Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ELECTRODE LEEP BALL 3MM 900161

Facility

$110.10

Hospital Charge Code	270608103
Hospital Revenue Code	272
Min. Negotiated Rate	$16.52
Max. Negotiated Rate	$16.52
Rate for Payer: Qualcare PPO/HMO/WC	$16.52

ELECTRODE LEEP BALL 3MM 900161

Facility

$110.10

Hospital Charge Code	270608103
Hospital Revenue Code	272
Min. Negotiated Rate	$3.13
Max. Negotiated Rate	$55.05
Rate for Payer: Aetna Commercial	$41.84
Rate for Payer: Aetna Medicare Advantage	$33.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.08
Rate for Payer: Cigna Commercial	$55.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.63
Rate for Payer: Oxford Commercial	$22.02
Rate for Payer: Qualcare PPO/HMO/WC	$16.52
Rate for Payer: UnitedHealthcare Commercial	$22.02
Rate for Payer: UnitedHealthcare Community & State	$3.48
Rate for Payer: Wellpoint Medicaid Managed Care	$3.13

ELECTRODE LEEP BALL 5MM 900163

Facility

$110.10

Hospital Charge Code	270608102
Hospital Revenue Code	272
Min. Negotiated Rate	$3.13
Max. Negotiated Rate	$55.05
Rate for Payer: Aetna Commercial	$41.84
Rate for Payer: Aetna Medicare Advantage	$33.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.08
Rate for Payer: Cigna Commercial	$55.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.63
Rate for Payer: Oxford Commercial	$22.02
Rate for Payer: Qualcare PPO/HMO/WC	$16.52
Rate for Payer: UnitedHealthcare Commercial	$22.02
Rate for Payer: UnitedHealthcare Community & State	$3.48
Rate for Payer: Wellpoint Medicaid Managed Care	$3.13

ELECTRODE LEEP BALL 5MM 900163

Facility

$110.10

Hospital Charge Code	270608102
Hospital Revenue Code	272
Min. Negotiated Rate	$16.52
Max. Negotiated Rate	$16.52
Rate for Payer: Qualcare PPO/HMO/WC	$16.52

ELECTRODE LEEP/LLETZ LOOP

Facility

$68.75

Hospital Charge Code	270676782
Hospital Revenue Code	272
Min. Negotiated Rate	$10.31
Max. Negotiated Rate	$10.31
Rate for Payer: Qualcare PPO/HMO/WC	$10.31

ELECTRODE LEEP/LLETZ LOOP

Facility

$68.75

Hospital Charge Code	270676782
Hospital Revenue Code	272
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$34.38
Rate for Payer: Aetna Commercial	$26.12
Rate for Payer: Aetna Medicare Advantage	$20.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.53
Rate for Payer: Cigna Commercial	$34.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.88
Rate for Payer: Oxford Commercial	$13.75
Rate for Payer: Qualcare PPO/HMO/WC	$10.31
Rate for Payer: UnitedHealthcare Commercial	$13.75
Rate for Payer: UnitedHealthcare Community & State	$2.17
Rate for Payer: Wellpoint Medicaid Managed Care	$1.95

ELECTRODE LETZ LOOP SML YELLOW

Facility

$75.00

Hospital Charge Code	270658132
Hospital Revenue Code	270
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$2.37
Rate for Payer: Wellpoint Medicaid Managed Care	$2.13

ELECTRODE LETZ LOOP SML YELLOW

Facility

$75.00

Hospital Charge Code	270658132
Hospital Revenue Code	270
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

ELECTRODE LEVEEN COACCESS 4.0

Facility

$10,175.00

Hospital Charge Code	270631815
Hospital Revenue Code	272
Min. Negotiated Rate	$288.97
Max. Negotiated Rate	$5,087.50
Rate for Payer: Aetna Commercial	$3,866.50
Rate for Payer: Aetna Medicare Advantage	$3,052.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,594.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,594.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,594.62
Rate for Payer: Cigna Commercial	$5,087.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,645.50
Rate for Payer: Oxford Commercial	$2,035.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,526.25
Rate for Payer: UnitedHealthcare Commercial	$2,035.00
Rate for Payer: UnitedHealthcare Community & State	$321.53
Rate for Payer: Wellpoint Medicaid Managed Care	$288.97

ELECTRODE LEVEEN COACCESS 4.0

Facility

$10,175.00

Hospital Charge Code	270631815
Hospital Revenue Code	272
Min. Negotiated Rate	$1,526.25
Max. Negotiated Rate	$1,526.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,526.25

ELECTRODE L HOOK 36CM

Facility

$162.70

Hospital Charge Code	270692089
Hospital Revenue Code	272
Min. Negotiated Rate	$4.62
Max. Negotiated Rate	$81.35
Rate for Payer: Aetna Commercial	$61.83
Rate for Payer: Aetna Medicare Advantage	$48.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.49
Rate for Payer: Cigna Commercial	$81.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.30
Rate for Payer: Oxford Commercial	$32.54
Rate for Payer: Qualcare PPO/HMO/WC	$24.41
Rate for Payer: UnitedHealthcare Commercial	$32.54
Rate for Payer: UnitedHealthcare Community & State	$5.14
Rate for Payer: Wellpoint Medicaid Managed Care	$4.62

ELECTRODE L HOOK 36CM

Facility

$162.70

Hospital Charge Code	270692089
Hospital Revenue Code	272
Min. Negotiated Rate	$24.41
Max. Negotiated Rate	$24.41
Rate for Payer: Qualcare PPO/HMO/WC	$24.41

ELECTRODE L HOOK 36CM

Facility

$162.72

Hospital Charge Code	270691560
Hospital Revenue Code	272
Min. Negotiated Rate	$24.41
Max. Negotiated Rate	$24.41
Rate for Payer: Qualcare PPO/HMO/WC	$24.41

ELECTRODE L HOOK 36CM

Facility

$162.72

Hospital Charge Code	270691560
Hospital Revenue Code	272
Min. Negotiated Rate	$4.62
Max. Negotiated Rate	$81.36
Rate for Payer: Aetna Commercial	$61.83
Rate for Payer: Aetna Medicare Advantage	$48.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.49
Rate for Payer: Cigna Commercial	$81.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.31
Rate for Payer: Oxford Commercial	$32.54
Rate for Payer: Qualcare PPO/HMO/WC	$24.41
Rate for Payer: UnitedHealthcare Commercial	$32.54
Rate for Payer: UnitedHealthcare Community & State	$5.14
Rate for Payer: Wellpoint Medicaid Managed Care	$4.62

ELECTRODE LOOP 20x12 DLPW11

Facility

$75.00

Hospital Charge Code	270632344
Hospital Revenue Code	272
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$2.37
Rate for Payer: Wellpoint Medicaid Managed Care	$2.13

ELECTRODE LOOP 20x12 DLPW11

Facility

$75.00

Hospital Charge Code	270632344
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

ELECTRODE LOOP 24FR

Facility

$662.50

Hospital Charge Code	270657516
Hospital Revenue Code	270
Min. Negotiated Rate	$99.38
Max. Negotiated Rate	$99.38
Rate for Payer: Qualcare PPO/HMO/WC	$99.38

ELECTRODE LOOP 24FR

Facility

$662.50

Hospital Charge Code	270657516
Hospital Revenue Code	270
Min. Negotiated Rate	$18.82
Max. Negotiated Rate	$331.25
Rate for Payer: Aetna Commercial	$251.75
Rate for Payer: Aetna Medicare Advantage	$198.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.94
Rate for Payer: Cigna Commercial	$331.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.25
Rate for Payer: Oxford Commercial	$132.50
Rate for Payer: Qualcare PPO/HMO/WC	$99.38
Rate for Payer: UnitedHealthcare Commercial	$132.50
Rate for Payer: UnitedHealthcare Community & State	$20.93
Rate for Payer: Wellpoint Medicaid Managed Care	$18.82

ELECTRODE LOOP GREEN 10X12mm

Facility

$75.00

Hospital Charge Code	270620072
Hospital Revenue Code	272
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$2.37
Rate for Payer: Wellpoint Medicaid Managed Care	$2.13

ELECTRODE LOOP GREEN 10X12mm

Facility

$75.00

Hospital Charge Code	270620072
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

ELECTRODE LOOP HF RESECT 26 FR

Facility

$5,860.05

Hospital Charge Code	270657327
Hospital Revenue Code	272
Min. Negotiated Rate	$879.01
Max. Negotiated Rate	$879.01
Rate for Payer: Qualcare PPO/HMO/WC	$879.01

ELECTRODE LOOP HF RESECT 26 FR

Facility

$5,860.05

Hospital Charge Code	270657327
Hospital Revenue Code	272
Min. Negotiated Rate	$166.43
Max. Negotiated Rate	$2,930.03
Rate for Payer: Aetna Commercial	$2,226.82
Rate for Payer: Aetna Medicare Advantage	$1,758.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,494.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,494.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,494.31
Rate for Payer: Cigna Commercial	$2,930.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,523.61
Rate for Payer: Oxford Commercial	$1,172.01
Rate for Payer: Qualcare PPO/HMO/WC	$879.01
Rate for Payer: UnitedHealthcare Commercial	$1,172.01
Rate for Payer: UnitedHealthcare Community & State	$185.18
Rate for Payer: Wellpoint Medicaid Managed Care	$166.43

ELECTRODE LOOP LLETZ 12x15MM

Facility

$65.50

Hospital Charge Code	270677127
Hospital Revenue Code	272
Min. Negotiated Rate	$1.86
Max. Negotiated Rate	$32.75
Rate for Payer: Aetna Commercial	$24.89
Rate for Payer: Aetna Medicare Advantage	$19.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.70
Rate for Payer: Cigna Commercial	$32.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.03
Rate for Payer: Oxford Commercial	$13.10
Rate for Payer: Qualcare PPO/HMO/WC	$9.82
Rate for Payer: UnitedHealthcare Commercial	$13.10
Rate for Payer: UnitedHealthcare Community & State	$2.07
Rate for Payer: Wellpoint Medicaid Managed Care	$1.86

ELECTRODE LOOP LLETZ 12x15MM

Facility

$65.50

Hospital Charge Code	270677127
Hospital Revenue Code	272
Min. Negotiated Rate	$9.82
Max. Negotiated Rate	$9.82
Rate for Payer: Qualcare PPO/HMO/WC	$9.82

ELECTRODE LOOP SMALL E1559

Facility

$68.42

Hospital Charge Code	270600259
Hospital Revenue Code	272
Min. Negotiated Rate	$10.26
Max. Negotiated Rate	$10.26
Rate for Payer: Qualcare PPO/HMO/WC	$10.26

Know your out-of-pocket cost for care.

All Charges