Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

GASTROSTOMY (PEG) TRAY 20FR

Facility

$724.00

Hospital Charge Code	270332481
Hospital Revenue Code	272
Min. Negotiated Rate	$20.56
Max. Negotiated Rate	$362.00
Rate for Payer: Aetna Commercial	$275.12
Rate for Payer: Aetna Medicare Advantage	$217.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.62
Rate for Payer: Cigna Commercial	$362.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.24
Rate for Payer: Oxford Commercial	$144.80
Rate for Payer: Qualcare PPO/HMO/WC	$108.60
Rate for Payer: UnitedHealthcare Commercial	$144.80
Rate for Payer: UnitedHealthcare Community & State	$22.88
Rate for Payer: Wellpoint Medicaid Managed Care	$20.56

GASTROSTOMY (PEG) TRAY 20FR

Facility

$724.00

Hospital Charge Code	270332481
Hospital Revenue Code	272
Min. Negotiated Rate	$108.60
Max. Negotiated Rate	$108.60
Rate for Payer: Qualcare PPO/HMO/WC	$108.60

GASTROSTOMY TUBE 18FR

Facility

$1,282.00

Hospital Charge Code	270332482
Hospital Revenue Code	272
Min. Negotiated Rate	$192.30
Max. Negotiated Rate	$192.30
Rate for Payer: Qualcare PPO/HMO/WC	$192.30

GASTROSTOMY TUBE 18FR

Facility

$1,282.00

Hospital Charge Code	270332482
Hospital Revenue Code	272
Min. Negotiated Rate	$36.41
Max. Negotiated Rate	$641.00
Rate for Payer: Aetna Commercial	$487.16
Rate for Payer: Aetna Medicare Advantage	$384.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$326.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$326.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$326.91
Rate for Payer: Cigna Commercial	$641.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.32
Rate for Payer: Oxford Commercial	$256.40
Rate for Payer: Qualcare PPO/HMO/WC	$192.30
Rate for Payer: UnitedHealthcare Commercial	$256.40
Rate for Payer: UnitedHealthcare Community & State	$40.51
Rate for Payer: Wellpoint Medicaid Managed Care	$36.41

GASTROSTOMY TUBE 20FR

Facility

$1,292.00

Hospital Charge Code	270332483
Hospital Revenue Code	272
Min. Negotiated Rate	$193.80
Max. Negotiated Rate	$193.80
Rate for Payer: Qualcare PPO/HMO/WC	$193.80

GASTROSTOMY TUBE 20FR

Facility

$1,292.00

Hospital Charge Code	270332483
Hospital Revenue Code	272
Min. Negotiated Rate	$36.69
Max. Negotiated Rate	$646.00
Rate for Payer: Aetna Commercial	$490.96
Rate for Payer: Aetna Medicare Advantage	$387.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$329.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$329.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$329.46
Rate for Payer: Cigna Commercial	$646.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.92
Rate for Payer: Oxford Commercial	$258.40
Rate for Payer: Qualcare PPO/HMO/WC	$193.80
Rate for Payer: UnitedHealthcare Commercial	$258.40
Rate for Payer: UnitedHealthcare Community & State	$40.83
Rate for Payer: Wellpoint Medicaid Managed Care	$36.69

GATA3

Facility

$1,082.30

Service Code	HCPCS 88342
Hospital Charge Code	4016883421
Hospital Revenue Code	310
Min. Negotiated Rate	$30.74
Max. Negotiated Rate	$734.21
Rate for Payer: Aetna Commercial	$550.53
Rate for Payer: Aetna Medicare Advantage	$655.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$734.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$734.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$202.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$734.21
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$202.40
Rate for Payer: Clover Medicare Advantage	$192.28
Rate for Payer: EmblemHealth Commercial	$607.20
Rate for Payer: Humana Medicare Advantage	$208.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$202.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$281.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$162.34
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$86.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$202.40
Rate for Payer: Wellcare Medicare Advantage	$202.40
Rate for Payer: Wellpoint Medicaid Managed Care	$30.74

GATA3

Facility

$1,082.30

Service Code	HCPCS 88342
Hospital Charge Code	4016883421
Hospital Revenue Code	310
Min. Negotiated Rate	$162.34
Max. Negotiated Rate	$162.34
Rate for Payer: Qualcare PPO/HMO/WC	$162.34

GAUGE DEPTH 2.0MM/2.4MM screws

Facility

$2,530.25

Hospital Charge Code	270677661
Hospital Revenue Code	272
Min. Negotiated Rate	$379.54
Max. Negotiated Rate	$379.54
Rate for Payer: Qualcare PPO/HMO/WC	$379.54

GAUGE DEPTH 2.0MM/2.4MM screws

Facility

$2,530.25

Hospital Charge Code	270677661
Hospital Revenue Code	272
Min. Negotiated Rate	$71.86
Max. Negotiated Rate	$1,265.12
Rate for Payer: Aetna Commercial	$961.50
Rate for Payer: Aetna Medicare Advantage	$759.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$645.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$645.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$645.21
Rate for Payer: Cigna Commercial	$1,265.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$657.87
Rate for Payer: Oxford Commercial	$506.05
Rate for Payer: Qualcare PPO/HMO/WC	$379.54
Rate for Payer: UnitedHealthcare Commercial	$506.05
Rate for Payer: UnitedHealthcare Community & State	$79.96
Rate for Payer: Wellpoint Medicaid Managed Care	$71.86

GAUGE DEPTH 2.7/3.5

Facility

$1,509.00

Hospital Charge Code	270672085
Hospital Revenue Code	272
Min. Negotiated Rate	$226.35
Max. Negotiated Rate	$226.35
Rate for Payer: Qualcare PPO/HMO/WC	$226.35

GAUGE DEPTH 2.7/3.5

Facility

$1,509.00

Hospital Charge Code	270672085
Hospital Revenue Code	272
Min. Negotiated Rate	$42.86
Max. Negotiated Rate	$754.50
Rate for Payer: Aetna Commercial	$573.42
Rate for Payer: Aetna Medicare Advantage	$452.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$384.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$384.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$384.80
Rate for Payer: Cigna Commercial	$754.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.34
Rate for Payer: Oxford Commercial	$301.80
Rate for Payer: Qualcare PPO/HMO/WC	$226.35
Rate for Payer: UnitedHealthcare Commercial	$301.80
Rate for Payer: UnitedHealthcare Community & State	$47.68
Rate for Payer: Wellpoint Medicaid Managed Care	$42.86

GAUGE MENDEZ DEGREE

Facility

$1,040.00

Hospital Charge Code	270667879
Hospital Revenue Code	272
Min. Negotiated Rate	$156.00
Max. Negotiated Rate	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$156.00

GAUGE MENDEZ DEGREE

Facility

$1,040.00

Hospital Charge Code	270667879
Hospital Revenue Code	272
Min. Negotiated Rate	$29.54
Max. Negotiated Rate	$520.00
Rate for Payer: Aetna Commercial	$395.20
Rate for Payer: Aetna Medicare Advantage	$312.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$265.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$265.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$265.20
Rate for Payer: Cigna Commercial	$520.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$270.40
Rate for Payer: Oxford Commercial	$208.00
Rate for Payer: Qualcare PPO/HMO/WC	$156.00
Rate for Payer: UnitedHealthcare Commercial	$208.00
Rate for Payer: UnitedHealthcare Community & State	$32.86
Rate for Payer: Wellpoint Medicaid Managed Care	$29.54

GAUZE NU IODO 1/2/5YD

Facility

$9.80

Hospital Charge Code	270300955W
Hospital Revenue Code	272
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$1.47
Rate for Payer: Qualcare PPO/HMO/WC	$1.47

GAUZE NU IODO 1/2/5YD

Facility

$9.80

Hospital Charge Code	270300955
Hospital Revenue Code	272
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$1.47
Rate for Payer: Qualcare PPO/HMO/WC	$1.47

GAUZE NU IODO 1/2/5YD

Facility

$9.80

Hospital Charge Code	270300955
Hospital Revenue Code	272
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$4.90
Rate for Payer: Aetna Commercial	$3.72
Rate for Payer: Aetna Medicare Advantage	$2.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.50
Rate for Payer: Cigna Commercial	$4.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.55
Rate for Payer: Oxford Commercial	$1.96
Rate for Payer: Qualcare PPO/HMO/WC	$1.47
Rate for Payer: UnitedHealthcare Commercial	$1.96
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.28

GAUZE NU IODO 1/2/5YD

Facility

$9.80

Hospital Charge Code	270300955W
Hospital Revenue Code	272
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$4.90
Rate for Payer: Aetna Commercial	$3.72
Rate for Payer: Aetna Medicare Advantage	$2.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.50
Rate for Payer: Cigna Commercial	$4.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.55
Rate for Payer: Oxford Commercial	$1.96
Rate for Payer: Qualcare PPO/HMO/WC	$1.47
Rate for Payer: UnitedHealthcare Commercial	$1.96
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.28

GAUZE NU IODO 1/4/5YD

Facility

$9.62

Hospital Charge Code	270300950W
Hospital Revenue Code	272
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$4.81
Rate for Payer: Aetna Commercial	$3.66
Rate for Payer: Aetna Medicare Advantage	$2.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.45
Rate for Payer: Cigna Commercial	$4.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.50
Rate for Payer: Oxford Commercial	$1.92
Rate for Payer: Qualcare PPO/HMO/WC	$1.44
Rate for Payer: UnitedHealthcare Commercial	$1.92
Rate for Payer: UnitedHealthcare Community & State	$0.30
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

GAUZE NU IODO 1/4/5YD

Facility

$9.62

Hospital Charge Code	270300950W
Hospital Revenue Code	272
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$1.44
Rate for Payer: Qualcare PPO/HMO/WC	$1.44

GAUZE NU IODO 1/4 IN /5YD

Facility

$9.62

Hospital Charge Code	270300950
Hospital Revenue Code	272
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$4.81
Rate for Payer: Aetna Commercial	$3.66
Rate for Payer: Aetna Medicare Advantage	$2.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.45
Rate for Payer: Cigna Commercial	$4.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.50
Rate for Payer: Oxford Commercial	$1.92
Rate for Payer: Qualcare PPO/HMO/WC	$1.44
Rate for Payer: UnitedHealthcare Commercial	$1.92
Rate for Payer: UnitedHealthcare Community & State	$0.30
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

GAUZE NU IODO 1/4 IN /5YD

Facility

$9.62

Hospital Charge Code	270300950
Hospital Revenue Code	272
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$1.44
Rate for Payer: Qualcare PPO/HMO/WC	$1.44

GAUZE NU IODO 1/5YD

Facility

$11.65

Hospital Charge Code	270300960
Hospital Revenue Code	272
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$5.83
Rate for Payer: Aetna Commercial	$4.43
Rate for Payer: Aetna Medicare Advantage	$3.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.97
Rate for Payer: Cigna Commercial	$5.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.03
Rate for Payer: Oxford Commercial	$2.33
Rate for Payer: Qualcare PPO/HMO/WC	$1.75
Rate for Payer: UnitedHealthcare Commercial	$2.33
Rate for Payer: UnitedHealthcare Community & State	$0.37
Rate for Payer: Wellpoint Medicaid Managed Care	$0.33

GAUZE NU IODO 1/5YD

Facility

$11.65

Hospital Charge Code	270300960
Hospital Revenue Code	272
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$1.75
Rate for Payer: Qualcare PPO/HMO/WC	$1.75

GAUZE NU IODO 1/5YD

Facility

$11.65

Hospital Charge Code	270300960W
Hospital Revenue Code	272
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$1.75
Rate for Payer: Qualcare PPO/HMO/WC	$1.75

Know your out-of-pocket cost for care.

All Charges