Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

FILTER LIPID

Facility

$224.60

Hospital Charge Code	270674073
Hospital Revenue Code	272
Min. Negotiated Rate	$33.69
Max. Negotiated Rate	$33.69
Rate for Payer: Qualcare PPO/HMO/WC	$33.69

FILTER LIPID

Facility

$224.60

Hospital Charge Code	270674073
Hospital Revenue Code	272
Min. Negotiated Rate	$6.38
Max. Negotiated Rate	$112.30
Rate for Payer: Aetna Commercial	$85.35
Rate for Payer: Aetna Medicare Advantage	$67.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.27
Rate for Payer: Cigna Commercial	$112.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.40
Rate for Payer: Oxford Commercial	$44.92
Rate for Payer: Qualcare PPO/HMO/WC	$33.69
Rate for Payer: UnitedHealthcare Commercial	$44.92
Rate for Payer: UnitedHealthcare Community & State	$7.10
Rate for Payer: Wellpoint Medicaid Managed Care	$6.38

FILTER MERIDIAN VENA

Facility

$7,725.00

Service Code	HCPCS C1880
Hospital Charge Code	270646957N
Hospital Revenue Code	278
Min. Negotiated Rate	$219.39
Max. Negotiated Rate	$3,862.50
Rate for Payer: Aetna Commercial	$2,935.50
Rate for Payer: Aetna Medicare Advantage	$2,317.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,969.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,969.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,545.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,969.88
Rate for Payer: Cigna Commercial	$3,862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,869.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,158.75
Rate for Payer: UnitedHealthcare Community & State	$244.11
Rate for Payer: Wellpoint Medicaid Managed Care	$219.39

FILTER MERIDIAN VENA

Facility

$7,725.00

Service Code	HCPCS C1880
Hospital Charge Code	270646957N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,158.75
Max. Negotiated Rate	$1,869.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,545.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,869.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,158.75

FILTER MERIDIAN VENA

Facility

$6,750.00

Service Code	HCPCS C1880
Hospital Charge Code	270646957C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

FILTER MERIDIAN VENA

Facility

$6,750.00

Service Code	HCPCS C1880
Hospital Charge Code	270646957C
Hospital Revenue Code	278
Min. Negotiated Rate	$191.70
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$213.30
Rate for Payer: Wellpoint Medicaid Managed Care	$191.70

FILTER MICRON 1.2

Facility

$10.66

Hospital Charge Code	270041075
Hospital Revenue Code	270
Min. Negotiated Rate	$1.60
Max. Negotiated Rate	$1.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.60

FILTER MICRON 1.2

Facility

$10.66

Hospital Charge Code	270041075
Hospital Revenue Code	270
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$5.33
Rate for Payer: Aetna Commercial	$4.05
Rate for Payer: Aetna Medicare Advantage	$3.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.72
Rate for Payer: Cigna Commercial	$5.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.77
Rate for Payer: Oxford Commercial	$2.13
Rate for Payer: Qualcare PPO/HMO/WC	$1.60
Rate for Payer: UnitedHealthcare Commercial	$2.13
Rate for Payer: UnitedHealthcare Community & State	$0.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

FILTER OPTION ELITE 100CM

Facility

$4,625.00

Service Code	HCPCS C1880
Hospital Charge Code	270676626N
Hospital Revenue Code	278
Min. Negotiated Rate	$693.75
Max. Negotiated Rate	$1,119.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,119.25
Rate for Payer: Qualcare PPO/HMO/WC	$693.75

FILTER OPTION ELITE 100CM

Facility

$4,475.00

Service Code	HCPCS C1880
Hospital Charge Code	270676626S
Hospital Revenue Code	278
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) NJ Health	$895.00
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	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25
Rate for Payer: UnitedHealthcare Community & State	$141.41
Rate for Payer: Wellpoint Medicaid Managed Care	$127.09

FILTER OPTION ELITE 100CM

Facility

$4,625.00

Service Code	HCPCS C1880
Hospital Charge Code	270676626N
Hospital Revenue Code	278
Min. Negotiated Rate	$131.35
Max. Negotiated Rate	$2,312.50
Rate for Payer: Aetna Commercial	$1,757.50
Rate for Payer: Aetna Medicare Advantage	$1,387.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,179.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,179.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,179.38
Rate for Payer: Cigna Commercial	$2,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,119.25
Rate for Payer: Qualcare PPO/HMO/WC	$693.75
Rate for Payer: UnitedHealthcare Community & State	$146.15
Rate for Payer: Wellpoint Medicaid Managed Care	$131.35

FILTER OPTION ELITE 100CM

Facility

$4,475.00

Service Code	HCPCS C1880
Hospital Charge Code	270676626S
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

FILTER OPTION ELITE 100CM

Facility

$4,475.00

Service Code	HCPCS C1880
Hospital Charge Code	270676626
Hospital Revenue Code	278
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) NJ Health	$895.00
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	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25
Rate for Payer: UnitedHealthcare Community & State	$141.41
Rate for Payer: Wellpoint Medicaid Managed Care	$127.09

FILTER OPTION ELITE 100CM

Facility

$4,475.00

Service Code	HCPCS C1880
Hospital Charge Code	270676626A
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

FILTER OPTION ELITE 100CM

Facility

$4,475.00

Service Code	HCPCS C1880
Hospital Charge Code	270676626A
Hospital Revenue Code	278
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) NJ Health	$895.00
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	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25
Rate for Payer: UnitedHealthcare Community & State	$141.41
Rate for Payer: Wellpoint Medicaid Managed Care	$127.09

FILTER OPTION ELITE 100CM

Facility

$4,475.00

Service Code	HCPCS C1880
Hospital Charge Code	270676626
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

FILTER PFT KOKO

Facility

$26.00

Hospital Charge Code	270652199
Hospital Revenue Code	270
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$3.90
Rate for Payer: Qualcare PPO/HMO/WC	$3.90

FILTER PFT KOKO

Facility

$26.00

Hospital Charge Code	270652199
Hospital Revenue Code	270
Min. Negotiated Rate	$0.74
Max. Negotiated Rate	$13.00
Rate for Payer: Aetna Commercial	$9.88
Rate for Payer: Aetna Medicare Advantage	$7.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.63
Rate for Payer: Cigna Commercial	$13.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.76
Rate for Payer: Oxford Commercial	$5.20
Rate for Payer: Qualcare PPO/HMO/WC	$3.90
Rate for Payer: UnitedHealthcare Commercial	$5.20
Rate for Payer: UnitedHealthcare Community & State	$0.82
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

FILTER PFT WHITE PRI757W

Facility

$5.50

Hospital Charge Code	270649462
Hospital Revenue Code	270
Min. Negotiated Rate	$0.83
Max. Negotiated Rate	$0.83
Rate for Payer: Qualcare PPO/HMO/WC	$0.83

FILTER PFT WHITE PRI757W

Facility

$5.50

Hospital Charge Code	270649462
Hospital Revenue Code	270
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$2.75
Rate for Payer: Aetna Commercial	$2.09
Rate for Payer: Aetna Medicare Advantage	$1.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.40
Rate for Payer: Cigna Commercial	$2.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.43
Rate for Payer: Oxford Commercial	$1.10
Rate for Payer: Qualcare PPO/HMO/WC	$0.83
Rate for Payer: UnitedHealthcare Commercial	$1.10
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

FILTER PUMP BRAVO

Facility

$475.00

Hospital Charge Code	270691425
Hospital Revenue Code	272
Min. Negotiated Rate	$13.49
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$180.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.50
Rate for Payer: Oxford Commercial	$95.00
Rate for Payer: Qualcare PPO/HMO/WC	$71.25
Rate for Payer: UnitedHealthcare Commercial	$95.00
Rate for Payer: UnitedHealthcare Community & State	$15.01
Rate for Payer: Wellpoint Medicaid Managed Care	$13.49

FILTER PUMP BRAVO

Facility

$475.00

Hospital Charge Code	270691425
Hospital Revenue Code	272
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$71.25
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

FILTER SYSTEM ELITE VENA CAVA

Facility

$3,975.00

Service Code	HCPCS C1880
Hospital Charge Code	270658294S
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$961.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

FILTER SYSTEM ELITE VENA CAVA

Facility

$4,475.00

Service Code	HCPCS C1880
Hospital Charge Code	270658294N
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

FILTER SYSTEM ELITE VENA CAVA

Facility

$3,975.00

Service Code	HCPCS C1880
Hospital Charge Code	270658294S
Hospital Revenue Code	278
Min. Negotiated Rate	$112.89
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,510.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25
Rate for Payer: UnitedHealthcare Community & State	$125.61
Rate for Payer: Wellpoint Medicaid Managed Care	$112.89

Know your out-of-pocket cost for care.

All Charges