Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CARNITOR 330MG TAB

Facility

$6.70

Service Code	NDC 54482014407
Hospital Charge Code	60635364
Hospital Revenue Code	250
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.00

CARNITOR 330MG TAB

Facility

$6.70

Service Code	NDC 54482014407
Hospital Charge Code	60635364
Hospital Revenue Code	250
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$3.35
Rate for Payer: Aetna Commercial	$2.55
Rate for Payer: Aetna Medicare Advantage	$2.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.71
Rate for Payer: Cigna Commercial	$3.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.01
Rate for Payer: Oxford Commercial	$1.34
Rate for Payer: Qualcare PPO/HMO/WC	$1.00
Rate for Payer: UnitedHealthcare Commercial	$1.34
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

CARNOX MOD TOPICAL SUSP 60 ML

Facility

$153.65

Hospital Charge Code	60628900
Hospital Revenue Code	250
Min. Negotiated Rate	$23.05
Max. Negotiated Rate	$23.05
Rate for Payer: Qualcare PPO/HMO/WC	$23.05

CARNOX MOD TOPICAL SUSP 60 ML

Facility

$153.65

Hospital Charge Code	60628900
Hospital Revenue Code	250
Min. Negotiated Rate	$3.70
Max. Negotiated Rate	$76.83
Rate for Payer: Aetna Commercial	$58.39
Rate for Payer: Aetna Medicare Advantage	$46.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.18
Rate for Payer: Cigna Commercial	$76.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.09
Rate for Payer: Oxford Commercial	$30.73
Rate for Payer: Qualcare PPO/HMO/WC	$23.05
Rate for Payer: UnitedHealthcare Commercial	$30.73
Rate for Payer: UnitedHealthcare Community & State	$3.70
Rate for Payer: Wellpoint Medicaid Managed Care	$4.07

CAROTENE

Facility

$390.00

Service Code	HCPCS 82380
Hospital Charge Code	38472170
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CAROTENE

Facility

$63.40

Service Code	HCPCS 82380
Hospital Charge Code	39900056
Hospital Revenue Code	301
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$25.08
Rate for Payer: Aetna Medicare Advantage	$29.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.22
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	$33.28
Rate for Payer: Cigna Commercial	$31.70
Rate for Payer: Cigna Medicare Advantage	$9.22
Rate for Payer: Clover Medicare Advantage	$8.76
Rate for Payer: EmblemHealth Commercial	$27.66
Rate for Payer: Humana Medicare Advantage	$9.50
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.02
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.51
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$7.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.22
Rate for Payer: Wellcare Medicare Advantage	$9.22
Rate for Payer: Wellpoint Medicaid Managed Care	$1.68

CAROTENE

Facility

$390.00

Service Code	HCPCS 82380
Hospital Charge Code	38472170
Hospital Revenue Code	301
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$25.08
Rate for Payer: Aetna Medicare Advantage	$29.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.22
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	$33.28
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$9.22
Rate for Payer: Clover Medicare Advantage	$8.76
Rate for Payer: EmblemHealth Commercial	$27.66
Rate for Payer: Humana Medicare Advantage	$9.50
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.22
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	$7.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.22
Rate for Payer: Wellcare Medicare Advantage	$9.22
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

CAROTENE

Facility

$63.40

Service Code	HCPCS 82380
Hospital Charge Code	39900056
Hospital Revenue Code	301
Min. Negotiated Rate	$9.51
Max. Negotiated Rate	$9.51
Rate for Payer: Qualcare PPO/HMO/WC	$9.51

CAROTENE***

Facility

$29.00

Hospital Charge Code	3010642
Hospital Revenue Code	309
Min. Negotiated Rate	$4.35
Max. Negotiated Rate	$4.35
Rate for Payer: Qualcare PPO/HMO/WC	$4.35

CAROTENE***

Facility

$29.00

Hospital Charge Code	3010642
Hospital Revenue Code	309
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$11.02
Rate for Payer: Aetna Medicare Advantage	$8.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.39
Rate for Payer: Cigna Commercial	$14.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.35
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$0.70
Rate for Payer: Wellpoint Medicaid Managed Care	$0.77

CAROTENE, BETA SERUM

Facility

$91.25

Service Code	HCPCS 82380
Hospital Charge Code	3000643
Hospital Revenue Code	301
Min. Negotiated Rate	$13.69
Max. Negotiated Rate	$13.69
Rate for Payer: Qualcare PPO/HMO/WC	$13.69

CAROTENE, BETA SERUM

Facility

$91.25

Service Code	HCPCS 82380
Hospital Charge Code	3000643
Hospital Revenue Code	301
Min. Negotiated Rate	$2.42
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$25.08
Rate for Payer: Aetna Medicare Advantage	$29.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.22
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	$33.28
Rate for Payer: Cigna Commercial	$45.62
Rate for Payer: Cigna Medicare Advantage	$9.22
Rate for Payer: Clover Medicare Advantage	$8.76
Rate for Payer: EmblemHealth Commercial	$27.66
Rate for Payer: Humana Medicare Advantage	$9.50
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.69
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$7.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.22
Rate for Payer: Wellcare Medicare Advantage	$9.22
Rate for Payer: Wellpoint Medicaid Managed Care	$2.42

CAROTID ARTERY STENT PROCEDURES WITH CC

Facility

$79,399.01

Service Code	MSDRG 035
Min. Negotiated Rate	$24,175.98
Max. Negotiated Rate	$79,399.01
Rate for Payer: Aetna Medicare Advantage	$79,399.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53,500.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53,500.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25,448.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53,500.30
Rate for Payer: Cigna Commercial	$44,735.82
Rate for Payer: Cigna Medicare Advantage	$25,448.40
Rate for Payer: Clover Medicare Advantage	$24,175.98
Rate for Payer: EmblemHealth Commercial	$76,345.20
Rate for Payer: Humana Medicare Advantage	$26,211.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$25,448.40
Rate for Payer: Oxford Commercial	$32,152.22
Rate for Payer: UnitedHealthcare Commercial	$56,379.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$25,448.40
Rate for Payer: Wellcare Medicare Advantage	$25,448.40

CAROTID ARTERY STENT PROCEDURES WITH MCC

Facility

$127,241.52

Service Code	MSDRG 034
Min. Negotiated Rate	$38,743.41
Max. Negotiated Rate	$127,241.52
Rate for Payer: Aetna Medicare Advantage	$127,241.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$90,717.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$90,717.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$40,782.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$90,717.90
Rate for Payer: Cigna Commercial	$72,436.28
Rate for Payer: Cigna Medicare Advantage	$40,782.54
Rate for Payer: Clover Medicare Advantage	$38,743.41
Rate for Payer: EmblemHealth Commercial	$122,347.62
Rate for Payer: Humana Medicare Advantage	$42,006.02
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$40,782.54
Rate for Payer: Oxford Commercial	$52,060.92
Rate for Payer: UnitedHealthcare Commercial	$91,290.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$40,782.54
Rate for Payer: Wellcare Medicare Advantage	$40,782.54

CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC

Facility

$64,928.60

Service Code	MSDRG 036
Min. Negotiated Rate	$19,769.93
Max. Negotiated Rate	$64,928.60
Rate for Payer: Aetna Medicare Advantage	$64,928.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42,102.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42,102.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,810.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42,102.41
Rate for Payer: Cigna Commercial	$36,357.56
Rate for Payer: Cigna Medicare Advantage	$20,810.45
Rate for Payer: Clover Medicare Advantage	$19,769.93
Rate for Payer: EmblemHealth Commercial	$62,431.35
Rate for Payer: Humana Medicare Advantage	$21,434.76
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20,810.45
Rate for Payer: Oxford Commercial	$26,130.66
Rate for Payer: UnitedHealthcare Commercial	$45,820.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,810.45
Rate for Payer: Wellcare Medicare Advantage	$20,810.45

CAROTID CEREBRAL-LT

Facility

$6,122.00

Hospital Charge Code	2691830
Hospital Revenue Code	323
Min. Negotiated Rate	$147.54
Max. Negotiated Rate	$3,061.00
Rate for Payer: Aetna Commercial	$2,326.36
Rate for Payer: Aetna Medicare Advantage	$1,836.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,561.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,561.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,561.11
Rate for Payer: Cigna Commercial	$3,061.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,836.60
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$918.30
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$147.54
Rate for Payer: Wellpoint Medicaid Managed Care	$162.23

CAROTID CEREBRAL-LT

Facility

$6,122.00

Hospital Charge Code	2691830
Hospital Revenue Code	323
Min. Negotiated Rate	$918.30
Max. Negotiated Rate	$918.30
Rate for Payer: Qualcare PPO/HMO/WC	$918.30

CAROTID CEREBRAL-RT

Facility

$6,122.00

Hospital Charge Code	2691835
Hospital Revenue Code	323
Min. Negotiated Rate	$918.30
Max. Negotiated Rate	$918.30
Rate for Payer: Qualcare PPO/HMO/WC	$918.30

CAROTID CEREBRAL-RT

Facility

$6,122.00

Hospital Charge Code	2691835
Hospital Revenue Code	323
Min. Negotiated Rate	$147.54
Max. Negotiated Rate	$3,061.00
Rate for Payer: Aetna Commercial	$2,326.36
Rate for Payer: Aetna Medicare Advantage	$1,836.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,561.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,561.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,561.11
Rate for Payer: Cigna Commercial	$3,061.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,836.60
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$918.30
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$147.54
Rate for Payer: Wellpoint Medicaid Managed Care	$162.23

CAROTID CERVICAL-LT

Facility

$6,122.00

Hospital Charge Code	2691840
Hospital Revenue Code	323
Min. Negotiated Rate	$147.54
Max. Negotiated Rate	$3,061.00
Rate for Payer: Aetna Commercial	$2,326.36
Rate for Payer: Aetna Medicare Advantage	$1,836.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,561.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,561.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,561.11
Rate for Payer: Cigna Commercial	$3,061.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,836.60
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$918.30
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$147.54
Rate for Payer: Wellpoint Medicaid Managed Care	$162.23

CAROTID CERVICAL-LT

Facility

$6,122.00

Hospital Charge Code	2691840
Hospital Revenue Code	323
Min. Negotiated Rate	$918.30
Max. Negotiated Rate	$918.30
Rate for Payer: Qualcare PPO/HMO/WC	$918.30

CAROTID CERVICAL-RT

Facility

$6,122.00

Hospital Charge Code	2691845
Hospital Revenue Code	323
Min. Negotiated Rate	$147.54
Max. Negotiated Rate	$3,061.00
Rate for Payer: Aetna Commercial	$2,326.36
Rate for Payer: Aetna Medicare Advantage	$1,836.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,561.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,561.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,561.11
Rate for Payer: Cigna Commercial	$3,061.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,836.60
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$918.30
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$147.54
Rate for Payer: Wellpoint Medicaid Managed Care	$162.23

CAROTID CERVICAL-RT

Facility

$6,122.00

Hospital Charge Code	2691845
Hospital Revenue Code	323
Min. Negotiated Rate	$918.30
Max. Negotiated Rate	$918.30
Rate for Payer: Qualcare PPO/HMO/WC	$918.30

CAROTID DUPLEX SCAN

Facility

$17,200.00

Service Code	HCPCS 93880
Hospital Charge Code	74115027
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

CAROTID DUPLEX SCAN

Facility

$17,200.00

Service Code	HCPCS 93880
Hospital Charge Code	2692015
Hospital Revenue Code	921
Min. Negotiated Rate	$269.30
Max. Negotiated Rate	$6,760.00
Rate for Payer: Aetna Commercial	$771.04
Rate for Payer: Aetna Medicare Advantage	$918.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$283.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$722.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,023.24
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: Cigna Medicare Advantage	$283.47
Rate for Payer: Clover Medicare Advantage	$269.30
Rate for Payer: EmblemHealth Commercial	$850.41
Rate for Payer: Humana Medicare Advantage	$291.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$283.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,160.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$6,760.00
Rate for Payer: UnitedHealthcare Community & State	$414.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$455.80

Know your out-of-pocket cost for care.

All Charges