Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

KIT FEMORAL PREP SZ 5 CR

Facility

$2,340.00

Hospital Charge Code	270698152
Hospital Revenue Code	272
Min. Negotiated Rate	$351.00
Max. Negotiated Rate	$351.00
Rate for Payer: Qualcare PPO/HMO/WC	$351.00

KIT FEMORAL/TIBIAL CHECKPT

Facility

$252.50

Hospital Charge Code	270668482
Hospital Revenue Code	272
Min. Negotiated Rate	$37.88
Max. Negotiated Rate	$37.88
Rate for Payer: Qualcare PPO/HMO/WC	$37.88

KIT FEMORAL/TIBIAL CHECKPT

Facility

$252.50

Hospital Charge Code	270668482
Hospital Revenue Code	272
Min. Negotiated Rate	$7.17
Max. Negotiated Rate	$126.25
Rate for Payer: Aetna Commercial	$95.95
Rate for Payer: Aetna Medicare Advantage	$75.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.39
Rate for Payer: Cigna Commercial	$126.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.65
Rate for Payer: Oxford Commercial	$50.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.88
Rate for Payer: UnitedHealthcare Commercial	$50.50
Rate for Payer: UnitedHealthcare Community & State	$7.98
Rate for Payer: Wellpoint Medicaid Managed Care	$7.17

KIT FHL IMPLANT 6.25 MM SUTURE

Facility

$1,245.83

Hospital Charge Code	270692400
Hospital Revenue Code	272
Min. Negotiated Rate	$186.87
Max. Negotiated Rate	$186.87
Rate for Payer: Qualcare PPO/HMO/WC	$186.87

KIT FHL IMPLANT 6.25 MM SUTURE

Facility

$1,245.83

Hospital Charge Code	270692400
Hospital Revenue Code	272
Min. Negotiated Rate	$35.38
Max. Negotiated Rate	$622.91
Rate for Payer: Aetna Commercial	$473.42
Rate for Payer: Aetna Medicare Advantage	$373.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$317.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$317.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$317.69
Rate for Payer: Cigna Commercial	$622.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$323.92
Rate for Payer: Oxford Commercial	$249.17
Rate for Payer: Qualcare PPO/HMO/WC	$186.87
Rate for Payer: UnitedHealthcare Commercial	$249.17
Rate for Payer: UnitedHealthcare Community & State	$39.37
Rate for Payer: Wellpoint Medicaid Managed Care	$35.38

KIT FHL IMPLANT SYSTEM 7.0MM

Facility

$1,245.83

Hospital Charge Code	270692401
Hospital Revenue Code	272
Min. Negotiated Rate	$35.38
Max. Negotiated Rate	$622.91
Rate for Payer: Aetna Commercial	$473.42
Rate for Payer: Aetna Medicare Advantage	$373.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$317.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$317.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$317.69
Rate for Payer: Cigna Commercial	$622.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$323.92
Rate for Payer: Oxford Commercial	$249.17
Rate for Payer: Qualcare PPO/HMO/WC	$186.87
Rate for Payer: UnitedHealthcare Commercial	$249.17
Rate for Payer: UnitedHealthcare Community & State	$39.37
Rate for Payer: Wellpoint Medicaid Managed Care	$35.38

KIT FHL IMPLANT SYSTEM 7.0MM

Facility

$1,245.83

Hospital Charge Code	270692401
Hospital Revenue Code	272
Min. Negotiated Rate	$186.87
Max. Negotiated Rate	$186.87
Rate for Payer: Qualcare PPO/HMO/WC	$186.87

KIT FIRST FRACTURE LNG BLIS-PK

Facility

$15,750.00

Hospital Charge Code	270670663
Hospital Revenue Code	272
Min. Negotiated Rate	$2,362.50
Max. Negotiated Rate	$2,362.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,362.50

KIT FIRST FRACTURE LNG BLIS-PK

Facility

$15,750.00

Hospital Charge Code	270670663
Hospital Revenue Code	272
Min. Negotiated Rate	$447.30
Max. Negotiated Rate	$7,875.00
Rate for Payer: Aetna Commercial	$5,985.00
Rate for Payer: Aetna Medicare Advantage	$4,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,016.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,016.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,016.25
Rate for Payer: Cigna Commercial	$7,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,095.00
Rate for Payer: Oxford Commercial	$3,150.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,362.50
Rate for Payer: UnitedHealthcare Commercial	$3,150.00
Rate for Payer: UnitedHealthcare Community & State	$497.70
Rate for Payer: Wellpoint Medicaid Managed Care	$447.30

KIT FIRST FRACTURE SH BLIS-PK

Facility

$15,750.00

Hospital Charge Code	270670664
Hospital Revenue Code	272
Min. Negotiated Rate	$2,362.50
Max. Negotiated Rate	$2,362.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,362.50

KIT FIRST FRACTURE SH BLIS-PK

Facility

$15,750.00

Hospital Charge Code	270670664
Hospital Revenue Code	272
Min. Negotiated Rate	$447.30
Max. Negotiated Rate	$7,875.00
Rate for Payer: Aetna Commercial	$5,985.00
Rate for Payer: Aetna Medicare Advantage	$4,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,016.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,016.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,016.25
Rate for Payer: Cigna Commercial	$7,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,095.00
Rate for Payer: Oxford Commercial	$3,150.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,362.50
Rate for Payer: UnitedHealthcare Commercial	$3,150.00
Rate for Payer: UnitedHealthcare Community & State	$497.70
Rate for Payer: Wellpoint Medicaid Managed Care	$447.30

KIT FIRSTPASS PASSER STR

Facility

$5,830.00

Hospital Charge Code	270681093
Hospital Revenue Code	272
Min. Negotiated Rate	$874.50
Max. Negotiated Rate	$874.50
Rate for Payer: Qualcare PPO/HMO/WC	$874.50

KIT FIRSTPASS PASSER STR

Facility

$5,830.00

Hospital Charge Code	270681093
Hospital Revenue Code	272
Min. Negotiated Rate	$165.57
Max. Negotiated Rate	$2,915.00
Rate for Payer: Aetna Commercial	$2,215.40
Rate for Payer: Aetna Medicare Advantage	$1,749.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,486.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,486.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,486.65
Rate for Payer: Cigna Commercial	$2,915.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,515.80
Rate for Payer: Oxford Commercial	$1,166.00
Rate for Payer: Qualcare PPO/HMO/WC	$874.50
Rate for Payer: UnitedHealthcare Commercial	$1,166.00
Rate for Payer: UnitedHealthcare Community & State	$184.23
Rate for Payer: Wellpoint Medicaid Managed Care	$165.57

KIT FIXATION FUSEFORCE 18X16MM

Facility

$6,975.00

Hospital Charge Code	27069233
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$1,687.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

KIT FIXATION FUSEFORCE 18X16MM

Facility

$6,975.00

Hospital Charge Code	27069233
Hospital Revenue Code	278
Min. Negotiated Rate	$198.09
Max. Negotiated Rate	$3,487.50
Rate for Payer: Aetna Commercial	$2,650.50
Rate for Payer: Aetna Medicare Advantage	$2,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,778.62
Rate for Payer: Cigna Commercial	$3,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25
Rate for Payer: UnitedHealthcare Community & State	$220.41
Rate for Payer: Wellpoint Medicaid Managed Care	$198.09

KIT FLIPCUTTER II T ROPE RT IM

Facility

$3,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270682534
Hospital Revenue Code	278
Min. Negotiated Rate	$95.85
Max. Negotiated Rate	$1,687.50
Rate for Payer: Aetna Commercial	$1,282.50
Rate for Payer: Aetna Medicare Advantage	$1,012.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$860.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$860.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$860.62
Rate for Payer: Cigna Commercial	$1,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$816.75
Rate for Payer: Qualcare PPO/HMO/WC	$506.25
Rate for Payer: UnitedHealthcare Community & State	$106.65
Rate for Payer: Wellpoint Medicaid Managed Care	$95.85

KIT FLIPCUTTER II T ROPE RT IM

Facility

$3,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270682534
Hospital Revenue Code	278
Min. Negotiated Rate	$506.25
Max. Negotiated Rate	$816.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$675.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$816.75
Rate for Payer: Qualcare PPO/HMO/WC	$506.25

KIT FRACTURE IVAS 11G

Facility

$13,705.00

Hospital Charge Code	270692056
Hospital Revenue Code	272
Min. Negotiated Rate	$389.22
Max. Negotiated Rate	$6,852.50
Rate for Payer: Aetna Commercial	$5,207.90
Rate for Payer: Aetna Medicare Advantage	$4,111.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,494.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,494.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,494.78
Rate for Payer: Cigna Commercial	$6,852.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,563.30
Rate for Payer: Oxford Commercial	$2,741.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,055.75
Rate for Payer: UnitedHealthcare Commercial	$2,741.00
Rate for Payer: UnitedHealthcare Community & State	$433.08
Rate for Payer: Wellpoint Medicaid Managed Care	$389.22

KIT FRACTURE IVAS 11G

Facility

$13,705.00

Hospital Charge Code	270692056
Hospital Revenue Code	272
Min. Negotiated Rate	$2,055.75
Max. Negotiated Rate	$2,055.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,055.75

KIT FRACTURE STABILIT LONG

Facility

$16,125.00

Hospital Charge Code	270670687
Hospital Revenue Code	272
Min. Negotiated Rate	$457.95
Max. Negotiated Rate	$8,062.50
Rate for Payer: Aetna Commercial	$6,127.50
Rate for Payer: Aetna Medicare Advantage	$4,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,111.88
Rate for Payer: Cigna Commercial	$8,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,192.50
Rate for Payer: Oxford Commercial	$3,225.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75
Rate for Payer: UnitedHealthcare Commercial	$3,225.00
Rate for Payer: UnitedHealthcare Community & State	$509.55
Rate for Payer: Wellpoint Medicaid Managed Care	$457.95

KIT FRACTURE STABILIT LONG

Facility

$16,125.00

Hospital Charge Code	270670687
Hospital Revenue Code	272
Min. Negotiated Rate	$2,418.75
Max. Negotiated Rate	$2,418.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75

KIT FRACTURE STABILIT SHORT

Facility

$16,125.00

Hospital Charge Code	270670686
Hospital Revenue Code	272
Min. Negotiated Rate	$2,418.75
Max. Negotiated Rate	$2,418.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75

KIT FRACTURE STABILIT SHORT

Facility

$16,125.00

Hospital Charge Code	270670686
Hospital Revenue Code	272
Min. Negotiated Rate	$457.95
Max. Negotiated Rate	$8,062.50
Rate for Payer: Aetna Commercial	$6,127.50
Rate for Payer: Aetna Medicare Advantage	$4,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,111.88
Rate for Payer: Cigna Commercial	$8,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,192.50
Rate for Payer: Oxford Commercial	$3,225.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75
Rate for Payer: UnitedHealthcare Commercial	$3,225.00
Rate for Payer: UnitedHealthcare Community & State	$509.55
Rate for Payer: Wellpoint Medicaid Managed Care	$457.95

KIT GAST PEG SAFEPULL 20F 6672

Facility

$562.50

Hospital Charge Code	270632927
Hospital Revenue Code	272
Min. Negotiated Rate	$15.97
Max. Negotiated Rate	$281.25
Rate for Payer: Aetna Commercial	$213.75
Rate for Payer: Aetna Medicare Advantage	$168.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.44
Rate for Payer: Cigna Commercial	$281.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.25
Rate for Payer: Oxford Commercial	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$84.38
Rate for Payer: UnitedHealthcare Commercial	$112.50
Rate for Payer: UnitedHealthcare Community & State	$17.77
Rate for Payer: Wellpoint Medicaid Managed Care	$15.97

KIT GAST PEG SAFEPULL 20F 6672

Facility

$562.50

Hospital Charge Code	270632927
Hospital Revenue Code	272
Min. Negotiated Rate	$84.38
Max. Negotiated Rate	$84.38
Rate for Payer: Qualcare PPO/HMO/WC	$84.38

Know your out-of-pocket cost for care.

All Charges