Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

VERSAJET PLUS HANDPIECE 45 DEG

Facility

$3,375.00

Hospital Charge Code	270659486
Hospital Revenue Code	270
Min. Negotiated Rate	$506.25
Max. Negotiated Rate	$506.25
Rate for Payer: Qualcare PPO/HMO/WC	$506.25

VERSAJET PLUS HANDPIECE 45 DEG

Facility

$3,375.00

Hospital Charge Code	270659486
Hospital Revenue Code	270
Min. Negotiated Rate	$81.34
Max. Negotiated Rate	$1,687.50
Rate for Payer: Aetna Commercial	$1,282.50
Rate for Payer: Aetna Medicare Advantage	$1,012.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$860.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$860.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$860.62
Rate for Payer: Cigna Commercial	$1,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,012.50
Rate for Payer: Oxford Commercial	$675.00
Rate for Payer: Qualcare PPO/HMO/WC	$506.25
Rate for Payer: UnitedHealthcare Commercial	$675.00
Rate for Payer: UnitedHealthcare Community & State	$81.34
Rate for Payer: Wellpoint Medicaid Managed Care	$89.44

VERSAJET PLUS HANDPIECE 45DEG

Facility

$2,975.00

Hospital Charge Code	270659462
Hospital Revenue Code	272
Min. Negotiated Rate	$446.25
Max. Negotiated Rate	$446.25
Rate for Payer: Qualcare PPO/HMO/WC	$446.25

VERSAJET PLUS HANDPIECE 45DEG

Facility

$2,975.00

Hospital Charge Code	270659462
Hospital Revenue Code	272
Min. Negotiated Rate	$71.70
Max. Negotiated Rate	$1,487.50
Rate for Payer: Aetna Commercial	$1,130.50
Rate for Payer: Aetna Medicare Advantage	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$758.62
Rate for Payer: Cigna Commercial	$1,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$892.50
Rate for Payer: Oxford Commercial	$595.00
Rate for Payer: Qualcare PPO/HMO/WC	$446.25
Rate for Payer: UnitedHealthcare Commercial	$595.00
Rate for Payer: UnitedHealthcare Community & State	$71.70
Rate for Payer: Wellpoint Medicaid Managed Care	$78.84

VERSALOK

Facility

$2,055.00

Hospital Charge Code	270657369
Hospital Revenue Code	270
Min. Negotiated Rate	$49.53
Max. Negotiated Rate	$1,027.50
Rate for Payer: Aetna Commercial	$780.90
Rate for Payer: Aetna Medicare Advantage	$616.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$524.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$524.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$524.02
Rate for Payer: Cigna Commercial	$1,027.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$616.50
Rate for Payer: Oxford Commercial	$411.00
Rate for Payer: Qualcare PPO/HMO/WC	$308.25
Rate for Payer: UnitedHealthcare Commercial	$411.00
Rate for Payer: UnitedHealthcare Community & State	$49.53
Rate for Payer: Wellpoint Medicaid Managed Care	$54.46

VERSALOK

Facility

$2,055.00

Hospital Charge Code	270657369
Hospital Revenue Code	270
Min. Negotiated Rate	$308.25
Max. Negotiated Rate	$308.25
Rate for Payer: Qualcare PPO/HMO/WC	$308.25

VERSAPORT 12MM TROCAR SLEEVE

Facility

$69.22

Hospital Charge Code	270654906
Hospital Revenue Code	270
Min. Negotiated Rate	$1.67
Max. Negotiated Rate	$34.61
Rate for Payer: Aetna Commercial	$26.30
Rate for Payer: Aetna Medicare Advantage	$20.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.65
Rate for Payer: Cigna Commercial	$34.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.77
Rate for Payer: Oxford Commercial	$13.84
Rate for Payer: Qualcare PPO/HMO/WC	$10.38
Rate for Payer: UnitedHealthcare Commercial	$13.84
Rate for Payer: UnitedHealthcare Community & State	$1.67
Rate for Payer: Wellpoint Medicaid Managed Care	$1.83

VERSAPORT 12MM TROCAR SLEEVE

Facility

$69.22

Hospital Charge Code	270654906
Hospital Revenue Code	270
Min. Negotiated Rate	$10.38
Max. Negotiated Rate	$10.38
Rate for Payer: Qualcare PPO/HMO/WC	$10.38

VERSAPORT 15mm LONG 179078P

Facility

$229.50

Hospital Charge Code	270627427
Hospital Revenue Code	272
Min. Negotiated Rate	$5.53
Max. Negotiated Rate	$114.75
Rate for Payer: Aetna Commercial	$87.21
Rate for Payer: Aetna Medicare Advantage	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.52
Rate for Payer: Cigna Commercial	$114.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.85
Rate for Payer: Oxford Commercial	$45.90
Rate for Payer: Qualcare PPO/HMO/WC	$34.42
Rate for Payer: UnitedHealthcare Commercial	$45.90
Rate for Payer: UnitedHealthcare Community & State	$5.53
Rate for Payer: Wellpoint Medicaid Managed Care	$6.08

VERSAPORT 15mm LONG 179078P

Facility

$229.50

Hospital Charge Code	270627427
Hospital Revenue Code	272
Min. Negotiated Rate	$34.42
Max. Negotiated Rate	$34.42
Rate for Payer: Qualcare PPO/HMO/WC	$34.42

VERSAPORT PLUS RPF 5MM-8MM

Facility

$238.15

Hospital Charge Code	270662186
Hospital Revenue Code	270
Min. Negotiated Rate	$5.74
Max. Negotiated Rate	$119.08
Rate for Payer: Aetna Commercial	$90.50
Rate for Payer: Aetna Medicare Advantage	$71.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.73
Rate for Payer: Cigna Commercial	$119.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.44
Rate for Payer: Oxford Commercial	$47.63
Rate for Payer: Qualcare PPO/HMO/WC	$35.72
Rate for Payer: UnitedHealthcare Commercial	$47.63
Rate for Payer: UnitedHealthcare Community & State	$5.74
Rate for Payer: Wellpoint Medicaid Managed Care	$6.31

VERSAPORT PLUS RPF 5MM-8MM

Facility

$238.15

Hospital Charge Code	270662186
Hospital Revenue Code	270
Min. Negotiated Rate	$35.72
Max. Negotiated Rate	$35.72
Rate for Payer: Qualcare PPO/HMO/WC	$35.72

VERSAPORT PLUS V2 11mm TROCAR

Facility

$142.80

Hospital Charge Code	270642023
Hospital Revenue Code	272
Min. Negotiated Rate	$3.44
Max. Negotiated Rate	$71.40
Rate for Payer: Aetna Commercial	$54.26
Rate for Payer: Aetna Medicare Advantage	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.41
Rate for Payer: Cigna Commercial	$71.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.84
Rate for Payer: Oxford Commercial	$28.56
Rate for Payer: Qualcare PPO/HMO/WC	$21.42
Rate for Payer: UnitedHealthcare Commercial	$28.56
Rate for Payer: UnitedHealthcare Community & State	$3.44
Rate for Payer: Wellpoint Medicaid Managed Care	$3.78

VERSAPORT PLUS V2 11mm TROCAR

Facility

$142.80

Hospital Charge Code	270642023
Hospital Revenue Code	272
Min. Negotiated Rate	$21.42
Max. Negotiated Rate	$21.42
Rate for Payer: Qualcare PPO/HMO/WC	$21.42

VERSAPORT RPF TROCAR 10-15MM

Facility

$150.00

Hospital Charge Code	270639246
Hospital Revenue Code	270
Min. Negotiated Rate	$3.62
Max. Negotiated Rate	$75.00
Rate for Payer: Aetna Commercial	$57.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.00
Rate for Payer: Oxford Commercial	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$30.00
Rate for Payer: UnitedHealthcare Community & State	$3.62
Rate for Payer: Wellpoint Medicaid Managed Care	$3.98

VERSAPORT RPF TROCAR 10-15MM

Facility

$150.00

Hospital Charge Code	270639246
Hospital Revenue Code	270
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

VERSAPORT V2 5MM

Facility

$102.00

Hospital Charge Code	270600067
Hospital Revenue Code	272
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$51.00
Rate for Payer: Aetna Commercial	$38.76
Rate for Payer: Aetna Medicare Advantage	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.01
Rate for Payer: Cigna Commercial	$51.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.60
Rate for Payer: Oxford Commercial	$20.40
Rate for Payer: Qualcare PPO/HMO/WC	$15.30
Rate for Payer: UnitedHealthcare Commercial	$20.40
Rate for Payer: UnitedHealthcare Community & State	$2.46
Rate for Payer: Wellpoint Medicaid Managed Care	$2.70

VERSAPORT V2 5MM

Facility

$102.00

Hospital Charge Code	270600067
Hospital Revenue Code	272
Min. Negotiated Rate	$15.30
Max. Negotiated Rate	$15.30
Rate for Payer: Qualcare PPO/HMO/WC	$15.30

VERSAPORT V2 BLDLES OPT 11 STD

Facility

$153.00

Hospital Charge Code	270675469
Hospital Revenue Code	272
Min. Negotiated Rate	$3.69
Max. Negotiated Rate	$76.50
Rate for Payer: Aetna Commercial	$58.14
Rate for Payer: Aetna Medicare Advantage	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.02
Rate for Payer: Cigna Commercial	$76.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.90
Rate for Payer: Oxford Commercial	$30.60
Rate for Payer: Qualcare PPO/HMO/WC	$22.95
Rate for Payer: UnitedHealthcare Commercial	$30.60
Rate for Payer: UnitedHealthcare Community & State	$3.69
Rate for Payer: Wellpoint Medicaid Managed Care	$4.05

VERSAPORT V2 BLDLES OPT 11 STD

Facility

$153.00

Hospital Charge Code	270675469
Hospital Revenue Code	272
Min. Negotiated Rate	$22.95
Max. Negotiated Rate	$22.95
Rate for Payer: Qualcare PPO/HMO/WC	$22.95

VERSAPORT V2 PLUS 12mm LONG

Facility

$142.80

Hospital Charge Code	270628983
Hospital Revenue Code	272
Min. Negotiated Rate	$21.42
Max. Negotiated Rate	$21.42
Rate for Payer: Qualcare PPO/HMO/WC	$21.42

VERSAPORT V2 PLUS 12mm LONG

Facility

$142.80

Hospital Charge Code	270628983
Hospital Revenue Code	272
Min. Negotiated Rate	$3.44
Max. Negotiated Rate	$71.40
Rate for Payer: Aetna Commercial	$54.26
Rate for Payer: Aetna Medicare Advantage	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.41
Rate for Payer: Cigna Commercial	$71.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.84
Rate for Payer: Oxford Commercial	$28.56
Rate for Payer: Qualcare PPO/HMO/WC	$21.42
Rate for Payer: UnitedHealthcare Commercial	$28.56
Rate for Payer: UnitedHealthcare Community & State	$3.44
Rate for Payer: Wellpoint Medicaid Managed Care	$3.78

VERSAPORT V2 PLUS 5-12MM

Facility

$142.80

Hospital Charge Code	270600113
Hospital Revenue Code	272
Min. Negotiated Rate	$21.42
Max. Negotiated Rate	$21.42
Rate for Payer: Qualcare PPO/HMO/WC	$21.42

VERSAPORT V2 PLUS 5-12MM

Facility

$142.80

Hospital Charge Code	270600113
Hospital Revenue Code	272
Min. Negotiated Rate	$3.44
Max. Negotiated Rate	$71.40
Rate for Payer: Aetna Commercial	$54.26
Rate for Payer: Aetna Medicare Advantage	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.41
Rate for Payer: Cigna Commercial	$71.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.84
Rate for Payer: Oxford Commercial	$28.56
Rate for Payer: Qualcare PPO/HMO/WC	$21.42
Rate for Payer: UnitedHealthcare Commercial	$28.56
Rate for Payer: UnitedHealthcare Community & State	$3.44
Rate for Payer: Wellpoint Medicaid Managed Care	$3.78

VERSAPORT V2 TROCAR 5-12MM LNG

Facility

$144.47

Hospital Charge Code	270600065
Hospital Revenue Code	272
Min. Negotiated Rate	$3.48
Max. Negotiated Rate	$72.23
Rate for Payer: Aetna Commercial	$54.90
Rate for Payer: Aetna Medicare Advantage	$43.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.84
Rate for Payer: Cigna Commercial	$72.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.34
Rate for Payer: Oxford Commercial	$28.89
Rate for Payer: Qualcare PPO/HMO/WC	$21.67
Rate for Payer: UnitedHealthcare Commercial	$28.89
Rate for Payer: UnitedHealthcare Community & State	$3.48
Rate for Payer: Wellpoint Medicaid Managed Care	$3.83

Know your out-of-pocket cost for care.

All Charges