Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BETAMETHASONE DIP 0.05%ONT 15G

Facility

$228.79

Hospital Charge Code	6063943372
Hospital Revenue Code	251
Min. Negotiated Rate	$34.32
Max. Negotiated Rate	$34.32
Rate for Payer: Qualcare PPO/HMO/WC	$34.32

BETAMETHASONE DIP 0.5% OINT

Facility

$31.02

Service Code	NDC 45802037635
Hospital Charge Code	606361047
Hospital Revenue Code	250
Min. Negotiated Rate	$4.65
Max. Negotiated Rate	$4.65
Rate for Payer: Qualcare PPO/HMO/WC	$4.65

BETAMETHASONE DIP 0.5% OINT

Facility

$31.02

Service Code	NDC 45802037635
Hospital Charge Code	606361047
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$15.51
Rate for Payer: Aetna Commercial	$11.79
Rate for Payer: Aetna Medicare Advantage	$9.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.91
Rate for Payer: Cigna Commercial	$15.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.31
Rate for Payer: Oxford Commercial	$6.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.65
Rate for Payer: UnitedHealthcare Commercial	$6.20
Rate for Payer: UnitedHealthcare Community & State	$0.75
Rate for Payer: Wellpoint Medicaid Managed Care	$0.82

BETAMETHASONE DIPRO 0.05

Facility

$26.00

Hospital Charge Code	60632551
Hospital Revenue Code	250
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$13.00
Rate for Payer: Aetna Commercial	$9.88
Rate for Payer: Aetna Medicare Advantage	$7.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.63
Rate for Payer: Cigna Commercial	$13.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.80
Rate for Payer: Oxford Commercial	$5.20
Rate for Payer: Qualcare PPO/HMO/WC	$3.90
Rate for Payer: UnitedHealthcare Commercial	$5.20
Rate for Payer: UnitedHealthcare Community & State	$0.63
Rate for Payer: Wellpoint Medicaid Managed Care	$0.69

BETAMETHASONE DIPRO 0.05

Facility

$26.00

Hospital Charge Code	60632551
Hospital Revenue Code	250
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$3.90
Rate for Payer: Qualcare PPO/HMO/WC	$3.90

BETAMETHASONE DIPROP 0.05

Facility

$26.00

Hospital Charge Code	60632550
Hospital Revenue Code	250
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$3.90
Rate for Payer: Qualcare PPO/HMO/WC	$3.90

BETAMETHASONE DIPROP 0.05

Facility

$26.00

Hospital Charge Code	60632550
Hospital Revenue Code	250
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$13.00
Rate for Payer: Aetna Commercial	$9.88
Rate for Payer: Aetna Medicare Advantage	$7.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.63
Rate for Payer: Cigna Commercial	$13.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.80
Rate for Payer: Oxford Commercial	$5.20
Rate for Payer: Qualcare PPO/HMO/WC	$3.90
Rate for Payer: UnitedHealthcare Commercial	$5.20
Rate for Payer: UnitedHealthcare Community & State	$0.63
Rate for Payer: Wellpoint Medicaid Managed Care	$0.69

BETAMETHASONE DIPROP LOT 60ML

Facility

$299.55

Hospital Charge Code	6000673
Hospital Revenue Code	251
Min. Negotiated Rate	$44.93
Max. Negotiated Rate	$44.93
Rate for Payer: Qualcare PPO/HMO/WC	$44.93

BETAMETHASONE DIPROP LOT 60ML

Facility

$299.55

Hospital Charge Code	6000673
Hospital Revenue Code	251
Min. Negotiated Rate	$7.22
Max. Negotiated Rate	$149.78
Rate for Payer: Aetna Commercial	$113.83
Rate for Payer: Aetna Medicare Advantage	$89.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.39
Rate for Payer: Cigna Commercial	$149.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.86
Rate for Payer: Oxford Commercial	$59.91
Rate for Payer: Qualcare PPO/HMO/WC	$44.93
Rate for Payer: UnitedHealthcare Commercial	$59.91
Rate for Payer: UnitedHealthcare Community & State	$7.22
Rate for Payer: Wellpoint Medicaid Managed Care	$7.94

BETAMETHASONE INJ 3MG/ML

Facility

$283.81

Service Code	HCPCS J0702
Hospital Charge Code	6000624
Hospital Revenue Code	636
Min. Negotiated Rate	$42.57
Max. Negotiated Rate	$68.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.68
Rate for Payer: Qualcare PPO/HMO/WC	$42.57

BETAMETHASONE INJ 3MG/ML

Facility

$283.81

Service Code	HCPCS J0702
Hospital Charge Code	6000624
Hospital Revenue Code	636
Min. Negotiated Rate	$6.84
Max. Negotiated Rate	$141.91
Rate for Payer: Aetna Commercial	$107.85
Rate for Payer: Aetna Medicare Advantage	$85.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.37
Rate for Payer: Cigna Commercial	$141.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.68
Rate for Payer: Qualcare PPO/HMO/WC	$42.57
Rate for Payer: UnitedHealthcare Community & State	$6.84
Rate for Payer: Wellpoint Medicaid Managed Care	$7.52

BETAMETHASONE INJ 4MG/1ML 5ML

Facility

$98.60

Hospital Charge Code	60628182
Hospital Revenue Code	250
Min. Negotiated Rate	$14.79
Max. Negotiated Rate	$14.79
Rate for Payer: Qualcare PPO/HMO/WC	$14.79

BETAMETHASONE INJ 4MG/1ML 5ML

Facility

$98.60

Hospital Charge Code	60628182
Hospital Revenue Code	250
Min. Negotiated Rate	$2.38
Max. Negotiated Rate	$49.30
Rate for Payer: Aetna Commercial	$37.47
Rate for Payer: Aetna Medicare Advantage	$29.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.14
Rate for Payer: Cigna Commercial	$49.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.58
Rate for Payer: Oxford Commercial	$19.72
Rate for Payer: Qualcare PPO/HMO/WC	$14.79
Rate for Payer: UnitedHealthcare Commercial	$19.72
Rate for Payer: UnitedHealthcare Community & State	$2.38
Rate for Payer: Wellpoint Medicaid Managed Care	$2.61

BETAMETHASONE LOT VAL 60ML

Facility

$53.80

Hospital Charge Code	6000657
Hospital Revenue Code	251
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$26.90
Rate for Payer: Aetna Commercial	$20.44
Rate for Payer: Aetna Medicare Advantage	$16.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.72
Rate for Payer: Cigna Commercial	$26.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.14
Rate for Payer: Oxford Commercial	$10.76
Rate for Payer: Qualcare PPO/HMO/WC	$8.07
Rate for Payer: UnitedHealthcare Commercial	$10.76
Rate for Payer: UnitedHealthcare Community & State	$1.30
Rate for Payer: Wellpoint Medicaid Managed Care	$1.43

BETAMETHASONE LOT VAL 60ML

Facility

$53.80

Hospital Charge Code	6000657
Hospital Revenue Code	251
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$8.07

BETAMETHASONE OINT 45GM VAL

Facility

$680.59

Service Code	NDC 472038145
Hospital Charge Code	6000640
Hospital Revenue Code	251
Min. Negotiated Rate	$16.40
Max. Negotiated Rate	$340.30
Rate for Payer: Aetna Commercial	$258.62
Rate for Payer: Aetna Medicare Advantage	$204.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$173.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$173.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$173.55
Rate for Payer: Cigna Commercial	$340.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$204.18
Rate for Payer: Oxford Commercial	$136.12
Rate for Payer: Qualcare PPO/HMO/WC	$102.09
Rate for Payer: UnitedHealthcare Commercial	$136.12
Rate for Payer: UnitedHealthcare Community & State	$16.40
Rate for Payer: Wellpoint Medicaid Managed Care	$18.04

BETAMETHASONE OINT 45GM VAL

Facility

$680.59

Service Code	NDC 472038145
Hospital Charge Code	6000640
Hospital Revenue Code	251
Min. Negotiated Rate	$102.09
Max. Negotiated Rate	$102.09
Rate for Payer: Qualcare PPO/HMO/WC	$102.09

BETAMETHASONE VALERATE 0.

Facility

$9.00

Hospital Charge Code	60632553
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

BETAMETHASONE VALERATE 0.

Facility

$482.40

Service Code	NDC 168004160
Hospital Charge Code	60632555
Hospital Revenue Code	250
Min. Negotiated Rate	$11.63
Max. Negotiated Rate	$241.20
Rate for Payer: Aetna Commercial	$183.31
Rate for Payer: Aetna Medicare Advantage	$144.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$123.01
Rate for Payer: Cigna Commercial	$241.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.72
Rate for Payer: Oxford Commercial	$96.48
Rate for Payer: Qualcare PPO/HMO/WC	$72.36
Rate for Payer: UnitedHealthcare Commercial	$96.48
Rate for Payer: UnitedHealthcare Community & State	$11.63
Rate for Payer: Wellpoint Medicaid Managed Care	$12.78

BETAMETHASONE VALERATE 0.

Facility

$9.00

Hospital Charge Code	60632552
Hospital Revenue Code	250
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$3.42
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.70
Rate for Payer: Oxford Commercial	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$1.80
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

BETAMETHASONE VALERATE 0.

Facility

$28.00

Hospital Charge Code	60632554
Hospital Revenue Code	250
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$14.00
Rate for Payer: Aetna Commercial	$10.64
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.40
Rate for Payer: Oxford Commercial	$5.60
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$5.60
Rate for Payer: UnitedHealthcare Community & State	$0.67
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

BETAMETHASONE VALERATE 0.

Facility

$482.40

Service Code	NDC 168004160
Hospital Charge Code	60632555
Hospital Revenue Code	250
Min. Negotiated Rate	$72.36
Max. Negotiated Rate	$72.36
Rate for Payer: Qualcare PPO/HMO/WC	$72.36

BETAMETHASONE VALERATE 0.

Facility

$28.00

Hospital Charge Code	60632554
Hospital Revenue Code	250
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

BETAMETHASONE VALERATE 0.

Facility

$9.00

Hospital Charge Code	60632553
Hospital Revenue Code	250
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$3.42
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.70
Rate for Payer: Oxford Commercial	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$1.80
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

BETAMETHASONE VALERATE 0.

Facility

$9.00

Hospital Charge Code	60632552
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

Know your out-of-pocket cost for care.

All Charges