Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

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	$35.72
Max. Negotiated Rate	$35.72
Rate for Payer: Qualcare PPO/HMO/WC	$35.72

VERSAPORT PLUS RPF 5MM-8MM

Facility

$238.15

Hospital Charge Code	270662186
Hospital Revenue Code	270
Min. Negotiated Rate	$6.76
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	$61.92
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	$7.53
Rate for Payer: Wellpoint Medicaid Managed Care	$6.76

VERSAPORT PLUS V2 11mm TROCAR

Facility

$142.80

Hospital Charge Code	270642023
Hospital Revenue Code	272
Min. Negotiated Rate	$4.06
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	$37.13
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	$4.51
Rate for Payer: Wellpoint Medicaid Managed Care	$4.06

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 V2 5MM

Facility

$102.00

Hospital Charge Code	270600067
Hospital Revenue Code	272
Min. Negotiated Rate	$2.90
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	$26.52
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	$3.22
Rate for Payer: Wellpoint Medicaid Managed Care	$2.90

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	$22.95
Max. Negotiated Rate	$22.95
Rate for Payer: Qualcare PPO/HMO/WC	$22.95

VERSAPORT V2 BLDLES OPT 11 STD

Facility

$153.00

Hospital Charge Code	270675469
Hospital Revenue Code	272
Min. Negotiated Rate	$4.35
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	$39.78
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	$4.83
Rate for Payer: Wellpoint Medicaid Managed Care	$4.35

VERSAPORT V2 PLUS 12mm LONG

Facility

$142.80

Hospital Charge Code	270628983
Hospital Revenue Code	272
Min. Negotiated Rate	$4.06
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	$37.13
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	$4.51
Rate for Payer: Wellpoint Medicaid Managed Care	$4.06

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 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	$4.06
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	$37.13
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	$4.51
Rate for Payer: Wellpoint Medicaid Managed Care	$4.06

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	$4.10
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	$37.56
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	$4.57
Rate for Payer: Wellpoint Medicaid Managed Care	$4.10

VERSAPORT VS 5-12MM TROCAR

Facility

$636.67

Hospital Charge Code	270639297
Hospital Revenue Code	272
Min. Negotiated Rate	$18.08
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	$165.53
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	$20.12
Rate for Payer: Wellpoint Medicaid Managed Care	$18.08

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	$15.94
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	$145.93
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	$17.74
Rate for Payer: Wellpoint Medicaid Managed Care	$15.94

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	$40.24
Max. Negotiated Rate	$40.24
Rate for Payer: Qualcare PPO/HMO/WC	$40.24

VERSASTEP 5-12MM

Facility

$268.30

Hospital Charge Code	270638917
Hospital Revenue Code	270
Min. Negotiated Rate	$7.62
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	$69.76
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	$8.48
Rate for Payer: Wellpoint Medicaid Managed Care	$7.62

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	$19.53
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	$178.79
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	$21.73
Rate for Payer: Wellpoint Medicaid Managed Care	$19.53

VERSASTEP PLUS LONG 12MM CANN

Facility

$650.72

Hospital Charge Code	270671311
Hospital Revenue Code	272
Min. Negotiated Rate	$18.48
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	$169.19
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	$20.56
Rate for Payer: Wellpoint Medicaid Managed Care	$18.48

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

Know your out-of-pocket cost for care.

All Charges