Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

KIT RESORABLE MIN BEAD

Facility

$3,490.00

Service Code	HCPCS C1713
Hospital Charge Code	270645042
Hospital Revenue Code	278
Min. Negotiated Rate	$523.50
Max. Negotiated Rate	$844.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$698.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$844.58
Rate for Payer: Qualcare PPO/HMO/WC	$523.50

KIT RETRIEVAL SNARE

Facility

$2,250.00

Hospital Charge Code	270671363S
Hospital Revenue Code	272
Min. Negotiated Rate	$63.90
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.00
Rate for Payer: Oxford Commercial	$450.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$450.00
Rate for Payer: UnitedHealthcare Community & State	$71.10
Rate for Payer: Wellpoint Medicaid Managed Care	$63.90

KIT RETRIEVAL SNARE

Facility

$2,250.00

Hospital Charge Code	270671363S
Hospital Revenue Code	272
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

KIT RETRIEVAL SNARE

Facility

$2,250.00

Hospital Charge Code	270671363C
Hospital Revenue Code	272
Min. Negotiated Rate	$63.90
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.00
Rate for Payer: Oxford Commercial	$450.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$450.00
Rate for Payer: UnitedHealthcare Community & State	$71.10
Rate for Payer: Wellpoint Medicaid Managed Care	$63.90

KIT RETRIEVAL SNARE

Facility

$2,500.00

Hospital Charge Code	270671363N
Hospital Revenue Code	272
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

KIT RETRIEVAL SNARE

Facility

$2,250.00

Hospital Charge Code	270671363C
Hospital Revenue Code	272
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

KIT RETRIEVAL SNARE

Facility

$2,500.00

Hospital Charge Code	270671363N
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 RIGHT HEART

Facility

$75.00

Hospital Charge Code	270678577
Hospital Revenue Code	272
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$2.37
Rate for Payer: Wellpoint Medicaid Managed Care	$2.13

KIT RIGHT HEART

Facility

$75.00

Hospital Charge Code	270678577
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

KIT RIGHT HEART

Facility

$750.00

Hospital Charge Code	270678577N
Hospital Revenue Code	272
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

KIT RIGHT HEART

Facility

$750.00

Hospital Charge Code	270678577N
Hospital Revenue Code	272
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.00
Rate for Payer: Oxford Commercial	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Commercial	$150.00
Rate for Payer: UnitedHealthcare Community & State	$23.70
Rate for Payer: Wellpoint Medicaid Managed Care	$21.30

KIT RIOLCENT WILSON FRAME 5322

Facility

$133.79

Hospital Charge Code	270627620
Hospital Revenue Code	272
Min. Negotiated Rate	$20.07
Max. Negotiated Rate	$20.07
Rate for Payer: Qualcare PPO/HMO/WC	$20.07

KIT RIOLCENT WILSON FRAME 5322

Facility

$133.79

Hospital Charge Code	270627620
Hospital Revenue Code	272
Min. Negotiated Rate	$3.80
Max. Negotiated Rate	$66.89
Rate for Payer: Aetna Commercial	$50.84
Rate for Payer: Aetna Medicare Advantage	$40.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.12
Rate for Payer: Cigna Commercial	$66.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.79
Rate for Payer: Oxford Commercial	$26.76
Rate for Payer: Qualcare PPO/HMO/WC	$20.07
Rate for Payer: UnitedHealthcare Commercial	$26.76
Rate for Payer: UnitedHealthcare Community & State	$4.23
Rate for Payer: Wellpoint Medicaid Managed Care	$3.80

KIT SAFESHEATH II 7FR

Facility

$292.50

Hospital Charge Code	270676908
Hospital Revenue Code	272
Min. Negotiated Rate	$43.88
Max. Negotiated Rate	$43.88
Rate for Payer: Qualcare PPO/HMO/WC	$43.88

KIT SAFESHEATH II 7FR

Facility

$292.50

Hospital Charge Code	270676908S
Hospital Revenue Code	272
Min. Negotiated Rate	$43.88
Max. Negotiated Rate	$43.88
Rate for Payer: Qualcare PPO/HMO/WC	$43.88

KIT SAFESHEATH II 7FR

Facility

$292.50

Hospital Charge Code	270676908
Hospital Revenue Code	272
Min. Negotiated Rate	$8.31
Max. Negotiated Rate	$146.25
Rate for Payer: Aetna Commercial	$111.15
Rate for Payer: Aetna Medicare Advantage	$87.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.59
Rate for Payer: Cigna Commercial	$146.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.05
Rate for Payer: Oxford Commercial	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$43.88
Rate for Payer: UnitedHealthcare Commercial	$58.50
Rate for Payer: UnitedHealthcare Community & State	$9.24
Rate for Payer: Wellpoint Medicaid Managed Care	$8.31

KIT SAFESHEATH II 7FR

Facility

$292.50

Hospital Charge Code	270676908S
Hospital Revenue Code	272
Min. Negotiated Rate	$8.31
Max. Negotiated Rate	$146.25
Rate for Payer: Aetna Commercial	$111.15
Rate for Payer: Aetna Medicare Advantage	$87.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.59
Rate for Payer: Cigna Commercial	$146.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.05
Rate for Payer: Oxford Commercial	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$43.88
Rate for Payer: UnitedHealthcare Commercial	$58.50
Rate for Payer: UnitedHealthcare Community & State	$9.24
Rate for Payer: Wellpoint Medicaid Managed Care	$8.31

KIT SAFESHEATH II 9FR

Facility

$292.50

Hospital Charge Code	270676907
Hospital Revenue Code	272
Min. Negotiated Rate	$8.31
Max. Negotiated Rate	$146.25
Rate for Payer: Aetna Commercial	$111.15
Rate for Payer: Aetna Medicare Advantage	$87.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.59
Rate for Payer: Cigna Commercial	$146.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.05
Rate for Payer: Oxford Commercial	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$43.88
Rate for Payer: UnitedHealthcare Commercial	$58.50
Rate for Payer: UnitedHealthcare Community & State	$9.24
Rate for Payer: Wellpoint Medicaid Managed Care	$8.31

KIT SAFESHEATH II 9FR

Facility

$292.50

Hospital Charge Code	270676907
Hospital Revenue Code	272
Min. Negotiated Rate	$43.88
Max. Negotiated Rate	$43.88
Rate for Payer: Qualcare PPO/HMO/WC	$43.88

KIT SCP FOOT AND ANKLE

Facility

$15,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270688551
Hospital Revenue Code	278
Min. Negotiated Rate	$451.56
Max. Negotiated Rate	$7,950.00
Rate for Payer: Aetna Commercial	$6,042.00
Rate for Payer: Aetna Medicare Advantage	$4,770.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,054.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,054.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,054.50
Rate for Payer: Cigna Commercial	$7,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,847.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,385.00
Rate for Payer: UnitedHealthcare Community & State	$502.44
Rate for Payer: Wellpoint Medicaid Managed Care	$451.56

KIT SCP FOOT AND ANKLE

Facility

$15,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270688551
Hospital Revenue Code	278
Min. Negotiated Rate	$2,385.00
Max. Negotiated Rate	$3,847.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,847.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,385.00

KIT SCP FOOT & ANKLE

Facility

$10,000.00

Hospital Charge Code	270677705
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

KIT SCP FOOT & ANKLE

Facility

$10,000.00

Hospital Charge Code	270677705
Hospital Revenue Code	278
Min. Negotiated Rate	$284.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,800.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Community & State	$316.00
Rate for Payer: Wellpoint Medicaid Managed Care	$284.00

KIT SCP KNEE

Facility

$20,375.00

Hospital Charge Code	270678971
Hospital Revenue Code	272
Min. Negotiated Rate	$578.65
Max. Negotiated Rate	$10,187.50
Rate for Payer: Aetna Commercial	$7,742.50
Rate for Payer: Aetna Medicare Advantage	$6,112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,195.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,195.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,195.62
Rate for Payer: Cigna Commercial	$10,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,297.50
Rate for Payer: Oxford Commercial	$4,075.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,056.25
Rate for Payer: UnitedHealthcare Commercial	$4,075.00
Rate for Payer: UnitedHealthcare Community & State	$643.85
Rate for Payer: Wellpoint Medicaid Managed Care	$578.65

KIT SCP KNEE

Facility

$20,375.00

Hospital Charge Code	270678971
Hospital Revenue Code	272
Min. Negotiated Rate	$3,056.25
Max. Negotiated Rate	$3,056.25
Rate for Payer: Qualcare PPO/HMO/WC	$3,056.25

Know your out-of-pocket cost for care.

All Charges