Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

HEAD W/CONTRAST

Facility

$9,500.00

Service Code	HCPCS 70460
Hospital Charge Code	2200012
Hospital Revenue Code	351
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

HEAD W/CONTRAST

Facility

$9,500.00

Service Code	HCPCS 70460
Hospital Charge Code	2200012
Hospital Revenue Code	351
Min. Negotiated Rate	$145.87
Max. Negotiated Rate	$3,916.00
Rate for Payer: Aetna Commercial	$566.79
Rate for Payer: Aetna Medicare Advantage	$675.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$755.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$755.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$208.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$231.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$755.90
Rate for Payer: Cigna Commercial	$417.70
Rate for Payer: Cigna Medicare Advantage	$145.87
Rate for Payer: Clover Medicare Advantage	$197.96
Rate for Payer: EmblemHealth Commercial	$625.14
Rate for Payer: Humana Medicare Advantage	$214.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$208.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,470.00
Rate for Payer: Oxford Commercial	$3,774.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$3,916.00
Rate for Payer: UnitedHealthcare Community & State	$300.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$208.38
Rate for Payer: Wellcare Medicare Advantage	$208.38
Rate for Payer: Wellpoint Medicaid Managed Care	$269.80

HEAD W/O CONTR

Facility

$9,500.00

Service Code	HCPCS 70450
Hospital Charge Code	2200020
Hospital Revenue Code	351
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

HEAD W/O CONTR

Facility

$9,500.00

Service Code	HCPCS 70450
Hospital Charge Code	2200020
Hospital Revenue Code	351
Min. Negotiated Rate	$86.94
Max. Negotiated Rate	$3,916.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$226.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$450.54
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$86.94
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,470.00
Rate for Payer: Oxford Commercial	$3,774.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$3,916.00
Rate for Payer: UnitedHealthcare Community & State	$300.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$269.80

HEAD W/WO CONTRAST

Facility

$9,500.00

Service Code	HCPCS 70470
Hospital Charge Code	2200038
Hospital Revenue Code	351
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

HEAD W/WO CONTRAST

Facility

$9,500.00

Service Code	HCPCS 70470
Hospital Charge Code	2200038
Hospital Revenue Code	351
Min. Negotiated Rate	$145.87
Max. Negotiated Rate	$3,916.00
Rate for Payer: Aetna Commercial	$566.79
Rate for Payer: Aetna Medicare Advantage	$675.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$755.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$755.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$208.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$283.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$755.90
Rate for Payer: Cigna Commercial	$417.70
Rate for Payer: Cigna Medicare Advantage	$145.87
Rate for Payer: Clover Medicare Advantage	$197.96
Rate for Payer: EmblemHealth Commercial	$625.14
Rate for Payer: Humana Medicare Advantage	$214.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$208.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,470.00
Rate for Payer: Oxford Commercial	$3,774.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$3,916.00
Rate for Payer: UnitedHealthcare Community & State	$300.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$208.38
Rate for Payer: Wellcare Medicare Advantage	$208.38
Rate for Payer: Wellpoint Medicaid Managed Care	$269.80

HEAD XL DELTA BIOLOX 32MM

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270683290
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

HEAD XL DELTA BIOLOX 32MM

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270683290
Hospital Revenue Code	278
Min. Negotiated Rate	$71.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Community & State	$79.00
Rate for Payer: Wellpoint Medicaid Managed Care	$71.00

HEALDESS COMPRES SCREW 2.5 14M

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270690412
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

HEALDESS COMPRES SCREW 2.5 14M

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270690412
Hospital Revenue Code	278
Min. Negotiated Rate	$41.89
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$46.61
Rate for Payer: Wellpoint Medicaid Managed Care	$41.89

HEALICOIL KNOTLESS ANCHOR

Facility

$3,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270690827
Hospital Revenue Code	278
Min. Negotiated Rate	$95.85
Max. Negotiated Rate	$1,687.50
Rate for Payer: Aetna Commercial	$1,282.50
Rate for Payer: Aetna Medicare Advantage	$1,012.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$860.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$860.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$860.62
Rate for Payer: Cigna Commercial	$1,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$816.75
Rate for Payer: Qualcare PPO/HMO/WC	$506.25
Rate for Payer: UnitedHealthcare Community & State	$106.65
Rate for Payer: Wellpoint Medicaid Managed Care	$95.85

HEALICOIL KNOTLESS ANCHOR

Facility

$3,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270690827
Hospital Revenue Code	278
Min. Negotiated Rate	$506.25
Max. Negotiated Rate	$816.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$675.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$816.75
Rate for Payer: Qualcare PPO/HMO/WC	$506.25

HEALICOIL RG SA 4.75 W/2 UB-BL

Facility

$1,872.00

Hospital Charge Code	270682438
Hospital Revenue Code	272
Min. Negotiated Rate	$280.80
Max. Negotiated Rate	$280.80
Rate for Payer: Qualcare PPO/HMO/WC	$280.80

HEALICOIL RG SA 4.75 W/2 UB-BL

Facility

$1,872.00

Hospital Charge Code	270682438
Hospital Revenue Code	272
Min. Negotiated Rate	$53.16
Max. Negotiated Rate	$936.00
Rate for Payer: Aetna Commercial	$711.36
Rate for Payer: Aetna Medicare Advantage	$561.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$477.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$477.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$477.36
Rate for Payer: Cigna Commercial	$936.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$486.72
Rate for Payer: Oxford Commercial	$374.40
Rate for Payer: Qualcare PPO/HMO/WC	$280.80
Rate for Payer: UnitedHealthcare Commercial	$374.40
Rate for Payer: UnitedHealthcare Community & State	$59.16
Rate for Payer: Wellpoint Medicaid Managed Care	$53.16

HEALICOIL RSB 4.75 MM SUTUR UL

Facility

$3,875.00

Hospital Charge Code	270682922
Hospital Revenue Code	272
Min. Negotiated Rate	$110.05
Max. Negotiated Rate	$1,937.50
Rate for Payer: Aetna Commercial	$1,472.50
Rate for Payer: Aetna Medicare Advantage	$1,162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$988.12
Rate for Payer: Cigna Commercial	$1,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,007.50
Rate for Payer: Oxford Commercial	$775.00
Rate for Payer: Qualcare PPO/HMO/WC	$581.25
Rate for Payer: UnitedHealthcare Commercial	$775.00
Rate for Payer: UnitedHealthcare Community & State	$122.45
Rate for Payer: Wellpoint Medicaid Managed Care	$110.05

HEALICOIL RSB 4.75 MM SUTUR UL

Facility

$3,875.00

Hospital Charge Code	270682922
Hospital Revenue Code	272
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$581.25
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

HEALIX ADVANCE KNOTLESS BR ANC

Facility

$2,525.00

Hospital Charge Code	270663292
Hospital Revenue Code	278
Min. Negotiated Rate	$71.71
Max. Negotiated Rate	$1,262.50
Rate for Payer: Aetna Commercial	$959.50
Rate for Payer: Aetna Medicare Advantage	$757.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$643.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$643.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$505.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$643.88
Rate for Payer: Cigna Commercial	$1,262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$611.05
Rate for Payer: Qualcare PPO/HMO/WC	$378.75
Rate for Payer: UnitedHealthcare Community & State	$79.79
Rate for Payer: Wellpoint Medicaid Managed Care	$71.71

HEALIX ADVANCE KNOTLESS BR ANC

Facility

$2,525.00

Hospital Charge Code	270663292
Hospital Revenue Code	278
Min. Negotiated Rate	$378.75
Max. Negotiated Rate	$611.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$505.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$611.05
Rate for Payer: Qualcare PPO/HMO/WC	$378.75

HEALON 4CC VIAL

Facility

$597.00

Hospital Charge Code	270331801
Hospital Revenue Code	272
Min. Negotiated Rate	$89.55
Max. Negotiated Rate	$89.55
Rate for Payer: Qualcare PPO/HMO/WC	$89.55

HEALON 4CC VIAL

Facility

$597.00

Hospital Charge Code	270331801
Hospital Revenue Code	272
Min. Negotiated Rate	$16.95
Max. Negotiated Rate	$298.50
Rate for Payer: Aetna Commercial	$226.86
Rate for Payer: Aetna Medicare Advantage	$179.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$152.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$152.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$152.24
Rate for Payer: Cigna Commercial	$298.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.22
Rate for Payer: Oxford Commercial	$119.40
Rate for Payer: Qualcare PPO/HMO/WC	$89.55
Rate for Payer: UnitedHealthcare Commercial	$119.40
Rate for Payer: UnitedHealthcare Community & State	$18.87
Rate for Payer: Wellpoint Medicaid Managed Care	$16.95

HEALON .85

Facility

$929.00

Hospital Charge Code	270332572
Hospital Revenue Code	272
Min. Negotiated Rate	$139.35
Max. Negotiated Rate	$139.35
Rate for Payer: Qualcare PPO/HMO/WC	$139.35

HEALON .85

Facility

$929.00

Hospital Charge Code	270332572
Hospital Revenue Code	272
Min. Negotiated Rate	$26.38
Max. Negotiated Rate	$464.50
Rate for Payer: Aetna Commercial	$353.02
Rate for Payer: Aetna Medicare Advantage	$278.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$236.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$236.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$236.90
Rate for Payer: Cigna Commercial	$464.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$241.54
Rate for Payer: Oxford Commercial	$185.80
Rate for Payer: Qualcare PPO/HMO/WC	$139.35
Rate for Payer: UnitedHealthcare Commercial	$185.80
Rate for Payer: UnitedHealthcare Community & State	$29.36
Rate for Payer: Wellpoint Medicaid Managed Care	$26.38

HEALON ACD+GEL REF:HDPRP15

Facility

$575.00

Hospital Charge Code	270703451
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$139.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

HEALON ACD+GEL REF:HDPRP15

Facility

$575.00

Hospital Charge Code	270703451
Hospital Revenue Code	278
Min. Negotiated Rate	$16.33
Max. Negotiated Rate	$287.50
Rate for Payer: Aetna Commercial	$218.50
Rate for Payer: Aetna Medicare Advantage	$172.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.62
Rate for Payer: Cigna Commercial	$287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25
Rate for Payer: UnitedHealthcare Community & State	$18.17
Rate for Payer: Wellpoint Medicaid Managed Care	$16.33

HEALON GV PRO 0.85ML

Facility

$955.22

Service Code	NDC 50474065165
Hospital Charge Code	606390481
Hospital Revenue Code	272
Min. Negotiated Rate	$27.13
Max. Negotiated Rate	$477.61
Rate for Payer: Aetna Commercial	$362.98
Rate for Payer: Aetna Medicare Advantage	$286.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$243.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$243.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$243.58
Rate for Payer: Cigna Commercial	$477.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.36
Rate for Payer: Oxford Commercial	$191.04
Rate for Payer: Qualcare PPO/HMO/WC	$143.28
Rate for Payer: UnitedHealthcare Commercial	$191.04
Rate for Payer: UnitedHealthcare Community & State	$30.18
Rate for Payer: Wellpoint Medicaid Managed Care	$27.13

Know your out-of-pocket cost for care.

All Charges