Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

I & D PILONIDAL CYST SIMPLE

Facility

$4,142.95

Service Code	HCPCS 10080
Hospital Charge Code	1600000287
Hospital Revenue Code	360
Min. Negotiated Rate	$117.66
Max. Negotiated Rate	$3,629.00
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,051.74
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,077.17
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$621.44
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$130.92
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$117.66

I & D PILONIDAL CYST SIMPLE

Facility

$4,142.95

Service Code	HCPCS 10080
Hospital Charge Code	1600000287
Hospital Revenue Code	360
Min. Negotiated Rate	$621.44
Max. Negotiated Rate	$621.44
Rate for Payer: Qualcare PPO/HMO/WC	$621.44

I&D VULVA/PERINEUM ABSCESS

Facility

$1,573.30

Service Code	HCPCS 56405
Hospital Charge Code	412356405
Hospital Revenue Code	361
Min. Negotiated Rate	$44.68
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$984.72
Rate for Payer: Aetna Medicare Advantage	$1,172.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,313.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,313.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$362.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,313.26
Rate for Payer: Cigna Commercial	$725.69
Rate for Payer: Cigna Medicare Advantage	$362.03
Rate for Payer: Clover Medicare Advantage	$343.93
Rate for Payer: EmblemHealth Commercial	$1,086.09
Rate for Payer: Humana Medicare Advantage	$372.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$362.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$409.06
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$236.00
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$49.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$362.03
Rate for Payer: Wellcare Medicare Advantage	$362.03
Rate for Payer: Wellpoint Medicaid Managed Care	$44.68

I&D VULVA/PERINEUM ABSCESS

Facility

$1,573.30

Service Code	HCPCS 56405
Hospital Charge Code	412356405
Hospital Revenue Code	361
Min. Negotiated Rate	$236.00
Max. Negotiated Rate	$236.00
Rate for Payer: Qualcare PPO/HMO/WC	$236.00

I- FACTOR 1CC

Facility

$3,750.00

Service Code	HCPCS C1762
Hospital Charge Code	270692259
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

I- FACTOR 1CC

Facility

$3,750.00

Service Code	HCPCS C1762
Hospital Charge Code	270692259
Hospital Revenue Code	278
Min. Negotiated Rate	$106.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$118.50
Rate for Payer: Wellpoint Medicaid Managed Care	$106.50

IFUSE-3D IMPLANT 7.0MM X 50MM

Facility

$17,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270692837
Hospital Revenue Code	278
Min. Negotiated Rate	$495.01
Max. Negotiated Rate	$8,715.00
Rate for Payer: Aetna Commercial	$6,623.40
Rate for Payer: Aetna Medicare Advantage	$5,229.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,444.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,444.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,486.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,444.65
Rate for Payer: Cigna Commercial	$8,715.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,218.06
Rate for Payer: Qualcare PPO/HMO/WC	$2,614.50
Rate for Payer: UnitedHealthcare Community & State	$550.79
Rate for Payer: Wellpoint Medicaid Managed Care	$495.01

IFUSE-3D IMPLANT 7.0MM X 50MM

Facility

$17,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270692837
Hospital Revenue Code	278
Min. Negotiated Rate	$2,614.50
Max. Negotiated Rate	$4,218.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,486.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,218.06
Rate for Payer: Qualcare PPO/HMO/WC	$2,614.50

IFUSE-3D IMPLANT 7.0MM X 65MM

Facility

$17,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270692836
Hospital Revenue Code	278
Min. Negotiated Rate	$495.01
Max. Negotiated Rate	$8,715.00
Rate for Payer: Aetna Commercial	$6,623.40
Rate for Payer: Aetna Medicare Advantage	$5,229.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,444.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,444.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,486.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,444.65
Rate for Payer: Cigna Commercial	$8,715.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,218.06
Rate for Payer: Qualcare PPO/HMO/WC	$2,614.50
Rate for Payer: UnitedHealthcare Community & State	$550.79
Rate for Payer: Wellpoint Medicaid Managed Care	$495.01

IFUSE-3D IMPLANT 7.0MM X 65MM

Facility

$17,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270692836
Hospital Revenue Code	278
Min. Negotiated Rate	$2,614.50
Max. Negotiated Rate	$4,218.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,486.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,218.06
Rate for Payer: Qualcare PPO/HMO/WC	$2,614.50

IFUSE IMPLANT SYST 7.0X30MM

Facility

$17,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270694944
Hospital Revenue Code	278
Min. Negotiated Rate	$2,614.50
Max. Negotiated Rate	$4,218.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,486.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,218.06
Rate for Payer: Qualcare PPO/HMO/WC	$2,614.50

IFUSE IMPLANT SYST 7.0X30MM

Facility

$17,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270694944
Hospital Revenue Code	278
Min. Negotiated Rate	$495.01
Max. Negotiated Rate	$8,715.00
Rate for Payer: Aetna Commercial	$6,623.40
Rate for Payer: Aetna Medicare Advantage	$5,229.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,444.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,444.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,486.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,444.65
Rate for Payer: Cigna Commercial	$8,715.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,218.06
Rate for Payer: Qualcare PPO/HMO/WC	$2,614.50
Rate for Payer: UnitedHealthcare Community & State	$550.79
Rate for Payer: Wellpoint Medicaid Managed Care	$495.01

IFUSE SYST SI JT 3D 7.0X35MM

Facility

$17,430.00

Service Code	HCPCS C1776
Hospital Charge Code	270693647
Hospital Revenue Code	278
Min. Negotiated Rate	$495.01
Max. Negotiated Rate	$8,715.00
Rate for Payer: Aetna Commercial	$6,623.40
Rate for Payer: Aetna Medicare Advantage	$5,229.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,444.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,444.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,486.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,444.65
Rate for Payer: Cigna Commercial	$8,715.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,218.06
Rate for Payer: Qualcare PPO/HMO/WC	$2,614.50
Rate for Payer: UnitedHealthcare Community & State	$550.79
Rate for Payer: Wellpoint Medicaid Managed Care	$495.01

IFUSE SYST SI JT 3D 7.0X35MM

Facility

$17,430.00

Service Code	HCPCS C1776
Hospital Charge Code	270693647
Hospital Revenue Code	278
Min. Negotiated Rate	$2,614.50
Max. Negotiated Rate	$4,218.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,486.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,218.06
Rate for Payer: Qualcare PPO/HMO/WC	$2,614.50

IFUSE TORQ 10X35MM IMPLANT

Facility

$16,125.00

Hospital Charge Code	270703479
Hospital Revenue Code	278
Min. Negotiated Rate	$2,418.75
Max. Negotiated Rate	$3,902.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75

IFUSE TORQ 10X35MM IMPLANT

Facility

$16,125.00

Hospital Charge Code	270703479
Hospital Revenue Code	278
Min. Negotiated Rate	$457.95
Max. Negotiated Rate	$8,062.50
Rate for Payer: Aetna Commercial	$6,127.50
Rate for Payer: Aetna Medicare Advantage	$4,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,111.88
Rate for Payer: Cigna Commercial	$8,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75
Rate for Payer: UnitedHealthcare Community & State	$509.55
Rate for Payer: Wellpoint Medicaid Managed Care	$457.95

iFUSE-TORQ 10X40MM

Facility

$16,125.00

Hospital Charge Code	270702582
Hospital Revenue Code	278
Min. Negotiated Rate	$2,418.75
Max. Negotiated Rate	$3,902.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75

iFUSE-TORQ 10X40MM

Facility

$16,125.00

Hospital Charge Code	270702582
Hospital Revenue Code	278
Min. Negotiated Rate	$457.95
Max. Negotiated Rate	$8,062.50
Rate for Payer: Aetna Commercial	$6,127.50
Rate for Payer: Aetna Medicare Advantage	$4,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,111.88
Rate for Payer: Cigna Commercial	$8,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75
Rate for Payer: UnitedHealthcare Community & State	$509.55
Rate for Payer: Wellpoint Medicaid Managed Care	$457.95

iFUSE-TORQ 10X45MM

Facility

$16,125.00

Hospital Charge Code	270702467
Hospital Revenue Code	278
Min. Negotiated Rate	$457.95
Max. Negotiated Rate	$8,062.50
Rate for Payer: Aetna Commercial	$6,127.50
Rate for Payer: Aetna Medicare Advantage	$4,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,111.88
Rate for Payer: Cigna Commercial	$8,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75
Rate for Payer: UnitedHealthcare Community & State	$509.55
Rate for Payer: Wellpoint Medicaid Managed Care	$457.95

iFUSE-TORQ 10X45MM

Facility

$16,125.00

Hospital Charge Code	270702467
Hospital Revenue Code	278
Min. Negotiated Rate	$2,418.75
Max. Negotiated Rate	$3,902.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75

iFUSE-TORQ 10X55MM

Facility

$16,125.00

Hospital Charge Code	270702466
Hospital Revenue Code	278
Min. Negotiated Rate	$2,418.75
Max. Negotiated Rate	$3,902.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75

iFUSE-TORQ 10X55MM

Facility

$16,125.00

Hospital Charge Code	270702466
Hospital Revenue Code	278
Min. Negotiated Rate	$457.95
Max. Negotiated Rate	$8,062.50
Rate for Payer: Aetna Commercial	$6,127.50
Rate for Payer: Aetna Medicare Advantage	$4,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,111.88
Rate for Payer: Cigna Commercial	$8,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75
Rate for Payer: UnitedHealthcare Community & State	$509.55
Rate for Payer: Wellpoint Medicaid Managed Care	$457.95

IFUSE TORQ 11.5X40MM

Facility

$16,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270702635
Hospital Revenue Code	278
Min. Negotiated Rate	$2,418.75
Max. Negotiated Rate	$3,902.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75

IFUSE TORQ 11.5X40MM

Facility

$16,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270702635
Hospital Revenue Code	278
Min. Negotiated Rate	$457.95
Max. Negotiated Rate	$8,062.50
Rate for Payer: Aetna Commercial	$6,127.50
Rate for Payer: Aetna Medicare Advantage	$4,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,111.88
Rate for Payer: Cigna Commercial	$8,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75
Rate for Payer: UnitedHealthcare Community & State	$509.55
Rate for Payer: Wellpoint Medicaid Managed Care	$457.95

IFUSE TORQ 11.5X45MM IMPLANT

Facility

$16,125.00

Hospital Charge Code	270703478
Hospital Revenue Code	278
Min. Negotiated Rate	$457.95
Max. Negotiated Rate	$8,062.50
Rate for Payer: Aetna Commercial	$6,127.50
Rate for Payer: Aetna Medicare Advantage	$4,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,111.88
Rate for Payer: Cigna Commercial	$8,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75
Rate for Payer: UnitedHealthcare Community & State	$509.55
Rate for Payer: Wellpoint Medicaid Managed Care	$457.95

Know your out-of-pocket cost for care.

All Charges