Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

AMNIOTIC FLUID TRI

Facility

$9,170.00

Hospital Charge Code	270680608
Hospital Revenue Code	278
Min. Negotiated Rate	$260.43
Max. Negotiated Rate	$4,585.00
Rate for Payer: Aetna Commercial	$3,484.60
Rate for Payer: Aetna Medicare Advantage	$2,751.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,338.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,338.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,834.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,338.35
Rate for Payer: Cigna Commercial	$4,585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,219.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,375.50
Rate for Payer: UnitedHealthcare Community & State	$289.77
Rate for Payer: Wellpoint Medicaid Managed Care	$260.43

AMNIOTIC MEMBRANE

Facility

$1,404.00

Hospital Charge Code	270335551
Hospital Revenue Code	278
Min. Negotiated Rate	$210.60
Max. Negotiated Rate	$339.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$339.77
Rate for Payer: Qualcare PPO/HMO/WC	$210.60

AMNIOTIC MEMBRANE

Facility

$1,404.00

Hospital Charge Code	270335551
Hospital Revenue Code	278
Min. Negotiated Rate	$39.87
Max. Negotiated Rate	$702.00
Rate for Payer: Aetna Commercial	$533.52
Rate for Payer: Aetna Medicare Advantage	$421.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$358.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$358.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$358.02
Rate for Payer: Cigna Commercial	$702.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$339.77
Rate for Payer: Qualcare PPO/HMO/WC	$210.60
Rate for Payer: UnitedHealthcare Community & State	$44.37
Rate for Payer: Wellpoint Medicaid Managed Care	$39.87

AMNIOTIC MEMBRANE ALLOGRAFT

Facility

$21,250.00

Hospital Charge Code	270337858
Hospital Revenue Code	278
Min. Negotiated Rate	$603.50
Max. Negotiated Rate	$10,625.00
Rate for Payer: Aetna Commercial	$8,075.00
Rate for Payer: Aetna Medicare Advantage	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,418.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,418.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,418.75
Rate for Payer: Cigna Commercial	$10,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,142.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,187.50
Rate for Payer: UnitedHealthcare Community & State	$671.50
Rate for Payer: Wellpoint Medicaid Managed Care	$603.50

AMNIOTIC MEMBRANE ALLOGRAFT

Facility

$21,250.00

Hospital Charge Code	270337858
Hospital Revenue Code	278
Min. Negotiated Rate	$3,187.50
Max. Negotiated Rate	$5,142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,142.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,187.50

AMNIOTIC MEMBRANE ALLOGRAFT

Facility

$9,170.00

Hospital Charge Code	270660772
Hospital Revenue Code	810
Min. Negotiated Rate	$260.43
Max. Negotiated Rate	$4,585.00
Rate for Payer: Aetna Commercial	$3,484.60
Rate for Payer: Aetna Medicare Advantage	$2,751.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,338.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,338.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,338.35
Rate for Payer: Cigna Commercial	$4,585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,384.20
Rate for Payer: Oxford Commercial	$1,834.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,375.50
Rate for Payer: UnitedHealthcare Commercial	$1,834.00
Rate for Payer: UnitedHealthcare Community & State	$289.77
Rate for Payer: Wellpoint Medicaid Managed Care	$260.43

AMNIOTIC MEMBRANE ALLOGRAFT

Facility

$9,170.00

Hospital Charge Code	270660772
Hospital Revenue Code	810
Min. Negotiated Rate	$1,375.50
Max. Negotiated Rate	$1,375.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,375.50

AMNIOTIC MEMBRANE ALLOGRAFT 1.

Facility

$9,170.00

Hospital Charge Code	270662351+
Hospital Revenue Code	272
Min. Negotiated Rate	$1,375.50
Max. Negotiated Rate	$1,375.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,375.50

AMNIOTIC MEMBRANE ALLOGRAFT 1.

Facility

$9,170.00

Hospital Charge Code	270662351+
Hospital Revenue Code	272
Min. Negotiated Rate	$260.43
Max. Negotiated Rate	$4,585.00
Rate for Payer: Aetna Commercial	$3,484.60
Rate for Payer: Aetna Medicare Advantage	$2,751.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,338.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,338.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,338.35
Rate for Payer: Cigna Commercial	$4,585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,384.20
Rate for Payer: Oxford Commercial	$1,834.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,375.50
Rate for Payer: UnitedHealthcare Commercial	$1,834.00
Rate for Payer: UnitedHealthcare Community & State	$289.77
Rate for Payer: Wellpoint Medicaid Managed Care	$260.43

AMNIOTICMEMBRANE ALLOGRAFT.5ML

Facility

$4,475.00

Hospital Charge Code	270662537
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

AMNIOTICMEMBRANE ALLOGRAFT.5ML

Facility

$4,475.00

Hospital Charge Code	270662537
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

AMNIOTIC MEMBRANE GRAFT

Facility

$1,144.00

Hospital Charge Code	270335698
Hospital Revenue Code	278
Min. Negotiated Rate	$32.49
Max. Negotiated Rate	$572.00
Rate for Payer: Aetna Commercial	$434.72
Rate for Payer: Aetna Medicare Advantage	$343.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$291.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$291.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$291.72
Rate for Payer: Cigna Commercial	$572.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$276.85
Rate for Payer: Qualcare PPO/HMO/WC	$171.60
Rate for Payer: UnitedHealthcare Community & State	$36.15
Rate for Payer: Wellpoint Medicaid Managed Care	$32.49

AMNIOTIC MEMBRANE GRAFT

Facility

$1,144.00

Hospital Charge Code	270335698
Hospital Revenue Code	278
Min. Negotiated Rate	$171.60
Max. Negotiated Rate	$276.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$276.85
Rate for Payer: Qualcare PPO/HMO/WC	$171.60

AMNIOTICMEMBRNEALLOGRAFT 7X7CM

Facility

$22,475.00

Hospital Charge Code	270662656
Hospital Revenue Code	278
Min. Negotiated Rate	$638.29
Max. Negotiated Rate	$11,237.50
Rate for Payer: Aetna Commercial	$8,540.50
Rate for Payer: Aetna Medicare Advantage	$6,742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,731.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,731.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,731.12
Rate for Payer: Cigna Commercial	$11,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,438.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,371.25
Rate for Payer: UnitedHealthcare Community & State	$710.21
Rate for Payer: Wellpoint Medicaid Managed Care	$638.29

AMNIOTICMEMBRNEALLOGRAFT 7X7CM

Facility

$22,475.00

Hospital Charge Code	270662656
Hospital Revenue Code	278
Min. Negotiated Rate	$3,371.25
Max. Negotiated Rate	$5,438.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,438.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,371.25

AMNIOTIC MENBRANE ALLOGRAFT

Facility

$6,475.00

Hospital Charge Code	270332706
Hospital Revenue Code	272
Min. Negotiated Rate	$183.89
Max. Negotiated Rate	$3,237.50
Rate for Payer: Aetna Commercial	$2,460.50
Rate for Payer: Aetna Medicare Advantage	$1,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,651.12
Rate for Payer: Cigna Commercial	$3,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,683.50
Rate for Payer: Oxford Commercial	$1,295.00
Rate for Payer: Qualcare PPO/HMO/WC	$971.25
Rate for Payer: UnitedHealthcare Commercial	$1,295.00
Rate for Payer: UnitedHealthcare Community & State	$204.61
Rate for Payer: Wellpoint Medicaid Managed Care	$183.89

AMNIOTIC MENBRANE ALLOGRAFT

Facility

$6,475.00

Hospital Charge Code	270332708
Hospital Revenue Code	272
Min. Negotiated Rate	$183.89
Max. Negotiated Rate	$3,237.50
Rate for Payer: Aetna Commercial	$2,460.50
Rate for Payer: Aetna Medicare Advantage	$1,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,651.12
Rate for Payer: Cigna Commercial	$3,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,683.50
Rate for Payer: Oxford Commercial	$1,295.00
Rate for Payer: Qualcare PPO/HMO/WC	$971.25
Rate for Payer: UnitedHealthcare Commercial	$1,295.00
Rate for Payer: UnitedHealthcare Community & State	$204.61
Rate for Payer: Wellpoint Medicaid Managed Care	$183.89

AMNIOTIC MENBRANE ALLOGRAFT

Facility

$6,475.00

Hospital Charge Code	270332706
Hospital Revenue Code	272
Min. Negotiated Rate	$971.25
Max. Negotiated Rate	$971.25
Rate for Payer: Qualcare PPO/HMO/WC	$971.25

AMNIOTIC MENBRANE ALLOGRAFT

Facility

$6,475.00

Hospital Charge Code	270332708
Hospital Revenue Code	272
Min. Negotiated Rate	$971.25
Max. Negotiated Rate	$971.25
Rate for Payer: Qualcare PPO/HMO/WC	$971.25

AMNIOVANT-G MEMBRANE 40MG INJ

Facility

$4,250.00

Service Code	HCPCS Q4100
Hospital Charge Code	270699004
Hospital Revenue Code	278
Min. Negotiated Rate	$120.70
Max. Negotiated Rate	$2,125.00
Rate for Payer: Aetna Commercial	$1,615.00
Rate for Payer: Aetna Medicare Advantage	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,083.75
Rate for Payer: Cigna Commercial	$2,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.50
Rate for Payer: Qualcare PPO/HMO/WC	$637.50
Rate for Payer: UnitedHealthcare Community & State	$134.30
Rate for Payer: Wellpoint Medicaid Managed Care	$120.70

AMNIOVANT-G MEMBRANE 40MG INJ

Facility

$4,250.00

Service Code	HCPCS Q4100
Hospital Charge Code	270699004
Hospital Revenue Code	278
Min. Negotiated Rate	$637.50
Max. Negotiated Rate	$1,028.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.50
Rate for Payer: Qualcare PPO/HMO/WC	$637.50

AMNIO VA PARTICLATE 100MG

Facility

$9,170.00

Service Code	HCPCS C1762
Hospital Charge Code	270672211
Hospital Revenue Code	278
Min. Negotiated Rate	$1,375.50
Max. Negotiated Rate	$2,219.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,834.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,219.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,375.50

AMNIO VA PARTICLATE 100MG

Facility

$9,170.00

Service Code	HCPCS C1762
Hospital Charge Code	270672211
Hospital Revenue Code	278
Min. Negotiated Rate	$260.43
Max. Negotiated Rate	$4,585.00
Rate for Payer: Aetna Commercial	$3,484.60
Rate for Payer: Aetna Medicare Advantage	$2,751.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,338.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,338.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,834.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,338.35
Rate for Payer: Cigna Commercial	$4,585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,219.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,375.50
Rate for Payer: UnitedHealthcare Community & State	$289.77
Rate for Payer: Wellpoint Medicaid Managed Care	$260.43

AMNIOX TISSUE 4X3

Facility

$7,475.00

Service Code	HCPCS Q4148
Hospital Charge Code	270675812
Hospital Revenue Code	278
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$1,808.95
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$536.29
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Community & State	$236.21
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$212.29

AMNIOX TISSUE 4X3

Facility

$7,475.00

Service Code	HCPCS Q4148
Hospital Charge Code	270675812
Hospital Revenue Code	278
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,808.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

Know your out-of-pocket cost for care.

All Charges