Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

VENOUS MECH THROMBECTOMY

Facility

$20,340.00

Service Code	HCPCS 37187
Hospital Charge Code	16000953
Hospital Revenue Code	360
Min. Negotiated Rate	$3,051.00
Max. Negotiated Rate	$3,051.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,051.00

VENOUS OUTFLOW COMPONENT

Facility

$9,775.00

Hospital Charge Code	270645659
Hospital Revenue Code	278
Min. Negotiated Rate	$235.58
Max. Negotiated Rate	$4,887.50
Rate for Payer: Aetna Commercial	$3,714.50
Rate for Payer: Aetna Medicare Advantage	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,492.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,492.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,955.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,492.62
Rate for Payer: Cigna Commercial	$4,887.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,365.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,150.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,466.25
Rate for Payer: UnitedHealthcare Community & State	$235.58
Rate for Payer: Wellpoint Medicaid Managed Care	$259.04

VENOUS OUTFLOW COMPONENT

Facility

$9,775.00

Hospital Charge Code	270645659
Hospital Revenue Code	278
Min. Negotiated Rate	$1,466.25
Max. Negotiated Rate	$2,365.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,955.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,365.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,150.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,466.25

VENOUS PVR

Facility

$551.00

Hospital Charge Code	2692065
Hospital Revenue Code	921
Min. Negotiated Rate	$13.28
Max. Negotiated Rate	$6,760.00
Rate for Payer: Aetna Commercial	$209.38
Rate for Payer: Aetna Medicare Advantage	$165.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.50
Rate for Payer: Cigna Commercial	$275.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.30
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.65
Rate for Payer: UnitedHealthcare Commercial	$6,760.00
Rate for Payer: UnitedHealthcare Community & State	$13.28
Rate for Payer: Wellpoint Medicaid Managed Care	$14.60

VENOUS PVR

Facility

$551.00

Hospital Charge Code	2692065
Hospital Revenue Code	921
Min. Negotiated Rate	$82.65
Max. Negotiated Rate	$82.65
Rate for Payer: Qualcare PPO/HMO/WC	$82.65

VENOUS VAS FAMILY OTHER 1&2ORD

Facility

$331.55

Service Code	HCPCS 36012
Hospital Charge Code	5100573
Hospital Revenue Code	361
Min. Negotiated Rate	$7.99
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$125.99
Rate for Payer: Aetna Medicare Advantage	$99.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.55
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	$84.55
Rate for Payer: Cigna Commercial	$165.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.47
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.73
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$7.99
Rate for Payer: Wellpoint Medicaid Managed Care	$8.79

VENOUS VAS FAMILY OTHER 1&2ORD

Facility

$331.55

Service Code	HCPCS 36012
Hospital Charge Code	5100573
Hospital Revenue Code	361
Min. Negotiated Rate	$49.73
Max. Negotiated Rate	$49.73
Rate for Payer: Qualcare PPO/HMO/WC	$49.73

VENTANA C INTERBODY 14X11X6MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704423
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

VENTANA C INTERBODY 14X11X6MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704423
Hospital Revenue Code	278
Min. Negotiated Rate	$132.55
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Community & State	$132.55
Rate for Payer: Wellpoint Medicaid Managed Care	$145.75

VENT CIRCUIT W/MR290 DUAL HEAT

Facility

$128.12

Hospital Charge Code	270648118
Hospital Revenue Code	272
Min. Negotiated Rate	$19.22
Max. Negotiated Rate	$19.22
Rate for Payer: Qualcare PPO/HMO/WC	$19.22

VENT CIRCUIT W/MR290 DUAL HEAT

Facility

$128.12

Hospital Charge Code	270648118
Hospital Revenue Code	272
Min. Negotiated Rate	$3.09
Max. Negotiated Rate	$64.06
Rate for Payer: Aetna Commercial	$48.69
Rate for Payer: Aetna Medicare Advantage	$38.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.67
Rate for Payer: Cigna Commercial	$64.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.44
Rate for Payer: Oxford Commercial	$25.62
Rate for Payer: Qualcare PPO/HMO/WC	$19.22
Rate for Payer: UnitedHealthcare Commercial	$25.62
Rate for Payer: UnitedHealthcare Community & State	$3.09
Rate for Payer: Wellpoint Medicaid Managed Care	$3.40

VENTILATOR ASSIST AND MANAGEM

Facility

$2,375.50

Service Code	HCPCS 94002
Hospital Charge Code	1600000668
Hospital Revenue Code	360
Min. Negotiated Rate	$57.25
Max. Negotiated Rate	$2,649.34
Rate for Payer: Aetna Commercial	$1,996.34
Rate for Payer: Aetna Medicare Advantage	$2,378.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,649.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,649.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$733.95
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	$2,649.34
Rate for Payer: Cigna Commercial	$1,471.21
Rate for Payer: Cigna Medicare Advantage	$733.95
Rate for Payer: Clover Medicare Advantage	$697.25
Rate for Payer: EmblemHealth Commercial	$2,201.85
Rate for Payer: Humana Medicare Advantage	$755.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$733.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$712.65
Rate for Payer: Qualcare PPO/HMO/WC	$356.32
Rate for Payer: UnitedHealthcare Community & State	$57.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$733.95
Rate for Payer: Wellcare Medicare Advantage	$733.95
Rate for Payer: Wellpoint Medicaid Managed Care	$62.95

VENTILATOR ASSIST AND MANAGEM

Facility

$2,375.50

Service Code	HCPCS 94002
Hospital Charge Code	1600000668
Hospital Revenue Code	360
Min. Negotiated Rate	$356.32
Max. Negotiated Rate	$356.32
Rate for Payer: Qualcare PPO/HMO/WC	$356.32

VENTILATOR MGMT ADULT - SUBSEQ

Facility

$2,375.50

Service Code	HCPCS 94003
Hospital Charge Code	1600000669
Hospital Revenue Code	360
Min. Negotiated Rate	$57.25
Max. Negotiated Rate	$2,649.34
Rate for Payer: Aetna Commercial	$1,996.34
Rate for Payer: Aetna Medicare Advantage	$2,378.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,649.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,649.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$733.95
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	$2,649.34
Rate for Payer: Cigna Commercial	$1,471.21
Rate for Payer: Cigna Medicare Advantage	$733.95
Rate for Payer: Clover Medicare Advantage	$697.25
Rate for Payer: EmblemHealth Commercial	$2,201.85
Rate for Payer: Humana Medicare Advantage	$755.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$733.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$712.65
Rate for Payer: Qualcare PPO/HMO/WC	$356.32
Rate for Payer: UnitedHealthcare Community & State	$57.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$733.95
Rate for Payer: Wellcare Medicare Advantage	$733.95
Rate for Payer: Wellpoint Medicaid Managed Care	$62.95

VENTILATOR MGMT ADULT - SUBSEQ

Facility

$2,375.50

Service Code	HCPCS 94003
Hospital Charge Code	1600000669
Hospital Revenue Code	360
Min. Negotiated Rate	$356.32
Max. Negotiated Rate	$356.32
Rate for Payer: Qualcare PPO/HMO/WC	$356.32

Ventiscan Kit

Facility

$2,421.17

Hospital Charge Code	4509092
Hospital Revenue Code	270
Min. Negotiated Rate	$363.18
Max. Negotiated Rate	$363.18
Rate for Payer: Qualcare PPO/HMO/WC	$363.18

Ventiscan Kit

Facility

$2,421.17

Hospital Charge Code	4509092
Hospital Revenue Code	270
Min. Negotiated Rate	$58.35
Max. Negotiated Rate	$1,210.59
Rate for Payer: Aetna Commercial	$920.04
Rate for Payer: Aetna Medicare Advantage	$726.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$617.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$617.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$617.40
Rate for Payer: Cigna Commercial	$1,210.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.35
Rate for Payer: Oxford Commercial	$484.23
Rate for Payer: Qualcare PPO/HMO/WC	$363.18
Rate for Payer: UnitedHealthcare Commercial	$484.23
Rate for Payer: UnitedHealthcare Community & State	$58.35
Rate for Payer: Wellpoint Medicaid Managed Care	$64.16

VENTOLIN 0.5%/5MG/1ML

Facility

$65.00

Hospital Charge Code	60634147
Hospital Revenue Code	250
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$9.75
Rate for Payer: Qualcare PPO/HMO/WC	$9.75

VENTOLIN 0.5%/5MG/1ML

Facility

$65.00

Hospital Charge Code	60634147
Hospital Revenue Code	250
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$32.50
Rate for Payer: Aetna Commercial	$24.70
Rate for Payer: Aetna Medicare Advantage	$19.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.57
Rate for Payer: Cigna Commercial	$32.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$13.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.75
Rate for Payer: UnitedHealthcare Commercial	$13.00
Rate for Payer: UnitedHealthcare Community & State	$1.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1.72

VENTOLIN/17GM

Facility

$118.00

Hospital Charge Code	60634142
Hospital Revenue Code	250
Min. Negotiated Rate	$2.84
Max. Negotiated Rate	$59.00
Rate for Payer: Aetna Commercial	$44.84
Rate for Payer: Aetna Medicare Advantage	$35.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.09
Rate for Payer: Cigna Commercial	$59.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.40
Rate for Payer: Oxford Commercial	$23.60
Rate for Payer: Qualcare PPO/HMO/WC	$17.70
Rate for Payer: UnitedHealthcare Commercial	$23.60
Rate for Payer: UnitedHealthcare Community & State	$2.84
Rate for Payer: Wellpoint Medicaid Managed Care	$3.13

VENTOLIN/17GM

Facility

$118.00

Hospital Charge Code	60634142
Hospital Revenue Code	250
Min. Negotiated Rate	$17.70
Max. Negotiated Rate	$17.70
Rate for Payer: Qualcare PPO/HMO/WC	$17.70

VENTOLIN/2MG/5ML

Facility

$4.00

Hospital Charge Code	60634146
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

VENTOLIN/2MG/5ML

Facility

$4.00

Hospital Charge Code	60634146
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

VENTOLIN/2MG/TAB

Facility

$3.00

Hospital Charge Code	60634143
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

VENTOLIN/2MG/TAB

Facility

$3.00

Hospital Charge Code	60634143
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