Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FLOWMETER TRUZONE PFM

Facility

$103.25

Hospital Charge Code	270600657
Hospital Revenue Code	272
Min. Negotiated Rate	$2.49
Max. Negotiated Rate	$51.62
Rate for Payer: Aetna Commercial	$39.23
Rate for Payer: Aetna Medicare Advantage	$30.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.33
Rate for Payer: Cigna Commercial	$51.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.98
Rate for Payer: Oxford Commercial	$20.65
Rate for Payer: Qualcare PPO/HMO/WC	$15.49
Rate for Payer: UnitedHealthcare Commercial	$20.65
Rate for Payer: UnitedHealthcare Community & State	$2.49
Rate for Payer: Wellpoint Medicaid Managed Care	$2.74

FLOWMETER TRUZONE PFM

Facility

$103.25

Hospital Charge Code	270600657
Hospital Revenue Code	272
Min. Negotiated Rate	$15.49
Max. Negotiated Rate	$15.49
Rate for Payer: Qualcare PPO/HMO/WC	$15.49

FLOWPORT CANN OBTURATOR 165MM

Facility

$1,954.05

Hospital Charge Code	270670491
Hospital Revenue Code	272
Min. Negotiated Rate	$293.11
Max. Negotiated Rate	$293.11
Rate for Payer: Qualcare PPO/HMO/WC	$293.11

FLOWPORT CANN OBTURATOR 165MM

Facility

$1,954.05

Hospital Charge Code	270670491
Hospital Revenue Code	272
Min. Negotiated Rate	$47.09
Max. Negotiated Rate	$977.02
Rate for Payer: Aetna Commercial	$742.54
Rate for Payer: Aetna Medicare Advantage	$586.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$498.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$498.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$498.28
Rate for Payer: Cigna Commercial	$977.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$586.22
Rate for Payer: Oxford Commercial	$390.81
Rate for Payer: Qualcare PPO/HMO/WC	$293.11
Rate for Payer: UnitedHealthcare Commercial	$390.81
Rate for Payer: UnitedHealthcare Community & State	$47.09
Rate for Payer: Wellpoint Medicaid Managed Care	$51.78

FLOWTRIEVER SYSTEM

Facility

$55,000.00

Service Code	HCPCS C1757
Hospital Charge Code	270697576
Hospital Revenue Code	278
Min. Negotiated Rate	$8,250.00
Max. Negotiated Rate	$13,310.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,310.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,250.00

FLOWTRIEVER SYSTEM

Facility

$55,000.00

Service Code	HCPCS C1757
Hospital Charge Code	270697576S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,325.50
Max. Negotiated Rate	$27,500.00
Rate for Payer: Aetna Commercial	$20,900.00
Rate for Payer: Aetna Medicare Advantage	$16,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,025.00
Rate for Payer: Cigna Commercial	$27,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,310.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,250.00
Rate for Payer: UnitedHealthcare Community & State	$1,325.50
Rate for Payer: Wellpoint Medicaid Managed Care	$1,457.50

FLOWTRIEVER SYSTEM

Facility

$55,000.00

Service Code	HCPCS C1757
Hospital Charge Code	270697576S
Hospital Revenue Code	278
Min. Negotiated Rate	$8,250.00
Max. Negotiated Rate	$13,310.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,310.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,250.00

FLOWTRIEVER SYSTEM

Facility

$55,000.00

Service Code	HCPCS C1757
Hospital Charge Code	270697576
Hospital Revenue Code	278
Min. Negotiated Rate	$1,325.50
Max. Negotiated Rate	$27,500.00
Rate for Payer: Aetna Commercial	$20,900.00
Rate for Payer: Aetna Medicare Advantage	$16,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,025.00
Rate for Payer: Cigna Commercial	$27,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,310.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,250.00
Rate for Payer: UnitedHealthcare Community & State	$1,325.50
Rate for Payer: Wellpoint Medicaid Managed Care	$1,457.50

FLOXIN/200MG/TAB

Facility

$13.00

Hospital Charge Code	60632997
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

FLOXIN/200MG/TAB

Facility

$13.00

Hospital Charge Code	60634320
Hospital Revenue Code	250
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$4.94
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$2.60
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

FLOXIN/200MG/TAB

Facility

$13.00

Hospital Charge Code	60634320
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

FLOXIN/200MG/TAB

Facility

$13.00

Hospital Charge Code	60632997
Hospital Revenue Code	250
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$4.94
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$2.60
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

FLOXIN/300MG/TAB

Facility

$18.00

Hospital Charge Code	60634321
Hospital Revenue Code	250
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$9.00
Rate for Payer: Aetna Commercial	$6.84
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.40
Rate for Payer: Oxford Commercial	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$3.60
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

FLOXIN/300MG/TAB

Facility

$18.00

Hospital Charge Code	60634321
Hospital Revenue Code	250
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

FLOXIN/300MG/TAB

Facility

$13.00

Hospital Charge Code	60632998
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

FLOXIN/300MG/TAB

Facility

$13.00

Hospital Charge Code	60632998
Hospital Revenue Code	250
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$4.94
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$2.60
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

FLOXIN/400MG/TAB

Facility

$13.00

Hospital Charge Code	60634322
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

FLOXIN/400MG/TAB

Facility

$13.00

Hospital Charge Code	60634322
Hospital Revenue Code	250
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$4.94
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$2.60
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

FLOXURIDINE 500 MG INJ

Facility

$681.90

Hospital Charge Code	60627381
Hospital Revenue Code	636
Min. Negotiated Rate	$102.28
Max. Negotiated Rate	$165.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.02
Rate for Payer: Qualcare PPO/HMO/WC	$102.28

FLOXURIDINE 500 MG INJ

Facility

$681.90

Hospital Charge Code	60627381
Hospital Revenue Code	636
Min. Negotiated Rate	$16.43
Max. Negotiated Rate	$340.95
Rate for Payer: Aetna Commercial	$259.12
Rate for Payer: Aetna Medicare Advantage	$204.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$173.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$173.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$173.88
Rate for Payer: Cigna Commercial	$340.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.02
Rate for Payer: Qualcare PPO/HMO/WC	$102.28
Rate for Payer: UnitedHealthcare Community & State	$16.43
Rate for Payer: Wellpoint Medicaid Managed Care	$18.07

FLOXURIDINE INJ VL 500MG

Facility

$993.95

Hospital Charge Code	6007660
Hospital Revenue Code	636
Min. Negotiated Rate	$149.09
Max. Negotiated Rate	$240.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.54
Rate for Payer: Qualcare PPO/HMO/WC	$149.09

FLOXURIDINE INJ VL 500MG

Facility

$993.95

Hospital Charge Code	6007660
Hospital Revenue Code	636
Min. Negotiated Rate	$23.95
Max. Negotiated Rate	$496.98
Rate for Payer: Aetna Commercial	$377.70
Rate for Payer: Aetna Medicare Advantage	$298.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.46
Rate for Payer: Cigna Commercial	$496.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.54
Rate for Payer: Qualcare PPO/HMO/WC	$149.09
Rate for Payer: UnitedHealthcare Community & State	$23.95
Rate for Payer: Wellpoint Medicaid Managed Care	$26.34

FLUAD HIGH DOSE VACCINE

Facility

$46.79

Service Code	HCPCS 90694
Hospital Charge Code	412390694
Hospital Revenue Code	636
Min. Negotiated Rate	$7.02
Max. Negotiated Rate	$11.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.32
Rate for Payer: Qualcare PPO/HMO/WC	$7.02

FLUAD HIGH DOSE VACCINE

Facility

$46.79

Service Code	HCPCS 90694
Hospital Charge Code	412390694
Hospital Revenue Code	636
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$23.39
Rate for Payer: Aetna Commercial	$17.78
Rate for Payer: Aetna Medicare Advantage	$14.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.93
Rate for Payer: Cigna Commercial	$23.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.32
Rate for Payer: Qualcare PPO/HMO/WC	$7.02
Rate for Payer: UnitedHealthcare Community & State	$1.13
Rate for Payer: Wellpoint Medicaid Managed Care	$1.24

FLUAD TRI 0.5 ML 2024-25

Facility

$0.01

Service Code	HCPCS 90653
Hospital Charge Code	606390626
Hospital Revenue Code	636
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Know your out-of-pocket cost for care.

All Charges