Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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

BENZTROPINE 1 MG TAB

Facility

$4.00

Service Code	NDC 832108100
Hospital Charge Code	6022198
Hospital Revenue Code	251
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

BENZTROPINE 1 MG TAB

Facility

$4.00

Service Code	NDC 832108100
Hospital Charge Code	6022198
Hospital Revenue Code	251
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

BENZTROPINE 2 MG/2 ML INJ

Facility

$393.63

Service Code	HCPCS J0515
Hospital Charge Code	60627418
Hospital Revenue Code	636
Min. Negotiated Rate	$59.04
Max. Negotiated Rate	$95.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.26
Rate for Payer: Qualcare PPO/HMO/WC	$59.04

BENZTROPINE 2 MG/2 ML INJ

Facility

$393.63

Service Code	HCPCS J0515
Hospital Charge Code	60627418
Hospital Revenue Code	636
Min. Negotiated Rate	$9.49
Max. Negotiated Rate	$196.81
Rate for Payer: Aetna Commercial	$149.58
Rate for Payer: Aetna Medicare Advantage	$118.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.38
Rate for Payer: Cigna Commercial	$196.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.26
Rate for Payer: Qualcare PPO/HMO/WC	$59.04
Rate for Payer: UnitedHealthcare Community & State	$9.49
Rate for Payer: Wellpoint Medicaid Managed Care	$10.43

BENZTROPINE 2 MG TAB

Facility

$4.00

Service Code	NDC 603243921
Hospital Charge Code	60627419
Hospital Revenue Code	251
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

BENZTROPINE 2 MG TAB

Facility

$4.00

Service Code	NDC 603243921
Hospital Charge Code	60627419
Hospital Revenue Code	251
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

BENZTROPINE INJ 1MG/ML; 2ML

Facility

$58.25

Hospital Charge Code	6000616
Hospital Revenue Code	250
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$29.12
Rate for Payer: Aetna Commercial	$22.14
Rate for Payer: Aetna Medicare Advantage	$17.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.85
Rate for Payer: Cigna Commercial	$29.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.48
Rate for Payer: Oxford Commercial	$11.65
Rate for Payer: Qualcare PPO/HMO/WC	$8.74
Rate for Payer: UnitedHealthcare Commercial	$11.65
Rate for Payer: UnitedHealthcare Community & State	$1.40
Rate for Payer: Wellpoint Medicaid Managed Care	$1.54

BENZTROPINE INJ 1MG/ML; 2ML

Facility

$58.25

Hospital Charge Code	6000616
Hospital Revenue Code	250
Min. Negotiated Rate	$8.74
Max. Negotiated Rate	$8.74
Rate for Payer: Qualcare PPO/HMO/WC	$8.74

BENZTROPINE MESYLATE/0.5M

Facility

$3.00

Hospital Charge Code	60632545
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

BENZTROPINE MESYLATE/0.5M

Facility

$3.00

Hospital Charge Code	60632542
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

BENZTROPINE MESYLATE/0.5M

Facility

$3.00

Hospital Charge Code	60632542
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

BENZTROPINE MESYLATE/0.5M

Facility

$3.00

Hospital Charge Code	60632545
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

BENZTROPINE MESYLATE/1MG

Facility

$3.00

Hospital Charge Code	60632543
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

BENZTROPINE MESYLATE/1MG

Facility

$3.00

Hospital Charge Code	60632543
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

BENZTROPINE MESYLATE/2MG

Facility

$3.00

Hospital Charge Code	60632544
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

BENZTROPINE MESYLATE/2MG

Facility

$3.00

Hospital Charge Code	60632544
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

BENZYLPENICILLOYL POLYLYSI INJ

Facility

$492.85

Hospital Charge Code	60627872
Hospital Revenue Code	250
Min. Negotiated Rate	$11.88
Max. Negotiated Rate	$246.43
Rate for Payer: Aetna Commercial	$187.28
Rate for Payer: Aetna Medicare Advantage	$147.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.68
Rate for Payer: Cigna Commercial	$246.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.85
Rate for Payer: Oxford Commercial	$98.57
Rate for Payer: Qualcare PPO/HMO/WC	$73.93
Rate for Payer: UnitedHealthcare Commercial	$98.57
Rate for Payer: UnitedHealthcare Community & State	$11.88
Rate for Payer: Wellpoint Medicaid Managed Care	$13.06

BENZYLPENICILLOYL POLYLYSI INJ

Facility

$492.85

Hospital Charge Code	60627872
Hospital Revenue Code	250
Min. Negotiated Rate	$73.93
Max. Negotiated Rate	$73.93
Rate for Payer: Qualcare PPO/HMO/WC	$73.93

BERING 10kX71/75mm CR-L 183540

Facility

$5,260.00

Hospital Charge Code	27063971
Hospital Revenue Code	278
Min. Negotiated Rate	$126.77
Max. Negotiated Rate	$2,630.00
Rate for Payer: Aetna Commercial	$1,998.80
Rate for Payer: Aetna Medicare Advantage	$1,578.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,341.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,341.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,052.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,341.30
Rate for Payer: Cigna Commercial	$2,630.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,272.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,157.20
Rate for Payer: Qualcare PPO/HMO/WC	$789.00
Rate for Payer: UnitedHealthcare Community & State	$126.77
Rate for Payer: Wellpoint Medicaid Managed Care	$139.39

BERING 10kX71/75mm CR-L 183540

Facility

$5,260.00

Hospital Charge Code	27063971
Hospital Revenue Code	278
Min. Negotiated Rate	$789.00
Max. Negotiated Rate	$1,272.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,052.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,272.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,157.20
Rate for Payer: Qualcare PPO/HMO/WC	$789.00

BETA-2 GLUCOPROTEIN ABS ****

Facility

$225.00

Service Code	HCPCS 86146
Hospital Charge Code	3007219P
Hospital Revenue Code	302
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

BETA-2 GLUCOPROTEIN ABS ****

Facility

$225.00

Service Code	HCPCS 86146
Hospital Charge Code	3007219P
Hospital Revenue Code	302
Min. Negotiated Rate	$5.96
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$69.22
Rate for Payer: Aetna Medicare Advantage	$82.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.87
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: Cigna Medicare Advantage	$25.45
Rate for Payer: Clover Medicare Advantage	$24.18
Rate for Payer: EmblemHealth Commercial	$76.35
Rate for Payer: Humana Medicare Advantage	$26.21
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$25.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$20.36
Rate for Payer: UnitedHealthcare Medicare Advantage	$25.45
Rate for Payer: Wellcare Medicare Advantage	$25.45
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

BETA-2 GLYCOPROTEIN IGA

Facility

$302.45

Service Code	HCPCS 86146
Hospital Charge Code	3007219B
Hospital Revenue Code	302
Min. Negotiated Rate	$8.01
Max. Negotiated Rate	$151.22
Rate for Payer: Aetna Commercial	$69.22
Rate for Payer: Aetna Medicare Advantage	$82.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.87
Rate for Payer: Cigna Commercial	$151.22
Rate for Payer: Cigna Medicare Advantage	$25.45
Rate for Payer: Clover Medicare Advantage	$24.18
Rate for Payer: EmblemHealth Commercial	$76.35
Rate for Payer: Humana Medicare Advantage	$26.21
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$25.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.37
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$20.36
Rate for Payer: UnitedHealthcare Medicare Advantage	$25.45
Rate for Payer: Wellcare Medicare Advantage	$25.45
Rate for Payer: Wellpoint Medicaid Managed Care	$8.01

BETA-2 GLYCOPROTEIN IGA

Facility

$302.45

Service Code	HCPCS 86146
Hospital Charge Code	3007219B
Hospital Revenue Code	302
Min. Negotiated Rate	$45.37
Max. Negotiated Rate	$45.37
Rate for Payer: Qualcare PPO/HMO/WC	$45.37

Know your out-of-pocket cost for care.

All Charges