	$0.98
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

BENZOCAINE GEL 7.5% INFANT

Facility

$25.39

Service Code	NDC 11917007948
Hospital Charge Code	60628572
Hospital Revenue Code	250
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$12.70
Rate for Payer: Aetna Commercial	$9.65
Rate for Payer: Aetna Medicare Advantage	$7.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.47
Rate for Payer: Cigna Commercial	$12.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.62
Rate for Payer: Oxford Commercial	$5.08
Rate for Payer: Qualcare PPO/HMO/WC	$3.81
Rate for Payer: UnitedHealthcare Commercial	$5.08
Rate for Payer: UnitedHealthcare Community & State	$0.61
Rate for Payer: Wellpoint Medicaid Managed Care	$0.67

BENZOCAINE GEL 7.5% INFANT

Facility

$25.39

Service Code	NDC 11917007948
Hospital Charge Code	60628572
Hospital Revenue Code	250
Min. Negotiated Rate	$3.81
Max. Negotiated Rate	$3.81
Rate for Payer: Qualcare PPO/HMO/WC	$3.81

BENZOCAINE PHENOL GEL

Facility

$4.50

Hospital Charge Code	60628573
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.25
Rate for Payer: Aetna Commercial	$1.71
Rate for Payer: Aetna Medicare Advantage	$1.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.15
Rate for Payer: Cigna Commercial	$2.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.35
Rate for Payer: Oxford Commercial	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.68
Rate for Payer: UnitedHealthcare Commercial	$0.90
Rate for Payer: UnitedHealthcare Community & State	$0.11
Rate for Payer: Wellpoint Medicaid Managed Care	$0.12

Know your out-of-pocket cost for care.

All Charges