Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ALEUTAIN 24X30MM 8DEG CON 11MM

Facility

$20,795.00

Hospital Charge Code	270670099
Hospital Revenue Code	278
Min. Negotiated Rate	$590.58
Max. Negotiated Rate	$10,397.50
Rate for Payer: Aetna Commercial	$7,902.10
Rate for Payer: Aetna Medicare Advantage	$6,238.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,302.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,302.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,159.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,302.73
Rate for Payer: Cigna Commercial	$10,397.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,032.39
Rate for Payer: Qualcare PPO/HMO/WC	$3,119.25
Rate for Payer: UnitedHealthcare Community & State	$657.12
Rate for Payer: Wellpoint Medicaid Managed Care	$590.58

ALEUTAIN 24X30MM 8DEG CON 11MM

Facility

$20,795.00

Hospital Charge Code	270670099
Hospital Revenue Code	278
Min. Negotiated Rate	$3,119.25
Max. Negotiated Rate	$5,032.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,159.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,032.39
Rate for Payer: Qualcare PPO/HMO/WC	$3,119.25

ALEUTAIN 24X30MM 8DEG CON 12MM

Facility

$20,795.00

Hospital Charge Code	270670106
Hospital Revenue Code	278
Min. Negotiated Rate	$3,119.25
Max. Negotiated Rate	$5,032.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,159.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,032.39
Rate for Payer: Qualcare PPO/HMO/WC	$3,119.25

ALEUTAIN 24X30MM 8DEG CON 12MM

Facility

$20,795.00

Hospital Charge Code	270670106
Hospital Revenue Code	278
Min. Negotiated Rate	$590.58
Max. Negotiated Rate	$10,397.50
Rate for Payer: Aetna Commercial	$7,902.10
Rate for Payer: Aetna Medicare Advantage	$6,238.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,302.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,302.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,159.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,302.73
Rate for Payer: Cigna Commercial	$10,397.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,032.39
Rate for Payer: Qualcare PPO/HMO/WC	$3,119.25
Rate for Payer: UnitedHealthcare Community & State	$657.12
Rate for Payer: Wellpoint Medicaid Managed Care	$590.58

ALEUTAIN 24X30MM 8DEG CON 14MM

Facility

$20,795.00

Hospital Charge Code	270670115
Hospital Revenue Code	278
Min. Negotiated Rate	$590.58
Max. Negotiated Rate	$10,397.50
Rate for Payer: Aetna Commercial	$7,902.10
Rate for Payer: Aetna Medicare Advantage	$6,238.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,302.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,302.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,159.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,302.73
Rate for Payer: Cigna Commercial	$10,397.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,032.39
Rate for Payer: Qualcare PPO/HMO/WC	$3,119.25
Rate for Payer: UnitedHealthcare Community & State	$657.12
Rate for Payer: Wellpoint Medicaid Managed Care	$590.58

ALEUTAIN 24X30MM 8DEG CON 14MM

Facility

$20,795.00

Hospital Charge Code	270670115
Hospital Revenue Code	278
Min. Negotiated Rate	$3,119.25
Max. Negotiated Rate	$5,032.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,159.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,032.39
Rate for Payer: Qualcare PPO/HMO/WC	$3,119.25

ALEUTAIN 24X30MM 8DEG CON 15MM

Facility

$20,795.00

Hospital Charge Code	270670116
Hospital Revenue Code	278
Min. Negotiated Rate	$3,119.25
Max. Negotiated Rate	$5,032.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,159.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,032.39
Rate for Payer: Qualcare PPO/HMO/WC	$3,119.25

ALEUTAIN 24X30MM 8DEG CON 15MM

Facility

$20,795.00

Hospital Charge Code	270670116
Hospital Revenue Code	278
Min. Negotiated Rate	$590.58
Max. Negotiated Rate	$10,397.50
Rate for Payer: Aetna Commercial	$7,902.10
Rate for Payer: Aetna Medicare Advantage	$6,238.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,302.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,302.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,159.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,302.73
Rate for Payer: Cigna Commercial	$10,397.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,032.39
Rate for Payer: Qualcare PPO/HMO/WC	$3,119.25
Rate for Payer: UnitedHealthcare Community & State	$657.12
Rate for Payer: Wellpoint Medicaid Managed Care	$590.58

ALEUTAIN 24X30MM 8DEG CON 16MM

Facility

$20,795.00

Hospital Charge Code	270670123
Hospital Revenue Code	278
Min. Negotiated Rate	$3,119.25
Max. Negotiated Rate	$5,032.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,159.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,032.39
Rate for Payer: Qualcare PPO/HMO/WC	$3,119.25

ALEUTAIN 24X30MM 8DEG CON 16MM

Facility

$20,795.00

Hospital Charge Code	270670123
Hospital Revenue Code	278
Min. Negotiated Rate	$590.58
Max. Negotiated Rate	$10,397.50
Rate for Payer: Aetna Commercial	$7,902.10
Rate for Payer: Aetna Medicare Advantage	$6,238.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,302.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,302.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,159.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,302.73
Rate for Payer: Cigna Commercial	$10,397.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,032.39
Rate for Payer: Qualcare PPO/HMO/WC	$3,119.25
Rate for Payer: UnitedHealthcare Community & State	$657.12
Rate for Payer: Wellpoint Medicaid Managed Care	$590.58

ALEUTAIN 24X30MM 8DEG CON 17MM

Facility

$20,795.00

Hospital Charge Code	270670124
Hospital Revenue Code	278
Min. Negotiated Rate	$3,119.25
Max. Negotiated Rate	$5,032.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,159.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,032.39
Rate for Payer: Qualcare PPO/HMO/WC	$3,119.25

ALEUTAIN 24X30MM 8DEG CON 17MM

Facility

$20,795.00

Hospital Charge Code	270670124
Hospital Revenue Code	278
Min. Negotiated Rate	$590.58
Max. Negotiated Rate	$10,397.50
Rate for Payer: Aetna Commercial	$7,902.10
Rate for Payer: Aetna Medicare Advantage	$6,238.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,302.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,302.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,159.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,302.73
Rate for Payer: Cigna Commercial	$10,397.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,032.39
Rate for Payer: Qualcare PPO/HMO/WC	$3,119.25
Rate for Payer: UnitedHealthcare Community & State	$657.12
Rate for Payer: Wellpoint Medicaid Managed Care	$590.58

ALEUTAIN 24X30MM 8DEG CON 19MM

Facility

$20,795.00

Hospital Charge Code	270670131
Hospital Revenue Code	278
Min. Negotiated Rate	$3,119.25
Max. Negotiated Rate	$5,032.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,159.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,032.39
Rate for Payer: Qualcare PPO/HMO/WC	$3,119.25

ALEUTAIN 24X30MM 8DEG CON 19MM

Facility

$20,795.00

Hospital Charge Code	270670131
Hospital Revenue Code	278
Min. Negotiated Rate	$590.58
Max. Negotiated Rate	$10,397.50
Rate for Payer: Aetna Commercial	$7,902.10
Rate for Payer: Aetna Medicare Advantage	$6,238.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,302.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,302.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,159.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,302.73
Rate for Payer: Cigna Commercial	$10,397.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,032.39
Rate for Payer: Qualcare PPO/HMO/WC	$3,119.25
Rate for Payer: UnitedHealthcare Community & State	$657.12
Rate for Payer: Wellpoint Medicaid Managed Care	$590.58

ALEUTAIN 24X30MM 8DEG CON 9MM

Facility

$20,795.00

Hospital Charge Code	270670093
Hospital Revenue Code	278
Min. Negotiated Rate	$3,119.25
Max. Negotiated Rate	$5,032.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,159.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,032.39
Rate for Payer: Qualcare PPO/HMO/WC	$3,119.25

ALEUTAIN 24X30MM 8DEG CON 9MM

Facility

$20,795.00

Hospital Charge Code	270670093
Hospital Revenue Code	278
Min. Negotiated Rate	$590.58
Max. Negotiated Rate	$10,397.50
Rate for Payer: Aetna Commercial	$7,902.10
Rate for Payer: Aetna Medicare Advantage	$6,238.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,302.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,302.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,159.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,302.73
Rate for Payer: Cigna Commercial	$10,397.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,032.39
Rate for Payer: Qualcare PPO/HMO/WC	$3,119.25
Rate for Payer: UnitedHealthcare Community & State	$657.12
Rate for Payer: Wellpoint Medicaid Managed Care	$590.58

ALEUTAIN 28X36MM 10DEG LOR 9MM

Facility

$23,515.00

Hospital Charge Code	270670096
Hospital Revenue Code	278
Min. Negotiated Rate	$3,527.25
Max. Negotiated Rate	$5,690.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,703.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,690.63
Rate for Payer: Qualcare PPO/HMO/WC	$3,527.25

ALEUTAIN 28X36MM 10DEG LOR 9MM

Facility

$23,515.00

Hospital Charge Code	270670096
Hospital Revenue Code	278
Min. Negotiated Rate	$667.83
Max. Negotiated Rate	$11,757.50
Rate for Payer: Aetna Commercial	$8,935.70
Rate for Payer: Aetna Medicare Advantage	$7,054.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,996.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,996.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,703.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,996.32
Rate for Payer: Cigna Commercial	$11,757.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,690.63
Rate for Payer: Qualcare PPO/HMO/WC	$3,527.25
Rate for Payer: UnitedHealthcare Community & State	$743.07
Rate for Payer: Wellpoint Medicaid Managed Care	$667.83

ALEUTAIN 28X36MM 10DG LOR 11MM

Facility

$23,515.00

Service Code	HCPCS C1713
Hospital Charge Code	270670104
Hospital Revenue Code	278
Min. Negotiated Rate	$3,527.25
Max. Negotiated Rate	$5,690.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,703.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,690.63
Rate for Payer: Qualcare PPO/HMO/WC	$3,527.25

ALEUTAIN 28X36MM 10DG LOR 11MM

Facility

$23,515.00

Service Code	HCPCS C1713
Hospital Charge Code	270670104
Hospital Revenue Code	278
Min. Negotiated Rate	$667.83
Max. Negotiated Rate	$11,757.50
Rate for Payer: Aetna Commercial	$8,935.70
Rate for Payer: Aetna Medicare Advantage	$7,054.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,996.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,996.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,703.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,996.32
Rate for Payer: Cigna Commercial	$11,757.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,690.63
Rate for Payer: Qualcare PPO/HMO/WC	$3,527.25
Rate for Payer: UnitedHealthcare Community & State	$743.07
Rate for Payer: Wellpoint Medicaid Managed Care	$667.83

ALEUTAIN 28X36MM 10DG LOR 13MM

Facility

$23,515.00

Hospital Charge Code	270670113
Hospital Revenue Code	278
Min. Negotiated Rate	$667.83
Max. Negotiated Rate	$11,757.50
Rate for Payer: Aetna Commercial	$8,935.70
Rate for Payer: Aetna Medicare Advantage	$7,054.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,996.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,996.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,703.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,996.32
Rate for Payer: Cigna Commercial	$11,757.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,690.63
Rate for Payer: Qualcare PPO/HMO/WC	$3,527.25
Rate for Payer: UnitedHealthcare Community & State	$743.07
Rate for Payer: Wellpoint Medicaid Managed Care	$667.83

ALEUTAIN 28X36MM 10DG LOR 13MM

Facility

$23,515.00

Hospital Charge Code	270670113
Hospital Revenue Code	278
Min. Negotiated Rate	$3,527.25
Max. Negotiated Rate	$5,690.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,703.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,690.63
Rate for Payer: Qualcare PPO/HMO/WC	$3,527.25

ALEUTAIN 28X36MM 10DG LOR 15MM

Facility

$23,515.00

Hospital Charge Code	270670121
Hospital Revenue Code	278
Min. Negotiated Rate	$3,527.25
Max. Negotiated Rate	$5,690.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,703.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,690.63
Rate for Payer: Qualcare PPO/HMO/WC	$3,527.25

ALEUTAIN 28X36MM 10DG LOR 15MM

Facility

$23,515.00

Hospital Charge Code	270670121
Hospital Revenue Code	278
Min. Negotiated Rate	$667.83
Max. Negotiated Rate	$11,757.50
Rate for Payer: Aetna Commercial	$8,935.70
Rate for Payer: Aetna Medicare Advantage	$7,054.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,996.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,996.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,703.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,996.32
Rate for Payer: Cigna Commercial	$11,757.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,690.63
Rate for Payer: Qualcare PPO/HMO/WC	$3,527.25
Rate for Payer: UnitedHealthcare Community & State	$743.07
Rate for Payer: Wellpoint Medicaid Managed Care	$667.83

ALEUTAIN 28X36MM 10DG LOR 17MM

Facility

$23,515.00

Hospital Charge Code	270670129
Hospital Revenue Code	278
Min. Negotiated Rate	$3,527.25
Max. Negotiated Rate	$5,690.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,703.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,690.63
Rate for Payer: Qualcare PPO/HMO/WC	$3,527.25

Know your out-of-pocket cost for care.

All Charges