Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

INFUSE BONE GFT KIT MEDIUM

Facility

$22,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270630534
Hospital Revenue Code	278
Min. Negotiated Rate	$624.80
Max. Negotiated Rate	$11,000.00
Rate for Payer: Aetna Commercial	$8,360.00
Rate for Payer: Aetna Medicare Advantage	$6,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,610.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,610.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,610.00
Rate for Payer: Cigna Commercial	$11,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,324.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,300.00
Rate for Payer: UnitedHealthcare Community & State	$695.20
Rate for Payer: Wellpoint Medicaid Managed Care	$624.80

INFUSE BONE GFT KIT MEDIUM

Facility

$22,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270630534
Hospital Revenue Code	278
Min. Negotiated Rate	$3,300.00
Max. Negotiated Rate	$5,324.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,324.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,300.00

INFUSE BONE GRAFT

Facility

$8,547.00

Hospital Charge Code	270335298
Hospital Revenue Code	278
Min. Negotiated Rate	$242.73
Max. Negotiated Rate	$4,273.50
Rate for Payer: Aetna Commercial	$3,247.86
Rate for Payer: Aetna Medicare Advantage	$2,564.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,179.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,179.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,709.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,179.49
Rate for Payer: Cigna Commercial	$4,273.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,068.37
Rate for Payer: Qualcare PPO/HMO/WC	$1,282.05
Rate for Payer: UnitedHealthcare Community & State	$270.09
Rate for Payer: Wellpoint Medicaid Managed Care	$242.73

INFUSE BONE GRAFT

Facility

$8,547.00

Hospital Charge Code	270335298
Hospital Revenue Code	278
Min. Negotiated Rate	$1,282.05
Max. Negotiated Rate	$2,068.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,709.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,068.37
Rate for Payer: Qualcare PPO/HMO/WC	$1,282.05

INFUSE BONE GRAFT

Facility

$9,525.00

Service Code	HCPCS C1889
Hospital Charge Code	270652417
Hospital Revenue Code	278
Min. Negotiated Rate	$270.51
Max. Negotiated Rate	$4,762.50
Rate for Payer: Aetna Commercial	$3,619.50
Rate for Payer: Aetna Medicare Advantage	$2,857.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,428.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,428.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,905.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,428.88
Rate for Payer: Cigna Commercial	$4,762.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,305.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,428.75
Rate for Payer: UnitedHealthcare Community & State	$300.99
Rate for Payer: Wellpoint Medicaid Managed Care	$270.51

INFUSE BONE GRAFT

Facility

$9,525.00

Service Code	HCPCS C1889
Hospital Charge Code	270652417
Hospital Revenue Code	278
Min. Negotiated Rate	$1,428.75
Max. Negotiated Rate	$2,305.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,905.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,305.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,428.75

INFUSE BONE GRAFT KIT LARGE

Facility

$30,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270670495
Hospital Revenue Code	278
Min. Negotiated Rate	$863.36
Max. Negotiated Rate	$15,200.00
Rate for Payer: Aetna Commercial	$11,552.00
Rate for Payer: Aetna Medicare Advantage	$9,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,752.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,752.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,752.00
Rate for Payer: Cigna Commercial	$15,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,356.80
Rate for Payer: Qualcare PPO/HMO/WC	$4,560.00
Rate for Payer: UnitedHealthcare Community & State	$960.64
Rate for Payer: Wellpoint Medicaid Managed Care	$863.36

INFUSE BONE GRAFT KIT LARGE

Facility

$30,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270670495
Hospital Revenue Code	278
Min. Negotiated Rate	$4,560.00
Max. Negotiated Rate	$7,356.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,356.80
Rate for Payer: Qualcare PPO/HMO/WC	$4,560.00

INFUSION PORT 8FR POL SIL SGL

Facility

$10,636.80

Service Code	HCPCS C1788
Hospital Charge Code	270701578
Hospital Revenue Code	278
Min. Negotiated Rate	$302.09
Max. Negotiated Rate	$5,318.40
Rate for Payer: Aetna Commercial	$4,041.98
Rate for Payer: Aetna Medicare Advantage	$3,191.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,712.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,712.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,127.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,712.38
Rate for Payer: Cigna Commercial	$5,318.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,574.11
Rate for Payer: Qualcare PPO/HMO/WC	$1,595.52
Rate for Payer: UnitedHealthcare Community & State	$336.12
Rate for Payer: Wellpoint Medicaid Managed Care	$302.09

INFUSION PORT 8FR POL SIL SGL

Facility

$10,636.80

Service Code	HCPCS C1788
Hospital Charge Code	270701578
Hospital Revenue Code	278
Min. Negotiated Rate	$1,595.52
Max. Negotiated Rate	$2,574.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,127.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,574.11
Rate for Payer: Qualcare PPO/HMO/WC	$1,595.52

INFUSION SET EZ HUBER 20g 3/4

Facility

$31.50

Hospital Charge Code	270642543
Hospital Revenue Code	272
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$15.75
Rate for Payer: Aetna Commercial	$11.97
Rate for Payer: Aetna Medicare Advantage	$9.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.03
Rate for Payer: Cigna Commercial	$15.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.19
Rate for Payer: Oxford Commercial	$6.30
Rate for Payer: Qualcare PPO/HMO/WC	$4.72
Rate for Payer: UnitedHealthcare Commercial	$6.30
Rate for Payer: UnitedHealthcare Community & State	$1.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.89

INFUSION SET EZ HUBER 20g 3/4

Facility

$31.50

Hospital Charge Code	270642543
Hospital Revenue Code	272
Min. Negotiated Rate	$4.72
Max. Negotiated Rate	$4.72
Rate for Payer: Qualcare PPO/HMO/WC	$4.72

INFUSION SET PRIMARY SAPPHIRE

Facility

$54.80

Hospital Charge Code	270675461
Hospital Revenue Code	272
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$27.40
Rate for Payer: Aetna Commercial	$20.82
Rate for Payer: Aetna Medicare Advantage	$16.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.97
Rate for Payer: Cigna Commercial	$27.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.25
Rate for Payer: Oxford Commercial	$10.96
Rate for Payer: Qualcare PPO/HMO/WC	$8.22
Rate for Payer: UnitedHealthcare Commercial	$10.96
Rate for Payer: UnitedHealthcare Community & State	$1.73
Rate for Payer: Wellpoint Medicaid Managed Care	$1.56

INFUSION SET PRIMARY SAPPHIRE

Facility

$54.80

Hospital Charge Code	270675461
Hospital Revenue Code	272
Min. Negotiated Rate	$8.22
Max. Negotiated Rate	$8.22
Rate for Payer: Qualcare PPO/HMO/WC	$8.22

INFUSOR PRESSURE 1000CC DISP

Facility

$41.21

Hospital Charge Code	270658033
Hospital Revenue Code	270
Min. Negotiated Rate	$6.18
Max. Negotiated Rate	$6.18
Rate for Payer: Qualcare PPO/HMO/WC	$6.18

INFUSOR PRESSURE 1000CC DISP

Facility

$41.21

Hospital Charge Code	270658033
Hospital Revenue Code	270
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$20.61
Rate for Payer: Aetna Commercial	$15.66
Rate for Payer: Aetna Medicare Advantage	$12.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.51
Rate for Payer: Cigna Commercial	$20.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.71
Rate for Payer: Oxford Commercial	$8.24
Rate for Payer: Qualcare PPO/HMO/WC	$6.18
Rate for Payer: UnitedHealthcare Commercial	$8.24
Rate for Payer: UnitedHealthcare Community & State	$1.30
Rate for Payer: Wellpoint Medicaid Managed Care	$1.17

INGEV MRI IS-1BI+FX RARV 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270679666
Hospital Revenue Code	278
Min. Negotiated Rate	$113.60
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$126.40
Rate for Payer: Wellpoint Medicaid Managed Care	$113.60

INGEV MRI IS-1BI+FX RARV 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270679666
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC

Facility

$67,629.06

Service Code	MSDRG 351
Min. Negotiated Rate	$20,592.18
Max. Negotiated Rate	$67,629.06
Rate for Payer: Aetna Commercial	$50,024.70
Rate for Payer: Aetna Medicare Advantage	$67,629.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40,449.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40,449.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,675.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40,449.30
Rate for Payer: Cigna Commercial	$33,985.68
Rate for Payer: Cigna Medicare Advantage	$21,675.98
Rate for Payer: Clover Medicare Advantage	$20,592.18
Rate for Payer: EmblemHealth Commercial	$65,027.94
Rate for Payer: Humana Medicare Advantage	$22,326.26
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21,675.98
Rate for Payer: Oxford Commercial	$26,861.69
Rate for Payer: UnitedHealthcare Commercial	$35,955.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$21,675.98
Rate for Payer: Wellcare Medicare Advantage	$21,675.98

INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC

Facility

$98,192.64

Service Code	MSDRG 350
Min. Negotiated Rate	$29,898.40
Max. Negotiated Rate	$98,192.64
Rate for Payer: Aetna Commercial	$71,792.43
Rate for Payer: Aetna Medicare Advantage	$98,192.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66,492.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66,492.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$31,472.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66,492.00
Rate for Payer: Cigna Commercial	$55,551.93
Rate for Payer: Cigna Medicare Advantage	$31,472.00
Rate for Payer: Clover Medicare Advantage	$29,898.40
Rate for Payer: EmblemHealth Commercial	$94,416.00
Rate for Payer: Humana Medicare Advantage	$32,416.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$31,472.00
Rate for Payer: Oxford Commercial	$43,907.28
Rate for Payer: UnitedHealthcare Commercial	$58,771.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$31,472.00
Rate for Payer: Wellcare Medicare Advantage	$31,472.00

INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC

Facility

$56,359.65

Service Code	MSDRG 352
Min. Negotiated Rate	$17,160.79
Max. Negotiated Rate	$56,359.65
Rate for Payer: Aetna Commercial	$41,998.50
Rate for Payer: Aetna Medicare Advantage	$56,359.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30,752.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30,752.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18,063.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30,752.55
Rate for Payer: Cigna Commercial	$26,033.77
Rate for Payer: Cigna Medicare Advantage	$18,063.99
Rate for Payer: Clover Medicare Advantage	$17,160.79
Rate for Payer: EmblemHealth Commercial	$54,191.97
Rate for Payer: Humana Medicare Advantage	$18,605.91
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18,063.99
Rate for Payer: Oxford Commercial	$20,576.64
Rate for Payer: UnitedHealthcare Commercial	$27,542.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$18,063.99
Rate for Payer: Wellcare Medicare Advantage	$18,063.99

INGUINAL BLOCK

Facility

$2,196.25

Service Code	HCPCS 64425
Hospital Charge Code	1650117A
Hospital Revenue Code	361
Min. Negotiated Rate	$329.44
Max. Negotiated Rate	$329.44
Rate for Payer: Qualcare PPO/HMO/WC	$329.44

INGUINAL BLOCK

Facility

$2,196.25

Service Code	HCPCS 64425
Hospital Charge Code	1650117A
Hospital Revenue Code	361
Min. Negotiated Rate	$62.37
Max. Negotiated Rate	$3,629.00
Rate for Payer: Aetna Commercial	$2,281.02
Rate for Payer: Aetna Medicare Advantage	$2,717.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,042.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,042.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$838.61
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	$3,042.06
Rate for Payer: Cigna Commercial	$1,680.99
Rate for Payer: Cigna Medicare Advantage	$838.61
Rate for Payer: Clover Medicare Advantage	$796.68
Rate for Payer: EmblemHealth Commercial	$2,515.83
Rate for Payer: Humana Medicare Advantage	$863.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$838.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$571.02
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$329.44
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$69.40
Rate for Payer: UnitedHealthcare Medicare Advantage	$838.61
Rate for Payer: Wellcare Medicare Advantage	$838.61
Rate for Payer: Wellpoint Medicaid Managed Care	$62.37

INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES

Facility

$15,775.41

Service Code	APR-DRG 2282
Min. Negotiated Rate	$15,466.09
Max. Negotiated Rate	$15,775.41
Rate for Payer: UnitedHealthcare Community & State	$15,466.09
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$15,775.41
Rate for Payer: Wellpoint Medicaid Managed Care	$15,466.09

INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES

Facility

$12,410.48

Service Code	APR-DRG 2281
Min. Negotiated Rate	$12,167.14
Max. Negotiated Rate	$12,410.48
Rate for Payer: UnitedHealthcare Community & State	$12,167.14
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,410.48
Rate for Payer: Wellpoint Medicaid Managed Care	$12,167.14

Know your out-of-pocket cost for care.

All Charges