Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BENZODIAZEPINES, URINE

Facility

$131.38

Service Code	HCPCS 80346
Hospital Charge Code	38472137
Hospital Revenue Code	301
Min. Negotiated Rate	$19.71
Max. Negotiated Rate	$19.71
Rate for Payer: Qualcare PPO/HMO/WC	$19.71

BENZODIAZEPINES, URINE

Facility

$131.38

Service Code	HCPCS 80346
Hospital Charge Code	38472137
Hospital Revenue Code	301
Min. Negotiated Rate	$3.48
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$49.92
Rate for Payer: Aetna Medicare Advantage	$39.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.50
Rate for Payer: Cigna Commercial	$65.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.41
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.71
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$20.96
Rate for Payer: Wellpoint Medicaid Managed Care	$3.48

BENZOIN COMPOUND TINCTURE

Facility

$37.12

Service Code	NDC 54162010002
Hospital Charge Code	60631132
Hospital Revenue Code	250
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$18.56
Rate for Payer: Aetna Commercial	$14.11
Rate for Payer: Aetna Medicare Advantage	$11.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.47
Rate for Payer: Cigna Commercial	$18.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.14
Rate for Payer: Oxford Commercial	$7.42
Rate for Payer: Qualcare PPO/HMO/WC	$5.57
Rate for Payer: UnitedHealthcare Commercial	$7.42
Rate for Payer: UnitedHealthcare Community & State	$0.89
Rate for Payer: Wellpoint Medicaid Managed Care	$0.98

BENZOIN COMPOUND TINCTURE

Facility

$37.12

Service Code	NDC 54162010002
Hospital Charge Code	60631132
Hospital Revenue Code	250
Min. Negotiated Rate	$5.57
Max. Negotiated Rate	$5.57
Rate for Payer: Qualcare PPO/HMO/WC	$5.57

BENZOIN COMPOUND TINCTURE 30ML

Facility

$24.72

Service Code	NDC 54162010001
Hospital Charge Code	6063943319
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$12.36
Rate for Payer: Aetna Commercial	$9.39
Rate for Payer: Aetna Medicare Advantage	$7.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.30
Rate for Payer: Cigna Commercial	$12.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.42
Rate for Payer: Oxford Commercial	$4.94
Rate for Payer: Qualcare PPO/HMO/WC	$3.71
Rate for Payer: UnitedHealthcare Commercial	$4.94
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

BENZOIN COMPOUND TINCTURE 30ML

Facility

$24.72

Service Code	NDC 54162010001
Hospital Charge Code	6063943319
Hospital Revenue Code	250
Min. Negotiated Rate	$3.71
Max. Negotiated Rate	$3.71
Rate for Payer: Qualcare PPO/HMO/WC	$3.71

BENZOIN SPRAY****

Facility

$98.00

Hospital Charge Code	8000127
Hospital Revenue Code	279
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$49.00
Rate for Payer: Aetna Commercial	$37.24
Rate for Payer: Aetna Medicare Advantage	$29.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.99
Rate for Payer: Cigna Commercial	$49.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.40
Rate for Payer: Oxford Commercial	$19.60
Rate for Payer: Qualcare PPO/HMO/WC	$14.70
Rate for Payer: UnitedHealthcare Commercial	$19.60
Rate for Payer: UnitedHealthcare Community & State	$2.36
Rate for Payer: Wellpoint Medicaid Managed Care	$2.60

BENZOIN SPRAY****

Facility

$98.00

Hospital Charge Code	8000127
Hospital Revenue Code	279
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$14.70
Rate for Payer: Qualcare PPO/HMO/WC	$14.70

BENZOIN SPRAY 105G CAN

Facility

$25.60

Hospital Charge Code	60628926
Hospital Revenue Code	250
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$12.80
Rate for Payer: Aetna Commercial	$9.73
Rate for Payer: Aetna Medicare Advantage	$7.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.53
Rate for Payer: Cigna Commercial	$12.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.68
Rate for Payer: Oxford Commercial	$5.12
Rate for Payer: Qualcare PPO/HMO/WC	$3.84
Rate for Payer: UnitedHealthcare Commercial	$5.12
Rate for Payer: UnitedHealthcare Community & State	$0.62
Rate for Payer: Wellpoint Medicaid Managed Care	$0.68

BENZOIN SPRAY 105G CAN

Facility

$25.60

Hospital Charge Code	60628926
Hospital Revenue Code	250
Min. Negotiated Rate	$3.84
Max. Negotiated Rate	$3.84
Rate for Payer: Qualcare PPO/HMO/WC	$3.84

BENZOIN TINCTURE 4OZ

Facility

$15.40

Hospital Charge Code	6012264
Hospital Revenue Code	251
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

BENZOIN TINCTURE 4OZ

Facility

$15.40

Hospital Charge Code	6012264
Hospital Revenue Code	251
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$2.31
Rate for Payer: Qualcare PPO/HMO/WC	$2.31

BENZOIN TINCTURE-60ML

Facility

$85.96

Service Code	NDC 395024792
Hospital Charge Code	606390067
Hospital Revenue Code	250
Min. Negotiated Rate	$12.89
Max. Negotiated Rate	$12.89
Rate for Payer: Qualcare PPO/HMO/WC	$12.89

BENZOIN TINCTURE-60ML

Facility

$85.96

Service Code	NDC 395024792
Hospital Charge Code	606390067
Hospital Revenue Code	250
Min. Negotiated Rate	$2.07
Max. Negotiated Rate	$42.98
Rate for Payer: Aetna Commercial	$32.66
Rate for Payer: Aetna Medicare Advantage	$25.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.92
Rate for Payer: Cigna Commercial	$42.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.79
Rate for Payer: Oxford Commercial	$17.19
Rate for Payer: Qualcare PPO/HMO/WC	$12.89
Rate for Payer: UnitedHealthcare Commercial	$17.19
Rate for Payer: UnitedHealthcare Community & State	$2.07
Rate for Payer: Wellpoint Medicaid Managed Care	$2.28

BENZOIN TINCTURE SPRAY 142.5ML

Facility

$115.85

Hospital Charge Code	6009260
Hospital Revenue Code	251
Min. Negotiated Rate	$2.79
Max. Negotiated Rate	$57.92
Rate for Payer: Aetna Commercial	$44.02
Rate for Payer: Aetna Medicare Advantage	$34.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.54
Rate for Payer: Cigna Commercial	$57.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.76
Rate for Payer: Oxford Commercial	$23.17
Rate for Payer: Qualcare PPO/HMO/WC	$17.38
Rate for Payer: UnitedHealthcare Commercial	$23.17
Rate for Payer: UnitedHealthcare Community & State	$2.79
Rate for Payer: Wellpoint Medicaid Managed Care	$3.07

BENZOIN TINCTURE SPRAY 142.5ML

Facility

$115.85

Hospital Charge Code	6009260
Hospital Revenue Code	251
Min. Negotiated Rate	$17.38
Max. Negotiated Rate	$17.38
Rate for Payer: Qualcare PPO/HMO/WC	$17.38

BENZOIN TOLU TINCTURE

Facility

$32.85

Hospital Charge Code	60628431
Hospital Revenue Code	250
Min. Negotiated Rate	$4.93
Max. Negotiated Rate	$4.93
Rate for Payer: Qualcare PPO/HMO/WC	$4.93

BENZOIN TOLU TINCTURE

Facility

$32.85

Hospital Charge Code	60628431
Hospital Revenue Code	250
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$16.43
Rate for Payer: Aetna Commercial	$12.48
Rate for Payer: Aetna Medicare Advantage	$9.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.38
Rate for Payer: Cigna Commercial	$16.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.86
Rate for Payer: Oxford Commercial	$6.57
Rate for Payer: Qualcare PPO/HMO/WC	$4.93
Rate for Payer: UnitedHealthcare Commercial	$6.57
Rate for Payer: UnitedHealthcare Community & State	$0.79
Rate for Payer: Wellpoint Medicaid Managed Care	$0.87

BENZONATATE 100 MG CAP

Facility

$16.75

Service Code	NDC 67877057301
Hospital Charge Code	60627984
Hospital Revenue Code	250
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$8.38
Rate for Payer: Aetna Commercial	$6.37
Rate for Payer: Aetna Medicare Advantage	$5.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.27
Rate for Payer: Cigna Commercial	$8.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.03
Rate for Payer: Oxford Commercial	$3.35
Rate for Payer: Qualcare PPO/HMO/WC	$2.51
Rate for Payer: UnitedHealthcare Commercial	$3.35
Rate for Payer: UnitedHealthcare Community & State	$0.40
Rate for Payer: Wellpoint Medicaid Managed Care	$0.44

BENZONATATE 100 MG CAP

Facility

$16.75

Service Code	NDC 67877057301
Hospital Charge Code	60627984
Hospital Revenue Code	250
Min. Negotiated Rate	$2.51
Max. Negotiated Rate	$2.51
Rate for Payer: Qualcare PPO/HMO/WC	$2.51

BENZOYL PEROX TOP 10%

Facility

$64.00

Hospital Charge Code	6000608
Hospital Revenue Code	251
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$9.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.60

BENZOYL PEROX TOP 10%

Facility

$64.00

Hospital Charge Code	6000608
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

BENZQUINAMIDE HC INJ 50MG VIAL

Facility

$82.00

Service Code	HCPCS J0510
Hospital Charge Code	6008742
Hospital Revenue Code	250
Min. Negotiated Rate	$12.30
Max. Negotiated Rate	$12.30
Rate for Payer: Qualcare PPO/HMO/WC	$12.30

BENZQUINAMIDE HC INJ 50MG VIAL

Facility

$82.00

Service Code	HCPCS J0510
Hospital Charge Code	6008742
Hospital Revenue Code	250
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$41.00
Rate for Payer: Aetna Commercial	$31.16
Rate for Payer: Aetna Medicare Advantage	$24.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.91
Rate for Payer: Cigna Commercial	$41.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.60
Rate for Payer: Oxford Commercial	$16.40
Rate for Payer: Qualcare PPO/HMO/WC	$12.30
Rate for Payer: UnitedHealthcare Commercial	$16.40
Rate for Payer: UnitedHealthcare Community & State	$1.98
Rate for Payer: Wellpoint Medicaid Managed Care	$2.17

BENZTROPINE 0.5 MG TAB

Facility

$4.00

Service Code	NDC 76385010301
Hospital Charge Code	60627417
Hospital Revenue Code	251
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

Know your out-of-pocket cost for care.

All Charges