Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FOLEY CATHETER 24FR 30CC 2WAY

Facility

$416.00

Hospital Charge Code	270332269
Hospital Revenue Code	272
Min. Negotiated Rate	$10.03
Max. Negotiated Rate	$208.00
Rate for Payer: Aetna Commercial	$158.08
Rate for Payer: Aetna Medicare Advantage	$124.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.08
Rate for Payer: Cigna Commercial	$208.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.80
Rate for Payer: Oxford Commercial	$83.20
Rate for Payer: Qualcare PPO/HMO/WC	$62.40
Rate for Payer: UnitedHealthcare Commercial	$83.20
Rate for Payer: UnitedHealthcare Community & State	$10.03
Rate for Payer: Wellpoint Medicaid Managed Care	$11.02

FOLEY CATH INSERTION

Facility

$159.00

Service Code	HCPCS 51702
Hospital Charge Code	7411145
Hospital Revenue Code	361
Min. Negotiated Rate	$3.83
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
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	$570.55
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.70
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.85
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$3.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$4.21

FOLEY CATH INSERTION

Facility

$159.00

Service Code	HCPCS 51702
Hospital Charge Code	366851702
Hospital Revenue Code	361
Min. Negotiated Rate	$3.83
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
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	$570.55
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.70
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.85
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$3.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$4.21

FOLEY CATH INSERTION

Facility

$499.90

Service Code	HCPCS 51702
Hospital Charge Code	1001196
Hospital Revenue Code	361
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
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	$570.55
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.97
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.98
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

FOLEY CATH INSERTION

Facility

$499.90

Service Code	HCPCS 51702
Hospital Charge Code	1001196
Hospital Revenue Code	361
Min. Negotiated Rate	$74.98
Max. Negotiated Rate	$74.98
Rate for Payer: Qualcare PPO/HMO/WC	$74.98

FOLEY CATH INSERTION

Facility

$159.00

Service Code	HCPCS 51702
Hospital Charge Code	366851702
Hospital Revenue Code	361
Min. Negotiated Rate	$23.85
Max. Negotiated Rate	$23.85
Rate for Payer: Qualcare PPO/HMO/WC	$23.85

FOLEY CATH INSERTION

Facility

$159.00

Service Code	HCPCS 51702
Hospital Charge Code	7411145
Hospital Revenue Code	361
Min. Negotiated Rate	$23.85
Max. Negotiated Rate	$23.85
Rate for Payer: Qualcare PPO/HMO/WC	$23.85

FOLEY CONE TIP URETERAL 8FR

Facility

$631.00

Hospital Charge Code	270331018
Hospital Revenue Code	272
Min. Negotiated Rate	$15.21
Max. Negotiated Rate	$315.50
Rate for Payer: Aetna Commercial	$239.78
Rate for Payer: Aetna Medicare Advantage	$189.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.91
Rate for Payer: Cigna Commercial	$315.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.30
Rate for Payer: Oxford Commercial	$126.20
Rate for Payer: Qualcare PPO/HMO/WC	$94.65
Rate for Payer: UnitedHealthcare Commercial	$126.20
Rate for Payer: UnitedHealthcare Community & State	$15.21
Rate for Payer: Wellpoint Medicaid Managed Care	$16.72

FOLEY CONE TIP URETERAL 8FR

Facility

$631.00

Hospital Charge Code	270331018
Hospital Revenue Code	272
Min. Negotiated Rate	$94.65
Max. Negotiated Rate	$94.65
Rate for Payer: Qualcare PPO/HMO/WC	$94.65

FOLIC ACID 1 MG TAB

Facility

$4.00

Service Code	NDC 63739053710
Hospital Charge Code	60628482
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

FOLIC ACID 1 MG TAB

Facility

$4.00

Service Code	NDC 63739053710
Hospital Charge Code	60628482
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

FOLIC ACID/1MG/TAB

Facility

$3.00

Hospital Charge Code	60633011
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

FOLIC ACID/1MG/TAB

Facility

$3.00

Hospital Charge Code	60633011
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

FOLIC ACID/1MG/TAB

Facility

$3.00

Hospital Charge Code	60633010
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

FOLIC ACID/1MG/TAB

Facility

$3.00

Hospital Charge Code	60633010
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

FOLIC ACID 5 MG/ML INJ

Facility

$21.44

Service Code	NDC 63323018410
Hospital Charge Code	6002513
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$10.72
Rate for Payer: Aetna Commercial	$8.15
Rate for Payer: Aetna Medicare Advantage	$6.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.47
Rate for Payer: Cigna Commercial	$10.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.43
Rate for Payer: Oxford Commercial	$4.29
Rate for Payer: Qualcare PPO/HMO/WC	$3.22
Rate for Payer: UnitedHealthcare Commercial	$4.29
Rate for Payer: UnitedHealthcare Community & State	$0.52
Rate for Payer: Wellpoint Medicaid Managed Care	$0.57

FOLIC ACID 5 MG/ML INJ

Facility

$21.44

Service Code	NDC 63323018410
Hospital Charge Code	6002513
Hospital Revenue Code	250
Min. Negotiated Rate	$3.22
Max. Negotiated Rate	$3.22
Rate for Payer: Qualcare PPO/HMO/WC	$3.22

FOLIC ACID TAB 1MG

Facility

$1.95

Hospital Charge Code	6023287
Hospital Revenue Code	251
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.29
Rate for Payer: Qualcare PPO/HMO/WC	$0.29

FOLIC ACID TAB 1MG

Facility

$1.95

Hospital Charge Code	6023287
Hospital Revenue Code	251
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.98
Rate for Payer: Aetna Commercial	$0.74
Rate for Payer: Aetna Medicare Advantage	$0.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.50
Rate for Payer: Cigna Commercial	$0.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.59
Rate for Payer: Oxford Commercial	$0.39
Rate for Payer: Qualcare PPO/HMO/WC	$0.29
Rate for Payer: UnitedHealthcare Commercial	$0.39
Rate for Payer: UnitedHealthcare Community & State	$0.05
Rate for Payer: Wellpoint Medicaid Managed Care	$0.05

FOLLICLE STIMULATING HORMONE

Facility

$192.85

Service Code	HCPCS 83001
Hospital Charge Code	3001344
Hospital Revenue Code	301
Min. Negotiated Rate	$28.93
Max. Negotiated Rate	$28.93
Rate for Payer: Qualcare PPO/HMO/WC	$28.93

FOLLICLE STIMULATING HORMONE

Facility

$192.85

Service Code	HCPCS 83001
Hospital Charge Code	3001344
Hospital Revenue Code	301
Min. Negotiated Rate	$5.11
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$50.54
Rate for Payer: Aetna Medicare Advantage	$60.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.07
Rate for Payer: Cigna Commercial	$96.42
Rate for Payer: Cigna Medicare Advantage	$18.58
Rate for Payer: Clover Medicare Advantage	$17.65
Rate for Payer: EmblemHealth Commercial	$55.74
Rate for Payer: Humana Medicare Advantage	$19.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.85
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.93
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.58
Rate for Payer: Wellcare Medicare Advantage	$18.58
Rate for Payer: Wellpoint Medicaid Managed Care	$5.11

FOLLOER URET BOUGIE 18 FR

Facility

$551.15

Hospital Charge Code	270664314
Hospital Revenue Code	270
Min. Negotiated Rate	$82.67
Max. Negotiated Rate	$82.67
Rate for Payer: Qualcare PPO/HMO/WC	$82.67

FOLLOER URET BOUGIE 18 FR

Facility

$551.15

Hospital Charge Code	270664314
Hospital Revenue Code	270
Min. Negotiated Rate	$13.28
Max. Negotiated Rate	$275.57
Rate for Payer: Aetna Commercial	$209.44
Rate for Payer: Aetna Medicare Advantage	$165.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.54
Rate for Payer: Cigna Commercial	$275.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.34
Rate for Payer: Oxford Commercial	$110.23
Rate for Payer: Qualcare PPO/HMO/WC	$82.67
Rate for Payer: UnitedHealthcare Commercial	$110.23
Rate for Payer: UnitedHealthcare Community & State	$13.28
Rate for Payer: Wellpoint Medicaid Managed Care	$14.61

FOLLOWER BOUGIE URETERAL 10FR

Facility

$920.00

Hospital Charge Code	270678181
Hospital Revenue Code	272
Min. Negotiated Rate	$138.00
Max. Negotiated Rate	$138.00
Rate for Payer: Qualcare PPO/HMO/WC	$138.00

FOLLOWER BOUGIE URETERAL 10FR

Facility

$920.00

Hospital Charge Code	270678181
Hospital Revenue Code	272
Min. Negotiated Rate	$22.17
Max. Negotiated Rate	$460.00
Rate for Payer: Aetna Commercial	$349.60
Rate for Payer: Aetna Medicare Advantage	$276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$234.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$234.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$234.60
Rate for Payer: Cigna Commercial	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$276.00
Rate for Payer: Oxford Commercial	$184.00
Rate for Payer: Qualcare PPO/HMO/WC	$138.00
Rate for Payer: UnitedHealthcare Commercial	$184.00
Rate for Payer: UnitedHealthcare Community & State	$22.17
Rate for Payer: Wellpoint Medicaid Managed Care	$24.38

Know your out-of-pocket cost for care.

All Charges