Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

VLDL CHOLESTEROL

Facility

$125.75

Service Code	HCPCS 83719
Hospital Charge Code	3006459B
Hospital Revenue Code	301
Min. Negotiated Rate	$18.86
Max. Negotiated Rate	$18.86
Rate for Payer: Qualcare PPO/HMO/WC	$18.86

VLDL CHOLESTEROL

Facility

$125.75

Service Code	HCPCS 83719
Hospital Charge Code	3006459B
Hospital Revenue Code	301
Min. Negotiated Rate	$3.33
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$34.68
Rate for Payer: Aetna Medicare Advantage	$41.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.02
Rate for Payer: Cigna Commercial	$62.88
Rate for Payer: Cigna Medicare Advantage	$12.75
Rate for Payer: Clover Medicare Advantage	$12.11
Rate for Payer: EmblemHealth Commercial	$38.25
Rate for Payer: Humana Medicare Advantage	$13.13
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.86
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.75
Rate for Payer: Wellcare Medicare Advantage	$12.75
Rate for Payer: Wellpoint Medicaid Managed Care	$3.33

V-LOC 180 3-0 ENDO STITCH

Facility

$296.25

Hospital Charge Code	270692038
Hospital Revenue Code	272
Min. Negotiated Rate	$7.14
Max. Negotiated Rate	$148.12
Rate for Payer: Aetna Commercial	$112.58
Rate for Payer: Aetna Medicare Advantage	$88.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.54
Rate for Payer: Cigna Commercial	$148.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.88
Rate for Payer: Oxford Commercial	$59.25
Rate for Payer: Qualcare PPO/HMO/WC	$44.44
Rate for Payer: UnitedHealthcare Commercial	$59.25
Rate for Payer: UnitedHealthcare Community & State	$7.14
Rate for Payer: Wellpoint Medicaid Managed Care	$7.85

V-LOC 180 3-0 ENDO STITCH

Facility

$296.25

Hospital Charge Code	270692038
Hospital Revenue Code	272
Min. Negotiated Rate	$44.44
Max. Negotiated Rate	$44.44
Rate for Payer: Qualcare PPO/HMO/WC	$44.44

V-LOCK 90-DEGREE 22mm NL-22

Facility

$421.65

Hospital Charge Code	270635026
Hospital Revenue Code	272
Min. Negotiated Rate	$63.25
Max. Negotiated Rate	$63.25
Rate for Payer: Qualcare PPO/HMO/WC	$63.25

V-LOCK 90-DEGREE 22mm NL-22

Facility

$421.65

Hospital Charge Code	270635026
Hospital Revenue Code	272
Min. Negotiated Rate	$10.16
Max. Negotiated Rate	$210.82
Rate for Payer: Aetna Commercial	$160.23
Rate for Payer: Aetna Medicare Advantage	$126.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.52
Rate for Payer: Cigna Commercial	$210.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.50
Rate for Payer: Oxford Commercial	$84.33
Rate for Payer: Qualcare PPO/HMO/WC	$63.25
Rate for Payer: UnitedHealthcare Commercial	$84.33
Rate for Payer: UnitedHealthcare Community & State	$10.16
Rate for Payer: Wellpoint Medicaid Managed Care	$11.17

V-LOCK 90-DEGREE 24mm NL-24

Facility

$421.65

Hospital Charge Code	270635027
Hospital Revenue Code	272
Min. Negotiated Rate	$10.16
Max. Negotiated Rate	$210.82
Rate for Payer: Aetna Commercial	$160.23
Rate for Payer: Aetna Medicare Advantage	$126.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.52
Rate for Payer: Cigna Commercial	$210.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.50
Rate for Payer: Oxford Commercial	$84.33
Rate for Payer: Qualcare PPO/HMO/WC	$63.25
Rate for Payer: UnitedHealthcare Commercial	$84.33
Rate for Payer: UnitedHealthcare Community & State	$10.16
Rate for Payer: Wellpoint Medicaid Managed Care	$11.17

V-LOCK 90-DEGREE 24mm NL-24

Facility

$421.65

Hospital Charge Code	270635027
Hospital Revenue Code	272
Min. Negotiated Rate	$63.25
Max. Negotiated Rate	$63.25
Rate for Payer: Qualcare PPO/HMO/WC	$63.25

V-LOCK 90-DEGREE 28mm NL28

Facility

$421.65

Hospital Charge Code	270634965
Hospital Revenue Code	272
Min. Negotiated Rate	$63.25
Max. Negotiated Rate	$63.25
Rate for Payer: Qualcare PPO/HMO/WC	$63.25

V-LOCK 90-DEGREE 28mm NL28

Facility

$421.65

Hospital Charge Code	270634965
Hospital Revenue Code	272
Min. Negotiated Rate	$10.16
Max. Negotiated Rate	$210.82
Rate for Payer: Aetna Commercial	$160.23
Rate for Payer: Aetna Medicare Advantage	$126.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.52
Rate for Payer: Cigna Commercial	$210.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.50
Rate for Payer: Oxford Commercial	$84.33
Rate for Payer: Qualcare PPO/HMO/WC	$63.25
Rate for Payer: UnitedHealthcare Commercial	$84.33
Rate for Payer: UnitedHealthcare Community & State	$10.16
Rate for Payer: Wellpoint Medicaid Managed Care	$11.17

V-LOCK 90-DEGREE 32mm NL32

Facility

$421.65

Hospital Charge Code	270634966
Hospital Revenue Code	272
Min. Negotiated Rate	$63.25
Max. Negotiated Rate	$63.25
Rate for Payer: Qualcare PPO/HMO/WC	$63.25

V-LOCK 90-DEGREE 32mm NL32

Facility

$421.65

Hospital Charge Code	270634966
Hospital Revenue Code	272
Min. Negotiated Rate	$10.16
Max. Negotiated Rate	$210.82
Rate for Payer: Aetna Commercial	$160.23
Rate for Payer: Aetna Medicare Advantage	$126.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.52
Rate for Payer: Cigna Commercial	$210.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.50
Rate for Payer: Oxford Commercial	$84.33
Rate for Payer: Qualcare PPO/HMO/WC	$63.25
Rate for Payer: UnitedHealthcare Commercial	$84.33
Rate for Payer: UnitedHealthcare Community & State	$10.16
Rate for Payer: Wellpoint Medicaid Managed Care	$11.17

V-LOCK 90-DEGRE SET SCREW NLSS

Facility

$248.00

Hospital Charge Code	270635028
Hospital Revenue Code	272
Min. Negotiated Rate	$37.20
Max. Negotiated Rate	$37.20
Rate for Payer: Qualcare PPO/HMO/WC	$37.20

V-LOCK 90-DEGRE SET SCREW NLSS

Facility

$248.00

Hospital Charge Code	270635028
Hospital Revenue Code	272
Min. Negotiated Rate	$5.98
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$94.24
Rate for Payer: Aetna Medicare Advantage	$74.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.24
Rate for Payer: Cigna Commercial	$124.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.40
Rate for Payer: Oxford Commercial	$49.60
Rate for Payer: Qualcare PPO/HMO/WC	$37.20
Rate for Payer: UnitedHealthcare Commercial	$49.60
Rate for Payer: UnitedHealthcare Community & State	$5.98
Rate for Payer: Wellpoint Medicaid Managed Care	$6.57

VLOK ADULT BP INFL SYST

Facility

$146.67

Hospital Charge Code	270650039
Hospital Revenue Code	272
Min. Negotiated Rate	$22.00
Max. Negotiated Rate	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.00

VLOK ADULT BP INFL SYST

Facility

$146.67

Hospital Charge Code	270650039
Hospital Revenue Code	272
Min. Negotiated Rate	$3.53
Max. Negotiated Rate	$73.33
Rate for Payer: Aetna Commercial	$55.73
Rate for Payer: Aetna Medicare Advantage	$44.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.40
Rate for Payer: Cigna Commercial	$73.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.00
Rate for Payer: Oxford Commercial	$29.33
Rate for Payer: Qualcare PPO/HMO/WC	$22.00
Rate for Payer: UnitedHealthcare Commercial	$29.33
Rate for Payer: UnitedHealthcare Community & State	$3.53
Rate for Payer: Wellpoint Medicaid Managed Care	$3.89

VMA 24 HR W/O CREATININE

Facility

$390.00

Service Code	HCPCS 84585
Hospital Charge Code	39900147
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

VMA 24 HR W/O CREATININE

Facility

$390.00

Service Code	HCPCS 84585
Hospital Charge Code	39900147
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$42.16
Rate for Payer: Aetna Medicare Advantage	$50.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.95
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$15.50
Rate for Payer: Clover Medicare Advantage	$14.72
Rate for Payer: EmblemHealth Commercial	$46.50
Rate for Payer: Humana Medicare Advantage	$15.96
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.50
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	$12.40
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.50
Rate for Payer: Wellcare Medicare Advantage	$15.50
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

VMA,URINE I

Facility

$390.00

Service Code	HCPCS 82570
Hospital Charge Code	39990067A
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

VMA,URINE I

Facility

$390.00

Service Code	HCPCS 82570
Hospital Charge Code	39990067A
Hospital Revenue Code	301
Min. Negotiated Rate	$4.14
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$14.09
Rate for Payer: Aetna Medicare Advantage	$16.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.70
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.18
Rate for Payer: Clover Medicare Advantage	$4.92
Rate for Payer: EmblemHealth Commercial	$15.54
Rate for Payer: Humana Medicare Advantage	$5.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.18
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	$4.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.18
Rate for Payer: Wellcare Medicare Advantage	$5.18
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

VMA,URINE II

Facility

$390.00

Service Code	HCPCS 84585
Hospital Charge Code	39990067B
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$42.16
Rate for Payer: Aetna Medicare Advantage	$50.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.95
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$15.50
Rate for Payer: Clover Medicare Advantage	$14.72
Rate for Payer: EmblemHealth Commercial	$46.50
Rate for Payer: Humana Medicare Advantage	$15.96
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.50
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	$12.40
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.50
Rate for Payer: Wellcare Medicare Advantage	$15.50
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

VMA,URINE II

Facility

$390.00

Service Code	HCPCS 84585
Hospital Charge Code	39990067B
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

VMA, URINE (QUANT)

Facility

$128.00

Service Code	HCPCS 84585
Hospital Charge Code	3002714
Hospital Revenue Code	301
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

VMA, URINE (QUANT)

Facility

$128.00

Service Code	HCPCS 84585
Hospital Charge Code	3002714
Hospital Revenue Code	301
Min. Negotiated Rate	$3.39
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$42.16
Rate for Payer: Aetna Medicare Advantage	$50.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.95
Rate for Payer: Cigna Commercial	$64.00
Rate for Payer: Cigna Medicare Advantage	$15.50
Rate for Payer: Clover Medicare Advantage	$14.72
Rate for Payer: EmblemHealth Commercial	$46.50
Rate for Payer: Humana Medicare Advantage	$15.96
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.40
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.50
Rate for Payer: Wellcare Medicare Advantage	$15.50
Rate for Payer: Wellpoint Medicaid Managed Care	$3.39

VMA URINE RANDOM

Facility

$128.00

Service Code	HCPCS 84585
Hospital Charge Code	3002715
Hospital Revenue Code	301
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

Know your out-of-pocket cost for care.

All Charges