Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TRAY URETHRAL CATH 14FR

Facility

$8.30

Hospital Charge Code	270650179
Hospital Revenue Code	272
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$4.15
Rate for Payer: Aetna Commercial	$3.15
Rate for Payer: Aetna Medicare Advantage	$2.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.12
Rate for Payer: Cigna Commercial	$4.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.49
Rate for Payer: Oxford Commercial	$1.66
Rate for Payer: Qualcare PPO/HMO/WC	$1.25
Rate for Payer: UnitedHealthcare Commercial	$1.66
Rate for Payer: UnitedHealthcare Community & State	$0.20
Rate for Payer: Wellpoint Medicaid Managed Care	$0.22

TRAY URETHRAL CATH 14FR

Facility

$8.30

Hospital Charge Code	270650179
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$1.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.25

TRAY URETHRL W/STR CATH 772414

Facility

$11.82

Hospital Charge Code	270302232
Hospital Revenue Code	272
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$5.91
Rate for Payer: Aetna Commercial	$4.49
Rate for Payer: Aetna Medicare Advantage	$3.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.01
Rate for Payer: Cigna Commercial	$5.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.55
Rate for Payer: Oxford Commercial	$2.36
Rate for Payer: Qualcare PPO/HMO/WC	$1.77
Rate for Payer: UnitedHealthcare Commercial	$2.36
Rate for Payer: UnitedHealthcare Community & State	$0.28
Rate for Payer: Wellpoint Medicaid Managed Care	$0.31

TRAY URETHRL W/STR CATH 772414

Facility

$11.82

Hospital Charge Code	270302232
Hospital Revenue Code	272
Min. Negotiated Rate	$1.77
Max. Negotiated Rate	$1.77
Rate for Payer: Qualcare PPO/HMO/WC	$1.77

TRAY URINARY DRAINAGE W/CATH

Facility

$72.00

Hospital Charge Code	270302236
Hospital Revenue Code	272
Min. Negotiated Rate	$10.80
Max. Negotiated Rate	$10.80
Rate for Payer: Qualcare PPO/HMO/WC	$10.80

TRAY URINARY DRAINAGE W/CATH

Facility

$72.00

Hospital Charge Code	270302236
Hospital Revenue Code	272
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$36.00
Rate for Payer: Aetna Commercial	$27.36
Rate for Payer: Aetna Medicare Advantage	$21.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.36
Rate for Payer: Cigna Commercial	$36.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.60
Rate for Payer: Oxford Commercial	$14.40
Rate for Payer: Qualcare PPO/HMO/WC	$10.80
Rate for Payer: UnitedHealthcare Commercial	$14.40
Rate for Payer: UnitedHealthcare Community & State	$1.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1.91

TRAY VASCULAR

Facility

$379.50

Hospital Charge Code	270654129
Hospital Revenue Code	271
Min. Negotiated Rate	$9.15
Max. Negotiated Rate	$189.75
Rate for Payer: Aetna Commercial	$144.21
Rate for Payer: Aetna Medicare Advantage	$113.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.77
Rate for Payer: Cigna Commercial	$189.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.85
Rate for Payer: Oxford Commercial	$75.90
Rate for Payer: Qualcare PPO/HMO/WC	$56.92
Rate for Payer: UnitedHealthcare Commercial	$75.90
Rate for Payer: UnitedHealthcare Community & State	$9.15
Rate for Payer: Wellpoint Medicaid Managed Care	$10.06

TRAY VASCULAR

Facility

$379.50

Hospital Charge Code	270654129
Hospital Revenue Code	271
Min. Negotiated Rate	$56.92
Max. Negotiated Rate	$56.92
Rate for Payer: Qualcare PPO/HMO/WC	$56.92

TRAY VENOUS CUT DOWN NON-DISP

Facility

$408.85

Hospital Charge Code	2708002438
Hospital Revenue Code	272
Min. Negotiated Rate	$61.33
Max. Negotiated Rate	$61.33
Rate for Payer: Qualcare PPO/HMO/WC	$61.33

TRAY VENOUS CUT DOWN NON-DISP

Facility

$408.85

Hospital Charge Code	2708002438
Hospital Revenue Code	272
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$204.43
Rate for Payer: Aetna Commercial	$155.36
Rate for Payer: Aetna Medicare Advantage	$122.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$104.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$104.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$104.26
Rate for Payer: Cigna Commercial	$204.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.66
Rate for Payer: Oxford Commercial	$81.77
Rate for Payer: Qualcare PPO/HMO/WC	$61.33
Rate for Payer: UnitedHealthcare Commercial	$81.77
Rate for Payer: UnitedHealthcare Community & State	$9.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.83

TRAZADONE,150MG,TAB

Facility

$1.00

Hospital Charge Code	60635467
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

TRAZADONE,150MG,TAB

Facility

$1.00

Hospital Charge Code	60635467
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.15

TRAZODONE 100 MG TAB

Facility

$5.63

Service Code	NDC 13668033005
Hospital Charge Code	60627783
Hospital Revenue Code	250
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$0.84
Rate for Payer: Qualcare PPO/HMO/WC	$0.84

TRAZODONE 100 MG TAB

Facility

$5.63

Service Code	NDC 13668033005
Hospital Charge Code	60627783
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.81
Rate for Payer: Aetna Commercial	$2.14
Rate for Payer: Aetna Medicare Advantage	$1.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.44
Rate for Payer: Cigna Commercial	$2.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.69
Rate for Payer: Oxford Commercial	$1.13
Rate for Payer: Qualcare PPO/HMO/WC	$0.84
Rate for Payer: UnitedHealthcare Commercial	$1.13
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

TRAZODONE 50 MG TAB

Facility

$7.17

Service Code	NDC 60505265301
Hospital Charge Code	60627784
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.58
Rate for Payer: Aetna Commercial	$2.72
Rate for Payer: Aetna Medicare Advantage	$2.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.83
Rate for Payer: Cigna Commercial	$3.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.15
Rate for Payer: Oxford Commercial	$1.43
Rate for Payer: Qualcare PPO/HMO/WC	$1.08
Rate for Payer: UnitedHealthcare Commercial	$1.43
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

TRAZODONE 50 MG TAB

Facility

$7.17

Service Code	NDC 60505265301
Hospital Charge Code	60627784
Hospital Revenue Code	250
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$1.08
Rate for Payer: Qualcare PPO/HMO/WC	$1.08

TRAZODONE (DESYREL)

Facility

$181.65

Service Code	HCPCS 80299
Hospital Charge Code	3009818
Hospital Revenue Code	301
Min. Negotiated Rate	$4.81
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$50.70
Rate for Payer: Aetna Medicare Advantage	$60.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.28
Rate for Payer: Cigna Commercial	$90.83
Rate for Payer: Cigna Medicare Advantage	$18.64
Rate for Payer: Clover Medicare Advantage	$17.71
Rate for Payer: EmblemHealth Commercial	$55.92
Rate for Payer: Humana Medicare Advantage	$19.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.49
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.25
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Medicare Advantage	$18.64
Rate for Payer: Wellpoint Medicaid Managed Care	$4.81

TRAZODONE (DESYREL)

Facility

$181.65

Service Code	HCPCS 80299
Hospital Charge Code	3009818
Hospital Revenue Code	301
Min. Negotiated Rate	$27.25
Max. Negotiated Rate	$27.25
Rate for Payer: Qualcare PPO/HMO/WC	$27.25

TRAZODONE,SERUM (DESYREL)

Facility

$323.00

Service Code	HCPCS 80299
Hospital Charge Code	38473097
Hospital Revenue Code	301
Min. Negotiated Rate	$8.56
Max. Negotiated Rate	$161.50
Rate for Payer: Aetna Commercial	$50.70
Rate for Payer: Aetna Medicare Advantage	$60.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.28
Rate for Payer: Cigna Commercial	$161.50
Rate for Payer: Cigna Medicare Advantage	$18.64
Rate for Payer: Clover Medicare Advantage	$17.71
Rate for Payer: EmblemHealth Commercial	$55.92
Rate for Payer: Humana Medicare Advantage	$19.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.45
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Medicare Advantage	$18.64
Rate for Payer: Wellpoint Medicaid Managed Care	$8.56

TRAZODONE,SERUM (DESYREL)

Facility

$323.00

Service Code	HCPCS 80299
Hospital Charge Code	38473097
Hospital Revenue Code	301
Min. Negotiated Rate	$48.45
Max. Negotiated Rate	$48.45
Rate for Payer: Qualcare PPO/HMO/WC	$48.45

TRAZODONE TAB 100MG

Facility

$5.80

Hospital Charge Code	60628729
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.90
Rate for Payer: Aetna Commercial	$2.20
Rate for Payer: Aetna Medicare Advantage	$1.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.48
Rate for Payer: Cigna Commercial	$2.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.74
Rate for Payer: Oxford Commercial	$1.16
Rate for Payer: Qualcare PPO/HMO/WC	$0.87
Rate for Payer: UnitedHealthcare Commercial	$1.16
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

TRAZODONE TAB 100MG

Facility

$5.80

Hospital Charge Code	60628729
Hospital Revenue Code	250
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$0.87
Rate for Payer: Qualcare PPO/HMO/WC	$0.87

TR BAND LNG W/INFLATOR XXRF06L

Facility

$210.00

Hospital Charge Code	270643741C
Hospital Revenue Code	272
Min. Negotiated Rate	$5.06
Max. Negotiated Rate	$105.00
Rate for Payer: Aetna Commercial	$79.80
Rate for Payer: Aetna Medicare Advantage	$63.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.55
Rate for Payer: Cigna Commercial	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.00
Rate for Payer: Oxford Commercial	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.50
Rate for Payer: UnitedHealthcare Commercial	$42.00
Rate for Payer: UnitedHealthcare Community & State	$5.06
Rate for Payer: Wellpoint Medicaid Managed Care	$5.57

TR BAND LNG W/INFLATOR XXRF06L

Facility

$210.00

Hospital Charge Code	270643741C
Hospital Revenue Code	272
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

TR BAND LONG W INFLATR XXRF06L

Facility

$175.00

Hospital Charge Code	270643741N
Hospital Revenue Code	272
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

Know your out-of-pocket cost for care.

All Charges