Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

GEL GRAFTON 1CC 121120

Facility

$950.00

Service Code	HCPCS C1713
Hospital Charge Code	270601115
Hospital Revenue Code	278
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$229.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$142.50

GELPOINT PATH

Facility

$4,375.00

Hospital Charge Code	270698635
Hospital Revenue Code	279
Min. Negotiated Rate	$124.25
Max. Negotiated Rate	$2,187.50
Rate for Payer: Aetna Commercial	$1,662.50
Rate for Payer: Aetna Medicare Advantage	$1,312.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,115.62
Rate for Payer: Cigna Commercial	$2,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,137.50
Rate for Payer: Oxford Commercial	$875.00
Rate for Payer: Qualcare PPO/HMO/WC	$656.25
Rate for Payer: UnitedHealthcare Commercial	$875.00
Rate for Payer: UnitedHealthcare Community & State	$138.25
Rate for Payer: Wellpoint Medicaid Managed Care	$124.25

GELPOINT PATH

Facility

$4,375.00

Hospital Charge Code	270698635
Hospital Revenue Code	279
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$656.25
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

GELPOINT PATH TRANSANAL ACCESS

Facility

$3,625.00

Hospital Charge Code	270676406
Hospital Revenue Code	272
Min. Negotiated Rate	$543.75
Max. Negotiated Rate	$543.75
Rate for Payer: Qualcare PPO/HMO/WC	$543.75

GELPOINT PATH TRANSANAL ACCESS

Facility

$3,625.00

Hospital Charge Code	270676406
Hospital Revenue Code	272
Min. Negotiated Rate	$102.95
Max. Negotiated Rate	$1,812.50
Rate for Payer: Aetna Commercial	$1,377.50
Rate for Payer: Aetna Medicare Advantage	$1,087.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$924.38
Rate for Payer: Cigna Commercial	$1,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$942.50
Rate for Payer: Oxford Commercial	$725.00
Rate for Payer: Qualcare PPO/HMO/WC	$543.75
Rate for Payer: UnitedHealthcare Commercial	$725.00
Rate for Payer: UnitedHealthcare Community & State	$114.55
Rate for Payer: Wellpoint Medicaid Managed Care	$102.95

GEL SOLOSITE WOUND

Facility

$31.51

Hospital Charge Code	270650220
Hospital Revenue Code	270
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$15.76
Rate for Payer: Aetna Commercial	$11.97
Rate for Payer: Aetna Medicare Advantage	$9.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.04
Rate for Payer: Cigna Commercial	$15.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.19
Rate for Payer: Oxford Commercial	$6.30
Rate for Payer: Qualcare PPO/HMO/WC	$4.73
Rate for Payer: UnitedHealthcare Commercial	$6.30
Rate for Payer: UnitedHealthcare Community & State	$1.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.89

GEL SOLOSITE WOUND

Facility

$31.51

Hospital Charge Code	270650220
Hospital Revenue Code	270
Min. Negotiated Rate	$4.73
Max. Negotiated Rate	$4.73
Rate for Payer: Qualcare PPO/HMO/WC	$4.73

GEL ULTRASOUND AQUASONIC

Facility

$9.30

Hospital Charge Code	270660313
Hospital Revenue Code	270
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$4.65
Rate for Payer: Aetna Commercial	$3.53
Rate for Payer: Aetna Medicare Advantage	$2.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.37
Rate for Payer: Cigna Commercial	$4.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.42
Rate for Payer: Oxford Commercial	$1.86
Rate for Payer: Qualcare PPO/HMO/WC	$1.40
Rate for Payer: UnitedHealthcare Commercial	$1.86
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

GEL ULTRASOUND AQUASONIC

Facility

$9.30

Hospital Charge Code	270660313
Hospital Revenue Code	270
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$1.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.40

GEL WOUND 1.5 OZ

Facility

$84.57

Hospital Charge Code	270685411
Hospital Revenue Code	272
Min. Negotiated Rate	$12.69
Max. Negotiated Rate	$12.69
Rate for Payer: Qualcare PPO/HMO/WC	$12.69

GEL WOUND 1.5 OZ

Facility

$84.57

Hospital Charge Code	270685411
Hospital Revenue Code	272
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$42.28
Rate for Payer: Aetna Commercial	$32.14
Rate for Payer: Aetna Medicare Advantage	$25.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.57
Rate for Payer: Cigna Commercial	$42.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.99
Rate for Payer: Oxford Commercial	$16.91
Rate for Payer: Qualcare PPO/HMO/WC	$12.69
Rate for Payer: UnitedHealthcare Commercial	$16.91
Rate for Payer: UnitedHealthcare Community & State	$2.67
Rate for Payer: Wellpoint Medicaid Managed Care	$2.40

GEMCITABINE 1000 MG INJ

Facility

$1,125.60

Service Code	HCPCS J9201
Hospital Charge Code	60627386
Hospital Revenue Code	636
Min. Negotiated Rate	$168.84
Max. Negotiated Rate	$272.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.40
Rate for Payer: Qualcare PPO/HMO/WC	$168.84

GEMCITABINE 1000 MG INJ

Facility

$1,125.60

Service Code	HCPCS J9201
Hospital Charge Code	60627386
Hospital Revenue Code	636
Min. Negotiated Rate	$31.97
Max. Negotiated Rate	$562.80
Rate for Payer: Aetna Commercial	$427.73
Rate for Payer: Aetna Medicare Advantage	$337.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$287.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$287.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$287.03
Rate for Payer: Cigna Commercial	$562.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.40
Rate for Payer: Qualcare PPO/HMO/WC	$168.84
Rate for Payer: UnitedHealthcare Community & State	$35.57
Rate for Payer: Wellpoint Medicaid Managed Care	$31.97

GEMCITABINE 200 MG INJ

Facility

$1,127.01

Service Code	HCPCS J9201
Hospital Charge Code	60627385
Hospital Revenue Code	636
Min. Negotiated Rate	$169.05
Max. Negotiated Rate	$272.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.74
Rate for Payer: Qualcare PPO/HMO/WC	$169.05

GEMCITABINE 200 MG INJ

Facility

$1,127.01

Service Code	HCPCS J9201
Hospital Charge Code	60627385
Hospital Revenue Code	636
Min. Negotiated Rate	$32.01
Max. Negotiated Rate	$563.50
Rate for Payer: Aetna Commercial	$428.26
Rate for Payer: Aetna Medicare Advantage	$338.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$287.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$287.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$287.39
Rate for Payer: Cigna Commercial	$563.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.74
Rate for Payer: Qualcare PPO/HMO/WC	$169.05
Rate for Payer: UnitedHealthcare Community & State	$35.61
Rate for Payer: Wellpoint Medicaid Managed Care	$32.01

GEMFIBROZIL 600 MG TAB

Facility

$7.64

Service Code	NDC 71073720
Hospital Charge Code	60627620
Hospital Revenue Code	250
Min. Negotiated Rate	$1.15
Max. Negotiated Rate	$1.15
Rate for Payer: Qualcare PPO/HMO/WC	$1.15

GEMFIBROZIL 600 MG TAB

Facility

$7.64

Service Code	NDC 71073720
Hospital Charge Code	60627620
Hospital Revenue Code	250
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$3.82
Rate for Payer: Aetna Commercial	$2.90
Rate for Payer: Aetna Medicare Advantage	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.95
Rate for Payer: Cigna Commercial	$3.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.99
Rate for Payer: Oxford Commercial	$1.53
Rate for Payer: Qualcare PPO/HMO/WC	$1.15
Rate for Payer: UnitedHealthcare Commercial	$1.53
Rate for Payer: UnitedHealthcare Community & State	$0.24
Rate for Payer: Wellpoint Medicaid Managed Care	$0.22

GEMINI ACETABULAR CUP

Facility

$4,052.00

Hospital Charge Code	270335031
Hospital Revenue Code	278
Min. Negotiated Rate	$607.80
Max. Negotiated Rate	$980.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$810.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$980.58
Rate for Payer: Qualcare PPO/HMO/WC	$607.80

GEMINI ACETABULAR CUP

Facility

$4,052.00

Hospital Charge Code	270335031
Hospital Revenue Code	278
Min. Negotiated Rate	$115.08
Max. Negotiated Rate	$2,026.00
Rate for Payer: Aetna Commercial	$1,539.76
Rate for Payer: Aetna Medicare Advantage	$1,215.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,033.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,033.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$810.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,033.26
Rate for Payer: Cigna Commercial	$2,026.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$980.58
Rate for Payer: Qualcare PPO/HMO/WC	$607.80
Rate for Payer: UnitedHealthcare Community & State	$128.04
Rate for Payer: Wellpoint Medicaid Managed Care	$115.08

GEN.CYT. FILTER METHOD ONLY

Facility

$259.00

Service Code	HCPCS 88106
Hospital Charge Code	38474085
Hospital Revenue Code	311
Min. Negotiated Rate	$38.85
Max. Negotiated Rate	$38.85
Rate for Payer: Qualcare PPO/HMO/WC	$38.85

GEN.CYT. FILTER METHOD ONLY

Facility

$259.00

Service Code	HCPCS 88106
Hospital Charge Code	38474085
Hospital Revenue Code	311
Min. Negotiated Rate	$7.36
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$93.46
Rate for Payer: Aetna Medicare Advantage	$111.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$34.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.64
Rate for Payer: Cigna Commercial	$68.87
Rate for Payer: Cigna Medicare Advantage	$34.36
Rate for Payer: Clover Medicare Advantage	$32.64
Rate for Payer: EmblemHealth Commercial	$103.08
Rate for Payer: Humana Medicare Advantage	$35.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$34.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.34
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.85
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$58.29
Rate for Payer: UnitedHealthcare Medicare Advantage	$34.36
Rate for Payer: Wellcare Medicare Advantage	$34.36
Rate for Payer: Wellpoint Medicaid Managed Care	$7.36

GENDER PFJ FEM COMP SIZE 2-RT

Facility

$25,560.00

Service Code	HCPCS C1776
Hospital Charge Code	270681300
Hospital Revenue Code	278
Min. Negotiated Rate	$3,834.00
Max. Negotiated Rate	$6,185.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,112.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,185.52
Rate for Payer: Qualcare PPO/HMO/WC	$3,834.00

GENDER PFJ FEM COMP SIZE 2-RT

Facility

$25,560.00

Service Code	HCPCS C1776
Hospital Charge Code	270681300
Hospital Revenue Code	278
Min. Negotiated Rate	$725.90
Max. Negotiated Rate	$12,780.00
Rate for Payer: Aetna Commercial	$9,712.80
Rate for Payer: Aetna Medicare Advantage	$7,668.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,517.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,517.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,112.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,517.80
Rate for Payer: Cigna Commercial	$12,780.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,185.52
Rate for Payer: Qualcare PPO/HMO/WC	$3,834.00
Rate for Payer: UnitedHealthcare Community & State	$807.70
Rate for Payer: Wellpoint Medicaid Managed Care	$725.90

GENDER PFJ MILL BURR STANDARD

Facility

$720.00

Hospital Charge Code	270681303
Hospital Revenue Code	272
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$108.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

GENDER PFJ MILL BURR STANDARD

Facility

$720.00

Hospital Charge Code	270681303
Hospital Revenue Code	272
Min. Negotiated Rate	$20.45
Max. Negotiated Rate	$360.00
Rate for Payer: Aetna Commercial	$273.60
Rate for Payer: Aetna Medicare Advantage	$216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.60
Rate for Payer: Cigna Commercial	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.20
Rate for Payer: Oxford Commercial	$144.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.00
Rate for Payer: UnitedHealthcare Commercial	$144.00
Rate for Payer: UnitedHealthcare Community & State	$22.75
Rate for Payer: Wellpoint Medicaid Managed Care	$20.45

Know your out-of-pocket cost for care.

All Charges