Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TICLOPIDINE TAB 250MG

Facility

$10.90

Hospital Charge Code	6017776
Hospital Revenue Code	252
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$5.45
Rate for Payer: Aetna Commercial	$4.14
Rate for Payer: Aetna Medicare Advantage	$3.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.78
Rate for Payer: Cigna Commercial	$5.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.27
Rate for Payer: Oxford Commercial	$2.18
Rate for Payer: Qualcare PPO/HMO/WC	$1.64
Rate for Payer: UnitedHealthcare Commercial	$2.18
Rate for Payer: UnitedHealthcare Community & State	$0.26
Rate for Payer: Wellpoint Medicaid Managed Care	$0.29

TICLOPIDINE TAB 250MG

Facility

$10.90

Hospital Charge Code	6017776
Hospital Revenue Code	252
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$1.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.64

TICLOPIDINE TAB 250MG

Facility

$10.25

Hospital Charge Code	60628721
Hospital Revenue Code	250
Min. Negotiated Rate	$1.54
Max. Negotiated Rate	$1.54
Rate for Payer: Qualcare PPO/HMO/WC	$1.54

TICLOPIDINE TAB 250MG

Facility

$10.25

Hospital Charge Code	60628721
Hospital Revenue Code	250
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$5.12
Rate for Payer: Aetna Commercial	$3.90
Rate for Payer: Aetna Medicare Advantage	$3.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.61
Rate for Payer: Cigna Commercial	$5.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.08
Rate for Payer: Oxford Commercial	$2.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.54
Rate for Payer: UnitedHealthcare Commercial	$2.05
Rate for Payer: UnitedHealthcare Community & State	$0.25
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

TIE JUGGERKNOT 1.0 2-0

Facility

$1,890.00

Hospital Charge Code	270661836
Hospital Revenue Code	278
Min. Negotiated Rate	$283.50
Max. Negotiated Rate	$457.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$378.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$457.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$415.80
Rate for Payer: Qualcare PPO/HMO/WC	$283.50

TIE JUGGERKNOT 1.0 2-0

Facility

$1,890.00

Hospital Charge Code	270661836
Hospital Revenue Code	278
Min. Negotiated Rate	$45.55
Max. Negotiated Rate	$945.00
Rate for Payer: Aetna Commercial	$718.20
Rate for Payer: Aetna Medicare Advantage	$567.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$481.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$481.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$378.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$481.95
Rate for Payer: Cigna Commercial	$945.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$457.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$415.80
Rate for Payer: Qualcare PPO/HMO/WC	$283.50
Rate for Payer: UnitedHealthcare Community & State	$45.55
Rate for Payer: Wellpoint Medicaid Managed Care	$50.09

TIE JUGGERKNOT 1.0 3-0

Facility

$1,890.00

Hospital Charge Code	270661848
Hospital Revenue Code	278
Min. Negotiated Rate	$283.50
Max. Negotiated Rate	$457.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$378.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$457.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$415.80
Rate for Payer: Qualcare PPO/HMO/WC	$283.50

TIE JUGGERKNOT 1.0 3-0

Facility

$1,890.00

Hospital Charge Code	270661848
Hospital Revenue Code	278
Min. Negotiated Rate	$45.55
Max. Negotiated Rate	$945.00
Rate for Payer: Aetna Commercial	$718.20
Rate for Payer: Aetna Medicare Advantage	$567.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$481.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$481.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$378.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$481.95
Rate for Payer: Cigna Commercial	$945.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$457.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$415.80
Rate for Payer: Qualcare PPO/HMO/WC	$283.50
Rate for Payer: UnitedHealthcare Community & State	$45.55
Rate for Payer: Wellpoint Medicaid Managed Care	$50.09

TI END CAP TIBIAL NAIL STRDRV

Facility

$1,103.15

Service Code	HCPCS C1713
Hospital Charge Code	270678634
Hospital Revenue Code	278
Min. Negotiated Rate	$26.59
Max. Negotiated Rate	$551.58
Rate for Payer: Aetna Commercial	$419.20
Rate for Payer: Aetna Medicare Advantage	$330.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$281.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$281.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$281.30
Rate for Payer: Cigna Commercial	$551.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$242.69
Rate for Payer: Qualcare PPO/HMO/WC	$165.47
Rate for Payer: UnitedHealthcare Community & State	$26.59
Rate for Payer: Wellpoint Medicaid Managed Care	$29.23

TI END CAP TIBIAL NAIL STRDRV

Facility

$1,103.15

Service Code	HCPCS C1713
Hospital Charge Code	270678634
Hospital Revenue Code	278
Min. Negotiated Rate	$165.47
Max. Negotiated Rate	$266.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$242.69
Rate for Payer: Qualcare PPO/HMO/WC	$165.47

TIGAN/100MG/1ML

Facility

$18.00

Hospital Charge Code	60634027
Hospital Revenue Code	250
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

TIGAN/100MG/1ML

Facility

$18.00

Hospital Charge Code	60634027
Hospital Revenue Code	250
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$9.00
Rate for Payer: Aetna Commercial	$6.84
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.40
Rate for Payer: Oxford Commercial	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$3.60
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

TIGAN/100MG/CAP

Facility

$4.00

Hospital Charge Code	60634810
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

TIGAN/100MG/CAP

Facility

$4.00

Hospital Charge Code	60634810
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

TIGAN/100MG/EACH

Facility

$4.00

Hospital Charge Code	60634028
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

TIGAN/100MG/EACH

Facility

$4.00

Hospital Charge Code	60634028
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

TIGAN/200MG/EACH

Facility

$4.00

Hospital Charge Code	60634029
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

TIGAN/200MG/EACH

Facility

$4.00

Hospital Charge Code	60634029
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

TIGAN 300MG

Facility

$1.00

Hospital Charge Code	60635502
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.15

TIGAN 300MG

Facility

$1.00

Hospital Charge Code	60635502
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.50
Rate for Payer: Aetna Commercial	$0.38
Rate for Payer: Aetna Medicare Advantage	$0.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.26
Rate for Payer: Cigna Commercial	$0.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.30
Rate for Payer: Oxford Commercial	$0.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.15
Rate for Payer: UnitedHealthcare Commercial	$0.20
Rate for Payer: UnitedHealthcare Community & State	$0.02
Rate for Payer: Wellpoint Medicaid Managed Care	$0.03

TIGAN 300MG CAPSULE

Facility

$2.00

Hospital Charge Code	60635528
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.30

TIGAN 300MG CAPSULE

Facility

$2.00

Hospital Charge Code	60635528
Hospital Revenue Code	250
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$1.00
Rate for Payer: Aetna Commercial	$0.76
Rate for Payer: Aetna Medicare Advantage	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.51
Rate for Payer: Cigna Commercial	$1.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.60
Rate for Payer: Oxford Commercial	$0.40
Rate for Payer: Qualcare PPO/HMO/WC	$0.30
Rate for Payer: UnitedHealthcare Commercial	$0.40
Rate for Payer: UnitedHealthcare Community & State	$0.05
Rate for Payer: Wellpoint Medicaid Managed Care	$0.05

TIGE FEMORALE SANS APPULSANS

Facility

$42,030.00

Hospital Charge Code	270657708
Hospital Revenue Code	278
Min. Negotiated Rate	$6,304.50
Max. Negotiated Rate	$10,171.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,406.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,171.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,246.60
Rate for Payer: Qualcare PPO/HMO/WC	$6,304.50

TIGE FEMORALE SANS APPULSANS

Facility

$42,030.00

Hospital Charge Code	270657708
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.92
Max. Negotiated Rate	$21,015.00
Rate for Payer: Aetna Commercial	$15,971.40
Rate for Payer: Aetna Medicare Advantage	$12,609.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,717.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,717.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,406.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,717.65
Rate for Payer: Cigna Commercial	$21,015.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,171.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,246.60
Rate for Payer: Qualcare PPO/HMO/WC	$6,304.50
Rate for Payer: UnitedHealthcare Community & State	$1,012.92
Rate for Payer: Wellpoint Medicaid Managed Care	$1,113.80

TIGERSTICK

Facility

$250.00

Hospital Charge Code	270663951
Hospital Revenue Code	270
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	$50.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$50.00
Rate for Payer: UnitedHealthcare Community & State	$6.03
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

Know your out-of-pocket cost for care.

All Charges