Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FIORICET/TAB

Facility

$3.00

Hospital Charge Code	60632991
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

FIOS SCREW 4X40MM

Facility

$1,760.00

Service Code	HCPCS C1713
Hospital Charge Code	270703681
Hospital Revenue Code	279
Min. Negotiated Rate	$42.42
Max. Negotiated Rate	$880.00
Rate for Payer: Aetna Commercial	$668.80
Rate for Payer: Aetna Medicare Advantage	$528.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.80
Rate for Payer: Cigna Commercial	$880.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$528.00
Rate for Payer: Oxford Commercial	$352.00
Rate for Payer: Qualcare PPO/HMO/WC	$264.00
Rate for Payer: UnitedHealthcare Commercial	$352.00
Rate for Payer: UnitedHealthcare Community & State	$42.42
Rate for Payer: Wellpoint Medicaid Managed Care	$46.64

FIOS SCREW 4X40MM

Facility

$1,760.00

Service Code	HCPCS C1713
Hospital Charge Code	270703681
Hospital Revenue Code	279
Min. Negotiated Rate	$264.00
Max. Negotiated Rate	$264.00
Rate for Payer: Qualcare PPO/HMO/WC	$264.00

FIRST TMT PLATE

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270686491
Hospital Revenue Code	278
Min. Negotiated Rate	$20.71
Max. Negotiated Rate	$429.68
Rate for Payer: Aetna Commercial	$326.55
Rate for Payer: Aetna Medicare Advantage	$257.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.13
Rate for Payer: Cigna Commercial	$429.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$189.06
Rate for Payer: Qualcare PPO/HMO/WC	$128.90
Rate for Payer: UnitedHealthcare Community & State	$20.71
Rate for Payer: Wellpoint Medicaid Managed Care	$22.77

FIRST TMT PLATE

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270686491
Hospital Revenue Code	278
Min. Negotiated Rate	$128.90
Max. Negotiated Rate	$207.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$189.06
Rate for Payer: Qualcare PPO/HMO/WC	$128.90

FIRST TRIMESTER SCREEN W/NT I

Facility

$103.50

Service Code	HCPCS 84163
Hospital Charge Code	3038512A
Hospital Revenue Code	300
Min. Negotiated Rate	$2.74
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$40.94
Rate for Payer: Aetna Medicare Advantage	$48.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.33
Rate for Payer: Cigna Commercial	$51.75
Rate for Payer: Cigna Medicare Advantage	$15.05
Rate for Payer: Clover Medicare Advantage	$14.30
Rate for Payer: EmblemHealth Commercial	$45.15
Rate for Payer: Humana Medicare Advantage	$15.50
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.05
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.53
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.05
Rate for Payer: Wellcare Medicare Advantage	$15.05
Rate for Payer: Wellpoint Medicaid Managed Care	$2.74

FIRST TRIMESTER SCREEN W/NT I

Facility

$103.50

Service Code	HCPCS 84163
Hospital Charge Code	3038512A
Hospital Revenue Code	300
Min. Negotiated Rate	$15.53
Max. Negotiated Rate	$15.53
Rate for Payer: Qualcare PPO/HMO/WC	$15.53

FIRST TRIMESTER SCREEN W/NT II

Facility

$59.00

Service Code	HCPCS 84702
Hospital Charge Code	3038512B
Hospital Revenue Code	300
Min. Negotiated Rate	$8.85
Max. Negotiated Rate	$8.85
Rate for Payer: Qualcare PPO/HMO/WC	$8.85

FIRST TRIMESTER SCREEN W/NT II

Facility

$59.00

Service Code	HCPCS 84702
Hospital Charge Code	3038512B
Hospital Revenue Code	300
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$40.94
Rate for Payer: Aetna Medicare Advantage	$48.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.33
Rate for Payer: Cigna Commercial	$29.50
Rate for Payer: Cigna Medicare Advantage	$15.05
Rate for Payer: Clover Medicare Advantage	$14.30
Rate for Payer: EmblemHealth Commercial	$45.15
Rate for Payer: Humana Medicare Advantage	$15.50
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.85
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.05
Rate for Payer: Wellcare Medicare Advantage	$15.05
Rate for Payer: Wellpoint Medicaid Managed Care	$1.56

FIRST TRIMESTER SCREN W/NT III

Facility

$110.35

Service Code	HCPCS 86336
Hospital Charge Code	3038512C
Hospital Revenue Code	300
Min. Negotiated Rate	$16.55
Max. Negotiated Rate	$16.55
Rate for Payer: Qualcare PPO/HMO/WC	$16.55

FIRST TRIMESTER SCREN W/NT III

Facility

$110.35

Service Code	HCPCS 86336
Hospital Charge Code	3038512C
Hospital Revenue Code	300
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$42.40
Rate for Payer: Aetna Medicare Advantage	$50.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.28
Rate for Payer: Cigna Commercial	$55.17
Rate for Payer: Cigna Medicare Advantage	$15.59
Rate for Payer: Clover Medicare Advantage	$14.81
Rate for Payer: EmblemHealth Commercial	$46.77
Rate for Payer: Humana Medicare Advantage	$16.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.55
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.59
Rate for Payer: Wellcare Medicare Advantage	$15.59
Rate for Payer: Wellpoint Medicaid Managed Care	$2.92

FIRVANQ 50MG/ML SUSP

Facility

$36.18

Service Code	NDC 65628020605
Hospital Charge Code	606390239
Hospital Revenue Code	250
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$18.09
Rate for Payer: Aetna Commercial	$13.75
Rate for Payer: Aetna Medicare Advantage	$10.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.23
Rate for Payer: Cigna Commercial	$18.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.85
Rate for Payer: Oxford Commercial	$7.24
Rate for Payer: Qualcare PPO/HMO/WC	$5.43
Rate for Payer: UnitedHealthcare Commercial	$7.24
Rate for Payer: UnitedHealthcare Community & State	$0.87
Rate for Payer: Wellpoint Medicaid Managed Care	$0.96

FIRVANQ 50MG/ML SUSP

Facility

$36.18

Service Code	NDC 65628020605
Hospital Charge Code	606390239
Hospital Revenue Code	250
Min. Negotiated Rate	$5.43
Max. Negotiated Rate	$5.43
Rate for Payer: Qualcare PPO/HMO/WC	$5.43

FISH DISPOSABLE

Facility

$115.70

Hospital Charge Code	270650902
Hospital Revenue Code	271
Min. Negotiated Rate	$2.79
Max. Negotiated Rate	$57.85
Rate for Payer: Aetna Commercial	$43.97
Rate for Payer: Aetna Medicare Advantage	$34.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.50
Rate for Payer: Cigna Commercial	$57.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.71
Rate for Payer: Oxford Commercial	$23.14
Rate for Payer: Qualcare PPO/HMO/WC	$17.36
Rate for Payer: UnitedHealthcare Commercial	$23.14
Rate for Payer: UnitedHealthcare Community & State	$2.79
Rate for Payer: Wellpoint Medicaid Managed Care	$3.07

FISH DISPOSABLE

Facility

$115.70

Hospital Charge Code	270650902
Hospital Revenue Code	271
Min. Negotiated Rate	$17.36
Max. Negotiated Rate	$17.36
Rate for Payer: Qualcare PPO/HMO/WC	$17.36

FISH DISPOSABLE VISCERAL LRG

Facility

$243.37

Hospital Charge Code	270653825
Hospital Revenue Code	272
Min. Negotiated Rate	$36.51
Max. Negotiated Rate	$36.51
Rate for Payer: Qualcare PPO/HMO/WC	$36.51

FISH DISPOSABLE VISCERAL LRG

Facility

$243.37

Hospital Charge Code	270653825
Hospital Revenue Code	272
Min. Negotiated Rate	$5.87
Max. Negotiated Rate	$121.69
Rate for Payer: Aetna Commercial	$92.48
Rate for Payer: Aetna Medicare Advantage	$73.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.06
Rate for Payer: Cigna Commercial	$121.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.01
Rate for Payer: Oxford Commercial	$48.67
Rate for Payer: Qualcare PPO/HMO/WC	$36.51
Rate for Payer: UnitedHealthcare Commercial	$48.67
Rate for Payer: UnitedHealthcare Community & State	$5.87
Rate for Payer: Wellpoint Medicaid Managed Care	$6.45

FISKARS SCHOOL WORKS SCISSORS

Facility

$67.95

Hospital Charge Code	270663162
Hospital Revenue Code	270
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$33.98
Rate for Payer: Aetna Commercial	$25.82
Rate for Payer: Aetna Medicare Advantage	$20.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.33
Rate for Payer: Cigna Commercial	$33.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.39
Rate for Payer: Oxford Commercial	$13.59
Rate for Payer: Qualcare PPO/HMO/WC	$10.19
Rate for Payer: UnitedHealthcare Commercial	$13.59
Rate for Payer: UnitedHealthcare Community & State	$1.64
Rate for Payer: Wellpoint Medicaid Managed Care	$1.80

FISKARS SCHOOL WORKS SCISSORS

Facility

$67.95

Hospital Charge Code	270663162
Hospital Revenue Code	270
Min. Negotiated Rate	$10.19
Max. Negotiated Rate	$10.19
Rate for Payer: Qualcare PPO/HMO/WC	$10.19

FISSURECTOMY

Facility

$11,435.00

Service Code	HCPCS 46200
Hospital Charge Code	1600000263
Hospital Revenue Code	360
Min. Negotiated Rate	$275.58
Max. Negotiated Rate	$11,903.20
Rate for Payer: Aetna Commercial	$8,969.36
Rate for Payer: Aetna Medicare Advantage	$10,684.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,903.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,903.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,297.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,903.20
Rate for Payer: Cigna Commercial	$6,609.93
Rate for Payer: Cigna Medicare Advantage	$3,297.56
Rate for Payer: Clover Medicare Advantage	$3,132.68
Rate for Payer: EmblemHealth Commercial	$9,892.68
Rate for Payer: Humana Medicare Advantage	$3,396.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,297.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,430.50
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,715.25
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$275.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,297.56
Rate for Payer: Wellcare Medicare Advantage	$3,297.56
Rate for Payer: Wellpoint Medicaid Managed Care	$303.03

FISSURECTOMY

Facility

$11,435.00

Service Code	HCPCS 46200
Hospital Charge Code	1600000263
Hospital Revenue Code	360
Min. Negotiated Rate	$1,715.25
Max. Negotiated Rate	$1,715.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,715.25

FISTULA PLUG

Facility

$4,210.00

Hospital Charge Code	270667870
Hospital Revenue Code	270
Min. Negotiated Rate	$631.50
Max. Negotiated Rate	$631.50
Rate for Payer: Qualcare PPO/HMO/WC	$631.50

FISTULA PLUG

Facility

$4,210.00

Hospital Charge Code	270667870
Hospital Revenue Code	270
Min. Negotiated Rate	$101.46
Max. Negotiated Rate	$2,105.00
Rate for Payer: Aetna Commercial	$1,599.80
Rate for Payer: Aetna Medicare Advantage	$1,263.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,073.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,073.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,073.55
Rate for Payer: Cigna Commercial	$2,105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,263.00
Rate for Payer: Oxford Commercial	$842.00
Rate for Payer: Qualcare PPO/HMO/WC	$631.50
Rate for Payer: UnitedHealthcare Commercial	$842.00
Rate for Payer: UnitedHealthcare Community & State	$101.46
Rate for Payer: Wellpoint Medicaid Managed Care	$111.56

FISTULA WOUND MANAGEMENT SYSTM

Facility

$439.74

Hospital Charge Code	270650457
Hospital Revenue Code	271
Min. Negotiated Rate	$65.96
Max. Negotiated Rate	$65.96
Rate for Payer: Qualcare PPO/HMO/WC	$65.96

FISTULA WOUND MANAGEMENT SYSTM

Facility

$439.74

Hospital Charge Code	270650457
Hospital Revenue Code	271
Min. Negotiated Rate	$10.60
Max. Negotiated Rate	$219.87
Rate for Payer: Aetna Commercial	$167.10
Rate for Payer: Aetna Medicare Advantage	$131.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.13
Rate for Payer: Cigna Commercial	$219.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.92
Rate for Payer: Oxford Commercial	$87.95
Rate for Payer: Qualcare PPO/HMO/WC	$65.96
Rate for Payer: UnitedHealthcare Commercial	$87.95
Rate for Payer: UnitedHealthcare Community & State	$10.60
Rate for Payer: Wellpoint Medicaid Managed Care	$11.65

Know your out-of-pocket cost for care.

All Charges