Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

AO CANNULATED HANDLE

Facility

$705.55

Service Code	HCPCS C1713
Hospital Charge Code	270704190
Hospital Revenue Code	278
Min. Negotiated Rate	$105.83
Max. Negotiated Rate	$170.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.74
Rate for Payer: Qualcare PPO/HMO/WC	$105.83

A-OK SLIT KNIVES 3.2MM

Facility

$365.00

Hospital Charge Code	270330823
Hospital Revenue Code	272
Min. Negotiated Rate	$10.37
Max. Negotiated Rate	$182.50
Rate for Payer: Aetna Commercial	$138.70
Rate for Payer: Aetna Medicare Advantage	$109.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.08
Rate for Payer: Cigna Commercial	$182.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.90
Rate for Payer: Oxford Commercial	$73.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.75
Rate for Payer: UnitedHealthcare Commercial	$73.00
Rate for Payer: UnitedHealthcare Community & State	$11.53
Rate for Payer: Wellpoint Medicaid Managed Care	$10.37

A-OK SLIT KNIVES 3.2MM

Facility

$365.00

Hospital Charge Code	270330823
Hospital Revenue Code	272
Min. Negotiated Rate	$54.75
Max. Negotiated Rate	$54.75
Rate for Payer: Qualcare PPO/HMO/WC	$54.75

AORTA&ILIAC ARTER DUP LTD

Facility

$17,200.00

Service Code	HCPCS 93979
Hospital Charge Code	74115054
Hospital Revenue Code	921
Min. Negotiated Rate	$117.99
Max. Negotiated Rate	$7,555.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$450.54
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$124.20
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,472.00
Rate for Payer: Oxford Commercial	$6,888.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$7,555.00
Rate for Payer: UnitedHealthcare Community & State	$543.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$488.48

AORTA&ILIAC ARTER DUP LTD

Facility

$17,200.00

Service Code	HCPCS 93979
Hospital Charge Code	2692095
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

AORTA&ILIAC ARTER DUP LTD

Facility

$17,200.00

Service Code	HCPCS 93979
Hospital Charge Code	2692095
Hospital Revenue Code	921
Min. Negotiated Rate	$117.99
Max. Negotiated Rate	$7,555.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$450.54
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$124.20
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,472.00
Rate for Payer: Oxford Commercial	$6,888.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$7,555.00
Rate for Payer: UnitedHealthcare Community & State	$543.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$488.48

AORTA&ILIAC ARTER DUP LTD

Facility

$17,200.00

Service Code	HCPCS 93979
Hospital Charge Code	74115054
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

AORT BDY SYS OVATN iX PMA 34MM

Facility

$56,395.00

Service Code	HCPCS C1768
Hospital Charge Code	270679784
Hospital Revenue Code	278
Min. Negotiated Rate	$1,601.62
Max. Negotiated Rate	$28,197.50
Rate for Payer: Aetna Commercial	$21,430.10
Rate for Payer: Aetna Medicare Advantage	$16,918.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,380.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,380.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,279.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,380.73
Rate for Payer: Cigna Commercial	$28,197.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,647.59
Rate for Payer: Qualcare PPO/HMO/WC	$8,459.25
Rate for Payer: UnitedHealthcare Community & State	$1,782.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1,601.62

AORT BDY SYS OVATN iX PMA 34MM

Facility

$56,395.00

Service Code	HCPCS C1768
Hospital Charge Code	270679784
Hospital Revenue Code	278
Min. Negotiated Rate	$8,459.25
Max. Negotiated Rate	$13,647.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,279.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,647.59
Rate for Payer: Qualcare PPO/HMO/WC	$8,459.25

AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC

Facility

$236,762.01

Service Code	MSDRG 268
Min. Negotiated Rate	$72,091.00
Max. Negotiated Rate	$236,762.01
Rate for Payer: Aetna Commercial	$170,483.14
Rate for Payer: Aetna Medicare Advantage	$236,762.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189,779.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189,779.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$75,885.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189,779.25
Rate for Payer: Cigna Commercial	$153,329.02
Rate for Payer: Cigna Medicare Advantage	$75,885.26
Rate for Payer: Clover Medicare Advantage	$72,091.00
Rate for Payer: EmblemHealth Commercial	$227,655.78
Rate for Payer: Humana Medicare Advantage	$78,161.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$75,885.26
Rate for Payer: Oxford Commercial	$121,188.60
Rate for Payer: UnitedHealthcare Commercial	$162,215.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$75,885.26
Rate for Payer: Wellcare Medicare Advantage	$75,885.26

AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC

Facility

$152,890.58

Service Code	MSDRG 269
Min. Negotiated Rate	$46,553.22
Max. Negotiated Rate	$152,890.58
Rate for Payer: Aetna Commercial	$110,748.93
Rate for Payer: Aetna Medicare Advantage	$152,890.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$115,252.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$115,252.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$49,003.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$115,252.80
Rate for Payer: Cigna Commercial	$94,147.80
Rate for Payer: Cigna Medicare Advantage	$49,003.39
Rate for Payer: Clover Medicare Advantage	$46,553.22
Rate for Payer: EmblemHealth Commercial	$147,010.17
Rate for Payer: Humana Medicare Advantage	$50,473.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$49,003.39
Rate for Payer: Oxford Commercial	$74,412.78
Rate for Payer: UnitedHealthcare Commercial	$99,604.17
Rate for Payer: UnitedHealthcare Medicare Advantage	$49,003.39
Rate for Payer: Wellcare Medicare Advantage	$49,003.39

AORTIC BODY 29MM ALTON

Facility

$69,995.00

Service Code	HCPCS C1768
Hospital Charge Code	270692801
Hospital Revenue Code	278
Min. Negotiated Rate	$10,499.25
Max. Negotiated Rate	$16,938.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13,999.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,938.79
Rate for Payer: Qualcare PPO/HMO/WC	$10,499.25

AORTIC BODY 29MM ALTON

Facility

$69,995.00

Service Code	HCPCS C1768
Hospital Charge Code	270692801
Hospital Revenue Code	278
Min. Negotiated Rate	$1,987.86
Max. Negotiated Rate	$34,997.50
Rate for Payer: Aetna Commercial	$26,598.10
Rate for Payer: Aetna Medicare Advantage	$20,998.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17,848.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17,848.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13,999.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17,848.72
Rate for Payer: Cigna Commercial	$34,997.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,938.79
Rate for Payer: Qualcare PPO/HMO/WC	$10,499.25
Rate for Payer: UnitedHealthcare Community & State	$2,211.84
Rate for Payer: Wellpoint Medicaid Managed Care	$1,987.86

AORTIC ENDOGRAFT KIT

Facility

$27,000.00

Hospital Charge Code	270339091
Hospital Revenue Code	272
Min. Negotiated Rate	$766.80
Max. Negotiated Rate	$13,500.00
Rate for Payer: Aetna Commercial	$10,260.00
Rate for Payer: Aetna Medicare Advantage	$8,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,885.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,885.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,885.00
Rate for Payer: Cigna Commercial	$13,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,020.00
Rate for Payer: Oxford Commercial	$5,400.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,050.00
Rate for Payer: UnitedHealthcare Commercial	$5,400.00
Rate for Payer: UnitedHealthcare Community & State	$853.20
Rate for Payer: Wellpoint Medicaid Managed Care	$766.80

AORTIC ENDOGRAFT KIT

Facility

$27,000.00

Hospital Charge Code	270339091
Hospital Revenue Code	272
Min. Negotiated Rate	$4,050.00
Max. Negotiated Rate	$4,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,050.00

AORTOGRAM ABD S&I

Facility

$21,359.77

Service Code	HCPCS 75625
Hospital Charge Code	74110052
Hospital Revenue Code	323
Min. Negotiated Rate	$3,203.97
Max. Negotiated Rate	$3,203.97
Rate for Payer: Qualcare PPO/HMO/WC	$3,203.97

AORTOGRAM ABD S&I

Facility

$21,359.77

Service Code	HCPCS 75625
Hospital Charge Code	366875625
Hospital Revenue Code	323
Min. Negotiated Rate	$3,203.97
Max. Negotiated Rate	$3,203.97
Rate for Payer: Qualcare PPO/HMO/WC	$3,203.97

AORTOGRAM ABD S&I

Facility

$21,359.77

Service Code	HCPCS 75625
Hospital Charge Code	366875625
Hospital Revenue Code	323
Min. Negotiated Rate	$249.48
Max. Negotiated Rate	$13,607.37
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$249.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,607.37
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$2,625.82
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,553.54
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,203.97
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$674.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$606.62

AORTOGRAM ABD S&I

Facility

$21,359.77

Service Code	HCPCS 75625
Hospital Charge Code	74110052
Hospital Revenue Code	323
Min. Negotiated Rate	$249.48
Max. Negotiated Rate	$13,607.37
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$249.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,607.37
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$2,625.82
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,553.54
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,203.97
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$674.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$606.62

APACHE 7MM LORDOTIC CAGE

Facility

$7,000.00

Hospital Charge Code	270667748
Hospital Revenue Code	278
Min. Negotiated Rate	$198.80
Max. Negotiated Rate	$3,500.00
Rate for Payer: Aetna Commercial	$2,660.00
Rate for Payer: Aetna Medicare Advantage	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,785.00
Rate for Payer: Cigna Commercial	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00
Rate for Payer: UnitedHealthcare Community & State	$221.20
Rate for Payer: Wellpoint Medicaid Managed Care	$198.80

APACHE 7MM LORDOTIC CAGE

Facility

$7,000.00

Hospital Charge Code	270667748
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$1,694.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

APAPBUTALBITALCAFF325-50-40 PO

Facility

$10.72

Service Code	NDC 527169505
Hospital Charge Code	60627731
Hospital Revenue Code	250
Min. Negotiated Rate	$1.61
Max. Negotiated Rate	$1.61
Rate for Payer: Qualcare PPO/HMO/WC	$1.61

APAPBUTALBITALCAFF325-50-40 PO

Facility

$10.72

Service Code	NDC 527169505
Hospital Charge Code	60627731
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$5.36
Rate for Payer: Aetna Commercial	$4.07
Rate for Payer: Aetna Medicare Advantage	$3.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.73
Rate for Payer: Cigna Commercial	$5.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.79
Rate for Payer: Oxford Commercial	$2.14
Rate for Payer: Qualcare PPO/HMO/WC	$1.61
Rate for Payer: UnitedHealthcare Commercial	$2.14
Rate for Payer: UnitedHealthcare Community & State	$0.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

APC ACTIV PROTEIN C RESISTANCE

Facility

$390.00

Service Code	HCPCS 85307
Hospital Charge Code	38478076
Hospital Revenue Code	305
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$41.67
Rate for Payer: Aetna Medicare Advantage	$49.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.57
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$15.32
Rate for Payer: Clover Medicare Advantage	$14.55
Rate for Payer: EmblemHealth Commercial	$45.96
Rate for Payer: Humana Medicare Advantage	$15.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$12.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.32
Rate for Payer: Wellcare Medicare Advantage	$15.32
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

APC ACTIV PROTEIN C RESISTANCE

Facility

$390.00

Service Code	HCPCS 85307
Hospital Charge Code	38478076
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Know your out-of-pocket cost for care.

All Charges