Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

V TIPS ENDOPROSTHESIS 12MMX8CM

Facility

$19,990.00

Hospital Charge Code	2709007356
Hospital Revenue Code	272
Min. Negotiated Rate	$2,998.50
Max. Negotiated Rate	$2,998.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,998.50

V TIPS ENDOPROSTHESIS 12MMX8CM

Facility

$19,990.00

Hospital Charge Code	2709007356
Hospital Revenue Code	272
Min. Negotiated Rate	$481.76
Max. Negotiated Rate	$9,995.00
Rate for Payer: Aetna Commercial	$7,596.20
Rate for Payer: Aetna Medicare Advantage	$5,997.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,097.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,097.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,097.45
Rate for Payer: Cigna Commercial	$9,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,997.00
Rate for Payer: Oxford Commercial	$3,998.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,998.50
Rate for Payer: UnitedHealthcare Commercial	$3,998.00
Rate for Payer: UnitedHealthcare Community & State	$481.76
Rate for Payer: Wellpoint Medicaid Managed Care	$529.74

VUCAN PROBE ABLATOR #910003

Facility

$697.00

Hospital Charge Code	270335610
Hospital Revenue Code	272
Min. Negotiated Rate	$104.55
Max. Negotiated Rate	$104.55
Rate for Payer: Qualcare PPO/HMO/WC	$104.55

VUCAN PROBE ABLATOR #910003

Facility

$697.00

Hospital Charge Code	270335610
Hospital Revenue Code	272
Min. Negotiated Rate	$16.80
Max. Negotiated Rate	$348.50
Rate for Payer: Aetna Commercial	$264.86
Rate for Payer: Aetna Medicare Advantage	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.74
Rate for Payer: Cigna Commercial	$348.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.10
Rate for Payer: Oxford Commercial	$139.40
Rate for Payer: Qualcare PPO/HMO/WC	$104.55
Rate for Payer: UnitedHealthcare Commercial	$139.40
Rate for Payer: UnitedHealthcare Community & State	$16.80
Rate for Payer: Wellpoint Medicaid Managed Care	$18.47

VUCAN PROBE ELECTROTHERMAL

Facility

$697.00

Hospital Charge Code	270335601
Hospital Revenue Code	272
Min. Negotiated Rate	$104.55
Max. Negotiated Rate	$104.55
Rate for Payer: Qualcare PPO/HMO/WC	$104.55

VUCAN PROBE ELECTROTHERMAL

Facility

$697.00

Hospital Charge Code	270335601
Hospital Revenue Code	272
Min. Negotiated Rate	$16.80
Max. Negotiated Rate	$348.50
Rate for Payer: Aetna Commercial	$264.86
Rate for Payer: Aetna Medicare Advantage	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.74
Rate for Payer: Cigna Commercial	$348.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.10
Rate for Payer: Oxford Commercial	$139.40
Rate for Payer: Qualcare PPO/HMO/WC	$104.55
Rate for Payer: UnitedHealthcare Commercial	$139.40
Rate for Payer: UnitedHealthcare Community & State	$16.80
Rate for Payer: Wellpoint Medicaid Managed Care	$18.47

VUCAN PROBE LIGAMENT CHISEL

Facility

$272.00

Hospital Charge Code	270335611
Hospital Revenue Code	272
Min. Negotiated Rate	$6.56
Max. Negotiated Rate	$136.00
Rate for Payer: Aetna Commercial	$103.36
Rate for Payer: Aetna Medicare Advantage	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.36
Rate for Payer: Cigna Commercial	$136.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.60
Rate for Payer: Oxford Commercial	$54.40
Rate for Payer: Qualcare PPO/HMO/WC	$40.80
Rate for Payer: UnitedHealthcare Commercial	$54.40
Rate for Payer: UnitedHealthcare Community & State	$6.56
Rate for Payer: Wellpoint Medicaid Managed Care	$7.21

VUCAN PROBE LIGAMENT CHISEL

Facility

$272.00

Hospital Charge Code	270335611
Hospital Revenue Code	272
Min. Negotiated Rate	$40.80
Max. Negotiated Rate	$40.80
Rate for Payer: Qualcare PPO/HMO/WC	$40.80

VUE POWERPORT 6 FR

Facility

$3,290.00

Service Code	HCPCS C1751
Hospital Charge Code	270654983
Hospital Revenue Code	278
Min. Negotiated Rate	$79.29
Max. Negotiated Rate	$1,645.00
Rate for Payer: Aetna Commercial	$1,250.20
Rate for Payer: Aetna Medicare Advantage	$987.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$838.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$838.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$658.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$838.95
Rate for Payer: Cigna Commercial	$1,645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$796.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$723.80
Rate for Payer: Qualcare PPO/HMO/WC	$493.50
Rate for Payer: UnitedHealthcare Community & State	$79.29
Rate for Payer: Wellpoint Medicaid Managed Care	$87.19

VUE POWERPORT 6 FR

Facility

$3,290.00

Service Code	HCPCS C1751
Hospital Charge Code	270654983
Hospital Revenue Code	278
Min. Negotiated Rate	$493.50
Max. Negotiated Rate	$796.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$658.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$796.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$723.80
Rate for Payer: Qualcare PPO/HMO/WC	$493.50

VZ AB IGM

Facility

$390.00

Service Code	HCPCS 86787
Hospital Charge Code	39900387
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

VZ AB IGM

Facility

$390.00

Service Code	HCPCS 86787
Hospital Charge Code	39900387
Hospital Revenue Code	302
Min. Negotiated Rate	$10.30
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$35.03
Rate for Payer: Aetna Medicare Advantage	$41.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.49
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.88
Rate for Payer: Clover Medicare Advantage	$12.24
Rate for Payer: EmblemHealth Commercial	$38.64
Rate for Payer: Humana Medicare Advantage	$13.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.88
Rate for Payer: Wellcare Medicare Advantage	$12.88
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

VZV AB (IGG),EIA

Facility

$390.00

Service Code	HCPCS 86787
Hospital Charge Code	39900258
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

VZV AB (IGG),EIA

Facility

$390.00

Service Code	HCPCS 86787
Hospital Charge Code	39900258
Hospital Revenue Code	302
Min. Negotiated Rate	$10.30
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$35.03
Rate for Payer: Aetna Medicare Advantage	$41.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.49
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.88
Rate for Payer: Clover Medicare Advantage	$12.24
Rate for Payer: EmblemHealth Commercial	$38.64
Rate for Payer: Humana Medicare Advantage	$13.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.88
Rate for Payer: Wellcare Medicare Advantage	$12.88
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

WADA ACTIVATION

Facility

$5,700.00

Service Code	HCPCS 95958
Hospital Charge Code	411095958
Hospital Revenue Code	740
Min. Negotiated Rate	$137.37
Max. Negotiated Rate	$5,944.00
Rate for Payer: Aetna Commercial	$2,774.97
Rate for Payer: Aetna Medicare Advantage	$3,305.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,682.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,682.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,020.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$938.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,682.65
Rate for Payer: Cigna Commercial	$2,044.99
Rate for Payer: Cigna Medicare Advantage	$1,020.21
Rate for Payer: Clover Medicare Advantage	$969.20
Rate for Payer: EmblemHealth Commercial	$3,060.63
Rate for Payer: Humana Medicare Advantage	$1,050.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,020.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,710.00
Rate for Payer: Oxford Commercial	$3,390.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00
Rate for Payer: UnitedHealthcare Commercial	$5,944.00
Rate for Payer: UnitedHealthcare Community & State	$137.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,020.21
Rate for Payer: Wellcare Medicare Advantage	$1,020.21
Rate for Payer: Wellpoint Medicaid Managed Care	$151.05

WADA ACTIVATION

Facility

$5,700.00

Service Code	HCPCS 95958
Hospital Charge Code	411095958
Hospital Revenue Code	740
Min. Negotiated Rate	$855.00
Max. Negotiated Rate	$855.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00

WAFER DURAHESIVE FLANGE 2-14

Facility

$6.60

Hospital Charge Code	270647419
Hospital Revenue Code	270
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$3.30
Rate for Payer: Aetna Commercial	$2.51
Rate for Payer: Aetna Medicare Advantage	$1.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.68
Rate for Payer: Cigna Commercial	$3.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.98
Rate for Payer: Oxford Commercial	$1.32
Rate for Payer: Qualcare PPO/HMO/WC	$0.99
Rate for Payer: UnitedHealthcare Commercial	$1.32
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.17

WAFER DURAHESIVE FLANGE 2-14

Facility

$6.60

Hospital Charge Code	270647419
Hospital Revenue Code	270
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$0.99
Rate for Payer: Qualcare PPO/HMO/WC	$0.99

WAFER DURA PRECUT 1

Facility

$71.25

Hospital Charge Code	270303183
Hospital Revenue Code	272
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$35.62
Rate for Payer: Aetna Commercial	$27.07
Rate for Payer: Aetna Medicare Advantage	$21.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.17
Rate for Payer: Cigna Commercial	$35.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.38
Rate for Payer: Oxford Commercial	$14.25
Rate for Payer: Qualcare PPO/HMO/WC	$10.69
Rate for Payer: UnitedHealthcare Commercial	$14.25
Rate for Payer: UnitedHealthcare Community & State	$1.72
Rate for Payer: Wellpoint Medicaid Managed Care	$1.89

WAFER DURA PRECUT 1

Facility

$71.25

Hospital Charge Code	270303183
Hospital Revenue Code	272
Min. Negotiated Rate	$10.69
Max. Negotiated Rate	$10.69
Rate for Payer: Qualcare PPO/HMO/WC	$10.69

WAFER DURA PRECUT 1 1/4

Facility

$56.00

Hospital Charge Code	270303185
Hospital Revenue Code	272
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$28.00
Rate for Payer: Aetna Commercial	$21.28
Rate for Payer: Aetna Medicare Advantage	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.28
Rate for Payer: Cigna Commercial	$28.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.80
Rate for Payer: Oxford Commercial	$11.20
Rate for Payer: Qualcare PPO/HMO/WC	$8.40
Rate for Payer: UnitedHealthcare Commercial	$11.20
Rate for Payer: UnitedHealthcare Community & State	$1.35
Rate for Payer: Wellpoint Medicaid Managed Care	$1.48

WAFER DURA PRECUT 1 1/4

Facility

$56.00

Hospital Charge Code	270303185
Hospital Revenue Code	272
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.40

WAFER DURA PRECUT 1 1/8

Facility

$56.00

Hospital Charge Code	270303184
Hospital Revenue Code	272
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$28.00
Rate for Payer: Aetna Commercial	$21.28
Rate for Payer: Aetna Medicare Advantage	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.28
Rate for Payer: Cigna Commercial	$28.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.80
Rate for Payer: Oxford Commercial	$11.20
Rate for Payer: Qualcare PPO/HMO/WC	$8.40
Rate for Payer: UnitedHealthcare Commercial	$11.20
Rate for Payer: UnitedHealthcare Community & State	$1.35
Rate for Payer: Wellpoint Medicaid Managed Care	$1.48

WAFER DURA PRECUT 1 1/8

Facility

$56.00

Hospital Charge Code	270303184
Hospital Revenue Code	272
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.40

WAFER DURA PRECUT 7/8

Facility

$56.00

Hospital Charge Code	270303182
Hospital Revenue Code	272
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.40

Know your out-of-pocket cost for care.

All Charges