Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

VESSEL MAPPING HEMO ACCESS

Facility

$6,700.00

Service Code	HCPCS G0365
Hospital Charge Code	2692240
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

VESSEL MAPPING HEMO ACCESS

Facility

$6,700.00

Service Code	HCPCS G0365
Hospital Charge Code	2692240
Hospital Revenue Code	402
Min. Negotiated Rate	$161.47
Max. Negotiated Rate	$3,350.00
Rate for Payer: Aetna Commercial	$2,546.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$3,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$161.47
Rate for Payer: Wellpoint Medicaid Managed Care	$177.55

VESSEL MAPPING HEMO ACCESS

Facility

$6,700.00

Service Code	HCPCS G0365
Hospital Charge Code	404270365
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

VESSEL MAPPING HEMO ACCESS

Facility

$6,700.00

Service Code	HCPCS G0365
Hospital Charge Code	404270365
Hospital Revenue Code	402
Min. Negotiated Rate	$161.47
Max. Negotiated Rate	$3,350.00
Rate for Payer: Aetna Commercial	$2,546.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$3,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$161.47
Rate for Payer: Wellpoint Medicaid Managed Care	$177.55

VESSEL MAPPING HEMO ACCESS BIL

Facility

$6,700.00

Service Code	HCPCS G0365
Hospital Charge Code	2692241
Hospital Revenue Code	402
Min. Negotiated Rate	$161.47
Max. Negotiated Rate	$3,350.00
Rate for Payer: Aetna Commercial	$2,546.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$3,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$161.47
Rate for Payer: Wellpoint Medicaid Managed Care	$177.55

VESSEL MAPPING HEMO ACCESS BIL

Facility

$6,700.00

Service Code	HCPCS G0365
Hospital Charge Code	2692241
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

VESSEL SEALER EXTEND

Facility

$3,125.00

Hospital Charge Code	270683865
Hospital Revenue Code	272
Min. Negotiated Rate	$75.31
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$1,187.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.50
Rate for Payer: Oxford Commercial	$625.00
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Commercial	$625.00
Rate for Payer: UnitedHealthcare Community & State	$75.31
Rate for Payer: Wellpoint Medicaid Managed Care	$82.81

VESSEL SEALER EXTEND

Facility

$3,125.00

Hospital Charge Code	270683865
Hospital Revenue Code	272
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$468.75
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

VESSEL UMBILICAL W/POWER CATH

Facility

$311.41

Hospital Charge Code	270654041
Hospital Revenue Code	270
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$155.71
Rate for Payer: Aetna Commercial	$118.34
Rate for Payer: Aetna Medicare Advantage	$93.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.41
Rate for Payer: Cigna Commercial	$155.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.42
Rate for Payer: Oxford Commercial	$62.28
Rate for Payer: Qualcare PPO/HMO/WC	$46.71
Rate for Payer: UnitedHealthcare Commercial	$62.28
Rate for Payer: UnitedHealthcare Community & State	$7.50
Rate for Payer: Wellpoint Medicaid Managed Care	$8.25

VESSEL UMBILICAL W/POWER CATH

Facility

$311.41

Hospital Charge Code	270654041
Hospital Revenue Code	270
Min. Negotiated Rate	$46.71
Max. Negotiated Rate	$46.71
Rate for Payer: Qualcare PPO/HMO/WC	$46.71

VESSLE SIZING CATH 100CM

Facility

$650.00

Hospital Charge Code	270686377
Hospital Revenue Code	272
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

VESSLE SIZING CATH 100CM

Facility

$650.00

Hospital Charge Code	270686377
Hospital Revenue Code	272
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.00
Rate for Payer: Oxford Commercial	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Commercial	$130.00
Rate for Payer: UnitedHealthcare Community & State	$15.66
Rate for Payer: Wellpoint Medicaid Managed Care	$17.23

VEST POSEY TIE-BACK ALL SZS

Facility

$124.85

Hospital Charge Code	270609500
Hospital Revenue Code	270
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$62.42
Rate for Payer: Aetna Commercial	$47.44
Rate for Payer: Aetna Medicare Advantage	$37.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.84
Rate for Payer: Cigna Commercial	$62.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.45
Rate for Payer: Oxford Commercial	$24.97
Rate for Payer: Qualcare PPO/HMO/WC	$18.73
Rate for Payer: UnitedHealthcare Commercial	$24.97
Rate for Payer: UnitedHealthcare Community & State	$3.01
Rate for Payer: Wellpoint Medicaid Managed Care	$3.31

VEST POSEY TIE-BACK ALL SZS

Facility

$124.85

Hospital Charge Code	270609500
Hospital Revenue Code	270
Min. Negotiated Rate	$18.73
Max. Negotiated Rate	$18.73
Rate for Payer: Qualcare PPO/HMO/WC	$18.73

VEST SPU DISP WRAP LG

Facility

$332.15

Hospital Charge Code	270653059
Hospital Revenue Code	270
Min. Negotiated Rate	$49.82
Max. Negotiated Rate	$49.82
Rate for Payer: Qualcare PPO/HMO/WC	$49.82

VEST SPU DISP WRAP LG

Facility

$332.15

Hospital Charge Code	270653059
Hospital Revenue Code	270
Min. Negotiated Rate	$8.00
Max. Negotiated Rate	$166.07
Rate for Payer: Aetna Commercial	$126.22
Rate for Payer: Aetna Medicare Advantage	$99.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.70
Rate for Payer: Cigna Commercial	$166.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.64
Rate for Payer: Oxford Commercial	$66.43
Rate for Payer: Qualcare PPO/HMO/WC	$49.82
Rate for Payer: UnitedHealthcare Commercial	$66.43
Rate for Payer: UnitedHealthcare Community & State	$8.00
Rate for Payer: Wellpoint Medicaid Managed Care	$8.80

VEST SPU DISP WRAP MED

Facility

$343.10

Hospital Charge Code	270653064
Hospital Revenue Code	270
Min. Negotiated Rate	$8.27
Max. Negotiated Rate	$171.55
Rate for Payer: Aetna Commercial	$130.38
Rate for Payer: Aetna Medicare Advantage	$102.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.49
Rate for Payer: Cigna Commercial	$171.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.93
Rate for Payer: Oxford Commercial	$68.62
Rate for Payer: Qualcare PPO/HMO/WC	$51.47
Rate for Payer: UnitedHealthcare Commercial	$68.62
Rate for Payer: UnitedHealthcare Community & State	$8.27
Rate for Payer: Wellpoint Medicaid Managed Care	$9.09

VEST SPU DISP WRAP MED

Facility

$343.10

Hospital Charge Code	270653064
Hospital Revenue Code	270
Min. Negotiated Rate	$51.47
Max. Negotiated Rate	$51.47
Rate for Payer: Qualcare PPO/HMO/WC	$51.47

VEST SPU DISP WRAP SM

Facility

$343.10

Hospital Charge Code	270653065
Hospital Revenue Code	270
Min. Negotiated Rate	$51.47
Max. Negotiated Rate	$51.47
Rate for Payer: Qualcare PPO/HMO/WC	$51.47

VEST SPU DISP WRAP SM

Facility

$343.10

Hospital Charge Code	270653065
Hospital Revenue Code	270
Min. Negotiated Rate	$8.27
Max. Negotiated Rate	$171.55
Rate for Payer: Aetna Commercial	$130.38
Rate for Payer: Aetna Medicare Advantage	$102.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.49
Rate for Payer: Cigna Commercial	$171.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.93
Rate for Payer: Oxford Commercial	$68.62
Rate for Payer: Qualcare PPO/HMO/WC	$51.47
Rate for Payer: UnitedHealthcare Commercial	$68.62
Rate for Payer: UnitedHealthcare Community & State	$8.27
Rate for Payer: Wellpoint Medicaid Managed Care	$9.09

VEST SPU DISP WRAP XLG

Facility

$343.10

Hospital Charge Code	270653067
Hospital Revenue Code	270
Min. Negotiated Rate	$51.47
Max. Negotiated Rate	$51.47
Rate for Payer: Qualcare PPO/HMO/WC	$51.47

VEST SPU DISP WRAP XLG

Facility

$343.10

Hospital Charge Code	270653067
Hospital Revenue Code	270
Min. Negotiated Rate	$8.27
Max. Negotiated Rate	$171.55
Rate for Payer: Aetna Commercial	$130.38
Rate for Payer: Aetna Medicare Advantage	$102.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.49
Rate for Payer: Cigna Commercial	$171.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.93
Rate for Payer: Oxford Commercial	$68.62
Rate for Payer: Qualcare PPO/HMO/WC	$51.47
Rate for Payer: UnitedHealthcare Commercial	$68.62
Rate for Payer: UnitedHealthcare Community & State	$8.27
Rate for Payer: Wellpoint Medicaid Managed Care	$9.09

VFEND 50MG TAB

Facility

$148.14

Service Code	NDC 49317030
Hospital Charge Code	60635403
Hospital Revenue Code	250
Min. Negotiated Rate	$22.22
Max. Negotiated Rate	$22.22
Rate for Payer: Qualcare PPO/HMO/WC	$22.22

VFEND 50MG TAB

Facility

$148.14

Service Code	NDC 49317030
Hospital Charge Code	60635403
Hospital Revenue Code	250
Min. Negotiated Rate	$3.57
Max. Negotiated Rate	$74.07
Rate for Payer: Aetna Commercial	$56.29
Rate for Payer: Aetna Medicare Advantage	$44.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.78
Rate for Payer: Cigna Commercial	$74.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.44
Rate for Payer: Oxford Commercial	$29.63
Rate for Payer: Qualcare PPO/HMO/WC	$22.22
Rate for Payer: UnitedHealthcare Commercial	$29.63
Rate for Payer: UnitedHealthcare Community & State	$3.57
Rate for Payer: Wellpoint Medicaid Managed Care	$3.93

VG 360 DST FM AG 62 5X5 LL/RM

Facility

$6,090.00

Service Code	HCPCS C1776
Hospital Charge Code	270687275
Hospital Revenue Code	278
Min. Negotiated Rate	$146.77
Max. Negotiated Rate	$3,045.00
Rate for Payer: Aetna Commercial	$2,314.20
Rate for Payer: Aetna Medicare Advantage	$1,827.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,552.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,552.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,218.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,552.95
Rate for Payer: Cigna Commercial	$3,045.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,473.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,339.80
Rate for Payer: Qualcare PPO/HMO/WC	$913.50
Rate for Payer: UnitedHealthcare Community & State	$146.77
Rate for Payer: Wellpoint Medicaid Managed Care	$161.38

Know your out-of-pocket cost for care.

All Charges