Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

LIFEPORT POWER IMPLANT (BARD)

Facility

$2,010.00

Service Code	HCPCS C1788
Hospital Charge Code	270650771
Hospital Revenue Code	278
Min. Negotiated Rate	$57.08
Max. Negotiated Rate	$1,005.00
Rate for Payer: Aetna Commercial	$763.80
Rate for Payer: Aetna Medicare Advantage	$603.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$512.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$512.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$402.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$512.55
Rate for Payer: Cigna Commercial	$1,005.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$486.42
Rate for Payer: Qualcare PPO/HMO/WC	$301.50
Rate for Payer: UnitedHealthcare Community & State	$63.52
Rate for Payer: Wellpoint Medicaid Managed Care	$57.08

LIFEPORT POWER IMPLANT (BARD)

Facility

$2,010.00

Service Code	HCPCS C1788
Hospital Charge Code	270650771
Hospital Revenue Code	278
Min. Negotiated Rate	$301.50
Max. Negotiated Rate	$486.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$402.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$486.42
Rate for Payer: Qualcare PPO/HMO/WC	$301.50

LIFE PORT VENOUS SYSTEM

Facility

$4,667.00

Service Code	HCPCS C1788
Hospital Charge Code	270335053
Hospital Revenue Code	278
Min. Negotiated Rate	$132.54
Max. Negotiated Rate	$2,333.50
Rate for Payer: Aetna Commercial	$1,773.46
Rate for Payer: Aetna Medicare Advantage	$1,400.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,190.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,190.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$933.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,190.09
Rate for Payer: Cigna Commercial	$2,333.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,129.41
Rate for Payer: Qualcare PPO/HMO/WC	$700.05
Rate for Payer: UnitedHealthcare Community & State	$147.48
Rate for Payer: Wellpoint Medicaid Managed Care	$132.54

LIFE PORT VENOUS SYSTEM

Facility

$4,667.00

Service Code	HCPCS C1788
Hospital Charge Code	270335053
Hospital Revenue Code	278
Min. Negotiated Rate	$700.05
Max. Negotiated Rate	$1,129.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$933.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,129.41
Rate for Payer: Qualcare PPO/HMO/WC	$700.05

LIFEPORT X-PORT ISP

Facility

$1,250.00

Hospital Charge Code	270660381
Hospital Revenue Code	270
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

LIFEPORT X-PORT ISP

Facility

$1,250.00

Hospital Charge Code	270660381
Hospital Revenue Code	270
Min. Negotiated Rate	$35.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$325.00
Rate for Payer: Oxford Commercial	$250.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Commercial	$250.00
Rate for Payer: UnitedHealthcare Community & State	$39.50
Rate for Payer: Wellpoint Medicaid Managed Care	$35.50

LIF GUIDEWIRE

Facility

$383.75

Hospital Charge Code	270702576
Hospital Revenue Code	278
Min. Negotiated Rate	$10.90
Max. Negotiated Rate	$191.88
Rate for Payer: Aetna Commercial	$145.82
Rate for Payer: Aetna Medicare Advantage	$115.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.86
Rate for Payer: Cigna Commercial	$191.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.87
Rate for Payer: Qualcare PPO/HMO/WC	$57.56
Rate for Payer: UnitedHealthcare Community & State	$12.13
Rate for Payer: Wellpoint Medicaid Managed Care	$10.90

LIF GUIDEWIRE

Facility

$383.75

Hospital Charge Code	270702576
Hospital Revenue Code	278
Min. Negotiated Rate	$57.56
Max. Negotiated Rate	$92.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.87
Rate for Payer: Qualcare PPO/HMO/WC	$57.56

LIGACLIP APPLIER

Facility

$101.00

Hospital Charge Code	270338713
Hospital Revenue Code	272
Min. Negotiated Rate	$15.15
Max. Negotiated Rate	$15.15
Rate for Payer: Qualcare PPO/HMO/WC	$15.15

LIGACLIP APPLIER

Facility

$101.00

Hospital Charge Code	270338713
Hospital Revenue Code	272
Min. Negotiated Rate	$2.87
Max. Negotiated Rate	$50.50
Rate for Payer: Aetna Commercial	$38.38
Rate for Payer: Aetna Medicare Advantage	$30.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.75
Rate for Payer: Cigna Commercial	$50.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.26
Rate for Payer: Oxford Commercial	$20.20
Rate for Payer: Qualcare PPO/HMO/WC	$15.15
Rate for Payer: UnitedHealthcare Commercial	$20.20
Rate for Payer: UnitedHealthcare Community & State	$3.19
Rate for Payer: Wellpoint Medicaid Managed Care	$2.87

LIGACLIP APPLIER 5MM

Facility

$1,924.30

Hospital Charge Code	270655946
Hospital Revenue Code	272
Min. Negotiated Rate	$54.65
Max. Negotiated Rate	$962.15
Rate for Payer: Aetna Commercial	$731.23
Rate for Payer: Aetna Medicare Advantage	$577.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$490.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$490.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$490.70
Rate for Payer: Cigna Commercial	$962.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$500.32
Rate for Payer: Oxford Commercial	$384.86
Rate for Payer: Qualcare PPO/HMO/WC	$288.64
Rate for Payer: UnitedHealthcare Commercial	$384.86
Rate for Payer: UnitedHealthcare Community & State	$60.81
Rate for Payer: Wellpoint Medicaid Managed Care	$54.65

LIGACLIP APPLIER 5MM

Facility

$1,924.30

Hospital Charge Code	270655946
Hospital Revenue Code	272
Min. Negotiated Rate	$288.64
Max. Negotiated Rate	$288.64
Rate for Payer: Qualcare PPO/HMO/WC	$288.64

LIGACLIP APPLIER LG 13-1/4 IN

Facility

$245.56

Hospital Charge Code	270608749
Hospital Revenue Code	272
Min. Negotiated Rate	$36.83
Max. Negotiated Rate	$36.83
Rate for Payer: Qualcare PPO/HMO/WC	$36.83

LIGACLIP APPLIER LG 13-1/4 IN

Facility

$245.56

Hospital Charge Code	270608749
Hospital Revenue Code	272
Min. Negotiated Rate	$6.97
Max. Negotiated Rate	$122.78
Rate for Payer: Aetna Commercial	$93.31
Rate for Payer: Aetna Medicare Advantage	$73.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.62
Rate for Payer: Cigna Commercial	$122.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.85
Rate for Payer: Oxford Commercial	$49.11
Rate for Payer: Qualcare PPO/HMO/WC	$36.83
Rate for Payer: UnitedHealthcare Commercial	$49.11
Rate for Payer: UnitedHealthcare Community & State	$7.76
Rate for Payer: Wellpoint Medicaid Managed Care	$6.97

LIGACLIP APPLIER MED 11-1/2

Facility

$810.39

Hospital Charge Code	270655919
Hospital Revenue Code	271
Min. Negotiated Rate	$121.56
Max. Negotiated Rate	$121.56
Rate for Payer: Qualcare PPO/HMO/WC	$121.56

LIGACLIP APPLIER MED 11-1/2

Facility

$810.39

Hospital Charge Code	270655919
Hospital Revenue Code	271
Min. Negotiated Rate	$23.02
Max. Negotiated Rate	$405.19
Rate for Payer: Aetna Commercial	$307.95
Rate for Payer: Aetna Medicare Advantage	$243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$206.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$206.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$206.65
Rate for Payer: Cigna Commercial	$405.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$210.70
Rate for Payer: Oxford Commercial	$162.08
Rate for Payer: Qualcare PPO/HMO/WC	$121.56
Rate for Payer: UnitedHealthcare Commercial	$162.08
Rate for Payer: UnitedHealthcare Community & State	$25.61
Rate for Payer: Wellpoint Medicaid Managed Care	$23.02

LIGACLIP APPLIER SML 9-3/8

Facility

$791.05

Hospital Charge Code	270658411
Hospital Revenue Code	270
Min. Negotiated Rate	$22.47
Max. Negotiated Rate	$395.52
Rate for Payer: Aetna Commercial	$300.60
Rate for Payer: Aetna Medicare Advantage	$237.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.72
Rate for Payer: Cigna Commercial	$395.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.67
Rate for Payer: Oxford Commercial	$158.21
Rate for Payer: Qualcare PPO/HMO/WC	$118.66
Rate for Payer: UnitedHealthcare Commercial	$158.21
Rate for Payer: UnitedHealthcare Community & State	$25.00
Rate for Payer: Wellpoint Medicaid Managed Care	$22.47

LIGACLIP APPLIER SML 9-3/8

Facility

$791.05

Hospital Charge Code	270658411
Hospital Revenue Code	270
Min. Negotiated Rate	$118.66
Max. Negotiated Rate	$118.66
Rate for Payer: Qualcare PPO/HMO/WC	$118.66

LIGACLIP APPLIER SML 9-3/8

Facility

$22.50

Hospital Charge Code	270608739
Hospital Revenue Code	272
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$11.25
Rate for Payer: Aetna Commercial	$8.55
Rate for Payer: Aetna Medicare Advantage	$6.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.74
Rate for Payer: Cigna Commercial	$11.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.85
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.38
Rate for Payer: UnitedHealthcare Commercial	$4.50
Rate for Payer: UnitedHealthcare Community & State	$0.71
Rate for Payer: Wellpoint Medicaid Managed Care	$0.64

LIGACLIP APPLIER SML 9-3/8

Facility

$22.50

Hospital Charge Code	270608739
Hospital Revenue Code	272
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$3.38
Rate for Payer: Qualcare PPO/HMO/WC	$3.38

LIGAMENT AUGMENTATION REP KIT

Facility

$6,965.00

Hospital Charge Code	270665751
Hospital Revenue Code	272
Min. Negotiated Rate	$197.81
Max. Negotiated Rate	$3,482.50
Rate for Payer: Aetna Commercial	$2,646.70
Rate for Payer: Aetna Medicare Advantage	$2,089.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,776.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,776.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,776.08
Rate for Payer: Cigna Commercial	$3,482.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,810.90
Rate for Payer: Oxford Commercial	$1,393.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,044.75
Rate for Payer: UnitedHealthcare Commercial	$1,393.00
Rate for Payer: UnitedHealthcare Community & State	$220.09
Rate for Payer: Wellpoint Medicaid Managed Care	$197.81

LIGAMENT AUGMENTATION REP KIT

Facility

$6,965.00

Hospital Charge Code	270665751
Hospital Revenue Code	272
Min. Negotiated Rate	$1,044.75
Max. Negotiated Rate	$1,044.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,044.75

LIGAMENT CHISEL

Facility

$418.00

Hospital Charge Code	270335492
Hospital Revenue Code	272
Min. Negotiated Rate	$11.87
Max. Negotiated Rate	$209.00
Rate for Payer: Aetna Commercial	$158.84
Rate for Payer: Aetna Medicare Advantage	$125.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.59
Rate for Payer: Cigna Commercial	$209.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.68
Rate for Payer: Oxford Commercial	$83.60
Rate for Payer: Qualcare PPO/HMO/WC	$62.70
Rate for Payer: UnitedHealthcare Commercial	$83.60
Rate for Payer: UnitedHealthcare Community & State	$13.21
Rate for Payer: Wellpoint Medicaid Managed Care	$11.87

LIGAMENT CHISEL

Facility

$418.00

Hospital Charge Code	270335492
Hospital Revenue Code	272
Min. Negotiated Rate	$62.70
Max. Negotiated Rate	$62.70
Rate for Payer: Qualcare PPO/HMO/WC	$62.70

LIGAMENTOUS RECONSTRUCTION (AUGMENTATION), KNEE; INTRA-ARTICULAR (OPEN)

Facility

$55,329.13

Service Code	CPT 27428
Hospital Revenue Code	360
Min. Negotiated Rate	$3,536.00
Max. Negotiated Rate	$55,329.13
Rate for Payer: Aetna Commercial	$41,487.32
Rate for Payer: Aetna Medicare Advantage	$49,418.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55,329.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55,329.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,252.69
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	$55,329.13
Rate for Payer: Cigna Commercial	$30,573.98
Rate for Payer: Cigna Medicare Advantage	$15,252.69
Rate for Payer: Clover Medicare Advantage	$14,490.06
Rate for Payer: EmblemHealth Commercial	$45,758.07
Rate for Payer: Humana Medicare Advantage	$15,710.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,252.69
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,252.69
Rate for Payer: Wellcare Medicare Advantage	$15,252.69

Know your out-of-pocket cost for care.

All Charges