Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FIBULA PLATE 1

Facility

$4,088.25

Hospital Charge Code	270656679
Hospital Revenue Code	278
Min. Negotiated Rate	$613.24
Max. Negotiated Rate	$989.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$817.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$989.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$899.41
Rate for Payer: Qualcare PPO/HMO/WC	$613.24

FIBULAR ANATOMIC LOCK RIGHT 3H

Facility

$3,867.50

Service Code	HCPCS C1776
Hospital Charge Code	270685944
Hospital Revenue Code	278
Min. Negotiated Rate	$93.21
Max. Negotiated Rate	$1,933.75
Rate for Payer: Aetna Commercial	$1,469.65
Rate for Payer: Aetna Medicare Advantage	$1,160.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$986.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$986.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$773.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$986.21
Rate for Payer: Cigna Commercial	$1,933.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$935.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.85
Rate for Payer: Qualcare PPO/HMO/WC	$580.12
Rate for Payer: UnitedHealthcare Community & State	$93.21
Rate for Payer: Wellpoint Medicaid Managed Care	$102.49

FIBULAR ANATOMIC LOCK RIGHT 3H

Facility

$3,867.50

Service Code	HCPCS C1776
Hospital Charge Code	270685944
Hospital Revenue Code	278
Min. Negotiated Rate	$580.12
Max. Negotiated Rate	$935.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$773.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$935.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.85
Rate for Payer: Qualcare PPO/HMO/WC	$580.12

FIBULAR PLATE STRAIGHT 3 HOLE

Facility

$3,435.00

Service Code	HCPCS C1713
Hospital Charge Code	270701710
Hospital Revenue Code	278
Min. Negotiated Rate	$82.78
Max. Negotiated Rate	$1,717.50
Rate for Payer: Aetna Commercial	$1,305.30
Rate for Payer: Aetna Medicare Advantage	$1,030.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$875.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$875.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$687.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$875.92
Rate for Payer: Cigna Commercial	$1,717.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$831.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$755.70
Rate for Payer: Qualcare PPO/HMO/WC	$515.25
Rate for Payer: UnitedHealthcare Community & State	$82.78
Rate for Payer: Wellpoint Medicaid Managed Care	$91.03

FIBULAR PLATE STRAIGHT 3 HOLE

Facility

$3,435.00

Service Code	HCPCS C1713
Hospital Charge Code	270701710
Hospital Revenue Code	278
Min. Negotiated Rate	$515.25
Max. Negotiated Rate	$831.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$687.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$831.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$755.70
Rate for Payer: Qualcare PPO/HMO/WC	$515.25

FIBULAR SEGMENT

Facility

$3,292.50

Hospital Charge Code	270662381
Hospital Revenue Code	270
Min. Negotiated Rate	$493.88
Max. Negotiated Rate	$493.88
Rate for Payer: Qualcare PPO/HMO/WC	$493.88

FIBULAR SEGMENT

Facility

$3,292.50

Hospital Charge Code	270662381
Hospital Revenue Code	270
Min. Negotiated Rate	$79.35
Max. Negotiated Rate	$1,646.25
Rate for Payer: Aetna Commercial	$1,251.15
Rate for Payer: Aetna Medicare Advantage	$987.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$839.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$839.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$839.59
Rate for Payer: Cigna Commercial	$1,646.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$987.75
Rate for Payer: Oxford Commercial	$658.50
Rate for Payer: Qualcare PPO/HMO/WC	$493.88
Rate for Payer: UnitedHealthcare Commercial	$658.50
Rate for Payer: UnitedHealthcare Community & State	$79.35
Rate for Payer: Wellpoint Medicaid Managed Care	$87.25

FIBULAR STRUT 8mm 450658

Facility

$4,890.00

Hospital Charge Code	270638883
Hospital Revenue Code	278
Min. Negotiated Rate	$117.85
Max. Negotiated Rate	$2,445.00
Rate for Payer: Aetna Commercial	$1,858.20
Rate for Payer: Aetna Medicare Advantage	$1,467.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,246.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,246.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$978.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,246.95
Rate for Payer: Cigna Commercial	$2,445.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,183.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,075.80
Rate for Payer: Qualcare PPO/HMO/WC	$733.50
Rate for Payer: UnitedHealthcare Community & State	$117.85
Rate for Payer: Wellpoint Medicaid Managed Care	$129.59

FIBULAR STRUT 8mm 450658

Facility

$4,890.00

Hospital Charge Code	270638883
Hospital Revenue Code	278
Min. Negotiated Rate	$733.50
Max. Negotiated Rate	$1,183.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$978.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,183.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,075.80
Rate for Payer: Qualcare PPO/HMO/WC	$733.50

FIBULOCK REMOVAL KIT

Facility

$8,125.00

Service Code	HCPCS A4649
Hospital Charge Code	270699330
Hospital Revenue Code	272
Min. Negotiated Rate	$195.81
Max. Negotiated Rate	$4,062.50
Rate for Payer: Aetna Commercial	$3,087.50
Rate for Payer: Aetna Medicare Advantage	$2,437.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,071.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,071.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,071.88
Rate for Payer: Cigna Commercial	$4,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,437.50
Rate for Payer: Oxford Commercial	$1,625.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,218.75
Rate for Payer: UnitedHealthcare Commercial	$1,625.00
Rate for Payer: UnitedHealthcare Community & State	$195.81
Rate for Payer: Wellpoint Medicaid Managed Care	$215.31

FIBULOCK REMOVAL KIT

Facility

$8,125.00

Service Code	HCPCS A4649
Hospital Charge Code	270699330
Hospital Revenue Code	272
Min. Negotiated Rate	$1,218.75
Max. Negotiated Rate	$1,218.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,218.75

FIDAXOMICIN 200 MG TAB

Facility

$1,329.68

Service Code	NDC 52015008001
Hospital Charge Code	60630096
Hospital Revenue Code	250
Min. Negotiated Rate	$199.45
Max. Negotiated Rate	$199.45
Rate for Payer: Qualcare PPO/HMO/WC	$199.45

FIDAXOMICIN 200 MG TAB

Facility

$1,329.68

Service Code	NDC 52015008001
Hospital Charge Code	60630096
Hospital Revenue Code	250
Min. Negotiated Rate	$32.05
Max. Negotiated Rate	$664.84
Rate for Payer: Aetna Commercial	$505.28
Rate for Payer: Aetna Medicare Advantage	$398.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$339.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$339.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$339.07
Rate for Payer: Cigna Commercial	$664.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$398.90
Rate for Payer: Oxford Commercial	$265.94
Rate for Payer: Qualcare PPO/HMO/WC	$199.45
Rate for Payer: UnitedHealthcare Commercial	$265.94
Rate for Payer: UnitedHealthcare Community & State	$32.05
Rate for Payer: Wellpoint Medicaid Managed Care	$35.24

FILAGASTRIM INJ 1ML

Facility

$1,239.70

Hospital Charge Code	6007173
Hospital Revenue Code	636
Min. Negotiated Rate	$29.88
Max. Negotiated Rate	$619.85
Rate for Payer: Aetna Commercial	$471.09
Rate for Payer: Aetna Medicare Advantage	$371.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.12
Rate for Payer: Cigna Commercial	$619.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.01
Rate for Payer: Qualcare PPO/HMO/WC	$185.96
Rate for Payer: UnitedHealthcare Community & State	$29.88
Rate for Payer: Wellpoint Medicaid Managed Care	$32.85

FILAGASTRIM INJ 1ML

Facility

$1,239.70

Hospital Charge Code	6007173
Hospital Revenue Code	636
Min. Negotiated Rate	$185.96
Max. Negotiated Rate	$300.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.01
Rate for Payer: Qualcare PPO/HMO/WC	$185.96

FILARIASIS

Facility

$133.65

Service Code	HCPCS 87207
Hospital Charge Code	3000188
Hospital Revenue Code	309
Min. Negotiated Rate	$3.54
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$16.29
Rate for Payer: Aetna Medicare Advantage	$19.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.99
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	$21.62
Rate for Payer: Cigna Commercial	$66.83
Rate for Payer: Cigna Medicare Advantage	$5.99
Rate for Payer: Clover Medicare Advantage	$5.69
Rate for Payer: EmblemHealth Commercial	$17.97
Rate for Payer: Humana Medicare Advantage	$6.17
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.09
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.99
Rate for Payer: Wellcare Medicare Advantage	$5.99
Rate for Payer: Wellpoint Medicaid Managed Care	$3.54

FILARIASIS

Facility

$133.65

Service Code	HCPCS 87207
Hospital Charge Code	3000188
Hospital Revenue Code	309
Min. Negotiated Rate	$20.05
Max. Negotiated Rate	$20.05
Rate for Payer: Qualcare PPO/HMO/WC	$20.05

FILARIASIS,BLOOD

Facility

$162.00

Service Code	HCPCS 87207
Hospital Charge Code	38475093
Hospital Revenue Code	309
Min. Negotiated Rate	$24.30
Max. Negotiated Rate	$24.30
Rate for Payer: Qualcare PPO/HMO/WC	$24.30

FILARIASIS,BLOOD

Facility

$162.00

Service Code	HCPCS 87207
Hospital Charge Code	38475093
Hospital Revenue Code	309
Min. Negotiated Rate	$4.29
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$16.29
Rate for Payer: Aetna Medicare Advantage	$19.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.99
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	$21.62
Rate for Payer: Cigna Commercial	$81.00
Rate for Payer: Cigna Medicare Advantage	$5.99
Rate for Payer: Clover Medicare Advantage	$5.69
Rate for Payer: EmblemHealth Commercial	$17.97
Rate for Payer: Humana Medicare Advantage	$6.17
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.30
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.99
Rate for Payer: Wellcare Medicare Advantage	$5.99
Rate for Payer: Wellpoint Medicaid Managed Care	$4.29

FI LAS 365 MIC HOL DHBFSF365DO

Facility

$1,050.00

Hospital Charge Code	270639739
Hospital Revenue Code	272
Min. Negotiated Rate	$25.30
Max. Negotiated Rate	$525.00
Rate for Payer: Aetna Commercial	$399.00
Rate for Payer: Aetna Medicare Advantage	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.75
Rate for Payer: Cigna Commercial	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$315.00
Rate for Payer: Oxford Commercial	$210.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.50
Rate for Payer: UnitedHealthcare Commercial	$210.00
Rate for Payer: UnitedHealthcare Community & State	$25.30
Rate for Payer: Wellpoint Medicaid Managed Care	$27.82

FI LAS 365 MIC HOL DHBFSF365DO

Facility

$1,050.00

Hospital Charge Code	270639739
Hospital Revenue Code	272
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$157.50
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

FILGRASTIM 300 MCG INJ

Facility

$2,423.59

Service Code	HCPCS J1442
Hospital Charge Code	60627535
Hospital Revenue Code	636
Min. Negotiated Rate	$363.54
Max. Negotiated Rate	$586.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$586.51
Rate for Payer: Qualcare PPO/HMO/WC	$363.54

FILGRASTIM 300 MCG INJ

Facility

$3,859.20

Service Code	HCPCS J1442
Hospital Charge Code	60630226
Hospital Revenue Code	636
Min. Negotiated Rate	$578.88
Max. Negotiated Rate	$933.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$933.93
Rate for Payer: Qualcare PPO/HMO/WC	$578.88

FILGRASTIM 300 MCG INJ

Facility

$2,423.59

Service Code	HCPCS J1442
Hospital Charge Code	60627535
Hospital Revenue Code	636
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$586.51
Rate for Payer: Aetna Commercial	$2.77
Rate for Payer: Aetna Medicare Advantage	$3.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.68
Rate for Payer: Cigna Medicare Advantage	$1.02
Rate for Payer: Clover Medicare Advantage	$0.97
Rate for Payer: EmblemHealth Commercial	$3.06
Rate for Payer: Humana Medicare Advantage	$1.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$586.51
Rate for Payer: Qualcare PPO/HMO/WC	$363.54
Rate for Payer: UnitedHealthcare Community & State	$58.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$1.02
Rate for Payer: Wellcare Medicare Advantage	$1.02
Rate for Payer: Wellpoint Medicaid Managed Care	$64.23

FILGRASTIM 300 MCG INJ

Facility

$3,859.20

Service Code	HCPCS J1442
Hospital Charge Code	60630226
Hospital Revenue Code	636
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$933.93
Rate for Payer: Aetna Commercial	$2.77
Rate for Payer: Aetna Medicare Advantage	$3.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.68
Rate for Payer: Cigna Medicare Advantage	$1.02
Rate for Payer: Clover Medicare Advantage	$0.97
Rate for Payer: EmblemHealth Commercial	$3.06
Rate for Payer: Humana Medicare Advantage	$1.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$933.93
Rate for Payer: Qualcare PPO/HMO/WC	$578.88
Rate for Payer: UnitedHealthcare Community & State	$93.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$1.02
Rate for Payer: Wellcare Medicare Advantage	$1.02
Rate for Payer: Wellpoint Medicaid Managed Care	$102.27

Know your out-of-pocket cost for care.

All Charges