Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

KIT POWER PULSE Y CONNECTOR

Facility

$170.00

Hospital Charge Code	270645569S
Hospital Revenue Code	272
Min. Negotiated Rate	$25.50
Max. Negotiated Rate	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.50

KIT POWER PULSE Y CONNECTOR

Facility

$170.00

Hospital Charge Code	270645569
Hospital Revenue Code	272
Min. Negotiated Rate	$4.83
Max. Negotiated Rate	$85.00
Rate for Payer: Aetna Commercial	$64.60
Rate for Payer: Aetna Medicare Advantage	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.35
Rate for Payer: Cigna Commercial	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.20
Rate for Payer: Oxford Commercial	$34.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.50
Rate for Payer: UnitedHealthcare Commercial	$34.00
Rate for Payer: UnitedHealthcare Community & State	$5.37
Rate for Payer: Wellpoint Medicaid Managed Care	$4.83

KIT POWER PULSE Y CONNECTOR

Facility

$170.00

Hospital Charge Code	270645569
Hospital Revenue Code	272
Min. Negotiated Rate	$25.50
Max. Negotiated Rate	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.50

KIT POWER PULSE Y CONNECTOR

Facility

$170.00

Hospital Charge Code	270645569S
Hospital Revenue Code	272
Min. Negotiated Rate	$4.83
Max. Negotiated Rate	$85.00
Rate for Payer: Aetna Commercial	$64.60
Rate for Payer: Aetna Medicare Advantage	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.35
Rate for Payer: Cigna Commercial	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.20
Rate for Payer: Oxford Commercial	$34.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.50
Rate for Payer: UnitedHealthcare Commercial	$34.00
Rate for Payer: UnitedHealthcare Community & State	$5.37
Rate for Payer: Wellpoint Medicaid Managed Care	$4.83

KIT POWER PULSE Y CONNECTOR

Facility

$535.00

Hospital Charge Code	270645569N
Hospital Revenue Code	272
Min. Negotiated Rate	$80.25
Max. Negotiated Rate	$80.25
Rate for Payer: Qualcare PPO/HMO/WC	$80.25

KIT PRECISION CHARGING SYSTEM

Facility

$14,000.00

Service Code	HCPCS C1778
Hospital Charge Code	270701896
Hospital Revenue Code	278
Min. Negotiated Rate	$2,100.00
Max. Negotiated Rate	$3,388.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,388.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,100.00

KIT PRECISION CHARGING SYSTEM

Facility

$14,000.00

Service Code	HCPCS C1778
Hospital Charge Code	270701896
Hospital Revenue Code	278
Min. Negotiated Rate	$397.60
Max. Negotiated Rate	$7,000.00
Rate for Payer: Aetna Commercial	$5,320.00
Rate for Payer: Aetna Medicare Advantage	$4,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,570.00
Rate for Payer: Cigna Commercial	$7,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,388.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,100.00
Rate for Payer: UnitedHealthcare Community & State	$442.40
Rate for Payer: Wellpoint Medicaid Managed Care	$397.60

KIT PREP SMALL DYND70288

Facility

$30.49

Hospital Charge Code	270632443
Hospital Revenue Code	270
Min. Negotiated Rate	$4.57
Max. Negotiated Rate	$4.57
Rate for Payer: Qualcare PPO/HMO/WC	$4.57

KIT PREP SMALL DYND70288

Facility

$30.49

Hospital Charge Code	270632443
Hospital Revenue Code	270
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$15.24
Rate for Payer: Aetna Commercial	$11.59
Rate for Payer: Aetna Medicare Advantage	$9.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.77
Rate for Payer: Cigna Commercial	$15.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.93
Rate for Payer: Oxford Commercial	$6.10
Rate for Payer: Qualcare PPO/HMO/WC	$4.57
Rate for Payer: UnitedHealthcare Commercial	$6.10
Rate for Payer: UnitedHealthcare Community & State	$0.96
Rate for Payer: Wellpoint Medicaid Managed Care	$0.87

KIT PROBE ABLATION OSTEOCOOL

Facility

$21,075.00

Hospital Charge Code	270689767
Hospital Revenue Code	272
Min. Negotiated Rate	$3,161.25
Max. Negotiated Rate	$3,161.25
Rate for Payer: Qualcare PPO/HMO/WC	$3,161.25

KIT PROBE ABLATION OSTEOCOOL

Facility

$21,075.00

Hospital Charge Code	270689767
Hospital Revenue Code	272
Min. Negotiated Rate	$598.53
Max. Negotiated Rate	$10,537.50
Rate for Payer: Aetna Commercial	$8,008.50
Rate for Payer: Aetna Medicare Advantage	$6,322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,374.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,374.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,374.12
Rate for Payer: Cigna Commercial	$10,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,479.50
Rate for Payer: Oxford Commercial	$4,215.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,161.25
Rate for Payer: UnitedHealthcare Commercial	$4,215.00
Rate for Payer: UnitedHealthcare Community & State	$665.97
Rate for Payer: Wellpoint Medicaid Managed Care	$598.53

KIT PROCEDURE PLEURIX

Facility

$295.00

Hospital Charge Code	270665608
Hospital Revenue Code	272
Min. Negotiated Rate	$8.38
Max. Negotiated Rate	$147.50
Rate for Payer: Aetna Commercial	$112.10
Rate for Payer: Aetna Medicare Advantage	$88.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.22
Rate for Payer: Cigna Commercial	$147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.70
Rate for Payer: Oxford Commercial	$59.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.25
Rate for Payer: UnitedHealthcare Commercial	$59.00
Rate for Payer: UnitedHealthcare Community & State	$9.32
Rate for Payer: Wellpoint Medicaid Managed Care	$8.38

KIT PROCEDURE PLEURIX

Facility

$295.00

Hospital Charge Code	270665608
Hospital Revenue Code	272
Min. Negotiated Rate	$44.25
Max. Negotiated Rate	$44.25
Rate for Payer: Qualcare PPO/HMO/WC	$44.25

KIT PROGEL PLEURAL LEAK SEALNT

Facility

$4,625.00

Service Code	HCPCS C2615
Hospital Charge Code	270662136
Hospital Revenue Code	278
Min. Negotiated Rate	$131.35
Max. Negotiated Rate	$2,312.50
Rate for Payer: Aetna Commercial	$1,757.50
Rate for Payer: Aetna Medicare Advantage	$1,387.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,179.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,179.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,179.38
Rate for Payer: Cigna Commercial	$2,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,119.25
Rate for Payer: Qualcare PPO/HMO/WC	$693.75
Rate for Payer: UnitedHealthcare Community & State	$146.15
Rate for Payer: Wellpoint Medicaid Managed Care	$131.35

KIT PROGEL PLEURAL LEAK SEALNT

Facility

$4,625.00

Service Code	HCPCS C2615
Hospital Charge Code	270662136
Hospital Revenue Code	278
Min. Negotiated Rate	$693.75
Max. Negotiated Rate	$1,119.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,119.25
Rate for Payer: Qualcare PPO/HMO/WC	$693.75

KIT PRO-NOX LARGE

Facility

$76.45

Hospital Charge Code	270679180
Hospital Revenue Code	272
Min. Negotiated Rate	$11.47
Max. Negotiated Rate	$11.47
Rate for Payer: Qualcare PPO/HMO/WC	$11.47

KIT PRO-NOX LARGE

Facility

$76.45

Hospital Charge Code	270679180
Hospital Revenue Code	272
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$38.23
Rate for Payer: Aetna Commercial	$29.05
Rate for Payer: Aetna Medicare Advantage	$22.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.49
Rate for Payer: Cigna Commercial	$38.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.88
Rate for Payer: Oxford Commercial	$15.29
Rate for Payer: Qualcare PPO/HMO/WC	$11.47
Rate for Payer: UnitedHealthcare Commercial	$15.29
Rate for Payer: UnitedHealthcare Community & State	$2.42
Rate for Payer: Wellpoint Medicaid Managed Care	$2.17

KIT PRO-NOX MEDIUM

Facility

$76.45

Hospital Charge Code	270679179
Hospital Revenue Code	272
Min. Negotiated Rate	$11.47
Max. Negotiated Rate	$11.47
Rate for Payer: Qualcare PPO/HMO/WC	$11.47

KIT PRO-NOX MEDIUM

Facility

$76.45

Hospital Charge Code	270679179
Hospital Revenue Code	272
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$38.23
Rate for Payer: Aetna Commercial	$29.05
Rate for Payer: Aetna Medicare Advantage	$22.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.49
Rate for Payer: Cigna Commercial	$38.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.88
Rate for Payer: Oxford Commercial	$15.29
Rate for Payer: Qualcare PPO/HMO/WC	$11.47
Rate for Payer: UnitedHealthcare Commercial	$15.29
Rate for Payer: UnitedHealthcare Community & State	$2.42
Rate for Payer: Wellpoint Medicaid Managed Care	$2.17

KIT PRO-NOX SMALL

Facility

$76.45

Hospital Charge Code	270679181
Hospital Revenue Code	272
Min. Negotiated Rate	$11.47
Max. Negotiated Rate	$11.47
Rate for Payer: Qualcare PPO/HMO/WC	$11.47

KIT PRO-NOX SMALL

Facility

$76.45

Hospital Charge Code	270679181
Hospital Revenue Code	272
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$38.23
Rate for Payer: Aetna Commercial	$29.05
Rate for Payer: Aetna Medicare Advantage	$22.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.49
Rate for Payer: Cigna Commercial	$38.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.88
Rate for Payer: Oxford Commercial	$15.29
Rate for Payer: Qualcare PPO/HMO/WC	$11.47
Rate for Payer: UnitedHealthcare Commercial	$15.29
Rate for Payer: UnitedHealthcare Community & State	$2.42
Rate for Payer: Wellpoint Medicaid Managed Care	$2.17

KIT PTD 5FR 65CM

Facility

$4,293.35

Hospital Charge Code	270664876
Hospital Revenue Code	272
Min. Negotiated Rate	$121.93
Max. Negotiated Rate	$2,146.68
Rate for Payer: Aetna Commercial	$1,631.47
Rate for Payer: Aetna Medicare Advantage	$1,288.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,094.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,094.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,094.80
Rate for Payer: Cigna Commercial	$2,146.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,116.27
Rate for Payer: Oxford Commercial	$858.67
Rate for Payer: Qualcare PPO/HMO/WC	$644.00
Rate for Payer: UnitedHealthcare Commercial	$858.67
Rate for Payer: UnitedHealthcare Community & State	$135.67
Rate for Payer: Wellpoint Medicaid Managed Care	$121.93

KIT PTD 5FR 65CM

Facility

$4,293.35

Hospital Charge Code	270664876
Hospital Revenue Code	272
Min. Negotiated Rate	$644.00
Max. Negotiated Rate	$644.00
Rate for Payer: Qualcare PPO/HMO/WC	$644.00

KIT PT POSIT W/CHIN STRAP 5345

Facility

$167.45

Hospital Charge Code	270635030
Hospital Revenue Code	270
Min. Negotiated Rate	$25.12
Max. Negotiated Rate	$25.12
Rate for Payer: Qualcare PPO/HMO/WC	$25.12

KIT PT POSIT W/CHIN STRAP 5345

Facility

$167.45

Hospital Charge Code	270635030
Hospital Revenue Code	270
Min. Negotiated Rate	$4.76
Max. Negotiated Rate	$83.72
Rate for Payer: Aetna Commercial	$63.63
Rate for Payer: Aetna Medicare Advantage	$50.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.70
Rate for Payer: Cigna Commercial	$83.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.54
Rate for Payer: Oxford Commercial	$33.49
Rate for Payer: Qualcare PPO/HMO/WC	$25.12
Rate for Payer: UnitedHealthcare Commercial	$33.49
Rate for Payer: UnitedHealthcare Community & State	$5.29
Rate for Payer: Wellpoint Medicaid Managed Care	$4.76

Know your out-of-pocket cost for care.

All Charges