Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

KIT STAPLE FUSEFORSE 15X15MM

Facility

$6,425.00

Hospital Charge Code	270678362
Hospital Revenue Code	272
Min. Negotiated Rate	$182.47
Max. Negotiated Rate	$3,212.50
Rate for Payer: Aetna Commercial	$2,441.50
Rate for Payer: Aetna Medicare Advantage	$1,927.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,638.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,638.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,638.38
Rate for Payer: Cigna Commercial	$3,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,670.50
Rate for Payer: Oxford Commercial	$1,285.00
Rate for Payer: Qualcare PPO/HMO/WC	$963.75
Rate for Payer: UnitedHealthcare Commercial	$1,285.00
Rate for Payer: UnitedHealthcare Community & State	$203.03
Rate for Payer: Wellpoint Medicaid Managed Care	$182.47

KIT STAPLE FUSEFORSE 20X20MM

Facility

$6,425.00

Hospital Charge Code	270678360
Hospital Revenue Code	272
Min. Negotiated Rate	$963.75
Max. Negotiated Rate	$963.75
Rate for Payer: Qualcare PPO/HMO/WC	$963.75

KIT STAPLE FUSEFORSE 20X20MM

Facility

$6,425.00

Hospital Charge Code	270678360
Hospital Revenue Code	272
Min. Negotiated Rate	$182.47
Max. Negotiated Rate	$3,212.50
Rate for Payer: Aetna Commercial	$2,441.50
Rate for Payer: Aetna Medicare Advantage	$1,927.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,638.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,638.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,638.38
Rate for Payer: Cigna Commercial	$3,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,670.50
Rate for Payer: Oxford Commercial	$1,285.00
Rate for Payer: Qualcare PPO/HMO/WC	$963.75
Rate for Payer: UnitedHealthcare Commercial	$1,285.00
Rate for Payer: UnitedHealthcare Community & State	$203.03
Rate for Payer: Wellpoint Medicaid Managed Care	$182.47

KIT STAPLE FUSEFORSE 25X22MM

Facility

$6,425.00

Hospital Charge Code	270678358
Hospital Revenue Code	272
Min. Negotiated Rate	$182.47
Max. Negotiated Rate	$3,212.50
Rate for Payer: Aetna Commercial	$2,441.50
Rate for Payer: Aetna Medicare Advantage	$1,927.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,638.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,638.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,638.38
Rate for Payer: Cigna Commercial	$3,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,670.50
Rate for Payer: Oxford Commercial	$1,285.00
Rate for Payer: Qualcare PPO/HMO/WC	$963.75
Rate for Payer: UnitedHealthcare Commercial	$1,285.00
Rate for Payer: UnitedHealthcare Community & State	$203.03
Rate for Payer: Wellpoint Medicaid Managed Care	$182.47

KIT STAPLE FUSEFORSE 25X22MM

Facility

$6,425.00

Hospital Charge Code	270678358
Hospital Revenue Code	272
Min. Negotiated Rate	$963.75
Max. Negotiated Rate	$963.75
Rate for Payer: Qualcare PPO/HMO/WC	$963.75

KIT STAPLER HEMORRHOID PPH03

Facility

$1,987.65

Hospital Charge Code	270632860
Hospital Revenue Code	272
Min. Negotiated Rate	$56.45
Max. Negotiated Rate	$993.83
Rate for Payer: Aetna Commercial	$755.31
Rate for Payer: Aetna Medicare Advantage	$596.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$506.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$506.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$506.85
Rate for Payer: Cigna Commercial	$993.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$516.79
Rate for Payer: Oxford Commercial	$397.53
Rate for Payer: Qualcare PPO/HMO/WC	$298.15
Rate for Payer: UnitedHealthcare Commercial	$397.53
Rate for Payer: UnitedHealthcare Community & State	$62.81
Rate for Payer: Wellpoint Medicaid Managed Care	$56.45

KIT STAPLER HEMORRHOID PPH03

Facility

$1,987.65

Hospital Charge Code	270632860
Hospital Revenue Code	272
Min. Negotiated Rate	$298.15
Max. Negotiated Rate	$298.15
Rate for Payer: Qualcare PPO/HMO/WC	$298.15

KIT STAPLE STRAIGHT 8X 8 MM

Facility

$6,585.00

Service Code	HCPCS C1713
Hospital Charge Code	270700260
Hospital Revenue Code	278
Min. Negotiated Rate	$987.75
Max. Negotiated Rate	$1,593.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,317.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,593.57
Rate for Payer: Qualcare PPO/HMO/WC	$987.75

KIT STAPLE STRAIGHT 8X 8 MM

Facility

$6,585.00

Service Code	HCPCS C1713
Hospital Charge Code	270700260
Hospital Revenue Code	278
Min. Negotiated Rate	$187.01
Max. Negotiated Rate	$3,292.50
Rate for Payer: Aetna Commercial	$2,502.30
Rate for Payer: Aetna Medicare Advantage	$1,975.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,679.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,679.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,317.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,679.17
Rate for Payer: Cigna Commercial	$3,292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,593.57
Rate for Payer: Qualcare PPO/HMO/WC	$987.75
Rate for Payer: UnitedHealthcare Community & State	$208.09
Rate for Payer: Wellpoint Medicaid Managed Care	$187.01

KIT STERILE WATER 1000ml

Facility

$14.58

Hospital Charge Code	270645085
Hospital Revenue Code	270
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$2.19
Rate for Payer: Qualcare PPO/HMO/WC	$2.19

KIT STERILE WATER 1000ml

Facility

$14.58

Hospital Charge Code	270645085
Hospital Revenue Code	270
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$7.29
Rate for Payer: Aetna Commercial	$5.54
Rate for Payer: Aetna Medicare Advantage	$4.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.72
Rate for Payer: Cigna Commercial	$7.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.79
Rate for Payer: Oxford Commercial	$2.92
Rate for Payer: Qualcare PPO/HMO/WC	$2.19
Rate for Payer: UnitedHealthcare Commercial	$2.92
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.41

KIT SUCTION W/CUP 14FR

Facility

$2.06

Hospital Charge Code	270649681
Hospital Revenue Code	270
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.03
Rate for Payer: Aetna Commercial	$0.78
Rate for Payer: Aetna Medicare Advantage	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.53
Rate for Payer: Cigna Commercial	$1.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.54
Rate for Payer: Oxford Commercial	$0.41
Rate for Payer: Qualcare PPO/HMO/WC	$0.31
Rate for Payer: UnitedHealthcare Commercial	$0.41
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.06

KIT SUCTION W/CUP 14FR

Facility

$2.06

Hospital Charge Code	270649681
Hospital Revenue Code	270
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$0.31
Rate for Payer: Qualcare PPO/HMO/WC	$0.31

KIT SUPERION IDS 102-9800

Facility

$1,500.00

Service Code	HCPCS A4649
Hospital Charge Code	270698877
Hospital Revenue Code	272
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

KIT SUPERION IDS 102-9800

Facility

$1,500.00

Service Code	HCPCS A4649
Hospital Charge Code	270698877
Hospital Revenue Code	272
Min. Negotiated Rate	$42.60
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.00
Rate for Payer: Oxford Commercial	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Commercial	$300.00
Rate for Payer: UnitedHealthcare Community & State	$47.40
Rate for Payer: Wellpoint Medicaid Managed Care	$42.60

KIT SUTURE

Facility

$45.75

Hospital Charge Code	270681104N
Hospital Revenue Code	272
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$22.88
Rate for Payer: Aetna Commercial	$17.39
Rate for Payer: Aetna Medicare Advantage	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.67
Rate for Payer: Cigna Commercial	$22.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.89
Rate for Payer: Oxford Commercial	$9.15
Rate for Payer: Qualcare PPO/HMO/WC	$6.86
Rate for Payer: UnitedHealthcare Commercial	$9.15
Rate for Payer: UnitedHealthcare Community & State	$1.45
Rate for Payer: Wellpoint Medicaid Managed Care	$1.30

KIT SUTURE

Facility

$45.75

Hospital Charge Code	270681104
Hospital Revenue Code	272
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$22.88
Rate for Payer: Aetna Commercial	$17.39
Rate for Payer: Aetna Medicare Advantage	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.67
Rate for Payer: Cigna Commercial	$22.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.89
Rate for Payer: Oxford Commercial	$9.15
Rate for Payer: Qualcare PPO/HMO/WC	$6.86
Rate for Payer: UnitedHealthcare Commercial	$9.15
Rate for Payer: UnitedHealthcare Community & State	$1.45
Rate for Payer: Wellpoint Medicaid Managed Care	$1.30

KIT SUTURE

Facility

$45.75

Hospital Charge Code	270681104N
Hospital Revenue Code	272
Min. Negotiated Rate	$6.86
Max. Negotiated Rate	$6.86
Rate for Payer: Qualcare PPO/HMO/WC	$6.86

KIT SUTURE

Facility

$45.75

Hospital Charge Code	270681104S
Hospital Revenue Code	272
Min. Negotiated Rate	$6.86
Max. Negotiated Rate	$6.86
Rate for Payer: Qualcare PPO/HMO/WC	$6.86

KIT SUTURE

Facility

$45.75

Hospital Charge Code	270681104S
Hospital Revenue Code	272
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$22.88
Rate for Payer: Aetna Commercial	$17.39
Rate for Payer: Aetna Medicare Advantage	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.67
Rate for Payer: Cigna Commercial	$22.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.89
Rate for Payer: Oxford Commercial	$9.15
Rate for Payer: Qualcare PPO/HMO/WC	$6.86
Rate for Payer: UnitedHealthcare Commercial	$9.15
Rate for Payer: UnitedHealthcare Community & State	$1.45
Rate for Payer: Wellpoint Medicaid Managed Care	$1.30

KIT SUTURE

Facility

$45.75

Hospital Charge Code	270681104
Hospital Revenue Code	272
Min. Negotiated Rate	$6.86
Max. Negotiated Rate	$6.86
Rate for Payer: Qualcare PPO/HMO/WC	$6.86

KIT SUTURTAK CURVED

Facility

$975.00

Hospital Charge Code	270677688
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 SUTURTAK CURVED

Facility

$975.00

Hospital Charge Code	270677688
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

KIT SYNDEX WITH CONSTRICTOR

Facility

$12,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270700499
Hospital Revenue Code	278
Min. Negotiated Rate	$340.80
Max. Negotiated Rate	$6,000.00
Rate for Payer: Aetna Commercial	$4,560.00
Rate for Payer: Aetna Medicare Advantage	$3,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,060.00
Rate for Payer: Cigna Commercial	$6,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00
Rate for Payer: UnitedHealthcare Community & State	$379.20
Rate for Payer: Wellpoint Medicaid Managed Care	$340.80

KIT SYNDEX WITH CONSTRICTOR

Facility

$12,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270700499
Hospital Revenue Code	278
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$2,904.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

Know your out-of-pocket cost for care.

All Charges