Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TROPICAMIDE OPH SOL 1% 3ML

Facility

$168.04

Service Code	NDC 17478010212
Hospital Charge Code	60628068
Hospital Revenue Code	250
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$84.02
Rate for Payer: Aetna Commercial	$63.86
Rate for Payer: Aetna Medicare Advantage	$50.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.85
Rate for Payer: Cigna Commercial	$84.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.41
Rate for Payer: Oxford Commercial	$33.61
Rate for Payer: Qualcare PPO/HMO/WC	$25.21
Rate for Payer: UnitedHealthcare Commercial	$33.61
Rate for Payer: UnitedHealthcare Community & State	$4.05
Rate for Payer: Wellpoint Medicaid Managed Care	$4.45

TROPIRAMATE

Facility

$84.00

Service Code	HCPCS 80201
Hospital Charge Code	38478082
Hospital Revenue Code	301
Min. Negotiated Rate	$2.23
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$32.42
Rate for Payer: Aetna Medicare Advantage	$38.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.03
Rate for Payer: Cigna Commercial	$42.00
Rate for Payer: Cigna Medicare Advantage	$11.92
Rate for Payer: Clover Medicare Advantage	$11.32
Rate for Payer: EmblemHealth Commercial	$35.76
Rate for Payer: Humana Medicare Advantage	$12.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.92
Rate for Payer: Wellcare Medicare Advantage	$11.92
Rate for Payer: Wellpoint Medicaid Managed Care	$2.23

TROPIRAMATE

Facility

$84.00

Service Code	HCPCS 80201
Hospital Charge Code	38478082
Hospital Revenue Code	301
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.60

TROPONIN

Facility

$389.20

Service Code	HCPCS 84484
Hospital Charge Code	38474118
Hospital Revenue Code	301
Min. Negotiated Rate	$9.98
Max. Negotiated Rate	$194.60
Rate for Payer: Aetna Commercial	$33.92
Rate for Payer: Aetna Medicare Advantage	$40.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.01
Rate for Payer: Cigna Commercial	$194.60
Rate for Payer: Cigna Medicare Advantage	$12.47
Rate for Payer: Clover Medicare Advantage	$11.85
Rate for Payer: EmblemHealth Commercial	$37.41
Rate for Payer: Humana Medicare Advantage	$12.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.38
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.98
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.47
Rate for Payer: Wellcare Medicare Advantage	$12.47
Rate for Payer: Wellpoint Medicaid Managed Care	$10.31

TROPONIN

Facility

$389.20

Service Code	HCPCS 84484
Hospital Charge Code	38474118
Hospital Revenue Code	301
Min. Negotiated Rate	$58.38
Max. Negotiated Rate	$58.38
Rate for Payer: Qualcare PPO/HMO/WC	$58.38

TROPONIN I***

Facility

$27.00

Service Code	HCPCS 83520
Hospital Charge Code	3042454
Hospital Revenue Code	309
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.05

TROPONIN I***

Facility

$27.00

Service Code	HCPCS 83520
Hospital Charge Code	3042454
Hospital Revenue Code	309
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$46.97
Rate for Payer: Aetna Medicare Advantage	$55.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.34
Rate for Payer: Cigna Commercial	$13.50
Rate for Payer: Cigna Medicare Advantage	$17.27
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.27
Rate for Payer: Wellcare Medicare Advantage	$17.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.72

TROPONIN (QUANT)

Facility

$650.82

Service Code	HCPCS 84484
Hospital Charge Code	3009820
Hospital Revenue Code	301
Min. Negotiated Rate	$97.62
Max. Negotiated Rate	$97.62
Rate for Payer: Qualcare PPO/HMO/WC	$97.62

TROPONIN (QUANT)

Facility

$650.82

Service Code	HCPCS 84484
Hospital Charge Code	3009820
Hospital Revenue Code	301
Min. Negotiated Rate	$9.98
Max. Negotiated Rate	$325.41
Rate for Payer: Aetna Commercial	$33.92
Rate for Payer: Aetna Medicare Advantage	$40.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.01
Rate for Payer: Cigna Commercial	$325.41
Rate for Payer: Cigna Medicare Advantage	$12.47
Rate for Payer: Clover Medicare Advantage	$11.85
Rate for Payer: EmblemHealth Commercial	$37.41
Rate for Payer: Humana Medicare Advantage	$12.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.62
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.98
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.47
Rate for Payer: Wellcare Medicare Advantage	$12.47
Rate for Payer: Wellpoint Medicaid Managed Care	$17.25

TROPONIN, QUANTITATIVE

Facility

$667.59

Service Code	HCPCS 84484
Hospital Charge Code	3032491
Hospital Revenue Code	301
Min. Negotiated Rate	$9.98
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$33.92
Rate for Payer: Aetna Medicare Advantage	$40.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.01
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$12.47
Rate for Payer: Clover Medicare Advantage	$11.85
Rate for Payer: EmblemHealth Commercial	$37.41
Rate for Payer: Humana Medicare Advantage	$12.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.98
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.47
Rate for Payer: Wellcare Medicare Advantage	$12.47
Rate for Payer: Wellpoint Medicaid Managed Care	$17.69

TROPONIN, QUANTITATIVE

Facility

$667.59

Service Code	HCPCS 84484
Hospital Charge Code	3032491
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

TROPONIN (QUANT) REPEAT

Facility

$123.44

Service Code	HCPCS 8448491
Hospital Charge Code	3009820R
Hospital Revenue Code	301
Min. Negotiated Rate	$2.97
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$46.91
Rate for Payer: Aetna Medicare Advantage	$37.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.48
Rate for Payer: Cigna Commercial	$61.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.03
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.52
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.97
Rate for Payer: Wellpoint Medicaid Managed Care	$3.27

TROPONIN (QUANT) REPEAT

Facility

$123.44

Service Code	HCPCS 8448491
Hospital Charge Code	3009820R
Hospital Revenue Code	301
Min. Negotiated Rate	$18.52
Max. Negotiated Rate	$18.52
Rate for Payer: Qualcare PPO/HMO/WC	$18.52

TROPOPIN I***

Facility

$32.00

Service Code	HCPCS 83520
Hospital Charge Code	3032455
Hospital Revenue Code	309
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

TROPOPIN I***

Facility

$32.00

Service Code	HCPCS 83520
Hospital Charge Code	3032455
Hospital Revenue Code	309
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$46.97
Rate for Payer: Aetna Medicare Advantage	$55.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.34
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: Cigna Medicare Advantage	$17.27
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.27
Rate for Payer: Wellcare Medicare Advantage	$17.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

TROVAFLOXACIN TAB 100MG

Facility

$40.35

Hospital Charge Code	60628761
Hospital Revenue Code	250
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$20.18
Rate for Payer: Aetna Commercial	$15.33
Rate for Payer: Aetna Medicare Advantage	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.29
Rate for Payer: Cigna Commercial	$20.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.11
Rate for Payer: Oxford Commercial	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$6.05
Rate for Payer: UnitedHealthcare Commercial	$8.07
Rate for Payer: UnitedHealthcare Community & State	$0.97
Rate for Payer: Wellpoint Medicaid Managed Care	$1.07

TROVAFLOXACIN TAB 100MG

Facility

$40.35

Hospital Charge Code	60628761
Hospital Revenue Code	250
Min. Negotiated Rate	$6.05
Max. Negotiated Rate	$6.05
Rate for Payer: Qualcare PPO/HMO/WC	$6.05

TROVAFLOXACIN TAB 200MG

Facility

$46.10

Hospital Charge Code	60629045
Hospital Revenue Code	250
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$23.05
Rate for Payer: Aetna Commercial	$17.52
Rate for Payer: Aetna Medicare Advantage	$13.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.76
Rate for Payer: Cigna Commercial	$23.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.83
Rate for Payer: Oxford Commercial	$9.22
Rate for Payer: Qualcare PPO/HMO/WC	$6.92
Rate for Payer: UnitedHealthcare Commercial	$9.22
Rate for Payer: UnitedHealthcare Community & State	$1.11
Rate for Payer: Wellpoint Medicaid Managed Care	$1.22

TROVAFLOXACIN TAB 200MG

Facility

$46.10

Hospital Charge Code	60629045
Hospital Revenue Code	250
Min. Negotiated Rate	$6.92
Max. Negotiated Rate	$6.92
Rate for Payer: Qualcare PPO/HMO/WC	$6.92

TROVAN 100MG TAB UD

Facility

$23.00

Hospital Charge Code	60635206
Hospital Revenue Code	250
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

TROVAN 100MG TAB UD

Facility

$23.00

Hospital Charge Code	60635206
Hospital Revenue Code	250
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$11.50
Rate for Payer: Aetna Commercial	$8.74
Rate for Payer: Aetna Medicare Advantage	$6.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.87
Rate for Payer: Cigna Commercial	$11.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.90
Rate for Payer: Oxford Commercial	$4.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$4.60
Rate for Payer: UnitedHealthcare Community & State	$0.55
Rate for Payer: Wellpoint Medicaid Managed Care	$0.61

TROVAN 200MG IV

Facility

$255.00

Hospital Charge Code	60635204
Hospital Revenue Code	250
Min. Negotiated Rate	$6.15
Max. Negotiated Rate	$127.50
Rate for Payer: Aetna Commercial	$96.90
Rate for Payer: Aetna Medicare Advantage	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.03
Rate for Payer: Cigna Commercial	$127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.50
Rate for Payer: Oxford Commercial	$51.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.25
Rate for Payer: UnitedHealthcare Commercial	$51.00
Rate for Payer: UnitedHealthcare Community & State	$6.15
Rate for Payer: Wellpoint Medicaid Managed Care	$6.76

TROVAN 200MG IV

Facility

$255.00

Hospital Charge Code	60635204
Hospital Revenue Code	250
Min. Negotiated Rate	$38.25
Max. Negotiated Rate	$38.25
Rate for Payer: Qualcare PPO/HMO/WC	$38.25

TROVAN 200MG TAB UD

Facility

$50.00

Hospital Charge Code	60635205
Hospital Revenue Code	250
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

TROVAN 200MG TAB UD

Facility

$50.00

Hospital Charge Code	60635205
Hospital Revenue Code	250
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$25.00
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.00
Rate for Payer: Oxford Commercial	$10.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$10.00
Rate for Payer: UnitedHealthcare Community & State	$1.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

Know your out-of-pocket cost for care.

All Charges