Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ELECTRODE LOOP SMALL E1559

Facility

$68.42

Hospital Charge Code	270600259
Hospital Revenue Code	272
Min. Negotiated Rate	$1.94
Max. Negotiated Rate	$34.21
Rate for Payer: Aetna Commercial	$26.00
Rate for Payer: Aetna Medicare Advantage	$20.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.45
Rate for Payer: Cigna Commercial	$34.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.79
Rate for Payer: Oxford Commercial	$13.68
Rate for Payer: Qualcare PPO/HMO/WC	$10.26
Rate for Payer: UnitedHealthcare Commercial	$13.68
Rate for Payer: UnitedHealthcare Community & State	$2.16
Rate for Payer: Wellpoint Medicaid Managed Care	$1.94

ELECTRODE LOOP WIDE E1561

Facility

$181.65

Hospital Charge Code	270600258
Hospital Revenue Code	272
Min. Negotiated Rate	$5.16
Max. Negotiated Rate	$90.83
Rate for Payer: Aetna Commercial	$69.03
Rate for Payer: Aetna Medicare Advantage	$54.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.32
Rate for Payer: Cigna Commercial	$90.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.23
Rate for Payer: Oxford Commercial	$36.33
Rate for Payer: Qualcare PPO/HMO/WC	$27.25
Rate for Payer: UnitedHealthcare Commercial	$36.33
Rate for Payer: UnitedHealthcare Community & State	$5.74
Rate for Payer: Wellpoint Medicaid Managed Care	$5.16

ELECTRODE LOOP WIDE E1561

Facility

$181.65

Hospital Charge Code	270600258
Hospital Revenue Code	272
Min. Negotiated Rate	$27.25
Max. Negotiated Rate	$27.25
Rate for Payer: Qualcare PPO/HMO/WC	$27.25

Electrode Meditrace 455

Facility

$2.40

Hospital Charge Code	270649777
Hospital Revenue Code	270
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$0.36
Rate for Payer: Qualcare PPO/HMO/WC	$0.36

Electrode Meditrace 455

Facility

$2.40

Hospital Charge Code	270649777
Hospital Revenue Code	270
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.20
Rate for Payer: Aetna Commercial	$0.91
Rate for Payer: Aetna Medicare Advantage	$0.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.61
Rate for Payer: Cigna Commercial	$1.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.62
Rate for Payer: Oxford Commercial	$0.48
Rate for Payer: Qualcare PPO/HMO/WC	$0.36
Rate for Payer: UnitedHealthcare Commercial	$0.48
Rate for Payer: UnitedHealthcare Community & State	$0.08
Rate for Payer: Wellpoint Medicaid Managed Care	$0.07

ELECTRODE PACING BI BALLOON FL

Facility

$925.00

Service Code	HCPCS C1730
Hospital Charge Code	270655417S
Hospital Revenue Code	278
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$223.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.85
Rate for Payer: Qualcare PPO/HMO/WC	$138.75

ELECTRODE PACING BI BALLOON FL

Facility

$925.00

Service Code	HCPCS C1730
Hospital Charge Code	270655417
Hospital Revenue Code	278
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$223.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.85
Rate for Payer: Qualcare PPO/HMO/WC	$138.75

ELECTRODE PACING BI BALLOON FL

Facility

$925.00

Service Code	HCPCS C1730
Hospital Charge Code	270655417S
Hospital Revenue Code	278
Min. Negotiated Rate	$26.27
Max. Negotiated Rate	$462.50
Rate for Payer: Aetna Commercial	$351.50
Rate for Payer: Aetna Medicare Advantage	$277.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.88
Rate for Payer: Cigna Commercial	$462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.85
Rate for Payer: Qualcare PPO/HMO/WC	$138.75
Rate for Payer: UnitedHealthcare Community & State	$29.23
Rate for Payer: Wellpoint Medicaid Managed Care	$26.27

ELECTRODE PACING BI BALLOON FL

Facility

$925.00

Service Code	HCPCS C1730
Hospital Charge Code	270655417
Hospital Revenue Code	278
Min. Negotiated Rate	$26.27
Max. Negotiated Rate	$462.50
Rate for Payer: Aetna Commercial	$351.50
Rate for Payer: Aetna Medicare Advantage	$277.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.88
Rate for Payer: Cigna Commercial	$462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.85
Rate for Payer: Qualcare PPO/HMO/WC	$138.75
Rate for Payer: UnitedHealthcare Community & State	$29.23
Rate for Payer: Wellpoint Medicaid Managed Care	$26.27

ELECTRODE PACING BI BALLOON FL

Facility

$905.00

Service Code	HCPCS C1730
Hospital Charge Code	270655417N
Hospital Revenue Code	278
Min. Negotiated Rate	$25.70
Max. Negotiated Rate	$452.50
Rate for Payer: Aetna Commercial	$343.90
Rate for Payer: Aetna Medicare Advantage	$271.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.78
Rate for Payer: Cigna Commercial	$452.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.01
Rate for Payer: Qualcare PPO/HMO/WC	$135.75
Rate for Payer: UnitedHealthcare Community & State	$28.60
Rate for Payer: Wellpoint Medicaid Managed Care	$25.70

ELECTRODE PACING BI BALLOON FL

Facility

$905.00

Service Code	HCPCS C1730
Hospital Charge Code	270655417N
Hospital Revenue Code	278
Min. Negotiated Rate	$135.75
Max. Negotiated Rate	$219.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.01
Rate for Payer: Qualcare PPO/HMO/WC	$135.75

ELECTRODE PAIRED 4-CHANNEL

Facility

$445.00

Hospital Charge Code	270678075
Hospital Revenue Code	272
Min. Negotiated Rate	$66.75
Max. Negotiated Rate	$66.75
Rate for Payer: Qualcare PPO/HMO/WC	$66.75

ELECTRODE PAIRED 4-CHANNEL

Facility

$445.00

Hospital Charge Code	270678075
Hospital Revenue Code	272
Min. Negotiated Rate	$12.64
Max. Negotiated Rate	$222.50
Rate for Payer: Aetna Commercial	$169.10
Rate for Payer: Aetna Medicare Advantage	$133.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.47
Rate for Payer: Cigna Commercial	$222.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$115.70
Rate for Payer: Oxford Commercial	$89.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.75
Rate for Payer: UnitedHealthcare Commercial	$89.00
Rate for Payer: UnitedHealthcare Community & State	$14.06
Rate for Payer: Wellpoint Medicaid Managed Care	$12.64

ELECTRODE RADIOFREQUENCY CURVE

Facility

$55.60

Hospital Charge Code	270657281
Hospital Revenue Code	272
Min. Negotiated Rate	$8.34
Max. Negotiated Rate	$8.34
Rate for Payer: Qualcare PPO/HMO/WC	$8.34

ELECTRODE RADIOFREQUENCY CURVE

Facility

$55.60

Hospital Charge Code	270657281
Hospital Revenue Code	272
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$27.80
Rate for Payer: Aetna Commercial	$21.13
Rate for Payer: Aetna Medicare Advantage	$16.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.18
Rate for Payer: Cigna Commercial	$27.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.46
Rate for Payer: Oxford Commercial	$11.12
Rate for Payer: Qualcare PPO/HMO/WC	$8.34
Rate for Payer: UnitedHealthcare Commercial	$11.12
Rate for Payer: UnitedHealthcare Community & State	$1.76
Rate for Payer: Wellpoint Medicaid Managed Care	$1.58

ELECTRODE RESECTASCOPE LOOP

Facility

$247.50

Hospital Charge Code	270618275
Hospital Revenue Code	272
Min. Negotiated Rate	$7.03
Max. Negotiated Rate	$123.75
Rate for Payer: Aetna Commercial	$94.05
Rate for Payer: Aetna Medicare Advantage	$74.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.11
Rate for Payer: Cigna Commercial	$123.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.35
Rate for Payer: Oxford Commercial	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.12
Rate for Payer: UnitedHealthcare Commercial	$49.50
Rate for Payer: UnitedHealthcare Community & State	$7.82
Rate for Payer: Wellpoint Medicaid Managed Care	$7.03

ELECTRODE RESECTASCOPE LOOP

Facility

$247.50

Hospital Charge Code	270618275
Hospital Revenue Code	272
Min. Negotiated Rate	$37.12
Max. Negotiated Rate	$37.12
Rate for Payer: Qualcare PPO/HMO/WC	$37.12

ELECTRODE ROLLER BALL

Facility

$499.17

Hospital Charge Code	270655414
Hospital Revenue Code	271
Min. Negotiated Rate	$14.18
Max. Negotiated Rate	$249.59
Rate for Payer: Aetna Commercial	$189.68
Rate for Payer: Aetna Medicare Advantage	$149.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.29
Rate for Payer: Cigna Commercial	$249.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.78
Rate for Payer: Oxford Commercial	$99.83
Rate for Payer: Qualcare PPO/HMO/WC	$74.88
Rate for Payer: UnitedHealthcare Commercial	$99.83
Rate for Payer: UnitedHealthcare Community & State	$15.77
Rate for Payer: Wellpoint Medicaid Managed Care	$14.18

ELECTRODE ROLLER BALL

Facility

$499.17

Hospital Charge Code	270655414
Hospital Revenue Code	271
Min. Negotiated Rate	$74.88
Max. Negotiated Rate	$74.88
Rate for Payer: Qualcare PPO/HMO/WC	$74.88

ELECTRODE SAFEOP EMG KIT

Facility

$6,600.00

Hospital Charge Code	270698069
Hospital Revenue Code	272
Min. Negotiated Rate	$187.44
Max. Negotiated Rate	$3,300.00
Rate for Payer: Aetna Commercial	$2,508.00
Rate for Payer: Aetna Medicare Advantage	$1,980.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.00
Rate for Payer: Cigna Commercial	$3,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.00
Rate for Payer: Oxford Commercial	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.00
Rate for Payer: UnitedHealthcare Commercial	$1,320.00
Rate for Payer: UnitedHealthcare Community & State	$208.56
Rate for Payer: Wellpoint Medicaid Managed Care	$187.44

ELECTRODE SAFEOP EMG KIT

Facility

$6,600.00

Hospital Charge Code	270698069
Hospital Revenue Code	272
Min. Negotiated Rate	$990.00
Max. Negotiated Rate	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.00

ELECTRODE SS BALL 5MM DIA

Facility

$68.78

Hospital Charge Code	270676242
Hospital Revenue Code	272
Min. Negotiated Rate	$10.32
Max. Negotiated Rate	$10.32
Rate for Payer: Qualcare PPO/HMO/WC	$10.32

ELECTRODE SS BALL 5MM DIA

Facility

$68.78

Hospital Charge Code	270676242
Hospital Revenue Code	272
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$34.39
Rate for Payer: Aetna Commercial	$26.14
Rate for Payer: Aetna Medicare Advantage	$20.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.54
Rate for Payer: Cigna Commercial	$34.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.88
Rate for Payer: Oxford Commercial	$13.76
Rate for Payer: Qualcare PPO/HMO/WC	$10.32
Rate for Payer: UnitedHealthcare Commercial	$13.76
Rate for Payer: UnitedHealthcare Community & State	$2.17
Rate for Payer: Wellpoint Medicaid Managed Care	$1.95

ELECTRODE STZ COAG 24F 27050L

Facility

$477.66

Hospital Charge Code	270627179
Hospital Revenue Code	272
Min. Negotiated Rate	$13.57
Max. Negotiated Rate	$238.83
Rate for Payer: Aetna Commercial	$181.51
Rate for Payer: Aetna Medicare Advantage	$143.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.80
Rate for Payer: Cigna Commercial	$238.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.19
Rate for Payer: Oxford Commercial	$95.53
Rate for Payer: Qualcare PPO/HMO/WC	$71.65
Rate for Payer: UnitedHealthcare Commercial	$95.53
Rate for Payer: UnitedHealthcare Community & State	$15.09
Rate for Payer: Wellpoint Medicaid Managed Care	$13.57

ELECTRODE STZ COAG 24F 27050L

Facility

$477.66

Hospital Charge Code	270627179
Hospital Revenue Code	272
Min. Negotiated Rate	$71.65
Max. Negotiated Rate	$71.65
Rate for Payer: Qualcare PPO/HMO/WC	$71.65

Know your out-of-pocket cost for care.

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