Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ZOLPIDEM 5 MG TAB

Facility

$172.73

Service Code	NDC 24540131
Hospital Charge Code	60629010
Hospital Revenue Code	250
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$86.36
Rate for Payer: Aetna Commercial	$65.64
Rate for Payer: Aetna Medicare Advantage	$51.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.05
Rate for Payer: Cigna Commercial	$86.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.82
Rate for Payer: Oxford Commercial	$34.55
Rate for Payer: Qualcare PPO/HMO/WC	$25.91
Rate for Payer: UnitedHealthcare Commercial	$34.55
Rate for Payer: UnitedHealthcare Community & State	$4.16
Rate for Payer: Wellpoint Medicaid Managed Care	$4.58

ZOLPIDEM TAB 10MG

Facility

$21.15

Hospital Charge Code	6010292
Hospital Revenue Code	252
Min. Negotiated Rate	$3.17
Max. Negotiated Rate	$3.17
Rate for Payer: Qualcare PPO/HMO/WC	$3.17

ZOLPIDEM TAB 10MG

Facility

$21.15

Hospital Charge Code	6010292
Hospital Revenue Code	252
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$10.57
Rate for Payer: Aetna Commercial	$8.04
Rate for Payer: Aetna Medicare Advantage	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.39
Rate for Payer: Cigna Commercial	$10.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.34
Rate for Payer: Oxford Commercial	$4.23
Rate for Payer: Qualcare PPO/HMO/WC	$3.17
Rate for Payer: UnitedHealthcare Commercial	$4.23
Rate for Payer: UnitedHealthcare Community & State	$0.51
Rate for Payer: Wellpoint Medicaid Managed Care	$0.56

ZOLPIDEM TAB 5MG

Facility

$12.80

Hospital Charge Code	60628943
Hospital Revenue Code	250
Min. Negotiated Rate	$1.92
Max. Negotiated Rate	$1.92
Rate for Payer: Qualcare PPO/HMO/WC	$1.92

ZOLPIDEM TAB 5MG

Facility

$12.80

Hospital Charge Code	60628943
Hospital Revenue Code	250
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.40
Rate for Payer: Aetna Commercial	$4.86
Rate for Payer: Aetna Medicare Advantage	$3.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.26
Rate for Payer: Cigna Commercial	$6.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.84
Rate for Payer: Oxford Commercial	$2.56
Rate for Payer: Qualcare PPO/HMO/WC	$1.92
Rate for Payer: UnitedHealthcare Commercial	$2.56
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

ZOLYSE/750U/9ML

Facility

$152.00

Hospital Charge Code	60634204
Hospital Revenue Code	250
Min. Negotiated Rate	$3.66
Max. Negotiated Rate	$76.00
Rate for Payer: Aetna Commercial	$57.76
Rate for Payer: Aetna Medicare Advantage	$45.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.76
Rate for Payer: Cigna Commercial	$76.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.60
Rate for Payer: Oxford Commercial	$30.40
Rate for Payer: Qualcare PPO/HMO/WC	$22.80
Rate for Payer: UnitedHealthcare Commercial	$30.40
Rate for Payer: UnitedHealthcare Community & State	$3.66
Rate for Payer: Wellpoint Medicaid Managed Care	$4.03

ZOLYSE/750U/9ML

Facility

$152.00

Hospital Charge Code	60634204
Hospital Revenue Code	250
Min. Negotiated Rate	$22.80
Max. Negotiated Rate	$22.80
Rate for Payer: Qualcare PPO/HMO/WC	$22.80

ZONE NAVIGATOR

Facility

$1,790.00

Hospital Charge Code	270691761
Hospital Revenue Code	272
Min. Negotiated Rate	$43.14
Max. Negotiated Rate	$895.00
Rate for Payer: Aetna Commercial	$680.20
Rate for Payer: Aetna Medicare Advantage	$537.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$456.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$456.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$456.45
Rate for Payer: Cigna Commercial	$895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$537.00
Rate for Payer: Oxford Commercial	$358.00
Rate for Payer: Qualcare PPO/HMO/WC	$268.50
Rate for Payer: UnitedHealthcare Commercial	$358.00
Rate for Payer: UnitedHealthcare Community & State	$43.14
Rate for Payer: Wellpoint Medicaid Managed Care	$47.44

ZONE NAVIGATOR

Facility

$1,790.00

Hospital Charge Code	270691761
Hospital Revenue Code	272
Min. Negotiated Rate	$268.50
Max. Negotiated Rate	$268.50
Rate for Payer: Qualcare PPO/HMO/WC	$268.50

ZONE SPECIAFIC II MENISCAL RIG

Facility

$1,070.00

Hospital Charge Code	270665310
Hospital Revenue Code	270
Min. Negotiated Rate	$25.79
Max. Negotiated Rate	$535.00
Rate for Payer: Aetna Commercial	$406.60
Rate for Payer: Aetna Medicare Advantage	$321.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.85
Rate for Payer: Cigna Commercial	$535.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$321.00
Rate for Payer: Oxford Commercial	$214.00
Rate for Payer: Qualcare PPO/HMO/WC	$160.50
Rate for Payer: UnitedHealthcare Commercial	$214.00
Rate for Payer: UnitedHealthcare Community & State	$25.79
Rate for Payer: Wellpoint Medicaid Managed Care	$28.36

ZONE SPECIAFIC II MENISCAL RIG

Facility

$1,070.00

Hospital Charge Code	270665310
Hospital Revenue Code	270
Min. Negotiated Rate	$160.50
Max. Negotiated Rate	$160.50
Rate for Payer: Qualcare PPO/HMO/WC	$160.50

ZONE SPECIFIC II MENISCAL REPA

Facility

$1,070.00

Hospital Charge Code	270665312
Hospital Revenue Code	270
Min. Negotiated Rate	$25.79
Max. Negotiated Rate	$535.00
Rate for Payer: Aetna Commercial	$406.60
Rate for Payer: Aetna Medicare Advantage	$321.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.85
Rate for Payer: Cigna Commercial	$535.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$321.00
Rate for Payer: Oxford Commercial	$214.00
Rate for Payer: Qualcare PPO/HMO/WC	$160.50
Rate for Payer: UnitedHealthcare Commercial	$214.00
Rate for Payer: UnitedHealthcare Community & State	$25.79
Rate for Payer: Wellpoint Medicaid Managed Care	$28.36

ZONE SPECIFIC II MENISCAL REPA

Facility

$1,070.00

Hospital Charge Code	270665312
Hospital Revenue Code	270
Min. Negotiated Rate	$160.50
Max. Negotiated Rate	$160.50
Rate for Payer: Qualcare PPO/HMO/WC	$160.50

ZONE SPECIFIC II MENISCAL REPA

Facility

$1,035.00

Hospital Charge Code	270665313
Hospital Revenue Code	270
Min. Negotiated Rate	$24.94
Max. Negotiated Rate	$517.50
Rate for Payer: Aetna Commercial	$393.30
Rate for Payer: Aetna Medicare Advantage	$310.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.93
Rate for Payer: Cigna Commercial	$517.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.50
Rate for Payer: Oxford Commercial	$207.00
Rate for Payer: Qualcare PPO/HMO/WC	$155.25
Rate for Payer: UnitedHealthcare Commercial	$207.00
Rate for Payer: UnitedHealthcare Community & State	$24.94
Rate for Payer: Wellpoint Medicaid Managed Care	$27.43

ZONE SPECIFIC II MENISCAL REPA

Facility

$1,035.00

Hospital Charge Code	270665311
Hospital Revenue Code	270
Min. Negotiated Rate	$155.25
Max. Negotiated Rate	$155.25
Rate for Payer: Qualcare PPO/HMO/WC	$155.25

ZONE SPECIFIC II MENISCAL REPA

Facility

$1,035.00

Hospital Charge Code	270665313
Hospital Revenue Code	270
Min. Negotiated Rate	$155.25
Max. Negotiated Rate	$155.25
Rate for Payer: Qualcare PPO/HMO/WC	$155.25

ZONE SPECIFIC II MENISCAL REPA

Facility

$1,035.00

Hospital Charge Code	270665311
Hospital Revenue Code	270
Min. Negotiated Rate	$24.94
Max. Negotiated Rate	$517.50
Rate for Payer: Aetna Commercial	$393.30
Rate for Payer: Aetna Medicare Advantage	$310.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.93
Rate for Payer: Cigna Commercial	$517.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.50
Rate for Payer: Oxford Commercial	$207.00
Rate for Payer: Qualcare PPO/HMO/WC	$155.25
Rate for Payer: UnitedHealthcare Commercial	$207.00
Rate for Payer: UnitedHealthcare Community & State	$24.94
Rate for Payer: Wellpoint Medicaid Managed Care	$27.43

ZONE SPECIFIC II MENISCAL REPA

Facility

$4,380.00

Hospital Charge Code	270665307
Hospital Revenue Code	270
Min. Negotiated Rate	$105.56
Max. Negotiated Rate	$2,190.00
Rate for Payer: Aetna Commercial	$1,664.40
Rate for Payer: Aetna Medicare Advantage	$1,314.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,116.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,116.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,116.90
Rate for Payer: Cigna Commercial	$2,190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,314.00
Rate for Payer: Oxford Commercial	$876.00
Rate for Payer: Qualcare PPO/HMO/WC	$657.00
Rate for Payer: UnitedHealthcare Commercial	$876.00
Rate for Payer: UnitedHealthcare Community & State	$105.56
Rate for Payer: Wellpoint Medicaid Managed Care	$116.07

ZONE SPECIFIC II MENISCAL REPA

Facility

$4,380.00

Hospital Charge Code	270665307
Hospital Revenue Code	270
Min. Negotiated Rate	$657.00
Max. Negotiated Rate	$657.00
Rate for Payer: Qualcare PPO/HMO/WC	$657.00

ZONE SPECIFIC II MENSICAL REPA

Facility

$1,035.00

Hospital Charge Code	270665308
Hospital Revenue Code	270
Min. Negotiated Rate	$155.25
Max. Negotiated Rate	$155.25
Rate for Payer: Qualcare PPO/HMO/WC	$155.25

ZONE SPECIFIC II MENSICAL REPA

Facility

$1,035.00

Hospital Charge Code	270665308
Hospital Revenue Code	270
Min. Negotiated Rate	$24.94
Max. Negotiated Rate	$517.50
Rate for Payer: Aetna Commercial	$393.30
Rate for Payer: Aetna Medicare Advantage	$310.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.93
Rate for Payer: Cigna Commercial	$517.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.50
Rate for Payer: Oxford Commercial	$207.00
Rate for Payer: Qualcare PPO/HMO/WC	$155.25
Rate for Payer: UnitedHealthcare Commercial	$207.00
Rate for Payer: UnitedHealthcare Community & State	$24.94
Rate for Payer: Wellpoint Medicaid Managed Care	$27.43

ZONE SPECIFIC MENISCAL REPAIR

Facility

$1,035.00

Hospital Charge Code	270665309
Hospital Revenue Code	270
Min. Negotiated Rate	$155.25
Max. Negotiated Rate	$155.25
Rate for Payer: Qualcare PPO/HMO/WC	$155.25

ZONE SPECIFIC MENISCAL REPAIR

Facility

$1,035.00

Hospital Charge Code	270665309
Hospital Revenue Code	270
Min. Negotiated Rate	$24.94
Max. Negotiated Rate	$517.50
Rate for Payer: Aetna Commercial	$393.30
Rate for Payer: Aetna Medicare Advantage	$310.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.93
Rate for Payer: Cigna Commercial	$517.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.50
Rate for Payer: Oxford Commercial	$207.00
Rate for Payer: Qualcare PPO/HMO/WC	$155.25
Rate for Payer: UnitedHealthcare Commercial	$207.00
Rate for Payer: UnitedHealthcare Community & State	$24.94
Rate for Payer: Wellpoint Medicaid Managed Care	$27.43

ZONISAMIDE

Facility

$181.65

Service Code	HCPCS 80299
Hospital Charge Code	3035100
Hospital Revenue Code	301
Min. Negotiated Rate	$27.25
Max. Negotiated Rate	$27.25
Rate for Payer: Qualcare PPO/HMO/WC	$27.25

ZONISAMIDE

Facility

$181.65

Service Code	HCPCS 80299
Hospital Charge Code	3035100
Hospital Revenue Code	301
Min. Negotiated Rate	$4.81
Max. Negotiated Rate	$124.00
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	$90.83
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	$54.49
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.25
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	$4.81

Know your out-of-pocket cost for care.

All Charges