Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BRILINTA 60 MG (TICAGRELOR)

Facility

$36.45

Service Code	NDC 186077660
Hospital Charge Code	606390095
Hospital Revenue Code	250
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$18.23
Rate for Payer: Aetna Commercial	$13.85
Rate for Payer: Aetna Medicare Advantage	$10.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.29
Rate for Payer: Cigna Commercial	$18.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.94
Rate for Payer: Oxford Commercial	$7.29
Rate for Payer: Qualcare PPO/HMO/WC	$5.47
Rate for Payer: UnitedHealthcare Commercial	$7.29
Rate for Payer: UnitedHealthcare Community & State	$0.88
Rate for Payer: Wellpoint Medicaid Managed Care	$0.97

BRILL BIT 2.0MM

Facility

$1,370.00

Hospital Charge Code	270661009
Hospital Revenue Code	272
Min. Negotiated Rate	$33.02
Max. Negotiated Rate	$685.00
Rate for Payer: Aetna Commercial	$520.60
Rate for Payer: Aetna Medicare Advantage	$411.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$349.35
Rate for Payer: Cigna Commercial	$685.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$411.00
Rate for Payer: Oxford Commercial	$274.00
Rate for Payer: Qualcare PPO/HMO/WC	$205.50
Rate for Payer: UnitedHealthcare Commercial	$274.00
Rate for Payer: UnitedHealthcare Community & State	$33.02
Rate for Payer: Wellpoint Medicaid Managed Care	$36.30

BRILL BIT 2.0MM

Facility

$1,370.00

Hospital Charge Code	270661009
Hospital Revenue Code	272
Min. Negotiated Rate	$205.50
Max. Negotiated Rate	$205.50
Rate for Payer: Qualcare PPO/HMO/WC	$205.50

BRIMONIDINE SOL OPH 0.2%

Facility

$28.80

Hospital Charge Code	60628578
Hospital Revenue Code	250
Min. Negotiated Rate	$4.32
Max. Negotiated Rate	$4.32
Rate for Payer: Qualcare PPO/HMO/WC	$4.32

BRIMONIDINE SOL OPH 0.2%

Facility

$28.80

Hospital Charge Code	60628578
Hospital Revenue Code	250
Min. Negotiated Rate	$0.69
Max. Negotiated Rate	$14.40
Rate for Payer: Aetna Commercial	$10.94
Rate for Payer: Aetna Medicare Advantage	$8.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.34
Rate for Payer: Cigna Commercial	$14.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.64
Rate for Payer: Oxford Commercial	$5.76
Rate for Payer: Qualcare PPO/HMO/WC	$4.32
Rate for Payer: UnitedHealthcare Commercial	$5.76
Rate for Payer: UnitedHealthcare Community & State	$0.69
Rate for Payer: Wellpoint Medicaid Managed Care	$0.76

BRINZOLAMIDE OPHTHALMIC 1% SUS

Facility

$393.75

Hospital Charge Code	60629909
Hospital Revenue Code	250
Min. Negotiated Rate	$9.49
Max. Negotiated Rate	$196.88
Rate for Payer: Aetna Commercial	$149.62
Rate for Payer: Aetna Medicare Advantage	$118.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.41
Rate for Payer: Cigna Commercial	$196.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.12
Rate for Payer: Oxford Commercial	$78.75
Rate for Payer: Qualcare PPO/HMO/WC	$59.06
Rate for Payer: UnitedHealthcare Commercial	$78.75
Rate for Payer: UnitedHealthcare Community & State	$9.49
Rate for Payer: Wellpoint Medicaid Managed Care	$10.43

BRINZOLAMIDE OPHTHALMIC 1% SUS

Facility

$393.75

Hospital Charge Code	60629909
Hospital Revenue Code	250
Min. Negotiated Rate	$59.06
Max. Negotiated Rate	$59.06
Rate for Payer: Qualcare PPO/HMO/WC	$59.06

BROACH BODY OFFSET

Facility

$39,720.00

Service Code	HCPCS C1776
Hospital Charge Code	270689650
Hospital Revenue Code	278
Min. Negotiated Rate	$957.25
Max. Negotiated Rate	$19,860.00
Rate for Payer: Aetna Commercial	$15,093.60
Rate for Payer: Aetna Medicare Advantage	$11,916.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,128.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,128.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,944.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,128.60
Rate for Payer: Cigna Commercial	$19,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,612.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,738.40
Rate for Payer: Qualcare PPO/HMO/WC	$5,958.00
Rate for Payer: UnitedHealthcare Community & State	$957.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1,052.58

BROACH BODY OFFSET

Facility

$39,720.00

Service Code	HCPCS C1776
Hospital Charge Code	270689650
Hospital Revenue Code	278
Min. Negotiated Rate	$5,958.00
Max. Negotiated Rate	$9,612.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,944.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,612.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,738.40
Rate for Payer: Qualcare PPO/HMO/WC	$5,958.00

BROACH BODY STD ARCOS 13X175MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690469
Hospital Revenue Code	278
Min. Negotiated Rate	$253.05
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,990.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00
Rate for Payer: UnitedHealthcare Community & State	$253.05
Rate for Payer: Wellpoint Medicaid Managed Care	$278.25

BROACH BODY STD ARCOS 13X175MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690469
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

BROACHED BODIES SZ #4

Facility

$36,100.00

Service Code	HCPCS C1776
Hospital Charge Code	270676120
Hospital Revenue Code	278
Min. Negotiated Rate	$5,415.00
Max. Negotiated Rate	$8,736.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,736.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,942.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,415.00

BROACHED BODIES SZ #4

Facility

$36,100.00

Service Code	HCPCS C1776
Hospital Charge Code	270676120
Hospital Revenue Code	278
Min. Negotiated Rate	$870.01
Max. Negotiated Rate	$18,050.00
Rate for Payer: Aetna Commercial	$13,718.00
Rate for Payer: Aetna Medicare Advantage	$10,830.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,205.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,205.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,220.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,205.50
Rate for Payer: Cigna Commercial	$18,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,736.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,942.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,415.00
Rate for Payer: UnitedHealthcare Community & State	$870.01
Rate for Payer: Wellpoint Medicaid Managed Care	$956.65

BROACH SM DISTAL 16x6x6MM

Facility

$1,351.00

Hospital Charge Code	270674685
Hospital Revenue Code	272
Min. Negotiated Rate	$202.65
Max. Negotiated Rate	$202.65
Rate for Payer: Qualcare PPO/HMO/WC	$202.65

BROACH SM DISTAL 16x6x6MM

Facility

$1,351.00

Hospital Charge Code	270674685
Hospital Revenue Code	272
Min. Negotiated Rate	$32.56
Max. Negotiated Rate	$675.50
Rate for Payer: Aetna Commercial	$513.38
Rate for Payer: Aetna Medicare Advantage	$405.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$344.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$344.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$344.50
Rate for Payer: Cigna Commercial	$675.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$405.30
Rate for Payer: Oxford Commercial	$270.20
Rate for Payer: Qualcare PPO/HMO/WC	$202.65
Rate for Payer: UnitedHealthcare Commercial	$270.20
Rate for Payer: UnitedHealthcare Community & State	$32.56
Rate for Payer: Wellpoint Medicaid Managed Care	$35.80

BROACH SM PROXI 19x4.5x4.5MM

Facility

$1,351.00

Hospital Charge Code	270674684
Hospital Revenue Code	272
Min. Negotiated Rate	$32.56
Max. Negotiated Rate	$675.50
Rate for Payer: Aetna Commercial	$513.38
Rate for Payer: Aetna Medicare Advantage	$405.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$344.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$344.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$344.50
Rate for Payer: Cigna Commercial	$675.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$405.30
Rate for Payer: Oxford Commercial	$270.20
Rate for Payer: Qualcare PPO/HMO/WC	$202.65
Rate for Payer: UnitedHealthcare Commercial	$270.20
Rate for Payer: UnitedHealthcare Community & State	$32.56
Rate for Payer: Wellpoint Medicaid Managed Care	$35.80

BROACH SM PROXI 19x4.5x4.5MM

Facility

$1,351.00

Hospital Charge Code	270674684
Hospital Revenue Code	272
Min. Negotiated Rate	$202.65
Max. Negotiated Rate	$202.65
Rate for Payer: Qualcare PPO/HMO/WC	$202.65

BROKEN SCREW EXTRACTOR 5MM

Facility

$1,550.00

Hospital Charge Code	270690525
Hospital Revenue Code	270
Min. Negotiated Rate	$232.50
Max. Negotiated Rate	$232.50
Rate for Payer: Qualcare PPO/HMO/WC	$232.50

BROKEN SCREW EXTRACTOR 5MM

Facility

$1,550.00

Hospital Charge Code	270690525
Hospital Revenue Code	270
Min. Negotiated Rate	$37.35
Max. Negotiated Rate	$775.00
Rate for Payer: Aetna Commercial	$589.00
Rate for Payer: Aetna Medicare Advantage	$465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$395.25
Rate for Payer: Cigna Commercial	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$465.00
Rate for Payer: Oxford Commercial	$310.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.50
Rate for Payer: UnitedHealthcare Commercial	$310.00
Rate for Payer: UnitedHealthcare Community & State	$37.35
Rate for Payer: Wellpoint Medicaid Managed Care	$41.08

BROMFENAL CAP 25MG

Facility

$5.15

Hospital Charge Code	60628743
Hospital Revenue Code	250
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$0.77
Rate for Payer: Qualcare PPO/HMO/WC	$0.77

BROMFENAL CAP 25MG

Facility

$5.15

Hospital Charge Code	60628743
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.58
Rate for Payer: Aetna Commercial	$1.96
Rate for Payer: Aetna Medicare Advantage	$1.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.31
Rate for Payer: Cigna Commercial	$2.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.54
Rate for Payer: Oxford Commercial	$1.03
Rate for Payer: Qualcare PPO/HMO/WC	$0.77
Rate for Payer: UnitedHealthcare Commercial	$1.03
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

BROMIDE (SERUM)

Facility

$383.25

Service Code	HCPCS 84311
Hospital Charge Code	3007226
Hospital Revenue Code	301
Min. Negotiated Rate	$57.49
Max. Negotiated Rate	$57.49
Rate for Payer: Qualcare PPO/HMO/WC	$57.49

BROMIDE (SERUM)

Facility

$383.25

Service Code	HCPCS 84311
Hospital Charge Code	3007226
Hospital Revenue Code	301
Min. Negotiated Rate	$6.48
Max. Negotiated Rate	$191.62
Rate for Payer: Aetna Commercial	$22.03
Rate for Payer: Aetna Medicare Advantage	$26.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.24
Rate for Payer: Cigna Commercial	$191.62
Rate for Payer: Cigna Medicare Advantage	$8.10
Rate for Payer: Clover Medicare Advantage	$7.70
Rate for Payer: EmblemHealth Commercial	$24.30
Rate for Payer: Humana Medicare Advantage	$8.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.49
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.10
Rate for Payer: Wellcare Medicare Advantage	$8.10
Rate for Payer: Wellpoint Medicaid Managed Care	$10.16

BROMOCRIPTINE 2.5 MG TAB

Facility

$44.69

Service Code	NDC 30698020230
Hospital Charge Code	6009278
Hospital Revenue Code	251
Min. Negotiated Rate	$6.70
Max. Negotiated Rate	$6.70
Rate for Payer: Qualcare PPO/HMO/WC	$6.70

BROMOCRIPTINE 2.5 MG TAB

Facility

$44.69

Service Code	NDC 30698020230
Hospital Charge Code	6009278
Hospital Revenue Code	251
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$22.34
Rate for Payer: Aetna Commercial	$16.98
Rate for Payer: Aetna Medicare Advantage	$13.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.40
Rate for Payer: Cigna Commercial	$22.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.41
Rate for Payer: Oxford Commercial	$8.94
Rate for Payer: Qualcare PPO/HMO/WC	$6.70
Rate for Payer: UnitedHealthcare Commercial	$8.94
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.18

Know your out-of-pocket cost for care.

All Charges