Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

KIT HEART RIGHT K0903252

Facility

$105.00

Hospital Charge Code	270658338N
Hospital Revenue Code	271
Min. Negotiated Rate	$15.75
Max. Negotiated Rate	$15.75
Rate for Payer: Qualcare PPO/HMO/WC	$15.75

KIT HEMOVAC 400CC 1/8 2500-000

Facility

$108.00

Hospital Charge Code	270607623
Hospital Revenue Code	272
Min. Negotiated Rate	$3.07
Max. Negotiated Rate	$54.00
Rate for Payer: Aetna Commercial	$41.04
Rate for Payer: Aetna Medicare Advantage	$32.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.54
Rate for Payer: Cigna Commercial	$54.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.08
Rate for Payer: Oxford Commercial	$21.60
Rate for Payer: Qualcare PPO/HMO/WC	$16.20
Rate for Payer: UnitedHealthcare Commercial	$21.60
Rate for Payer: UnitedHealthcare Community & State	$3.41
Rate for Payer: Wellpoint Medicaid Managed Care	$3.07

KIT HEMOVAC 400CC 1/8 2500-000

Facility

$108.00

Hospital Charge Code	270607623
Hospital Revenue Code	272
Min. Negotiated Rate	$16.20
Max. Negotiated Rate	$16.20
Rate for Payer: Qualcare PPO/HMO/WC	$16.20

KIT HIP ARTHO W/ BANANA BLADE

Facility

$1,875.00

Service Code	HCPCS C1776
Hospital Charge Code	270681364
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$453.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

KIT HIP ARTHO W/ BANANA BLADE

Facility

$1,875.00

Service Code	HCPCS C1776
Hospital Charge Code	270681364
Hospital Revenue Code	278
Min. Negotiated Rate	$53.25
Max. Negotiated Rate	$937.50
Rate for Payer: Aetna Commercial	$712.50
Rate for Payer: Aetna Medicare Advantage	$562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.12
Rate for Payer: Cigna Commercial	$937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: Qualcare PPO/HMO/WC	$281.25
Rate for Payer: UnitedHealthcare Community & State	$59.25
Rate for Payer: Wellpoint Medicaid Managed Care	$53.25

KIT HIP ARTHROSCOPY MSTR W/BLD

Facility

$2,250.00

Hospital Charge Code	270675642
Hospital Revenue Code	272
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

KIT HIP ARTHROSCOPY MSTR W/BLD

Facility

$2,250.00

Hospital Charge Code	270675642
Hospital Revenue Code	272
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

KIT HVAC 400 EVACTOR 254000010

Facility

$82.75

Hospital Charge Code	270632891
Hospital Revenue Code	272
Min. Negotiated Rate	$12.41
Max. Negotiated Rate	$12.41
Rate for Payer: Qualcare PPO/HMO/WC	$12.41

KIT HVAC 400 EVACTOR 254000010

Facility

$82.75

Hospital Charge Code	270632891
Hospital Revenue Code	272
Min. Negotiated Rate	$2.35
Max. Negotiated Rate	$41.38
Rate for Payer: Aetna Commercial	$31.45
Rate for Payer: Aetna Medicare Advantage	$24.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.10
Rate for Payer: Cigna Commercial	$41.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.52
Rate for Payer: Oxford Commercial	$16.55
Rate for Payer: Qualcare PPO/HMO/WC	$12.41
Rate for Payer: UnitedHealthcare Commercial	$16.55
Rate for Payer: UnitedHealthcare Community & State	$2.61
Rate for Payer: Wellpoint Medicaid Managed Care	$2.35

KIT IMPLANT ANKLE SYNDESMOSIS

Facility

$425.00

Hospital Charge Code	270655838
Hospital Revenue Code	278
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$102.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

KIT IMPLANT ANKLE SYNDESMOSIS

Facility

$425.00

Hospital Charge Code	270655838
Hospital Revenue Code	278
Min. Negotiated Rate	$12.07
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Community & State	$13.43
Rate for Payer: Wellpoint Medicaid Managed Care	$12.07

KIT IMPLANT BRCE SYST AR1638CP

Facility

$8,099.00

Service Code	HCPCS C1713
Hospital Charge Code	270698671
Hospital Revenue Code	278
Min. Negotiated Rate	$1,214.85
Max. Negotiated Rate	$1,959.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,619.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,959.96
Rate for Payer: Qualcare PPO/HMO/WC	$1,214.85

KIT IMPLANT BRCE SYST AR1638CP

Facility

$8,099.00

Service Code	HCPCS C1713
Hospital Charge Code	270698671
Hospital Revenue Code	278
Min. Negotiated Rate	$230.01
Max. Negotiated Rate	$4,049.50
Rate for Payer: Aetna Commercial	$3,077.62
Rate for Payer: Aetna Medicare Advantage	$2,429.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,065.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,065.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,619.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,065.24
Rate for Payer: Cigna Commercial	$4,049.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,959.96
Rate for Payer: Qualcare PPO/HMO/WC	$1,214.85
Rate for Payer: UnitedHealthcare Community & State	$255.93
Rate for Payer: Wellpoint Medicaid Managed Care	$230.01

KIT INTERNAL BRACE IMPLANT

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270676522
Hospital Revenue Code	278
Min. Negotiated Rate	$152.65
Max. Negotiated Rate	$2,687.50
Rate for Payer: Aetna Commercial	$2,042.50
Rate for Payer: Aetna Medicare Advantage	$1,612.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,370.62
Rate for Payer: Cigna Commercial	$2,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: Qualcare PPO/HMO/WC	$806.25
Rate for Payer: UnitedHealthcare Community & State	$169.85
Rate for Payer: Wellpoint Medicaid Managed Care	$152.65

KIT INTERNAL BRACE IMPLANT

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270676522
Hospital Revenue Code	278
Min. Negotiated Rate	$806.25
Max. Negotiated Rate	$1,300.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: Qualcare PPO/HMO/WC	$806.25

KIT INTERNAL BRACE LIS ANC

Facility

$7,475.00

Hospital Charge Code	270684906
Hospital Revenue Code	272
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,121.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

KIT INTERNAL BRACE LIS ANC

Facility

$7,475.00

Hospital Charge Code	270684906
Hospital Revenue Code	272
Min. Negotiated Rate	$212.29
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,840.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,943.50
Rate for Payer: Oxford Commercial	$1,495.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Commercial	$1,495.00
Rate for Payer: UnitedHealthcare Community & State	$236.21
Rate for Payer: Wellpoint Medicaid Managed Care	$212.29

KIT INTRAGASTRIC ORBERA

Facility

$500.00

Hospital Charge Code	270693543
Hospital Revenue Code	272
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$100.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

KIT INTRAGASTRIC ORBERA

Facility

$500.00

Hospital Charge Code	270693543
Hospital Revenue Code	272
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

KIT INTRODUCER

Facility

$990.35

Hospital Charge Code	270670059
Hospital Revenue Code	272
Min. Negotiated Rate	$28.13
Max. Negotiated Rate	$495.18
Rate for Payer: Aetna Commercial	$376.33
Rate for Payer: Aetna Medicare Advantage	$297.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$252.54
Rate for Payer: Cigna Commercial	$495.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.49
Rate for Payer: Oxford Commercial	$198.07
Rate for Payer: Qualcare PPO/HMO/WC	$148.55
Rate for Payer: UnitedHealthcare Commercial	$198.07
Rate for Payer: UnitedHealthcare Community & State	$31.30
Rate for Payer: Wellpoint Medicaid Managed Care	$28.13

KIT INTRODUCER

Facility

$990.35

Hospital Charge Code	270670059
Hospital Revenue Code	272
Min. Negotiated Rate	$148.55
Max. Negotiated Rate	$148.55
Rate for Payer: Qualcare PPO/HMO/WC	$148.55

KIT INTRODUCER 4 FR

Facility

$90.00

Hospital Charge Code	270685421
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

KIT INTRODUCER 4 FR

Facility

$90.00

Hospital Charge Code	270685421
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

KIT INTRODUCER GASTRO MIC G-18

Facility

$997.45

Hospital Charge Code	270671877
Hospital Revenue Code	272
Min. Negotiated Rate	$149.62
Max. Negotiated Rate	$149.62
Rate for Payer: Qualcare PPO/HMO/WC	$149.62

KIT INTRODUCER GASTRO MIC G-18

Facility

$997.45

Hospital Charge Code	270671877
Hospital Revenue Code	272
Min. Negotiated Rate	$28.33
Max. Negotiated Rate	$498.73
Rate for Payer: Aetna Commercial	$379.03
Rate for Payer: Aetna Medicare Advantage	$299.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$254.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$254.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$254.35
Rate for Payer: Cigna Commercial	$498.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.34
Rate for Payer: Oxford Commercial	$199.49
Rate for Payer: Qualcare PPO/HMO/WC	$149.62
Rate for Payer: UnitedHealthcare Commercial	$199.49
Rate for Payer: UnitedHealthcare Community & State	$31.52
Rate for Payer: Wellpoint Medicaid Managed Care	$28.33

Know your out-of-pocket cost for care.

All Charges