Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

KIT NAIL IM VALOR LT 10X250MM

Facility

$16,205.00

Service Code	HCPCS C1713
Hospital Charge Code	270700406
Hospital Revenue Code	278
Min. Negotiated Rate	$2,430.75
Max. Negotiated Rate	$3,921.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,241.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,921.61
Rate for Payer: Qualcare PPO/HMO/WC	$2,430.75

KIT NAIL LONG R1.5 TI LEFT

Facility

$13,061.10

Service Code	HCPCS C1713
Hospital Charge Code	270672766
Hospital Revenue Code	278
Min. Negotiated Rate	$370.94
Max. Negotiated Rate	$6,530.55
Rate for Payer: Aetna Commercial	$4,963.22
Rate for Payer: Aetna Medicare Advantage	$3,918.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,330.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,330.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,612.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,330.58
Rate for Payer: Cigna Commercial	$6,530.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,160.79
Rate for Payer: Qualcare PPO/HMO/WC	$1,959.16
Rate for Payer: UnitedHealthcare Community & State	$412.73
Rate for Payer: Wellpoint Medicaid Managed Care	$370.94

KIT NAIL LONG R1.5 TI LEFT

Facility

$13,061.10

Service Code	HCPCS C1713
Hospital Charge Code	270672766
Hospital Revenue Code	278
Min. Negotiated Rate	$1,959.16
Max. Negotiated Rate	$3,160.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,612.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,160.79
Rate for Payer: Qualcare PPO/HMO/WC	$1,959.16

KIT NANONEEDLE HIGHFLOW 125MM

Facility

$960.00

Service Code	HCPCS A4649
Hospital Charge Code	270699065
Hospital Revenue Code	272
Min. Negotiated Rate	$144.00
Max. Negotiated Rate	$144.00
Rate for Payer: Qualcare PPO/HMO/WC	$144.00

KIT NANONEEDLE HIGHFLOW 125MM

Facility

$960.00

Service Code	HCPCS A4649
Hospital Charge Code	270699065
Hospital Revenue Code	272
Min. Negotiated Rate	$27.26
Max. Negotiated Rate	$480.00
Rate for Payer: Aetna Commercial	$364.80
Rate for Payer: Aetna Medicare Advantage	$288.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$244.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$244.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$244.80
Rate for Payer: Cigna Commercial	$480.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.60
Rate for Payer: Oxford Commercial	$192.00
Rate for Payer: Qualcare PPO/HMO/WC	$144.00
Rate for Payer: UnitedHealthcare Commercial	$192.00
Rate for Payer: UnitedHealthcare Community & State	$30.34
Rate for Payer: Wellpoint Medicaid Managed Care	$27.26

KIT NERVE BLOCK 22X8

Facility

$75.35

Hospital Charge Code	270669572
Hospital Revenue Code	272
Min. Negotiated Rate	$11.30
Max. Negotiated Rate	$11.30
Rate for Payer: Qualcare PPO/HMO/WC	$11.30

KIT NERVE BLOCK 22X8

Facility

$75.35

Hospital Charge Code	270669572
Hospital Revenue Code	272
Min. Negotiated Rate	$2.14
Max. Negotiated Rate	$37.67
Rate for Payer: Aetna Commercial	$28.63
Rate for Payer: Aetna Medicare Advantage	$22.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.21
Rate for Payer: Cigna Commercial	$37.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.59
Rate for Payer: Oxford Commercial	$15.07
Rate for Payer: Qualcare PPO/HMO/WC	$11.30
Rate for Payer: UnitedHealthcare Commercial	$15.07
Rate for Payer: UnitedHealthcare Community & State	$2.38
Rate for Payer: Wellpoint Medicaid Managed Care	$2.14

KIT NERVE STIM NERVEANA DRAGON

Facility

$5,750.00

Service Code	HCPCS A4649
Hospital Charge Code	270695163
Hospital Revenue Code	272
Min. Negotiated Rate	$862.50
Max. Negotiated Rate	$862.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

KIT NERVE STIM NERVEANA DRAGON

Facility

$5,750.00

Service Code	HCPCS A4649
Hospital Charge Code	270695163
Hospital Revenue Code	272
Min. Negotiated Rate	$163.30
Max. Negotiated Rate	$2,875.00
Rate for Payer: Aetna Commercial	$2,185.00
Rate for Payer: Aetna Medicare Advantage	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,466.25
Rate for Payer: Cigna Commercial	$2,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,495.00
Rate for Payer: Oxford Commercial	$1,150.00
Rate for Payer: Qualcare PPO/HMO/WC	$862.50
Rate for Payer: UnitedHealthcare Commercial	$1,150.00
Rate for Payer: UnitedHealthcare Community & State	$181.70
Rate for Payer: Wellpoint Medicaid Managed Care	$163.30

KIT ONYX 18 AVM

Facility

$15,475.00

Service Code	HCPCS C1887
Hospital Charge Code	270685187
Hospital Revenue Code	278
Min. Negotiated Rate	$439.49
Max. Negotiated Rate	$7,737.50
Rate for Payer: Aetna Commercial	$5,880.50
Rate for Payer: Aetna Medicare Advantage	$4,642.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,946.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,946.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,095.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,946.12
Rate for Payer: Cigna Commercial	$7,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,744.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,321.25
Rate for Payer: UnitedHealthcare Community & State	$489.01
Rate for Payer: Wellpoint Medicaid Managed Care	$439.49

KIT ONYX 18 AVM

Facility

$15,475.00

Service Code	HCPCS C1887
Hospital Charge Code	270685187
Hospital Revenue Code	278
Min. Negotiated Rate	$2,321.25
Max. Negotiated Rate	$3,744.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,095.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,744.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,321.25

KIT ONYX 18 AVM

Facility

$15,475.00

Service Code	HCPCS C1889
Hospital Charge Code	270685187S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,321.25
Max. Negotiated Rate	$3,744.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,095.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,744.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,321.25

KIT ONYX 18 AVM

Facility

$15,475.00

Service Code	HCPCS C1889
Hospital Charge Code	270685187S
Hospital Revenue Code	278
Min. Negotiated Rate	$439.49
Max. Negotiated Rate	$7,737.50
Rate for Payer: Aetna Commercial	$5,880.50
Rate for Payer: Aetna Medicare Advantage	$4,642.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,946.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,946.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,095.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,946.12
Rate for Payer: Cigna Commercial	$7,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,744.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,321.25
Rate for Payer: UnitedHealthcare Community & State	$489.01
Rate for Payer: Wellpoint Medicaid Managed Care	$439.49

KIT ONYX 34 AVM US

Facility

$15,475.00

Service Code	HCPCS C1887
Hospital Charge Code	270685188
Hospital Revenue Code	278
Min. Negotiated Rate	$439.49
Max. Negotiated Rate	$7,737.50
Rate for Payer: Aetna Commercial	$5,880.50
Rate for Payer: Aetna Medicare Advantage	$4,642.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,946.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,946.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,095.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,946.12
Rate for Payer: Cigna Commercial	$7,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,744.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,321.25
Rate for Payer: UnitedHealthcare Community & State	$489.01
Rate for Payer: Wellpoint Medicaid Managed Care	$439.49

KIT ONYX 34 AVM US

Facility

$15,475.00

Service Code	HCPCS C1887
Hospital Charge Code	270685188
Hospital Revenue Code	278
Min. Negotiated Rate	$2,321.25
Max. Negotiated Rate	$3,744.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,095.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,744.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,321.25

KIT OPTIVAC 41700

Facility

$850.00

Hospital Charge Code	270629379
Hospital Revenue Code	272
Min. Negotiated Rate	$24.14
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$323.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$221.00
Rate for Payer: Oxford Commercial	$170.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Commercial	$170.00
Rate for Payer: UnitedHealthcare Community & State	$26.86
Rate for Payer: Wellpoint Medicaid Managed Care	$24.14

KIT OPTIVAC 41700

Facility

$850.00

Hospital Charge Code	270629379
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

KIT OPTIVAC MIX HIP

Facility

$850.00

Hospital Charge Code	270621291
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

KIT OPTIVAC MIX HIP

Facility

$850.00

Hospital Charge Code	270621291
Hospital Revenue Code	272
Min. Negotiated Rate	$24.14
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$323.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$221.00
Rate for Payer: Oxford Commercial	$170.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Commercial	$170.00
Rate for Payer: UnitedHealthcare Community & State	$26.86
Rate for Payer: Wellpoint Medicaid Managed Care	$24.14

KIT ORISE GEL SYRINGE

Facility

$975.00

Hospital Charge Code	270687104E
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

KIT ORISE GEL SYRINGE

Facility

$975.00

Hospital Charge Code	270687104
Hospital Revenue Code	272
Min. Negotiated Rate	$27.69
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$253.50
Rate for Payer: Oxford Commercial	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$195.00
Rate for Payer: UnitedHealthcare Community & State	$30.81
Rate for Payer: Wellpoint Medicaid Managed Care	$27.69

KIT ORISE GEL SYRINGE

Facility

$975.00

Hospital Charge Code	270687104E
Hospital Revenue Code	272
Min. Negotiated Rate	$27.69
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$253.50
Rate for Payer: Oxford Commercial	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$195.00
Rate for Payer: UnitedHealthcare Community & State	$30.81
Rate for Payer: Wellpoint Medicaid Managed Care	$27.69

KIT ORISE GEL SYRINGE

Facility

$975.00

Hospital Charge Code	270687104
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

KIT ORTHOSORB PIN 84-1070

Facility

$1,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270601198
Hospital Revenue Code	278
Min. Negotiated Rate	$170.25
Max. Negotiated Rate	$274.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$227.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$274.67
Rate for Payer: Qualcare PPO/HMO/WC	$170.25

KIT ORTHOSORB PIN 84-1070

Facility

$1,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270601198
Hospital Revenue Code	278
Min. Negotiated Rate	$32.23
Max. Negotiated Rate	$567.50
Rate for Payer: Aetna Commercial	$431.30
Rate for Payer: Aetna Medicare Advantage	$340.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$289.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$289.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$227.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$289.43
Rate for Payer: Cigna Commercial	$567.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$274.67
Rate for Payer: Qualcare PPO/HMO/WC	$170.25
Rate for Payer: UnitedHealthcare Community & State	$35.87
Rate for Payer: Wellpoint Medicaid Managed Care	$32.23

Know your out-of-pocket cost for care.

All Charges