Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ENDO DISC KIT

Facility

$12,500.00

Hospital Charge Code	270702956
Hospital Revenue Code	272
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$1,875.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

ENDO EMR KIT

Facility

$495.00

Hospital Charge Code	270325500
Hospital Revenue Code	272
Min. Negotiated Rate	$74.25
Max. Negotiated Rate	$74.25
Rate for Payer: Qualcare PPO/HMO/WC	$74.25

ENDO EMR KIT

Facility

$495.00

Hospital Charge Code	270325500
Hospital Revenue Code	272
Min. Negotiated Rate	$14.06
Max. Negotiated Rate	$247.50
Rate for Payer: Aetna Commercial	$188.10
Rate for Payer: Aetna Medicare Advantage	$148.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.22
Rate for Payer: Cigna Commercial	$247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.70
Rate for Payer: Oxford Commercial	$99.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.25
Rate for Payer: UnitedHealthcare Commercial	$99.00
Rate for Payer: UnitedHealthcare Community & State	$15.64
Rate for Payer: Wellpoint Medicaid Managed Care	$14.06

ENDO GIA 30 3.5 DLU

Facility

$619.00

Hospital Charge Code	270334728
Hospital Revenue Code	272
Min. Negotiated Rate	$92.85
Max. Negotiated Rate	$92.85
Rate for Payer: Qualcare PPO/HMO/WC	$92.85

ENDO GIA 30 3.5 DLU

Facility

$619.00

Hospital Charge Code	270334728
Hospital Revenue Code	272
Min. Negotiated Rate	$17.58
Max. Negotiated Rate	$309.50
Rate for Payer: Aetna Commercial	$235.22
Rate for Payer: Aetna Medicare Advantage	$185.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.84
Rate for Payer: Cigna Commercial	$309.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.94
Rate for Payer: Oxford Commercial	$123.80
Rate for Payer: Qualcare PPO/HMO/WC	$92.85
Rate for Payer: UnitedHealthcare Commercial	$123.80
Rate for Payer: UnitedHealthcare Community & State	$19.56
Rate for Payer: Wellpoint Medicaid Managed Care	$17.58

ENDO GIA 30MM CURVED TIP

Facility

$3,123.75

Service Code	HCPCS A4649
Hospital Charge Code	270697938
Hospital Revenue Code	272
Min. Negotiated Rate	$468.56
Max. Negotiated Rate	$468.56
Rate for Payer: Qualcare PPO/HMO/WC	$468.56

ENDO GIA 30MM CURVED TIP

Facility

$3,123.75

Service Code	HCPCS A4649
Hospital Charge Code	270697938
Hospital Revenue Code	272
Min. Negotiated Rate	$88.71
Max. Negotiated Rate	$1,561.88
Rate for Payer: Aetna Commercial	$1,187.03
Rate for Payer: Aetna Medicare Advantage	$937.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.56
Rate for Payer: Cigna Commercial	$1,561.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$812.17
Rate for Payer: Oxford Commercial	$624.75
Rate for Payer: Qualcare PPO/HMO/WC	$468.56
Rate for Payer: UnitedHealthcare Commercial	$624.75
Rate for Payer: UnitedHealthcare Community & State	$98.71
Rate for Payer: Wellpoint Medicaid Managed Care	$88.71

ENDO GIA RELOAD 45MM MED THICK

Facility

$481.84

Hospital Charge Code	270652106
Hospital Revenue Code	272
Min. Negotiated Rate	$72.28
Max. Negotiated Rate	$72.28
Rate for Payer: Qualcare PPO/HMO/WC	$72.28

ENDO GIA RELOAD 45MM MED THICK

Facility

$481.84

Hospital Charge Code	270652106
Hospital Revenue Code	272
Min. Negotiated Rate	$13.68
Max. Negotiated Rate	$240.92
Rate for Payer: Aetna Commercial	$183.10
Rate for Payer: Aetna Medicare Advantage	$144.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.87
Rate for Payer: Cigna Commercial	$240.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.28
Rate for Payer: Oxford Commercial	$96.37
Rate for Payer: Qualcare PPO/HMO/WC	$72.28
Rate for Payer: UnitedHealthcare Commercial	$96.37
Rate for Payer: UnitedHealthcare Community & State	$15.23
Rate for Payer: Wellpoint Medicaid Managed Care	$13.68

ENDO GIA UNIV ULTRA STD

Facility

$539.98

Hospital Charge Code	270655981
Hospital Revenue Code	271
Min. Negotiated Rate	$15.34
Max. Negotiated Rate	$269.99
Rate for Payer: Aetna Commercial	$205.19
Rate for Payer: Aetna Medicare Advantage	$161.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$137.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$137.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$137.69
Rate for Payer: Cigna Commercial	$269.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.39
Rate for Payer: Oxford Commercial	$108.00
Rate for Payer: Qualcare PPO/HMO/WC	$81.00
Rate for Payer: UnitedHealthcare Commercial	$108.00
Rate for Payer: UnitedHealthcare Community & State	$17.06
Rate for Payer: Wellpoint Medicaid Managed Care	$15.34

ENDO GIA UNIV ULTRA STD

Facility

$539.98

Hospital Charge Code	270655981
Hospital Revenue Code	271
Min. Negotiated Rate	$81.00
Max. Negotiated Rate	$81.00
Rate for Payer: Qualcare PPO/HMO/WC	$81.00

ENDO GRASP

Facility

$908.00

Hospital Charge Code	270335076
Hospital Revenue Code	272
Min. Negotiated Rate	$25.79
Max. Negotiated Rate	$454.00
Rate for Payer: Aetna Commercial	$345.04
Rate for Payer: Aetna Medicare Advantage	$272.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.54
Rate for Payer: Cigna Commercial	$454.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.08
Rate for Payer: Oxford Commercial	$181.60
Rate for Payer: Qualcare PPO/HMO/WC	$136.20
Rate for Payer: UnitedHealthcare Commercial	$181.60
Rate for Payer: UnitedHealthcare Community & State	$28.69
Rate for Payer: Wellpoint Medicaid Managed Care	$25.79

ENDO GRASP

Facility

$908.00

Hospital Charge Code	270335076
Hospital Revenue Code	272
Min. Negotiated Rate	$136.20
Max. Negotiated Rate	$136.20
Rate for Payer: Qualcare PPO/HMO/WC	$136.20

ENDO HERNIA LOAD UNIT

Facility

$223.00

Hospital Charge Code	270335081
Hospital Revenue Code	272
Min. Negotiated Rate	$6.33
Max. Negotiated Rate	$111.50
Rate for Payer: Aetna Commercial	$84.74
Rate for Payer: Aetna Medicare Advantage	$66.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.87
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.98
Rate for Payer: Oxford Commercial	$44.60
Rate for Payer: Qualcare PPO/HMO/WC	$33.45
Rate for Payer: UnitedHealthcare Commercial	$44.60
Rate for Payer: UnitedHealthcare Community & State	$7.05
Rate for Payer: Wellpoint Medicaid Managed Care	$6.33

ENDO HERNIA LOAD UNIT

Facility

$223.00

Hospital Charge Code	270335081
Hospital Revenue Code	272
Min. Negotiated Rate	$33.45
Max. Negotiated Rate	$33.45
Rate for Payer: Qualcare PPO/HMO/WC	$33.45

ENDO HERNIA STAPLER

Facility

$770.00

Hospital Charge Code	270335080
Hospital Revenue Code	272
Min. Negotiated Rate	$21.87
Max. Negotiated Rate	$385.00
Rate for Payer: Aetna Commercial	$292.60
Rate for Payer: Aetna Medicare Advantage	$231.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$196.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$196.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$196.35
Rate for Payer: Cigna Commercial	$385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.20
Rate for Payer: Oxford Commercial	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$115.50
Rate for Payer: UnitedHealthcare Commercial	$154.00
Rate for Payer: UnitedHealthcare Community & State	$24.33
Rate for Payer: Wellpoint Medicaid Managed Care	$21.87

ENDO HERNIA STAPLER

Facility

$770.00

Hospital Charge Code	270335080
Hospital Revenue Code	272
Min. Negotiated Rate	$115.50
Max. Negotiated Rate	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$115.50

ENDOHOLDER ENDOSUTURE SYSTEM

Facility

$1,184.70

Hospital Charge Code	270669354
Hospital Revenue Code	272
Min. Negotiated Rate	$177.71
Max. Negotiated Rate	$177.71
Rate for Payer: Qualcare PPO/HMO/WC	$177.71

ENDOHOLDER ENDOSUTURE SYSTEM

Facility

$1,184.70

Hospital Charge Code	270669354
Hospital Revenue Code	272
Min. Negotiated Rate	$33.65
Max. Negotiated Rate	$592.35
Rate for Payer: Aetna Commercial	$450.19
Rate for Payer: Aetna Medicare Advantage	$355.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$302.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$302.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$302.10
Rate for Payer: Cigna Commercial	$592.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.02
Rate for Payer: Oxford Commercial	$236.94
Rate for Payer: Qualcare PPO/HMO/WC	$177.71
Rate for Payer: UnitedHealthcare Commercial	$236.94
Rate for Payer: UnitedHealthcare Community & State	$37.44
Rate for Payer: Wellpoint Medicaid Managed Care	$33.65

ENDOKNOT ETHIBOND

Facility

$124.00

Hospital Charge Code	270335232
Hospital Revenue Code	272
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$18.60
Rate for Payer: Qualcare PPO/HMO/WC	$18.60

ENDOKNOT ETHIBOND

Facility

$124.00

Hospital Charge Code	270335232
Hospital Revenue Code	272
Min. Negotiated Rate	$3.52
Max. Negotiated Rate	$62.00
Rate for Payer: Aetna Commercial	$47.12
Rate for Payer: Aetna Medicare Advantage	$37.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.62
Rate for Payer: Cigna Commercial	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.24
Rate for Payer: Oxford Commercial	$24.80
Rate for Payer: Qualcare PPO/HMO/WC	$18.60
Rate for Payer: UnitedHealthcare Commercial	$24.80
Rate for Payer: UnitedHealthcare Community & State	$3.92
Rate for Payer: Wellpoint Medicaid Managed Care	$3.52

ENDOKNOT VICRYL

Facility

$124.00

Hospital Charge Code	270335233
Hospital Revenue Code	272
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$18.60
Rate for Payer: Qualcare PPO/HMO/WC	$18.60

ENDOKNOT VICRYL

Facility

$124.00

Hospital Charge Code	270335233
Hospital Revenue Code	272
Min. Negotiated Rate	$3.52
Max. Negotiated Rate	$62.00
Rate for Payer: Aetna Commercial	$47.12
Rate for Payer: Aetna Medicare Advantage	$37.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.62
Rate for Payer: Cigna Commercial	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.24
Rate for Payer: Oxford Commercial	$24.80
Rate for Payer: Qualcare PPO/HMO/WC	$18.60
Rate for Payer: UnitedHealthcare Commercial	$24.80
Rate for Payer: UnitedHealthcare Community & State	$3.92
Rate for Payer: Wellpoint Medicaid Managed Care	$3.52

ENDO LEVEL 1 VISIT

Facility

$224.00

Service Code	HCPCS 99211
Hospital Charge Code	2300920
Hospital Revenue Code	510
Min. Negotiated Rate	$33.60
Max. Negotiated Rate	$33.60
Rate for Payer: Qualcare PPO/HMO/WC	$33.60

ENDO LEVEL 1 VISIT

Facility

$224.00

Service Code	HCPCS 99211
Hospital Charge Code	2300920
Hospital Revenue Code	510
Min. Negotiated Rate	$6.36
Max. Negotiated Rate	$112.00
Rate for Payer: Aetna Commercial	$85.12
Rate for Payer: Aetna Medicare Advantage	$67.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.12
Rate for Payer: Cigna Commercial	$112.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.24
Rate for Payer: Qualcare PPO/HMO/WC	$33.60
Rate for Payer: UnitedHealthcare Community & State	$7.08
Rate for Payer: Wellpoint Medicaid Managed Care	$6.36

Know your out-of-pocket cost for care.

All Charges