Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ANATOMIC HEAD 36MM +5MM

Facility

$11,795.00

Service Code	HCPCS C1776
Hospital Charge Code	270675960
Hospital Revenue Code	278
Min. Negotiated Rate	$334.98
Max. Negotiated Rate	$5,897.50
Rate for Payer: Aetna Commercial	$4,482.10
Rate for Payer: Aetna Medicare Advantage	$3,538.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,007.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,007.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,359.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,007.72
Rate for Payer: Cigna Commercial	$5,897.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,854.39
Rate for Payer: Qualcare PPO/HMO/WC	$1,769.25
Rate for Payer: UnitedHealthcare Community & State	$372.72
Rate for Payer: Wellpoint Medicaid Managed Care	$334.98

ANATOMIC HEAD 36MM +5MM

Facility

$11,795.00

Service Code	HCPCS C1776
Hospital Charge Code	270675960
Hospital Revenue Code	278
Min. Negotiated Rate	$1,769.25
Max. Negotiated Rate	$2,854.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,359.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,854.39
Rate for Payer: Qualcare PPO/HMO/WC	$1,769.25

ANATOMIC PORTS

Facility

$4,750.00

Hospital Charge Code	270671360
Hospital Revenue Code	272
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$712.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

ANATOMIC PORTS

Facility

$4,750.00

Hospital Charge Code	270671360
Hospital Revenue Code	272
Min. Negotiated Rate	$134.90
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,805.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,235.00
Rate for Payer: Oxford Commercial	$950.00
Rate for Payer: Qualcare PPO/HMO/WC	$712.50
Rate for Payer: UnitedHealthcare Commercial	$950.00
Rate for Payer: UnitedHealthcare Community & State	$150.10
Rate for Payer: Wellpoint Medicaid Managed Care	$134.90

ANBESOL 12 ML

Facility

$44.82

Service Code	NDC 573021341
Hospital Charge Code	60635739
Hospital Revenue Code	250
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$22.41
Rate for Payer: Aetna Commercial	$17.03
Rate for Payer: Aetna Medicare Advantage	$13.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.43
Rate for Payer: Cigna Commercial	$22.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.65
Rate for Payer: Oxford Commercial	$8.96
Rate for Payer: Qualcare PPO/HMO/WC	$6.72
Rate for Payer: UnitedHealthcare Commercial	$8.96
Rate for Payer: UnitedHealthcare Community & State	$1.42
Rate for Payer: Wellpoint Medicaid Managed Care	$1.27

ANBESOL 12 ML

Facility

$44.82

Service Code	NDC 573021341
Hospital Charge Code	60635739
Hospital Revenue Code	250
Min. Negotiated Rate	$6.72
Max. Negotiated Rate	$6.72
Rate for Payer: Qualcare PPO/HMO/WC	$6.72

ANBESOL MAXIMUM 20%

Facility

$47.50

Service Code	NDC 573021541
Hospital Charge Code	606390470
Hospital Revenue Code	250
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$7.12
Rate for Payer: Qualcare PPO/HMO/WC	$7.12

ANBESOL MAXIMUM 20%

Facility

$47.50

Service Code	NDC 573021541
Hospital Charge Code	606390470
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$23.75
Rate for Payer: Aetna Commercial	$18.05
Rate for Payer: Aetna Medicare Advantage	$14.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.11
Rate for Payer: Cigna Commercial	$23.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.35
Rate for Payer: Oxford Commercial	$9.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.12
Rate for Payer: UnitedHealthcare Commercial	$9.50
Rate for Payer: UnitedHealthcare Community & State	$1.50
Rate for Payer: Wellpoint Medicaid Managed Care	$1.35

ANCA/VASCULITIDES I

Facility

$667.59

Service Code	HCPCS 8602191
Hospital Charge Code	39990020A
Hospital Revenue Code	302
Min. Negotiated Rate	$18.96
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$253.68
Rate for Payer: Aetna Medicare Advantage	$200.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.24
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.57
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$21.10
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

ANCA/VASCULITIDES I

Facility

$667.59

Service Code	HCPCS 8602191
Hospital Charge Code	39990020A
Hospital Revenue Code	302
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

ANCA/VASCULITIDES II

Facility

$667.59

Service Code	HCPCS 8602191
Hospital Charge Code	39990020B
Hospital Revenue Code	302
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

ANCA/VASCULITIDES II

Facility

$667.59

Service Code	HCPCS 8602191
Hospital Charge Code	39990020B
Hospital Revenue Code	302
Min. Negotiated Rate	$18.96
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$253.68
Rate for Payer: Aetna Medicare Advantage	$200.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.24
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.57
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$21.10
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

ANCHOR 2 MM ALL SUTRE

Facility

$2,323.75

Service Code	HCPCS C1713
Hospital Charge Code	270701369
Hospital Revenue Code	278
Min. Negotiated Rate	$348.56
Max. Negotiated Rate	$562.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$464.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.35
Rate for Payer: Qualcare PPO/HMO/WC	$348.56

ANCHOR 2 MM ALL SUTRE

Facility

$2,323.75

Service Code	HCPCS C1713
Hospital Charge Code	270701369
Hospital Revenue Code	278
Min. Negotiated Rate	$65.99
Max. Negotiated Rate	$1,161.88
Rate for Payer: Aetna Commercial	$883.02
Rate for Payer: Aetna Medicare Advantage	$697.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$592.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$592.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$464.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$592.56
Rate for Payer: Cigna Commercial	$1,161.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.35
Rate for Payer: Qualcare PPO/HMO/WC	$348.56
Rate for Payer: UnitedHealthcare Community & State	$73.43
Rate for Payer: Wellpoint Medicaid Managed Care	$65.99

ANCHOR 4.5 MM KNOTLESS

Facility

$1,928.75

Service Code	HCPCS C1713
Hospital Charge Code	270701371
Hospital Revenue Code	278
Min. Negotiated Rate	$54.78
Max. Negotiated Rate	$964.38
Rate for Payer: Aetna Commercial	$732.92
Rate for Payer: Aetna Medicare Advantage	$578.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$491.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$491.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$385.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$491.83
Rate for Payer: Cigna Commercial	$964.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$466.76
Rate for Payer: Qualcare PPO/HMO/WC	$289.31
Rate for Payer: UnitedHealthcare Community & State	$60.95
Rate for Payer: Wellpoint Medicaid Managed Care	$54.78

ANCHOR 4.5 MM KNOTLESS

Facility

$1,928.75

Service Code	HCPCS C1713
Hospital Charge Code	270701371
Hospital Revenue Code	278
Min. Negotiated Rate	$289.31
Max. Negotiated Rate	$466.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$385.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$466.76
Rate for Payer: Qualcare PPO/HMO/WC	$289.31

ANCHOR 4.5 MM KNOTLESS KIT

Facility

$2,323.75

Service Code	HCPCS C1713
Hospital Charge Code	270701370
Hospital Revenue Code	278
Min. Negotiated Rate	$348.56
Max. Negotiated Rate	$562.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$464.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.35
Rate for Payer: Qualcare PPO/HMO/WC	$348.56

ANCHOR 4.5 MM KNOTLESS KIT

Facility

$2,323.75

Service Code	HCPCS C1713
Hospital Charge Code	270701370
Hospital Revenue Code	278
Min. Negotiated Rate	$65.99
Max. Negotiated Rate	$1,161.88
Rate for Payer: Aetna Commercial	$883.02
Rate for Payer: Aetna Medicare Advantage	$697.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$592.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$592.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$464.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$592.56
Rate for Payer: Cigna Commercial	$1,161.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.35
Rate for Payer: Qualcare PPO/HMO/WC	$348.56
Rate for Payer: UnitedHealthcare Community & State	$73.43
Rate for Payer: Wellpoint Medicaid Managed Care	$65.99

ANCHOR 5.5 MM SWIVELOCK

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270684036
Hospital Revenue Code	278
Min. Negotiated Rate	$53.25
Max. Negotiated Rate	$937.50
Rate for Payer: Aetna Commercial	$712.50
Rate for Payer: Aetna Medicare Advantage	$562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.12
Rate for Payer: Cigna Commercial	$937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: Qualcare PPO/HMO/WC	$281.25
Rate for Payer: UnitedHealthcare Community & State	$59.25
Rate for Payer: Wellpoint Medicaid Managed Care	$53.25

ANCHOR 5.5 MM SWIVELOCK

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270684036
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$453.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

ANCHOR 6.5 W/ORTHOCORD

Facility

$2,030.00

Service Code	HCPCS C1713
Hospital Charge Code	270688487
Hospital Revenue Code	278
Min. Negotiated Rate	$57.65
Max. Negotiated Rate	$1,015.00
Rate for Payer: Aetna Commercial	$771.40
Rate for Payer: Aetna Medicare Advantage	$609.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$517.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$517.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$406.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$517.65
Rate for Payer: Cigna Commercial	$1,015.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$491.26
Rate for Payer: Qualcare PPO/HMO/WC	$304.50
Rate for Payer: UnitedHealthcare Community & State	$64.15
Rate for Payer: Wellpoint Medicaid Managed Care	$57.65

ANCHOR 6.5 W/ORTHOCORD

Facility

$2,030.00

Service Code	HCPCS C1713
Hospital Charge Code	270688487
Hospital Revenue Code	278
Min. Negotiated Rate	$304.50
Max. Negotiated Rate	$491.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$406.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$491.26
Rate for Payer: Qualcare PPO/HMO/WC	$304.50

ANCHOR AIR+MENISCAL SYST CRVD

Facility

$2,446.25

Service Code	HCPCS C1713
Hospital Charge Code	270700415
Hospital Revenue Code	278
Min. Negotiated Rate	$366.94
Max. Negotiated Rate	$591.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$489.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$591.99
Rate for Payer: Qualcare PPO/HMO/WC	$366.94

ANCHOR AIR+MENISCAL SYST CRVD

Facility

$2,446.25

Service Code	HCPCS C1713
Hospital Charge Code	270700415
Hospital Revenue Code	278
Min. Negotiated Rate	$69.47
Max. Negotiated Rate	$1,223.12
Rate for Payer: Aetna Commercial	$929.58
Rate for Payer: Aetna Medicare Advantage	$733.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$623.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$623.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$489.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$623.79
Rate for Payer: Cigna Commercial	$1,223.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$591.99
Rate for Payer: Qualcare PPO/HMO/WC	$366.94
Rate for Payer: UnitedHealthcare Community & State	$77.30
Rate for Payer: Wellpoint Medicaid Managed Care	$69.47

ANCHOR ALPHAVENT 4.75 MM BIOCO

Facility

$3,000.00

Hospital Charge Code	270701806
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

Know your out-of-pocket cost for care.

All Charges