Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FLU INTRADERMAL >18 YR

Facility

$99.36

Service Code	HCPCS 90654
Hospital Charge Code	83652309
Hospital Revenue Code	636
Min. Negotiated Rate	$2.39
Max. Negotiated Rate	$49.68
Rate for Payer: Aetna Commercial	$37.76
Rate for Payer: Aetna Medicare Advantage	$29.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.34
Rate for Payer: Cigna Commercial	$49.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.05
Rate for Payer: Qualcare PPO/HMO/WC	$14.90
Rate for Payer: UnitedHealthcare Community & State	$2.39
Rate for Payer: Wellpoint Medicaid Managed Care	$2.63

FLUIONAZOLE ORL SSP 40MG/ML

Facility

$671.40

Hospital Charge Code	6017982
Hospital Revenue Code	252
Min. Negotiated Rate	$100.71
Max. Negotiated Rate	$100.71
Rate for Payer: Qualcare PPO/HMO/WC	$100.71

FLUIONAZOLE ORL SSP 40MG/ML

Facility

$671.40

Hospital Charge Code	6017982
Hospital Revenue Code	252
Min. Negotiated Rate	$16.18
Max. Negotiated Rate	$335.70
Rate for Payer: Aetna Commercial	$255.13
Rate for Payer: Aetna Medicare Advantage	$201.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$171.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$171.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$171.21
Rate for Payer: Cigna Commercial	$335.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.42
Rate for Payer: Oxford Commercial	$134.28
Rate for Payer: Qualcare PPO/HMO/WC	$100.71
Rate for Payer: UnitedHealthcare Commercial	$134.28
Rate for Payer: UnitedHealthcare Community & State	$16.18
Rate for Payer: Wellpoint Medicaid Managed Care	$17.79

FLUMADINE/100MG/TAB

Facility

$8.00

Hospital Charge Code	60634986
Hospital Revenue Code	250
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

FLUMADINE/100MG/TAB

Facility

$8.00

Hospital Charge Code	60634986
Hospital Revenue Code	250
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$3.04
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.40
Rate for Payer: Oxford Commercial	$1.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$1.60
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

FLUMAZENIL 0.1 MG/ML LNJ

Facility

$1,090.43

Service Code	NDC 63323042405
Hospital Charge Code	6007520
Hospital Revenue Code	250
Min. Negotiated Rate	$26.28
Max. Negotiated Rate	$545.22
Rate for Payer: Aetna Commercial	$414.36
Rate for Payer: Aetna Medicare Advantage	$327.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$278.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$278.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$278.06
Rate for Payer: Cigna Commercial	$545.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$327.13
Rate for Payer: Oxford Commercial	$218.09
Rate for Payer: Qualcare PPO/HMO/WC	$163.56
Rate for Payer: UnitedHealthcare Commercial	$218.09
Rate for Payer: UnitedHealthcare Community & State	$26.28
Rate for Payer: Wellpoint Medicaid Managed Care	$28.90

FLUMAZENIL 0.1 MG/ML LNJ

Facility

$1,090.43

Service Code	NDC 63323042405
Hospital Charge Code	6007520
Hospital Revenue Code	250
Min. Negotiated Rate	$163.56
Max. Negotiated Rate	$163.56
Rate for Payer: Qualcare PPO/HMO/WC	$163.56

FLUNISOLIDE 250 MCG/INH AER.M

Facility

$70.00

Hospital Charge Code	60628037
Hospital Revenue Code	250
Min. Negotiated Rate	$10.50
Max. Negotiated Rate	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.50

FLUNISOLIDE 250 MCG/INH AER.M

Facility

$70.00

Hospital Charge Code	60628037
Hospital Revenue Code	250
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$35.00
Rate for Payer: Aetna Commercial	$26.60
Rate for Payer: Aetna Medicare Advantage	$21.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.85
Rate for Payer: Cigna Commercial	$35.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.00
Rate for Payer: Oxford Commercial	$14.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.50
Rate for Payer: UnitedHealthcare Commercial	$14.00
Rate for Payer: UnitedHealthcare Community & State	$1.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1.85

FLUNISOLIDE INH 7GM

Facility

$367.40

Hospital Charge Code	6002406
Hospital Revenue Code	252
Min. Negotiated Rate	$8.85
Max. Negotiated Rate	$183.70
Rate for Payer: Aetna Commercial	$139.61
Rate for Payer: Aetna Medicare Advantage	$110.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.69
Rate for Payer: Cigna Commercial	$183.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.22
Rate for Payer: Oxford Commercial	$73.48
Rate for Payer: Qualcare PPO/HMO/WC	$55.11
Rate for Payer: UnitedHealthcare Commercial	$73.48
Rate for Payer: UnitedHealthcare Community & State	$8.85
Rate for Payer: Wellpoint Medicaid Managed Care	$9.74

FLUNISOLIDE INH 7GM

Facility

$367.40

Hospital Charge Code	6002406
Hospital Revenue Code	252
Min. Negotiated Rate	$55.11
Max. Negotiated Rate	$55.11
Rate for Payer: Qualcare PPO/HMO/WC	$55.11

FLUNISOLIDE NASAL 25 MCG SPRAY

Facility

$282.45

Hospital Charge Code	60628193
Hospital Revenue Code	250
Min. Negotiated Rate	$42.37
Max. Negotiated Rate	$42.37
Rate for Payer: Qualcare PPO/HMO/WC	$42.37

FLUNISOLIDE NASAL 25 MCG SPRAY

Facility

$282.45

Hospital Charge Code	60628193
Hospital Revenue Code	250
Min. Negotiated Rate	$6.81
Max. Negotiated Rate	$141.22
Rate for Payer: Aetna Commercial	$107.33
Rate for Payer: Aetna Medicare Advantage	$84.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.02
Rate for Payer: Cigna Commercial	$141.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.73
Rate for Payer: Oxford Commercial	$56.49
Rate for Payer: Qualcare PPO/HMO/WC	$42.37
Rate for Payer: UnitedHealthcare Commercial	$56.49
Rate for Payer: UnitedHealthcare Community & State	$6.81
Rate for Payer: Wellpoint Medicaid Managed Care	$7.48

FLUNISOLIDE ORL INH 250MCG

Facility

$70.00

Hospital Charge Code	60628036
Hospital Revenue Code	250
Min. Negotiated Rate	$10.50
Max. Negotiated Rate	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.50

FLUNISOLIDE ORL INH 250MCG

Facility

$70.00

Hospital Charge Code	60628036
Hospital Revenue Code	250
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$35.00
Rate for Payer: Aetna Commercial	$26.60
Rate for Payer: Aetna Medicare Advantage	$21.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.85
Rate for Payer: Cigna Commercial	$35.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.00
Rate for Payer: Oxford Commercial	$14.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.50
Rate for Payer: UnitedHealthcare Commercial	$14.00
Rate for Payer: UnitedHealthcare Community & State	$1.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1.85

FLUOCINOLONE ACETONIDE 0.

Facility

$226.26

Service Code	NDC 168006015
Hospital Charge Code	60632999
Hospital Revenue Code	250
Min. Negotiated Rate	$5.45
Max. Negotiated Rate	$113.13
Rate for Payer: Aetna Commercial	$85.98
Rate for Payer: Aetna Medicare Advantage	$67.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.70
Rate for Payer: Cigna Commercial	$113.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.88
Rate for Payer: Oxford Commercial	$45.25
Rate for Payer: Qualcare PPO/HMO/WC	$33.94
Rate for Payer: UnitedHealthcare Commercial	$45.25
Rate for Payer: UnitedHealthcare Community & State	$5.45
Rate for Payer: Wellpoint Medicaid Managed Care	$6.00

FLUOCINOLONE ACETONIDE 0.

Facility

$226.26

Service Code	NDC 168006015
Hospital Charge Code	60632999
Hospital Revenue Code	250
Min. Negotiated Rate	$33.94
Max. Negotiated Rate	$33.94
Rate for Payer: Qualcare PPO/HMO/WC	$33.94

FLUOCINOLONE CRM 0.01%

Facility

$44.00

Hospital Charge Code	60628380
Hospital Revenue Code	250
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

FLUOCINOLONE CRM 0.01%

Facility

$44.00

Hospital Charge Code	60628380
Hospital Revenue Code	250
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$22.00
Rate for Payer: Aetna Commercial	$16.72
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.20
Rate for Payer: Oxford Commercial	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$8.80
Rate for Payer: UnitedHealthcare Community & State	$1.06
Rate for Payer: Wellpoint Medicaid Managed Care	$1.17

FLUOCINOLONE CRM 0.025%

Facility

$168.80

Hospital Charge Code	60628382
Hospital Revenue Code	250
Min. Negotiated Rate	$4.07
Max. Negotiated Rate	$84.40
Rate for Payer: Aetna Commercial	$64.14
Rate for Payer: Aetna Medicare Advantage	$50.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.04
Rate for Payer: Cigna Commercial	$84.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.64
Rate for Payer: Oxford Commercial	$33.76
Rate for Payer: Qualcare PPO/HMO/WC	$25.32
Rate for Payer: UnitedHealthcare Commercial	$33.76
Rate for Payer: UnitedHealthcare Community & State	$4.07
Rate for Payer: Wellpoint Medicaid Managed Care	$4.47

FLUOCINOLONE CRM 0.025%

Facility

$168.80

Hospital Charge Code	60628382
Hospital Revenue Code	250
Min. Negotiated Rate	$25.32
Max. Negotiated Rate	$25.32
Rate for Payer: Qualcare PPO/HMO/WC	$25.32

FLUOCINOLONE SOL 0.01%

Facility

$103.25

Hospital Charge Code	60628381
Hospital Revenue Code	250
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

FLUOCINOLONE SOL 0.01%

Facility

$103.25

Hospital Charge Code	60628381
Hospital Revenue Code	250
Min. Negotiated Rate	$15.49
Max. Negotiated Rate	$15.49
Rate for Payer: Qualcare PPO/HMO/WC	$15.49

FLUOCINOLONE SOLUTION

Facility

$26.00

Hospital Charge Code	60634925
Hospital Revenue Code	250
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$3.90
Rate for Payer: Qualcare PPO/HMO/WC	$3.90

FLUOCINOLONE SOLUTION

Facility

$26.00

Hospital Charge Code	60634925
Hospital Revenue Code	250
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$13.00
Rate for Payer: Aetna Commercial	$9.88
Rate for Payer: Aetna Medicare Advantage	$7.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.63
Rate for Payer: Cigna Commercial	$13.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.80
Rate for Payer: Oxford Commercial	$5.20
Rate for Payer: Qualcare PPO/HMO/WC	$3.90
Rate for Payer: UnitedHealthcare Commercial	$5.20
Rate for Payer: UnitedHealthcare Community & State	$0.63
Rate for Payer: Wellpoint Medicaid Managed Care	$0.69

Know your out-of-pocket cost for care.

All Charges