Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

VALSARTAN 80 MG TAB

Facility

$8.00

Hospital Charge Code	60629228
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

VALSARTAN 80 MG TAB

Facility

$8.00

Hospital Charge Code	60629228
Hospital Revenue Code	250
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

VALSARTAN CAP 80MG

Facility

$12.00

Service Code	HCPCS J8499
Hospital Charge Code	60628734
Hospital Revenue Code	250
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$4.56
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.60
Rate for Payer: Oxford Commercial	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$2.40
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

VALSARTAN CAP 80MG

Facility

$12.00

Service Code	HCPCS J8499
Hospital Charge Code	60628734
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

VALSARTAN (DIOVAN) 320MG TAB

Facility

$33.03

Service Code	NDC 78036034
Hospital Charge Code	60630147
Hospital Revenue Code	250
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$4.95
Rate for Payer: Qualcare PPO/HMO/WC	$4.95

VALSARTAN (DIOVAN) 320MG TAB

Facility

$33.03

Service Code	NDC 78036034
Hospital Charge Code	60630147
Hospital Revenue Code	250
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$16.52
Rate for Payer: Aetna Commercial	$12.55
Rate for Payer: Aetna Medicare Advantage	$9.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.42
Rate for Payer: Cigna Commercial	$16.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.91
Rate for Payer: Oxford Commercial	$6.61
Rate for Payer: Qualcare PPO/HMO/WC	$4.95
Rate for Payer: UnitedHealthcare Commercial	$6.61
Rate for Payer: UnitedHealthcare Community & State	$0.80
Rate for Payer: Wellpoint Medicaid Managed Care	$0.88

VAL SCREW TI 2.4 10MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270690417
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

VAL SCREW TI 2.4 10MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270690417
Hospital Revenue Code	278
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

VALTREX 500MG/TAB

Facility

$6.00

Hospital Charge Code	60635412
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$2.28
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.80
Rate for Payer: Oxford Commercial	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.20
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

VALTREX 500MG/TAB

Facility

$6.00

Hospital Charge Code	60635412
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

VALUEAIR WATER SUCTION BIOPSY

Facility

$28.00

Hospital Charge Code	270700336
Hospital Revenue Code	272
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

VALUEAIR WATER SUCTION BIOPSY

Facility

$28.00

Hospital Charge Code	270700336
Hospital Revenue Code	272
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$14.00
Rate for Payer: Aetna Commercial	$10.64
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.40
Rate for Payer: Oxford Commercial	$5.60
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$5.60
Rate for Payer: UnitedHealthcare Community & State	$0.67
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

VALUE PASSY-MUIR AQUA

Facility

$348.54

Hospital Charge Code	270633316
Hospital Revenue Code	270
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$174.27
Rate for Payer: Aetna Commercial	$132.45
Rate for Payer: Aetna Medicare Advantage	$104.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.88
Rate for Payer: Cigna Commercial	$174.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.56
Rate for Payer: Oxford Commercial	$69.71
Rate for Payer: Qualcare PPO/HMO/WC	$52.28
Rate for Payer: UnitedHealthcare Commercial	$69.71
Rate for Payer: UnitedHealthcare Community & State	$8.40
Rate for Payer: Wellpoint Medicaid Managed Care	$9.24

VALUE PASSY-MUIR AQUA

Facility

$348.54

Hospital Charge Code	270633316
Hospital Revenue Code	270
Min. Negotiated Rate	$52.28
Max. Negotiated Rate	$52.28
Rate for Payer: Qualcare PPO/HMO/WC	$52.28

VALVE ACCESSPLUS ANGIO KIT LG

Facility

$33.28

Hospital Charge Code	270637998S
Hospital Revenue Code	272
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$16.64
Rate for Payer: Aetna Commercial	$12.65
Rate for Payer: Aetna Medicare Advantage	$9.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.49
Rate for Payer: Cigna Commercial	$16.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.98
Rate for Payer: Oxford Commercial	$6.66
Rate for Payer: Qualcare PPO/HMO/WC	$4.99
Rate for Payer: UnitedHealthcare Commercial	$6.66
Rate for Payer: UnitedHealthcare Community & State	$0.80
Rate for Payer: Wellpoint Medicaid Managed Care	$0.88

VALVE ACCESSPLUS ANGIO KIT LG

Facility

$33.28

Hospital Charge Code	270637998S
Hospital Revenue Code	272
Min. Negotiated Rate	$4.99
Max. Negotiated Rate	$4.99
Rate for Payer: Qualcare PPO/HMO/WC	$4.99

VALVE BIOPSY SINGLE USE

Facility

$22.00

Hospital Charge Code	270654385
Hospital Revenue Code	272
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$3.30
Rate for Payer: Qualcare PPO/HMO/WC	$3.30

VALVE BIOPSY SINGLE USE

Facility

$372.50

Hospital Charge Code	270651525
Hospital Revenue Code	272
Min. Negotiated Rate	$55.88
Max. Negotiated Rate	$55.88
Rate for Payer: Qualcare PPO/HMO/WC	$55.88

VALVE BIOPSY SINGLE USE

Facility

$372.50

Hospital Charge Code	270651525
Hospital Revenue Code	272
Min. Negotiated Rate	$8.98
Max. Negotiated Rate	$186.25
Rate for Payer: Aetna Commercial	$141.55
Rate for Payer: Aetna Medicare Advantage	$111.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.99
Rate for Payer: Cigna Commercial	$186.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.75
Rate for Payer: Oxford Commercial	$74.50
Rate for Payer: Qualcare PPO/HMO/WC	$55.88
Rate for Payer: UnitedHealthcare Commercial	$74.50
Rate for Payer: UnitedHealthcare Community & State	$8.98
Rate for Payer: Wellpoint Medicaid Managed Care	$9.87

VALVE BIOPSY SINGLE USE

Facility

$22.00

Hospital Charge Code	270654385
Hospital Revenue Code	272
Min. Negotiated Rate	$0.53
Max. Negotiated Rate	$11.00
Rate for Payer: Aetna Commercial	$8.36
Rate for Payer: Aetna Medicare Advantage	$6.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.61
Rate for Payer: Cigna Commercial	$11.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.60
Rate for Payer: Oxford Commercial	$4.40
Rate for Payer: Qualcare PPO/HMO/WC	$3.30
Rate for Payer: UnitedHealthcare Commercial	$4.40
Rate for Payer: UnitedHealthcare Community & State	$0.53
Rate for Payer: Wellpoint Medicaid Managed Care	$0.58

VALVE CHEST DRAIN PNEWMOSTAT

Facility

$164.00

Hospital Charge Code	270664233
Hospital Revenue Code	272
Min. Negotiated Rate	$24.60
Max. Negotiated Rate	$24.60
Rate for Payer: Qualcare PPO/HMO/WC	$24.60

VALVE CHEST DRAIN PNEWMOSTAT

Facility

$164.00

Hospital Charge Code	270664233
Hospital Revenue Code	272
Min. Negotiated Rate	$3.95
Max. Negotiated Rate	$82.00
Rate for Payer: Aetna Commercial	$62.32
Rate for Payer: Aetna Medicare Advantage	$49.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.82
Rate for Payer: Cigna Commercial	$82.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.20
Rate for Payer: Oxford Commercial	$32.80
Rate for Payer: Qualcare PPO/HMO/WC	$24.60
Rate for Payer: UnitedHealthcare Commercial	$32.80
Rate for Payer: UnitedHealthcare Community & State	$3.95
Rate for Payer: Wellpoint Medicaid Managed Care	$4.35

VALVE CODM CERTAS PL INLINE SM

Facility

$30,120.00

Service Code	HCPCS C1889
Hospital Charge Code	270698460
Hospital Revenue Code	278
Min. Negotiated Rate	$725.89
Max. Negotiated Rate	$15,060.00
Rate for Payer: Aetna Commercial	$11,445.60
Rate for Payer: Aetna Medicare Advantage	$9,036.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,680.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,680.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,024.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,680.60
Rate for Payer: Cigna Commercial	$15,060.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,289.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,626.40
Rate for Payer: Qualcare PPO/HMO/WC	$4,518.00
Rate for Payer: UnitedHealthcare Community & State	$725.89
Rate for Payer: Wellpoint Medicaid Managed Care	$798.18

VALVE CODM CERTAS PL INLINE SM

Facility

$30,120.00

Service Code	HCPCS C1889
Hospital Charge Code	270698460
Hospital Revenue Code	278
Min. Negotiated Rate	$4,518.00
Max. Negotiated Rate	$7,289.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,024.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,289.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,626.40
Rate for Payer: Qualcare PPO/HMO/WC	$4,518.00

VALVE CONT LOWLOWPRE CSF SHUNT

Facility

$5,635.00

Service Code	HCPCS L8699
Hospital Charge Code	270698772
Hospital Revenue Code	278
Min. Negotiated Rate	$135.80
Max. Negotiated Rate	$2,817.50
Rate for Payer: Aetna Commercial	$2,141.30
Rate for Payer: Aetna Medicare Advantage	$1,690.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,436.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,436.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,127.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,436.92
Rate for Payer: Cigna Commercial	$2,817.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,363.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,239.70
Rate for Payer: Qualcare PPO/HMO/WC	$845.25
Rate for Payer: UnitedHealthcare Community & State	$135.80
Rate for Payer: Wellpoint Medicaid Managed Care	$149.33

Know your out-of-pocket cost for care.

All Charges