Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CARBOPROST TRO INJ 250MCG/1ML

Facility

$1,196.20

Hospital Charge Code	6000939
Hospital Revenue Code	250
Min. Negotiated Rate	$28.83
Max. Negotiated Rate	$598.10
Rate for Payer: Aetna Commercial	$454.56
Rate for Payer: Aetna Medicare Advantage	$358.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$305.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$305.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$305.03
Rate for Payer: Cigna Commercial	$598.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$358.86
Rate for Payer: Oxford Commercial	$239.24
Rate for Payer: Qualcare PPO/HMO/WC	$179.43
Rate for Payer: UnitedHealthcare Commercial	$239.24
Rate for Payer: UnitedHealthcare Community & State	$28.83
Rate for Payer: Wellpoint Medicaid Managed Care	$31.70

CARBOXYHEMOGLOBIN

Facility

$182.00

Service Code	HCPCS 82375
Hospital Charge Code	38473085
Hospital Revenue Code	301
Min. Negotiated Rate	$4.82
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$33.51
Rate for Payer: Aetna Medicare Advantage	$39.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.47
Rate for Payer: Cigna Commercial	$91.00
Rate for Payer: Cigna Medicare Advantage	$12.32
Rate for Payer: Clover Medicare Advantage	$11.70
Rate for Payer: EmblemHealth Commercial	$36.96
Rate for Payer: Humana Medicare Advantage	$12.69
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.30
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.32
Rate for Payer: Wellcare Medicare Advantage	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$4.82

CARBOXYHEMOGLOBIN

Facility

$182.00

Service Code	HCPCS 82375
Hospital Charge Code	38473085
Hospital Revenue Code	301
Min. Negotiated Rate	$27.30
Max. Negotiated Rate	$27.30
Rate for Payer: Qualcare PPO/HMO/WC	$27.30

CARBOXYHEMOGLOBIN

Facility

$84.70

Service Code	HCPCS 82375
Hospital Charge Code	39900054
Hospital Revenue Code	301
Min. Negotiated Rate	$2.24
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$33.51
Rate for Payer: Aetna Medicare Advantage	$39.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.47
Rate for Payer: Cigna Commercial	$42.35
Rate for Payer: Cigna Medicare Advantage	$12.32
Rate for Payer: Clover Medicare Advantage	$11.70
Rate for Payer: EmblemHealth Commercial	$36.96
Rate for Payer: Humana Medicare Advantage	$12.69
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.41
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.71
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.32
Rate for Payer: Wellcare Medicare Advantage	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$2.24

CARBOXYHEMOGLOBIN

Facility

$84.70

Service Code	HCPCS 82375
Hospital Charge Code	39900054
Hospital Revenue Code	301
Min. Negotiated Rate	$12.71
Max. Negotiated Rate	$12.71
Rate for Payer: Qualcare PPO/HMO/WC	$12.71

CARBOXYHEMOGLOBIN BLOOD

Facility

$390.00

Service Code	HCPCS 82375
Hospital Charge Code	9501263
Hospital Revenue Code	301
Min. Negotiated Rate	$9.86
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$33.51
Rate for Payer: Aetna Medicare Advantage	$39.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.47
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.32
Rate for Payer: Clover Medicare Advantage	$11.70
Rate for Payer: EmblemHealth Commercial	$36.96
Rate for Payer: Humana Medicare Advantage	$12.69
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.32
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	$9.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.32
Rate for Payer: Wellcare Medicare Advantage	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

CARBOXYHEMOGLOBIN BLOOD

Facility

$390.00

Service Code	HCPCS 82375
Hospital Charge Code	9501263
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CARBOXYMETHYLCELLULOSE 1% OPHT

Facility

$4.00

Service Code	NDC 23455430
Hospital Charge Code	60628095
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

CARBOXYMETHYLCELLULOSE 1% OPHT

Facility

$4.00

Service Code	NDC 23455430
Hospital Charge Code	60628095
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

CARCINOEMBRYONIC ANTIGEN - CEA

Facility

$624.00

Service Code	HCPCS 82378
Hospital Charge Code	38472167
Hospital Revenue Code	301
Min. Negotiated Rate	$15.17
Max. Negotiated Rate	$312.00
Rate for Payer: Aetna Commercial	$51.57
Rate for Payer: Aetna Medicare Advantage	$61.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.44
Rate for Payer: Cigna Commercial	$312.00
Rate for Payer: Cigna Medicare Advantage	$18.96
Rate for Payer: Clover Medicare Advantage	$18.01
Rate for Payer: EmblemHealth Commercial	$56.88
Rate for Payer: Humana Medicare Advantage	$19.53
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$15.17
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.96
Rate for Payer: Wellcare Medicare Advantage	$18.96
Rate for Payer: Wellpoint Medicaid Managed Care	$16.54

CARCINOEMBRYONIC ANTIGEN - CEA

Facility

$624.00

Service Code	HCPCS 82378
Hospital Charge Code	38472167
Hospital Revenue Code	301
Min. Negotiated Rate	$93.60
Max. Negotiated Rate	$93.60
Rate for Payer: Qualcare PPO/HMO/WC	$93.60

CARDEC-DM/120ML

Facility

$5.00

Hospital Charge Code	60632622
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.90
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.50
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$1.00
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

CARDEC-DM/120ML

Facility

$5.00

Hospital Charge Code	60632622
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

CARDEC-DM/480ML

Facility

$43.00

Hospital Charge Code	60632623
Hospital Revenue Code	250
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

CARDEC-DM/480ML

Facility

$43.00

Hospital Charge Code	60632623
Hospital Revenue Code	250
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$16.34
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.90
Rate for Payer: Oxford Commercial	$8.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$8.60
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.14

CARDEC DM DROPS (1ML)

Facility

$4.00

Service Code	NDC 52083005501
Hospital Charge Code	60635796
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

CARDEC DM DROPS (1ML)

Facility

$4.00

Service Code	NDC 52083005501
Hospital Charge Code	60635796
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

CARDEC DM DROPS 30 ML

Facility

$32.00

Hospital Charge Code	60629157
Hospital Revenue Code	250
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

CARDEC DM DROPS 30 ML

Facility

$32.00

Hospital Charge Code	60629157
Hospital Revenue Code	250
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna Commercial	$12.16
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.60
Rate for Payer: Oxford Commercial	$6.40
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$6.40
Rate for Payer: UnitedHealthcare Community & State	$0.77
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

CARDEC-DM DROPS/30ML

Facility

$24.00

Hospital Charge Code	60632621
Hospital Revenue Code	250
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.60

CARDEC-DM DROPS/30ML

Facility

$24.00

Hospital Charge Code	60632621
Hospital Revenue Code	250
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$12.00
Rate for Payer: Aetna Commercial	$9.12
Rate for Payer: Aetna Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.12
Rate for Payer: Cigna Commercial	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.20
Rate for Payer: Oxford Commercial	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$3.60
Rate for Payer: UnitedHealthcare Commercial	$4.80
Rate for Payer: UnitedHealthcare Community & State	$0.58
Rate for Payer: Wellpoint Medicaid Managed Care	$0.64

CARDENE 20MG/200ML PREMIX

Facility

$817.27

Service Code	NDC 10122031410
Hospital Charge Code	60635698
Hospital Revenue Code	250
Min. Negotiated Rate	$19.70
Max. Negotiated Rate	$408.63
Rate for Payer: Aetna Commercial	$310.56
Rate for Payer: Aetna Medicare Advantage	$245.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$208.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$208.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$208.40
Rate for Payer: Cigna Commercial	$408.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$245.18
Rate for Payer: Oxford Commercial	$163.45
Rate for Payer: Qualcare PPO/HMO/WC	$122.59
Rate for Payer: UnitedHealthcare Commercial	$163.45
Rate for Payer: UnitedHealthcare Community & State	$19.70
Rate for Payer: Wellpoint Medicaid Managed Care	$21.66

CARDENE 20MG/200ML PREMIX

Facility

$817.27

Service Code	NDC 10122031410
Hospital Charge Code	60635698
Hospital Revenue Code	250
Min. Negotiated Rate	$122.59
Max. Negotiated Rate	$122.59
Rate for Payer: Qualcare PPO/HMO/WC	$122.59

CARDENE/20MG/CAP

Facility

$6.00

Hospital Charge Code	60632624
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

CARDENE/20MG/CAP

Facility

$6.00

Hospital Charge Code	60632624
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

Know your out-of-pocket cost for care.

All Charges