Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

APPLICATION OF LONG LEG CAST

Facility

$1,563.80

Service Code	HCPCS 29365
Hospital Charge Code	1600000357
Hospital Revenue Code	360
Min. Negotiated Rate	$234.57
Max. Negotiated Rate	$234.57
Rate for Payer: Qualcare PPO/HMO/WC	$234.57

APPLICATION SHORT LEG CAST

Facility

$1,360.45

Service Code	HCPCS 29405
Hospital Charge Code	412329405
Hospital Revenue Code	361
Min. Negotiated Rate	$38.64
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$903.80
Rate for Payer: Aetna Medicare Advantage	$1,076.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,205.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,205.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$332.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,205.35
Rate for Payer: Cigna Commercial	$666.07
Rate for Payer: Cigna Medicare Advantage	$332.28
Rate for Payer: Clover Medicare Advantage	$315.67
Rate for Payer: EmblemHealth Commercial	$996.84
Rate for Payer: Humana Medicare Advantage	$342.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$332.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$353.72
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$204.07
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$42.99
Rate for Payer: UnitedHealthcare Medicare Advantage	$332.28
Rate for Payer: Wellcare Medicare Advantage	$332.28
Rate for Payer: Wellpoint Medicaid Managed Care	$38.64

APPLICATION SHORT LEG CAST

Facility

$1,360.45

Service Code	HCPCS 29405
Hospital Charge Code	412329405
Hospital Revenue Code	361
Min. Negotiated Rate	$204.07
Max. Negotiated Rate	$204.07
Rate for Payer: Qualcare PPO/HMO/WC	$204.07

APPLICATOR ENDOSCOPIC 360

Facility

$3,278.20

Hospital Charge Code	270680888
Hospital Revenue Code	272
Min. Negotiated Rate	$93.10
Max. Negotiated Rate	$1,639.10
Rate for Payer: Aetna Commercial	$1,245.72
Rate for Payer: Aetna Medicare Advantage	$983.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$835.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$835.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$835.94
Rate for Payer: Cigna Commercial	$1,639.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$852.33
Rate for Payer: Oxford Commercial	$655.64
Rate for Payer: Qualcare PPO/HMO/WC	$491.73
Rate for Payer: UnitedHealthcare Commercial	$655.64
Rate for Payer: UnitedHealthcare Community & State	$103.59
Rate for Payer: Wellpoint Medicaid Managed Care	$93.10

APPLICATOR ENDOSCOPIC 360

Facility

$3,278.20

Hospital Charge Code	270680888
Hospital Revenue Code	272
Min. Negotiated Rate	$491.73
Max. Negotiated Rate	$491.73
Rate for Payer: Qualcare PPO/HMO/WC	$491.73

APPLICATOR ENDOSCOP SUGICEL

Facility

$104.00

Hospital Charge Code	270688737
Hospital Revenue Code	272
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$15.60
Rate for Payer: Qualcare PPO/HMO/WC	$15.60

APPLICATOR ENDOSCOP SUGICEL

Facility

$104.00

Hospital Charge Code	270688737
Hospital Revenue Code	272
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$52.00
Rate for Payer: Aetna Commercial	$39.52
Rate for Payer: Aetna Medicare Advantage	$31.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.52
Rate for Payer: Cigna Commercial	$52.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.04
Rate for Payer: Oxford Commercial	$20.80
Rate for Payer: Qualcare PPO/HMO/WC	$15.60
Rate for Payer: UnitedHealthcare Commercial	$20.80
Rate for Payer: UnitedHealthcare Community & State	$3.29
Rate for Payer: Wellpoint Medicaid Managed Care	$2.95

APPLICATOR FLEXIBLE 45 CM TIP

Facility

$319.70

Hospital Charge Code	270689526
Hospital Revenue Code	272
Min. Negotiated Rate	$9.08
Max. Negotiated Rate	$159.85
Rate for Payer: Aetna Commercial	$121.49
Rate for Payer: Aetna Medicare Advantage	$95.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.52
Rate for Payer: Cigna Commercial	$159.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.12
Rate for Payer: Oxford Commercial	$63.94
Rate for Payer: Qualcare PPO/HMO/WC	$47.95
Rate for Payer: UnitedHealthcare Commercial	$63.94
Rate for Payer: UnitedHealthcare Community & State	$10.10
Rate for Payer: Wellpoint Medicaid Managed Care	$9.08

APPLICATOR FLEXIBLE 45 CM TIP

Facility

$319.70

Hospital Charge Code	270689526
Hospital Revenue Code	272
Min. Negotiated Rate	$47.95
Max. Negotiated Rate	$47.95
Rate for Payer: Qualcare PPO/HMO/WC	$47.95

APPLICATOR FLEXTIP RIGID 38 CM

Facility

$207.50

Hospital Charge Code	270687376
Hospital Revenue Code	272
Min. Negotiated Rate	$31.12
Max. Negotiated Rate	$31.12
Rate for Payer: Qualcare PPO/HMO/WC	$31.12

APPLICATOR FLEXTIP RIGID 38 CM

Facility

$207.50

Hospital Charge Code	270687376
Hospital Revenue Code	272
Min. Negotiated Rate	$5.89
Max. Negotiated Rate	$103.75
Rate for Payer: Aetna Commercial	$78.85
Rate for Payer: Aetna Medicare Advantage	$62.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.91
Rate for Payer: Cigna Commercial	$103.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.95
Rate for Payer: Oxford Commercial	$41.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.12
Rate for Payer: UnitedHealthcare Commercial	$41.50
Rate for Payer: UnitedHealthcare Community & State	$6.56
Rate for Payer: Wellpoint Medicaid Managed Care	$5.89

APPLICATOR FLEXTIP XL ARISTA

Facility

$71.50

Hospital Charge Code	270687375
Hospital Revenue Code	272
Min. Negotiated Rate	$2.03
Max. Negotiated Rate	$35.75
Rate for Payer: Aetna Commercial	$27.17
Rate for Payer: Aetna Medicare Advantage	$21.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.23
Rate for Payer: Cigna Commercial	$35.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.59
Rate for Payer: Oxford Commercial	$14.30
Rate for Payer: Qualcare PPO/HMO/WC	$10.72
Rate for Payer: UnitedHealthcare Commercial	$14.30
Rate for Payer: UnitedHealthcare Community & State	$2.26
Rate for Payer: Wellpoint Medicaid Managed Care	$2.03

APPLICATOR FLEXTIP XL ARISTA

Facility

$71.50

Hospital Charge Code	270687375
Hospital Revenue Code	272
Min. Negotiated Rate	$10.72
Max. Negotiated Rate	$10.72
Rate for Payer: Qualcare PPO/HMO/WC	$10.72

APPLICATOR PROGEL EXTED 6

Facility

$300.00

Hospital Charge Code	270678576
Hospital Revenue Code	272
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

APPLICATOR PROGEL EXTED 6

Facility

$300.00

Hospital Charge Code	270678576
Hospital Revenue Code	272
Min. Negotiated Rate	$8.52
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.00
Rate for Payer: Oxford Commercial	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$60.00
Rate for Payer: UnitedHealthcare Community & State	$9.48
Rate for Payer: Wellpoint Medicaid Managed Care	$8.52

APPLICATOR SURGIFLO

Facility

$257.87

Hospital Charge Code	270688803
Hospital Revenue Code	272
Min. Negotiated Rate	$38.68
Max. Negotiated Rate	$38.68
Rate for Payer: Qualcare PPO/HMO/WC	$38.68

APPLICATOR SURGIFLO

Facility

$257.87

Hospital Charge Code	270688803
Hospital Revenue Code	272
Min. Negotiated Rate	$7.32
Max. Negotiated Rate	$128.94
Rate for Payer: Aetna Commercial	$97.99
Rate for Payer: Aetna Medicare Advantage	$77.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.76
Rate for Payer: Cigna Commercial	$128.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.05
Rate for Payer: Oxford Commercial	$51.57
Rate for Payer: Qualcare PPO/HMO/WC	$38.68
Rate for Payer: UnitedHealthcare Commercial	$51.57
Rate for Payer: UnitedHealthcare Community & State	$8.15
Rate for Payer: Wellpoint Medicaid Managed Care	$7.32

APPLICATOR ULTRAMIST

Facility

$270.00

Hospital Charge Code	270677093
Hospital Revenue Code	270
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$40.50
Rate for Payer: Qualcare PPO/HMO/WC	$40.50

APPLICATOR ULTRAMIST

Facility

$270.00

Hospital Charge Code	270677093
Hospital Revenue Code	270
Min. Negotiated Rate	$7.67
Max. Negotiated Rate	$135.00
Rate for Payer: Aetna Commercial	$102.60
Rate for Payer: Aetna Medicare Advantage	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.85
Rate for Payer: Cigna Commercial	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.20
Rate for Payer: Oxford Commercial	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.50
Rate for Payer: UnitedHealthcare Commercial	$54.00
Rate for Payer: UnitedHealthcare Community & State	$8.53
Rate for Payer: Wellpoint Medicaid Managed Care	$7.67

APPLIER ENDO CLIPS 5mm 544965

Facility

$7,691.25

Hospital Charge Code	270640218
Hospital Revenue Code	272
Min. Negotiated Rate	$218.43
Max. Negotiated Rate	$3,845.62
Rate for Payer: Aetna Commercial	$2,922.68
Rate for Payer: Aetna Medicare Advantage	$2,307.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,961.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,961.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,961.27
Rate for Payer: Cigna Commercial	$3,845.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,999.72
Rate for Payer: Oxford Commercial	$1,538.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,153.69
Rate for Payer: UnitedHealthcare Commercial	$1,538.25
Rate for Payer: UnitedHealthcare Community & State	$243.04
Rate for Payer: Wellpoint Medicaid Managed Care	$218.43

APPLIER ENDO CLIPS 5mm 544965

Facility

$7,691.25

Hospital Charge Code	270640218
Hospital Revenue Code	272
Min. Negotiated Rate	$1,153.69
Max. Negotiated Rate	$1,153.69
Rate for Payer: Qualcare PPO/HMO/WC	$1,153.69

APPLIER LIGACLIP MCA MED LONG

Facility

$588.25

Hospital Charge Code	270671547
Hospital Revenue Code	272
Min. Negotiated Rate	$16.71
Max. Negotiated Rate	$294.12
Rate for Payer: Aetna Commercial	$223.53
Rate for Payer: Aetna Medicare Advantage	$176.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$150.00
Rate for Payer: Cigna Commercial	$294.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.94
Rate for Payer: Oxford Commercial	$117.65
Rate for Payer: Qualcare PPO/HMO/WC	$88.24
Rate for Payer: UnitedHealthcare Commercial	$117.65
Rate for Payer: UnitedHealthcare Community & State	$18.59
Rate for Payer: Wellpoint Medicaid Managed Care	$16.71

APPLIER LIGACLIP MCA MED LONG

Facility

$588.25

Hospital Charge Code	270671547
Hospital Revenue Code	272
Min. Negotiated Rate	$88.24
Max. Negotiated Rate	$88.24
Rate for Payer: Qualcare PPO/HMO/WC	$88.24

APPLIER LIGACLIP MCA MED SHORT

Facility

$507.15

Hospital Charge Code	270671548
Hospital Revenue Code	272
Min. Negotiated Rate	$76.07
Max. Negotiated Rate	$76.07
Rate for Payer: Qualcare PPO/HMO/WC	$76.07

APPLIER LIGACLIP MCA MED SHORT

Facility

$507.15

Hospital Charge Code	270671548
Hospital Revenue Code	272
Min. Negotiated Rate	$14.40
Max. Negotiated Rate	$253.57
Rate for Payer: Aetna Commercial	$192.72
Rate for Payer: Aetna Medicare Advantage	$152.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$129.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$129.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$129.32
Rate for Payer: Cigna Commercial	$253.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.86
Rate for Payer: Oxford Commercial	$101.43
Rate for Payer: Qualcare PPO/HMO/WC	$76.07
Rate for Payer: UnitedHealthcare Commercial	$101.43
Rate for Payer: UnitedHealthcare Community & State	$16.03
Rate for Payer: Wellpoint Medicaid Managed Care	$14.40

Know your out-of-pocket cost for care.

All Charges