Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TRIAZOLAM 0.25MG

Facility

$4.50

Hospital Charge Code	6011159
Hospital Revenue Code	251
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.25
Rate for Payer: Aetna Commercial	$1.71
Rate for Payer: Aetna Medicare Advantage	$1.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.15
Rate for Payer: Cigna Commercial	$2.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.35
Rate for Payer: Oxford Commercial	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.68
Rate for Payer: UnitedHealthcare Commercial	$0.90
Rate for Payer: UnitedHealthcare Community & State	$0.11
Rate for Payer: Wellpoint Medicaid Managed Care	$0.12

TRIAZOLAM TAB 0.125MG

Facility

$5.65

Hospital Charge Code	60627852
Hospital Revenue Code	250
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.85

TRIAZOLAM TAB 0.125MG

Facility

$5.65

Hospital Charge Code	60627852
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.83
Rate for Payer: Aetna Commercial	$2.15
Rate for Payer: Aetna Medicare Advantage	$1.70
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	$2.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.70
Rate for Payer: Oxford Commercial	$1.13
Rate for Payer: Qualcare PPO/HMO/WC	$0.85
Rate for Payer: UnitedHealthcare Commercial	$1.13
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

TRIAZOLAM TAB 0.25MG

Facility

$4.50

Hospital Charge Code	60627853
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.25
Rate for Payer: Aetna Commercial	$1.71
Rate for Payer: Aetna Medicare Advantage	$1.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.15
Rate for Payer: Cigna Commercial	$2.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.35
Rate for Payer: Oxford Commercial	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.68
Rate for Payer: UnitedHealthcare Commercial	$0.90
Rate for Payer: UnitedHealthcare Community & State	$0.11
Rate for Payer: Wellpoint Medicaid Managed Care	$0.12

TRIAZOLAM TAB 0.25MG

Facility

$4.50

Hospital Charge Code	60627853
Hospital Revenue Code	250
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$0.68
Rate for Payer: Qualcare PPO/HMO/WC	$0.68

TRICHINELLA AB IGG ELISA SERUM

Facility

$182.23

Service Code	HCPCS 86784
Hospital Charge Code	401386784
Hospital Revenue Code	302
Min. Negotiated Rate	$4.83
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$34.16
Rate for Payer: Aetna Medicare Advantage	$40.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.34
Rate for Payer: Cigna Commercial	$91.11
Rate for Payer: Cigna Medicare Advantage	$12.56
Rate for Payer: Clover Medicare Advantage	$11.93
Rate for Payer: EmblemHealth Commercial	$37.68
Rate for Payer: Humana Medicare Advantage	$12.94
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.67
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.33
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.56
Rate for Payer: Wellcare Medicare Advantage	$12.56
Rate for Payer: Wellpoint Medicaid Managed Care	$4.83

TRICHINELLA AB IGG ELISA SERUM

Facility

$182.23

Service Code	HCPCS 86784
Hospital Charge Code	401386784
Hospital Revenue Code	302
Min. Negotiated Rate	$27.33
Max. Negotiated Rate	$27.33
Rate for Payer: Qualcare PPO/HMO/WC	$27.33

TRICHINELLA ANTIBODY

Facility

$346.45

Service Code	HCPCS 86784
Hospital Charge Code	3009529
Hospital Revenue Code	302
Min. Negotiated Rate	$9.18
Max. Negotiated Rate	$173.22
Rate for Payer: Aetna Commercial	$34.16
Rate for Payer: Aetna Medicare Advantage	$40.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.34
Rate for Payer: Cigna Commercial	$173.22
Rate for Payer: Cigna Medicare Advantage	$12.56
Rate for Payer: Clover Medicare Advantage	$11.93
Rate for Payer: EmblemHealth Commercial	$37.68
Rate for Payer: Humana Medicare Advantage	$12.94
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.94
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.97
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.56
Rate for Payer: Wellcare Medicare Advantage	$12.56
Rate for Payer: Wellpoint Medicaid Managed Care	$9.18

TRICHINELLA ANTIBODY

Facility

$136.00

Service Code	HCPCS 86784
Hospital Charge Code	38476213
Hospital Revenue Code	302
Min. Negotiated Rate	$20.40
Max. Negotiated Rate	$20.40
Rate for Payer: Qualcare PPO/HMO/WC	$20.40

TRICHINELLA ANTIBODY

Facility

$136.00

Service Code	HCPCS 86784
Hospital Charge Code	38476213
Hospital Revenue Code	302
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$34.16
Rate for Payer: Aetna Medicare Advantage	$40.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.34
Rate for Payer: Cigna Commercial	$68.00
Rate for Payer: Cigna Medicare Advantage	$12.56
Rate for Payer: Clover Medicare Advantage	$11.93
Rate for Payer: EmblemHealth Commercial	$37.68
Rate for Payer: Humana Medicare Advantage	$12.94
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.56
Rate for Payer: Wellcare Medicare Advantage	$12.56
Rate for Payer: Wellpoint Medicaid Managed Care	$3.60

TRICHINELLA ANTIBODY

Facility

$346.45

Service Code	HCPCS 86784
Hospital Charge Code	3009529
Hospital Revenue Code	302
Min. Negotiated Rate	$51.97
Max. Negotiated Rate	$51.97
Rate for Payer: Qualcare PPO/HMO/WC	$51.97

TRICHINELLA IGG AB,ELISA (SERU

Facility

$123.05

Service Code	HCPCS 86784
Hospital Charge Code	397080019
Hospital Revenue Code	302
Min. Negotiated Rate	$3.26
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$34.16
Rate for Payer: Aetna Medicare Advantage	$40.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.34
Rate for Payer: Cigna Commercial	$61.52
Rate for Payer: Cigna Medicare Advantage	$12.56
Rate for Payer: Clover Medicare Advantage	$11.93
Rate for Payer: EmblemHealth Commercial	$37.68
Rate for Payer: Humana Medicare Advantage	$12.94
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.91
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.46
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.56
Rate for Payer: Wellcare Medicare Advantage	$12.56
Rate for Payer: Wellpoint Medicaid Managed Care	$3.26

TRICHINELLA IGG AB,ELISA (SERU

Facility

$123.05

Service Code	HCPCS 86784
Hospital Charge Code	397080019
Hospital Revenue Code	302
Min. Negotiated Rate	$18.46
Max. Negotiated Rate	$18.46
Rate for Payer: Qualcare PPO/HMO/WC	$18.46

TRICHOMONAS VAGINALIS AMPLIF

Facility

$390.00

Service Code	HCPCS 87661
Hospital Charge Code	3990245B
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TRICHOMONAS VAGINALIS AMPLIF

Facility

$390.00

Service Code	HCPCS 87661
Hospital Charge Code	3990245B
Hospital Revenue Code	306
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$95.44
Rate for Payer: Aetna Medicare Advantage	$113.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.66
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$35.09
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$28.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Medicare Advantage	$35.09
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

TRICHOMONAS VAG RNA QUAL TMA

Facility

$390.00

Service Code	HCPCS 87661
Hospital Charge Code	38479745
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TRICHOMONAS VAG RNA QUAL TMA

Facility

$390.00

Service Code	HCPCS 87661
Hospital Charge Code	38479745
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$95.44
Rate for Payer: Aetna Medicare Advantage	$113.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.66
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$35.09
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$28.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Medicare Advantage	$35.09
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

TRICHOPHYTON INJ 1:500W/V

Facility

$22.45

Hospital Charge Code	60628947
Hospital Revenue Code	250
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$3.37

TRICHOPHYTON INJ 1:500W/V

Facility

$22.45

Hospital Charge Code	60628947
Hospital Revenue Code	250
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$11.22
Rate for Payer: Aetna Commercial	$8.53
Rate for Payer: Aetna Medicare Advantage	$6.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.72
Rate for Payer: Cigna Commercial	$11.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.74
Rate for Payer: Oxford Commercial	$4.49
Rate for Payer: Qualcare PPO/HMO/WC	$3.37
Rate for Payer: UnitedHealthcare Commercial	$4.49
Rate for Payer: UnitedHealthcare Community & State	$0.54
Rate for Payer: Wellpoint Medicaid Managed Care	$0.59

TRICHOPHYTON MENTAGROPHYT

Facility

$19.03

Service Code	NDC 268043202
Hospital Charge Code	60634535
Hospital Revenue Code	250
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$9.52
Rate for Payer: Aetna Commercial	$7.23
Rate for Payer: Aetna Medicare Advantage	$5.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.85
Rate for Payer: Cigna Commercial	$9.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.71
Rate for Payer: Oxford Commercial	$3.81
Rate for Payer: Qualcare PPO/HMO/WC	$2.85
Rate for Payer: UnitedHealthcare Commercial	$3.81
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.50

TRICHOPHYTON MENTAGROPHYT

Facility

$19.03

Service Code	NDC 268043202
Hospital Charge Code	60634535
Hospital Revenue Code	250
Min. Negotiated Rate	$2.85
Max. Negotiated Rate	$2.85
Rate for Payer: Qualcare PPO/HMO/WC	$2.85

TRICHROME STAIN

Facility

$244.00

Service Code	HCPCS 87209
Hospital Charge Code	38475089
Hospital Revenue Code	309
Min. Negotiated Rate	$36.60
Max. Negotiated Rate	$36.60
Rate for Payer: Qualcare PPO/HMO/WC	$36.60

TRICHROME STAIN

Facility

$244.00

Service Code	HCPCS 87209
Hospital Charge Code	38475089
Hospital Revenue Code	309
Min. Negotiated Rate	$6.47
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$48.91
Rate for Payer: Aetna Medicare Advantage	$58.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.90
Rate for Payer: Cigna Commercial	$122.00
Rate for Payer: Cigna Medicare Advantage	$17.98
Rate for Payer: Clover Medicare Advantage	$17.08
Rate for Payer: EmblemHealth Commercial	$53.94
Rate for Payer: Humana Medicare Advantage	$18.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.98
Rate for Payer: Wellcare Medicare Advantage	$17.98
Rate for Payer: Wellpoint Medicaid Managed Care	$6.47

TRICOR 145 MG TAB

Facility

$14.10

Hospital Charge Code	60629829
Hospital Revenue Code	251
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$7.05
Rate for Payer: Aetna Commercial	$5.36
Rate for Payer: Aetna Medicare Advantage	$4.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.60
Rate for Payer: Cigna Commercial	$7.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.23
Rate for Payer: Oxford Commercial	$2.82
Rate for Payer: Qualcare PPO/HMO/WC	$2.12
Rate for Payer: UnitedHealthcare Commercial	$2.82
Rate for Payer: UnitedHealthcare Community & State	$0.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

TRICOR 145 MG TAB

Facility

$14.10

Hospital Charge Code	60629829
Hospital Revenue Code	251
Min. Negotiated Rate	$2.12
Max. Negotiated Rate	$2.12
Rate for Payer: Qualcare PPO/HMO/WC	$2.12

Know your out-of-pocket cost for care.

All Charges