Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CEFAZOLIN 1GM INJECTION

Facility

$36.05

Service Code	HCPCS J0690
Hospital Charge Code	60632292
Hospital Revenue Code	636
Min. Negotiated Rate	$5.41
Max. Negotiated Rate	$8.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.72
Rate for Payer: Qualcare PPO/HMO/WC	$5.41

CEFAZOLIN 1GM INJECTION

Facility

$36.05

Service Code	HCPCS J0690
Hospital Charge Code	60632292
Hospital Revenue Code	636
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$18.02
Rate for Payer: Aetna Commercial	$13.70
Rate for Payer: Aetna Medicare Advantage	$10.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.19
Rate for Payer: Cigna Commercial	$18.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.72
Rate for Payer: Qualcare PPO/HMO/WC	$5.41
Rate for Payer: UnitedHealthcare Community & State	$0.87
Rate for Payer: Wellpoint Medicaid Managed Care	$0.96

CEFAZOLIN 2GM/100ML NACL IVPB

Facility

$142.11

Service Code	HCPCS J0690
Hospital Charge Code	606390508
Hospital Revenue Code	636
Min. Negotiated Rate	$3.42
Max. Negotiated Rate	$71.06
Rate for Payer: Aetna Commercial	$54.00
Rate for Payer: Aetna Medicare Advantage	$42.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.24
Rate for Payer: Cigna Commercial	$71.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.39
Rate for Payer: Qualcare PPO/HMO/WC	$21.32
Rate for Payer: UnitedHealthcare Community & State	$3.42
Rate for Payer: Wellpoint Medicaid Managed Care	$3.77

CEFAZOLIN 2GM/100ML NACL IVPB

Facility

$142.11

Service Code	HCPCS J0690
Hospital Charge Code	606390508
Hospital Revenue Code	636
Min. Negotiated Rate	$21.32
Max. Negotiated Rate	$34.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.39
Rate for Payer: Qualcare PPO/HMO/WC	$21.32

CEFAZOLIN 2GM/50 ML DUPLEX

Facility

$58.69

Service Code	HCPCS J0690
Hospital Charge Code	606350942
Hospital Revenue Code	636
Min. Negotiated Rate	$1.41
Max. Negotiated Rate	$29.34
Rate for Payer: Aetna Commercial	$22.30
Rate for Payer: Aetna Medicare Advantage	$17.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.97
Rate for Payer: Cigna Commercial	$29.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.20
Rate for Payer: Qualcare PPO/HMO/WC	$8.80
Rate for Payer: UnitedHealthcare Community & State	$1.41
Rate for Payer: Wellpoint Medicaid Managed Care	$1.56

CEFAZOLIN 2GM/50 ML DUPLEX

Facility

$58.69

Service Code	HCPCS J0690
Hospital Charge Code	606350942
Hospital Revenue Code	636
Min. Negotiated Rate	$8.80
Max. Negotiated Rate	$14.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.20
Rate for Payer: Qualcare PPO/HMO/WC	$8.80

CEFAZOLIN 2GM VIAL

Facility

$43.28

Service Code	HCPCS J0690
Hospital Charge Code	606390502
Hospital Revenue Code	636
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.64
Rate for Payer: Aetna Commercial	$16.45
Rate for Payer: Aetna Medicare Advantage	$12.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.04
Rate for Payer: Cigna Commercial	$21.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.47
Rate for Payer: Qualcare PPO/HMO/WC	$6.49
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.15

CEFAZOLIN 2GM VIAL

Facility

$43.28

Service Code	HCPCS J0690
Hospital Charge Code	606390502
Hospital Revenue Code	636
Min. Negotiated Rate	$6.49
Max. Negotiated Rate	$10.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.47
Rate for Payer: Qualcare PPO/HMO/WC	$6.49

CEFAZOLIN 500 MG INJ

Facility

$14.54

Service Code	HCPCS J0690
Hospital Charge Code	60629075
Hospital Revenue Code	636
Min. Negotiated Rate	$2.18
Max. Negotiated Rate	$3.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.52
Rate for Payer: Qualcare PPO/HMO/WC	$2.18

CEFAZOLIN 500 MG INJ

Facility

$14.54

Service Code	HCPCS J0690
Hospital Charge Code	60629075
Hospital Revenue Code	636
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$7.27
Rate for Payer: Aetna Commercial	$5.53
Rate for Payer: Aetna Medicare Advantage	$4.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.71
Rate for Payer: Cigna Commercial	$7.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.52
Rate for Payer: Qualcare PPO/HMO/WC	$2.18
Rate for Payer: UnitedHealthcare Community & State	$0.35
Rate for Payer: Wellpoint Medicaid Managed Care	$0.39

CEFAZOLIN 500MG VIAL

Facility

$15.00

Hospital Charge Code	60635709
Hospital Revenue Code	636
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$5.70
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.63
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Community & State	$0.36
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

CEFAZOLIN 500MG VIAL

Facility

$15.00

Hospital Charge Code	60635709
Hospital Revenue Code	636
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$3.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.63
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

CEFAZOLIN (ANCEF) 500 MG INJ

Facility

$9.65

Hospital Charge Code	60627257
Hospital Revenue Code	250
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$4.83
Rate for Payer: Aetna Commercial	$3.67
Rate for Payer: Aetna Medicare Advantage	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.46
Rate for Payer: Cigna Commercial	$4.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.90
Rate for Payer: Oxford Commercial	$1.93
Rate for Payer: Qualcare PPO/HMO/WC	$1.45
Rate for Payer: UnitedHealthcare Commercial	$1.93
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

CEFAZOLIN (ANCEF) 500 MG INJ

Facility

$9.65

Hospital Charge Code	60627257
Hospital Revenue Code	250
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.45

CEFAZOLIN FORTIFIED OPTH DROPS

Facility

$36.73

Service Code	NDC 75245201
Hospital Charge Code	60628996
Hospital Revenue Code	250
Min. Negotiated Rate	$5.51
Max. Negotiated Rate	$5.51
Rate for Payer: Qualcare PPO/HMO/WC	$5.51

CEFAZOLIN FORTIFIED OPTH DROPS

Facility

$36.73

Service Code	NDC 75245201
Hospital Charge Code	60628996
Hospital Revenue Code	250
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$18.36
Rate for Payer: Aetna Commercial	$13.96
Rate for Payer: Aetna Medicare Advantage	$11.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.37
Rate for Payer: Cigna Commercial	$18.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.02
Rate for Payer: Oxford Commercial	$7.35
Rate for Payer: Qualcare PPO/HMO/WC	$5.51
Rate for Payer: UnitedHealthcare Commercial	$7.35
Rate for Payer: UnitedHealthcare Community & State	$0.89
Rate for Payer: Wellpoint Medicaid Managed Care	$0.97

CEFAZOLIN INJ 1GM 7313001

Facility

$10.90

Hospital Charge Code	6007058
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$5.45
Rate for Payer: Aetna Commercial	$4.14
Rate for Payer: Aetna Medicare Advantage	$3.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.78
Rate for Payer: Cigna Commercial	$5.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.27
Rate for Payer: Oxford Commercial	$2.18
Rate for Payer: Qualcare PPO/HMO/WC	$1.64
Rate for Payer: UnitedHealthcare Commercial	$2.18
Rate for Payer: UnitedHealthcare Community & State	$0.26
Rate for Payer: Wellpoint Medicaid Managed Care	$0.29

CEFAZOLIN INJ 1GM 7313001

Facility

$10.90

Hospital Charge Code	6007058
Hospital Revenue Code	250
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$1.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.64

CEFAZOLIN IVPB 1GM/NS 50ML

Facility

$34.60

Hospital Charge Code	60627253
Hospital Revenue Code	250
Min. Negotiated Rate	$0.83
Max. Negotiated Rate	$17.30
Rate for Payer: Aetna Commercial	$13.15
Rate for Payer: Aetna Medicare Advantage	$10.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.82
Rate for Payer: Cigna Commercial	$17.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.38
Rate for Payer: Oxford Commercial	$6.92
Rate for Payer: Qualcare PPO/HMO/WC	$5.19
Rate for Payer: UnitedHealthcare Commercial	$6.92
Rate for Payer: UnitedHealthcare Community & State	$0.83
Rate for Payer: Wellpoint Medicaid Managed Care	$0.92

CEFAZOLIN IVPB 1GM/NS 50ML

Facility

$34.60

Hospital Charge Code	60627253
Hospital Revenue Code	250
Min. Negotiated Rate	$5.19
Max. Negotiated Rate	$5.19
Rate for Payer: Qualcare PPO/HMO/WC	$5.19

CEFAZOLIN IVPB 2GM/D5W 50ML

Facility

$26.25

Hospital Charge Code	60627256
Hospital Revenue Code	250
Min. Negotiated Rate	$3.94
Max. Negotiated Rate	$3.94
Rate for Payer: Qualcare PPO/HMO/WC	$3.94

CEFAZOLIN IVPB 2GM/D5W 50ML

Facility

$26.25

Hospital Charge Code	60627256
Hospital Revenue Code	250
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$13.12
Rate for Payer: Aetna Commercial	$9.97
Rate for Payer: Aetna Medicare Advantage	$7.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.69
Rate for Payer: Cigna Commercial	$13.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.88
Rate for Payer: Oxford Commercial	$5.25
Rate for Payer: Qualcare PPO/HMO/WC	$3.94
Rate for Payer: UnitedHealthcare Commercial	$5.25
Rate for Payer: UnitedHealthcare Community & State	$0.63
Rate for Payer: Wellpoint Medicaid Managed Care	$0.70

CEFAZOLIN SODIUM 1 GM VIAL

Facility

$43.28

Service Code	HCPCS J0690
Hospital Charge Code	60627254
Hospital Revenue Code	636
Min. Negotiated Rate	$6.49
Max. Negotiated Rate	$10.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.47
Rate for Payer: Qualcare PPO/HMO/WC	$6.49

CEFAZOLIN SODIUM 1 GM VIAL

Facility

$245.65

Hospital Charge Code	60627255
Hospital Revenue Code	250
Min. Negotiated Rate	$5.92
Max. Negotiated Rate	$122.83
Rate for Payer: Aetna Commercial	$93.35
Rate for Payer: Aetna Medicare Advantage	$73.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.64
Rate for Payer: Cigna Commercial	$122.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.69
Rate for Payer: Oxford Commercial	$49.13
Rate for Payer: Qualcare PPO/HMO/WC	$36.85
Rate for Payer: UnitedHealthcare Commercial	$49.13
Rate for Payer: UnitedHealthcare Community & State	$5.92
Rate for Payer: Wellpoint Medicaid Managed Care	$6.51

CEFAZOLIN SODIUM 1 GM VIAL

Facility

$245.65

Hospital Charge Code	60627255
Hospital Revenue Code	250
Min. Negotiated Rate	$36.85
Max. Negotiated Rate	$36.85
Rate for Payer: Qualcare PPO/HMO/WC	$36.85

Know your out-of-pocket cost for care.

All Charges