Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FLIPCUTTER II 6MM

Facility

$1,625.00

Hospital Charge Code	270671284
Hospital Revenue Code	272
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$243.75
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

FLIPCUTTER II 6MM

Facility

$1,625.00

Hospital Charge Code	270671284
Hospital Revenue Code	272
Min. Negotiated Rate	$39.16
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$617.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$487.50
Rate for Payer: Oxford Commercial	$325.00
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Commercial	$325.00
Rate for Payer: UnitedHealthcare Community & State	$39.16
Rate for Payer: Wellpoint Medicaid Managed Care	$43.06

FLIPCUTTER II 7MM

Facility

$1,625.00

Hospital Charge Code	270670866
Hospital Revenue Code	272
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$243.75
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

FLIPCUTTER II 7MM

Facility

$1,625.00

Hospital Charge Code	270670866
Hospital Revenue Code	272
Min. Negotiated Rate	$39.16
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$617.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$487.50
Rate for Payer: Oxford Commercial	$325.00
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Commercial	$325.00
Rate for Payer: UnitedHealthcare Community & State	$39.16
Rate for Payer: Wellpoint Medicaid Managed Care	$43.06

FLIPCUTTER II SHORT 9MM

Facility

$1,625.00

Hospital Charge Code	270681911
Hospital Revenue Code	272
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$243.75
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

FLIPCUTTER II SHORT 9MM

Facility

$1,625.00

Hospital Charge Code	270681911
Hospital Revenue Code	272
Min. Negotiated Rate	$39.16
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$617.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$487.50
Rate for Payer: Oxford Commercial	$325.00
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Commercial	$325.00
Rate for Payer: UnitedHealthcare Community & State	$39.16
Rate for Payer: Wellpoint Medicaid Managed Care	$43.06

FLIPCUTTER SHORT 11 MM

Facility

$3,475.00

Hospital Charge Code	270679793
Hospital Revenue Code	272
Min. Negotiated Rate	$521.25
Max. Negotiated Rate	$521.25
Rate for Payer: Qualcare PPO/HMO/WC	$521.25

FLIPCUTTER SHORT 11 MM

Facility

$3,475.00

Hospital Charge Code	270679793
Hospital Revenue Code	272
Min. Negotiated Rate	$83.75
Max. Negotiated Rate	$1,737.50
Rate for Payer: Aetna Commercial	$1,320.50
Rate for Payer: Aetna Medicare Advantage	$1,042.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$886.12
Rate for Payer: Cigna Commercial	$1,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,042.50
Rate for Payer: Oxford Commercial	$695.00
Rate for Payer: Qualcare PPO/HMO/WC	$521.25
Rate for Payer: UnitedHealthcare Commercial	$695.00
Rate for Payer: UnitedHealthcare Community & State	$83.75
Rate for Payer: Wellpoint Medicaid Managed Care	$92.09

FLIPCUTTER SHORT 8 MM

Facility

$3,475.00

Hospital Charge Code	270681859
Hospital Revenue Code	272
Min. Negotiated Rate	$83.75
Max. Negotiated Rate	$1,737.50
Rate for Payer: Aetna Commercial	$1,320.50
Rate for Payer: Aetna Medicare Advantage	$1,042.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$886.12
Rate for Payer: Cigna Commercial	$1,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,042.50
Rate for Payer: Oxford Commercial	$695.00
Rate for Payer: Qualcare PPO/HMO/WC	$521.25
Rate for Payer: UnitedHealthcare Commercial	$695.00
Rate for Payer: UnitedHealthcare Community & State	$83.75
Rate for Payer: Wellpoint Medicaid Managed Care	$92.09

FLIPCUTTER SHORT 8 MM

Facility

$3,475.00

Hospital Charge Code	270681859
Hospital Revenue Code	272
Min. Negotiated Rate	$521.25
Max. Negotiated Rate	$521.25
Rate for Payer: Qualcare PPO/HMO/WC	$521.25

FLIPCUTTER SHORT 9.5 MM

Facility

$3,475.00

Hospital Charge Code	270679790
Hospital Revenue Code	272
Min. Negotiated Rate	$521.25
Max. Negotiated Rate	$521.25
Rate for Payer: Qualcare PPO/HMO/WC	$521.25

FLIPCUTTER SHORT 9.5 MM

Facility

$3,475.00

Hospital Charge Code	270679790
Hospital Revenue Code	272
Min. Negotiated Rate	$83.75
Max. Negotiated Rate	$1,737.50
Rate for Payer: Aetna Commercial	$1,320.50
Rate for Payer: Aetna Medicare Advantage	$1,042.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$886.12
Rate for Payer: Cigna Commercial	$1,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,042.50
Rate for Payer: Oxford Commercial	$695.00
Rate for Payer: Qualcare PPO/HMO/WC	$521.25
Rate for Payer: UnitedHealthcare Commercial	$695.00
Rate for Payer: UnitedHealthcare Community & State	$83.75
Rate for Payer: Wellpoint Medicaid Managed Care	$92.09

FLIPCUTTER SHORT 9.MM

Facility

$3,475.00

Hospital Charge Code	270679789
Hospital Revenue Code	272
Min. Negotiated Rate	$521.25
Max. Negotiated Rate	$521.25
Rate for Payer: Qualcare PPO/HMO/WC	$521.25

FLIPCUTTER SHORT 9.MM

Facility

$3,475.00

Hospital Charge Code	270679789
Hospital Revenue Code	272
Min. Negotiated Rate	$83.75
Max. Negotiated Rate	$1,737.50
Rate for Payer: Aetna Commercial	$1,320.50
Rate for Payer: Aetna Medicare Advantage	$1,042.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$886.12
Rate for Payer: Cigna Commercial	$1,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,042.50
Rate for Payer: Oxford Commercial	$695.00
Rate for Payer: Qualcare PPO/HMO/WC	$521.25
Rate for Payer: UnitedHealthcare Commercial	$695.00
Rate for Payer: UnitedHealthcare Community & State	$83.75
Rate for Payer: Wellpoint Medicaid Managed Care	$92.09

FLIPCUTTER TRAY LOANER

Facility

$1,250.00

Hospital Charge Code	270667129
Hospital Revenue Code	272
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

FLIPCUTTER TRAY LOANER

Facility

$1,250.00

Hospital Charge Code	270667129
Hospital Revenue Code	272
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.00
Rate for Payer: Oxford Commercial	$250.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Commercial	$250.00
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

FLOGRAFT XL

Facility

$14,875.00

Hospital Charge Code	270663892
Hospital Revenue Code	272
Min. Negotiated Rate	$2,231.25
Max. Negotiated Rate	$2,231.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,231.25

FLOGRAFT XL

Facility

$14,875.00

Hospital Charge Code	270663892
Hospital Revenue Code	272
Min. Negotiated Rate	$358.49
Max. Negotiated Rate	$7,437.50
Rate for Payer: Aetna Commercial	$5,652.50
Rate for Payer: Aetna Medicare Advantage	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,793.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,793.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,793.12
Rate for Payer: Cigna Commercial	$7,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,462.50
Rate for Payer: Oxford Commercial	$2,975.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,231.25
Rate for Payer: UnitedHealthcare Commercial	$2,975.00
Rate for Payer: UnitedHealthcare Community & State	$358.49
Rate for Payer: Wellpoint Medicaid Managed Care	$394.19

FLONASE .05% SPRAY

Facility

$564.94

Service Code	NDC 50383070016
Hospital Charge Code	60629341
Hospital Revenue Code	250
Min. Negotiated Rate	$84.74
Max. Negotiated Rate	$84.74
Rate for Payer: Qualcare PPO/HMO/WC	$84.74

FLONASE .05% SPRAY

Facility

$564.94

Service Code	NDC 50383070016
Hospital Charge Code	60629341
Hospital Revenue Code	250
Min. Negotiated Rate	$13.62
Max. Negotiated Rate	$282.47
Rate for Payer: Aetna Commercial	$214.68
Rate for Payer: Aetna Medicare Advantage	$169.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.06
Rate for Payer: Cigna Commercial	$282.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.48
Rate for Payer: Oxford Commercial	$112.99
Rate for Payer: Qualcare PPO/HMO/WC	$84.74
Rate for Payer: UnitedHealthcare Commercial	$112.99
Rate for Payer: UnitedHealthcare Community & State	$13.62
Rate for Payer: Wellpoint Medicaid Managed Care	$14.97

FLORASTOR 250MG CAP

Facility

$6.63

Service Code	NDC 4142000007
Hospital Charge Code	60635700
Hospital Revenue Code	250
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$3.31
Rate for Payer: Aetna Commercial	$2.52
Rate for Payer: Aetna Medicare Advantage	$1.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.69
Rate for Payer: Cigna Commercial	$3.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.99
Rate for Payer: Oxford Commercial	$1.33
Rate for Payer: Qualcare PPO/HMO/WC	$0.99
Rate for Payer: UnitedHealthcare Commercial	$1.33
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

FLORASTOR 250MG CAP

Facility

$6.63

Service Code	NDC 4142000007
Hospital Charge Code	60635700
Hospital Revenue Code	250
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$0.99
Rate for Payer: Qualcare PPO/HMO/WC	$0.99

FLOSEAL HEMOSTATIC MATRIX 10 M

Facility

$1,541.68

Service Code	HCPCS C2615
Hospital Charge Code	670680120
Hospital Revenue Code	278
Min. Negotiated Rate	$37.15
Max. Negotiated Rate	$770.84
Rate for Payer: Aetna Commercial	$585.84
Rate for Payer: Aetna Medicare Advantage	$462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$393.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$393.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$308.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$393.13
Rate for Payer: Cigna Commercial	$770.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$373.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$339.17
Rate for Payer: Qualcare PPO/HMO/WC	$231.25
Rate for Payer: UnitedHealthcare Community & State	$37.15
Rate for Payer: Wellpoint Medicaid Managed Care	$40.85

FLOSEAL HEMOSTATIC MATRIX 10 M

Facility

$1,541.68

Service Code	HCPCS C2615
Hospital Charge Code	670680120
Hospital Revenue Code	278
Min. Negotiated Rate	$231.25
Max. Negotiated Rate	$373.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$308.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$373.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$339.17
Rate for Payer: Qualcare PPO/HMO/WC	$231.25

FLOSEAL HEMOSTATIC MATRIX 10ml

Facility

$1,541.68

Service Code	HCPCS C2615
Hospital Charge Code	270680120
Hospital Revenue Code	278
Min. Negotiated Rate	$231.25
Max. Negotiated Rate	$373.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$308.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$373.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$339.17
Rate for Payer: Qualcare PPO/HMO/WC	$231.25

Know your out-of-pocket cost for care.

All Charges