Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ENDO L HOOK LAP 13/.5 STRL

Facility

$1,650.00

Hospital Charge Code	270657331
Hospital Revenue Code	272
Min. Negotiated Rate	$247.50
Max. Negotiated Rate	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$247.50

ENDO L HOOK LAP 13/.5 STRL

Facility

$1,650.00

Hospital Charge Code	270657331
Hospital Revenue Code	272
Min. Negotiated Rate	$46.86
Max. Negotiated Rate	$825.00
Rate for Payer: Aetna Commercial	$627.00
Rate for Payer: Aetna Medicare Advantage	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$420.75
Rate for Payer: Cigna Commercial	$825.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$429.00
Rate for Payer: Oxford Commercial	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$247.50
Rate for Payer: UnitedHealthcare Commercial	$330.00
Rate for Payer: UnitedHealthcare Community & State	$52.14
Rate for Payer: Wellpoint Medicaid Managed Care	$46.86

ENDOLINEAR 60MM RELOADS

Facility

$433.00

Hospital Charge Code	270337851
Hospital Revenue Code	272
Min. Negotiated Rate	$12.30
Max. Negotiated Rate	$216.50
Rate for Payer: Aetna Commercial	$164.54
Rate for Payer: Aetna Medicare Advantage	$129.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.42
Rate for Payer: Cigna Commercial	$216.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.58
Rate for Payer: Oxford Commercial	$86.60
Rate for Payer: Qualcare PPO/HMO/WC	$64.95
Rate for Payer: UnitedHealthcare Commercial	$86.60
Rate for Payer: UnitedHealthcare Community & State	$13.68
Rate for Payer: Wellpoint Medicaid Managed Care	$12.30

ENDOLINEAR 60MM RELOADS

Facility

$433.00

Hospital Charge Code	270337851
Hospital Revenue Code	272
Min. Negotiated Rate	$64.95
Max. Negotiated Rate	$64.95
Rate for Payer: Qualcare PPO/HMO/WC	$64.95

ENDOLINEAR STAPLER 60 MM

Facility

$811.00

Hospital Charge Code	270337850
Hospital Revenue Code	272
Min. Negotiated Rate	$23.03
Max. Negotiated Rate	$405.50
Rate for Payer: Aetna Commercial	$308.18
Rate for Payer: Aetna Medicare Advantage	$243.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$206.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$206.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$206.81
Rate for Payer: Cigna Commercial	$405.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$210.86
Rate for Payer: Oxford Commercial	$162.20
Rate for Payer: Qualcare PPO/HMO/WC	$121.65
Rate for Payer: UnitedHealthcare Commercial	$162.20
Rate for Payer: UnitedHealthcare Community & State	$25.63
Rate for Payer: Wellpoint Medicaid Managed Care	$23.03

ENDOLINEAR STAPLER 60 MM

Facility

$811.00

Hospital Charge Code	270337850
Hospital Revenue Code	272
Min. Negotiated Rate	$121.65
Max. Negotiated Rate	$121.65
Rate for Payer: Qualcare PPO/HMO/WC	$121.65

ENDO LINEAR STAPLER X-L 45MM

Facility

$493.00

Hospital Charge Code	270338709
Hospital Revenue Code	272
Min. Negotiated Rate	$73.95
Max. Negotiated Rate	$73.95
Rate for Payer: Qualcare PPO/HMO/WC	$73.95

ENDO LINEAR STAPLER X-L 45MM

Facility

$493.00

Hospital Charge Code	270338709
Hospital Revenue Code	272
Min. Negotiated Rate	$14.00
Max. Negotiated Rate	$246.50
Rate for Payer: Aetna Commercial	$187.34
Rate for Payer: Aetna Medicare Advantage	$147.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.72
Rate for Payer: Cigna Commercial	$246.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.18
Rate for Payer: Oxford Commercial	$98.60
Rate for Payer: Qualcare PPO/HMO/WC	$73.95
Rate for Payer: UnitedHealthcare Commercial	$98.60
Rate for Payer: UnitedHealthcare Community & State	$15.58
Rate for Payer: Wellpoint Medicaid Managed Care	$14.00

ENDOLOGIX ENSNARE

Facility

$2,325.00

Service Code	HCPCS C1773
Hospital Charge Code	270665547
Hospital Revenue Code	272
Min. Negotiated Rate	$348.75
Max. Negotiated Rate	$348.75
Rate for Payer: Qualcare PPO/HMO/WC	$348.75

ENDOLOGIX ENSNARE

Facility

$2,325.00

Service Code	HCPCS C1773
Hospital Charge Code	270665547
Hospital Revenue Code	272
Min. Negotiated Rate	$66.03
Max. Negotiated Rate	$1,162.50
Rate for Payer: Aetna Commercial	$883.50
Rate for Payer: Aetna Medicare Advantage	$697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$592.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$592.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$592.88
Rate for Payer: Cigna Commercial	$1,162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$604.50
Rate for Payer: Oxford Commercial	$465.00
Rate for Payer: Qualcare PPO/HMO/WC	$348.75
Rate for Payer: UnitedHealthcare Commercial	$465.00
Rate for Payer: UnitedHealthcare Community & State	$73.47
Rate for Payer: Wellpoint Medicaid Managed Care	$66.03

ENDOLOOP COATED VICRYL 0 18

Facility

$682.90

Hospital Charge Code	270638747
Hospital Revenue Code	272
Min. Negotiated Rate	$19.39
Max. Negotiated Rate	$341.45
Rate for Payer: Aetna Commercial	$259.50
Rate for Payer: Aetna Medicare Advantage	$204.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.14
Rate for Payer: Cigna Commercial	$341.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.55
Rate for Payer: Oxford Commercial	$136.58
Rate for Payer: Qualcare PPO/HMO/WC	$102.44
Rate for Payer: UnitedHealthcare Commercial	$136.58
Rate for Payer: UnitedHealthcare Community & State	$21.58
Rate for Payer: Wellpoint Medicaid Managed Care	$19.39

ENDOLOOP COATED VICRYL 0 18

Facility

$682.90

Hospital Charge Code	270638747
Hospital Revenue Code	272
Min. Negotiated Rate	$102.44
Max. Negotiated Rate	$102.44
Rate for Payer: Qualcare PPO/HMO/WC	$102.44

ENDO LOOP VICRYL

Facility

$181.00

Hospital Charge Code	270335196
Hospital Revenue Code	272
Min. Negotiated Rate	$5.14
Max. Negotiated Rate	$90.50
Rate for Payer: Aetna Commercial	$68.78
Rate for Payer: Aetna Medicare Advantage	$54.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.16
Rate for Payer: Cigna Commercial	$90.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.06
Rate for Payer: Oxford Commercial	$36.20
Rate for Payer: Qualcare PPO/HMO/WC	$27.15
Rate for Payer: UnitedHealthcare Commercial	$36.20
Rate for Payer: UnitedHealthcare Community & State	$5.72
Rate for Payer: Wellpoint Medicaid Managed Care	$5.14

ENDO LOOP VICRYL

Facility

$181.00

Hospital Charge Code	270335196
Hospital Revenue Code	272
Min. Negotiated Rate	$27.15
Max. Negotiated Rate	$27.15
Rate for Payer: Qualcare PPO/HMO/WC	$27.15

ENDOLUMINAL BX URTR RNL PLVS

Facility

$3,090.18

Service Code	HCPCS 50606
Hospital Charge Code	2011579
Hospital Revenue Code	361
Min. Negotiated Rate	$87.76
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,174.27
Rate for Payer: Aetna Medicare Advantage	$927.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$788.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$788.00
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	$788.00
Rate for Payer: Cigna Commercial	$1,545.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$803.45
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$463.53
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$97.65
Rate for Payer: Wellpoint Medicaid Managed Care	$87.76

ENDOLUMINAL BX URTR RNL PLVS

Facility

$3,090.18

Service Code	HCPCS 50606
Hospital Charge Code	7411614
Hospital Revenue Code	361
Min. Negotiated Rate	$463.53
Max. Negotiated Rate	$463.53
Rate for Payer: Qualcare PPO/HMO/WC	$463.53

ENDOLUMINAL BX URTR RNL PLVS

Facility

$3,090.18

Service Code	HCPCS 50606
Hospital Charge Code	7411614
Hospital Revenue Code	361
Min. Negotiated Rate	$87.76
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,174.27
Rate for Payer: Aetna Medicare Advantage	$927.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$788.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$788.00
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	$788.00
Rate for Payer: Cigna Commercial	$1,545.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$803.45
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$463.53
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$97.65
Rate for Payer: Wellpoint Medicaid Managed Care	$87.76

ENDOLUMINAL BX URTR RNL PLVS

Facility

$3,090.18

Service Code	HCPCS 50606
Hospital Charge Code	2011579
Hospital Revenue Code	361
Min. Negotiated Rate	$463.53
Max. Negotiated Rate	$463.53
Rate for Payer: Qualcare PPO/HMO/WC	$463.53

ENDOLUMINAL BX URTR RNL PLVS

Facility

$3,090.18

Service Code	HCPCS 50606
Hospital Charge Code	2600231
Hospital Revenue Code	361
Min. Negotiated Rate	$463.53
Max. Negotiated Rate	$463.53
Rate for Payer: Qualcare PPO/HMO/WC	$463.53

ENDOLUMINAL BX URTR RNL PLVS

Facility

$3,090.18

Service Code	HCPCS 50606
Hospital Charge Code	2600231
Hospital Revenue Code	361
Min. Negotiated Rate	$87.76
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,174.27
Rate for Payer: Aetna Medicare Advantage	$927.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$788.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$788.00
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	$788.00
Rate for Payer: Cigna Commercial	$1,545.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$803.45
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$463.53
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$97.65
Rate for Payer: Wellpoint Medicaid Managed Care	$87.76

ENDO MARK

Facility

$155.56

Hospital Charge Code	270667919
Hospital Revenue Code	272
Min. Negotiated Rate	$4.42
Max. Negotiated Rate	$77.78
Rate for Payer: Aetna Commercial	$59.11
Rate for Payer: Aetna Medicare Advantage	$46.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.67
Rate for Payer: Cigna Commercial	$77.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.45
Rate for Payer: Oxford Commercial	$31.11
Rate for Payer: Qualcare PPO/HMO/WC	$23.33
Rate for Payer: UnitedHealthcare Commercial	$31.11
Rate for Payer: UnitedHealthcare Community & State	$4.92
Rate for Payer: Wellpoint Medicaid Managed Care	$4.42

ENDO MARK

Facility

$155.56

Hospital Charge Code	270667919
Hospital Revenue Code	272
Min. Negotiated Rate	$23.33
Max. Negotiated Rate	$23.33
Rate for Payer: Qualcare PPO/HMO/WC	$23.33

ENDOMETAL BX WO CERVICL DILATN

Facility

$2,249.90

Service Code	HCPCS 58100
Hospital Charge Code	16000759
Hospital Revenue Code	360
Min. Negotiated Rate	$337.49
Max. Negotiated Rate	$337.49
Rate for Payer: Qualcare PPO/HMO/WC	$337.49

ENDOMETAL BX WO CERVICL DILATN

Facility

$2,249.90

Service Code	HCPCS 58100
Hospital Charge Code	16000759
Hospital Revenue Code	360
Min. Negotiated Rate	$63.90
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$653.29
Rate for Payer: Aetna Medicare Advantage	$778.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$871.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$871.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$240.18
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	$871.25
Rate for Payer: Cigna Commercial	$481.45
Rate for Payer: Cigna Medicare Advantage	$240.18
Rate for Payer: Clover Medicare Advantage	$228.17
Rate for Payer: EmblemHealth Commercial	$720.54
Rate for Payer: Humana Medicare Advantage	$247.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$240.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$584.97
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.49
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$71.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$240.18
Rate for Payer: Wellcare Medicare Advantage	$240.18
Rate for Payer: Wellpoint Medicaid Managed Care	$63.90

ENDOMETRIAL CRYOABLATION

Facility

$29,715.20

Service Code	HCPCS 58356
Hospital Charge Code	1600000874
Hospital Revenue Code	360
Min. Negotiated Rate	$4,457.28
Max. Negotiated Rate	$4,457.28
Rate for Payer: Qualcare PPO/HMO/WC	$4,457.28

Know your out-of-pocket cost for care.

All Charges