Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HEXADROL/6MG/TAB/U/D

Facility

$3.00

Hospital Charge Code	60634798
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

HEXADROL/6MG/TAB/U/D

Facility

$3.00

Hospital Charge Code	60634798
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

HEXAGONAL PHASE PHOSPHOLIPID

Facility

$123.55

Service Code	HCPCS 85598
Hospital Charge Code	3038097
Hospital Revenue Code	300
Min. Negotiated Rate	$18.53
Max. Negotiated Rate	$18.53
Rate for Payer: Qualcare PPO/HMO/WC	$18.53

HEXAGONAL PHASE PHOSPHOLIPID

Facility

$123.55

Service Code	HCPCS 85598
Hospital Charge Code	3038097
Hospital Revenue Code	300
Min. Negotiated Rate	$3.27
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$48.91
Rate for Payer: Aetna Medicare Advantage	$58.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.90
Rate for Payer: Cigna Commercial	$61.77
Rate for Payer: Cigna Medicare Advantage	$17.98
Rate for Payer: Clover Medicare Advantage	$17.08
Rate for Payer: EmblemHealth Commercial	$53.94
Rate for Payer: Humana Medicare Advantage	$18.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.06
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.53
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.98
Rate for Payer: Wellcare Medicare Advantage	$17.98
Rate for Payer: Wellpoint Medicaid Managed Care	$3.27

HEXAVITAMIN/TAB

Facility

$4.00

Service Code	NDC 49348010110
Hospital Charge Code	60633092
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

HEXAVITAMIN/TAB

Facility

$4.00

Service Code	NDC 49348010110
Hospital Charge Code	60633092
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

HEXTENE 6% (500ML)

Facility

$43.00

Hospital Charge Code	60635274
Hospital Revenue Code	250
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$16.34
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.90
Rate for Payer: Oxford Commercial	$8.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$8.60
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.14

HEXTENE 6% (500ML)

Facility

$43.00

Hospital Charge Code	60635274
Hospital Revenue Code	250
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

HEX WRENCH PRECISION

Facility

$375.00

Hospital Charge Code	270679696
Hospital Revenue Code	272
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.50
Rate for Payer: Oxford Commercial	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Commercial	$75.00
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

HEX WRENCH PRECISION

Facility

$375.00

Hospital Charge Code	270679696
Hospital Revenue Code	272
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

HFH LH 125 DEG 9MMX320MM

Facility

$9,825.00

Service Code	HCPCS C1713
Hospital Charge Code	270689270
Hospital Revenue Code	278
Min. Negotiated Rate	$1,473.75
Max. Negotiated Rate	$2,377.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,965.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,377.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,161.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,473.75

HFH LH 125 DEG 9MMX320MM

Facility

$9,825.00

Service Code	HCPCS C1713
Hospital Charge Code	270689270
Hospital Revenue Code	278
Min. Negotiated Rate	$236.78
Max. Negotiated Rate	$4,912.50
Rate for Payer: Aetna Commercial	$3,733.50
Rate for Payer: Aetna Medicare Advantage	$2,947.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,505.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,505.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,965.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,505.38
Rate for Payer: Cigna Commercial	$4,912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,377.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,161.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,473.75
Rate for Payer: UnitedHealthcare Community & State	$236.78
Rate for Payer: Wellpoint Medicaid Managed Care	$260.36

HFN 125 DEG 9MM X 180MM

Facility

$6,648.00

Service Code	HCPCS C1713
Hospital Charge Code	270681531
Hospital Revenue Code	278
Min. Negotiated Rate	$160.22
Max. Negotiated Rate	$3,324.00
Rate for Payer: Aetna Commercial	$2,526.24
Rate for Payer: Aetna Medicare Advantage	$1,994.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,695.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,695.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,329.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,695.24
Rate for Payer: Cigna Commercial	$3,324.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,608.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,462.56
Rate for Payer: Qualcare PPO/HMO/WC	$997.20
Rate for Payer: UnitedHealthcare Community & State	$160.22
Rate for Payer: Wellpoint Medicaid Managed Care	$176.17

HFN 125 DEG 9MM X 180MM

Facility

$6,648.00

Service Code	HCPCS C1713
Hospital Charge Code	270681531
Hospital Revenue Code	278
Min. Negotiated Rate	$997.20
Max. Negotiated Rate	$1,608.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,329.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,608.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,462.56
Rate for Payer: Qualcare PPO/HMO/WC	$997.20

HFN 130 DEG 13MM X 180MM

Facility

$6,362.40

Service Code	HCPCS C1713
Hospital Charge Code	270679319
Hospital Revenue Code	278
Min. Negotiated Rate	$954.36
Max. Negotiated Rate	$1,539.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,272.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,539.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,399.73
Rate for Payer: Qualcare PPO/HMO/WC	$954.36

HFN 130 DEG 13MM X 180MM

Facility

$6,362.40

Service Code	HCPCS C1713
Hospital Charge Code	270679319
Hospital Revenue Code	278
Min. Negotiated Rate	$153.33
Max. Negotiated Rate	$3,181.20
Rate for Payer: Aetna Commercial	$2,417.71
Rate for Payer: Aetna Medicare Advantage	$1,908.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,622.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,622.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,272.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,622.41
Rate for Payer: Cigna Commercial	$3,181.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,539.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,399.73
Rate for Payer: Qualcare PPO/HMO/WC	$954.36
Rate for Payer: UnitedHealthcare Community & State	$153.33
Rate for Payer: Wellpoint Medicaid Managed Care	$168.60

HFN 130 DEG 9MM X 180MM

Facility

$6,925.00

Service Code	HCPCS C1713
Hospital Charge Code	270687401
Hospital Revenue Code	278
Min. Negotiated Rate	$166.89
Max. Negotiated Rate	$3,462.50
Rate for Payer: Aetna Commercial	$2,631.50
Rate for Payer: Aetna Medicare Advantage	$2,077.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,765.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,765.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,385.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,765.88
Rate for Payer: Cigna Commercial	$3,462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,675.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,523.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,038.75
Rate for Payer: UnitedHealthcare Community & State	$166.89
Rate for Payer: Wellpoint Medicaid Managed Care	$183.51

HFN 130 DEG 9MM X 180MM

Facility

$6,925.00

Service Code	HCPCS C1713
Hospital Charge Code	270687401
Hospital Revenue Code	278
Min. Negotiated Rate	$1,038.75
Max. Negotiated Rate	$1,675.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,675.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,523.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,038.75

HFN A/R SCREW 65MM

Facility

$1,032.00

Service Code	HCPCS C1713
Hospital Charge Code	270681533
Hospital Revenue Code	278
Min. Negotiated Rate	$24.87
Max. Negotiated Rate	$516.00
Rate for Payer: Aetna Commercial	$392.16
Rate for Payer: Aetna Medicare Advantage	$309.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.16
Rate for Payer: Cigna Commercial	$516.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$227.04
Rate for Payer: Qualcare PPO/HMO/WC	$154.80
Rate for Payer: UnitedHealthcare Community & State	$24.87
Rate for Payer: Wellpoint Medicaid Managed Care	$27.35

HFN A/R SCREW 65MM

Facility

$1,032.00

Service Code	HCPCS C1713
Hospital Charge Code	270681533
Hospital Revenue Code	278
Min. Negotiated Rate	$154.80
Max. Negotiated Rate	$249.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$227.04
Rate for Payer: Qualcare PPO/HMO/WC	$154.80

HFN A/R SCREW 75MM

Facility

$1,032.00

Service Code	HCPCS C1713
Hospital Charge Code	270680792
Hospital Revenue Code	278
Min. Negotiated Rate	$154.80
Max. Negotiated Rate	$249.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$227.04
Rate for Payer: Qualcare PPO/HMO/WC	$154.80

HFN A/R SCREW 75MM

Facility

$1,032.00

Service Code	HCPCS C1713
Hospital Charge Code	270680792
Hospital Revenue Code	278
Min. Negotiated Rate	$24.87
Max. Negotiated Rate	$516.00
Rate for Payer: Aetna Commercial	$392.16
Rate for Payer: Aetna Medicare Advantage	$309.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.16
Rate for Payer: Cigna Commercial	$516.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$227.04
Rate for Payer: Qualcare PPO/HMO/WC	$154.80
Rate for Payer: UnitedHealthcare Community & State	$24.87
Rate for Payer: Wellpoint Medicaid Managed Care	$27.35

HFN AR SCREW 80MM

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270679371
Hospital Revenue Code	278
Min. Negotiated Rate	$27.11
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Community & State	$27.11
Rate for Payer: Wellpoint Medicaid Managed Care	$29.81

HFN AR SCREW 80MM

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270679371
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

HFN A/R SCREW 85MM

Facility

$1,047.00

Service Code	HCPCS C1713
Hospital Charge Code	270681529
Hospital Revenue Code	278
Min. Negotiated Rate	$25.23
Max. Negotiated Rate	$523.50
Rate for Payer: Aetna Commercial	$397.86
Rate for Payer: Aetna Medicare Advantage	$314.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$266.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$266.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$209.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$266.99
Rate for Payer: Cigna Commercial	$523.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$253.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$230.34
Rate for Payer: Qualcare PPO/HMO/WC	$157.05
Rate for Payer: UnitedHealthcare Community & State	$25.23
Rate for Payer: Wellpoint Medicaid Managed Care	$27.75

Know your out-of-pocket cost for care.

All Charges