Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

KIT INTRODUCER GASTRO MIC G-18

Facility

$997.45

Hospital Charge Code	270671877N
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

KIT INTRODUCER GASTRO MIC G-18

Facility

$997.45

Hospital Charge Code	270671877N
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 MIC G16 98422

Facility

$995.00

Hospital Charge Code	270672031N
Hospital Revenue Code	272
Min. Negotiated Rate	$149.25
Max. Negotiated Rate	$149.25
Rate for Payer: Qualcare PPO/HMO/WC	$149.25

KIT INTRODUCER MIC G16 98422

Facility

$997.45

Hospital Charge Code	270672031
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 MIC G16 98422

Facility

$997.45

Hospital Charge Code	270672031
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

KIT INTRODUCER MIC G16 98422

Facility

$997.45

Hospital Charge Code	270672031S
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 MIC G16 98422

Facility

$997.45

Hospital Charge Code	270672031S
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

KIT INTRODUCER MIC G16 98422

Facility

$995.00

Hospital Charge Code	270672031N
Hospital Revenue Code	272
Min. Negotiated Rate	$28.26
Max. Negotiated Rate	$497.50
Rate for Payer: Aetna Commercial	$378.10
Rate for Payer: Aetna Medicare Advantage	$298.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.72
Rate for Payer: Cigna Commercial	$497.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.70
Rate for Payer: Oxford Commercial	$199.00
Rate for Payer: Qualcare PPO/HMO/WC	$149.25
Rate for Payer: UnitedHealthcare Commercial	$199.00
Rate for Payer: UnitedHealthcare Community & State	$31.44
Rate for Payer: Wellpoint Medicaid Managed Care	$28.26

KIT INTRODUCER MINI ACCESS

Facility

$330.00

Hospital Charge Code	270659650
Hospital Revenue Code	272
Min. Negotiated Rate	$9.37
Max. Negotiated Rate	$165.00
Rate for Payer: Aetna Commercial	$125.40
Rate for Payer: Aetna Medicare Advantage	$99.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.15
Rate for Payer: Cigna Commercial	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.80
Rate for Payer: Oxford Commercial	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.50
Rate for Payer: UnitedHealthcare Commercial	$66.00
Rate for Payer: UnitedHealthcare Community & State	$10.43
Rate for Payer: Wellpoint Medicaid Managed Care	$9.37

KIT INTRODUCER MINI ACCESS

Facility

$325.00

Hospital Charge Code	270659650N
Hospital Revenue Code	272
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

KIT INTRODUCER MINI ACCESS

Facility

$330.00

Hospital Charge Code	270659650S
Hospital Revenue Code	272
Min. Negotiated Rate	$9.37
Max. Negotiated Rate	$165.00
Rate for Payer: Aetna Commercial	$125.40
Rate for Payer: Aetna Medicare Advantage	$99.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.15
Rate for Payer: Cigna Commercial	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.80
Rate for Payer: Oxford Commercial	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.50
Rate for Payer: UnitedHealthcare Commercial	$66.00
Rate for Payer: UnitedHealthcare Community & State	$10.43
Rate for Payer: Wellpoint Medicaid Managed Care	$9.37

KIT INTRODUCER MINI ACCESS

Facility

$330.00

Hospital Charge Code	270659650
Hospital Revenue Code	272
Min. Negotiated Rate	$49.50
Max. Negotiated Rate	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$49.50

KIT INTRODUCER MINI ACCESS

Facility

$330.00

Hospital Charge Code	270659650S
Hospital Revenue Code	272
Min. Negotiated Rate	$49.50
Max. Negotiated Rate	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$49.50

KIT INTRODUCER MINI ACCESS

Facility

$325.00

Hospital Charge Code	270659650N
Hospital Revenue Code	272
Min. Negotiated Rate	$9.23
Max. Negotiated Rate	$162.50
Rate for Payer: Aetna Commercial	$123.50
Rate for Payer: Aetna Medicare Advantage	$97.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.88
Rate for Payer: Cigna Commercial	$162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.50
Rate for Payer: Oxford Commercial	$65.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.75
Rate for Payer: UnitedHealthcare Commercial	$65.00
Rate for Payer: UnitedHealthcare Community & State	$10.27
Rate for Payer: Wellpoint Medicaid Managed Care	$9.23

KIT IV START

Facility

$5.00

Hospital Charge Code	270649637S
Hospital Revenue Code	272
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.90
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.30
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$1.00
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

KIT IV START

Facility

$5.00

Hospital Charge Code	270649637N
Hospital Revenue Code	272
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.90
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.30
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$1.00
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

KIT IV START

Facility

$5.00

Hospital Charge Code	270649637
Hospital Revenue Code	270
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

KIT IV START

Facility

$5.00

Hospital Charge Code	270649637S
Hospital Revenue Code	272
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

KIT IV START

Facility

$5.00

Hospital Charge Code	270649637N
Hospital Revenue Code	272
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

KIT IV START

Facility

$5.00

Hospital Charge Code	270649637
Hospital Revenue Code	270
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.90
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.30
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$1.00
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

KIT JOINT PREP ORTHOLOC 2

Facility

$2,520.00

Hospital Charge Code	270697011
Hospital Revenue Code	272
Min. Negotiated Rate	$378.00
Max. Negotiated Rate	$378.00
Rate for Payer: Qualcare PPO/HMO/WC	$378.00

KIT JOINT PREP ORTHOLOC 2

Facility

$2,520.00

Hospital Charge Code	270697011
Hospital Revenue Code	272
Min. Negotiated Rate	$71.57
Max. Negotiated Rate	$1,260.00
Rate for Payer: Aetna Commercial	$957.60
Rate for Payer: Aetna Medicare Advantage	$756.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$642.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$642.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$642.60
Rate for Payer: Cigna Commercial	$1,260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$655.20
Rate for Payer: Oxford Commercial	$504.00
Rate for Payer: Qualcare PPO/HMO/WC	$378.00
Rate for Payer: UnitedHealthcare Commercial	$504.00
Rate for Payer: UnitedHealthcare Community & State	$79.63
Rate for Payer: Wellpoint Medicaid Managed Care	$71.57

KIT KCL DONUT

Facility

$151.00

Hospital Charge Code	270331415
Hospital Revenue Code	272
Min. Negotiated Rate	$4.29
Max. Negotiated Rate	$75.50
Rate for Payer: Aetna Commercial	$57.38
Rate for Payer: Aetna Medicare Advantage	$45.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.51
Rate for Payer: Cigna Commercial	$75.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.26
Rate for Payer: Oxford Commercial	$30.20
Rate for Payer: Qualcare PPO/HMO/WC	$22.65
Rate for Payer: UnitedHealthcare Commercial	$30.20
Rate for Payer: UnitedHealthcare Community & State	$4.77
Rate for Payer: Wellpoint Medicaid Managed Care	$4.29

KIT KCL DONUT

Facility

$151.00

Hospital Charge Code	270331415
Hospital Revenue Code	272
Min. Negotiated Rate	$22.65
Max. Negotiated Rate	$22.65
Rate for Payer: Qualcare PPO/HMO/WC	$22.65

KIT KNOTLESS HIP

Facility

$2,750.00

Hospital Charge Code	270687983
Hospital Revenue Code	272
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

Know your out-of-pocket cost for care.

All Charges