Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

HOFFMANTELESTRUTXSLRF100-125MM

Facility

$16,310.00

Service Code	HCPCS C1713
Hospital Charge Code	270700226
Hospital Revenue Code	278
Min. Negotiated Rate	$463.20
Max. Negotiated Rate	$8,155.00
Rate for Payer: Aetna Commercial	$6,197.80
Rate for Payer: Aetna Medicare Advantage	$4,893.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,159.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,159.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,262.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,159.05
Rate for Payer: Cigna Commercial	$8,155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,947.02
Rate for Payer: Qualcare PPO/HMO/WC	$2,446.50
Rate for Payer: UnitedHealthcare Community & State	$515.40
Rate for Payer: Wellpoint Medicaid Managed Care	$463.20

HOFFMAN WASHER LRF 2MM YELLOW

Facility

$287.85

Service Code	HCPCS C1713
Hospital Charge Code	270700228
Hospital Revenue Code	278
Min. Negotiated Rate	$43.18
Max. Negotiated Rate	$69.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.66
Rate for Payer: Qualcare PPO/HMO/WC	$43.18

HOFFMAN WASHER LRF 2MM YELLOW

Facility

$287.85

Service Code	HCPCS C1713
Hospital Charge Code	270700228
Hospital Revenue Code	278
Min. Negotiated Rate	$8.17
Max. Negotiated Rate	$143.93
Rate for Payer: Aetna Commercial	$109.38
Rate for Payer: Aetna Medicare Advantage	$86.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.40
Rate for Payer: Cigna Commercial	$143.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.66
Rate for Payer: Qualcare PPO/HMO/WC	$43.18
Rate for Payer: UnitedHealthcare Community & State	$9.10
Rate for Payer: Wellpoint Medicaid Managed Care	$8.17

HOHMANN-STYLE RETRACTOR

Facility

$1,158.00

Hospital Charge Code	270659360
Hospital Revenue Code	272
Min. Negotiated Rate	$173.70
Max. Negotiated Rate	$173.70
Rate for Payer: Qualcare PPO/HMO/WC	$173.70

HOHMANN-STYLE RETRACTOR

Facility

$1,158.00

Hospital Charge Code	270659360
Hospital Revenue Code	272
Min. Negotiated Rate	$32.89
Max. Negotiated Rate	$579.00
Rate for Payer: Aetna Commercial	$440.04
Rate for Payer: Aetna Medicare Advantage	$347.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$295.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$295.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$295.29
Rate for Payer: Cigna Commercial	$579.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.08
Rate for Payer: Oxford Commercial	$231.60
Rate for Payer: Qualcare PPO/HMO/WC	$173.70
Rate for Payer: UnitedHealthcare Commercial	$231.60
Rate for Payer: UnitedHealthcare Community & State	$36.59
Rate for Payer: Wellpoint Medicaid Managed Care	$32.89

HOLDER BACKSTOP MINI SHARP

Facility

$30.75

Hospital Charge Code	270662069
Hospital Revenue Code	272
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$15.38
Rate for Payer: Aetna Commercial	$11.69
Rate for Payer: Aetna Medicare Advantage	$9.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.84
Rate for Payer: Cigna Commercial	$15.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.00
Rate for Payer: Oxford Commercial	$6.15
Rate for Payer: Qualcare PPO/HMO/WC	$4.61
Rate for Payer: UnitedHealthcare Commercial	$6.15
Rate for Payer: UnitedHealthcare Community & State	$0.97
Rate for Payer: Wellpoint Medicaid Managed Care	$0.87

HOLDER BACKSTOP MINI SHARP

Facility

$30.75

Hospital Charge Code	270662069
Hospital Revenue Code	272
Min. Negotiated Rate	$4.61
Max. Negotiated Rate	$4.61
Rate for Payer: Qualcare PPO/HMO/WC	$4.61

HOLDER ET TUBE ADHESIVE

Facility

$38.70

Hospital Charge Code	270302217
Hospital Revenue Code	270
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$19.35
Rate for Payer: Aetna Commercial	$14.71
Rate for Payer: Aetna Medicare Advantage	$11.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.87
Rate for Payer: Cigna Commercial	$19.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.06
Rate for Payer: Oxford Commercial	$7.74
Rate for Payer: Qualcare PPO/HMO/WC	$5.80
Rate for Payer: UnitedHealthcare Commercial	$7.74
Rate for Payer: UnitedHealthcare Community & State	$1.22
Rate for Payer: Wellpoint Medicaid Managed Care	$1.10

HOLDER ET TUBE ADHESIVE

Facility

$38.70

Hospital Charge Code	270302217
Hospital Revenue Code	270
Min. Negotiated Rate	$5.80
Max. Negotiated Rate	$5.80
Rate for Payer: Qualcare PPO/HMO/WC	$5.80

HOLDER LIMB DISPOSABLE

Facility

$13.98

Hospital Charge Code	270649967
Hospital Revenue Code	270
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$2.10
Rate for Payer: Qualcare PPO/HMO/WC	$2.10

HOLDER LIMB DISPOSABLE

Facility

$13.98

Hospital Charge Code	270649967
Hospital Revenue Code	270
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$6.99
Rate for Payer: Aetna Commercial	$5.31
Rate for Payer: Aetna Medicare Advantage	$4.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.56
Rate for Payer: Cigna Commercial	$6.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.63
Rate for Payer: Oxford Commercial	$2.80
Rate for Payer: Qualcare PPO/HMO/WC	$2.10
Rate for Payer: UnitedHealthcare Commercial	$2.80
Rate for Payer: UnitedHealthcare Community & State	$0.44
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

HOLDER NASAL DRESSING

Facility

$23.80

Hospital Charge Code	270600308
Hospital Revenue Code	272
Min. Negotiated Rate	$3.57
Max. Negotiated Rate	$3.57
Rate for Payer: Qualcare PPO/HMO/WC	$3.57

HOLDER NASAL DRESSING

Facility

$23.80

Hospital Charge Code	270600308
Hospital Revenue Code	272
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$11.90
Rate for Payer: Aetna Commercial	$9.04
Rate for Payer: Aetna Medicare Advantage	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.07
Rate for Payer: Cigna Commercial	$11.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.19
Rate for Payer: Oxford Commercial	$4.76
Rate for Payer: Qualcare PPO/HMO/WC	$3.57
Rate for Payer: UnitedHealthcare Commercial	$4.76
Rate for Payer: UnitedHealthcare Community & State	$0.75
Rate for Payer: Wellpoint Medicaid Managed Care	$0.68

HOLDER PIN

Facility

$1,475.00

Hospital Charge Code	270677967
Hospital Revenue Code	272
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$221.25
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

HOLDER PIN

Facility

$1,475.00

Hospital Charge Code	270677967
Hospital Revenue Code	272
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) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$383.50
Rate for Payer: Oxford Commercial	$295.00
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Commercial	$295.00
Rate for Payer: UnitedHealthcare Community & State	$46.61
Rate for Payer: Wellpoint Medicaid Managed Care	$41.89

HOLDER TRACH TUBE

Facility

$162.43

Hospital Charge Code	270655464
Hospital Revenue Code	270
Min. Negotiated Rate	$4.61
Max. Negotiated Rate	$81.22
Rate for Payer: Aetna Commercial	$61.72
Rate for Payer: Aetna Medicare Advantage	$48.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.42
Rate for Payer: Cigna Commercial	$81.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.23
Rate for Payer: Oxford Commercial	$32.49
Rate for Payer: Qualcare PPO/HMO/WC	$24.36
Rate for Payer: UnitedHealthcare Commercial	$32.49
Rate for Payer: UnitedHealthcare Community & State	$5.13
Rate for Payer: Wellpoint Medicaid Managed Care	$4.61

HOLDER TRACH TUBE

Facility

$4.46

Hospital Charge Code	270649129
Hospital Revenue Code	270
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$0.67
Rate for Payer: Qualcare PPO/HMO/WC	$0.67

HOLDER TRACH TUBE

Facility

$4.46

Hospital Charge Code	270649129
Hospital Revenue Code	270
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$2.23
Rate for Payer: Aetna Commercial	$1.69
Rate for Payer: Aetna Medicare Advantage	$1.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.14
Rate for Payer: Cigna Commercial	$2.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.16
Rate for Payer: Oxford Commercial	$0.89
Rate for Payer: Qualcare PPO/HMO/WC	$0.67
Rate for Payer: UnitedHealthcare Commercial	$0.89
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

HOLDER TRACH TUBE

Facility

$162.43

Hospital Charge Code	270655464
Hospital Revenue Code	270
Min. Negotiated Rate	$24.36
Max. Negotiated Rate	$24.36
Rate for Payer: Qualcare PPO/HMO/WC	$24.36

HOLDER TRACH TUBE 1

Facility

$14.44

Hospital Charge Code	270302216
Hospital Revenue Code	270
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$7.22
Rate for Payer: Aetna Commercial	$5.49
Rate for Payer: Aetna Medicare Advantage	$4.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.68
Rate for Payer: Cigna Commercial	$7.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.75
Rate for Payer: Oxford Commercial	$2.89
Rate for Payer: Qualcare PPO/HMO/WC	$2.17
Rate for Payer: UnitedHealthcare Commercial	$2.89
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.41

HOLDER TRACH TUBE 1

Facility

$14.44

Hospital Charge Code	270302216
Hospital Revenue Code	270
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$2.17
Rate for Payer: Qualcare PPO/HMO/WC	$2.17

HOLDER TRUCLIP 8X2.7X2.5 IN

Facility

$600.00

Hospital Charge Code	270683526
Hospital Revenue Code	272
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

HOLDER TRUCLIP 8X2.7X2.5 IN

Facility

$600.00

Hospital Charge Code	270683526
Hospital Revenue Code	272
Min. Negotiated Rate	$17.04
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.00
Rate for Payer: Oxford Commercial	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Commercial	$120.00
Rate for Payer: UnitedHealthcare Community & State	$18.96
Rate for Payer: Wellpoint Medicaid Managed Care	$17.04

HOLDING PINS MINI HEAD 3.2mm

Facility

$1,675.00

Service Code	HCPCS C1713
Hospital Charge Code	270674366
Hospital Revenue Code	278
Min. Negotiated Rate	$47.57
Max. Negotiated Rate	$837.50
Rate for Payer: Aetna Commercial	$636.50
Rate for Payer: Aetna Medicare Advantage	$502.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$427.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$427.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$335.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$427.12
Rate for Payer: Cigna Commercial	$837.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$405.35
Rate for Payer: Qualcare PPO/HMO/WC	$251.25
Rate for Payer: UnitedHealthcare Community & State	$52.93
Rate for Payer: Wellpoint Medicaid Managed Care	$47.57

HOLDING PINS MINI HEAD 3.2mm

Facility

$1,675.00

Service Code	HCPCS C1713
Hospital Charge Code	270674366
Hospital Revenue Code	278
Min. Negotiated Rate	$251.25
Max. Negotiated Rate	$405.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$405.35
Rate for Payer: Qualcare PPO/HMO/WC	$251.25

Know your out-of-pocket cost for care.

All Charges