Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

KIT PUSHLOK 3.5MM

Facility

$875.00

Hospital Charge Code	270663912
Hospital Revenue Code	272
Min. Negotiated Rate	$24.85
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$27.65
Rate for Payer: Wellpoint Medicaid Managed Care	$24.85

KIT PUSHLOK 3.5MM

Facility

$875.00

Hospital Charge Code	270663912
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

KIT Q-IX SHOULDER 1.8MM

Facility

$2,500.00

Hospital Charge Code	270681092
Hospital Revenue Code	272
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

KIT Q-IX SHOULDER 1.8MM

Facility

$2,500.00

Hospital Charge Code	270681092
Hospital Revenue Code	272
Min. Negotiated Rate	$71.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$650.00
Rate for Payer: Oxford Commercial	$500.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Commercial	$500.00
Rate for Payer: UnitedHealthcare Community & State	$79.00
Rate for Payer: Wellpoint Medicaid Managed Care	$71.00

KIT RADIAL HEAD REPLACEMENT

Facility

$1,770.30

Hospital Charge Code	270695504
Hospital Revenue Code	272
Min. Negotiated Rate	$265.55
Max. Negotiated Rate	$265.55
Rate for Payer: Qualcare PPO/HMO/WC	$265.55

KIT RADIAL HEAD REPLACEMENT

Facility

$1,770.30

Hospital Charge Code	270695504
Hospital Revenue Code	272
Min. Negotiated Rate	$50.28
Max. Negotiated Rate	$885.15
Rate for Payer: Aetna Commercial	$672.71
Rate for Payer: Aetna Medicare Advantage	$531.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$451.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$451.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$451.43
Rate for Payer: Cigna Commercial	$885.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$460.28
Rate for Payer: Oxford Commercial	$354.06
Rate for Payer: Qualcare PPO/HMO/WC	$265.55
Rate for Payer: UnitedHealthcare Commercial	$354.06
Rate for Payer: UnitedHealthcare Community & State	$55.94
Rate for Payer: Wellpoint Medicaid Managed Care	$50.28

KIT RAPR-ROUND LARGE 46-56

Facility

$680.00

Hospital Charge Code	270660605
Hospital Revenue Code	272
Min. Negotiated Rate	$19.31
Max. Negotiated Rate	$340.00
Rate for Payer: Aetna Commercial	$258.40
Rate for Payer: Aetna Medicare Advantage	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$173.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$173.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$173.40
Rate for Payer: Cigna Commercial	$340.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.80
Rate for Payer: Oxford Commercial	$136.00
Rate for Payer: Qualcare PPO/HMO/WC	$102.00
Rate for Payer: UnitedHealthcare Commercial	$136.00
Rate for Payer: UnitedHealthcare Community & State	$21.49
Rate for Payer: Wellpoint Medicaid Managed Care	$19.31

KIT RAPR-ROUND LARGE 46-56

Facility

$680.00

Hospital Charge Code	270660605
Hospital Revenue Code	272
Min. Negotiated Rate	$102.00
Max. Negotiated Rate	$102.00
Rate for Payer: Qualcare PPO/HMO/WC	$102.00

KIT RAPR-ROUND SM/MED 32-46

Facility

$655.00

Hospital Charge Code	270660604
Hospital Revenue Code	272
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$327.50
Rate for Payer: Aetna Commercial	$248.90
Rate for Payer: Aetna Medicare Advantage	$196.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$167.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$167.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$167.03
Rate for Payer: Cigna Commercial	$327.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.30
Rate for Payer: Oxford Commercial	$131.00
Rate for Payer: Qualcare PPO/HMO/WC	$98.25
Rate for Payer: UnitedHealthcare Commercial	$131.00
Rate for Payer: UnitedHealthcare Community & State	$20.70
Rate for Payer: Wellpoint Medicaid Managed Care	$18.60

KIT RAPR-ROUND SM/MED 32-46

Facility

$655.00

Hospital Charge Code	270660604
Hospital Revenue Code	272
Min. Negotiated Rate	$98.25
Max. Negotiated Rate	$98.25
Rate for Payer: Qualcare PPO/HMO/WC	$98.25

KIT REAMER MINIBUNION

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270690786
Hospital Revenue Code	278
Min. Negotiated Rate	$31.95
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$31.95

KIT REAMER MINIBUNION

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270690786
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

KIT RENEGADE HI FLOW 150/10

Facility

$1,799.20

Hospital Charge Code	270645209
Hospital Revenue Code	278
Min. Negotiated Rate	$269.88
Max. Negotiated Rate	$435.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.41
Rate for Payer: Qualcare PPO/HMO/WC	$269.88

KIT RENEGADE HI FLOW 150/10

Facility

$1,638.15

Service Code	HCPCS C1887
Hospital Charge Code	270645209A
Hospital Revenue Code	278
Min. Negotiated Rate	$245.72
Max. Negotiated Rate	$396.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$327.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$396.43
Rate for Payer: Qualcare PPO/HMO/WC	$245.72

KIT RENEGADE HI FLOW 150/10

Facility

$1,799.20

Hospital Charge Code	270645209
Hospital Revenue Code	278
Min. Negotiated Rate	$51.10
Max. Negotiated Rate	$899.60
Rate for Payer: Aetna Commercial	$683.70
Rate for Payer: Aetna Medicare Advantage	$539.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$458.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$458.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$458.80
Rate for Payer: Cigna Commercial	$899.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.41
Rate for Payer: Qualcare PPO/HMO/WC	$269.88
Rate for Payer: UnitedHealthcare Community & State	$56.85
Rate for Payer: Wellpoint Medicaid Managed Care	$51.10

KIT RENEGADE HI FLOW 150/10

Facility

$1,638.15

Service Code	HCPCS C1887
Hospital Charge Code	270645209C
Hospital Revenue Code	278
Min. Negotiated Rate	$245.72
Max. Negotiated Rate	$396.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$327.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$396.43
Rate for Payer: Qualcare PPO/HMO/WC	$245.72

KIT RENEGADE HI FLOW 150/10

Facility

$1,638.15

Service Code	HCPCS C1887
Hospital Charge Code	270645209A
Hospital Revenue Code	278
Min. Negotiated Rate	$46.52
Max. Negotiated Rate	$819.08
Rate for Payer: Aetna Commercial	$622.50
Rate for Payer: Aetna Medicare Advantage	$491.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$417.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$417.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$327.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$417.73
Rate for Payer: Cigna Commercial	$819.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$396.43
Rate for Payer: Qualcare PPO/HMO/WC	$245.72
Rate for Payer: UnitedHealthcare Community & State	$51.77
Rate for Payer: Wellpoint Medicaid Managed Care	$46.52

KIT RENEGADE HI FLOW 150/10

Facility

$1,638.15

Service Code	HCPCS C1887
Hospital Charge Code	270645209C
Hospital Revenue Code	278
Min. Negotiated Rate	$46.52
Max. Negotiated Rate	$819.08
Rate for Payer: Aetna Commercial	$622.50
Rate for Payer: Aetna Medicare Advantage	$491.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$417.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$417.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$327.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$417.73
Rate for Payer: Cigna Commercial	$819.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$396.43
Rate for Payer: Qualcare PPO/HMO/WC	$245.72
Rate for Payer: UnitedHealthcare Community & State	$51.77
Rate for Payer: Wellpoint Medicaid Managed Care	$46.52

KIT RENEGADE HI FLOW 35

Facility

$2,455.70

Service Code	HCPCS C1887
Hospital Charge Code	270630465
Hospital Revenue Code	278
Min. Negotiated Rate	$69.74
Max. Negotiated Rate	$1,227.85
Rate for Payer: Aetna Commercial	$933.17
Rate for Payer: Aetna Medicare Advantage	$736.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$626.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$626.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$491.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$626.20
Rate for Payer: Cigna Commercial	$1,227.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$594.28
Rate for Payer: Qualcare PPO/HMO/WC	$368.36
Rate for Payer: UnitedHealthcare Community & State	$77.60
Rate for Payer: Wellpoint Medicaid Managed Care	$69.74

KIT RENEGADE HI FLOW 35

Facility

$2,455.70

Service Code	HCPCS C1887
Hospital Charge Code	270630465
Hospital Revenue Code	278
Min. Negotiated Rate	$368.36
Max. Negotiated Rate	$594.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$491.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$594.28
Rate for Payer: Qualcare PPO/HMO/WC	$368.36

KIT RENEGADE HI FLOW 35 18-302

Facility

$2,455.70

Service Code	HCPCS C1887
Hospital Charge Code	270630465C
Hospital Revenue Code	278
Min. Negotiated Rate	$69.74
Max. Negotiated Rate	$1,227.85
Rate for Payer: Aetna Commercial	$933.17
Rate for Payer: Aetna Medicare Advantage	$736.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$626.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$626.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$491.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$626.20
Rate for Payer: Cigna Commercial	$1,227.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$594.28
Rate for Payer: Qualcare PPO/HMO/WC	$368.36
Rate for Payer: UnitedHealthcare Community & State	$77.60
Rate for Payer: Wellpoint Medicaid Managed Care	$69.74

KIT RENEGADE HI FLOW 35 18-302

Facility

$2,455.70

Service Code	HCPCS C1887
Hospital Charge Code	270630465C
Hospital Revenue Code	278
Min. Negotiated Rate	$368.36
Max. Negotiated Rate	$594.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$491.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$594.28
Rate for Payer: Qualcare PPO/HMO/WC	$368.36

KIT REPAIR LIGAMENT 2.0

Facility

$7,475.00

Hospital Charge Code	270688256
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 REPAIR LIGAMENT 2.0

Facility

$7,475.00

Hospital Charge Code	270688256
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 RESORABLE MIN BEAD

Facility

$3,490.00

Service Code	HCPCS C1713
Hospital Charge Code	270645042
Hospital Revenue Code	278
Min. Negotiated Rate	$99.12
Max. Negotiated Rate	$1,745.00
Rate for Payer: Aetna Commercial	$1,326.20
Rate for Payer: Aetna Medicare Advantage	$1,047.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$889.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$889.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$698.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$889.95
Rate for Payer: Cigna Commercial	$1,745.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$844.58
Rate for Payer: Qualcare PPO/HMO/WC	$523.50
Rate for Payer: UnitedHealthcare Community & State	$110.28
Rate for Payer: Wellpoint Medicaid Managed Care	$99.12

Know your out-of-pocket cost for care.

All Charges