Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

JAGWIRE HYDRA .35X 450CM ANG

Facility

$950.00

Service Code	HCPCS C1769
Hospital Charge Code	270689959
Hospital Revenue Code	278
Min. Negotiated Rate	$26.98
Max. Negotiated Rate	$475.00
Rate for Payer: Aetna Commercial	$361.00
Rate for Payer: Aetna Medicare Advantage	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.25
Rate for Payer: Cigna Commercial	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$142.50
Rate for Payer: UnitedHealthcare Community & State	$30.02
Rate for Payer: Wellpoint Medicaid Managed Care	$26.98

JAGWIRE HYDRA .35X 450CM ANG

Facility

$950.00

Service Code	HCPCS C1769
Hospital Charge Code	270689959
Hospital Revenue Code	278
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$229.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$142.50

JAGWIRE--STRAIGHT TIP 0.038 in

Facility

$492.48

Service Code	HCPCS C1769
Hospital Charge Code	270680059
Hospital Revenue Code	278
Min. Negotiated Rate	$13.99
Max. Negotiated Rate	$246.24
Rate for Payer: Aetna Commercial	$187.14
Rate for Payer: Aetna Medicare Advantage	$147.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.58
Rate for Payer: Cigna Commercial	$246.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.18
Rate for Payer: Qualcare PPO/HMO/WC	$73.87
Rate for Payer: UnitedHealthcare Community & State	$15.56
Rate for Payer: Wellpoint Medicaid Managed Care	$13.99

JAGWIRE--STRAIGHT TIP 0.038 in

Facility

$492.48

Service Code	HCPCS C1769
Hospital Charge Code	270680059
Hospital Revenue Code	278
Min. Negotiated Rate	$73.87
Max. Negotiated Rate	$119.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.18
Rate for Payer: Qualcare PPO/HMO/WC	$73.87

JAK2 EXON 12 MUTATION ANALYSIS

Facility

$400.00

Service Code	HCPCS 81403
Hospital Charge Code	401381403
Hospital Revenue Code	310
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

JAK2 EXON 12 MUTATION ANALYSIS

Facility

$400.00

Service Code	HCPCS 81403
Hospital Charge Code	401381403
Hospital Revenue Code	310
Min. Negotiated Rate	$11.36
Max. Negotiated Rate	$671.81
Rate for Payer: Aetna Commercial	$503.74
Rate for Payer: Aetna Medicare Advantage	$600.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$671.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$671.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$185.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$671.81
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: Cigna Medicare Advantage	$185.20
Rate for Payer: Clover Medicare Advantage	$175.94
Rate for Payer: EmblemHealth Commercial	$555.60
Rate for Payer: Humana Medicare Advantage	$190.76
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$185.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.00
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$148.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$185.20
Rate for Payer: Wellcare Medicare Advantage	$185.20
Rate for Payer: Wellpoint Medicaid Managed Care	$11.36

JAK2 MUTATION,QN,PLAS,LEU

Facility

$1,566.65

Service Code	HCPCS 81270
Hospital Charge Code	39900020
Hospital Revenue Code	310
Min. Negotiated Rate	$44.49
Max. Negotiated Rate	$783.33
Rate for Payer: Aetna Commercial	$249.32
Rate for Payer: Aetna Medicare Advantage	$296.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$332.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$332.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$91.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$332.50
Rate for Payer: Cigna Commercial	$783.33
Rate for Payer: Cigna Medicare Advantage	$91.66
Rate for Payer: Clover Medicare Advantage	$87.08
Rate for Payer: EmblemHealth Commercial	$274.98
Rate for Payer: Humana Medicare Advantage	$94.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$91.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$407.33
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$235.00
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$73.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$91.66
Rate for Payer: Wellcare Medicare Advantage	$91.66
Rate for Payer: Wellpoint Medicaid Managed Care	$44.49

JAK2 MUTATION,QN,PLAS,LEU

Facility

$1,566.65

Service Code	HCPCS 81270
Hospital Charge Code	39900020
Hospital Revenue Code	310
Min. Negotiated Rate	$235.00
Max. Negotiated Rate	$235.00
Rate for Payer: Qualcare PPO/HMO/WC	$235.00

JAK2 V617F MUTATION, QL

Facility

$1,566.65

Service Code	HCPCS 81270
Hospital Charge Code	39900021
Hospital Revenue Code	310
Min. Negotiated Rate	$235.00
Max. Negotiated Rate	$235.00
Rate for Payer: Qualcare PPO/HMO/WC	$235.00

JAK2 V617F MUTATION, QL

Facility

$1,566.65

Service Code	HCPCS 81270
Hospital Charge Code	39900021
Hospital Revenue Code	310
Min. Negotiated Rate	$44.49
Max. Negotiated Rate	$783.33
Rate for Payer: Aetna Commercial	$249.32
Rate for Payer: Aetna Medicare Advantage	$296.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$332.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$332.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$91.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$332.50
Rate for Payer: Cigna Commercial	$783.33
Rate for Payer: Cigna Medicare Advantage	$91.66
Rate for Payer: Clover Medicare Advantage	$87.08
Rate for Payer: EmblemHealth Commercial	$274.98
Rate for Payer: Humana Medicare Advantage	$94.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$91.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$407.33
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$235.00
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$73.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$91.66
Rate for Payer: Wellcare Medicare Advantage	$91.66
Rate for Payer: Wellpoint Medicaid Managed Care	$44.49

JAMSHEDI NEEDLE

Facility

$750.00

Hospital Charge Code	270703309
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

JAMSHEDI NEEDLE

Facility

$750.00

Hospital Charge Code	270703309
Hospital Revenue Code	278
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$23.70
Rate for Payer: Wellpoint Medicaid Managed Care	$21.30

JAMSHEDI /TROCAR

Facility

$750.00

Hospital Charge Code	270704095
Hospital Revenue Code	272
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

JAMSHEDI /TROCAR

Facility

$750.00

Hospital Charge Code	270704095
Hospital Revenue Code	272
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.00
Rate for Payer: Oxford Commercial	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Commercial	$150.00
Rate for Payer: UnitedHealthcare Community & State	$23.70
Rate for Payer: Wellpoint Medicaid Managed Care	$21.30

JAMSHIDI

Facility

$1,250.00

Hospital Charge Code	270703278
Hospital Revenue Code	279
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

JAMSHIDI

Facility

$750.00

Hospital Charge Code	270703850
Hospital Revenue Code	272
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

JAMSHIDI

Facility

$1,250.00

Hospital Charge Code	270703278
Hospital Revenue Code	279
Min. Negotiated Rate	$35.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$325.00
Rate for Payer: Oxford Commercial	$250.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Commercial	$250.00
Rate for Payer: UnitedHealthcare Community & State	$39.50
Rate for Payer: Wellpoint Medicaid Managed Care	$35.50

JAMSHIDI

Facility

$750.00

Hospital Charge Code	270703850
Hospital Revenue Code	272
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.00
Rate for Payer: Oxford Commercial	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Commercial	$150.00
Rate for Payer: UnitedHealthcare Community & State	$23.70
Rate for Payer: Wellpoint Medicaid Managed Care	$21.30

JAMSHIDI BONE GRAFT NEEDLE

Facility

$675.00

Hospital Charge Code	270704179
Hospital Revenue Code	279
Min. Negotiated Rate	$101.25
Max. Negotiated Rate	$101.25
Rate for Payer: Qualcare PPO/HMO/WC	$101.25

JAMSHIDI BONE GRAFT NEEDLE

Facility

$675.00

Hospital Charge Code	270704179
Hospital Revenue Code	279
Min. Negotiated Rate	$19.17
Max. Negotiated Rate	$337.50
Rate for Payer: Aetna Commercial	$256.50
Rate for Payer: Aetna Medicare Advantage	$202.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.12
Rate for Payer: Cigna Commercial	$337.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.50
Rate for Payer: Oxford Commercial	$135.00
Rate for Payer: Qualcare PPO/HMO/WC	$101.25
Rate for Payer: UnitedHealthcare Commercial	$135.00
Rate for Payer: UnitedHealthcare Community & State	$21.33
Rate for Payer: Wellpoint Medicaid Managed Care	$19.17

JAMSHIDI EVOLVE

Facility

$875.00

Hospital Charge Code	270702850
Hospital Revenue Code	278
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) NJ Health	$175.00
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	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Community & State	$27.65
Rate for Payer: Wellpoint Medicaid Managed Care	$24.85

JAMSHIDI EVOLVE

Facility

$875.00

Hospital Charge Code	270702850
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

JAM SHIDI NEEDLE

Facility

$2,250.00

Hospital Charge Code	270705702
Hospital Revenue Code	279
Min. Negotiated Rate	$63.90
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.00
Rate for Payer: Oxford Commercial	$450.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$450.00
Rate for Payer: UnitedHealthcare Community & State	$71.10
Rate for Payer: Wellpoint Medicaid Managed Care	$63.90

JAM SHIDI NEEDLE

Facility

$2,250.00

Hospital Charge Code	270705702
Hospital Revenue Code	279
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

JAMSHIDI NEEDLE 11GX5IN

Facility

$875.00

Hospital Charge Code	270705446
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

Know your out-of-pocket cost for care.

All Charges