Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CALCIJEX 1MCG (CALCITRIOL)

Facility

$152.00

Service Code	HCPCS J0635
Hospital Charge Code	6007736
Hospital Revenue Code	250
Min. Negotiated Rate	$3.66
Max. Negotiated Rate	$76.00
Rate for Payer: Aetna Commercial	$57.76
Rate for Payer: Aetna Medicare Advantage	$45.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.76
Rate for Payer: Cigna Commercial	$76.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.60
Rate for Payer: Oxford Commercial	$30.40
Rate for Payer: Qualcare PPO/HMO/WC	$22.80
Rate for Payer: UnitedHealthcare Commercial	$30.40
Rate for Payer: UnitedHealthcare Community & State	$3.66
Rate for Payer: Wellpoint Medicaid Managed Care	$4.03

CALCIMAR/200U/1ML

Facility

$154.00

Hospital Charge Code	60632601
Hospital Revenue Code	250
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$23.10
Rate for Payer: Qualcare PPO/HMO/WC	$23.10

CALCIMAR/200U/1ML

Facility

$154.00

Hospital Charge Code	60632601
Hospital Revenue Code	250
Min. Negotiated Rate	$3.71
Max. Negotiated Rate	$77.00
Rate for Payer: Aetna Commercial	$58.52
Rate for Payer: Aetna Medicare Advantage	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.27
Rate for Payer: Cigna Commercial	$77.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.20
Rate for Payer: Oxford Commercial	$30.80
Rate for Payer: Qualcare PPO/HMO/WC	$23.10
Rate for Payer: UnitedHealthcare Commercial	$30.80
Rate for Payer: UnitedHealthcare Community & State	$3.71
Rate for Payer: Wellpoint Medicaid Managed Care	$4.08

CALCIPOTRIENE 0.005% OINTMENT

Facility

$312.00

Hospital Charge Code	60628875
Hospital Revenue Code	250
Min. Negotiated Rate	$7.52
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$118.56
Rate for Payer: Aetna Medicare Advantage	$93.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.56
Rate for Payer: Cigna Commercial	$156.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.60
Rate for Payer: Oxford Commercial	$62.40
Rate for Payer: Qualcare PPO/HMO/WC	$46.80
Rate for Payer: UnitedHealthcare Commercial	$62.40
Rate for Payer: UnitedHealthcare Community & State	$7.52
Rate for Payer: Wellpoint Medicaid Managed Care	$8.27

CALCIPOTRIENE 0.005% OINTMENT

Facility

$312.00

Hospital Charge Code	60628875
Hospital Revenue Code	250
Min. Negotiated Rate	$46.80
Max. Negotiated Rate	$46.80
Rate for Payer: Qualcare PPO/HMO/WC	$46.80

CALCITONIN

Facility

$680.00

Service Code	HCPCS 82308
Hospital Charge Code	38472146
Hospital Revenue Code	301
Min. Negotiated Rate	$102.00
Max. Negotiated Rate	$102.00
Rate for Payer: Qualcare PPO/HMO/WC	$102.00

CALCITONIN

Facility

$338.45

Service Code	HCPCS 82308
Hospital Charge Code	3008315
Hospital Revenue Code	301
Min. Negotiated Rate	$50.77
Max. Negotiated Rate	$50.77
Rate for Payer: Qualcare PPO/HMO/WC	$50.77

CALCITONIN

Facility

$680.00

Service Code	HCPCS 82308
Hospital Charge Code	38472146
Hospital Revenue Code	301
Min. Negotiated Rate	$18.02
Max. Negotiated Rate	$340.00
Rate for Payer: Aetna Commercial	$72.87
Rate for Payer: Aetna Medicare Advantage	$86.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.70
Rate for Payer: Cigna Commercial	$340.00
Rate for Payer: Cigna Medicare Advantage	$26.79
Rate for Payer: Clover Medicare Advantage	$25.45
Rate for Payer: EmblemHealth Commercial	$80.37
Rate for Payer: Humana Medicare Advantage	$27.59
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$204.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$102.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$21.43
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.79
Rate for Payer: Wellcare Medicare Advantage	$26.79
Rate for Payer: Wellpoint Medicaid Managed Care	$18.02

CALCITONIN

Facility

$338.45

Service Code	HCPCS 82308
Hospital Charge Code	3008315
Hospital Revenue Code	301
Min. Negotiated Rate	$8.97
Max. Negotiated Rate	$169.22
Rate for Payer: Aetna Commercial	$72.87
Rate for Payer: Aetna Medicare Advantage	$86.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.70
Rate for Payer: Cigna Commercial	$169.22
Rate for Payer: Cigna Medicare Advantage	$26.79
Rate for Payer: Clover Medicare Advantage	$25.45
Rate for Payer: EmblemHealth Commercial	$80.37
Rate for Payer: Humana Medicare Advantage	$27.59
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.53
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.77
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$21.43
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.79
Rate for Payer: Wellcare Medicare Advantage	$26.79
Rate for Payer: Wellpoint Medicaid Managed Care	$8.97

CALCITONIN

Facility

$390.00

Service Code	HCPCS 82308
Hospital Charge Code	39900051
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$72.87
Rate for Payer: Aetna Medicare Advantage	$86.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.70
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$26.79
Rate for Payer: Clover Medicare Advantage	$25.45
Rate for Payer: EmblemHealth Commercial	$80.37
Rate for Payer: Humana Medicare Advantage	$27.59
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26.79
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	$21.43
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.79
Rate for Payer: Wellcare Medicare Advantage	$26.79
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

CALCITONIN

Facility

$390.00

Service Code	HCPCS 82308
Hospital Charge Code	39900051
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CALCITONIN INJ 200IU/ML

Facility

$7,422.26

Service Code	HCPCS J0630
Hospital Charge Code	6000830
Hospital Revenue Code	636
Min. Negotiated Rate	$178.88
Max. Negotiated Rate	$3,711.13
Rate for Payer: Aetna Commercial	$2,820.46
Rate for Payer: Aetna Medicare Advantage	$2,226.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,892.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,892.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,892.68
Rate for Payer: Cigna Commercial	$3,711.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,796.19
Rate for Payer: Qualcare PPO/HMO/WC	$1,113.34
Rate for Payer: UnitedHealthcare Community & State	$178.88
Rate for Payer: Wellpoint Medicaid Managed Care	$196.69

CALCITONIN INJ 200IU/ML

Facility

$7,422.26

Service Code	HCPCS J0630
Hospital Charge Code	6000830
Hospital Revenue Code	636
Min. Negotiated Rate	$1,113.34
Max. Negotiated Rate	$1,796.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,796.19
Rate for Payer: Qualcare PPO/HMO/WC	$1,113.34

CALCITONIN NSL SPR 200U/0.09ML

Facility

$26.47

Service Code	NDC 60505082306
Hospital Charge Code	60628243
Hospital Revenue Code	250
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$13.23
Rate for Payer: Aetna Commercial	$10.06
Rate for Payer: Aetna Medicare Advantage	$7.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.75
Rate for Payer: Cigna Commercial	$13.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.94
Rate for Payer: Oxford Commercial	$5.29
Rate for Payer: Qualcare PPO/HMO/WC	$3.97
Rate for Payer: UnitedHealthcare Commercial	$5.29
Rate for Payer: UnitedHealthcare Community & State	$0.64
Rate for Payer: Wellpoint Medicaid Managed Care	$0.70

CALCITONIN NSL SPR 200U/0.09ML

Facility

$26.47

Service Code	NDC 60505082306
Hospital Charge Code	60628243
Hospital Revenue Code	250
Min. Negotiated Rate	$3.97
Max. Negotiated Rate	$3.97
Rate for Payer: Qualcare PPO/HMO/WC	$3.97

CALCITONIN SALMON NSL SOL 2ML

Facility

$204.80

Hospital Charge Code	6017883
Hospital Revenue Code	252
Min. Negotiated Rate	$30.72
Max. Negotiated Rate	$30.72
Rate for Payer: Qualcare PPO/HMO/WC	$30.72

CALCITONIN SALMON NSL SOL 2ML

Facility

$204.80

Hospital Charge Code	6017883
Hospital Revenue Code	252
Min. Negotiated Rate	$4.94
Max. Negotiated Rate	$102.40
Rate for Payer: Aetna Commercial	$77.82
Rate for Payer: Aetna Medicare Advantage	$61.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.22
Rate for Payer: Cigna Commercial	$102.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.44
Rate for Payer: Oxford Commercial	$40.96
Rate for Payer: Qualcare PPO/HMO/WC	$30.72
Rate for Payer: UnitedHealthcare Commercial	$40.96
Rate for Payer: UnitedHealthcare Community & State	$4.94
Rate for Payer: Wellpoint Medicaid Managed Care	$5.43

CALCITRIOL 0.25 MCG CAP

Facility

$10.45

Service Code	NDC 63304023901
Hospital Charge Code	60628491
Hospital Revenue Code	250
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$1.57
Rate for Payer: Qualcare PPO/HMO/WC	$1.57

CALCITRIOL 0.25 MCG CAP

Facility

$10.45

Service Code	NDC 63304023901
Hospital Charge Code	60628491
Hospital Revenue Code	250
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$5.22
Rate for Payer: Aetna Commercial	$3.97
Rate for Payer: Aetna Medicare Advantage	$3.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.66
Rate for Payer: Cigna Commercial	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.13
Rate for Payer: Oxford Commercial	$2.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.57
Rate for Payer: UnitedHealthcare Commercial	$2.09
Rate for Payer: UnitedHealthcare Community & State	$0.25
Rate for Payer: Wellpoint Medicaid Managed Care	$0.28

CALCITRIOL 1 MCG/ML INJ

Facility

$39.25

Hospital Charge Code	6007033
Hospital Revenue Code	250
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$19.62
Rate for Payer: Aetna Commercial	$14.91
Rate for Payer: Aetna Medicare Advantage	$11.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.01
Rate for Payer: Cigna Commercial	$19.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.78
Rate for Payer: Oxford Commercial	$7.85
Rate for Payer: Qualcare PPO/HMO/WC	$5.89
Rate for Payer: UnitedHealthcare Commercial	$7.85
Rate for Payer: UnitedHealthcare Community & State	$0.95
Rate for Payer: Wellpoint Medicaid Managed Care	$1.04

CALCITRIOL 1 MCG/ML INJ

Facility

$39.25

Hospital Charge Code	6007033
Hospital Revenue Code	250
Min. Negotiated Rate	$5.89
Max. Negotiated Rate	$5.89
Rate for Payer: Qualcare PPO/HMO/WC	$5.89

CALCITROIL 1MCG/15 ML SOL

Facility

$79.93

Service Code	HCPCS J0636
Hospital Charge Code	60635677
Hospital Revenue Code	636
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$39.97
Rate for Payer: Aetna Commercial	$30.37
Rate for Payer: Aetna Medicare Advantage	$23.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.38
Rate for Payer: Cigna Commercial	$39.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.34
Rate for Payer: Qualcare PPO/HMO/WC	$11.99
Rate for Payer: UnitedHealthcare Community & State	$1.93
Rate for Payer: Wellpoint Medicaid Managed Care	$2.12

CALCITROIL 1MCG/15 ML SOL

Facility

$79.93

Service Code	HCPCS J0636
Hospital Charge Code	60635677
Hospital Revenue Code	636
Min. Negotiated Rate	$11.99
Max. Negotiated Rate	$19.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.34
Rate for Payer: Qualcare PPO/HMO/WC	$11.99

CALCITROL 1MCG/1ML INJ***

Facility

$32.40

Service Code	HCPCS J0635
Hospital Charge Code	6007033P
Hospital Revenue Code	259
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$16.20
Rate for Payer: Aetna Commercial	$12.31
Rate for Payer: Aetna Medicare Advantage	$9.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.26
Rate for Payer: Cigna Commercial	$16.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.72
Rate for Payer: Oxford Commercial	$6.48
Rate for Payer: Qualcare PPO/HMO/WC	$4.86
Rate for Payer: UnitedHealthcare Commercial	$6.48
Rate for Payer: UnitedHealthcare Community & State	$0.78
Rate for Payer: Wellpoint Medicaid Managed Care	$0.86

CALCITROL 1MCG/1ML INJ***

Facility

$32.40

Service Code	HCPCS J0635
Hospital Charge Code	6007033P
Hospital Revenue Code	259
Min. Negotiated Rate	$4.86
Max. Negotiated Rate	$4.86
Rate for Payer: Qualcare PPO/HMO/WC	$4.86

Know your out-of-pocket cost for care.

All Charges