Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

VORICONAZOLE 200 MG TAB

Facility

$592.62

Service Code	NDC 49318030
Hospital Charge Code	60629938
Hospital Revenue Code	250
Min. Negotiated Rate	$14.28
Max. Negotiated Rate	$296.31
Rate for Payer: Aetna Commercial	$225.20
Rate for Payer: Aetna Medicare Advantage	$177.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.12
Rate for Payer: Cigna Commercial	$296.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.79
Rate for Payer: Oxford Commercial	$118.52
Rate for Payer: Qualcare PPO/HMO/WC	$88.89
Rate for Payer: UnitedHealthcare Commercial	$118.52
Rate for Payer: UnitedHealthcare Community & State	$14.28
Rate for Payer: Wellpoint Medicaid Managed Care	$15.70

VORICONAZOLE 200 MG VIAL

Facility

$1,199.50

Service Code	HCPCS J3465
Hospital Charge Code	60629297
Hospital Revenue Code	636
Min. Negotiated Rate	$179.93
Max. Negotiated Rate	$290.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.28
Rate for Payer: Qualcare PPO/HMO/WC	$179.93

VORICONAZOLE 200 MG VIAL

Facility

$1,199.50

Service Code	HCPCS J3465
Hospital Charge Code	60629297
Hospital Revenue Code	636
Min. Negotiated Rate	$28.91
Max. Negotiated Rate	$599.75
Rate for Payer: Aetna Commercial	$455.81
Rate for Payer: Aetna Medicare Advantage	$359.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$305.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$305.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$305.87
Rate for Payer: Cigna Commercial	$599.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.28
Rate for Payer: Qualcare PPO/HMO/WC	$179.93
Rate for Payer: UnitedHealthcare Community & State	$28.91
Rate for Payer: Wellpoint Medicaid Managed Care	$31.79

VORICONAZOLE LC MS MS

Facility

$390.00

Service Code	HCPCS 80299
Hospital Charge Code	401080299
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

VORICONAZOLE LC MS MS

Facility

$390.00

Service Code	HCPCS 80299
Hospital Charge Code	401080299
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$50.70
Rate for Payer: Aetna Medicare Advantage	$60.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.28
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$18.64
Rate for Payer: Clover Medicare Advantage	$17.71
Rate for Payer: EmblemHealth Commercial	$55.92
Rate for Payer: Humana Medicare Advantage	$19.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.64
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	$14.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Medicare Advantage	$18.64
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

VORTEX VACUUM MIXING SYSTEM

Facility

$5,547.40

Hospital Charge Code	270686907
Hospital Revenue Code	272
Min. Negotiated Rate	$133.69
Max. Negotiated Rate	$2,773.70
Rate for Payer: Aetna Commercial	$2,108.01
Rate for Payer: Aetna Medicare Advantage	$1,664.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,414.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,414.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,414.59
Rate for Payer: Cigna Commercial	$2,773.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,664.22
Rate for Payer: Oxford Commercial	$1,109.48
Rate for Payer: Qualcare PPO/HMO/WC	$832.11
Rate for Payer: UnitedHealthcare Commercial	$1,109.48
Rate for Payer: UnitedHealthcare Community & State	$133.69
Rate for Payer: Wellpoint Medicaid Managed Care	$147.01

VORTEX VACUUM MIXING SYSTEM

Facility

$5,547.40

Hospital Charge Code	270686907
Hospital Revenue Code	272
Min. Negotiated Rate	$832.11
Max. Negotiated Rate	$832.11
Rate for Payer: Qualcare PPO/HMO/WC	$832.11

VOSOL HC OTIC/10ML

Facility

$414.00

Hospital Charge Code	60634168
Hospital Revenue Code	250
Min. Negotiated Rate	$62.10
Max. Negotiated Rate	$62.10
Rate for Payer: Qualcare PPO/HMO/WC	$62.10

VOSOL HC OTIC/10ML

Facility

$414.00

Hospital Charge Code	60634168
Hospital Revenue Code	250
Min. Negotiated Rate	$9.98
Max. Negotiated Rate	$207.00
Rate for Payer: Aetna Commercial	$157.32
Rate for Payer: Aetna Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.57
Rate for Payer: Cigna Commercial	$207.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.20
Rate for Payer: Oxford Commercial	$82.80
Rate for Payer: Qualcare PPO/HMO/WC	$62.10
Rate for Payer: UnitedHealthcare Commercial	$82.80
Rate for Payer: UnitedHealthcare Community & State	$9.98
Rate for Payer: Wellpoint Medicaid Managed Care	$10.97

VOSOL OTIC

Facility

$256.65

Hospital Charge Code	6008403
Hospital Revenue Code	251
Min. Negotiated Rate	$6.19
Max. Negotiated Rate	$128.32
Rate for Payer: Aetna Commercial	$97.53
Rate for Payer: Aetna Medicare Advantage	$77.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.45
Rate for Payer: Cigna Commercial	$128.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.00
Rate for Payer: Oxford Commercial	$51.33
Rate for Payer: Qualcare PPO/HMO/WC	$38.50
Rate for Payer: UnitedHealthcare Commercial	$51.33
Rate for Payer: UnitedHealthcare Community & State	$6.19
Rate for Payer: Wellpoint Medicaid Managed Care	$6.80

VOSOL OTIC

Facility

$256.65

Hospital Charge Code	6008403
Hospital Revenue Code	251
Min. Negotiated Rate	$38.50
Max. Negotiated Rate	$38.50
Rate for Payer: Qualcare PPO/HMO/WC	$38.50

VOSOL OTIC/10ML

Facility

$181.00

Hospital Charge Code	60634631
Hospital Revenue Code	250
Min. Negotiated Rate	$4.36
Max. Negotiated Rate	$90.50
Rate for Payer: Aetna Commercial	$68.78
Rate for Payer: Aetna Medicare Advantage	$54.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.16
Rate for Payer: Cigna Commercial	$90.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.30
Rate for Payer: Oxford Commercial	$36.20
Rate for Payer: Qualcare PPO/HMO/WC	$27.15
Rate for Payer: UnitedHealthcare Commercial	$36.20
Rate for Payer: UnitedHealthcare Community & State	$4.36
Rate for Payer: Wellpoint Medicaid Managed Care	$4.80

VOSOL OTIC/10ML

Facility

$181.00

Hospital Charge Code	60634631
Hospital Revenue Code	250
Min. Negotiated Rate	$27.15
Max. Negotiated Rate	$27.15
Rate for Payer: Qualcare PPO/HMO/WC	$27.15

VPC SCREW 4.0X40MM

Facility

$1,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270686589
Hospital Revenue Code	278
Min. Negotiated Rate	$292.50
Max. Negotiated Rate	$471.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$429.00
Rate for Payer: Qualcare PPO/HMO/WC	$292.50

VPC SCREW 4.0X40MM

Facility

$1,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270686589
Hospital Revenue Code	278
Min. Negotiated Rate	$46.99
Max. Negotiated Rate	$975.00
Rate for Payer: Aetna Commercial	$741.00
Rate for Payer: Aetna Medicare Advantage	$585.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$497.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$497.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$497.25
Rate for Payer: Cigna Commercial	$975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$429.00
Rate for Payer: Qualcare PPO/HMO/WC	$292.50
Rate for Payer: UnitedHealthcare Community & State	$46.99
Rate for Payer: Wellpoint Medicaid Managed Care	$51.67

VPRWIRE ADVGDFRMWIRE 0.017 TIP

Facility

$850.00

Hospital Charge Code	2709003742
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

VPRWIRE ADVGDFRMWIRE 0.017 TIP

Facility

$850.00

Hospital Charge Code	2709003742
Hospital Revenue Code	272
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$323.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.00
Rate for Payer: Oxford Commercial	$170.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Commercial	$170.00
Rate for Payer: UnitedHealthcare Community & State	$20.48
Rate for Payer: Wellpoint Medicaid Managed Care	$22.52

VRBLE SLF DRILLING SCHOOL 14MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270694167
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

VRBLE SLF DRILLING SCHOOL 14MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270694167
Hospital Revenue Code	278
Min. Negotiated Rate	$54.23
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Community & State	$54.23
Rate for Payer: Wellpoint Medicaid Managed Care	$59.62

VRE SCREEN

Facility

$390.00

Service Code	HCPCS 87081
Hospital Charge Code	3036051
Hospital Revenue Code	309
Min. Negotiated Rate	$5.30
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$18.03
Rate for Payer: Aetna Medicare Advantage	$21.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.93
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$6.63
Rate for Payer: Clover Medicare Advantage	$6.30
Rate for Payer: EmblemHealth Commercial	$19.89
Rate for Payer: Humana Medicare Advantage	$6.83
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.63
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	$5.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.63
Rate for Payer: Wellcare Medicare Advantage	$6.63
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

VRE SCREEN

Facility

$390.00

Service Code	HCPCS 87081
Hospital Charge Code	3036051
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

VRTBR CRPCTMY,CERV EA ADTL SGM

Facility

$19,892.30

Service Code	HCPCS 63082
Hospital Charge Code	160000224
Hospital Revenue Code	360
Min. Negotiated Rate	$479.40
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$7,559.07
Rate for Payer: Aetna Medicare Advantage	$5,967.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,072.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,072.54
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	$5,072.54
Rate for Payer: Cigna Commercial	$9,946.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,967.69
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,983.84
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$479.40
Rate for Payer: Wellpoint Medicaid Managed Care	$527.15

VRTBR CRPCTMY,CERV EA ADTL SGM

Facility

$19,892.30

Service Code	HCPCS 63082
Hospital Charge Code	160000224
Hospital Revenue Code	360
Min. Negotiated Rate	$2,983.84
Max. Negotiated Rate	$2,983.84
Rate for Payer: Qualcare PPO/HMO/WC	$2,983.84

V TIPS ENDOPROSTHESIS

Facility

$19,990.00

Hospital Charge Code	2709007355
Hospital Revenue Code	272
Min. Negotiated Rate	$2,998.50
Max. Negotiated Rate	$2,998.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,998.50

V TIPS ENDOPROSTHESIS

Facility

$19,990.00

Hospital Charge Code	2709007355
Hospital Revenue Code	272
Min. Negotiated Rate	$481.76
Max. Negotiated Rate	$9,995.00
Rate for Payer: Aetna Commercial	$7,596.20
Rate for Payer: Aetna Medicare Advantage	$5,997.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,097.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,097.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,097.45
Rate for Payer: Cigna Commercial	$9,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,997.00
Rate for Payer: Oxford Commercial	$3,998.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,998.50
Rate for Payer: UnitedHealthcare Commercial	$3,998.00
Rate for Payer: UnitedHealthcare Community & State	$481.76
Rate for Payer: Wellpoint Medicaid Managed Care	$529.74

Know your out-of-pocket cost for care.

All Charges