Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

Vitamin D, 25-Hydroxy

Facility

$667.59

Service Code	HCPCS 82306
Hospital Charge Code	39888005
Hospital Revenue Code	301
Min. Negotiated Rate	$17.69
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$80.51
Rate for Payer: Aetna Medicare Advantage	$95.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.85
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$29.60
Rate for Payer: Clover Medicare Advantage	$28.12
Rate for Payer: EmblemHealth Commercial	$88.80
Rate for Payer: Humana Medicare Advantage	$30.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$29.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$23.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.60
Rate for Payer: Wellcare Medicare Advantage	$29.60
Rate for Payer: Wellpoint Medicaid Managed Care	$17.69

VITAMIN D, 25 HYDROXY

Facility

$390.00

Service Code	HCPCS 82306
Hospital Charge Code	39900050
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

VITAMIN D, 25 HYDROXY

Facility

$390.00

Service Code	HCPCS 82306
Hospital Charge Code	39900050
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$80.51
Rate for Payer: Aetna Medicare Advantage	$95.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.85
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$29.60
Rate for Payer: Clover Medicare Advantage	$28.12
Rate for Payer: EmblemHealth Commercial	$88.80
Rate for Payer: Humana Medicare Advantage	$30.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$29.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$23.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.60
Rate for Payer: Wellcare Medicare Advantage	$29.60
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

VITAMIN D, 25 HYDROXY***

Facility

$252.00

Hospital Charge Code	3010634
Hospital Revenue Code	301
Min. Negotiated Rate	$6.07
Max. Negotiated Rate	$126.00
Rate for Payer: Aetna Commercial	$95.76
Rate for Payer: Aetna Medicare Advantage	$75.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.26
Rate for Payer: Cigna Commercial	$126.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.80
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.07
Rate for Payer: Wellpoint Medicaid Managed Care	$6.68

VITAMIN D, 25 HYDROXY***

Facility

$252.00

Hospital Charge Code	3010634
Hospital Revenue Code	301
Min. Negotiated Rate	$37.80
Max. Negotiated Rate	$37.80
Rate for Payer: Qualcare PPO/HMO/WC	$37.80

VITAMIN D, 25-HYDROXY

Facility

$278.45

Service Code	HCPCS 82306
Hospital Charge Code	3000635
Hospital Revenue Code	301
Min. Negotiated Rate	$41.77
Max. Negotiated Rate	$41.77
Rate for Payer: Qualcare PPO/HMO/WC	$41.77

VITAMIN D, 25-HYDROXY

Facility

$278.45

Service Code	HCPCS 82306
Hospital Charge Code	3000635
Hospital Revenue Code	301
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$139.22
Rate for Payer: Aetna Commercial	$80.51
Rate for Payer: Aetna Medicare Advantage	$95.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.85
Rate for Payer: Cigna Commercial	$139.22
Rate for Payer: Cigna Medicare Advantage	$29.60
Rate for Payer: Clover Medicare Advantage	$28.12
Rate for Payer: EmblemHealth Commercial	$88.80
Rate for Payer: Humana Medicare Advantage	$30.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$29.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.53
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.77
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$23.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.60
Rate for Payer: Wellcare Medicare Advantage	$29.60
Rate for Payer: Wellpoint Medicaid Managed Care	$7.38

VITAMIN D 25 - HYDROXY

Facility

$618.80

Service Code	HCPCS 82306
Hospital Charge Code	38472040
Hospital Revenue Code	301
Min. Negotiated Rate	$16.40
Max. Negotiated Rate	$309.40
Rate for Payer: Aetna Commercial	$80.51
Rate for Payer: Aetna Medicare Advantage	$95.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.85
Rate for Payer: Cigna Commercial	$309.40
Rate for Payer: Cigna Medicare Advantage	$29.60
Rate for Payer: Clover Medicare Advantage	$28.12
Rate for Payer: EmblemHealth Commercial	$88.80
Rate for Payer: Humana Medicare Advantage	$30.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$29.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.64
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$92.82
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$23.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.60
Rate for Payer: Wellcare Medicare Advantage	$29.60
Rate for Payer: Wellpoint Medicaid Managed Care	$16.40

VITAMIN D 25 - HYDROXY

Facility

$618.80

Service Code	HCPCS 82306
Hospital Charge Code	38472040
Hospital Revenue Code	301
Min. Negotiated Rate	$92.82
Max. Negotiated Rate	$92.82
Rate for Payer: Qualcare PPO/HMO/WC	$92.82

VITAMIN D, 25-OH, LCMSMS

Facility

$278.45

Service Code	HCPCS 82306
Hospital Charge Code	3035110
Hospital Revenue Code	301
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$139.22
Rate for Payer: Aetna Commercial	$80.51
Rate for Payer: Aetna Medicare Advantage	$95.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.85
Rate for Payer: Cigna Commercial	$139.22
Rate for Payer: Cigna Medicare Advantage	$29.60
Rate for Payer: Clover Medicare Advantage	$28.12
Rate for Payer: EmblemHealth Commercial	$88.80
Rate for Payer: Humana Medicare Advantage	$30.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$29.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.53
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.77
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$23.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.60
Rate for Payer: Wellcare Medicare Advantage	$29.60
Rate for Payer: Wellpoint Medicaid Managed Care	$7.38

VITAMIN D, 25-OH, LCMSMS

Facility

$278.45

Service Code	HCPCS 82306
Hospital Charge Code	3035110
Hospital Revenue Code	301
Min. Negotiated Rate	$41.77
Max. Negotiated Rate	$41.77
Rate for Payer: Qualcare PPO/HMO/WC	$41.77

VITAMIN D3 5000IU 125MCG TAB

Facility

$4.00

Service Code	NDC 7610017840
Hospital Charge Code	606390340
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

VITAMIN D3 5000IU 125MCG TAB

Facility

$4.00

Service Code	NDC 7610017840
Hospital Charge Code	606390340
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

VITAMIN D/50,000U

Facility

$3.00

Hospital Charge Code	60634795
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

VITAMIN D/50,000U

Facility

$3.00

Hospital Charge Code	60634795
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

VITAMIN D (CALCIFEROL)

Facility

$278.45

Service Code	HCPCS 82306
Hospital Charge Code	3007788
Hospital Revenue Code	301
Min. Negotiated Rate	$41.77
Max. Negotiated Rate	$41.77
Rate for Payer: Qualcare PPO/HMO/WC	$41.77

VITAMIN D (CALCIFEROL)

Facility

$278.45

Service Code	HCPCS 82306
Hospital Charge Code	3007788
Hospital Revenue Code	301
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$139.22
Rate for Payer: Aetna Commercial	$80.51
Rate for Payer: Aetna Medicare Advantage	$95.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.85
Rate for Payer: Cigna Commercial	$139.22
Rate for Payer: Cigna Medicare Advantage	$29.60
Rate for Payer: Clover Medicare Advantage	$28.12
Rate for Payer: EmblemHealth Commercial	$88.80
Rate for Payer: Humana Medicare Advantage	$30.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$29.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.53
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.77
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$23.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.60
Rate for Payer: Wellcare Medicare Advantage	$29.60
Rate for Payer: Wellpoint Medicaid Managed Care	$7.38

VITAMIN D TAB 400 IU

Facility

$4.00

Service Code	NDC 43292055881
Hospital Charge Code	60628737
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

VITAMIN D TAB 400 IU

Facility

$4.00

Service Code	NDC 43292055881
Hospital Charge Code	60628737
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

VITAMIN E

Facility

$390.00

Service Code	HCPCS 84446
Hospital Charge Code	39900143
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

VITAMIN E

Facility

$390.00

Service Code	HCPCS 84446
Hospital Charge Code	39900143
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$38.57
Rate for Payer: Aetna Medicare Advantage	$45.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.19
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$14.18
Rate for Payer: Clover Medicare Advantage	$13.47
Rate for Payer: EmblemHealth Commercial	$42.54
Rate for Payer: Humana Medicare Advantage	$14.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.18
Rate for Payer: Wellcare Medicare Advantage	$14.18
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

VITAMIN E

Facility

$236.00

Service Code	HCPCS 84446
Hospital Charge Code	38472701
Hospital Revenue Code	301
Min. Negotiated Rate	$6.25
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$38.57
Rate for Payer: Aetna Medicare Advantage	$45.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.19
Rate for Payer: Cigna Commercial	$118.00
Rate for Payer: Cigna Medicare Advantage	$14.18
Rate for Payer: Clover Medicare Advantage	$13.47
Rate for Payer: EmblemHealth Commercial	$42.54
Rate for Payer: Humana Medicare Advantage	$14.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.18
Rate for Payer: Wellcare Medicare Advantage	$14.18
Rate for Payer: Wellpoint Medicaid Managed Care	$6.25

VITAMIN E

Facility

$236.00

Service Code	HCPCS 84446
Hospital Charge Code	38472701
Hospital Revenue Code	301
Min. Negotiated Rate	$35.40
Max. Negotiated Rate	$35.40
Rate for Payer: Qualcare PPO/HMO/WC	$35.40

VITAMIN E 100 IU SGL

Facility

$4.00

Service Code	NDC 904027060
Hospital Charge Code	6063943261
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

VITAMIN E 100 IU SGL

Facility

$4.00

Service Code	NDC 904027060
Hospital Charge Code	6063943261
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

Know your out-of-pocket cost for care.

All Charges