Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

VASCULAR LINEAR STAPLER 30MM

Facility

$172.00

Hospital Charge Code	270338702
Hospital Revenue Code	272
Min. Negotiated Rate	$25.80
Max. Negotiated Rate	$25.80
Rate for Payer: Qualcare PPO/HMO/WC	$25.80

VASCULAR STUDY ABDOMEN SMA

Facility

$17,200.00

Service Code	HCPCS 93976
Hospital Charge Code	2692175
Hospital Revenue Code	921
Min. Negotiated Rate	$117.99
Max. Negotiated Rate	$6,760.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$551.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$124.20
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,160.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$6,760.00
Rate for Payer: UnitedHealthcare Community & State	$414.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$455.80

VASCULAR STUDY ABDOMEN SMA

Facility

$17,200.00

Service Code	HCPCS 93976
Hospital Charge Code	2692175
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

VASCULAR STUDY COM

Facility

$17,200.00

Service Code	HCPCS 93975
Hospital Charge Code	94061203
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

VASCULAR STUDY COM

Facility

$17,200.00

Service Code	HCPCS 93975
Hospital Charge Code	94061203
Hospital Revenue Code	921
Min. Negotiated Rate	$269.30
Max. Negotiated Rate	$6,760.00
Rate for Payer: Aetna Commercial	$771.04
Rate for Payer: Aetna Medicare Advantage	$918.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$283.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,023.24
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: Cigna Medicare Advantage	$283.47
Rate for Payer: Clover Medicare Advantage	$269.30
Rate for Payer: EmblemHealth Commercial	$850.41
Rate for Payer: Humana Medicare Advantage	$291.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$283.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,160.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$6,760.00
Rate for Payer: UnitedHealthcare Community & State	$414.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$455.80

VASCULAR SURGERY PROCEDURE

Facility

$3,327.75

Service Code	HCPCS 37799
Hospital Charge Code	421037799
Hospital Revenue Code	761
Min. Negotiated Rate	$499.16
Max. Negotiated Rate	$499.16
Rate for Payer: Qualcare PPO/HMO/WC	$499.16

VASCULAR SURGERY PROCEDURE

Facility

$3,327.75

Service Code	HCPCS 37799
Hospital Charge Code	421037799
Hospital Revenue Code	761
Min. Negotiated Rate	$80.20
Max. Negotiated Rate	$2,690.13
Rate for Payer: Aetna Commercial	$2,027.08
Rate for Payer: Aetna Medicare Advantage	$2,414.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,690.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,690.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$745.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,690.13
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: Cigna Medicare Advantage	$745.25
Rate for Payer: Clover Medicare Advantage	$707.99
Rate for Payer: EmblemHealth Commercial	$2,235.75
Rate for Payer: Humana Medicare Advantage	$767.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$745.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$998.33
Rate for Payer: Oxford Commercial	$665.55
Rate for Payer: Qualcare PPO/HMO/WC	$499.16
Rate for Payer: UnitedHealthcare Commercial	$665.55
Rate for Payer: UnitedHealthcare Community & State	$80.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$745.25
Rate for Payer: Wellcare Medicare Advantage	$745.25
Rate for Payer: Wellpoint Medicaid Managed Care	$88.19

VASCULAR SURGERY PROCEDURE

Facility

$2,450.28

Service Code	HCPCS 37799
Hospital Charge Code	5600123
Hospital Revenue Code	361
Min. Negotiated Rate	$59.05
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,027.08
Rate for Payer: Aetna Medicare Advantage	$2,414.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,690.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,690.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$745.25
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	$2,690.13
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: Cigna Medicare Advantage	$745.25
Rate for Payer: Clover Medicare Advantage	$707.99
Rate for Payer: EmblemHealth Commercial	$2,235.75
Rate for Payer: Humana Medicare Advantage	$767.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$745.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$735.08
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$367.54
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$59.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$745.25
Rate for Payer: Wellcare Medicare Advantage	$745.25
Rate for Payer: Wellpoint Medicaid Managed Care	$64.93

VASCULAR SURGERY PROCEDURE

Facility

$2,450.28

Service Code	HCPCS 37799
Hospital Charge Code	5600123
Hospital Revenue Code	361
Min. Negotiated Rate	$367.54
Max. Negotiated Rate	$367.54
Rate for Payer: Qualcare PPO/HMO/WC	$367.54

VASCULAR SURGERY PROCEDURE

Facility

$2,450.28

Service Code	HCPCS 37799
Hospital Charge Code	16000385
Hospital Revenue Code	360
Min. Negotiated Rate	$367.54
Max. Negotiated Rate	$367.54
Rate for Payer: Qualcare PPO/HMO/WC	$367.54

VASCULAR SURGERY PROCEDURE

Facility

$2,450.28

Service Code	HCPCS 37799
Hospital Charge Code	16000385
Hospital Revenue Code	360
Min. Negotiated Rate	$59.05
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,027.08
Rate for Payer: Aetna Medicare Advantage	$2,414.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,690.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,690.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$745.25
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	$2,690.13
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: Cigna Medicare Advantage	$745.25
Rate for Payer: Clover Medicare Advantage	$707.99
Rate for Payer: EmblemHealth Commercial	$2,235.75
Rate for Payer: Humana Medicare Advantage	$767.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$745.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$735.08
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$367.54
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$59.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$745.25
Rate for Payer: Wellcare Medicare Advantage	$745.25
Rate for Payer: Wellpoint Medicaid Managed Care	$64.93

VASECTOMY

Facility

$20,610.70

Service Code	HCPCS 55250
Hospital Charge Code	1600000320
Hospital Revenue Code	360
Min. Negotiated Rate	$3,091.61
Max. Negotiated Rate	$3,091.61
Rate for Payer: Qualcare PPO/HMO/WC	$3,091.61

VASECTOMY

Facility

$20,610.70

Service Code	HCPCS 55250
Hospital Charge Code	1600000320
Hospital Revenue Code	360
Min. Negotiated Rate	$496.72
Max. Negotiated Rate	$8,964.44
Rate for Payer: Aetna Commercial	$6,754.93
Rate for Payer: Aetna Medicare Advantage	$8,046.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,964.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,964.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,483.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,964.44
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: Cigna Medicare Advantage	$2,483.43
Rate for Payer: Clover Medicare Advantage	$2,359.26
Rate for Payer: EmblemHealth Commercial	$7,450.29
Rate for Payer: Humana Medicare Advantage	$2,557.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,483.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,183.21
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,091.61
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$496.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,483.43
Rate for Payer: Wellcare Medicare Advantage	$2,483.43
Rate for Payer: Wellpoint Medicaid Managed Care	$546.18

VASELINE TUBEN*****

Facility

$25.00

Hospital Charge Code	8002149
Hospital Revenue Code	279
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

VASELINE TUBEN*****

Facility

$25.00

Hospital Charge Code	8002149
Hospital Revenue Code	279
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$12.50
Rate for Payer: Aetna Commercial	$9.50
Rate for Payer: Aetna Medicare Advantage	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.38
Rate for Payer: Cigna Commercial	$12.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.50
Rate for Payer: Oxford Commercial	$5.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$5.00
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

VASOACTIVE INTESTINAL POLYPEPT

Facility

$250.24

Service Code	HCPCS 84586
Hospital Charge Code	38472677
Hospital Revenue Code	301
Min. Negotiated Rate	$6.63
Max. Negotiated Rate	$127.53
Rate for Payer: Aetna Commercial	$96.10
Rate for Payer: Aetna Medicare Advantage	$114.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.53
Rate for Payer: Cigna Commercial	$125.12
Rate for Payer: Cigna Medicare Advantage	$35.33
Rate for Payer: Clover Medicare Advantage	$33.56
Rate for Payer: EmblemHealth Commercial	$105.99
Rate for Payer: Humana Medicare Advantage	$36.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.07
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.54
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$28.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.33
Rate for Payer: Wellcare Medicare Advantage	$35.33
Rate for Payer: Wellpoint Medicaid Managed Care	$6.63

VASOACTIVE INTESTINAL POLYPEPT

Facility

$250.24

Service Code	HCPCS 84586
Hospital Charge Code	38472677
Hospital Revenue Code	301
Min. Negotiated Rate	$37.54
Max. Negotiated Rate	$37.54
Rate for Payer: Qualcare PPO/HMO/WC	$37.54

VASOACTIVE INTEST PEPTID VIP

Facility

$256.00

Service Code	HCPCS 84586
Hospital Charge Code	3007721
Hospital Revenue Code	301
Min. Negotiated Rate	$6.78
Max. Negotiated Rate	$128.00
Rate for Payer: Aetna Commercial	$96.10
Rate for Payer: Aetna Medicare Advantage	$114.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.53
Rate for Payer: Cigna Commercial	$128.00
Rate for Payer: Cigna Medicare Advantage	$35.33
Rate for Payer: Clover Medicare Advantage	$33.56
Rate for Payer: EmblemHealth Commercial	$105.99
Rate for Payer: Humana Medicare Advantage	$36.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$28.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.33
Rate for Payer: Wellcare Medicare Advantage	$35.33
Rate for Payer: Wellpoint Medicaid Managed Care	$6.78

VASOACTIVE INTEST PEPTID VIP

Facility

$256.00

Service Code	HCPCS 84586
Hospital Charge Code	3007721
Hospital Revenue Code	301
Min. Negotiated Rate	$38.40
Max. Negotiated Rate	$38.40
Rate for Payer: Qualcare PPO/HMO/WC	$38.40

VASOCIDIN 0.25% OPHTH/5ML

Facility

$44.00

Hospital Charge Code	60634127
Hospital Revenue Code	250
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$22.00
Rate for Payer: Aetna Commercial	$16.72
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.20
Rate for Payer: Oxford Commercial	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$8.80
Rate for Payer: UnitedHealthcare Community & State	$1.06
Rate for Payer: Wellpoint Medicaid Managed Care	$1.17

VASOCIDIN 0.25% OPHTH/5ML

Facility

$44.00

Hospital Charge Code	60634127
Hospital Revenue Code	250
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

VASOCIDIN OPHTH OINT

Facility

$71.00

Hospital Charge Code	60634783
Hospital Revenue Code	250
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$10.65
Rate for Payer: Qualcare PPO/HMO/WC	$10.65

VASOCIDIN OPHTH OINT

Facility

$71.00

Hospital Charge Code	60634783
Hospital Revenue Code	250
Min. Negotiated Rate	$1.71
Max. Negotiated Rate	$35.50
Rate for Payer: Aetna Commercial	$26.98
Rate for Payer: Aetna Medicare Advantage	$21.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.11
Rate for Payer: Cigna Commercial	$35.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.30
Rate for Payer: Oxford Commercial	$14.20
Rate for Payer: Qualcare PPO/HMO/WC	$10.65
Rate for Payer: UnitedHealthcare Commercial	$14.20
Rate for Payer: UnitedHealthcare Community & State	$1.71
Rate for Payer: Wellpoint Medicaid Managed Care	$1.88

VASOCON/15ML

Facility

$89.00

Hospital Charge Code	60634546
Hospital Revenue Code	250
Min. Negotiated Rate	$13.35
Max. Negotiated Rate	$13.35
Rate for Payer: Qualcare PPO/HMO/WC	$13.35

VASOCON/15ML

Facility

$89.00

Hospital Charge Code	60634546
Hospital Revenue Code	250
Min. Negotiated Rate	$2.14
Max. Negotiated Rate	$44.50
Rate for Payer: Aetna Commercial	$33.82
Rate for Payer: Aetna Medicare Advantage	$26.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.70
Rate for Payer: Cigna Commercial	$44.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.70
Rate for Payer: Oxford Commercial	$17.80
Rate for Payer: Qualcare PPO/HMO/WC	$13.35
Rate for Payer: UnitedHealthcare Commercial	$17.80
Rate for Payer: UnitedHealthcare Community & State	$2.14
Rate for Payer: Wellpoint Medicaid Managed Care	$2.36

Know your out-of-pocket cost for care.

All Charges