Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

JUGGERKNOT 2.0 DISP KIT

Facility

$2,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270681525
Hospital Revenue Code	278
Min. Negotiated Rate	$75.26
Max. Negotiated Rate	$1,325.00
Rate for Payer: Aetna Commercial	$1,007.00
Rate for Payer: Aetna Medicare Advantage	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$675.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$675.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$675.75
Rate for Payer: Cigna Commercial	$1,325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$641.30
Rate for Payer: Qualcare PPO/HMO/WC	$397.50
Rate for Payer: UnitedHealthcare Community & State	$83.74
Rate for Payer: Wellpoint Medicaid Managed Care	$75.26

JUMBO BIOSPY FORCEPS

Facility

$35.00

Hospital Charge Code	270701121
Hospital Revenue Code	272
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$17.50
Rate for Payer: Aetna Commercial	$13.30
Rate for Payer: Aetna Medicare Advantage	$10.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.93
Rate for Payer: Cigna Commercial	$17.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.10
Rate for Payer: Oxford Commercial	$7.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.25
Rate for Payer: UnitedHealthcare Commercial	$7.00
Rate for Payer: UnitedHealthcare Community & State	$1.11
Rate for Payer: Wellpoint Medicaid Managed Care	$0.99

JUMBO BIOSPY FORCEPS

Facility

$35.00

Hospital Charge Code	270701121
Hospital Revenue Code	272
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$5.25
Rate for Payer: Qualcare PPO/HMO/WC	$5.25

JUMBO FORCEPS

Facility

$116.00

Hospital Charge Code	270325681
Hospital Revenue Code	272
Min. Negotiated Rate	$17.40
Max. Negotiated Rate	$17.40
Rate for Payer: Qualcare PPO/HMO/WC	$17.40

JUMBO FORCEPS

Facility

$116.00

Hospital Charge Code	270325681
Hospital Revenue Code	272
Min. Negotiated Rate	$3.29
Max. Negotiated Rate	$58.00
Rate for Payer: Aetna Commercial	$44.08
Rate for Payer: Aetna Medicare Advantage	$34.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.58
Rate for Payer: Cigna Commercial	$58.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.16
Rate for Payer: Oxford Commercial	$23.20
Rate for Payer: Qualcare PPO/HMO/WC	$17.40
Rate for Payer: UnitedHealthcare Commercial	$23.20
Rate for Payer: UnitedHealthcare Community & State	$3.67
Rate for Payer: Wellpoint Medicaid Managed Care	$3.29

JUMPSTART KIT 4x4

Facility

$125.00

Hospital Charge Code	270676731
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

JUMPSTART KIT 4x4

Facility

$125.00

Hospital Charge Code	270676731
Hospital Revenue Code	272
Min. Negotiated Rate	$3.55
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$25.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$25.00
Rate for Payer: UnitedHealthcare Community & State	$3.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3.55

JURGAN BABY PIN BALL 0.9MM

Facility

$175.00

Hospital Charge Code	270673129
Hospital Revenue Code	272
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

JURGAN BABY PIN BALL 0.9MM

Facility

$175.00

Hospital Charge Code	270673129
Hospital Revenue Code	272
Min. Negotiated Rate	$4.97
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.50
Rate for Payer: Oxford Commercial	$35.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$35.00
Rate for Payer: UnitedHealthcare Community & State	$5.53
Rate for Payer: Wellpoint Medicaid Managed Care	$4.97

JUVENO FEM HIPSYS SZ 5

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270703609
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

JUVENO FEM HIPSYS SZ 5

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270703609
Hospital Revenue Code	278
Min. Negotiated Rate	$170.40
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$189.60
Rate for Payer: Wellpoint Medicaid Managed Care	$170.40

KAPPA/LAMBDA,FREE W/REFL I

Facility

$93.45

Service Code	HCPCS 8388391
Hospital Charge Code	39990015A
Hospital Revenue Code	301
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$35.51
Rate for Payer: Aetna Medicare Advantage	$28.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.83
Rate for Payer: Cigna Commercial	$46.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.30
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.02
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$2.95
Rate for Payer: Wellpoint Medicaid Managed Care	$2.65

KAPPA/LAMBDA,FREE W/REFL I

Facility

$93.45

Service Code	HCPCS 8388391
Hospital Charge Code	39990015A
Hospital Revenue Code	301
Min. Negotiated Rate	$14.02
Max. Negotiated Rate	$14.02
Rate for Payer: Qualcare PPO/HMO/WC	$14.02

KAPPA/LAMBDA,FREE W/REFL II

Facility

$93.45

Service Code	HCPCS 8388391
Hospital Charge Code	39990015B
Hospital Revenue Code	301
Min. Negotiated Rate	$14.02
Max. Negotiated Rate	$14.02
Rate for Payer: Qualcare PPO/HMO/WC	$14.02

KAPPA/LAMBDA,FREE W/REFL II

Facility

$93.45

Service Code	HCPCS 8388391
Hospital Charge Code	39990015B
Hospital Revenue Code	301
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$35.51
Rate for Payer: Aetna Medicare Advantage	$28.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.83
Rate for Payer: Cigna Commercial	$46.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.30
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.02
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$2.95
Rate for Payer: Wellpoint Medicaid Managed Care	$2.65

KAPPA LIGHT CHAIN,FREE

Facility

$390.00

Service Code	HCPCS 83883
Hospital Charge Code	39900111
Hospital Revenue Code	301
Min. Negotiated Rate	$10.88
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$36.99
Rate for Payer: Aetna Medicare Advantage	$44.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.33
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$13.60
Rate for Payer: Clover Medicare Advantage	$12.92
Rate for Payer: EmblemHealth Commercial	$40.80
Rate for Payer: Humana Medicare Advantage	$14.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.60
Rate for Payer: Wellcare Medicare Advantage	$13.60
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

KAPPA LIGHT CHAIN,FREE

Facility

$390.00

Service Code	HCPCS 83883
Hospital Charge Code	39900111
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

KCENTRA PER IU

Facility

$18.56

Service Code	HCPCS J7168
Hospital Charge Code	606390086
Hospital Revenue Code	636
Min. Negotiated Rate	$2.78
Max. Negotiated Rate	$4.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.49
Rate for Payer: Qualcare PPO/HMO/WC	$2.78

KCENTRA PER IU

Facility

$18.56

Service Code	HCPCS J7168
Hospital Charge Code	606390086
Hospital Revenue Code	636
Min. Negotiated Rate	$0.53
Max. Negotiated Rate	$7.44
Rate for Payer: Aetna Commercial	$5.58
Rate for Payer: Aetna Medicare Advantage	$6.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.44
Rate for Payer: Cigna Medicare Advantage	$2.05
Rate for Payer: Clover Medicare Advantage	$1.95
Rate for Payer: EmblemHealth Commercial	$6.15
Rate for Payer: Humana Medicare Advantage	$2.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.49
Rate for Payer: Qualcare PPO/HMO/WC	$2.78
Rate for Payer: UnitedHealthcare Community & State	$0.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.05
Rate for Payer: Wellcare Medicare Advantage	$2.05
Rate for Payer: Wellpoint Medicaid Managed Care	$0.53

KCL 40MEQ 1L NS

Facility

$21.98

Service Code	NDC 990711609
Hospital Charge Code	6063943121
Hospital Revenue Code	258
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$10.99
Rate for Payer: Aetna Commercial	$8.35
Rate for Payer: Aetna Medicare Advantage	$6.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.60
Rate for Payer: Cigna Commercial	$10.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.71
Rate for Payer: Oxford Commercial	$4.40
Rate for Payer: Qualcare PPO/HMO/WC	$3.30
Rate for Payer: UnitedHealthcare Commercial	$4.40
Rate for Payer: UnitedHealthcare Community & State	$0.69
Rate for Payer: Wellpoint Medicaid Managed Care	$0.62

KCL 40MEQ 1L NS

Facility

$21.98

Service Code	NDC 990711609
Hospital Charge Code	6063943121
Hospital Revenue Code	258
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$3.30
Rate for Payer: Qualcare PPO/HMO/WC	$3.30

K-DUR/10MEQ/TAB

Facility

$4.00

Service Code	NDC 378456177
Hospital Charge Code	60633227
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

K-DUR/10MEQ/TAB

Facility

$4.00

Service Code	NDC 378456177
Hospital Charge Code	60633227
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

KEDRAB 1500UNITS/10ML

Facility

$27,362.06

Service Code	HCPCS 90377
Hospital Charge Code	606390343
Hospital Revenue Code	636
Min. Negotiated Rate	$230.07
Max. Negotiated Rate	$6,621.62
Rate for Payer: Aetna Commercial	$658.73
Rate for Payer: Aetna Medicare Advantage	$784.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$878.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$878.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$242.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$256.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$878.51
Rate for Payer: Cigna Medicare Advantage	$242.18
Rate for Payer: Clover Medicare Advantage	$230.07
Rate for Payer: EmblemHealth Commercial	$726.54
Rate for Payer: Humana Medicare Advantage	$249.45
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$242.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,621.62
Rate for Payer: Qualcare PPO/HMO/WC	$4,104.31
Rate for Payer: UnitedHealthcare Community & State	$864.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$242.18
Rate for Payer: Wellcare Medicare Advantage	$242.18
Rate for Payer: Wellpoint Medicaid Managed Care	$777.08

KEDRAB 1500UNITS/10ML

Facility

$27,362.06

Service Code	HCPCS 90377
Hospital Charge Code	606390343
Hospital Revenue Code	636
Min. Negotiated Rate	$4,104.31
Max. Negotiated Rate	$6,621.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,621.62
Rate for Payer: Qualcare PPO/HMO/WC	$4,104.31

Know your out-of-pocket cost for care.

All Charges