Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

INST KIT MICRO SUTURETAK

Facility

$875.00

Hospital Charge Code	270677969
Hospital Revenue Code	272
Min. Negotiated Rate	$24.85
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$27.65
Rate for Payer: Wellpoint Medicaid Managed Care	$24.85

INST KIT MICRO SUTURETAK

Facility

$875.00

Hospital Charge Code	270677969
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

INST. KIT,SUPERIOR,GLENOID

Facility

$1,960.00

Hospital Charge Code	270687343
Hospital Revenue Code	272
Min. Negotiated Rate	$294.00
Max. Negotiated Rate	$294.00
Rate for Payer: Qualcare PPO/HMO/WC	$294.00

INST. KIT,SUPERIOR,GLENOID

Facility

$1,960.00

Hospital Charge Code	270687343
Hospital Revenue Code	272
Min. Negotiated Rate	$55.66
Max. Negotiated Rate	$980.00
Rate for Payer: Aetna Commercial	$744.80
Rate for Payer: Aetna Medicare Advantage	$588.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$499.80
Rate for Payer: Cigna Commercial	$980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$509.60
Rate for Payer: Oxford Commercial	$392.00
Rate for Payer: Qualcare PPO/HMO/WC	$294.00
Rate for Payer: UnitedHealthcare Commercial	$392.00
Rate for Payer: UnitedHealthcare Community & State	$61.94
Rate for Payer: Wellpoint Medicaid Managed Care	$55.66

INSTRATEK BLADE

Facility

$620.00

Hospital Charge Code	270332654
Hospital Revenue Code	272
Min. Negotiated Rate	$17.61
Max. Negotiated Rate	$310.00
Rate for Payer: Aetna Commercial	$235.60
Rate for Payer: Aetna Medicare Advantage	$186.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.10
Rate for Payer: Cigna Commercial	$310.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.20
Rate for Payer: Oxford Commercial	$124.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$19.59
Rate for Payer: Wellpoint Medicaid Managed Care	$17.61

INSTRATEK BLADE

Facility

$620.00

Hospital Charge Code	270332654
Hospital Revenue Code	272
Min. Negotiated Rate	$93.00
Max. Negotiated Rate	$93.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.00

INSTRUMENT KIT PRO-TOE

Facility

$1,135.00

Hospital Charge Code	270661604
Hospital Revenue Code	272
Min. Negotiated Rate	$32.23
Max. Negotiated Rate	$567.50
Rate for Payer: Aetna Commercial	$431.30
Rate for Payer: Aetna Medicare Advantage	$340.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$289.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$289.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$289.43
Rate for Payer: Cigna Commercial	$567.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$295.10
Rate for Payer: Oxford Commercial	$227.00
Rate for Payer: Qualcare PPO/HMO/WC	$170.25
Rate for Payer: UnitedHealthcare Commercial	$227.00
Rate for Payer: UnitedHealthcare Community & State	$35.87
Rate for Payer: Wellpoint Medicaid Managed Care	$32.23

INSTRUMENT KIT PRO-TOE

Facility

$1,135.00

Hospital Charge Code	270661604
Hospital Revenue Code	272
Min. Negotiated Rate	$170.25
Max. Negotiated Rate	$170.25
Rate for Payer: Qualcare PPO/HMO/WC	$170.25

INSTRUMENT SET SEREW

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270687872
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

INSTRUMENT SET SEREW

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270687872
Hospital Revenue Code	278
Min. Negotiated Rate	$23.43
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$26.07
Rate for Payer: Wellpoint Medicaid Managed Care	$23.43

INST SET CALCANEUS

Facility

$4,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270687870
Hospital Revenue Code	278
Min. Negotiated Rate	$663.75
Max. Negotiated Rate	$1,070.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$885.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,070.85
Rate for Payer: Qualcare PPO/HMO/WC	$663.75

INST SET CALCANEUS

Facility

$4,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270687870
Hospital Revenue Code	278
Min. Negotiated Rate	$125.67
Max. Negotiated Rate	$2,212.50
Rate for Payer: Aetna Commercial	$1,681.50
Rate for Payer: Aetna Medicare Advantage	$1,327.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,128.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,128.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$885.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,128.38
Rate for Payer: Cigna Commercial	$2,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,070.85
Rate for Payer: Qualcare PPO/HMO/WC	$663.75
Rate for Payer: UnitedHealthcare Community & State	$139.83
Rate for Payer: Wellpoint Medicaid Managed Care	$125.67

INS TUN INT PERIT CATH

Facility

$17,259.20

Service Code	HCPCS 49418
Hospital Charge Code	321049418
Hospital Revenue Code	361
Min. Negotiated Rate	$2,588.88
Max. Negotiated Rate	$2,588.88
Rate for Payer: Qualcare PPO/HMO/WC	$2,588.88

INS TUN INT PERIT CATH

Facility

$14,554.80

Service Code	HCPCS 49418
Hospital Charge Code	411049418
Hospital Revenue Code	361
Min. Negotiated Rate	$413.36
Max. Negotiated Rate	$15,429.97
Rate for Payer: Aetna Commercial	$11,569.82
Rate for Payer: Aetna Medicare Advantage	$13,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,429.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,429.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,253.61
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	$15,429.97
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: Cigna Medicare Advantage	$4,253.61
Rate for Payer: Clover Medicare Advantage	$4,040.93
Rate for Payer: EmblemHealth Commercial	$12,760.83
Rate for Payer: Humana Medicare Advantage	$4,381.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,253.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,784.25
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,183.22
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$459.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,253.61
Rate for Payer: Wellcare Medicare Advantage	$4,253.61
Rate for Payer: Wellpoint Medicaid Managed Care	$413.36

INS TUN INT PERIT CATH

Facility

$14,554.80

Service Code	HCPCS 49418
Hospital Charge Code	411049418
Hospital Revenue Code	361
Min. Negotiated Rate	$2,183.22
Max. Negotiated Rate	$2,183.22
Rate for Payer: Qualcare PPO/HMO/WC	$2,183.22

INS TUN INT PERIT CATH

Facility

$14,554.80

Service Code	HCPCS 49418
Hospital Charge Code	366849418
Hospital Revenue Code	361
Min. Negotiated Rate	$2,183.22
Max. Negotiated Rate	$2,183.22
Rate for Payer: Qualcare PPO/HMO/WC	$2,183.22

INS TUN INT PERIT CATH

Facility

$14,554.80

Service Code	HCPCS 49418
Hospital Charge Code	366849418
Hospital Revenue Code	361
Min. Negotiated Rate	$413.36
Max. Negotiated Rate	$15,429.97
Rate for Payer: Aetna Commercial	$11,569.82
Rate for Payer: Aetna Medicare Advantage	$13,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,429.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,429.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,253.61
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	$15,429.97
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: Cigna Medicare Advantage	$4,253.61
Rate for Payer: Clover Medicare Advantage	$4,040.93
Rate for Payer: EmblemHealth Commercial	$12,760.83
Rate for Payer: Humana Medicare Advantage	$4,381.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,253.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,784.25
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,183.22
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$459.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,253.61
Rate for Payer: Wellcare Medicare Advantage	$4,253.61
Rate for Payer: Wellpoint Medicaid Managed Care	$413.36

INS TUN INT PERIT CATH

Facility

$17,259.20

Service Code	HCPCS 49418
Hospital Charge Code	2690145
Hospital Revenue Code	361
Min. Negotiated Rate	$2,588.88
Max. Negotiated Rate	$2,588.88
Rate for Payer: Qualcare PPO/HMO/WC	$2,588.88

INS TUN INT PERIT CATH

Facility

$17,259.20

Service Code	HCPCS 49418
Hospital Charge Code	2690145
Hospital Revenue Code	361
Min. Negotiated Rate	$490.16
Max. Negotiated Rate	$15,429.97
Rate for Payer: Aetna Commercial	$11,569.82
Rate for Payer: Aetna Medicare Advantage	$13,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,429.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,429.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,253.61
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	$15,429.97
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: Cigna Medicare Advantage	$4,253.61
Rate for Payer: Clover Medicare Advantage	$4,040.93
Rate for Payer: EmblemHealth Commercial	$12,760.83
Rate for Payer: Humana Medicare Advantage	$4,381.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,253.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,487.39
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,588.88
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$545.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,253.61
Rate for Payer: Wellcare Medicare Advantage	$4,253.61
Rate for Payer: Wellpoint Medicaid Managed Care	$490.16

INS TUN INT PERIT CATH

Facility

$17,259.20

Service Code	HCPCS 49418
Hospital Charge Code	321049418
Hospital Revenue Code	361
Min. Negotiated Rate	$490.16
Max. Negotiated Rate	$15,429.97
Rate for Payer: Aetna Commercial	$11,569.82
Rate for Payer: Aetna Medicare Advantage	$13,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,429.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,429.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,253.61
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	$15,429.97
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: Cigna Medicare Advantage	$4,253.61
Rate for Payer: Clover Medicare Advantage	$4,040.93
Rate for Payer: EmblemHealth Commercial	$12,760.83
Rate for Payer: Humana Medicare Advantage	$4,381.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,253.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,487.39
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,588.88
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$545.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,253.61
Rate for Payer: Wellcare Medicare Advantage	$4,253.61
Rate for Payer: Wellpoint Medicaid Managed Care	$490.16

INS TUNN CNTRL VENOUS<5 YEARS

Facility

$12,584.00

Service Code	HCPCS 36560
Hospital Charge Code	2008005
Hospital Revenue Code	361
Min. Negotiated Rate	$357.39
Max. Negotiated Rate	$13,607.37
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
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	$13,607.37
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,271.84
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.60
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$397.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$357.39

INS TUNN CNTRL VENOUS<5 YEARS

Facility

$12,584.00

Service Code	HCPCS 36560
Hospital Charge Code	2008005
Hospital Revenue Code	361
Min. Negotiated Rate	$1,887.60
Max. Negotiated Rate	$1,887.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.60

INS TUNN CVAD W PORT AGE 5YR>

Facility

$37,793.28

Service Code	HCPCS 36561
Hospital Charge Code	1600000346
Hospital Revenue Code	360
Min. Negotiated Rate	$1,073.33
Max. Negotiated Rate	$13,607.37
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
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	$13,607.37
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,826.25
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,668.99
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$1,194.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$1,073.33

INS TUNN CVAD W PORT AGE 5YR>

Facility

$37,793.28

Service Code	HCPCS 36561
Hospital Charge Code	1600000346
Hospital Revenue Code	360
Min. Negotiated Rate	$5,668.99
Max. Negotiated Rate	$5,668.99
Rate for Payer: Qualcare PPO/HMO/WC	$5,668.99

INS TUNNELED CV CATH AGE 5/>

Facility

$29,451.76

Service Code	HCPCS 36558
Hospital Charge Code	16000735
Hospital Revenue Code	360
Min. Negotiated Rate	$4,417.76
Max. Negotiated Rate	$4,417.76
Rate for Payer: Qualcare PPO/HMO/WC	$4,417.76

Know your out-of-pocket cost for care.

All Charges