Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ZONISAMIDE 100MG CAP

Facility

$8.00

Hospital Charge Code	60635676
Hospital Revenue Code	250
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$3.04
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.40
Rate for Payer: Oxford Commercial	$1.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$1.60
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

ZONISAMIDE 100MG CAP

Facility

$8.00

Hospital Charge Code	60635676
Hospital Revenue Code	250
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

ZOOM POD ASPIRATION TUBING

Facility

$1,775.00

Hospital Charge Code	270696635S
Hospital Revenue Code	272
Min. Negotiated Rate	$42.78
Max. Negotiated Rate	$887.50
Rate for Payer: Aetna Commercial	$674.50
Rate for Payer: Aetna Medicare Advantage	$532.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$452.62
Rate for Payer: Cigna Commercial	$887.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.50
Rate for Payer: Oxford Commercial	$355.00
Rate for Payer: Qualcare PPO/HMO/WC	$266.25
Rate for Payer: UnitedHealthcare Commercial	$355.00
Rate for Payer: UnitedHealthcare Community & State	$42.78
Rate for Payer: Wellpoint Medicaid Managed Care	$47.04

ZOOM POD ASPIRATION TUBING

Facility

$1,775.00

Hospital Charge Code	270696635S
Hospital Revenue Code	272
Min. Negotiated Rate	$266.25
Max. Negotiated Rate	$266.25
Rate for Payer: Qualcare PPO/HMO/WC	$266.25

ZOSTER(SHINGLES)VACC

Facility

$1,306.50

Service Code	HCPCS 90736
Hospital Charge Code	83652337
Hospital Revenue Code	636
Min. Negotiated Rate	$195.97
Max. Negotiated Rate	$316.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$316.17
Rate for Payer: Qualcare PPO/HMO/WC	$195.97

ZOSTER(SHINGLES)VACC

Facility

$1,306.50

Service Code	HCPCS 90736
Hospital Charge Code	83652337
Hospital Revenue Code	636
Min. Negotiated Rate	$31.49
Max. Negotiated Rate	$653.25
Rate for Payer: Aetna Commercial	$496.47
Rate for Payer: Aetna Medicare Advantage	$391.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$333.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$333.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$333.16
Rate for Payer: Cigna Commercial	$653.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$316.17
Rate for Payer: Qualcare PPO/HMO/WC	$195.97
Rate for Payer: UnitedHealthcare Community & State	$31.49
Rate for Payer: Wellpoint Medicaid Managed Care	$34.62

ZOSTRIX/30GM

Facility

$110.55

Service Code	NDC 603064888
Hospital Charge Code	60634302
Hospital Revenue Code	250
Min. Negotiated Rate	$16.58
Max. Negotiated Rate	$16.58
Rate for Payer: Qualcare PPO/HMO/WC	$16.58

ZOSTRIX/30GM

Facility

$110.55

Service Code	NDC 603064888
Hospital Charge Code	60634302
Hospital Revenue Code	250
Min. Negotiated Rate	$2.66
Max. Negotiated Rate	$55.27
Rate for Payer: Aetna Commercial	$42.01
Rate for Payer: Aetna Medicare Advantage	$33.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.19
Rate for Payer: Cigna Commercial	$55.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.16
Rate for Payer: Oxford Commercial	$22.11
Rate for Payer: Qualcare PPO/HMO/WC	$16.58
Rate for Payer: UnitedHealthcare Commercial	$22.11
Rate for Payer: UnitedHealthcare Community & State	$2.66
Rate for Payer: Wellpoint Medicaid Managed Care	$2.93

ZOSYN 2.25GM ADD-VANT VIA

Facility

$25.00

Hospital Charge Code	60635368
Hospital Revenue Code	250
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

ZOSYN 2.25GM ADD-VANT VIA

Facility

$25.00

Hospital Charge Code	60635368
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$12.50
Rate for Payer: Aetna Commercial	$9.50
Rate for Payer: Aetna Medicare Advantage	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.38
Rate for Payer: Cigna Commercial	$12.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.50
Rate for Payer: Oxford Commercial	$5.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$5.00
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

ZOSYN 2.25GM VIAL

Facility

$61.05

Hospital Charge Code	60635764
Hospital Revenue Code	636
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$30.52
Rate for Payer: Aetna Commercial	$23.20
Rate for Payer: Aetna Medicare Advantage	$18.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.57
Rate for Payer: Cigna Commercial	$30.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.77
Rate for Payer: Qualcare PPO/HMO/WC	$9.16
Rate for Payer: UnitedHealthcare Community & State	$1.47
Rate for Payer: Wellpoint Medicaid Managed Care	$1.62

ZOSYN 2.25GM VIAL

Facility

$61.05

Hospital Charge Code	60635764
Hospital Revenue Code	636
Min. Negotiated Rate	$9.16
Max. Negotiated Rate	$14.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.77
Rate for Payer: Qualcare PPO/HMO/WC	$9.16

ZOSYN 3.375GM ADDV/D5W1

Facility

$72.00

Hospital Charge Code	60635169
Hospital Revenue Code	250
Min. Negotiated Rate	$10.80
Max. Negotiated Rate	$10.80
Rate for Payer: Qualcare PPO/HMO/WC	$10.80

ZOSYN 3.375GM ADDV/D5W1

Facility

$72.00

Hospital Charge Code	60635169
Hospital Revenue Code	250
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$36.00
Rate for Payer: Aetna Commercial	$27.36
Rate for Payer: Aetna Medicare Advantage	$21.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.36
Rate for Payer: Cigna Commercial	$36.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.60
Rate for Payer: Oxford Commercial	$14.40
Rate for Payer: Qualcare PPO/HMO/WC	$10.80
Rate for Payer: UnitedHealthcare Commercial	$14.40
Rate for Payer: UnitedHealthcare Community & State	$1.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1.91

ZOSYN,4.5ML,ADVANTAGE,VIA

Facility

$32.00

Hospital Charge Code	60635427
Hospital Revenue Code	250
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

ZOSYN,4.5ML,ADVANTAGE,VIA

Facility

$32.00

Hospital Charge Code	60635427
Hospital Revenue Code	250
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna Commercial	$12.16
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.60
Rate for Payer: Oxford Commercial	$6.40
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$6.40
Rate for Payer: UnitedHealthcare Community & State	$0.77
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

ZOVIRAX/200MG/5ML

Facility

$479.00

Hospital Charge Code	60634208
Hospital Revenue Code	250
Min. Negotiated Rate	$71.85
Max. Negotiated Rate	$71.85
Rate for Payer: Qualcare PPO/HMO/WC	$71.85

ZOVIRAX/200MG/5ML

Facility

$479.00

Hospital Charge Code	60634208
Hospital Revenue Code	250
Min. Negotiated Rate	$11.54
Max. Negotiated Rate	$239.50
Rate for Payer: Aetna Commercial	$182.02
Rate for Payer: Aetna Medicare Advantage	$143.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.14
Rate for Payer: Cigna Commercial	$239.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.70
Rate for Payer: Oxford Commercial	$95.80
Rate for Payer: Qualcare PPO/HMO/WC	$71.85
Rate for Payer: UnitedHealthcare Commercial	$95.80
Rate for Payer: UnitedHealthcare Community & State	$11.54
Rate for Payer: Wellpoint Medicaid Managed Care	$12.69

ZOVIRAX/200MG/CAP

Facility

$6.00

Hospital Charge Code	60634206
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$2.28
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.80
Rate for Payer: Oxford Commercial	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.20
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

ZOVIRAX/200MG/CAP

Facility

$5.00

Hospital Charge Code	60634207
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.90
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.50
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$1.00
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

ZOVIRAX/200MG/CAP

Facility

$5.00

Hospital Charge Code	60634207
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

ZOVIRAX/200MG/CAP

Facility

$6.00

Hospital Charge Code	60634206
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

ZOVIRAX 400MG U/D TAB

Facility

$12.66

Service Code	NDC 93894301
Hospital Charge Code	60635283
Hospital Revenue Code	250
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.33
Rate for Payer: Aetna Commercial	$4.81
Rate for Payer: Aetna Medicare Advantage	$3.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.23
Rate for Payer: Cigna Commercial	$6.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.80
Rate for Payer: Oxford Commercial	$2.53
Rate for Payer: Qualcare PPO/HMO/WC	$1.90
Rate for Payer: UnitedHealthcare Commercial	$2.53
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

ZOVIRAX 400MG U/D TAB

Facility

$12.66

Service Code	NDC 93894301
Hospital Charge Code	60635283
Hospital Revenue Code	250
Min. Negotiated Rate	$1.90
Max. Negotiated Rate	$1.90
Rate for Payer: Qualcare PPO/HMO/WC	$1.90

ZOVIRAX/500MG

Facility

$266.00

Hospital Charge Code	60634205
Hospital Revenue Code	250
Min. Negotiated Rate	$39.90
Max. Negotiated Rate	$39.90
Rate for Payer: Qualcare PPO/HMO/WC	$39.90

Know your out-of-pocket cost for care.

All Charges