Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

DRILL BIT CANNULATED 2.0X130MM

Facility

$840.00

Service Code	HCPCS A4649
Hospital Charge Code	270698260
Hospital Revenue Code	272
Min. Negotiated Rate	$23.86
Max. Negotiated Rate	$420.00
Rate for Payer: Aetna Commercial	$319.20
Rate for Payer: Aetna Medicare Advantage	$252.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$214.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$214.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$214.20
Rate for Payer: Cigna Commercial	$420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.40
Rate for Payer: Oxford Commercial	$168.00
Rate for Payer: Qualcare PPO/HMO/WC	$126.00
Rate for Payer: UnitedHealthcare Commercial	$168.00
Rate for Payer: UnitedHealthcare Community & State	$26.54
Rate for Payer: Wellpoint Medicaid Managed Care	$23.86

DRILL BIT CANNULATED 2.1MM

Facility

$1,893.75

Service Code	HCPCS A4649
Hospital Charge Code	270698690
Hospital Revenue Code	272
Min. Negotiated Rate	$53.78
Max. Negotiated Rate	$946.88
Rate for Payer: Aetna Commercial	$719.62
Rate for Payer: Aetna Medicare Advantage	$568.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$482.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$482.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$482.91
Rate for Payer: Cigna Commercial	$946.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$492.38
Rate for Payer: Oxford Commercial	$378.75
Rate for Payer: Qualcare PPO/HMO/WC	$284.06
Rate for Payer: UnitedHealthcare Commercial	$378.75
Rate for Payer: UnitedHealthcare Community & State	$59.84
Rate for Payer: Wellpoint Medicaid Managed Care	$53.78

DRILL BIT CANNULATED 2.1MM

Facility

$1,893.75

Service Code	HCPCS A4649
Hospital Charge Code	270698690
Hospital Revenue Code	272
Min. Negotiated Rate	$284.06
Max. Negotiated Rate	$284.06
Rate for Payer: Qualcare PPO/HMO/WC	$284.06

DRILL BIT CANNULATED 2.2MM

Facility

$840.00

Hospital Charge Code	270667125
Hospital Revenue Code	272
Min. Negotiated Rate	$23.86
Max. Negotiated Rate	$420.00
Rate for Payer: Aetna Commercial	$319.20
Rate for Payer: Aetna Medicare Advantage	$252.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$214.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$214.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$214.20
Rate for Payer: Cigna Commercial	$420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.40
Rate for Payer: Oxford Commercial	$168.00
Rate for Payer: Qualcare PPO/HMO/WC	$126.00
Rate for Payer: UnitedHealthcare Commercial	$168.00
Rate for Payer: UnitedHealthcare Community & State	$26.54
Rate for Payer: Wellpoint Medicaid Managed Care	$23.86

DRILL BIT CANNULATED 2.2MM

Facility

$840.00

Hospital Charge Code	270667125
Hospital Revenue Code	272
Min. Negotiated Rate	$126.00
Max. Negotiated Rate	$126.00
Rate for Payer: Qualcare PPO/HMO/WC	$126.00

DRILL BIT CANNULATED 2.4MM

Facility

$2,375.00

Hospital Charge Code	270669224
Hospital Revenue Code	272
Min. Negotiated Rate	$67.45
Max. Negotiated Rate	$1,187.50
Rate for Payer: Aetna Commercial	$902.50
Rate for Payer: Aetna Medicare Advantage	$712.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$605.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$605.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$605.62
Rate for Payer: Cigna Commercial	$1,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$617.50
Rate for Payer: Oxford Commercial	$475.00
Rate for Payer: Qualcare PPO/HMO/WC	$356.25
Rate for Payer: UnitedHealthcare Commercial	$475.00
Rate for Payer: UnitedHealthcare Community & State	$75.05
Rate for Payer: Wellpoint Medicaid Managed Care	$67.45

DRILL BIT CANNULATED 2.4MM

Facility

$1,965.00

Hospital Charge Code	270674572
Hospital Revenue Code	272
Min. Negotiated Rate	$55.81
Max. Negotiated Rate	$982.50
Rate for Payer: Aetna Commercial	$746.70
Rate for Payer: Aetna Medicare Advantage	$589.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$501.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$501.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$501.07
Rate for Payer: Cigna Commercial	$982.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$510.90
Rate for Payer: Oxford Commercial	$393.00
Rate for Payer: Qualcare PPO/HMO/WC	$294.75
Rate for Payer: UnitedHealthcare Commercial	$393.00
Rate for Payer: UnitedHealthcare Community & State	$62.09
Rate for Payer: Wellpoint Medicaid Managed Care	$55.81

DRILL BIT CANNULATED 2.4MM

Facility

$1,965.00

Hospital Charge Code	270674572
Hospital Revenue Code	272
Min. Negotiated Rate	$294.75
Max. Negotiated Rate	$294.75
Rate for Payer: Qualcare PPO/HMO/WC	$294.75

DRILL BIT CANNULATED 2.4MM

Facility

$2,375.00

Hospital Charge Code	270669224
Hospital Revenue Code	272
Min. Negotiated Rate	$356.25
Max. Negotiated Rate	$356.25
Rate for Payer: Qualcare PPO/HMO/WC	$356.25

DRILL BIT CANNULATED 2.5MM

Facility

$840.00

Hospital Charge Code	270675124
Hospital Revenue Code	272
Min. Negotiated Rate	$126.00
Max. Negotiated Rate	$126.00
Rate for Payer: Qualcare PPO/HMO/WC	$126.00

DRILL BIT CANNULATED 2.5MM

Facility

$840.00

Hospital Charge Code	270675124
Hospital Revenue Code	272
Min. Negotiated Rate	$23.86
Max. Negotiated Rate	$420.00
Rate for Payer: Aetna Commercial	$319.20
Rate for Payer: Aetna Medicare Advantage	$252.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$214.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$214.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$214.20
Rate for Payer: Cigna Commercial	$420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.40
Rate for Payer: Oxford Commercial	$168.00
Rate for Payer: Qualcare PPO/HMO/WC	$126.00
Rate for Payer: UnitedHealthcare Commercial	$168.00
Rate for Payer: UnitedHealthcare Community & State	$26.54
Rate for Payer: Wellpoint Medicaid Managed Care	$23.86

DRILL BIT CANNULATED 2.5MM

Facility

$1,100.00

Hospital Charge Code	270698540
Hospital Revenue Code	272
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00

DRILL BIT CANNULATED 2.5MM

Facility

$1,100.00

Hospital Charge Code	270698540
Hospital Revenue Code	272
Min. Negotiated Rate	$31.24
Max. Negotiated Rate	$550.00
Rate for Payer: Aetna Commercial	$418.00
Rate for Payer: Aetna Medicare Advantage	$330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$280.50
Rate for Payer: Cigna Commercial	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$286.00
Rate for Payer: Oxford Commercial	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00
Rate for Payer: UnitedHealthcare Commercial	$220.00
Rate for Payer: UnitedHealthcare Community & State	$34.76
Rate for Payer: Wellpoint Medicaid Managed Care	$31.24

DRILL BIT CANNULATED 3.0MM

Facility

$840.00

Hospital Charge Code	270676768
Hospital Revenue Code	272
Min. Negotiated Rate	$23.86
Max. Negotiated Rate	$420.00
Rate for Payer: Aetna Commercial	$319.20
Rate for Payer: Aetna Medicare Advantage	$252.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$214.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$214.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$214.20
Rate for Payer: Cigna Commercial	$420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.40
Rate for Payer: Oxford Commercial	$168.00
Rate for Payer: Qualcare PPO/HMO/WC	$126.00
Rate for Payer: UnitedHealthcare Commercial	$168.00
Rate for Payer: UnitedHealthcare Community & State	$26.54
Rate for Payer: Wellpoint Medicaid Managed Care	$23.86

DRILL BIT CANNULATED 3.0MM

Facility

$1,250.00

Hospital Charge Code	270687933
Hospital Revenue Code	272
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

DRILL BIT CANNULATED 3.0MM

Facility

$1,250.00

Hospital Charge Code	270687933
Hospital Revenue Code	272
Min. Negotiated Rate	$35.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$325.00
Rate for Payer: Oxford Commercial	$250.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Commercial	$250.00
Rate for Payer: UnitedHealthcare Community & State	$39.50
Rate for Payer: Wellpoint Medicaid Managed Care	$35.50

DRILL BIT CANNULATED 3.0MM

Facility

$840.00

Hospital Charge Code	270676768
Hospital Revenue Code	272
Min. Negotiated Rate	$126.00
Max. Negotiated Rate	$126.00
Rate for Payer: Qualcare PPO/HMO/WC	$126.00

DRILL BIT CANNULATED 3.2MM

Facility

$1,990.00

Hospital Charge Code	270673485
Hospital Revenue Code	272
Min. Negotiated Rate	$298.50
Max. Negotiated Rate	$298.50
Rate for Payer: Qualcare PPO/HMO/WC	$298.50

DRILL BIT CANNULATED 3.2MM

Facility

$1,990.00

Hospital Charge Code	270673485
Hospital Revenue Code	272
Min. Negotiated Rate	$56.52
Max. Negotiated Rate	$995.00
Rate for Payer: Aetna Commercial	$756.20
Rate for Payer: Aetna Medicare Advantage	$597.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$507.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$507.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$507.45
Rate for Payer: Cigna Commercial	$995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$517.40
Rate for Payer: Oxford Commercial	$398.00
Rate for Payer: Qualcare PPO/HMO/WC	$298.50
Rate for Payer: UnitedHealthcare Commercial	$398.00
Rate for Payer: UnitedHealthcare Community & State	$62.88
Rate for Payer: Wellpoint Medicaid Managed Care	$56.52

DRILL BIT CANNULATED 3.7X200MM

Facility

$2,330.00

Service Code	HCPCS A4649
Hospital Charge Code	270698261
Hospital Revenue Code	272
Min. Negotiated Rate	$349.50
Max. Negotiated Rate	$349.50
Rate for Payer: Qualcare PPO/HMO/WC	$349.50

DRILL BIT CANNULATED 3.7X200MM

Facility

$2,330.00

Service Code	HCPCS A4649
Hospital Charge Code	270698261
Hospital Revenue Code	272
Min. Negotiated Rate	$66.17
Max. Negotiated Rate	$1,165.00
Rate for Payer: Aetna Commercial	$885.40
Rate for Payer: Aetna Medicare Advantage	$699.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$594.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$594.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$594.15
Rate for Payer: Cigna Commercial	$1,165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.80
Rate for Payer: Oxford Commercial	$466.00
Rate for Payer: Qualcare PPO/HMO/WC	$349.50
Rate for Payer: UnitedHealthcare Commercial	$466.00
Rate for Payer: UnitedHealthcare Community & State	$73.63
Rate for Payer: Wellpoint Medicaid Managed Care	$66.17

DRILL BIT CANNULATED 3MM

Facility

$875.00

Hospital Charge Code	270661060
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

DRILL BIT CANNULATED 3MM

Facility

$875.00

Hospital Charge Code	270661060
Hospital Revenue Code	272
Min. Negotiated Rate	$24.85
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$27.65
Rate for Payer: Wellpoint Medicaid Managed Care	$24.85

DRILL BIT CANNULATED 3 X 170mm

Facility

$1,650.00

Hospital Charge Code	270681219
Hospital Revenue Code	272
Min. Negotiated Rate	$247.50
Max. Negotiated Rate	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$247.50

DRILL BIT CANNULATED 3 X 170mm

Facility

$1,650.00

Hospital Charge Code	270681219
Hospital Revenue Code	272
Min. Negotiated Rate	$46.86
Max. Negotiated Rate	$825.00
Rate for Payer: Aetna Commercial	$627.00
Rate for Payer: Aetna Medicare Advantage	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$420.75
Rate for Payer: Cigna Commercial	$825.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$429.00
Rate for Payer: Oxford Commercial	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$247.50
Rate for Payer: UnitedHealthcare Commercial	$330.00
Rate for Payer: UnitedHealthcare Community & State	$52.14
Rate for Payer: Wellpoint Medicaid Managed Care	$46.86

Know your out-of-pocket cost for care.

All Charges