Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

HASKAL TIP SET G36126

Facility

$3,150.00

Hospital Charge Code	270635529S
Hospital Revenue Code	272
Min. Negotiated Rate	$89.46
Max. Negotiated Rate	$1,575.00
Rate for Payer: Aetna Commercial	$1,197.00
Rate for Payer: Aetna Medicare Advantage	$945.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$803.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$803.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$803.25
Rate for Payer: Cigna Commercial	$1,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$819.00
Rate for Payer: Oxford Commercial	$630.00
Rate for Payer: Qualcare PPO/HMO/WC	$472.50
Rate for Payer: UnitedHealthcare Commercial	$630.00
Rate for Payer: UnitedHealthcare Community & State	$99.54
Rate for Payer: Wellpoint Medicaid Managed Care	$89.46

HASKAL TIP SET G36126

Facility

$3,150.00

Hospital Charge Code	270635529
Hospital Revenue Code	272
Min. Negotiated Rate	$89.46
Max. Negotiated Rate	$1,575.00
Rate for Payer: Aetna Commercial	$1,197.00
Rate for Payer: Aetna Medicare Advantage	$945.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$803.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$803.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$803.25
Rate for Payer: Cigna Commercial	$1,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$819.00
Rate for Payer: Oxford Commercial	$630.00
Rate for Payer: Qualcare PPO/HMO/WC	$472.50
Rate for Payer: UnitedHealthcare Commercial	$630.00
Rate for Payer: UnitedHealthcare Community & State	$99.54
Rate for Payer: Wellpoint Medicaid Managed Care	$89.46

HASKAL TIP SET G36126

Facility

$3,150.00

Hospital Charge Code	270635529
Hospital Revenue Code	272
Min. Negotiated Rate	$472.50
Max. Negotiated Rate	$472.50
Rate for Payer: Qualcare PPO/HMO/WC	$472.50

HATCHED TITANIUM PROBE KIT

Facility

$2,025.00

Hospital Charge Code	270663190
Hospital Revenue Code	272
Min. Negotiated Rate	$303.75
Max. Negotiated Rate	$303.75
Rate for Payer: Qualcare PPO/HMO/WC	$303.75

HATCHED TITANIUM PROBE KIT

Facility

$2,025.00

Hospital Charge Code	270663190
Hospital Revenue Code	272
Min. Negotiated Rate	$57.51
Max. Negotiated Rate	$1,012.50
Rate for Payer: Aetna Commercial	$769.50
Rate for Payer: Aetna Medicare Advantage	$607.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$516.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$516.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$516.38
Rate for Payer: Cigna Commercial	$1,012.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$526.50
Rate for Payer: Oxford Commercial	$405.00
Rate for Payer: Qualcare PPO/HMO/WC	$303.75
Rate for Payer: UnitedHealthcare Commercial	$405.00
Rate for Payer: UnitedHealthcare Community & State	$63.99
Rate for Payer: Wellpoint Medicaid Managed Care	$57.51

HAV AB,TOTAL

Facility

$390.00

Service Code	HCPCS 86708
Hospital Charge Code	39900247
Hospital Revenue Code	302
Min. Negotiated Rate	$9.91
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$33.70
Rate for Payer: Aetna Medicare Advantage	$40.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.94
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.39
Rate for Payer: Clover Medicare Advantage	$11.77
Rate for Payer: EmblemHealth Commercial	$37.17
Rate for Payer: Humana Medicare Advantage	$12.76
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.39
Rate for Payer: Wellcare Medicare Advantage	$12.39
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

HAV AB,TOTAL

Facility

$390.00

Service Code	HCPCS 86708
Hospital Charge Code	39900247
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Hawk One LS

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270673802
Hospital Revenue Code	278
Min. Negotiated Rate	$517.59
Max. Negotiated Rate	$9,112.50
Rate for Payer: Aetna Commercial	$6,925.50
Rate for Payer: Aetna Medicare Advantage	$5,467.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,647.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,647.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,647.38
Rate for Payer: Cigna Commercial	$9,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75
Rate for Payer: UnitedHealthcare Community & State	$575.91
Rate for Payer: Wellpoint Medicaid Managed Care	$517.59

Hawk One LS

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270673802N
Hospital Revenue Code	278
Min. Negotiated Rate	$517.59
Max. Negotiated Rate	$9,112.50
Rate for Payer: Aetna Commercial	$6,925.50
Rate for Payer: Aetna Medicare Advantage	$5,467.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,647.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,647.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,647.38
Rate for Payer: Cigna Commercial	$9,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75
Rate for Payer: UnitedHealthcare Community & State	$575.91
Rate for Payer: Wellpoint Medicaid Managed Care	$517.59

Hawk One LS

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270673802N
Hospital Revenue Code	278
Min. Negotiated Rate	$2,733.75
Max. Negotiated Rate	$4,410.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75

Hawk One LS

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270673802
Hospital Revenue Code	278
Min. Negotiated Rate	$2,733.75
Max. Negotiated Rate	$4,410.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75

Hawk One LX

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270677280
Hospital Revenue Code	278
Min. Negotiated Rate	$517.59
Max. Negotiated Rate	$9,112.50
Rate for Payer: Aetna Commercial	$6,925.50
Rate for Payer: Aetna Medicare Advantage	$5,467.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,647.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,647.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,647.38
Rate for Payer: Cigna Commercial	$9,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75
Rate for Payer: UnitedHealthcare Community & State	$575.91
Rate for Payer: Wellpoint Medicaid Managed Care	$517.59

Hawk One LX

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270677280
Hospital Revenue Code	278
Min. Negotiated Rate	$2,733.75
Max. Negotiated Rate	$4,410.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75

Hawk One LX

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270677280N
Hospital Revenue Code	278
Min. Negotiated Rate	$2,733.75
Max. Negotiated Rate	$4,410.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75

Hawk One LX

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270677280N
Hospital Revenue Code	278
Min. Negotiated Rate	$517.59
Max. Negotiated Rate	$9,112.50
Rate for Payer: Aetna Commercial	$6,925.50
Rate for Payer: Aetna Medicare Advantage	$5,467.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,647.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,647.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,647.38
Rate for Payer: Cigna Commercial	$9,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75
Rate for Payer: UnitedHealthcare Community & State	$575.91
Rate for Payer: Wellpoint Medicaid Managed Care	$517.59

Hawk One M 6F 2.2 135

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270683844N
Hospital Revenue Code	278
Min. Negotiated Rate	$517.59
Max. Negotiated Rate	$9,112.50
Rate for Payer: Aetna Commercial	$6,925.50
Rate for Payer: Aetna Medicare Advantage	$5,467.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,647.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,647.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,647.38
Rate for Payer: Cigna Commercial	$9,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75
Rate for Payer: UnitedHealthcare Community & State	$575.91
Rate for Payer: Wellpoint Medicaid Managed Care	$517.59

Hawk One M 6F 2.2 135

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270683844
Hospital Revenue Code	278
Min. Negotiated Rate	$517.59
Max. Negotiated Rate	$9,112.50
Rate for Payer: Aetna Commercial	$6,925.50
Rate for Payer: Aetna Medicare Advantage	$5,467.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,647.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,647.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,647.38
Rate for Payer: Cigna Commercial	$9,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75
Rate for Payer: UnitedHealthcare Community & State	$575.91
Rate for Payer: Wellpoint Medicaid Managed Care	$517.59

Hawk One M 6F 2.2 135

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270683844N
Hospital Revenue Code	278
Min. Negotiated Rate	$2,733.75
Max. Negotiated Rate	$4,410.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75

Hawk One M 6F 2.2 135

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270683844
Hospital Revenue Code	278
Min. Negotiated Rate	$2,733.75
Max. Negotiated Rate	$4,410.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75

HAWK ONE M 6F 2.2 135

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270683844S
Hospital Revenue Code	278
Min. Negotiated Rate	$517.59
Max. Negotiated Rate	$9,112.50
Rate for Payer: Aetna Commercial	$6,925.50
Rate for Payer: Aetna Medicare Advantage	$5,467.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,647.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,647.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,647.38
Rate for Payer: Cigna Commercial	$9,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75
Rate for Payer: UnitedHealthcare Community & State	$575.91
Rate for Payer: Wellpoint Medicaid Managed Care	$517.59

HAWK ONE M 6F 2.2 135

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270683844S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,733.75
Max. Negotiated Rate	$4,410.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75

Hawk One S

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270683845N
Hospital Revenue Code	278
Min. Negotiated Rate	$2,733.75
Max. Negotiated Rate	$4,410.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75

Hawk One S

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270683845N
Hospital Revenue Code	278
Min. Negotiated Rate	$517.59
Max. Negotiated Rate	$9,112.50
Rate for Payer: Aetna Commercial	$6,925.50
Rate for Payer: Aetna Medicare Advantage	$5,467.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,647.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,647.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,647.38
Rate for Payer: Cigna Commercial	$9,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75
Rate for Payer: UnitedHealthcare Community & State	$575.91
Rate for Payer: Wellpoint Medicaid Managed Care	$517.59

Hawk One S

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270683845
Hospital Revenue Code	278
Min. Negotiated Rate	$517.59
Max. Negotiated Rate	$9,112.50
Rate for Payer: Aetna Commercial	$6,925.50
Rate for Payer: Aetna Medicare Advantage	$5,467.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,647.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,647.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,647.38
Rate for Payer: Cigna Commercial	$9,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75
Rate for Payer: UnitedHealthcare Community & State	$575.91
Rate for Payer: Wellpoint Medicaid Managed Care	$517.59

Hawk One S

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270683845
Hospital Revenue Code	278
Min. Negotiated Rate	$2,733.75
Max. Negotiated Rate	$4,410.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75

Know your out-of-pocket cost for care.

All Charges