Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

LOAD UNIT ENDO GIA 45 2.5R

Facility

$781.22

Hospital Charge Code	270619587
Hospital Revenue Code	272
Min. Negotiated Rate	$117.18
Max. Negotiated Rate	$117.18
Rate for Payer: Qualcare PPO/HMO/WC	$117.18

LOAD UNIT ENDO GIA 45 3.5R

Facility

$781.22

Hospital Charge Code	270619588
Hospital Revenue Code	272
Min. Negotiated Rate	$22.19
Max. Negotiated Rate	$390.61
Rate for Payer: Aetna Commercial	$296.86
Rate for Payer: Aetna Medicare Advantage	$234.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$199.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$199.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$199.21
Rate for Payer: Cigna Commercial	$390.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$203.12
Rate for Payer: Oxford Commercial	$156.24
Rate for Payer: Qualcare PPO/HMO/WC	$117.18
Rate for Payer: UnitedHealthcare Commercial	$156.24
Rate for Payer: UnitedHealthcare Community & State	$24.69
Rate for Payer: Wellpoint Medicaid Managed Care	$22.19

LOAD UNIT ENDO GIA 45 3.5R

Facility

$781.22

Hospital Charge Code	270619588
Hospital Revenue Code	272
Min. Negotiated Rate	$117.18
Max. Negotiated Rate	$117.18
Rate for Payer: Qualcare PPO/HMO/WC	$117.18

LOAD UNIT ENDO GIA 45 4.8R

Facility

$820.33

Hospital Charge Code	270640220
Hospital Revenue Code	272
Min. Negotiated Rate	$23.30
Max. Negotiated Rate	$410.17
Rate for Payer: Aetna Commercial	$311.73
Rate for Payer: Aetna Medicare Advantage	$246.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.18
Rate for Payer: Cigna Commercial	$410.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.29
Rate for Payer: Oxford Commercial	$164.07
Rate for Payer: Qualcare PPO/HMO/WC	$123.05
Rate for Payer: UnitedHealthcare Commercial	$164.07
Rate for Payer: UnitedHealthcare Community & State	$25.92
Rate for Payer: Wellpoint Medicaid Managed Care	$23.30

LOAD UNIT ENDO GIA 45 4.8R

Facility

$820.33

Hospital Charge Code	270640220
Hospital Revenue Code	272
Min. Negotiated Rate	$123.05
Max. Negotiated Rate	$123.05
Rate for Payer: Qualcare PPO/HMO/WC	$123.05

LOAD UNIT ENDO GIA 60-3.5R

Facility

$1,777.35

Hospital Charge Code	270660575
Hospital Revenue Code	272
Min. Negotiated Rate	$50.48
Max. Negotiated Rate	$888.67
Rate for Payer: Aetna Commercial	$675.39
Rate for Payer: Aetna Medicare Advantage	$533.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$453.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$453.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$453.22
Rate for Payer: Cigna Commercial	$888.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$462.11
Rate for Payer: Oxford Commercial	$355.47
Rate for Payer: Qualcare PPO/HMO/WC	$266.60
Rate for Payer: UnitedHealthcare Commercial	$355.47
Rate for Payer: UnitedHealthcare Community & State	$56.16
Rate for Payer: Wellpoint Medicaid Managed Care	$50.48

LOAD UNIT ENDO GIA 60-3.5R

Facility

$1,777.35

Hospital Charge Code	270660575
Hospital Revenue Code	272
Min. Negotiated Rate	$266.60
Max. Negotiated Rate	$266.60
Rate for Payer: Qualcare PPO/HMO/WC	$266.60

LOAD UNIT ENDO GIA II 30-3.5

Facility

$439.47

Hospital Charge Code	270621874
Hospital Revenue Code	272
Min. Negotiated Rate	$12.48
Max. Negotiated Rate	$219.74
Rate for Payer: Aetna Commercial	$167.00
Rate for Payer: Aetna Medicare Advantage	$131.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.06
Rate for Payer: Cigna Commercial	$219.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.26
Rate for Payer: Oxford Commercial	$87.89
Rate for Payer: Qualcare PPO/HMO/WC	$65.92
Rate for Payer: UnitedHealthcare Commercial	$87.89
Rate for Payer: UnitedHealthcare Community & State	$13.89
Rate for Payer: Wellpoint Medicaid Managed Care	$12.48

LOAD UNIT ENDO GIA II 30-3.5

Facility

$439.47

Hospital Charge Code	270621874
Hospital Revenue Code	272
Min. Negotiated Rate	$65.92
Max. Negotiated Rate	$65.92
Rate for Payer: Qualcare PPO/HMO/WC	$65.92

LOAD UNIT ENDO GIA II 45-3.5

Facility

$439.47

Hospital Charge Code	270608866
Hospital Revenue Code	272
Min. Negotiated Rate	$65.92
Max. Negotiated Rate	$65.92
Rate for Payer: Qualcare PPO/HMO/WC	$65.92

LOAD UNIT ENDO GIA II 45-3.5

Facility

$439.47

Hospital Charge Code	270608866
Hospital Revenue Code	272
Min. Negotiated Rate	$12.48
Max. Negotiated Rate	$219.74
Rate for Payer: Aetna Commercial	$167.00
Rate for Payer: Aetna Medicare Advantage	$131.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.06
Rate for Payer: Cigna Commercial	$219.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.26
Rate for Payer: Oxford Commercial	$87.89
Rate for Payer: Qualcare PPO/HMO/WC	$65.92
Rate for Payer: UnitedHealthcare Commercial	$87.89
Rate for Payer: UnitedHealthcare Community & State	$13.89
Rate for Payer: Wellpoint Medicaid Managed Care	$12.48

LOAD UNIT ENDOWRIST 30MM BLUE

Facility

$854.15

Hospital Charge Code	270677822
Hospital Revenue Code	272
Min. Negotiated Rate	$128.12
Max. Negotiated Rate	$128.12
Rate for Payer: Qualcare PPO/HMO/WC	$128.12

LOAD UNIT ENDOWRIST 30MM BLUE

Facility

$854.15

Hospital Charge Code	270677822
Hospital Revenue Code	272
Min. Negotiated Rate	$24.26
Max. Negotiated Rate	$427.07
Rate for Payer: Aetna Commercial	$324.58
Rate for Payer: Aetna Medicare Advantage	$256.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$217.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$217.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$217.81
Rate for Payer: Cigna Commercial	$427.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.08
Rate for Payer: Oxford Commercial	$170.83
Rate for Payer: Qualcare PPO/HMO/WC	$128.12
Rate for Payer: UnitedHealthcare Commercial	$170.83
Rate for Payer: UnitedHealthcare Community & State	$26.99
Rate for Payer: Wellpoint Medicaid Managed Care	$24.26

LOAD UNIT ENDOWRIST 30MM GRAY

Facility

$10,250.00

Hospital Charge Code	270677911
Hospital Revenue Code	272
Min. Negotiated Rate	$291.10
Max. Negotiated Rate	$5,125.00
Rate for Payer: Aetna Commercial	$3,895.00
Rate for Payer: Aetna Medicare Advantage	$3,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,613.75
Rate for Payer: Cigna Commercial	$5,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,665.00
Rate for Payer: Oxford Commercial	$2,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50
Rate for Payer: UnitedHealthcare Commercial	$2,050.00
Rate for Payer: UnitedHealthcare Community & State	$323.90
Rate for Payer: Wellpoint Medicaid Managed Care	$291.10

LOAD UNIT ENDOWRIST 30MM GRAY

Facility

$10,250.00

Hospital Charge Code	270677911
Hospital Revenue Code	272
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$1,537.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

LOAD UNIT ENDOWRIST 30MM GREEN

Facility

$854.17

Hospital Charge Code	270677824
Hospital Revenue Code	272
Min. Negotiated Rate	$128.13
Max. Negotiated Rate	$128.13
Rate for Payer: Qualcare PPO/HMO/WC	$128.13

LOAD UNIT ENDOWRIST 30MM GREEN

Facility

$854.17

Hospital Charge Code	270677824
Hospital Revenue Code	272
Min. Negotiated Rate	$24.26
Max. Negotiated Rate	$427.08
Rate for Payer: Aetna Commercial	$324.58
Rate for Payer: Aetna Medicare Advantage	$256.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$217.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$217.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$217.81
Rate for Payer: Cigna Commercial	$427.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.08
Rate for Payer: Oxford Commercial	$170.83
Rate for Payer: Qualcare PPO/HMO/WC	$128.13
Rate for Payer: UnitedHealthcare Commercial	$170.83
Rate for Payer: UnitedHealthcare Community & State	$26.99
Rate for Payer: Wellpoint Medicaid Managed Care	$24.26

LOAD UNIT ENDOWRIST 30MM WHITE

Facility

$854.17

Hospital Charge Code	270677823
Hospital Revenue Code	272
Min. Negotiated Rate	$128.13
Max. Negotiated Rate	$128.13
Rate for Payer: Qualcare PPO/HMO/WC	$128.13

LOAD UNIT ENDOWRIST 30MM WHITE

Facility

$854.17

Hospital Charge Code	270677823
Hospital Revenue Code	272
Min. Negotiated Rate	$24.26
Max. Negotiated Rate	$427.08
Rate for Payer: Aetna Commercial	$324.58
Rate for Payer: Aetna Medicare Advantage	$256.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$217.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$217.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$217.81
Rate for Payer: Cigna Commercial	$427.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.08
Rate for Payer: Oxford Commercial	$170.83
Rate for Payer: Qualcare PPO/HMO/WC	$128.13
Rate for Payer: UnitedHealthcare Commercial	$170.83
Rate for Payer: UnitedHealthcare Community & State	$26.99
Rate for Payer: Wellpoint Medicaid Managed Care	$24.26

LOAD UNIT EN GIA 30 2.5 030418

Facility

$443.78

Hospital Charge Code	270621873
Hospital Revenue Code	270
Min. Negotiated Rate	$66.57
Max. Negotiated Rate	$66.57
Rate for Payer: Qualcare PPO/HMO/WC	$66.57

LOAD UNIT EN GIA 30 2.5 030418

Facility

$443.78

Hospital Charge Code	270621873
Hospital Revenue Code	270
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$221.89
Rate for Payer: Aetna Commercial	$168.64
Rate for Payer: Aetna Medicare Advantage	$133.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.16
Rate for Payer: Cigna Commercial	$221.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$115.38
Rate for Payer: Oxford Commercial	$88.76
Rate for Payer: Qualcare PPO/HMO/WC	$66.57
Rate for Payer: UnitedHealthcare Commercial	$88.76
Rate for Payer: UnitedHealthcare Community & State	$14.02
Rate for Payer: Wellpoint Medicaid Managed Care	$12.60

LOAD UNIT GIA 60-3.8 SINGLE US

Facility

$236.54

Hospital Charge Code	270600047
Hospital Revenue Code	272
Min. Negotiated Rate	$35.48
Max. Negotiated Rate	$35.48
Rate for Payer: Qualcare PPO/HMO/WC	$35.48

LOAD UNIT GIA 60-3.8 SINGLE US

Facility

$236.54

Hospital Charge Code	270600047
Hospital Revenue Code	272
Min. Negotiated Rate	$6.72
Max. Negotiated Rate	$118.27
Rate for Payer: Aetna Commercial	$89.89
Rate for Payer: Aetna Medicare Advantage	$70.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.32
Rate for Payer: Cigna Commercial	$118.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.50
Rate for Payer: Oxford Commercial	$47.31
Rate for Payer: Qualcare PPO/HMO/WC	$35.48
Rate for Payer: UnitedHealthcare Commercial	$47.31
Rate for Payer: UnitedHealthcare Community & State	$7.47
Rate for Payer: Wellpoint Medicaid Managed Care	$6.72

LOAD UNIT GIA 60-4.8 SINGLE

Facility

$233.07

Hospital Charge Code	270659453
Hospital Revenue Code	272
Min. Negotiated Rate	$34.96
Max. Negotiated Rate	$34.96
Rate for Payer: Qualcare PPO/HMO/WC	$34.96

LOAD UNIT GIA 60-4.8 SINGLE

Facility

$233.07

Hospital Charge Code	270659453
Hospital Revenue Code	272
Min. Negotiated Rate	$6.62
Max. Negotiated Rate	$116.53
Rate for Payer: Aetna Commercial	$88.57
Rate for Payer: Aetna Medicare Advantage	$69.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.43
Rate for Payer: Cigna Commercial	$116.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.60
Rate for Payer: Oxford Commercial	$46.61
Rate for Payer: Qualcare PPO/HMO/WC	$34.96
Rate for Payer: UnitedHealthcare Commercial	$46.61
Rate for Payer: UnitedHealthcare Community & State	$7.37
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

Know your out-of-pocket cost for care.

All Charges