Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TI LIFE ANT LORDOTIC CERV CAGE

Facility

$19,975.00

Hospital Charge Code	270702219
Hospital Revenue Code	278
Min. Negotiated Rate	$481.40
Max. Negotiated Rate	$9,987.50
Rate for Payer: Aetna Commercial	$7,590.50
Rate for Payer: Aetna Medicare Advantage	$5,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,093.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,093.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,093.62
Rate for Payer: Cigna Commercial	$9,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,833.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,394.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,996.25
Rate for Payer: UnitedHealthcare Community & State	$481.40
Rate for Payer: Wellpoint Medicaid Managed Care	$529.34

TI LIFE ANT LORDOTIC CERV CAGE

Facility

$19,975.00

Hospital Charge Code	270702219
Hospital Revenue Code	278
Min. Negotiated Rate	$2,996.25
Max. Negotiated Rate	$4,833.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,833.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,394.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,996.25

TILT TABLE EVAL

Facility

$1,235.00

Service Code	HCPCS 93660
Hospital Charge Code	7411249
Hospital Revenue Code	482
Min. Negotiated Rate	$185.25
Max. Negotiated Rate	$185.25
Rate for Payer: Qualcare PPO/HMO/WC	$185.25

TILT TABLE EVAL

Facility

$1,235.00

Service Code	HCPCS 93660
Hospital Charge Code	7411249
Hospital Revenue Code	482
Min. Negotiated Rate	$29.76
Max. Negotiated Rate	$4,924.00
Rate for Payer: Aetna Commercial	$1,205.83
Rate for Payer: Aetna Medicare Advantage	$1,436.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,600.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,600.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$443.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,111.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,600.25
Rate for Payer: Cigna Commercial	$888.63
Rate for Payer: Cigna Medicare Advantage	$443.32
Rate for Payer: Clover Medicare Advantage	$421.15
Rate for Payer: EmblemHealth Commercial	$1,329.96
Rate for Payer: Humana Medicare Advantage	$456.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$443.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$370.50
Rate for Payer: Oxford Commercial	$2,807.00
Rate for Payer: Qualcare PPO/HMO/WC	$185.25
Rate for Payer: UnitedHealthcare Commercial	$4,924.00
Rate for Payer: UnitedHealthcare Community & State	$29.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$443.32
Rate for Payer: Wellcare Medicare Advantage	$443.32
Rate for Payer: Wellpoint Medicaid Managed Care	$32.73

TILT TABLE EVAL

Facility

$1,235.00

Service Code	HCPCS 93660
Hospital Charge Code	366893660
Hospital Revenue Code	482
Min. Negotiated Rate	$29.76
Max. Negotiated Rate	$4,924.00
Rate for Payer: Aetna Commercial	$1,205.83
Rate for Payer: Aetna Medicare Advantage	$1,436.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,600.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,600.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$443.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,111.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,600.25
Rate for Payer: Cigna Commercial	$888.63
Rate for Payer: Cigna Medicare Advantage	$443.32
Rate for Payer: Clover Medicare Advantage	$421.15
Rate for Payer: EmblemHealth Commercial	$1,329.96
Rate for Payer: Humana Medicare Advantage	$456.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$443.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$370.50
Rate for Payer: Oxford Commercial	$2,807.00
Rate for Payer: Qualcare PPO/HMO/WC	$185.25
Rate for Payer: UnitedHealthcare Commercial	$4,924.00
Rate for Payer: UnitedHealthcare Community & State	$29.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$443.32
Rate for Payer: Wellcare Medicare Advantage	$443.32
Rate for Payer: Wellpoint Medicaid Managed Care	$32.73

TILT TABLE EVAL

Facility

$1,235.00

Service Code	HCPCS 93660
Hospital Charge Code	366893660
Hospital Revenue Code	482
Min. Negotiated Rate	$185.25
Max. Negotiated Rate	$185.25
Rate for Payer: Qualcare PPO/HMO/WC	$185.25

TIMENTIN/3.1GM

Facility

$75.00

Hospital Charge Code	60634031
Hospital Revenue Code	250
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

TIMENTIN/3.1GM

Facility

$75.00

Hospital Charge Code	60634031
Hospital Revenue Code	250
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

TIMENTIN/3.1GM

Facility

$86.00

Hospital Charge Code	60634030
Hospital Revenue Code	250
Min. Negotiated Rate	$12.90
Max. Negotiated Rate	$12.90
Rate for Payer: Qualcare PPO/HMO/WC	$12.90

TIMENTIN/3.1GM

Facility

$86.00

Hospital Charge Code	60634030
Hospital Revenue Code	250
Min. Negotiated Rate	$2.07
Max. Negotiated Rate	$43.00
Rate for Payer: Aetna Commercial	$32.68
Rate for Payer: Aetna Medicare Advantage	$25.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.93
Rate for Payer: Cigna Commercial	$43.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.80
Rate for Payer: Oxford Commercial	$17.20
Rate for Payer: Qualcare PPO/HMO/WC	$12.90
Rate for Payer: UnitedHealthcare Commercial	$17.20
Rate for Payer: UnitedHealthcare Community & State	$2.07
Rate for Payer: Wellpoint Medicaid Managed Care	$2.28

TIMENTIN 3.1GM/100ML

Facility

$90.00

Hospital Charge Code	60635030
Hospital Revenue Code	250
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

TIMENTIN 3.1GM/100ML

Facility

$90.00

Hospital Charge Code	60635030
Hospital Revenue Code	250
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$34.20
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.00
Rate for Payer: Oxford Commercial	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$18.00
Rate for Payer: UnitedHealthcare Community & State	$2.17
Rate for Payer: Wellpoint Medicaid Managed Care	$2.38

TIMENTIN ADDVANTAGE/3.1G

Facility

$61.00

Hospital Charge Code	60634463
Hospital Revenue Code	250
Min. Negotiated Rate	$9.15
Max. Negotiated Rate	$9.15
Rate for Payer: Qualcare PPO/HMO/WC	$9.15

TIMENTIN ADDVANTAGE/3.1G

Facility

$61.00

Hospital Charge Code	60634463
Hospital Revenue Code	250
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$30.50
Rate for Payer: Aetna Commercial	$23.18
Rate for Payer: Aetna Medicare Advantage	$18.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.55
Rate for Payer: Cigna Commercial	$30.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.30
Rate for Payer: Oxford Commercial	$12.20
Rate for Payer: Qualcare PPO/HMO/WC	$9.15
Rate for Payer: UnitedHealthcare Commercial	$12.20
Rate for Payer: UnitedHealthcare Community & State	$1.47
Rate for Payer: Wellpoint Medicaid Managed Care	$1.62

TI-MESH 4 X 6-HERNIA

Facility

$162.00

Hospital Charge Code	270338793
Hospital Revenue Code	278
Min. Negotiated Rate	$24.30
Max. Negotiated Rate	$39.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$35.64
Rate for Payer: Qualcare PPO/HMO/WC	$24.30

TI-MESH 4 X 6-HERNIA

Facility

$162.00

Hospital Charge Code	270338793
Hospital Revenue Code	278
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$81.00
Rate for Payer: Aetna Commercial	$61.56
Rate for Payer: Aetna Medicare Advantage	$48.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.31
Rate for Payer: Cigna Commercial	$81.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$35.64
Rate for Payer: Qualcare PPO/HMO/WC	$24.30
Rate for Payer: UnitedHealthcare Community & State	$3.90
Rate for Payer: Wellpoint Medicaid Managed Care	$4.29

TI-MESH 6 X 6 -HERNIA

Facility

$182.00

Hospital Charge Code	270338794
Hospital Revenue Code	278
Min. Negotiated Rate	$4.39
Max. Negotiated Rate	$91.00
Rate for Payer: Aetna Commercial	$69.16
Rate for Payer: Aetna Medicare Advantage	$54.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.41
Rate for Payer: Cigna Commercial	$91.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$40.04
Rate for Payer: Qualcare PPO/HMO/WC	$27.30
Rate for Payer: UnitedHealthcare Community & State	$4.39
Rate for Payer: Wellpoint Medicaid Managed Care	$4.82

TI-MESH 6 X 6 -HERNIA

Facility

$182.00

Hospital Charge Code	270338794
Hospital Revenue Code	278
Min. Negotiated Rate	$27.30
Max. Negotiated Rate	$44.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$40.04
Rate for Payer: Qualcare PPO/HMO/WC	$27.30

TI-MESH 6 X 8- HERNIA

Facility

$552.00

Hospital Charge Code	270338795
Hospital Revenue Code	278
Min. Negotiated Rate	$13.30
Max. Negotiated Rate	$276.00
Rate for Payer: Aetna Commercial	$209.76
Rate for Payer: Aetna Medicare Advantage	$165.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.76
Rate for Payer: Cigna Commercial	$276.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.44
Rate for Payer: Qualcare PPO/HMO/WC	$82.80
Rate for Payer: UnitedHealthcare Community & State	$13.30
Rate for Payer: Wellpoint Medicaid Managed Care	$14.63

TI-MESH 6 X 8- HERNIA

Facility

$552.00

Hospital Charge Code	270338795
Hospital Revenue Code	278
Min. Negotiated Rate	$82.80
Max. Negotiated Rate	$133.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.44
Rate for Payer: Qualcare PPO/HMO/WC	$82.80

TIMOLOL 10 MG TAB

Facility

$4.85

Hospital Charge Code	60627611
Hospital Revenue Code	250
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$0.73
Rate for Payer: Qualcare PPO/HMO/WC	$0.73

TIMOLOL 10 MG TAB

Facility

$4.85

Hospital Charge Code	60627611
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.42
Rate for Payer: Aetna Commercial	$1.84
Rate for Payer: Aetna Medicare Advantage	$1.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.24
Rate for Payer: Cigna Commercial	$2.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.46
Rate for Payer: Oxford Commercial	$0.97
Rate for Payer: Qualcare PPO/HMO/WC	$0.73
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

TIMOLOL DORZOLAMIDE OPH 5ML

Facility

$254.45

Hospital Charge Code	60628941
Hospital Revenue Code	250
Min. Negotiated Rate	$38.17
Max. Negotiated Rate	$38.17
Rate for Payer: Qualcare PPO/HMO/WC	$38.17

TIMOLOL DORZOLAMIDE OPH 5ML

Facility

$254.45

Hospital Charge Code	60628941
Hospital Revenue Code	250
Min. Negotiated Rate	$6.13
Max. Negotiated Rate	$127.22
Rate for Payer: Aetna Commercial	$96.69
Rate for Payer: Aetna Medicare Advantage	$76.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.88
Rate for Payer: Cigna Commercial	$127.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.33
Rate for Payer: Oxford Commercial	$50.89
Rate for Payer: Qualcare PPO/HMO/WC	$38.17
Rate for Payer: UnitedHealthcare Commercial	$50.89
Rate for Payer: UnitedHealthcare Community & State	$6.13
Rate for Payer: Wellpoint Medicaid Managed Care	$6.74

TIMOLOL HCTZ TAB 10-25MG

Facility

$5.65

Hospital Charge Code	60628722
Hospital Revenue Code	250
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.85

Know your out-of-pocket cost for care.

All Charges