Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

VERSAPORT V2 TROCAR 5-12MM LNG

Facility

$144.47

Hospital Charge Code	270600065
Hospital Revenue Code	272
Min. Negotiated Rate	$21.67
Max. Negotiated Rate	$21.67
Rate for Payer: Qualcare PPO/HMO/WC	$21.67

VERSAPORT VS 5-12MM TROCAR

Facility

$636.67

Hospital Charge Code	270639297
Hospital Revenue Code	272
Min. Negotiated Rate	$15.34
Max. Negotiated Rate	$318.33
Rate for Payer: Aetna Commercial	$241.93
Rate for Payer: Aetna Medicare Advantage	$191.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$162.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$162.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$162.35
Rate for Payer: Cigna Commercial	$318.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.00
Rate for Payer: Oxford Commercial	$127.33
Rate for Payer: Qualcare PPO/HMO/WC	$95.50
Rate for Payer: UnitedHealthcare Commercial	$127.33
Rate for Payer: UnitedHealthcare Community & State	$15.34
Rate for Payer: Wellpoint Medicaid Managed Care	$16.87

VERSAPORT VS 5-12MM TROCAR

Facility

$636.67

Hospital Charge Code	270639297
Hospital Revenue Code	272
Min. Negotiated Rate	$95.50
Max. Negotiated Rate	$95.50
Rate for Payer: Qualcare PPO/HMO/WC	$95.50

VERSA SHORT 5 MM CANNULA

Facility

$561.28

Hospital Charge Code	270690399
Hospital Revenue Code	272
Min. Negotiated Rate	$13.53
Max. Negotiated Rate	$280.64
Rate for Payer: Aetna Commercial	$213.29
Rate for Payer: Aetna Medicare Advantage	$168.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.13
Rate for Payer: Cigna Commercial	$280.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.38
Rate for Payer: Oxford Commercial	$112.26
Rate for Payer: Qualcare PPO/HMO/WC	$84.19
Rate for Payer: UnitedHealthcare Commercial	$112.26
Rate for Payer: UnitedHealthcare Community & State	$13.53
Rate for Payer: Wellpoint Medicaid Managed Care	$14.87

VERSA SHORT 5 MM CANNULA

Facility

$561.28

Hospital Charge Code	270690399
Hospital Revenue Code	272
Min. Negotiated Rate	$84.19
Max. Negotiated Rate	$84.19
Rate for Payer: Qualcare PPO/HMO/WC	$84.19

VERSASTEP 5-12MM

Facility

$268.30

Hospital Charge Code	270638917
Hospital Revenue Code	270
Min. Negotiated Rate	$6.47
Max. Negotiated Rate	$134.15
Rate for Payer: Aetna Commercial	$101.95
Rate for Payer: Aetna Medicare Advantage	$80.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.42
Rate for Payer: Cigna Commercial	$134.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.49
Rate for Payer: Oxford Commercial	$53.66
Rate for Payer: Qualcare PPO/HMO/WC	$40.24
Rate for Payer: UnitedHealthcare Commercial	$53.66
Rate for Payer: UnitedHealthcare Community & State	$6.47
Rate for Payer: Wellpoint Medicaid Managed Care	$7.11

VERSASTEP 5-12MM

Facility

$268.30

Hospital Charge Code	270638917
Hospital Revenue Code	270
Min. Negotiated Rate	$40.24
Max. Negotiated Rate	$40.24
Rate for Payer: Qualcare PPO/HMO/WC	$40.24

VERSASTEP PLUS 12MM CANN

Facility

$687.65

Hospital Charge Code	270671310
Hospital Revenue Code	272
Min. Negotiated Rate	$16.57
Max. Negotiated Rate	$343.82
Rate for Payer: Aetna Commercial	$261.31
Rate for Payer: Aetna Medicare Advantage	$206.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$175.35
Rate for Payer: Cigna Commercial	$343.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.29
Rate for Payer: Oxford Commercial	$137.53
Rate for Payer: Qualcare PPO/HMO/WC	$103.15
Rate for Payer: UnitedHealthcare Commercial	$137.53
Rate for Payer: UnitedHealthcare Community & State	$16.57
Rate for Payer: Wellpoint Medicaid Managed Care	$18.22

VERSASTEP PLUS 12MM CANN

Facility

$687.65

Hospital Charge Code	270671310
Hospital Revenue Code	272
Min. Negotiated Rate	$103.15
Max. Negotiated Rate	$103.15
Rate for Payer: Qualcare PPO/HMO/WC	$103.15

VERSASTEP PLUS LONG 12MM CANN

Facility

$650.72

Hospital Charge Code	270671311
Hospital Revenue Code	272
Min. Negotiated Rate	$97.61
Max. Negotiated Rate	$97.61
Rate for Payer: Qualcare PPO/HMO/WC	$97.61

VERSASTEP PLUS LONG 12MM CANN

Facility

$650.72

Hospital Charge Code	270671311
Hospital Revenue Code	272
Min. Negotiated Rate	$15.68
Max. Negotiated Rate	$325.36
Rate for Payer: Aetna Commercial	$247.27
Rate for Payer: Aetna Medicare Advantage	$195.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.93
Rate for Payer: Cigna Commercial	$325.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.22
Rate for Payer: Oxford Commercial	$130.14
Rate for Payer: Qualcare PPO/HMO/WC	$97.61
Rate for Payer: UnitedHealthcare Commercial	$130.14
Rate for Payer: UnitedHealthcare Community & State	$15.68
Rate for Payer: Wellpoint Medicaid Managed Care	$17.24

VERSA V2 RT OBTUR W/ 179101

Facility

$162.25

Hospital Charge Code	270636249
Hospital Revenue Code	272
Min. Negotiated Rate	$3.91
Max. Negotiated Rate	$81.12
Rate for Payer: Aetna Commercial	$61.66
Rate for Payer: Aetna Medicare Advantage	$48.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.37
Rate for Payer: Cigna Commercial	$81.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.67
Rate for Payer: Oxford Commercial	$32.45
Rate for Payer: Qualcare PPO/HMO/WC	$24.34
Rate for Payer: UnitedHealthcare Commercial	$32.45
Rate for Payer: UnitedHealthcare Community & State	$3.91
Rate for Payer: Wellpoint Medicaid Managed Care	$4.30

VERSA V2 RT OBTUR W/ 179101

Facility

$162.25

Hospital Charge Code	270636249
Hospital Revenue Code	272
Min. Negotiated Rate	$24.34
Max. Negotiated Rate	$24.34
Rate for Payer: Qualcare PPO/HMO/WC	$24.34

VERSAWRAP 5X5CM

Facility

$15,000.00

Service Code	HCPCS C1781
Hospital Charge Code	270704758
Hospital Revenue Code	278
Min. Negotiated Rate	$2,250.00
Max. Negotiated Rate	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00

VERSAWRAP 5X5CM

Facility

$15,000.00

Service Code	HCPCS C1781
Hospital Charge Code	270704758
Hospital Revenue Code	278
Min. Negotiated Rate	$361.50
Max. Negotiated Rate	$7,500.00
Rate for Payer: Aetna Commercial	$5,700.00
Rate for Payer: Aetna Medicare Advantage	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,825.00
Rate for Payer: Cigna Commercial	$7,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00
Rate for Payer: UnitedHealthcare Community & State	$361.50
Rate for Payer: Wellpoint Medicaid Managed Care	$397.50

VERSED/5MG/1ML

Facility

$71.00

Hospital Charge Code	60634153
Hospital Revenue Code	250
Min. Negotiated Rate	$1.71
Max. Negotiated Rate	$35.50
Rate for Payer: Aetna Commercial	$26.98
Rate for Payer: Aetna Medicare Advantage	$21.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.11
Rate for Payer: Cigna Commercial	$35.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.30
Rate for Payer: Oxford Commercial	$14.20
Rate for Payer: Qualcare PPO/HMO/WC	$10.65
Rate for Payer: UnitedHealthcare Commercial	$14.20
Rate for Payer: UnitedHealthcare Community & State	$1.71
Rate for Payer: Wellpoint Medicaid Managed Care	$1.88

VERSED/5MG/1ML

Facility

$71.00

Hospital Charge Code	60634153
Hospital Revenue Code	250
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$10.65
Rate for Payer: Qualcare PPO/HMO/WC	$10.65

VERSED INJ/2MG/ML/VIAL

Facility

$18.00

Hospital Charge Code	60634667
Hospital Revenue Code	636
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$9.00
Rate for Payer: Aetna Commercial	$6.84
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.36
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

VERSED INJ/2MG/ML/VIAL

Facility

$18.00

Hospital Charge Code	60634667
Hospital Revenue Code	636
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$4.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.36
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

VERSED INJ/5MG/1ML

Facility

$48.00

Hospital Charge Code	60634626
Hospital Revenue Code	636
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$24.00
Rate for Payer: Aetna Commercial	$18.24
Rate for Payer: Aetna Medicare Advantage	$14.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.24
Rate for Payer: Cigna Commercial	$24.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.62
Rate for Payer: Qualcare PPO/HMO/WC	$7.20
Rate for Payer: UnitedHealthcare Community & State	$1.16
Rate for Payer: Wellpoint Medicaid Managed Care	$1.27

VERSED INJ/5MG/1ML

Facility

$48.00

Hospital Charge Code	60634626
Hospital Revenue Code	636
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$11.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.62
Rate for Payer: Qualcare PPO/HMO/WC	$7.20

VERSY CEM/REV/CAL BUIL78710110

Facility

$1,943.75

Hospital Charge Code	270639587
Hospital Revenue Code	272
Min. Negotiated Rate	$46.84
Max. Negotiated Rate	$971.88
Rate for Payer: Aetna Commercial	$738.62
Rate for Payer: Aetna Medicare Advantage	$583.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$495.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$495.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$495.66
Rate for Payer: Cigna Commercial	$971.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$583.12
Rate for Payer: Oxford Commercial	$388.75
Rate for Payer: Qualcare PPO/HMO/WC	$291.56
Rate for Payer: UnitedHealthcare Commercial	$388.75
Rate for Payer: UnitedHealthcare Community & State	$46.84
Rate for Payer: Wellpoint Medicaid Managed Care	$51.51

VERSY CEM/REV/CAL BUIL78710110

Facility

$1,943.75

Hospital Charge Code	270639587
Hospital Revenue Code	272
Min. Negotiated Rate	$291.56
Max. Negotiated Rate	$291.56
Rate for Payer: Qualcare PPO/HMO/WC	$291.56

VERSYS ADVOCATE STDRD OFFSET

Facility

$29,335.00

Hospital Charge Code	270658835
Hospital Revenue Code	270
Min. Negotiated Rate	$706.97
Max. Negotiated Rate	$14,667.50
Rate for Payer: Aetna Commercial	$11,147.30
Rate for Payer: Aetna Medicare Advantage	$8,800.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,480.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,480.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,480.43
Rate for Payer: Cigna Commercial	$14,667.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,800.50
Rate for Payer: Oxford Commercial	$5,867.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,400.25
Rate for Payer: UnitedHealthcare Commercial	$5,867.00
Rate for Payer: UnitedHealthcare Community & State	$706.97
Rate for Payer: Wellpoint Medicaid Managed Care	$777.38

VERSYS ADVOCATE STDRD OFFSET

Facility

$29,335.00

Hospital Charge Code	270658835
Hospital Revenue Code	270
Min. Negotiated Rate	$4,400.25
Max. Negotiated Rate	$4,400.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,400.25

Know your out-of-pocket cost for care.

All Charges