Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA

Facility

$138,351.22

Service Code	MSDRG 956
Min. Negotiated Rate	$42,126.17
Max. Negotiated Rate	$138,351.22
Rate for Payer: Aetna Commercial	$100,393.83
Rate for Payer: Aetna Medicare Advantage	$138,351.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107,495.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107,495.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$44,343.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107,495.40
Rate for Payer: Cigna Commercial	$83,888.56
Rate for Payer: Cigna Medicare Advantage	$44,343.34
Rate for Payer: Clover Medicare Advantage	$42,126.17
Rate for Payer: EmblemHealth Commercial	$133,030.02
Rate for Payer: Humana Medicare Advantage	$45,673.64
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$44,343.34
Rate for Payer: Oxford Commercial	$66,304.06
Rate for Payer: UnitedHealthcare Commercial	$88,750.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$44,343.34
Rate for Payer: Wellcare Medicare Advantage	$44,343.34

LIMITOOR VOL LTG CSF DRAIN SYS

Facility

$450.00

Hospital Charge Code	270697035
Hospital Revenue Code	271
Min. Negotiated Rate	$12.78
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$171.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Commercial	$90.00
Rate for Payer: UnitedHealthcare Community & State	$14.22
Rate for Payer: Wellpoint Medicaid Managed Care	$12.78

LIMITOOR VOL LTG CSF DRAIN SYS

Facility

$450.00

Hospital Charge Code	270697035
Hospital Revenue Code	271
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

LINDANE 1% LOTION 60 ML

Facility

$14.81

Service Code	NDC 61748040102
Hospital Charge Code	6003321
Hospital Revenue Code	250
Min. Negotiated Rate	$2.22
Max. Negotiated Rate	$2.22
Rate for Payer: Qualcare PPO/HMO/WC	$2.22

LINDANE 1% LOTION 60 ML

Facility

$14.81

Service Code	NDC 61748040102
Hospital Charge Code	6003321
Hospital Revenue Code	250
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$7.41
Rate for Payer: Aetna Commercial	$5.63
Rate for Payer: Aetna Medicare Advantage	$4.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.78
Rate for Payer: Cigna Commercial	$7.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.85
Rate for Payer: Oxford Commercial	$2.96
Rate for Payer: Qualcare PPO/HMO/WC	$2.22
Rate for Payer: UnitedHealthcare Commercial	$2.96
Rate for Payer: UnitedHealthcare Community & State	$0.47
Rate for Payer: Wellpoint Medicaid Managed Care	$0.42

LINEAR CUTTER 75MM

Facility

$267.00

Hospital Charge Code	270338707
Hospital Revenue Code	272
Min. Negotiated Rate	$7.58
Max. Negotiated Rate	$133.50
Rate for Payer: Aetna Commercial	$101.46
Rate for Payer: Aetna Medicare Advantage	$80.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.08
Rate for Payer: Cigna Commercial	$133.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.42
Rate for Payer: Oxford Commercial	$53.40
Rate for Payer: Qualcare PPO/HMO/WC	$40.05
Rate for Payer: UnitedHealthcare Commercial	$53.40
Rate for Payer: UnitedHealthcare Community & State	$8.44
Rate for Payer: Wellpoint Medicaid Managed Care	$7.58

LINEAR CUTTER 75MM

Facility

$267.00

Hospital Charge Code	270338707
Hospital Revenue Code	272
Min. Negotiated Rate	$40.05
Max. Negotiated Rate	$40.05
Rate for Payer: Qualcare PPO/HMO/WC	$40.05

LINEAR CUTTER ECH FLEX 60MM 28

Facility

$1,887.30

Hospital Charge Code	270671549
Hospital Revenue Code	272
Min. Negotiated Rate	$53.60
Max. Negotiated Rate	$943.65
Rate for Payer: Aetna Commercial	$717.17
Rate for Payer: Aetna Medicare Advantage	$566.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$481.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$481.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$481.26
Rate for Payer: Cigna Commercial	$943.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$490.70
Rate for Payer: Oxford Commercial	$377.46
Rate for Payer: Qualcare PPO/HMO/WC	$283.10
Rate for Payer: UnitedHealthcare Commercial	$377.46
Rate for Payer: UnitedHealthcare Community & State	$59.64
Rate for Payer: Wellpoint Medicaid Managed Care	$53.60

LINEAR CUTTER ECH FLEX 60MM 28

Facility

$1,887.30

Hospital Charge Code	270671549
Hospital Revenue Code	272
Min. Negotiated Rate	$283.10
Max. Negotiated Rate	$283.10
Rate for Payer: Qualcare PPO/HMO/WC	$283.10

LINEAR CUTTER STAPLER 55MM

Facility

$178.00

Hospital Charge Code	270335692
Hospital Revenue Code	272
Min. Negotiated Rate	$5.06
Max. Negotiated Rate	$89.00
Rate for Payer: Aetna Commercial	$67.64
Rate for Payer: Aetna Medicare Advantage	$53.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.39
Rate for Payer: Cigna Commercial	$89.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.28
Rate for Payer: Oxford Commercial	$35.60
Rate for Payer: Qualcare PPO/HMO/WC	$26.70
Rate for Payer: UnitedHealthcare Commercial	$35.60
Rate for Payer: UnitedHealthcare Community & State	$5.62
Rate for Payer: Wellpoint Medicaid Managed Care	$5.06

LINEAR CUTTER STAPLER 55MM

Facility

$178.00

Hospital Charge Code	270335692
Hospital Revenue Code	272
Min. Negotiated Rate	$26.70
Max. Negotiated Rate	$26.70
Rate for Payer: Qualcare PPO/HMO/WC	$26.70

LINEAR INTRALUMINAL STAPLER

Facility

$511.00

Hospital Charge Code	270338714
Hospital Revenue Code	272
Min. Negotiated Rate	$14.51
Max. Negotiated Rate	$255.50
Rate for Payer: Aetna Commercial	$194.18
Rate for Payer: Aetna Medicare Advantage	$153.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.31
Rate for Payer: Cigna Commercial	$255.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.86
Rate for Payer: Oxford Commercial	$102.20
Rate for Payer: Qualcare PPO/HMO/WC	$76.65
Rate for Payer: UnitedHealthcare Commercial	$102.20
Rate for Payer: UnitedHealthcare Community & State	$16.15
Rate for Payer: Wellpoint Medicaid Managed Care	$14.51

LINEAR INTRALUMINAL STAPLER

Facility

$511.00

Hospital Charge Code	270338714
Hospital Revenue Code	272
Min. Negotiated Rate	$76.65
Max. Negotiated Rate	$76.65
Rate for Payer: Qualcare PPO/HMO/WC	$76.65

LINEAR STAPLER 30MM

Facility

$170.00

Hospital Charge Code	270338697
Hospital Revenue Code	272
Min. Negotiated Rate	$25.50
Max. Negotiated Rate	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.50

LINEAR STAPLER 30MM

Facility

$170.00

Hospital Charge Code	270338697
Hospital Revenue Code	272
Min. Negotiated Rate	$4.83
Max. Negotiated Rate	$85.00
Rate for Payer: Aetna Commercial	$64.60
Rate for Payer: Aetna Medicare Advantage	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.35
Rate for Payer: Cigna Commercial	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.20
Rate for Payer: Oxford Commercial	$34.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.50
Rate for Payer: UnitedHealthcare Commercial	$34.00
Rate for Payer: UnitedHealthcare Community & State	$5.37
Rate for Payer: Wellpoint Medicaid Managed Care	$4.83

LINEAR STAPLER 60MM

Facility

$174.00

Hospital Charge Code	270338699
Hospital Revenue Code	272
Min. Negotiated Rate	$26.10
Max. Negotiated Rate	$26.10
Rate for Payer: Qualcare PPO/HMO/WC	$26.10

LINEAR STAPLER 60MM

Facility

$174.00

Hospital Charge Code	270338699
Hospital Revenue Code	272
Min. Negotiated Rate	$4.94
Max. Negotiated Rate	$87.00
Rate for Payer: Aetna Commercial	$66.12
Rate for Payer: Aetna Medicare Advantage	$52.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.37
Rate for Payer: Cigna Commercial	$87.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.24
Rate for Payer: Oxford Commercial	$34.80
Rate for Payer: Qualcare PPO/HMO/WC	$26.10
Rate for Payer: UnitedHealthcare Commercial	$34.80
Rate for Payer: UnitedHealthcare Community & State	$5.50
Rate for Payer: Wellpoint Medicaid Managed Care	$4.94

LINEAR STAPLER 90MM

Facility

$180.00

Hospital Charge Code	270338705
Hospital Revenue Code	272
Min. Negotiated Rate	$5.11
Max. Negotiated Rate	$90.00
Rate for Payer: Aetna Commercial	$68.40
Rate for Payer: Aetna Medicare Advantage	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.90
Rate for Payer: Cigna Commercial	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.80
Rate for Payer: Oxford Commercial	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00
Rate for Payer: UnitedHealthcare Commercial	$36.00
Rate for Payer: UnitedHealthcare Community & State	$5.69
Rate for Payer: Wellpoint Medicaid Managed Care	$5.11

LINEAR STAPLER 90MM

Facility

$180.00

Hospital Charge Code	270338705
Hospital Revenue Code	272
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00

LINER 42MM DUAL MOBILITY

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270690602
Hospital Revenue Code	278
Min. Negotiated Rate	$142.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Community & State	$158.00
Rate for Payer: Wellpoint Medicaid Managed Care	$142.00

LINER 42MM DUAL MOBILITY

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270690602
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

LINER 67/63MM X 18 MM

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270688247
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

LINER 67/63MM X 18 MM

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270688247
Hospital Revenue Code	278
Min. Negotiated Rate	$170.40
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$189.60
Rate for Payer: Wellpoint Medicaid Managed Care	$170.40

LINER ACET 36MM

Facility

$7,875.00

Service Code	HCPCS C1776
Hospital Charge Code	270692211
Hospital Revenue Code	278
Min. Negotiated Rate	$223.65
Max. Negotiated Rate	$3,937.50
Rate for Payer: Aetna Commercial	$2,992.50
Rate for Payer: Aetna Medicare Advantage	$2,362.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,008.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,008.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,008.12
Rate for Payer: Cigna Commercial	$3,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,905.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,181.25
Rate for Payer: UnitedHealthcare Community & State	$248.85
Rate for Payer: Wellpoint Medicaid Managed Care	$223.65

LINER ACET 36MM

Facility

$7,875.00

Service Code	HCPCS C1776
Hospital Charge Code	270692211
Hospital Revenue Code	278
Min. Negotiated Rate	$1,181.25
Max. Negotiated Rate	$1,905.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,905.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,181.25

Know your out-of-pocket cost for care.

All Charges