Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

KIT CATH HEMOSPLIT STRT STD 27

Facility

$1,750.00

Service Code	HCPCS C1750
Hospital Charge Code	270655799
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$423.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

KIT CATH HEMOSPLIT STRT STD 27

Facility

$1,750.00

Service Code	HCPCS C1750
Hospital Charge Code	270655799
Hospital Revenue Code	278
Min. Negotiated Rate	$49.70
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Community & State	$55.30
Rate for Payer: Wellpoint Medicaid Managed Care	$49.70

KIT CATH NEPHROMAX BALN 210117

Facility

$1,215.00

Hospital Charge Code	270614843
Hospital Revenue Code	272
Min. Negotiated Rate	$182.25
Max. Negotiated Rate	$182.25
Rate for Payer: Qualcare PPO/HMO/WC	$182.25

KIT CATH NEPHROMAX BALN 210117

Facility

$1,215.00

Hospital Charge Code	270614843
Hospital Revenue Code	272
Min. Negotiated Rate	$34.51
Max. Negotiated Rate	$607.50
Rate for Payer: Aetna Commercial	$461.70
Rate for Payer: Aetna Medicare Advantage	$364.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$309.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$309.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$309.82
Rate for Payer: Cigna Commercial	$607.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$315.90
Rate for Payer: Oxford Commercial	$243.00
Rate for Payer: Qualcare PPO/HMO/WC	$182.25
Rate for Payer: UnitedHealthcare Commercial	$243.00
Rate for Payer: UnitedHealthcare Community & State	$38.39
Rate for Payer: Wellpoint Medicaid Managed Care	$34.51

KIT CATH PERIT CURL 2CUFF 57CM

Facility

$618.41

Hospital Charge Code	270607726
Hospital Revenue Code	270
Min. Negotiated Rate	$92.76
Max. Negotiated Rate	$92.76
Rate for Payer: Qualcare PPO/HMO/WC	$92.76

KIT CATH PERIT CURL 2CUFF 57CM

Facility

$618.41

Hospital Charge Code	270607726
Hospital Revenue Code	270
Min. Negotiated Rate	$17.56
Max. Negotiated Rate	$309.20
Rate for Payer: Aetna Commercial	$235.00
Rate for Payer: Aetna Medicare Advantage	$185.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.69
Rate for Payer: Cigna Commercial	$309.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.79
Rate for Payer: Oxford Commercial	$123.68
Rate for Payer: Qualcare PPO/HMO/WC	$92.76
Rate for Payer: UnitedHealthcare Commercial	$123.68
Rate for Payer: UnitedHealthcare Community & State	$19.54
Rate for Payer: Wellpoint Medicaid Managed Care	$17.56

KIT CHAIR TRIMANO BEACH

Facility

$375.00

Hospital Charge Code	270648819
Hospital Revenue Code	272
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

KIT CHAIR TRIMANO BEACH

Facility

$375.00

Hospital Charge Code	270648819
Hospital Revenue Code	272
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Oxford Commercial	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Commercial	$75.00
Rate for Payer: UnitedHealthcare Community & State	$11.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.65

KIT CLOSURE DEVICE M-CLOSE

Facility

$449.95

Hospital Charge Code	270696983
Hospital Revenue Code	272
Min. Negotiated Rate	$12.78
Max. Negotiated Rate	$224.97
Rate for Payer: Aetna Commercial	$170.98
Rate for Payer: Aetna Medicare Advantage	$134.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.74
Rate for Payer: Cigna Commercial	$224.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.99
Rate for Payer: Oxford Commercial	$89.99
Rate for Payer: Qualcare PPO/HMO/WC	$67.49
Rate for Payer: UnitedHealthcare Commercial	$89.99
Rate for Payer: UnitedHealthcare Community & State	$14.22
Rate for Payer: Wellpoint Medicaid Managed Care	$12.78

KIT CLOSURE DEVICE M-CLOSE

Facility

$449.95

Hospital Charge Code	270696983
Hospital Revenue Code	272
Min. Negotiated Rate	$67.49
Max. Negotiated Rate	$67.49
Rate for Payer: Qualcare PPO/HMO/WC	$67.49

KIT COLOSTOMY/ILEOSTOMY 4

Facility

$14.28

Hospital Charge Code	270654223
Hospital Revenue Code	272
Min. Negotiated Rate	$2.14
Max. Negotiated Rate	$2.14
Rate for Payer: Qualcare PPO/HMO/WC	$2.14

KIT COLOSTOMY/ILEOSTOMY 4

Facility

$14.28

Hospital Charge Code	270654223
Hospital Revenue Code	272
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$7.14
Rate for Payer: Aetna Commercial	$5.43
Rate for Payer: Aetna Medicare Advantage	$4.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.64
Rate for Payer: Cigna Commercial	$7.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.71
Rate for Payer: Oxford Commercial	$2.86
Rate for Payer: Qualcare PPO/HMO/WC	$2.14
Rate for Payer: UnitedHealthcare Commercial	$2.86
Rate for Payer: UnitedHealthcare Community & State	$0.45
Rate for Payer: Wellpoint Medicaid Managed Care	$0.41

KIT CRANIOPLASTIC 43-1050

Facility

$2,760.85

Hospital Charge Code	270600729
Hospital Revenue Code	272
Min. Negotiated Rate	$414.13
Max. Negotiated Rate	$414.13
Rate for Payer: Qualcare PPO/HMO/WC	$414.13

KIT CRANIOPLASTIC 43-1050

Facility

$2,760.85

Hospital Charge Code	270600729
Hospital Revenue Code	272
Min. Negotiated Rate	$78.41
Max. Negotiated Rate	$1,380.42
Rate for Payer: Aetna Commercial	$1,049.12
Rate for Payer: Aetna Medicare Advantage	$828.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$704.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$704.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$704.02
Rate for Payer: Cigna Commercial	$1,380.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$717.82
Rate for Payer: Oxford Commercial	$552.17
Rate for Payer: Qualcare PPO/HMO/WC	$414.13
Rate for Payer: UnitedHealthcare Commercial	$552.17
Rate for Payer: UnitedHealthcare Community & State	$87.24
Rate for Payer: Wellpoint Medicaid Managed Care	$78.41

KIT CURETTE TITANIUM PROBE

Facility

$2,225.00

Hospital Charge Code	270663201
Hospital Revenue Code	272
Min. Negotiated Rate	$63.19
Max. Negotiated Rate	$1,112.50
Rate for Payer: Aetna Commercial	$845.50
Rate for Payer: Aetna Medicare Advantage	$667.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$567.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$567.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$567.38
Rate for Payer: Cigna Commercial	$1,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$578.50
Rate for Payer: Oxford Commercial	$445.00
Rate for Payer: Qualcare PPO/HMO/WC	$333.75
Rate for Payer: UnitedHealthcare Commercial	$445.00
Rate for Payer: UnitedHealthcare Community & State	$70.31
Rate for Payer: Wellpoint Medicaid Managed Care	$63.19

KIT CURETTE TITANIUM PROBE

Facility

$2,225.00

Hospital Charge Code	270663201
Hospital Revenue Code	272
Min. Negotiated Rate	$333.75
Max. Negotiated Rate	$333.75
Rate for Payer: Qualcare PPO/HMO/WC	$333.75

KIT CUSTOM INFLATION

Facility

$175.00

Hospital Charge Code	270663111S
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

KIT CUSTOM INFLATION

Facility

$175.00

Hospital Charge Code	270663111
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

KIT CUSTOM INFLATION

Facility

$175.00

Hospital Charge Code	270663111S
Hospital Revenue Code	272
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

KIT CUSTOM INFLATION

Facility

$175.00

Hospital Charge Code	270663111
Hospital Revenue Code	272
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

KIT CUSTOM INFLATION (PTCA)

Facility

$150.00

Hospital Charge Code	270646784C
Hospital Revenue Code	272
Min. Negotiated Rate	$4.26
Max. Negotiated Rate	$75.00
Rate for Payer: Aetna Commercial	$57.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.00
Rate for Payer: Oxford Commercial	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$30.00
Rate for Payer: UnitedHealthcare Community & State	$4.74
Rate for Payer: Wellpoint Medicaid Managed Care	$4.26

KIT CUSTOM INFLATION (PTCA)

Facility

$150.00

Hospital Charge Code	270646784N
Hospital Revenue Code	272
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

KIT CUSTOM INFLATION (PTCA)

Facility

$150.00

Hospital Charge Code	270646784C
Hospital Revenue Code	272
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

KIT CUSTOM INFLATION (PTCA)

Facility

$150.00

Hospital Charge Code	270646784N
Hospital Revenue Code	272
Min. Negotiated Rate	$4.26
Max. Negotiated Rate	$75.00
Rate for Payer: Aetna Commercial	$57.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.00
Rate for Payer: Oxford Commercial	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$30.00
Rate for Payer: UnitedHealthcare Community & State	$4.74
Rate for Payer: Wellpoint Medicaid Managed Care	$4.26

KIT DISP FOR FIBERTAK RC

Facility

$975.00

Hospital Charge Code	270683557
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

Know your out-of-pocket cost for care.

All Charges