Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

DRILL CANNULATED 2.9 X 140 MM

Facility

$1,550.00

Hospital Charge Code	270690332
Hospital Revenue Code	272
Min. Negotiated Rate	$232.50
Max. Negotiated Rate	$232.50
Rate for Payer: Qualcare PPO/HMO/WC	$232.50

DRILL CANNULATED 2.9 X 140 MM

Facility

$1,550.00

Hospital Charge Code	270690332
Hospital Revenue Code	272
Min. Negotiated Rate	$44.02
Max. Negotiated Rate	$775.00
Rate for Payer: Aetna Commercial	$589.00
Rate for Payer: Aetna Medicare Advantage	$465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$395.25
Rate for Payer: Cigna Commercial	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$403.00
Rate for Payer: Oxford Commercial	$310.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.50
Rate for Payer: UnitedHealthcare Commercial	$310.00
Rate for Payer: UnitedHealthcare Community & State	$48.98
Rate for Payer: Wellpoint Medicaid Managed Care	$44.02

DRILL CANNULATED 3.2MM

Facility

$840.00

Hospital Charge Code	270656782
Hospital Revenue Code	272
Min. Negotiated Rate	$126.00
Max. Negotiated Rate	$126.00
Rate for Payer: Qualcare PPO/HMO/WC	$126.00

DRILL CANNULATED 3.2MM

Facility

$840.00

Hospital Charge Code	270656782
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 CANNULATED 3.2x150mm

Facility

$1,125.00

Hospital Charge Code	270680222
Hospital Revenue Code	272
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$168.75
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

DRILL CANNULATED 3.2x150mm

Facility

$1,125.00

Hospital Charge Code	270680222
Hospital Revenue Code	272
Min. Negotiated Rate	$31.95
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Commercial	$225.00
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$31.95

DRILL CANNULATED 3.5MM

Facility

$1,460.00

Hospital Charge Code	270698763
Hospital Revenue Code	272
Min. Negotiated Rate	$219.00
Max. Negotiated Rate	$219.00
Rate for Payer: Qualcare PPO/HMO/WC	$219.00

DRILL CANNULATED 3.5MM

Facility

$1,460.00

Hospital Charge Code	270698763
Hospital Revenue Code	272
Min. Negotiated Rate	$41.46
Max. Negotiated Rate	$730.00
Rate for Payer: Aetna Commercial	$554.80
Rate for Payer: Aetna Medicare Advantage	$438.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$372.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$372.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$372.30
Rate for Payer: Cigna Commercial	$730.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$379.60
Rate for Payer: Oxford Commercial	$292.00
Rate for Payer: Qualcare PPO/HMO/WC	$219.00
Rate for Payer: UnitedHealthcare Commercial	$292.00
Rate for Payer: UnitedHealthcare Community & State	$46.14
Rate for Payer: Wellpoint Medicaid Managed Care	$41.46

DRILL CANNULATED 4.0MM

Facility

$2,455.00

Hospital Charge Code	270668440
Hospital Revenue Code	278
Min. Negotiated Rate	$69.72
Max. Negotiated Rate	$1,227.50
Rate for Payer: Aetna Commercial	$932.90
Rate for Payer: Aetna Medicare Advantage	$736.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$626.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$626.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$491.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$626.02
Rate for Payer: Cigna Commercial	$1,227.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$594.11
Rate for Payer: Qualcare PPO/HMO/WC	$368.25
Rate for Payer: UnitedHealthcare Community & State	$77.58
Rate for Payer: Wellpoint Medicaid Managed Care	$69.72

DRILL CANNULATED 4.0MM

Facility

$2,455.00

Hospital Charge Code	270668440
Hospital Revenue Code	278
Min. Negotiated Rate	$368.25
Max. Negotiated Rate	$594.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$491.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$594.11
Rate for Payer: Qualcare PPO/HMO/WC	$368.25

DRILL CANNULATED 4.0MM

Facility

$875.00

Service Code	HCPCS A4649
Hospital Charge Code	270697346
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

DRILL CANNULATED 4.0MM

Facility

$875.00

Service Code	HCPCS A4649
Hospital Charge Code	270697346
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 CANNULATED 4.5MM

Facility

$920.00

Hospital Charge Code	270655173
Hospital Revenue Code	272
Min. Negotiated Rate	$138.00
Max. Negotiated Rate	$138.00
Rate for Payer: Qualcare PPO/HMO/WC	$138.00

DRILL CANNULATED 4.5MM

Facility

$920.00

Hospital Charge Code	270655173
Hospital Revenue Code	272
Min. Negotiated Rate	$26.13
Max. Negotiated Rate	$460.00
Rate for Payer: Aetna Commercial	$349.60
Rate for Payer: Aetna Medicare Advantage	$276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$234.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$234.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$234.60
Rate for Payer: Cigna Commercial	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$239.20
Rate for Payer: Oxford Commercial	$184.00
Rate for Payer: Qualcare PPO/HMO/WC	$138.00
Rate for Payer: UnitedHealthcare Commercial	$184.00
Rate for Payer: UnitedHealthcare Community & State	$29.07
Rate for Payer: Wellpoint Medicaid Managed Care	$26.13

DRILL CANNULATED 4MM

Facility

$920.00

Hospital Charge Code	270655174
Hospital Revenue Code	272
Min. Negotiated Rate	$26.13
Max. Negotiated Rate	$460.00
Rate for Payer: Aetna Commercial	$349.60
Rate for Payer: Aetna Medicare Advantage	$276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$234.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$234.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$234.60
Rate for Payer: Cigna Commercial	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$239.20
Rate for Payer: Oxford Commercial	$184.00
Rate for Payer: Qualcare PPO/HMO/WC	$138.00
Rate for Payer: UnitedHealthcare Commercial	$184.00
Rate for Payer: UnitedHealthcare Community & State	$29.07
Rate for Payer: Wellpoint Medicaid Managed Care	$26.13

DRILL CANNULATED 4MM

Facility

$920.00

Hospital Charge Code	270655174
Hospital Revenue Code	272
Min. Negotiated Rate	$138.00
Max. Negotiated Rate	$138.00
Rate for Payer: Qualcare PPO/HMO/WC	$138.00

DRILL CANNULATED 5.0MM

Facility

$1,740.00

Hospital Charge Code	270662004
Hospital Revenue Code	272
Min. Negotiated Rate	$49.42
Max. Negotiated Rate	$870.00
Rate for Payer: Aetna Commercial	$661.20
Rate for Payer: Aetna Medicare Advantage	$522.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$443.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$443.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$443.70
Rate for Payer: Cigna Commercial	$870.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$452.40
Rate for Payer: Oxford Commercial	$348.00
Rate for Payer: Qualcare PPO/HMO/WC	$261.00
Rate for Payer: UnitedHealthcare Commercial	$348.00
Rate for Payer: UnitedHealthcare Community & State	$54.98
Rate for Payer: Wellpoint Medicaid Managed Care	$49.42

DRILL CANNULATED 5.0MM

Facility

$1,740.00

Hospital Charge Code	270662004
Hospital Revenue Code	272
Min. Negotiated Rate	$261.00
Max. Negotiated Rate	$261.00
Rate for Payer: Qualcare PPO/HMO/WC	$261.00

DRILL CANNULATED 6.5 MM

Facility

$2,200.00

Service Code	HCPCS A4649
Hospital Charge Code	270698643
Hospital Revenue Code	272
Min. Negotiated Rate	$62.48
Max. Negotiated Rate	$1,100.00
Rate for Payer: Aetna Commercial	$836.00
Rate for Payer: Aetna Medicare Advantage	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$561.00
Rate for Payer: Cigna Commercial	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$572.00
Rate for Payer: Oxford Commercial	$440.00
Rate for Payer: Qualcare PPO/HMO/WC	$330.00
Rate for Payer: UnitedHealthcare Commercial	$440.00
Rate for Payer: UnitedHealthcare Community & State	$69.52
Rate for Payer: Wellpoint Medicaid Managed Care	$62.48

DRILL CANNULATED 6.5 MM

Facility

$2,200.00

Service Code	HCPCS A4649
Hospital Charge Code	270698643
Hospital Revenue Code	272
Min. Negotiated Rate	$330.00
Max. Negotiated Rate	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$330.00

DRILL CANNULATED DIAMETER 7MM

Facility

$1,058.75

Hospital Charge Code	270666235
Hospital Revenue Code	272
Min. Negotiated Rate	$158.81
Max. Negotiated Rate	$158.81
Rate for Payer: Qualcare PPO/HMO/WC	$158.81

DRILL CANNULATED DIAMETER 7MM

Facility

$1,058.75

Hospital Charge Code	270666235
Hospital Revenue Code	272
Min. Negotiated Rate	$30.07
Max. Negotiated Rate	$529.38
Rate for Payer: Aetna Commercial	$402.32
Rate for Payer: Aetna Medicare Advantage	$317.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$269.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$269.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$269.98
Rate for Payer: Cigna Commercial	$529.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$275.27
Rate for Payer: Oxford Commercial	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$158.81
Rate for Payer: UnitedHealthcare Commercial	$211.75
Rate for Payer: UnitedHealthcare Community & State	$33.46
Rate for Payer: Wellpoint Medicaid Managed Care	$30.07

DRILL CANNULATED KIT 2.2mm

Facility

$750.00

Hospital Charge Code	270669881
Hospital Revenue Code	272
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.00
Rate for Payer: Oxford Commercial	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Commercial	$150.00
Rate for Payer: UnitedHealthcare Community & State	$23.70
Rate for Payer: Wellpoint Medicaid Managed Care	$21.30

DRILL CANNULATED KIT 2.2mm

Facility

$750.00

Hospital Charge Code	270669881
Hospital Revenue Code	272
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

DRILL CANNULATED MAX VPC 2.4MM

Facility

$1,440.00

Hospital Charge Code	270689418
Hospital Revenue Code	272
Min. Negotiated Rate	$40.90
Max. Negotiated Rate	$720.00
Rate for Payer: Aetna Commercial	$547.20
Rate for Payer: Aetna Medicare Advantage	$432.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$367.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$367.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$367.20
Rate for Payer: Cigna Commercial	$720.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$374.40
Rate for Payer: Oxford Commercial	$288.00
Rate for Payer: Qualcare PPO/HMO/WC	$216.00
Rate for Payer: UnitedHealthcare Commercial	$288.00
Rate for Payer: UnitedHealthcare Community & State	$45.50
Rate for Payer: Wellpoint Medicaid Managed Care	$40.90

Know your out-of-pocket cost for care.

All Charges