Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

AVALON ELITE VAS ACC KIT 100CM

Facility

$1,114.80

Hospital Charge Code	2703110Q
Hospital Revenue Code	272
Min. Negotiated Rate	$167.22
Max. Negotiated Rate	$167.22
Rate for Payer: Qualcare PPO/HMO/WC	$167.22

AVALON ELITE VAS ACC KIT 100CM

Facility

$1,114.80

Hospital Charge Code	2703110Q
Hospital Revenue Code	272
Min. Negotiated Rate	$26.87
Max. Negotiated Rate	$557.40
Rate for Payer: Aetna Commercial	$423.62
Rate for Payer: Aetna Medicare Advantage	$334.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$284.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$284.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$284.27
Rate for Payer: Cigna Commercial	$557.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$334.44
Rate for Payer: Oxford Commercial	$222.96
Rate for Payer: Qualcare PPO/HMO/WC	$167.22
Rate for Payer: UnitedHealthcare Commercial	$222.96
Rate for Payer: UnitedHealthcare Community & State	$26.87
Rate for Payer: Wellpoint Medicaid Managed Care	$29.54

AVALON ELITE VAS ACC KIT 210CM

Facility

$4,613.75

Hospital Charge Code	2703110R
Hospital Revenue Code	272
Min. Negotiated Rate	$692.06
Max. Negotiated Rate	$692.06
Rate for Payer: Qualcare PPO/HMO/WC	$692.06

AVALON ELITE VAS ACC KIT 210CM

Facility

$4,613.75

Hospital Charge Code	2703110R
Hospital Revenue Code	272
Min. Negotiated Rate	$111.19
Max. Negotiated Rate	$2,306.88
Rate for Payer: Aetna Commercial	$1,753.22
Rate for Payer: Aetna Medicare Advantage	$1,384.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,176.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,176.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,176.51
Rate for Payer: Cigna Commercial	$2,306.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,384.12
Rate for Payer: Oxford Commercial	$922.75
Rate for Payer: Qualcare PPO/HMO/WC	$692.06
Rate for Payer: UnitedHealthcare Commercial	$922.75
Rate for Payer: UnitedHealthcare Community & State	$111.19
Rate for Payer: Wellpoint Medicaid Managed Care	$122.26

AV ANASTOMOSIS OPEN,ANY SITE

Facility

$38,857.60

Service Code	HCPCS 36821
Hospital Charge Code	16000582
Hospital Revenue Code	360
Min. Negotiated Rate	$5,828.64
Max. Negotiated Rate	$5,828.64
Rate for Payer: Qualcare PPO/HMO/WC	$5,828.64

AV ANASTOMOSIS OPEN,ANY SITE

Facility

$38,857.60

Service Code	HCPCS 36821
Hospital Charge Code	16000582
Hospital Revenue Code	360
Min. Negotiated Rate	$936.47
Max. Negotiated Rate	$13,540.60
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,540.60
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,657.28
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,828.64
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$936.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$1,029.73

AVANCE GRAFT NERVE 1X2X70

Facility

$36,620.00

Service Code	HCPCS C1889
Hospital Charge Code	270690222
Hospital Revenue Code	278
Min. Negotiated Rate	$882.54
Max. Negotiated Rate	$18,310.00
Rate for Payer: Aetna Commercial	$13,915.60
Rate for Payer: Aetna Medicare Advantage	$10,986.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,338.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,338.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,324.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,338.10
Rate for Payer: Cigna Commercial	$18,310.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,862.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,056.40
Rate for Payer: Qualcare PPO/HMO/WC	$5,493.00
Rate for Payer: UnitedHealthcare Community & State	$882.54
Rate for Payer: Wellpoint Medicaid Managed Care	$970.43

AVANCE GRAFT NERVE 1X2X70

Facility

$36,620.00

Service Code	HCPCS C1889
Hospital Charge Code	270690222
Hospital Revenue Code	278
Min. Negotiated Rate	$5,493.00
Max. Negotiated Rate	$8,862.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,324.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,862.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,056.40
Rate for Payer: Qualcare PPO/HMO/WC	$5,493.00

AVANCE NERVE GRAFT

Facility

$10,625.00

Service Code	HCPCS C1768
Hospital Charge Code	270664250
Hospital Revenue Code	278
Min. Negotiated Rate	$1,593.75
Max. Negotiated Rate	$2,571.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,571.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,337.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,593.75

AVANCE NERVE GRAFT

Facility

$10,625.00

Service Code	HCPCS C1768
Hospital Charge Code	270664250
Hospital Revenue Code	278
Min. Negotiated Rate	$256.06
Max. Negotiated Rate	$5,312.50
Rate for Payer: Aetna Commercial	$4,037.50
Rate for Payer: Aetna Medicare Advantage	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,709.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,709.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,709.38
Rate for Payer: Cigna Commercial	$5,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,571.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,337.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,593.75
Rate for Payer: UnitedHealthcare Community & State	$256.06
Rate for Payer: Wellpoint Medicaid Managed Care	$281.56

AVANDIA 2MG TAB

Facility

$8.00

Hospital Charge Code	60635284
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

AVANDIA 2MG TAB

Facility

$8.00

Hospital Charge Code	60635284
Hospital Revenue Code	250
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

AVANDIA 4MG TAB

Facility

$13.00

Hospital Charge Code	60635885
Hospital Revenue Code	259
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

AVANDIA 4MG TAB

Facility

$13.00

Hospital Charge Code	60635885
Hospital Revenue Code	259
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$4.94
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$2.60
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

AVANDIA 8 MG TAB

Facility

$23.00

Hospital Charge Code	60635285
Hospital Revenue Code	250
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

AVANDIA 8 MG TAB

Facility

$23.00

Hospital Charge Code	60635285
Hospital Revenue Code	250
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$11.50
Rate for Payer: Aetna Commercial	$8.74
Rate for Payer: Aetna Medicare Advantage	$6.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.87
Rate for Payer: Cigna Commercial	$11.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.90
Rate for Payer: Oxford Commercial	$4.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$4.60
Rate for Payer: UnitedHealthcare Community & State	$0.55
Rate for Payer: Wellpoint Medicaid Managed Care	$0.61

AVAPRO,150MG,TAB

Facility

$3.00

Hospital Charge Code	60635455
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

AVAPRO,150MG,TAB

Facility

$3.00

Hospital Charge Code	60635455
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

AVAPRO,300MG,TAB

Facility

$3.00

Hospital Charge Code	60635456
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

AVAPRO,300MG,TAB

Facility

$3.00

Hospital Charge Code	60635456
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

AVAPRO, 75MG,TAB

Facility

$2.00

Hospital Charge Code	60635454
Hospital Revenue Code	250
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$1.00
Rate for Payer: Aetna Commercial	$0.76
Rate for Payer: Aetna Medicare Advantage	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.51
Rate for Payer: Cigna Commercial	$1.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.60
Rate for Payer: Oxford Commercial	$0.40
Rate for Payer: Qualcare PPO/HMO/WC	$0.30
Rate for Payer: UnitedHealthcare Commercial	$0.40
Rate for Payer: UnitedHealthcare Community & State	$0.05
Rate for Payer: Wellpoint Medicaid Managed Care	$0.05

AVAPRO, 75MG,TAB

Facility

$2.00

Hospital Charge Code	60635454
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.30

AVC 15%/120GM

Facility

$135.00

Hospital Charge Code	60632515
Hospital Revenue Code	250
Min. Negotiated Rate	$20.25
Max. Negotiated Rate	$20.25
Rate for Payer: Qualcare PPO/HMO/WC	$20.25

AVC 15%/120GM

Facility

$135.00

Hospital Charge Code	60632515
Hospital Revenue Code	250
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$67.50
Rate for Payer: Aetna Commercial	$51.30
Rate for Payer: Aetna Medicare Advantage	$40.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.42
Rate for Payer: Cigna Commercial	$67.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.50
Rate for Payer: Oxford Commercial	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.25
Rate for Payer: UnitedHealthcare Commercial	$27.00
Rate for Payer: UnitedHealthcare Community & State	$3.25
Rate for Payer: Wellpoint Medicaid Managed Care	$3.58

AVC VAGINAL CREAM

Facility

$124.00

Hospital Charge Code	60635346
Hospital Revenue Code	250
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$62.00
Rate for Payer: Aetna Commercial	$47.12
Rate for Payer: Aetna Medicare Advantage	$37.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.62
Rate for Payer: Cigna Commercial	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.20
Rate for Payer: Oxford Commercial	$24.80
Rate for Payer: Qualcare PPO/HMO/WC	$18.60
Rate for Payer: UnitedHealthcare Commercial	$24.80
Rate for Payer: UnitedHealthcare Community & State	$2.99
Rate for Payer: Wellpoint Medicaid Managed Care	$3.29

Know your out-of-pocket cost for care.

All Charges