Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$18.56
Max. Negotiated Rate	$71.40
Rate for Payer: Aetna Commercial	$42.84
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	$18.56
Rate for Payer: Oxford Commercial	$71.40
Rate for Payer: Qualcare PPO/HMO/WC	$21.42
Rate for Payer: UnitedHealthcare Commercial	$71.40

VERSAPORT V2 PLUS 5-12MM

Facility

$142.80

Hospital Charge Code	270600113
Hospital Revenue Code	272
Min. Negotiated Rate	$18.56
Max. Negotiated Rate	$71.40
Rate for Payer: Aetna Commercial	$42.84
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	$18.56
Rate for Payer: Oxford Commercial	$71.40
Rate for Payer: Qualcare PPO/HMO/WC	$21.42
Rate for Payer: UnitedHealthcare Commercial	$71.40

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 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 V2 TROCAR 5-12MM LNG

Facility

$144.47

Hospital Charge Code	270600065
Hospital Revenue Code	272
Min. Negotiated Rate	$18.78
Max. Negotiated Rate	$72.23
Rate for Payer: Aetna Commercial	$43.34
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	$18.78
Rate for Payer: Oxford Commercial	$72.23
Rate for Payer: Qualcare PPO/HMO/WC	$21.67
Rate for Payer: UnitedHealthcare Commercial	$72.23

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

VERSAPORT VS 5-12MM TROCAR

Facility

$636.67

Hospital Charge Code	270639297
Hospital Revenue Code	272
Min. Negotiated Rate	$82.77
Max. Negotiated Rate	$318.33
Rate for Payer: Aetna Commercial	$191.00
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	$82.77
Rate for Payer: Oxford Commercial	$318.33
Rate for Payer: Qualcare PPO/HMO/WC	$95.50
Rate for Payer: UnitedHealthcare Commercial	$318.33

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

VERSA SHORT 5 MM CANNULA

Facility

$561.28

Hospital Charge Code	270690399
Hospital Revenue Code	272
Min. Negotiated Rate	$72.97
Max. Negotiated Rate	$280.64
Rate for Payer: Aetna Commercial	$168.38
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	$72.97
Rate for Payer: Oxford Commercial	$280.64
Rate for Payer: Qualcare PPO/HMO/WC	$84.19
Rate for Payer: UnitedHealthcare Commercial	$280.64

VERSASTEP 5-12MM

Facility

$268.30

Hospital Charge Code	270638917
Hospital Revenue Code	270
Min. Negotiated Rate	$34.88
Max. Negotiated Rate	$134.15
Rate for Payer: Aetna Commercial	$80.49
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	$34.88
Rate for Payer: Oxford Commercial	$134.15
Rate for Payer: Qualcare PPO/HMO/WC	$40.24
Rate for Payer: UnitedHealthcare Commercial	$134.15

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	$103.15
Max. Negotiated Rate	$103.15
Rate for Payer: Qualcare PPO/HMO/WC	$103.15

VERSASTEP PLUS 12MM CANN

Facility

$687.65

Hospital Charge Code	270671310
Hospital Revenue Code	272
Min. Negotiated Rate	$89.39
Max. Negotiated Rate	$343.82
Rate for Payer: Aetna Commercial	$206.29
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	$89.39
Rate for Payer: Oxford Commercial	$343.82
Rate for Payer: Qualcare PPO/HMO/WC	$103.15
Rate for Payer: UnitedHealthcare Commercial	$343.82

VERSASTEP PLUS LONG 12MM CANN

Facility

$650.72

Hospital Charge Code	270671311
Hospital Revenue Code	272
Min. Negotiated Rate	$84.59
Max. Negotiated Rate	$325.36
Rate for Payer: Aetna Commercial	$195.22
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	$84.59
Rate for Payer: Oxford Commercial	$325.36
Rate for Payer: Qualcare PPO/HMO/WC	$97.61
Rate for Payer: UnitedHealthcare Commercial	$325.36

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

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

VERSA V2 RT OBTUR W/ 179101

Facility

$162.25

Hospital Charge Code	270636249
Hospital Revenue Code	272
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$81.12
Rate for Payer: Aetna Commercial	$48.67
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	$21.09
Rate for Payer: Oxford Commercial	$81.12
Rate for Payer: Qualcare PPO/HMO/WC	$24.34
Rate for Payer: UnitedHealthcare Commercial	$81.12

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	$7,500.00
Rate for Payer: Aetna Commercial	$4,500.00
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: 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	$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: Qualcare PPO/HMO/WC	$2,250.00

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/5MG/1ML

Facility

$71.00

Hospital Charge Code	60634153
Hospital Revenue Code	250
Min. Negotiated Rate	$9.23
Max. Negotiated Rate	$35.50
Rate for Payer: Aetna Commercial	$21.30
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	$9.23
Rate for Payer: Oxford Commercial	$35.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.65
Rate for Payer: UnitedHealthcare Commercial	$35.50

VERSED INJ/2MG/ML/VIAL

Facility

$18.00

Hospital Charge Code	60634667
Hospital Revenue Code	636
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$9.00
Rate for Payer: Aetna Commercial	$5.40
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

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	$7.20
Max. Negotiated Rate	$24.00
Rate for Payer: Aetna Commercial	$14.40
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

Know your out-of-pocket cost for care.

All Charges