Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FLUOCINONIDE SOL 60ML

Facility

$154.25

Hospital Charge Code	6002448
Hospital Revenue Code	251
Min. Negotiated Rate	$3.72
Max. Negotiated Rate	$77.12
Rate for Payer: Aetna Commercial	$58.62
Rate for Payer: Aetna Medicare Advantage	$46.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.33
Rate for Payer: Cigna Commercial	$77.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.27
Rate for Payer: Oxford Commercial	$30.85
Rate for Payer: Qualcare PPO/HMO/WC	$23.14
Rate for Payer: UnitedHealthcare Commercial	$30.85
Rate for Payer: UnitedHealthcare Community & State	$3.72
Rate for Payer: Wellpoint Medicaid Managed Care	$4.09

FLUORESCEIN 2% OPHTH SOLN

Facility

$9.65

Hospital Charge Code	6002463
Hospital Revenue Code	250
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$4.83
Rate for Payer: Aetna Commercial	$3.67
Rate for Payer: Aetna Medicare Advantage	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.46
Rate for Payer: Cigna Commercial	$4.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.90
Rate for Payer: Oxford Commercial	$1.93
Rate for Payer: Qualcare PPO/HMO/WC	$1.45
Rate for Payer: UnitedHealthcare Commercial	$1.93
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

FLUORESCEIN 2% OPHTH SOLN

Facility

$9.65

Hospital Charge Code	6002463
Hospital Revenue Code	250
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.45

FLUORESCEIN BENOXINATE SOL OPH

Facility

$94.10

Hospital Charge Code	60628050
Hospital Revenue Code	250
Min. Negotiated Rate	$2.27
Max. Negotiated Rate	$47.05
Rate for Payer: Aetna Commercial	$35.76
Rate for Payer: Aetna Medicare Advantage	$28.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.00
Rate for Payer: Cigna Commercial	$47.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.23
Rate for Payer: Oxford Commercial	$18.82
Rate for Payer: Qualcare PPO/HMO/WC	$14.12
Rate for Payer: UnitedHealthcare Commercial	$18.82
Rate for Payer: UnitedHealthcare Community & State	$2.27
Rate for Payer: Wellpoint Medicaid Managed Care	$2.49

FLUORESCEIN BENOXINATE SOL OPH

Facility

$94.10

Hospital Charge Code	60628050
Hospital Revenue Code	250
Min. Negotiated Rate	$14.12
Max. Negotiated Rate	$14.12
Rate for Payer: Qualcare PPO/HMO/WC	$14.12

FLUORESCEIN OPTHALM STRIP

Facility

$11.40

Hospital Charge Code	270658298
Hospital Revenue Code	250
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$5.70
Rate for Payer: Aetna Commercial	$4.33
Rate for Payer: Aetna Medicare Advantage	$3.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.91
Rate for Payer: Cigna Commercial	$5.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.42
Rate for Payer: Oxford Commercial	$2.28
Rate for Payer: Qualcare PPO/HMO/WC	$1.71
Rate for Payer: UnitedHealthcare Commercial	$2.28
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

FLUORESCEIN OPTHALM STRIP

Facility

$11.40

Hospital Charge Code	270658298
Hospital Revenue Code	250
Min. Negotiated Rate	$1.71
Max. Negotiated Rate	$1.71
Rate for Payer: Qualcare PPO/HMO/WC	$1.71

FLUORESCEIN OPTH SOL/ML

Facility

$296.14

Service Code	NDC 54799050721
Hospital Charge Code	606390178
Hospital Revenue Code	250
Min. Negotiated Rate	$44.42
Max. Negotiated Rate	$44.42
Rate for Payer: Qualcare PPO/HMO/WC	$44.42

FLUORESCEIN OPTH SOL/ML

Facility

$296.14

Service Code	NDC 54799050721
Hospital Charge Code	606390178
Hospital Revenue Code	250
Min. Negotiated Rate	$7.14
Max. Negotiated Rate	$148.07
Rate for Payer: Aetna Commercial	$112.53
Rate for Payer: Aetna Medicare Advantage	$88.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.52
Rate for Payer: Cigna Commercial	$148.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.84
Rate for Payer: Oxford Commercial	$59.23
Rate for Payer: Qualcare PPO/HMO/WC	$44.42
Rate for Payer: UnitedHealthcare Commercial	$59.23
Rate for Payer: UnitedHealthcare Community & State	$7.14
Rate for Payer: Wellpoint Medicaid Managed Care	$7.85

FLUORESCEIN O.S. 2%

Facility

$73.00

Hospital Charge Code	6012579
Hospital Revenue Code	252
Min. Negotiated Rate	$10.95
Max. Negotiated Rate	$10.95
Rate for Payer: Qualcare PPO/HMO/WC	$10.95

FLUORESCEIN O.S. 2%

Facility

$73.00

Hospital Charge Code	6012579
Hospital Revenue Code	252
Min. Negotiated Rate	$1.76
Max. Negotiated Rate	$36.50
Rate for Payer: Aetna Commercial	$27.74
Rate for Payer: Aetna Medicare Advantage	$21.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.61
Rate for Payer: Cigna Commercial	$36.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.90
Rate for Payer: Oxford Commercial	$14.60
Rate for Payer: Qualcare PPO/HMO/WC	$10.95
Rate for Payer: UnitedHealthcare Commercial	$14.60
Rate for Payer: UnitedHealthcare Community & State	$1.76
Rate for Payer: Wellpoint Medicaid Managed Care	$1.93

FLUORESCEIN SODIUM STRIP

Facility

$4.00

Service Code	NDC 17238090011
Hospital Charge Code	6022453
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

FLUORESCEIN SODIUM STRIP

Facility

$4.00

Service Code	NDC 17238090011
Hospital Charge Code	6022453
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

FLUORESCENCE IMAGING PACK

Facility

$975.00

Hospital Charge Code	270663998
Hospital Revenue Code	270
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$195.00
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

FLUORESCENCE IMAGING PACK

Facility

$975.00

Hospital Charge Code	270663998
Hospital Revenue Code	270
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

FLUORESCENT NONINFECT ANTIBODY

Facility

$121.00

Service Code	HCPCS 86255
Hospital Charge Code	3035001A
Hospital Revenue Code	302
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.50
Rate for Payer: Cigna Commercial	$60.50
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$3.21

FLUORESCENT NONINFECT ANTIBODY

Facility

$121.00

Service Code	HCPCS 86255
Hospital Charge Code	3035001A
Hospital Revenue Code	302
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$18.15

FLUORESCITE 10% 5ML

Facility

$387.66

Service Code	NDC 65009265
Hospital Charge Code	606390412
Hospital Revenue Code	250
Min. Negotiated Rate	$58.15
Max. Negotiated Rate	$58.15
Rate for Payer: Qualcare PPO/HMO/WC	$58.15

FLUORESCITE 10% 5ML

Facility

$387.66

Service Code	NDC 65009265
Hospital Charge Code	606390412
Hospital Revenue Code	250
Min. Negotiated Rate	$9.34
Max. Negotiated Rate	$193.83
Rate for Payer: Aetna Commercial	$147.31
Rate for Payer: Aetna Medicare Advantage	$116.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.85
Rate for Payer: Cigna Commercial	$193.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.30
Rate for Payer: Oxford Commercial	$77.53
Rate for Payer: Qualcare PPO/HMO/WC	$58.15
Rate for Payer: UnitedHealthcare Commercial	$77.53
Rate for Payer: UnitedHealthcare Community & State	$9.34
Rate for Payer: Wellpoint Medicaid Managed Care	$10.27

FLUORESCITE 10%/5ML

Facility

$61.00

Hospital Charge Code	60633003
Hospital Revenue Code	250
Min. Negotiated Rate	$9.15
Max. Negotiated Rate	$9.15
Rate for Payer: Qualcare PPO/HMO/WC	$9.15

FLUORESCITE 10%/5ML

Facility

$61.00

Hospital Charge Code	60633003
Hospital Revenue Code	250
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$30.50
Rate for Payer: Aetna Commercial	$23.18
Rate for Payer: Aetna Medicare Advantage	$18.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.55
Rate for Payer: Cigna Commercial	$30.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.30
Rate for Payer: Oxford Commercial	$12.20
Rate for Payer: Qualcare PPO/HMO/WC	$9.15
Rate for Payer: UnitedHealthcare Commercial	$12.20
Rate for Payer: UnitedHealthcare Community & State	$1.47
Rate for Payer: Wellpoint Medicaid Managed Care	$1.62

FLUOR GRID RF ABL BONE-BI

Facility

$6,649.00

Service Code	HCPCS 2099950
Hospital Charge Code	7411772
Hospital Revenue Code	361
Min. Negotiated Rate	$997.35
Max. Negotiated Rate	$997.35
Rate for Payer: Qualcare PPO/HMO/WC	$997.35

FLUOR GRID RF ABL BONE-BI

Facility

$6,649.00

Service Code	HCPCS 2099950
Hospital Charge Code	7411772
Hospital Revenue Code	361
Min. Negotiated Rate	$160.24
Max. Negotiated Rate	$3,324.50
Rate for Payer: Aetna Commercial	$2,526.62
Rate for Payer: Aetna Medicare Advantage	$1,994.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,695.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,695.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,695.49
Rate for Payer: Cigna Commercial	$3,324.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,994.70
Rate for Payer: Qualcare PPO/HMO/WC	$997.35
Rate for Payer: UnitedHealthcare Community & State	$160.24
Rate for Payer: Wellpoint Medicaid Managed Care	$176.20

FLUOR GRID RF ABL BONE-BI

Facility

$6,649.00

Service Code	HCPCS 2099950
Hospital Charge Code	2690320
Hospital Revenue Code	361
Min. Negotiated Rate	$160.24
Max. Negotiated Rate	$3,324.50
Rate for Payer: Aetna Commercial	$2,526.62
Rate for Payer: Aetna Medicare Advantage	$1,994.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,695.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,695.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,695.49
Rate for Payer: Cigna Commercial	$3,324.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,994.70
Rate for Payer: Qualcare PPO/HMO/WC	$997.35
Rate for Payer: UnitedHealthcare Community & State	$160.24
Rate for Payer: Wellpoint Medicaid Managed Care	$176.20

FLUOR GRID RF ABL BONE-BI

Facility

$6,649.00

Service Code	HCPCS 2099950
Hospital Charge Code	2690320
Hospital Revenue Code	361
Min. Negotiated Rate	$997.35
Max. Negotiated Rate	$997.35
Rate for Payer: Qualcare PPO/HMO/WC	$997.35

Know your out-of-pocket cost for care.

All Charges