Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

IRRIGATING CYSTITOMES 25G

Facility

$50.00

Hospital Charge Code	270331005
Hospital Revenue Code	272
Min. Negotiated Rate	$1.42
Max. Negotiated Rate	$25.00
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.00
Rate for Payer: Oxford Commercial	$10.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$10.00
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.42

IRRIGATING CYSTITOMES 25G

Facility

$50.00

Hospital Charge Code	270331005
Hospital Revenue Code	272
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

IRRIGATING TUBING 3318503E

Facility

$90.00

Hospital Charge Code	270639697
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

IRRIGATING TUBING 3318503E

Facility

$90.00

Hospital Charge Code	270639697
Hospital Revenue Code	272
Min. Negotiated Rate	$2.56
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$34.20
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.40
Rate for Payer: Oxford Commercial	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$18.00
Rate for Payer: UnitedHealthcare Community & State	$2.84
Rate for Payer: Wellpoint Medicaid Managed Care	$2.56

IRRIGATION CATH 6FR 80CM

Facility

$182.00

Hospital Charge Code	270331055
Hospital Revenue Code	272
Min. Negotiated Rate	$5.17
Max. Negotiated Rate	$91.00
Rate for Payer: Aetna Commercial	$69.16
Rate for Payer: Aetna Medicare Advantage	$54.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.41
Rate for Payer: Cigna Commercial	$91.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.32
Rate for Payer: Oxford Commercial	$36.40
Rate for Payer: Qualcare PPO/HMO/WC	$27.30
Rate for Payer: UnitedHealthcare Commercial	$36.40
Rate for Payer: UnitedHealthcare Community & State	$5.75
Rate for Payer: Wellpoint Medicaid Managed Care	$5.17

IRRIGATION CATH 6FR 80CM

Facility

$182.00

Hospital Charge Code	270331055
Hospital Revenue Code	272
Min. Negotiated Rate	$27.30
Max. Negotiated Rate	$27.30
Rate for Payer: Qualcare PPO/HMO/WC	$27.30

IRRIGATION CLIP

Facility

$601.25

Hospital Charge Code	270690849
Hospital Revenue Code	272
Min. Negotiated Rate	$90.19
Max. Negotiated Rate	$90.19
Rate for Payer: Qualcare PPO/HMO/WC	$90.19

IRRIGATION CLIP

Facility

$601.25

Hospital Charge Code	270690849
Hospital Revenue Code	272
Min. Negotiated Rate	$17.08
Max. Negotiated Rate	$300.62
Rate for Payer: Aetna Commercial	$228.47
Rate for Payer: Aetna Medicare Advantage	$180.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.32
Rate for Payer: Cigna Commercial	$300.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.32
Rate for Payer: Oxford Commercial	$120.25
Rate for Payer: Qualcare PPO/HMO/WC	$90.19
Rate for Payer: UnitedHealthcare Commercial	$120.25
Rate for Payer: UnitedHealthcare Community & State	$19.00
Rate for Payer: Wellpoint Medicaid Managed Care	$17.08

IRRIGATION CONTROL BUTTON

Facility

$83.00

Hospital Charge Code	270332495
Hospital Revenue Code	272
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$41.50
Rate for Payer: Aetna Commercial	$31.54
Rate for Payer: Aetna Medicare Advantage	$24.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.16
Rate for Payer: Cigna Commercial	$41.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.58
Rate for Payer: Oxford Commercial	$16.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.45
Rate for Payer: UnitedHealthcare Commercial	$16.60
Rate for Payer: UnitedHealthcare Community & State	$2.62
Rate for Payer: Wellpoint Medicaid Managed Care	$2.36

IRRIGATION CONTROL BUTTON

Facility

$83.00

Hospital Charge Code	270332495
Hospital Revenue Code	272
Min. Negotiated Rate	$12.45
Max. Negotiated Rate	$12.45
Rate for Payer: Qualcare PPO/HMO/WC	$12.45

IRRIGATION CYSTOTOME 25G.

Facility

$33.00

Hospital Charge Code	270331399
Hospital Revenue Code	272
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$4.95
Rate for Payer: Qualcare PPO/HMO/WC	$4.95

IRRIGATION CYSTOTOME 25G.

Facility

$33.00

Hospital Charge Code	270331399
Hospital Revenue Code	272
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$16.50
Rate for Payer: Aetna Commercial	$12.54
Rate for Payer: Aetna Medicare Advantage	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.41
Rate for Payer: Cigna Commercial	$16.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.58
Rate for Payer: Oxford Commercial	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$4.95
Rate for Payer: UnitedHealthcare Commercial	$6.60
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$0.94

IRRIGATION NOZZLE F/ 05.001.05

Facility

$833.00

Hospital Charge Code	270674165
Hospital Revenue Code	272
Min. Negotiated Rate	$23.66
Max. Negotiated Rate	$416.50
Rate for Payer: Aetna Commercial	$316.54
Rate for Payer: Aetna Medicare Advantage	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.41
Rate for Payer: Cigna Commercial	$416.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.58
Rate for Payer: Oxford Commercial	$166.60
Rate for Payer: Qualcare PPO/HMO/WC	$124.95
Rate for Payer: UnitedHealthcare Commercial	$166.60
Rate for Payer: UnitedHealthcare Community & State	$26.32
Rate for Payer: Wellpoint Medicaid Managed Care	$23.66

IRRIGATION NOZZLE F/ 05.001.05

Facility

$833.00

Hospital Charge Code	270674165
Hospital Revenue Code	272
Min. Negotiated Rate	$124.95
Max. Negotiated Rate	$124.95
Rate for Payer: Qualcare PPO/HMO/WC	$124.95

IRRIGATION NOZZLE F/05.001.183

Facility

$833.00

Hospital Charge Code	270674707
Hospital Revenue Code	272
Min. Negotiated Rate	$23.66
Max. Negotiated Rate	$416.50
Rate for Payer: Aetna Commercial	$316.54
Rate for Payer: Aetna Medicare Advantage	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.41
Rate for Payer: Cigna Commercial	$416.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.58
Rate for Payer: Oxford Commercial	$166.60
Rate for Payer: Qualcare PPO/HMO/WC	$124.95
Rate for Payer: UnitedHealthcare Commercial	$166.60
Rate for Payer: UnitedHealthcare Community & State	$26.32
Rate for Payer: Wellpoint Medicaid Managed Care	$23.66

IRRIGATION NOZZLE F/05.001.183

Facility

$833.00

Hospital Charge Code	270674707
Hospital Revenue Code	272
Min. Negotiated Rate	$124.95
Max. Negotiated Rate	$124.95
Rate for Payer: Qualcare PPO/HMO/WC	$124.95

IRRIGATION TUBE

Facility

$601.25

Hospital Charge Code	270690850
Hospital Revenue Code	272
Min. Negotiated Rate	$17.08
Max. Negotiated Rate	$300.62
Rate for Payer: Aetna Commercial	$228.47
Rate for Payer: Aetna Medicare Advantage	$180.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.32
Rate for Payer: Cigna Commercial	$300.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.32
Rate for Payer: Oxford Commercial	$120.25
Rate for Payer: Qualcare PPO/HMO/WC	$90.19
Rate for Payer: UnitedHealthcare Commercial	$120.25
Rate for Payer: UnitedHealthcare Community & State	$19.00
Rate for Payer: Wellpoint Medicaid Managed Care	$17.08

IRRIGATION TUBE

Facility

$601.25

Hospital Charge Code	270690850
Hospital Revenue Code	272
Min. Negotiated Rate	$90.19
Max. Negotiated Rate	$90.19
Rate for Payer: Qualcare PPO/HMO/WC	$90.19

IRRIGATION TUBE SET

Facility

$250.00

Hospital Charge Code	270669366
Hospital Revenue Code	272
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

IRRIGATION TUBE SET

Facility

$250.00

Hospital Charge Code	270669366
Hospital Revenue Code	272
Min. Negotiated Rate	$7.10
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$95.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.00
Rate for Payer: Oxford Commercial	$50.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$50.00
Rate for Payer: UnitedHealthcare Community & State	$7.90
Rate for Payer: Wellpoint Medicaid Managed Care	$7.10

IRRIGATION TUBE SET SINGLE PK

Facility

$231.00

Hospital Charge Code	270674704
Hospital Revenue Code	272
Min. Negotiated Rate	$34.65
Max. Negotiated Rate	$34.65
Rate for Payer: Qualcare PPO/HMO/WC	$34.65

IRRIGATION TUBE SET SINGLE PK

Facility

$231.00

Hospital Charge Code	270674704
Hospital Revenue Code	272
Min. Negotiated Rate	$6.56
Max. Negotiated Rate	$115.50
Rate for Payer: Aetna Commercial	$87.78
Rate for Payer: Aetna Medicare Advantage	$69.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.91
Rate for Payer: Cigna Commercial	$115.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.06
Rate for Payer: Oxford Commercial	$46.20
Rate for Payer: Qualcare PPO/HMO/WC	$34.65
Rate for Payer: UnitedHealthcare Commercial	$46.20
Rate for Payer: UnitedHealthcare Community & State	$7.30
Rate for Payer: Wellpoint Medicaid Managed Care	$6.56

IRRIGATOR ARTHRO FLO

Facility

$120.00

Hospital Charge Code	270654349
Hospital Revenue Code	272
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

IRRIGATOR ARTHRO FLO

Facility

$120.00

Hospital Charge Code	270654349
Hospital Revenue Code	272
Min. Negotiated Rate	$3.41
Max. Negotiated Rate	$60.00
Rate for Payer: Aetna Commercial	$45.60
Rate for Payer: Aetna Medicare Advantage	$36.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.60
Rate for Payer: Cigna Commercial	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.20
Rate for Payer: Oxford Commercial	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00
Rate for Payer: UnitedHealthcare Commercial	$24.00
Rate for Payer: UnitedHealthcare Community & State	$3.79
Rate for Payer: Wellpoint Medicaid Managed Care	$3.41

IRRIGATOR SHOWEHEAD SET TIP

Facility

$628.45

Hospital Charge Code	270657856
Hospital Revenue Code	270
Min. Negotiated Rate	$17.85
Max. Negotiated Rate	$314.23
Rate for Payer: Aetna Commercial	$238.81
Rate for Payer: Aetna Medicare Advantage	$188.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.25
Rate for Payer: Cigna Commercial	$314.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.40
Rate for Payer: Oxford Commercial	$125.69
Rate for Payer: Qualcare PPO/HMO/WC	$94.27
Rate for Payer: UnitedHealthcare Commercial	$125.69
Rate for Payer: UnitedHealthcare Community & State	$19.86
Rate for Payer: Wellpoint Medicaid Managed Care	$17.85

Know your out-of-pocket cost for care.

All Charges