Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BUR ZIM ULPR WP 2.0MM 7021-042

Facility

$698.45

Hospital Charge Code	270603867
Hospital Revenue Code	272
Min. Negotiated Rate	$16.83
Max. Negotiated Rate	$349.23
Rate for Payer: Aetna Commercial	$265.41
Rate for Payer: Aetna Medicare Advantage	$209.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.10
Rate for Payer: Cigna Commercial	$349.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.53
Rate for Payer: Oxford Commercial	$139.69
Rate for Payer: Qualcare PPO/HMO/WC	$104.77
Rate for Payer: UnitedHealthcare Commercial	$139.69
Rate for Payer: UnitedHealthcare Community & State	$16.83
Rate for Payer: Wellpoint Medicaid Managed Care	$18.51

BUR ZIM WIRE PASS 5091-249

Facility

$244.85

Hospital Charge Code	270601069
Hospital Revenue Code	272
Min. Negotiated Rate	$5.90
Max. Negotiated Rate	$122.42
Rate for Payer: Aetna Commercial	$93.04
Rate for Payer: Aetna Medicare Advantage	$73.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.44
Rate for Payer: Cigna Commercial	$122.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.45
Rate for Payer: Oxford Commercial	$48.97
Rate for Payer: Qualcare PPO/HMO/WC	$36.73
Rate for Payer: UnitedHealthcare Commercial	$48.97
Rate for Payer: UnitedHealthcare Community & State	$5.90
Rate for Payer: Wellpoint Medicaid Managed Care	$6.49

BUR ZIM WIRE PASS 5091-249

Facility

$244.85

Hospital Charge Code	270601069
Hospital Revenue Code	272
Min. Negotiated Rate	$36.73
Max. Negotiated Rate	$36.73
Rate for Payer: Qualcare PPO/HMO/WC	$36.73

BUSINESS CARDS

Facility

$221.25

Hospital Charge Code	270656345
Hospital Revenue Code	271
Min. Negotiated Rate	$5.33
Max. Negotiated Rate	$110.62
Rate for Payer: Aetna Commercial	$84.08
Rate for Payer: Aetna Medicare Advantage	$66.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.42
Rate for Payer: Cigna Commercial	$110.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.38
Rate for Payer: Oxford Commercial	$44.25
Rate for Payer: Qualcare PPO/HMO/WC	$33.19
Rate for Payer: UnitedHealthcare Commercial	$44.25
Rate for Payer: UnitedHealthcare Community & State	$5.33
Rate for Payer: Wellpoint Medicaid Managed Care	$5.86

BUSINESS CARDS

Facility

$221.25

Hospital Charge Code	270656345
Hospital Revenue Code	271
Min. Negotiated Rate	$33.19
Max. Negotiated Rate	$33.19
Rate for Payer: Qualcare PPO/HMO/WC	$33.19

BUSPAR/10MG/TAB

Facility

$9.05

Service Code	NDC 51079098620
Hospital Charge Code	60632592
Hospital Revenue Code	250
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.53
Rate for Payer: Aetna Commercial	$3.44
Rate for Payer: Aetna Medicare Advantage	$2.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.31
Rate for Payer: Cigna Commercial	$4.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.71
Rate for Payer: Oxford Commercial	$1.81
Rate for Payer: Qualcare PPO/HMO/WC	$1.36
Rate for Payer: UnitedHealthcare Commercial	$1.81
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

BUSPAR/10MG/TAB

Facility

$9.05

Service Code	NDC 51079098620
Hospital Charge Code	60632592
Hospital Revenue Code	250
Min. Negotiated Rate	$1.36
Max. Negotiated Rate	$1.36
Rate for Payer: Qualcare PPO/HMO/WC	$1.36

BUSPAR/10MG/TAB

Facility

$7.00

Hospital Charge Code	60632594
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

BUSPAR/10MG/TAB

Facility

$7.00

Hospital Charge Code	60632594
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.66
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.10
Rate for Payer: Oxford Commercial	$1.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$1.40
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

BUSPAR/10MG/TAB

Facility

$6.00

Hospital Charge Code	60632595
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

BUSPAR/10MG/TAB

Facility

$6.00

Hospital Charge Code	60632595
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$2.28
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.80
Rate for Payer: Oxford Commercial	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.20
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

BUSPAR 15MG

Facility

$7.00

Hospital Charge Code	60635250
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

BUSPAR 15MG

Facility

$7.00

Hospital Charge Code	60635250
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.66
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.10
Rate for Payer: Oxford Commercial	$1.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$1.40
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

BUSPAR/5MG/TAB

Facility

$7.00

Hospital Charge Code	60632593
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.66
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.10
Rate for Payer: Oxford Commercial	$1.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$1.40
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

BUSPAR/5MG/TAB

Facility

$7.00

Hospital Charge Code	60632593
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

BUSPIRONE 5 MG TAB

Facility

$5.16

Service Code	NDC 51079098520
Hospital Charge Code	60627854
Hospital Revenue Code	250
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$0.77
Rate for Payer: Qualcare PPO/HMO/WC	$0.77

BUSPIRONE 5 MG TAB

Facility

$5.16

Service Code	NDC 51079098520
Hospital Charge Code	60627854
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	$1.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.32
Rate for Payer: Cigna Commercial	$2.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.55
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

BUSPIRONE 7.5MG TABLET

Facility

$10.59

Service Code	NDC 64380078706
Hospital Charge Code	606390258
Hospital Revenue Code	250
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$1.59
Rate for Payer: Qualcare PPO/HMO/WC	$1.59

BUSPIRONE 7.5MG TABLET

Facility

$10.59

Service Code	NDC 64380078706
Hospital Charge Code	606390258
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$5.29
Rate for Payer: Aetna Commercial	$4.02
Rate for Payer: Aetna Medicare Advantage	$3.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.70
Rate for Payer: Cigna Commercial	$5.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.18
Rate for Payer: Oxford Commercial	$2.12
Rate for Payer: Qualcare PPO/HMO/WC	$1.59
Rate for Payer: UnitedHealthcare Commercial	$2.12
Rate for Payer: UnitedHealthcare Community & State	$0.26
Rate for Payer: Wellpoint Medicaid Managed Care	$0.28

BUTABARBITAL (BARBITUATE) BLD

Facility

$159.25

Service Code	HCPCS 80345
Hospital Charge Code	3007168
Hospital Revenue Code	301
Min. Negotiated Rate	$23.89
Max. Negotiated Rate	$23.89
Rate for Payer: Qualcare PPO/HMO/WC	$23.89

BUTABARBITAL (BARBITUATE) BLD

Facility

$159.25

Service Code	HCPCS 80345
Hospital Charge Code	3007168
Hospital Revenue Code	301
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$60.52
Rate for Payer: Aetna Medicare Advantage	$47.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.61
Rate for Payer: Cigna Commercial	$79.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.77
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.89
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$22.05
Rate for Payer: Wellpoint Medicaid Managed Care	$4.22

BUTFLY BLD COLLECT 21ga 367281

Facility

$3.60

Hospital Charge Code	270639106
Hospital Revenue Code	272
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$0.54
Rate for Payer: Qualcare PPO/HMO/WC	$0.54

BUTFLY BLD COLLECT 21ga 367281

Facility

$3.60

Hospital Charge Code	270639106
Hospital Revenue Code	272
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$1.80
Rate for Payer: Aetna Commercial	$1.37
Rate for Payer: Aetna Medicare Advantage	$1.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.92
Rate for Payer: Cigna Commercial	$1.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.08
Rate for Payer: Oxford Commercial	$0.72
Rate for Payer: Qualcare PPO/HMO/WC	$0.54
Rate for Payer: UnitedHealthcare Commercial	$0.72
Rate for Payer: UnitedHealthcare Community & State	$0.09
Rate for Payer: Wellpoint Medicaid Managed Care	$0.10

BUT LVT UP RD 4 8 7021327

Facility

$222.45

Hospital Charge Code	270629146
Hospital Revenue Code	272
Min. Negotiated Rate	$5.36
Max. Negotiated Rate	$111.22
Rate for Payer: Aetna Commercial	$84.53
Rate for Payer: Aetna Medicare Advantage	$66.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.72
Rate for Payer: Cigna Commercial	$111.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.73
Rate for Payer: Oxford Commercial	$44.49
Rate for Payer: Qualcare PPO/HMO/WC	$33.37
Rate for Payer: UnitedHealthcare Commercial	$44.49
Rate for Payer: UnitedHealthcare Community & State	$5.36
Rate for Payer: Wellpoint Medicaid Managed Care	$5.89

BUT LVT UP RD 4 8 7021327

Facility

$222.45

Hospital Charge Code	270629146
Hospital Revenue Code	272
Min. Negotiated Rate	$33.37
Max. Negotiated Rate	$33.37
Rate for Payer: Qualcare PPO/HMO/WC	$33.37

Know your out-of-pocket cost for care.

All Charges