Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

WATER IRRIG STER 500ml 6139-03

Facility

$22.50

Hospital Charge Code	270649263
Hospital Revenue Code	270
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$11.25
Rate for Payer: Aetna Commercial	$8.55
Rate for Payer: Aetna Medicare Advantage	$6.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.74
Rate for Payer: Cigna Commercial	$11.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.75
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.38
Rate for Payer: UnitedHealthcare Commercial	$4.50
Rate for Payer: UnitedHealthcare Community & State	$0.54
Rate for Payer: Wellpoint Medicaid Managed Care	$0.60

WATER/MINERAL OIL/PETROL LOTIO

Facility

$21.15

Hospital Charge Code	60628830
Hospital Revenue Code	250
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$10.57
Rate for Payer: Aetna Commercial	$8.04
Rate for Payer: Aetna Medicare Advantage	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.39
Rate for Payer: Cigna Commercial	$10.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.34
Rate for Payer: Oxford Commercial	$4.23
Rate for Payer: Qualcare PPO/HMO/WC	$3.17
Rate for Payer: UnitedHealthcare Commercial	$4.23
Rate for Payer: UnitedHealthcare Community & State	$0.51
Rate for Payer: Wellpoint Medicaid Managed Care	$0.56

WATER/MINERAL OIL/PETROL LOTIO

Facility

$21.15

Hospital Charge Code	60628830
Hospital Revenue Code	250
Min. Negotiated Rate	$3.17
Max. Negotiated Rate	$3.17
Rate for Payer: Qualcare PPO/HMO/WC	$3.17

WATER PETROLAT MINRL OIL 120GM

Facility

$34.37

Service Code	NDC 54162060002
Hospital Charge Code	60628463
Hospital Revenue Code	250
Min. Negotiated Rate	$0.83
Max. Negotiated Rate	$17.18
Rate for Payer: Aetna Commercial	$13.06
Rate for Payer: Aetna Medicare Advantage	$10.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.76
Rate for Payer: Cigna Commercial	$17.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.31
Rate for Payer: Oxford Commercial	$6.87
Rate for Payer: Qualcare PPO/HMO/WC	$5.16
Rate for Payer: UnitedHealthcare Commercial	$6.87
Rate for Payer: UnitedHealthcare Community & State	$0.83
Rate for Payer: Wellpoint Medicaid Managed Care	$0.91

WATER PETROLAT MINRL OIL 120GM

Facility

$34.37

Service Code	NDC 54162060002
Hospital Charge Code	60628463
Hospital Revenue Code	250
Min. Negotiated Rate	$5.16
Max. Negotiated Rate	$5.16
Rate for Payer: Qualcare PPO/HMO/WC	$5.16

WATER PETROLAT MINRL OIL 454GM

Facility

$94.45

Hospital Charge Code	60628464
Hospital Revenue Code	250
Min. Negotiated Rate	$14.17
Max. Negotiated Rate	$14.17
Rate for Payer: Qualcare PPO/HMO/WC	$14.17

WATER PETROLAT MINRL OIL 454GM

Facility

$94.45

Hospital Charge Code	60628464
Hospital Revenue Code	250
Min. Negotiated Rate	$2.28
Max. Negotiated Rate	$47.23
Rate for Payer: Aetna Commercial	$35.89
Rate for Payer: Aetna Medicare Advantage	$28.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.08
Rate for Payer: Cigna Commercial	$47.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.34
Rate for Payer: Oxford Commercial	$18.89
Rate for Payer: Qualcare PPO/HMO/WC	$14.17
Rate for Payer: UnitedHealthcare Commercial	$18.89
Rate for Payer: UnitedHealthcare Community & State	$2.28
Rate for Payer: Wellpoint Medicaid Managed Care	$2.50

WATER SNAKE

Facility

$939.45

Hospital Charge Code	270655971
Hospital Revenue Code	270
Min. Negotiated Rate	$22.64
Max. Negotiated Rate	$469.73
Rate for Payer: Aetna Commercial	$356.99
Rate for Payer: Aetna Medicare Advantage	$281.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$239.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$239.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$239.56
Rate for Payer: Cigna Commercial	$469.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$281.83
Rate for Payer: Oxford Commercial	$187.89
Rate for Payer: Qualcare PPO/HMO/WC	$140.92
Rate for Payer: UnitedHealthcare Commercial	$187.89
Rate for Payer: UnitedHealthcare Community & State	$22.64
Rate for Payer: Wellpoint Medicaid Managed Care	$24.90

WATER SNAKE

Facility

$939.45

Hospital Charge Code	270655971
Hospital Revenue Code	270
Min. Negotiated Rate	$140.92
Max. Negotiated Rate	$140.92
Rate for Payer: Qualcare PPO/HMO/WC	$140.92

WATER STERIL 1000cc BOTTLE

Facility

$22.50

Hospital Charge Code	270650061
Hospital Revenue Code	272
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$11.25
Rate for Payer: Aetna Commercial	$8.55
Rate for Payer: Aetna Medicare Advantage	$6.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.74
Rate for Payer: Cigna Commercial	$11.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.75
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.38
Rate for Payer: UnitedHealthcare Commercial	$4.50
Rate for Payer: UnitedHealthcare Community & State	$0.54
Rate for Payer: Wellpoint Medicaid Managed Care	$0.60

WATER STERIL 1000cc BOTTLE

Facility

$22.50

Hospital Charge Code	270650061
Hospital Revenue Code	272
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$3.38
Rate for Payer: Qualcare PPO/HMO/WC	$3.38

WATER STERILE 1000cc BAG

Facility

$17.70

Hospital Charge Code	270650118
Hospital Revenue Code	270
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$8.85
Rate for Payer: Aetna Commercial	$6.73
Rate for Payer: Aetna Medicare Advantage	$5.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.51
Rate for Payer: Cigna Commercial	$8.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.31
Rate for Payer: Oxford Commercial	$3.54
Rate for Payer: Qualcare PPO/HMO/WC	$2.65
Rate for Payer: UnitedHealthcare Commercial	$3.54
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.47

WATER STERILE 1000cc BAG

Facility

$17.70

Hospital Charge Code	270650118
Hospital Revenue Code	270
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$2.65
Rate for Payer: Qualcare PPO/HMO/WC	$2.65

WATER STERILE 1000ml BAG L8500

Facility

$65.15

Hospital Charge Code	270632977
Hospital Revenue Code	272
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$32.58
Rate for Payer: Aetna Commercial	$24.76
Rate for Payer: Aetna Medicare Advantage	$19.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.61
Rate for Payer: Cigna Commercial	$32.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.55
Rate for Payer: Oxford Commercial	$13.03
Rate for Payer: Qualcare PPO/HMO/WC	$9.77
Rate for Payer: UnitedHealthcare Commercial	$13.03
Rate for Payer: UnitedHealthcare Community & State	$1.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1.73

WATER STERILE 1000ml BAG L8500

Facility

$65.15

Hospital Charge Code	270632977
Hospital Revenue Code	272
Min. Negotiated Rate	$9.77
Max. Negotiated Rate	$9.77
Rate for Payer: Qualcare PPO/HMO/WC	$9.77

WATER, STERILE 10ML 10 ML SOL

Facility

$22.65

Service Code	NDC 63323018510
Hospital Charge Code	6063943271
Hospital Revenue Code	250
Min. Negotiated Rate	$3.40
Max. Negotiated Rate	$3.40
Rate for Payer: Qualcare PPO/HMO/WC	$3.40

WATER, STERILE 10ML 10 ML SOL

Facility

$22.65

Service Code	NDC 63323018510
Hospital Charge Code	6063943271
Hospital Revenue Code	250
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$11.32
Rate for Payer: Aetna Commercial	$8.61
Rate for Payer: Aetna Medicare Advantage	$6.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.78
Rate for Payer: Cigna Commercial	$11.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.79
Rate for Payer: Oxford Commercial	$4.53
Rate for Payer: Qualcare PPO/HMO/WC	$3.40
Rate for Payer: UnitedHealthcare Commercial	$4.53
Rate for Payer: UnitedHealthcare Community & State	$0.55
Rate for Payer: Wellpoint Medicaid Managed Care	$0.60

WATER STERILE 250cc BOTTLE

Facility

$22.50

Hospital Charge Code	270650064
Hospital Revenue Code	272
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$3.38
Rate for Payer: Qualcare PPO/HMO/WC	$3.38

WATER STERILE 250cc BOTTLE

Facility

$22.50

Hospital Charge Code	270650064
Hospital Revenue Code	272
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$11.25
Rate for Payer: Aetna Commercial	$8.55
Rate for Payer: Aetna Medicare Advantage	$6.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.74
Rate for Payer: Cigna Commercial	$11.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.75
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.38
Rate for Payer: UnitedHealthcare Commercial	$4.50
Rate for Payer: UnitedHealthcare Community & State	$0.54
Rate for Payer: Wellpoint Medicaid Managed Care	$0.60

WATER STERILE 2OUNCE BOTTLE

Facility

$22.19

Hospital Charge Code	270653903
Hospital Revenue Code	272
Min. Negotiated Rate	$0.53
Max. Negotiated Rate	$11.10
Rate for Payer: Aetna Commercial	$8.43
Rate for Payer: Aetna Medicare Advantage	$6.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.66
Rate for Payer: Cigna Commercial	$11.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.66
Rate for Payer: Oxford Commercial	$4.44
Rate for Payer: Qualcare PPO/HMO/WC	$3.33
Rate for Payer: UnitedHealthcare Commercial	$4.44
Rate for Payer: UnitedHealthcare Community & State	$0.53
Rate for Payer: Wellpoint Medicaid Managed Care	$0.59

WATER STERILE 2OUNCE BOTTLE

Facility

$22.19

Hospital Charge Code	270653903
Hospital Revenue Code	272
Min. Negotiated Rate	$3.33
Max. Negotiated Rate	$3.33
Rate for Payer: Qualcare PPO/HMO/WC	$3.33

WATER, STERILE 50 ML SOL

Facility

$15.61

Service Code	NDC 409488750
Hospital Charge Code	6063943272
Hospital Revenue Code	250
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$2.34
Rate for Payer: Qualcare PPO/HMO/WC	$2.34

WATER, STERILE 50 ML SOL

Facility

$15.61

Service Code	NDC 409488750
Hospital Charge Code	6063943272
Hospital Revenue Code	250
Min. Negotiated Rate	$0.38
Max. Negotiated Rate	$7.80
Rate for Payer: Aetna Commercial	$5.93
Rate for Payer: Aetna Medicare Advantage	$4.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.98
Rate for Payer: Cigna Commercial	$7.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.68
Rate for Payer: Oxford Commercial	$3.12
Rate for Payer: Qualcare PPO/HMO/WC	$2.34
Rate for Payer: UnitedHealthcare Commercial	$3.12
Rate for Payer: UnitedHealthcare Community & State	$0.38
Rate for Payer: Wellpoint Medicaid Managed Care	$0.41

WATER STERILE IN HANGING BOTTL

Facility

$36.00

Hospital Charge Code	270689129
Hospital Revenue Code	270
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$18.00
Rate for Payer: Aetna Commercial	$13.68
Rate for Payer: Aetna Medicare Advantage	$10.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.18
Rate for Payer: Cigna Commercial	$18.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.80
Rate for Payer: Oxford Commercial	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$5.40
Rate for Payer: UnitedHealthcare Commercial	$7.20
Rate for Payer: UnitedHealthcare Community & State	$0.87
Rate for Payer: Wellpoint Medicaid Managed Care	$0.95

WATER STERILE IN HANGING BOTTL

Facility

$36.00

Hospital Charge Code	270689129
Hospital Revenue Code	270
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$5.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.40

Know your out-of-pocket cost for care.

All Charges