Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CALCIUM GLUCONATE 10%/1GM

Facility

$412.00

Hospital Charge Code	60632606
Hospital Revenue Code	250
Min. Negotiated Rate	$61.80
Max. Negotiated Rate	$61.80
Rate for Payer: Qualcare PPO/HMO/WC	$61.80

CALCIUM GLUCONATE 10%/1GM

Facility

$114.00

Hospital Charge Code	60632605
Hospital Revenue Code	250
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$57.00
Rate for Payer: Aetna Commercial	$43.32
Rate for Payer: Aetna Medicare Advantage	$34.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.07
Rate for Payer: Cigna Commercial	$57.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.20
Rate for Payer: Oxford Commercial	$22.80
Rate for Payer: Qualcare PPO/HMO/WC	$17.10
Rate for Payer: UnitedHealthcare Commercial	$22.80
Rate for Payer: UnitedHealthcare Community & State	$2.75
Rate for Payer: Wellpoint Medicaid Managed Care	$3.02

CALCIUM GLUCONATE/1G/TAB

Facility

$3.00

Hospital Charge Code	60634355
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

CALCIUM GLUCONATE/1G/TAB

Facility

$3.00

Hospital Charge Code	60634355
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

CALCIUM GLUCONATE 500 MG TAB

Facility

$4.00

Service Code	NDC 54026225
Hospital Charge Code	60627897
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

CALCIUM GLUCONATE 500 MG TAB

Facility

$4.00

Service Code	NDC 54026225
Hospital Charge Code	60627897
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

CALCIUM GLUCONATE INJ 1G/50ML

Facility

$10.85

Service Code	HCPCS J0612
Hospital Charge Code	60627898
Hospital Revenue Code	636
Min. Negotiated Rate	$1.63
Max. Negotiated Rate	$2.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.63
Rate for Payer: Qualcare PPO/HMO/WC	$1.63

CALCIUM GLUCONATE INJ 1G/50ML

Facility

$10.85

Service Code	HCPCS J0612
Hospital Charge Code	60627898
Hospital Revenue Code	636
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$5.42
Rate for Payer: Aetna Commercial	$4.12
Rate for Payer: Aetna Medicare Advantage	$3.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.77
Rate for Payer: Cigna Commercial	$5.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.63
Rate for Payer: Qualcare PPO/HMO/WC	$1.63
Rate for Payer: UnitedHealthcare Community & State	$0.26
Rate for Payer: Wellpoint Medicaid Managed Care	$0.29

CALCIUM, IONIZED

Facility

$609.00

Service Code	HCPCS 82330
Hospital Charge Code	38472155
Hospital Revenue Code	301
Min. Negotiated Rate	$91.35
Max. Negotiated Rate	$91.35
Rate for Payer: Qualcare PPO/HMO/WC	$91.35

CALCIUM, IONIZED

Facility

$609.00

Service Code	HCPCS 82330
Hospital Charge Code	38472155
Hospital Revenue Code	301
Min. Negotiated Rate	$10.94
Max. Negotiated Rate	$304.50
Rate for Payer: Aetna Commercial	$37.21
Rate for Payer: Aetna Medicare Advantage	$44.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.38
Rate for Payer: Cigna Commercial	$304.50
Rate for Payer: Cigna Medicare Advantage	$13.68
Rate for Payer: Clover Medicare Advantage	$13.00
Rate for Payer: EmblemHealth Commercial	$41.04
Rate for Payer: Humana Medicare Advantage	$14.09
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.35
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.68
Rate for Payer: Wellcare Medicare Advantage	$13.68
Rate for Payer: Wellpoint Medicaid Managed Care	$16.14

CALCIUM IONIZED SERUM

Facility

$121.65

Service Code	HCPCS 82330
Hospital Charge Code	3030996
Hospital Revenue Code	301
Min. Negotiated Rate	$3.22
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$37.21
Rate for Payer: Aetna Medicare Advantage	$44.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.38
Rate for Payer: Cigna Commercial	$60.83
Rate for Payer: Cigna Medicare Advantage	$13.68
Rate for Payer: Clover Medicare Advantage	$13.00
Rate for Payer: EmblemHealth Commercial	$41.04
Rate for Payer: Humana Medicare Advantage	$14.09
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.49
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.25
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.68
Rate for Payer: Wellcare Medicare Advantage	$13.68
Rate for Payer: Wellpoint Medicaid Managed Care	$3.22

CALCIUM IONIZED SERUM

Facility

$121.65

Service Code	HCPCS 82330
Hospital Charge Code	3030996
Hospital Revenue Code	301
Min. Negotiated Rate	$18.25
Max. Negotiated Rate	$18.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.25

CALCIUM,IONIZED,SERUM

Facility

$667.59

Service Code	HCPCS 82330
Hospital Charge Code	39900052
Hospital Revenue Code	301
Min. Negotiated Rate	$10.94
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$37.21
Rate for Payer: Aetna Medicare Advantage	$44.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.38
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$13.68
Rate for Payer: Clover Medicare Advantage	$13.00
Rate for Payer: EmblemHealth Commercial	$41.04
Rate for Payer: Humana Medicare Advantage	$14.09
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.68
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	$10.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.68
Rate for Payer: Wellcare Medicare Advantage	$13.68
Rate for Payer: Wellpoint Medicaid Managed Care	$17.69

CALCIUM,IONIZED,SERUM

Facility

$667.59

Service Code	HCPCS 82330
Hospital Charge Code	39900052
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

CALCIUM POLY CARBO 625MG

Facility

$2.45

Hospital Charge Code	60628585
Hospital Revenue Code	250
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.23
Rate for Payer: Aetna Commercial	$0.93
Rate for Payer: Aetna Medicare Advantage	$0.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.62
Rate for Payer: Cigna Commercial	$1.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.74
Rate for Payer: Oxford Commercial	$0.49
Rate for Payer: Qualcare PPO/HMO/WC	$0.37
Rate for Payer: UnitedHealthcare Commercial	$0.49
Rate for Payer: UnitedHealthcare Community & State	$0.06
Rate for Payer: Wellpoint Medicaid Managed Care	$0.06

CALCIUM POLY CARBO 625MG

Facility

$2.45

Hospital Charge Code	60628585
Hospital Revenue Code	250
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.37
Rate for Payer: Qualcare PPO/HMO/WC	$0.37

CALCIUM POLY CARBO TAB 500MG

Facility

$1.95

Hospital Charge Code	60628584
Hospital Revenue Code	250
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.98
Rate for Payer: Aetna Commercial	$0.74
Rate for Payer: Aetna Medicare Advantage	$0.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.50
Rate for Payer: Cigna Commercial	$0.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.59
Rate for Payer: Oxford Commercial	$0.39
Rate for Payer: Qualcare PPO/HMO/WC	$0.29
Rate for Payer: UnitedHealthcare Commercial	$0.39
Rate for Payer: UnitedHealthcare Community & State	$0.05
Rate for Payer: Wellpoint Medicaid Managed Care	$0.05

CALCIUM POLY CARBO TAB 500MG

Facility

$1.95

Hospital Charge Code	60628584
Hospital Revenue Code	250
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.29
Rate for Payer: Qualcare PPO/HMO/WC	$0.29

CALCIUM, SERUM

Facility

$54.45

Service Code	HCPCS 82310
Hospital Charge Code	3000577
Hospital Revenue Code	301
Min. Negotiated Rate	$8.17
Max. Negotiated Rate	$8.17
Rate for Payer: Qualcare PPO/HMO/WC	$8.17

CALCIUM, SERUM

Facility

$54.45

Service Code	HCPCS 82310
Hospital Charge Code	3000577
Hospital Revenue Code	301
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$14.04
Rate for Payer: Aetna Medicare Advantage	$16.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.63
Rate for Payer: Cigna Commercial	$27.23
Rate for Payer: Cigna Medicare Advantage	$5.16
Rate for Payer: Clover Medicare Advantage	$4.90
Rate for Payer: EmblemHealth Commercial	$15.48
Rate for Payer: Humana Medicare Advantage	$5.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.34
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.17
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.13
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.16
Rate for Payer: Wellcare Medicare Advantage	$5.16
Rate for Payer: Wellpoint Medicaid Managed Care	$1.44

CALCIUM, SERUM PANEL***

Facility

$7.20

Service Code	HCPCS 82310
Hospital Charge Code	3000577P
Hospital Revenue Code	301
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$14.04
Rate for Payer: Aetna Medicare Advantage	$16.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.63
Rate for Payer: Cigna Commercial	$3.60
Rate for Payer: Cigna Medicare Advantage	$5.16
Rate for Payer: Clover Medicare Advantage	$4.90
Rate for Payer: EmblemHealth Commercial	$15.48
Rate for Payer: Humana Medicare Advantage	$5.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.16
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.08
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.13
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.16
Rate for Payer: Wellcare Medicare Advantage	$5.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

CALCIUM, SERUM PANEL***

Facility

$7.20

Service Code	HCPCS 82310
Hospital Charge Code	3000577P
Hospital Revenue Code	301
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$1.08
Rate for Payer: Qualcare PPO/HMO/WC	$1.08

CALCIUM SULPHATE RPD CURE 5CC

Facility

$7,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270668725
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$1,694.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,540.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

CALCIUM SULPHATE RPD CURE 5CC

Facility

$7,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270668725
Hospital Revenue Code	278
Min. Negotiated Rate	$168.70
Max. Negotiated Rate	$3,500.00
Rate for Payer: Aetna Commercial	$2,660.00
Rate for Payer: Aetna Medicare Advantage	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,785.00
Rate for Payer: Cigna Commercial	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,540.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00
Rate for Payer: UnitedHealthcare Community & State	$168.70
Rate for Payer: Wellpoint Medicaid Managed Care	$185.50

CALCIUM,TOTAL

Facility

$145.00

Service Code	HCPCS 82310
Hospital Charge Code	38472149
Hospital Revenue Code	301
Min. Negotiated Rate	$3.84
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$14.04
Rate for Payer: Aetna Medicare Advantage	$16.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.63
Rate for Payer: Cigna Commercial	$72.50
Rate for Payer: Cigna Medicare Advantage	$5.16
Rate for Payer: Clover Medicare Advantage	$4.90
Rate for Payer: EmblemHealth Commercial	$15.48
Rate for Payer: Humana Medicare Advantage	$5.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.75
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.13
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.16
Rate for Payer: Wellcare Medicare Advantage	$5.16
Rate for Payer: Wellpoint Medicaid Managed Care	$3.84

Know your out-of-pocket cost for care.

All Charges