Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

KIT VERTIFLEX SUPERION VIP

Facility

$1,500.00

Service Code	HCPCS A4649
Hospital Charge Code	270698878
Hospital Revenue Code	272
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

KIT VIZADISC HIP

Facility

$1,150.00

Hospital Charge Code	270668614
Hospital Revenue Code	272
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$172.50
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

KIT VIZADISC HIP

Facility

$1,150.00

Hospital Charge Code	270668614
Hospital Revenue Code	272
Min. Negotiated Rate	$32.66
Max. Negotiated Rate	$575.00
Rate for Payer: Aetna Commercial	$437.00
Rate for Payer: Aetna Medicare Advantage	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.25
Rate for Payer: Cigna Commercial	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$299.00
Rate for Payer: Oxford Commercial	$230.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.50
Rate for Payer: UnitedHealthcare Commercial	$230.00
Rate for Payer: UnitedHealthcare Community & State	$36.34
Rate for Payer: Wellpoint Medicaid Managed Care	$32.66

KIT WAVE WRITER ALPHA THAL

Facility

$500.00

Hospital Charge Code	270701897
Hospital Revenue Code	278
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

KIT WAVE WRITER ALPHA THAL

Facility

$500.00

Hospital Charge Code	270701897
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

KIT WOUNDEVAC 400ml SU1304040

Facility

$41.05

Hospital Charge Code	270627962
Hospital Revenue Code	272
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$20.52
Rate for Payer: Aetna Commercial	$15.60
Rate for Payer: Aetna Medicare Advantage	$12.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.47
Rate for Payer: Cigna Commercial	$20.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.67
Rate for Payer: Oxford Commercial	$8.21
Rate for Payer: Qualcare PPO/HMO/WC	$6.16
Rate for Payer: UnitedHealthcare Commercial	$8.21
Rate for Payer: UnitedHealthcare Community & State	$1.30
Rate for Payer: Wellpoint Medicaid Managed Care	$1.17

KIT WOUNDEVAC 400ml SU1304040

Facility

$41.05

Hospital Charge Code	270627962
Hospital Revenue Code	272
Min. Negotiated Rate	$6.16
Max. Negotiated Rate	$6.16
Rate for Payer: Qualcare PPO/HMO/WC	$6.16

KIT WRIST LARGE TENET SYSTEM

Facility

$362.30

Hospital Charge Code	270688363
Hospital Revenue Code	272
Min. Negotiated Rate	$10.29
Max. Negotiated Rate	$181.15
Rate for Payer: Aetna Commercial	$137.67
Rate for Payer: Aetna Medicare Advantage	$108.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.39
Rate for Payer: Cigna Commercial	$181.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.20
Rate for Payer: Oxford Commercial	$72.46
Rate for Payer: Qualcare PPO/HMO/WC	$54.34
Rate for Payer: UnitedHealthcare Commercial	$72.46
Rate for Payer: UnitedHealthcare Community & State	$11.45
Rate for Payer: Wellpoint Medicaid Managed Care	$10.29

KIT WRIST LARGE TENET SYSTEM

Facility

$362.30

Hospital Charge Code	270688363
Hospital Revenue Code	272
Min. Negotiated Rate	$54.34
Max. Negotiated Rate	$54.34
Rate for Payer: Qualcare PPO/HMO/WC	$54.34

KIT WRIST MEDIUM TENET SYSTEM

Facility

$362.30

Hospital Charge Code	270688364
Hospital Revenue Code	272
Min. Negotiated Rate	$54.34
Max. Negotiated Rate	$54.34
Rate for Payer: Qualcare PPO/HMO/WC	$54.34

KIT WRIST MEDIUM TENET SYSTEM

Facility

$362.30

Hospital Charge Code	270688364
Hospital Revenue Code	272
Min. Negotiated Rate	$10.29
Max. Negotiated Rate	$181.15
Rate for Payer: Aetna Commercial	$137.67
Rate for Payer: Aetna Medicare Advantage	$108.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.39
Rate for Payer: Cigna Commercial	$181.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.20
Rate for Payer: Oxford Commercial	$72.46
Rate for Payer: Qualcare PPO/HMO/WC	$54.34
Rate for Payer: UnitedHealthcare Commercial	$72.46
Rate for Payer: UnitedHealthcare Community & State	$11.45
Rate for Payer: Wellpoint Medicaid Managed Care	$10.29

KIT WRIST SMALL TENET SYSTEM

Facility

$362.30

Hospital Charge Code	270688365
Hospital Revenue Code	272
Min. Negotiated Rate	$54.34
Max. Negotiated Rate	$54.34
Rate for Payer: Qualcare PPO/HMO/WC	$54.34

KIT WRIST SMALL TENET SYSTEM

Facility

$362.30

Hospital Charge Code	270688365
Hospital Revenue Code	272
Min. Negotiated Rate	$10.29
Max. Negotiated Rate	$181.15
Rate for Payer: Aetna Commercial	$137.67
Rate for Payer: Aetna Medicare Advantage	$108.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.39
Rate for Payer: Cigna Commercial	$181.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.20
Rate for Payer: Oxford Commercial	$72.46
Rate for Payer: Qualcare PPO/HMO/WC	$54.34
Rate for Payer: UnitedHealthcare Commercial	$72.46
Rate for Payer: UnitedHealthcare Community & State	$11.45
Rate for Payer: Wellpoint Medicaid Managed Care	$10.29

KIT ZIM PULSEVAC FAN 5150-475

Facility

$650.00

Hospital Charge Code	270626178
Hospital Revenue Code	272
Min. Negotiated Rate	$18.46
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.00
Rate for Payer: Oxford Commercial	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Commercial	$130.00
Rate for Payer: UnitedHealthcare Community & State	$20.54
Rate for Payer: Wellpoint Medicaid Managed Care	$18.46

KIT ZIM PULSEVAC FAN 5150-475

Facility

$650.00

Hospital Charge Code	270626178
Hospital Revenue Code	272
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

KLEIHAUER-BETKE STAIN

Facility

$226.10

Service Code	HCPCS 85460
Hospital Charge Code	397043304
Hospital Revenue Code	305
Min. Negotiated Rate	$6.18
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$21.03
Rate for Payer: Aetna Medicare Advantage	$25.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.04
Rate for Payer: Cigna Commercial	$113.05
Rate for Payer: Cigna Medicare Advantage	$7.73
Rate for Payer: Clover Medicare Advantage	$7.34
Rate for Payer: EmblemHealth Commercial	$23.19
Rate for Payer: Humana Medicare Advantage	$7.96
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.79
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.91
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$6.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.73
Rate for Payer: Wellcare Medicare Advantage	$7.73
Rate for Payer: Wellpoint Medicaid Managed Care	$6.42

KLEIHAUER-BETKE STAIN

Facility

$226.10

Service Code	HCPCS 85460
Hospital Charge Code	397043304
Hospital Revenue Code	305
Min. Negotiated Rate	$33.91
Max. Negotiated Rate	$33.91
Rate for Payer: Qualcare PPO/HMO/WC	$33.91

KLEPPINGER FORCEPS

Facility

$1,030.00

Hospital Charge Code	270335091
Hospital Revenue Code	272
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$515.00
Rate for Payer: Aetna Commercial	$391.40
Rate for Payer: Aetna Medicare Advantage	$309.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$262.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$262.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$262.65
Rate for Payer: Cigna Commercial	$515.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$267.80
Rate for Payer: Oxford Commercial	$206.00
Rate for Payer: Qualcare PPO/HMO/WC	$154.50
Rate for Payer: UnitedHealthcare Commercial	$206.00
Rate for Payer: UnitedHealthcare Community & State	$32.55
Rate for Payer: Wellpoint Medicaid Managed Care	$29.25

KLEPPINGER FORCEPS

Facility

$1,030.00

Hospital Charge Code	270335091
Hospital Revenue Code	272
Min. Negotiated Rate	$154.50
Max. Negotiated Rate	$154.50
Rate for Payer: Qualcare PPO/HMO/WC	$154.50

KLING 1

Facility

$9.65

Hospital Charge Code	270350010
Hospital Revenue Code	272
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.45

KLING 1

Facility

$9.65

Hospital Charge Code	270350010
Hospital Revenue Code	272
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$4.83
Rate for Payer: Aetna Commercial	$3.67
Rate for Payer: Aetna Medicare Advantage	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.46
Rate for Payer: Cigna Commercial	$4.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.51
Rate for Payer: Oxford Commercial	$1.93
Rate for Payer: Qualcare PPO/HMO/WC	$1.45
Rate for Payer: UnitedHealthcare Commercial	$1.93
Rate for Payer: UnitedHealthcare Community & State	$0.30
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

KLING 3

Facility

$5.00

Hospital Charge Code	270350025
Hospital Revenue Code	272
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

KLING 3

Facility

$5.00

Hospital Charge Code	270350025
Hospital Revenue Code	272
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.90
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.30
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$1.00
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

KLING 4

Facility

$5.00

Hospital Charge Code	270350030
Hospital Revenue Code	272
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.90
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.30
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$1.00
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

KLING 4

Facility

$5.00

Hospital Charge Code	270350030
Hospital Revenue Code	272
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

Know your out-of-pocket cost for care.

All Charges