Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FORTE CNCLLOUS SCRW 4.0MMX18MM

Facility

$299.10

Hospital Charge Code	270663185
Hospital Revenue Code	278
Min. Negotiated Rate	$7.21
Max. Negotiated Rate	$149.55
Rate for Payer: Aetna Commercial	$113.66
Rate for Payer: Aetna Medicare Advantage	$89.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.27
Rate for Payer: Cigna Commercial	$149.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$65.80
Rate for Payer: Qualcare PPO/HMO/WC	$44.87
Rate for Payer: UnitedHealthcare Community & State	$7.21
Rate for Payer: Wellpoint Medicaid Managed Care	$7.93

FORTE CNCLLOUS SCRW 4.0MMX22MM

Facility

$299.10

Hospital Charge Code	270663186
Hospital Revenue Code	278
Min. Negotiated Rate	$7.21
Max. Negotiated Rate	$149.55
Rate for Payer: Aetna Commercial	$113.66
Rate for Payer: Aetna Medicare Advantage	$89.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.27
Rate for Payer: Cigna Commercial	$149.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$65.80
Rate for Payer: Qualcare PPO/HMO/WC	$44.87
Rate for Payer: UnitedHealthcare Community & State	$7.21
Rate for Payer: Wellpoint Medicaid Managed Care	$7.93

FORTE CNCLLOUS SCRW 4.0MMX22MM

Facility

$299.10

Hospital Charge Code	270663186
Hospital Revenue Code	278
Min. Negotiated Rate	$44.87
Max. Negotiated Rate	$72.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$65.80
Rate for Payer: Qualcare PPO/HMO/WC	$44.87

FORTE CNCLLOUS SCRW 4.0MMX24MM

Facility

$299.10

Hospital Charge Code	270663187
Hospital Revenue Code	278
Min. Negotiated Rate	$44.87
Max. Negotiated Rate	$72.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$65.80
Rate for Payer: Qualcare PPO/HMO/WC	$44.87

FORTE CNCLLOUS SCRW 4.0MMX24MM

Facility

$299.10

Hospital Charge Code	270663187
Hospital Revenue Code	278
Min. Negotiated Rate	$7.21
Max. Negotiated Rate	$149.55
Rate for Payer: Aetna Commercial	$113.66
Rate for Payer: Aetna Medicare Advantage	$89.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.27
Rate for Payer: Cigna Commercial	$149.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$65.80
Rate for Payer: Qualcare PPO/HMO/WC	$44.87
Rate for Payer: UnitedHealthcare Community & State	$7.21
Rate for Payer: Wellpoint Medicaid Managed Care	$7.93

FORTE CNCLLOUS SCRW 4.0MMX26MM

Facility

$299.10

Hospital Charge Code	270663188
Hospital Revenue Code	278
Min. Negotiated Rate	$44.87
Max. Negotiated Rate	$72.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$65.80
Rate for Payer: Qualcare PPO/HMO/WC	$44.87

FORTE CNCLLOUS SCRW 4.0MMX26MM

Facility

$299.10

Hospital Charge Code	270663188
Hospital Revenue Code	278
Min. Negotiated Rate	$7.21
Max. Negotiated Rate	$149.55
Rate for Payer: Aetna Commercial	$113.66
Rate for Payer: Aetna Medicare Advantage	$89.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.27
Rate for Payer: Cigna Commercial	$149.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$65.80
Rate for Payer: Qualcare PPO/HMO/WC	$44.87
Rate for Payer: UnitedHealthcare Community & State	$7.21
Rate for Payer: Wellpoint Medicaid Managed Care	$7.93

FORTE CNCLLOUS SCRW 4.0MMX28MM

Facility

$299.10

Hospital Charge Code	270663189
Hospital Revenue Code	278
Min. Negotiated Rate	$44.87
Max. Negotiated Rate	$72.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$65.80
Rate for Payer: Qualcare PPO/HMO/WC	$44.87

FORTE CNCLLOUS SCRW 4.0MMX28MM

Facility

$299.10

Hospital Charge Code	270663189
Hospital Revenue Code	278
Min. Negotiated Rate	$7.21
Max. Negotiated Rate	$149.55
Rate for Payer: Aetna Commercial	$113.66
Rate for Payer: Aetna Medicare Advantage	$89.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.27
Rate for Payer: Cigna Commercial	$149.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$65.80
Rate for Payer: Qualcare PPO/HMO/WC	$44.87
Rate for Payer: UnitedHealthcare Community & State	$7.21
Rate for Payer: Wellpoint Medicaid Managed Care	$7.93

FORTEC XPS MOXY FIBER

Facility

$5,000.00

Hospital Charge Code	270657506
Hospital Revenue Code	272
Min. Negotiated Rate	$120.50
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,500.00
Rate for Payer: Oxford Commercial	$1,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Commercial	$1,000.00
Rate for Payer: UnitedHealthcare Community & State	$120.50
Rate for Payer: Wellpoint Medicaid Managed Care	$132.50

FORTEC XPS MOXY FIBER

Facility

$5,000.00

Hospital Charge Code	270657506
Hospital Revenue Code	272
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$750.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

FORTIFIED TOBREX OPHTH

Facility

$150.00

Hospital Charge Code	60634815
Hospital Revenue Code	250
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

FORTIFIED TOBREX OPHTH

Facility

$150.00

Hospital Charge Code	60634815
Hospital Revenue Code	250
Min. Negotiated Rate	$3.62
Max. Negotiated Rate	$75.00
Rate for Payer: Aetna Commercial	$57.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.00
Rate for Payer: Oxford Commercial	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$30.00
Rate for Payer: UnitedHealthcare Community & State	$3.62
Rate for Payer: Wellpoint Medicaid Managed Care	$3.98

FORTILINK 8CM

Facility

$0.01

Service Code	HCPCS C1889
Hospital Charge Code	270689963
Hospital Revenue Code	278
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

FORTILINK 8CM

Facility

$0.01

Service Code	HCPCS C1889
Hospital Charge Code	270689963
Hospital Revenue Code	278
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

FORTILINK-C CAGE 12X14X9MM 6D

Facility

$21,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270695702
Hospital Revenue Code	278
Min. Negotiated Rate	$3,225.00
Max. Negotiated Rate	$5,203.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,203.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,730.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,225.00

FORTILINK-C CAGE 12X14X9MM 6D

Facility

$21,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270695702
Hospital Revenue Code	278
Min. Negotiated Rate	$518.15
Max. Negotiated Rate	$10,750.00
Rate for Payer: Aetna Commercial	$8,170.00
Rate for Payer: Aetna Medicare Advantage	$6,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,482.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,482.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,482.50
Rate for Payer: Cigna Commercial	$10,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,203.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,730.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,225.00
Rate for Payer: UnitedHealthcare Community & State	$518.15
Rate for Payer: Wellpoint Medicaid Managed Care	$569.75

FORTLINK 7CM

Facility

$0.01

Service Code	HCPCS C1889
Hospital Charge Code	270689962
Hospital Revenue Code	278
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

FORTLINK 7CM

Facility

$0.01

Service Code	HCPCS C1889
Hospital Charge Code	270689962
Hospital Revenue Code	278
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

FORTOVASE 200MG CAP

Facility

$4.00

Hospital Charge Code	60635480
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

FORTOVASE 200MG CAP

Facility

$4.00

Hospital Charge Code	60635480
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

FOSAMAX 35MG

Facility

$18.00

Hospital Charge Code	60635498
Hospital Revenue Code	250
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

FOSAMAX 35MG

Facility

$18.00

Hospital Charge Code	60635498
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

FOSAMAX 5MG TABLET

Facility

$3.00

Hospital Charge Code	60635414
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

FOSAMAX 5MG TABLET

Facility

$3.00

Hospital Charge Code	60635414
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

Know your out-of-pocket cost for care.

All Charges