Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CEFAZOLIN SODIUM 1 GM VIAL

Facility

$43.28

Service Code	HCPCS J0690
Hospital Charge Code	60627254
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

CEFDINIR 250MG/5ML SUSP

Facility

$55.54

Service Code	NDC 68180072304
Hospital Charge Code	6063943075
Hospital Revenue Code	250
Min. Negotiated Rate	$8.33
Max. Negotiated Rate	$8.33
Rate for Payer: Qualcare PPO/HMO/WC	$8.33

CEFDINIR 250MG/5ML SUSP

Facility

$55.54

Service Code	NDC 68180072304
Hospital Charge Code	6063943075
Hospital Revenue Code	250
Min. Negotiated Rate	$1.34
Max. Negotiated Rate	$27.77
Rate for Payer: Aetna Commercial	$21.11
Rate for Payer: Aetna Medicare Advantage	$16.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.16
Rate for Payer: Cigna Commercial	$27.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.66
Rate for Payer: Oxford Commercial	$11.11
Rate for Payer: Qualcare PPO/HMO/WC	$8.33
Rate for Payer: UnitedHealthcare Commercial	$11.11
Rate for Payer: UnitedHealthcare Community & State	$1.34
Rate for Payer: Wellpoint Medicaid Managed Care	$1.47

CEFDINIR 300MG CAP

Facility

$34.24

Service Code	NDC 93316006
Hospital Charge Code	6063943076
Hospital Revenue Code	250
Min. Negotiated Rate	$5.14
Max. Negotiated Rate	$5.14
Rate for Payer: Qualcare PPO/HMO/WC	$5.14

CEFDINIR 300MG CAP

Facility

$34.24

Service Code	NDC 93316006
Hospital Charge Code	6063943076
Hospital Revenue Code	250
Min. Negotiated Rate	$0.83
Max. Negotiated Rate	$17.12
Rate for Payer: Aetna Commercial	$13.01
Rate for Payer: Aetna Medicare Advantage	$10.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.73
Rate for Payer: Cigna Commercial	$17.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.27
Rate for Payer: Oxford Commercial	$6.85
Rate for Payer: Qualcare PPO/HMO/WC	$5.14
Rate for Payer: UnitedHealthcare Commercial	$6.85
Rate for Payer: UnitedHealthcare Community & State	$0.83
Rate for Payer: Wellpoint Medicaid Managed Care	$0.91

CEFEPIME 2G

Facility

$72.06

Hospital Charge Code	60635762
Hospital Revenue Code	636
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$36.03
Rate for Payer: Aetna Commercial	$27.38
Rate for Payer: Aetna Medicare Advantage	$21.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.38
Rate for Payer: Cigna Commercial	$36.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.44
Rate for Payer: Qualcare PPO/HMO/WC	$10.81
Rate for Payer: UnitedHealthcare Community & State	$1.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1.91

CEFEPIME 2G

Facility

$72.06

Hospital Charge Code	60635762
Hospital Revenue Code	636
Min. Negotiated Rate	$10.81
Max. Negotiated Rate	$17.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.44
Rate for Payer: Qualcare PPO/HMO/WC	$10.81

CEFEPIME 2G FROZEN BAG

Facility

$342.37

Service Code	HCPCS J0692
Hospital Charge Code	60635694
Hospital Revenue Code	636
Min. Negotiated Rate	$51.36
Max. Negotiated Rate	$82.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.85
Rate for Payer: Qualcare PPO/HMO/WC	$51.36

CEFEPIME 2G FROZEN BAG

Facility

$342.37

Service Code	HCPCS J0692
Hospital Charge Code	60635694
Hospital Revenue Code	636
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$171.19
Rate for Payer: Aetna Commercial	$130.10
Rate for Payer: Aetna Medicare Advantage	$102.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.30
Rate for Payer: Cigna Commercial	$171.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.85
Rate for Payer: Qualcare PPO/HMO/WC	$51.36
Rate for Payer: UnitedHealthcare Community & State	$8.25
Rate for Payer: Wellpoint Medicaid Managed Care	$9.07

CEFEPIME 2 GRAM VIAL

Facility

$19.00

Hospital Charge Code	60635119
Hospital Revenue Code	636
Min. Negotiated Rate	$2.85
Max. Negotiated Rate	$4.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.85

CEFEPIME 2 GRAM VIAL

Facility

$19.00

Hospital Charge Code	60635119
Hospital Revenue Code	636
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$9.50
Rate for Payer: Aetna Commercial	$7.22
Rate for Payer: Aetna Medicare Advantage	$5.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.84
Rate for Payer: Cigna Commercial	$9.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.85
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.50

CEFEPIME HCL 5% 2MG 50ML PB

Facility

$139.76

Service Code	HCPCS J0703
Hospital Charge Code	606494028
Hospital Revenue Code	636
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$69.88
Rate for Payer: Aetna Commercial	$53.11
Rate for Payer: Aetna Medicare Advantage	$41.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.64
Rate for Payer: Cigna Commercial	$69.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.82
Rate for Payer: Qualcare PPO/HMO/WC	$20.96
Rate for Payer: UnitedHealthcare Community & State	$3.37
Rate for Payer: Wellpoint Medicaid Managed Care	$3.70

CEFEPIME HCL 5% 2MG 50ML PB

Facility

$139.76

Service Code	HCPCS J0703
Hospital Charge Code	606494028
Hospital Revenue Code	636
Min. Negotiated Rate	$20.96
Max. Negotiated Rate	$33.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.82
Rate for Payer: Qualcare PPO/HMO/WC	$20.96

CEFEPIME INJ 1G

Facility

$98.60

Hospital Charge Code	60628988
Hospital Revenue Code	250
Min. Negotiated Rate	$2.38
Max. Negotiated Rate	$49.30
Rate for Payer: Aetna Commercial	$37.47
Rate for Payer: Aetna Medicare Advantage	$29.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.14
Rate for Payer: Cigna Commercial	$49.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.58
Rate for Payer: Oxford Commercial	$19.72
Rate for Payer: Qualcare PPO/HMO/WC	$14.79
Rate for Payer: UnitedHealthcare Commercial	$19.72
Rate for Payer: UnitedHealthcare Community & State	$2.38
Rate for Payer: Wellpoint Medicaid Managed Care	$2.61

CEFEPIME INJ 1G

Facility

$98.60

Hospital Charge Code	60628988
Hospital Revenue Code	250
Min. Negotiated Rate	$14.79
Max. Negotiated Rate	$14.79
Rate for Payer: Qualcare PPO/HMO/WC	$14.79

CEFEPIME IVPB 1G/NACL 50ML

Facility

$98.60

Hospital Charge Code	60628987
Hospital Revenue Code	250
Min. Negotiated Rate	$2.38
Max. Negotiated Rate	$49.30
Rate for Payer: Aetna Commercial	$37.47
Rate for Payer: Aetna Medicare Advantage	$29.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.14
Rate for Payer: Cigna Commercial	$49.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.58
Rate for Payer: Oxford Commercial	$19.72
Rate for Payer: Qualcare PPO/HMO/WC	$14.79
Rate for Payer: UnitedHealthcare Commercial	$19.72
Rate for Payer: UnitedHealthcare Community & State	$2.38
Rate for Payer: Wellpoint Medicaid Managed Care	$2.61

CEFEPIME IVPB 1G/NACL 50ML

Facility

$98.60

Hospital Charge Code	60628987
Hospital Revenue Code	250
Min. Negotiated Rate	$14.79
Max. Negotiated Rate	$14.79
Rate for Payer: Qualcare PPO/HMO/WC	$14.79

CEFEPIME IVPB 2G/NACL 100ML

Facility

$195.85

Hospital Charge Code	60628990
Hospital Revenue Code	250
Min. Negotiated Rate	$4.72
Max. Negotiated Rate	$97.92
Rate for Payer: Aetna Commercial	$74.42
Rate for Payer: Aetna Medicare Advantage	$58.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.94
Rate for Payer: Cigna Commercial	$97.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.76
Rate for Payer: Oxford Commercial	$39.17
Rate for Payer: Qualcare PPO/HMO/WC	$29.38
Rate for Payer: UnitedHealthcare Commercial	$39.17
Rate for Payer: UnitedHealthcare Community & State	$4.72
Rate for Payer: Wellpoint Medicaid Managed Care	$5.19

CEFEPIME IVPB 2G/NACL 100ML

Facility

$195.85

Hospital Charge Code	60628990
Hospital Revenue Code	250
Min. Negotiated Rate	$29.38
Max. Negotiated Rate	$29.38
Rate for Payer: Qualcare PPO/HMO/WC	$29.38

CEFEPIME (MAXIPIME) 1 G INJ

Facility

$427.06

Service Code	HCPCS J0692
Hospital Charge Code	60628986
Hospital Revenue Code	636
Min. Negotiated Rate	$10.29
Max. Negotiated Rate	$213.53
Rate for Payer: Aetna Commercial	$162.28
Rate for Payer: Aetna Medicare Advantage	$128.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.90
Rate for Payer: Cigna Commercial	$213.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.35
Rate for Payer: Qualcare PPO/HMO/WC	$64.06
Rate for Payer: UnitedHealthcare Community & State	$10.29
Rate for Payer: Wellpoint Medicaid Managed Care	$11.32

CEFEPIME (MAXIPIME) 1 G INJ

Facility

$427.06

Service Code	HCPCS J0692
Hospital Charge Code	60628986
Hospital Revenue Code	636
Min. Negotiated Rate	$64.06
Max. Negotiated Rate	$103.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.35
Rate for Payer: Qualcare PPO/HMO/WC	$64.06

CEFEPIME (MAXIPIME) 2 G INJ

Facility

$342.37

Service Code	HCPCS J0692
Hospital Charge Code	60628989
Hospital Revenue Code	636
Min. Negotiated Rate	$51.36
Max. Negotiated Rate	$82.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.85
Rate for Payer: Qualcare PPO/HMO/WC	$51.36

CEFEPIME (MAXIPIME) 2 G INJ

Facility

$342.37

Service Code	HCPCS J0692
Hospital Charge Code	60628989
Hospital Revenue Code	636
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$171.19
Rate for Payer: Aetna Commercial	$130.10
Rate for Payer: Aetna Medicare Advantage	$102.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.30
Rate for Payer: Cigna Commercial	$171.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.85
Rate for Payer: Qualcare PPO/HMO/WC	$51.36
Rate for Payer: UnitedHealthcare Community & State	$8.25
Rate for Payer: Wellpoint Medicaid Managed Care	$9.07

CEFIXIME SSP 100MG/5ML 50ML

Facility

$19.50

Hospital Charge Code	60627258
Hospital Revenue Code	250
Min. Negotiated Rate	$0.47
Max. Negotiated Rate	$9.75
Rate for Payer: Aetna Commercial	$7.41
Rate for Payer: Aetna Medicare Advantage	$5.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.97
Rate for Payer: Cigna Commercial	$9.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.85
Rate for Payer: Oxford Commercial	$3.90
Rate for Payer: Qualcare PPO/HMO/WC	$2.92
Rate for Payer: UnitedHealthcare Commercial	$3.90
Rate for Payer: UnitedHealthcare Community & State	$0.47
Rate for Payer: Wellpoint Medicaid Managed Care	$0.52

CEFIXIME SSP 100MG/5ML 50ML

Facility

$19.50

Hospital Charge Code	60627258
Hospital Revenue Code	250
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$2.92
Rate for Payer: Qualcare PPO/HMO/WC	$2.92

Know your out-of-pocket cost for care.

All Charges