Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

KIT ORTHOSORB PIN 84-2052

Facility

$1,385.00

Service Code	HCPCS C1713
Hospital Charge Code	270601204
Hospital Revenue Code	278
Min. Negotiated Rate	$207.75
Max. Negotiated Rate	$335.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$277.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.17
Rate for Payer: Qualcare PPO/HMO/WC	$207.75

KIT ORTHOSORB PIN 84-2052

Facility

$1,385.00

Service Code	HCPCS C1713
Hospital Charge Code	270601204
Hospital Revenue Code	278
Min. Negotiated Rate	$39.33
Max. Negotiated Rate	$692.50
Rate for Payer: Aetna Commercial	$526.30
Rate for Payer: Aetna Medicare Advantage	$415.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$353.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$353.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$277.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$353.18
Rate for Payer: Cigna Commercial	$692.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.17
Rate for Payer: Qualcare PPO/HMO/WC	$207.75
Rate for Payer: UnitedHealthcare Community & State	$43.77
Rate for Payer: Wellpoint Medicaid Managed Care	$39.33

KIT PAD POSITIONING

Facility

$265.00

Hospital Charge Code	270677848
Hospital Revenue Code	272
Min. Negotiated Rate	$39.75
Max. Negotiated Rate	$39.75
Rate for Payer: Qualcare PPO/HMO/WC	$39.75

KIT PAD POSITIONING

Facility

$265.00

Hospital Charge Code	270677848
Hospital Revenue Code	272
Min. Negotiated Rate	$7.53
Max. Negotiated Rate	$132.50
Rate for Payer: Aetna Commercial	$100.70
Rate for Payer: Aetna Medicare Advantage	$79.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.58
Rate for Payer: Cigna Commercial	$132.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.90
Rate for Payer: Oxford Commercial	$53.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.75
Rate for Payer: UnitedHealthcare Commercial	$53.00
Rate for Payer: UnitedHealthcare Community & State	$8.37
Rate for Payer: Wellpoint Medicaid Managed Care	$7.53

KIT PATELLA TEMPLATE ANTERIOR

Facility

$965.25

Hospital Charge Code	270694963
Hospital Revenue Code	272
Min. Negotiated Rate	$144.79
Max. Negotiated Rate	$144.79
Rate for Payer: Qualcare PPO/HMO/WC	$144.79

KIT PATELLA TEMPLATE ANTERIOR

Facility

$965.25

Hospital Charge Code	270694963
Hospital Revenue Code	272
Min. Negotiated Rate	$27.41
Max. Negotiated Rate	$482.62
Rate for Payer: Aetna Commercial	$366.80
Rate for Payer: Aetna Medicare Advantage	$289.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$246.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$246.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$246.14
Rate for Payer: Cigna Commercial	$482.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$250.97
Rate for Payer: Oxford Commercial	$193.05
Rate for Payer: Qualcare PPO/HMO/WC	$144.79
Rate for Payer: UnitedHealthcare Commercial	$193.05
Rate for Payer: UnitedHealthcare Community & State	$30.50
Rate for Payer: Wellpoint Medicaid Managed Care	$27.41

KIT PEEK ROOT REPAIR

Facility

$6,975.00

Hospital Charge Code	270688311
Hospital Revenue Code	272
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) PPO	$1,778.62
Rate for Payer: Cigna Commercial	$3,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,813.50
Rate for Payer: Oxford Commercial	$1,395.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25
Rate for Payer: UnitedHealthcare Commercial	$1,395.00
Rate for Payer: UnitedHealthcare Community & State	$220.41
Rate for Payer: Wellpoint Medicaid Managed Care	$198.09

KIT PEEK ROOT REPAIR

Facility

$6,975.00

Hospital Charge Code	270688311
Hospital Revenue Code	272
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$1,046.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

KIT PEG 24FR SAFETY PUSH

Facility

$442.18

Hospital Charge Code	270676987
Hospital Revenue Code	278
Min. Negotiated Rate	$66.33
Max. Negotiated Rate	$107.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.01
Rate for Payer: Qualcare PPO/HMO/WC	$66.33

KIT PEG 24FR SAFETY PUSH

Facility

$442.18

Hospital Charge Code	270676987
Hospital Revenue Code	278
Min. Negotiated Rate	$12.56
Max. Negotiated Rate	$221.09
Rate for Payer: Aetna Commercial	$168.03
Rate for Payer: Aetna Medicare Advantage	$132.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.76
Rate for Payer: Cigna Commercial	$221.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.01
Rate for Payer: Qualcare PPO/HMO/WC	$66.33
Rate for Payer: UnitedHealthcare Community & State	$13.97
Rate for Payer: Wellpoint Medicaid Managed Care	$12.56

KIT PEG SAFETY 20FR PULL

Facility

$442.18

Hospital Charge Code	270647892
Hospital Revenue Code	272
Min. Negotiated Rate	$12.56
Max. Negotiated Rate	$221.09
Rate for Payer: Aetna Commercial	$168.03
Rate for Payer: Aetna Medicare Advantage	$132.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.76
Rate for Payer: Cigna Commercial	$221.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.97
Rate for Payer: Oxford Commercial	$88.44
Rate for Payer: Qualcare PPO/HMO/WC	$66.33
Rate for Payer: UnitedHealthcare Commercial	$88.44
Rate for Payer: UnitedHealthcare Community & State	$13.97
Rate for Payer: Wellpoint Medicaid Managed Care	$12.56

KIT PEG SAFETY 20FR PULL

Facility

$442.18

Hospital Charge Code	270647892
Hospital Revenue Code	272
Min. Negotiated Rate	$66.33
Max. Negotiated Rate	$66.33
Rate for Payer: Qualcare PPO/HMO/WC	$66.33

KIT PERCUTANEOUS 3MM

Facility

$975.00

Hospital Charge Code	270672213
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

KIT PERCUTANEOUS 3MM

Facility

$975.00

Hospital Charge Code	270672213
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 PERCUTANEOUS CAVITY DRAING

Facility

$651.50

Hospital Charge Code	270676124
Hospital Revenue Code	272
Min. Negotiated Rate	$18.50
Max. Negotiated Rate	$325.75
Rate for Payer: Aetna Commercial	$247.57
Rate for Payer: Aetna Medicare Advantage	$195.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$166.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$166.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$166.13
Rate for Payer: Cigna Commercial	$325.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.39
Rate for Payer: Oxford Commercial	$130.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.72
Rate for Payer: UnitedHealthcare Commercial	$130.30
Rate for Payer: UnitedHealthcare Community & State	$20.59
Rate for Payer: Wellpoint Medicaid Managed Care	$18.50

KIT PERCUTANEOUS CAVITY DRAING

Facility

$651.50

Hospital Charge Code	270676124
Hospital Revenue Code	272
Min. Negotiated Rate	$97.72
Max. Negotiated Rate	$97.72
Rate for Payer: Qualcare PPO/HMO/WC	$97.72

KIT PERIVAC PERICARDIOCENTISIS

Facility

$866.67

Service Code	HCPCS C1729
Hospital Charge Code	270645514C
Hospital Revenue Code	278
Min. Negotiated Rate	$130.00
Max. Negotiated Rate	$209.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$173.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.73
Rate for Payer: Qualcare PPO/HMO/WC	$130.00

KIT PERIVAC PERICARDIOCENTISIS

Facility

$866.67

Service Code	HCPCS C1729
Hospital Charge Code	270645514C
Hospital Revenue Code	278
Min. Negotiated Rate	$24.61
Max. Negotiated Rate	$433.33
Rate for Payer: Aetna Commercial	$329.33
Rate for Payer: Aetna Medicare Advantage	$260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$221.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$221.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$173.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$221.00
Rate for Payer: Cigna Commercial	$433.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.73
Rate for Payer: Qualcare PPO/HMO/WC	$130.00
Rate for Payer: UnitedHealthcare Community & State	$27.39
Rate for Payer: Wellpoint Medicaid Managed Care	$24.61

KIT PLEURX PLEURAL CATH 507000

Facility

$2,875.00

Service Code	HCPCS C1729
Hospital Charge Code	270629872
Hospital Revenue Code	278
Min. Negotiated Rate	$81.65
Max. Negotiated Rate	$1,437.50
Rate for Payer: Aetna Commercial	$1,092.50
Rate for Payer: Aetna Medicare Advantage	$862.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$733.12
Rate for Payer: Cigna Commercial	$1,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$695.75
Rate for Payer: Qualcare PPO/HMO/WC	$431.25
Rate for Payer: UnitedHealthcare Community & State	$90.85
Rate for Payer: Wellpoint Medicaid Managed Care	$81.65

KIT PLEURX PLEURAL CATH 507000

Facility

$2,875.00

Service Code	HCPCS C1729
Hospital Charge Code	270629872
Hospital Revenue Code	278
Min. Negotiated Rate	$431.25
Max. Negotiated Rate	$695.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$695.75
Rate for Payer: Qualcare PPO/HMO/WC	$431.25

KIT PORTAL ENTRY

Facility

$1,627.55

Hospital Charge Code	270673921
Hospital Revenue Code	272
Min. Negotiated Rate	$244.13
Max. Negotiated Rate	$244.13
Rate for Payer: Qualcare PPO/HMO/WC	$244.13

KIT PORTAL ENTRY

Facility

$1,627.55

Hospital Charge Code	270673921
Hospital Revenue Code	272
Min. Negotiated Rate	$46.22
Max. Negotiated Rate	$813.77
Rate for Payer: Aetna Commercial	$618.47
Rate for Payer: Aetna Medicare Advantage	$488.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$415.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$415.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$415.03
Rate for Payer: Cigna Commercial	$813.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.16
Rate for Payer: Oxford Commercial	$325.51
Rate for Payer: Qualcare PPO/HMO/WC	$244.13
Rate for Payer: UnitedHealthcare Commercial	$325.51
Rate for Payer: UnitedHealthcare Community & State	$51.43
Rate for Payer: Wellpoint Medicaid Managed Care	$46.22

KIT POST OP NATURA ST 2 PIECE

Facility

$97.27

Hospital Charge Code	270648475
Hospital Revenue Code	271
Min. Negotiated Rate	$2.76
Max. Negotiated Rate	$48.63
Rate for Payer: Aetna Commercial	$36.96
Rate for Payer: Aetna Medicare Advantage	$29.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.80
Rate for Payer: Cigna Commercial	$48.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.29
Rate for Payer: Oxford Commercial	$19.45
Rate for Payer: Qualcare PPO/HMO/WC	$14.59
Rate for Payer: UnitedHealthcare Commercial	$19.45
Rate for Payer: UnitedHealthcare Community & State	$3.07
Rate for Payer: Wellpoint Medicaid Managed Care	$2.76

KIT POST OP NATURA ST 2 PIECE

Facility

$97.27

Hospital Charge Code	270648475
Hospital Revenue Code	271
Min. Negotiated Rate	$14.59
Max. Negotiated Rate	$14.59
Rate for Payer: Qualcare PPO/HMO/WC	$14.59

KIT POWER PULSE Y CONNECTOR

Facility

$535.00

Hospital Charge Code	270645569N
Hospital Revenue Code	272
Min. Negotiated Rate	$15.19
Max. Negotiated Rate	$267.50
Rate for Payer: Aetna Commercial	$203.30
Rate for Payer: Aetna Medicare Advantage	$160.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.43
Rate for Payer: Cigna Commercial	$267.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.10
Rate for Payer: Oxford Commercial	$107.00
Rate for Payer: Qualcare PPO/HMO/WC	$80.25
Rate for Payer: UnitedHealthcare Commercial	$107.00
Rate for Payer: UnitedHealthcare Community & State	$16.91
Rate for Payer: Wellpoint Medicaid Managed Care	$15.19

Know your out-of-pocket cost for care.

All Charges