Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

END CAP TI T40 STARDRIVE

Facility

$879.00

Service Code	HCPCS C1713
Hospital Charge Code	270671812
Hospital Revenue Code	278
Min. Negotiated Rate	$24.96
Max. Negotiated Rate	$439.50
Rate for Payer: Aetna Commercial	$334.02
Rate for Payer: Aetna Medicare Advantage	$263.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.15
Rate for Payer: Cigna Commercial	$439.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$212.72
Rate for Payer: Qualcare PPO/HMO/WC	$131.85
Rate for Payer: UnitedHealthcare Community & State	$27.78
Rate for Payer: Wellpoint Medicaid Managed Care	$24.96

END CAP TI T40 STARDRIVE

Facility

$879.00

Service Code	HCPCS C1713
Hospital Charge Code	270671812
Hospital Revenue Code	278
Min. Negotiated Rate	$131.85
Max. Negotiated Rate	$212.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$212.72
Rate for Payer: Qualcare PPO/HMO/WC	$131.85

END CAP TI W T25 SD FOR NAIL

Facility

$1,106.15

Service Code	HCPCS C1713
Hospital Charge Code	270693261
Hospital Revenue Code	278
Min. Negotiated Rate	$165.92
Max. Negotiated Rate	$267.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$221.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$267.69
Rate for Payer: Qualcare PPO/HMO/WC	$165.92

END CAP TI W T25 SD FOR NAIL

Facility

$1,106.15

Service Code	HCPCS C1713
Hospital Charge Code	270693261
Hospital Revenue Code	278
Min. Negotiated Rate	$31.41
Max. Negotiated Rate	$553.08
Rate for Payer: Aetna Commercial	$420.34
Rate for Payer: Aetna Medicare Advantage	$331.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$282.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$282.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$221.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$282.07
Rate for Payer: Cigna Commercial	$553.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$267.69
Rate for Payer: Qualcare PPO/HMO/WC	$165.92
Rate for Payer: UnitedHealthcare Community & State	$34.95
Rate for Payer: Wellpoint Medicaid Managed Care	$31.41

END CAP VALOR

Facility

$1,060.00

Hospital Charge Code	270677452
Hospital Revenue Code	272
Min. Negotiated Rate	$30.10
Max. Negotiated Rate	$530.00
Rate for Payer: Aetna Commercial	$402.80
Rate for Payer: Aetna Medicare Advantage	$318.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$270.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$270.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$270.30
Rate for Payer: Cigna Commercial	$530.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$275.60
Rate for Payer: Oxford Commercial	$212.00
Rate for Payer: Qualcare PPO/HMO/WC	$159.00
Rate for Payer: UnitedHealthcare Commercial	$212.00
Rate for Payer: UnitedHealthcare Community & State	$33.50
Rate for Payer: Wellpoint Medicaid Managed Care	$30.10

END CAP VALOR

Facility

$1,060.00

Hospital Charge Code	270677452
Hospital Revenue Code	272
Min. Negotiated Rate	$159.00
Max. Negotiated Rate	$159.00
Rate for Payer: Qualcare PPO/HMO/WC	$159.00

ENDOBABCOCK 10mm

Facility

$349.65

Hospital Charge Code	270655928
Hospital Revenue Code	272
Min. Negotiated Rate	$9.93
Max. Negotiated Rate	$174.82
Rate for Payer: Aetna Commercial	$132.87
Rate for Payer: Aetna Medicare Advantage	$104.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.16
Rate for Payer: Cigna Commercial	$174.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.91
Rate for Payer: Oxford Commercial	$69.93
Rate for Payer: Qualcare PPO/HMO/WC	$52.45
Rate for Payer: UnitedHealthcare Commercial	$69.93
Rate for Payer: UnitedHealthcare Community & State	$11.05
Rate for Payer: Wellpoint Medicaid Managed Care	$9.93

ENDOBABCOCK 10mm

Facility

$349.65

Hospital Charge Code	270655928
Hospital Revenue Code	272
Min. Negotiated Rate	$52.45
Max. Negotiated Rate	$52.45
Rate for Payer: Qualcare PPO/HMO/WC	$52.45

ENDO BABCOCK 1MM CLAMP

Facility

$567.00

Hospital Charge Code	270330811
Hospital Revenue Code	272
Min. Negotiated Rate	$16.10
Max. Negotiated Rate	$283.50
Rate for Payer: Aetna Commercial	$215.46
Rate for Payer: Aetna Medicare Advantage	$170.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.59
Rate for Payer: Cigna Commercial	$283.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.42
Rate for Payer: Oxford Commercial	$113.40
Rate for Payer: Qualcare PPO/HMO/WC	$85.05
Rate for Payer: UnitedHealthcare Commercial	$113.40
Rate for Payer: UnitedHealthcare Community & State	$17.92
Rate for Payer: Wellpoint Medicaid Managed Care	$16.10

ENDO BABCOCK 1MM CLAMP

Facility

$567.00

Hospital Charge Code	270330811
Hospital Revenue Code	272
Min. Negotiated Rate	$85.05
Max. Negotiated Rate	$85.05
Rate for Payer: Qualcare PPO/HMO/WC	$85.05

ENDO BEDSIDE TUBE PROCEDURE

Facility

$500.00

Hospital Charge Code	2500263
Hospital Revenue Code	360
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

ENDO BEDSIDE TUBE PROCEDURE

Facility

$500.00

Hospital Charge Code	2500263
Hospital Revenue Code	360
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

ENDO BIOPSY FORCEPS

Facility

$229.00

Hospital Charge Code	270325602
Hospital Revenue Code	272
Min. Negotiated Rate	$34.35
Max. Negotiated Rate	$34.35
Rate for Payer: Qualcare PPO/HMO/WC	$34.35

ENDO BIOPSY FORCEPS

Facility

$229.00

Hospital Charge Code	270325602
Hospital Revenue Code	272
Min. Negotiated Rate	$6.50
Max. Negotiated Rate	$114.50
Rate for Payer: Aetna Commercial	$87.02
Rate for Payer: Aetna Medicare Advantage	$68.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.40
Rate for Payer: Cigna Commercial	$114.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.54
Rate for Payer: Oxford Commercial	$45.80
Rate for Payer: Qualcare PPO/HMO/WC	$34.35
Rate for Payer: UnitedHealthcare Commercial	$45.80
Rate for Payer: UnitedHealthcare Community & State	$7.24
Rate for Payer: Wellpoint Medicaid Managed Care	$6.50

ENDOBLADE

Facility

$4,475.00

Hospital Charge Code	270681170
Hospital Revenue Code	272
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$671.25
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

ENDOBLADE

Facility

$4,475.00

Hospital Charge Code	270681170
Hospital Revenue Code	272
Min. Negotiated Rate	$127.09
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,700.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,163.50
Rate for Payer: Oxford Commercial	$895.00
Rate for Payer: Qualcare PPO/HMO/WC	$671.25
Rate for Payer: UnitedHealthcare Commercial	$895.00
Rate for Payer: UnitedHealthcare Community & State	$141.41
Rate for Payer: Wellpoint Medicaid Managed Care	$127.09

ENDOBLADE PLANTAR X2

Facility

$4,475.00

Hospital Charge Code	270689930
Hospital Revenue Code	272
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$671.25
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

ENDOBLADE PLANTAR X2

Facility

$4,475.00

Hospital Charge Code	270689930
Hospital Revenue Code	272
Min. Negotiated Rate	$127.09
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,700.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,163.50
Rate for Payer: Oxford Commercial	$895.00
Rate for Payer: Qualcare PPO/HMO/WC	$671.25
Rate for Payer: UnitedHealthcare Commercial	$895.00
Rate for Payer: UnitedHealthcare Community & State	$141.41
Rate for Payer: Wellpoint Medicaid Managed Care	$127.09

ENDO BLADE SAMURAI

Facility

$1,225.00

Hospital Charge Code	270668507
Hospital Revenue Code	272
Min. Negotiated Rate	$183.75
Max. Negotiated Rate	$183.75
Rate for Payer: Qualcare PPO/HMO/WC	$183.75

ENDO BLADE SAMURAI

Facility

$1,225.00

Hospital Charge Code	270668507
Hospital Revenue Code	272
Min. Negotiated Rate	$34.79
Max. Negotiated Rate	$612.50
Rate for Payer: Aetna Commercial	$465.50
Rate for Payer: Aetna Medicare Advantage	$367.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$312.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$312.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$312.38
Rate for Payer: Cigna Commercial	$612.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.50
Rate for Payer: Oxford Commercial	$245.00
Rate for Payer: Qualcare PPO/HMO/WC	$183.75
Rate for Payer: UnitedHealthcare Commercial	$245.00
Rate for Payer: UnitedHealthcare Community & State	$38.71
Rate for Payer: Wellpoint Medicaid Managed Care	$34.79

ENDOBRONCHIAL BLOCKER ARNDT 9F

Facility

$1,305.20

Hospital Charge Code	270663829
Hospital Revenue Code	270
Min. Negotiated Rate	$195.78
Max. Negotiated Rate	$195.78
Rate for Payer: Qualcare PPO/HMO/WC	$195.78

ENDOBRONCHIAL BLOCKER ARNDT 9F

Facility

$1,305.20

Hospital Charge Code	270663829
Hospital Revenue Code	270
Min. Negotiated Rate	$37.07
Max. Negotiated Rate	$652.60
Rate for Payer: Aetna Commercial	$495.98
Rate for Payer: Aetna Medicare Advantage	$391.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$332.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$332.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$332.83
Rate for Payer: Cigna Commercial	$652.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$339.35
Rate for Payer: Oxford Commercial	$261.04
Rate for Payer: Qualcare PPO/HMO/WC	$195.78
Rate for Payer: UnitedHealthcare Commercial	$261.04
Rate for Payer: UnitedHealthcare Community & State	$41.24
Rate for Payer: Wellpoint Medicaid Managed Care	$37.07

ENDO CANNULA FLOWPORT II

Facility

$1,445.00

Hospital Charge Code	270668508
Hospital Revenue Code	272
Min. Negotiated Rate	$41.04
Max. Negotiated Rate	$722.50
Rate for Payer: Aetna Commercial	$549.10
Rate for Payer: Aetna Medicare Advantage	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$368.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$368.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$368.48
Rate for Payer: Cigna Commercial	$722.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.70
Rate for Payer: Oxford Commercial	$289.00
Rate for Payer: Qualcare PPO/HMO/WC	$216.75
Rate for Payer: UnitedHealthcare Commercial	$289.00
Rate for Payer: UnitedHealthcare Community & State	$45.66
Rate for Payer: Wellpoint Medicaid Managed Care	$41.04

ENDO CANNULA FLOWPORT II

Facility

$1,445.00

Hospital Charge Code	270668508
Hospital Revenue Code	272
Min. Negotiated Rate	$216.75
Max. Negotiated Rate	$216.75
Rate for Payer: Qualcare PPO/HMO/WC	$216.75

ENDO CANNULA TRANSPORT

Facility

$450.00

Hospital Charge Code	270668506
Hospital Revenue Code	272
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

Know your out-of-pocket cost for care.

All Charges