Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

LOAD UNIT SURGIDAC 0 7 GREEN

Facility

$102.25

Hospital Charge Code	270669363
Hospital Revenue Code	272
Min. Negotiated Rate	$15.34
Max. Negotiated Rate	$15.34
Rate for Payer: Qualcare PPO/HMO/WC	$15.34

LOAD UNIT TA60-3.5 SINGLE USE

Facility

$203.85

Hospital Charge Code	270630409
Hospital Revenue Code	272
Min. Negotiated Rate	$30.58
Max. Negotiated Rate	$30.58
Rate for Payer: Qualcare PPO/HMO/WC	$30.58

LOAD UNIT TA60-3.5 SINGLE USE

Facility

$203.85

Hospital Charge Code	270630409
Hospital Revenue Code	272
Min. Negotiated Rate	$5.79
Max. Negotiated Rate	$101.92
Rate for Payer: Aetna Commercial	$77.46
Rate for Payer: Aetna Medicare Advantage	$61.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.98
Rate for Payer: Cigna Commercial	$101.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.00
Rate for Payer: Oxford Commercial	$40.77
Rate for Payer: Qualcare PPO/HMO/WC	$30.58
Rate for Payer: UnitedHealthcare Commercial	$40.77
Rate for Payer: UnitedHealthcare Community & State	$6.44
Rate for Payer: Wellpoint Medicaid Managed Care	$5.79

LOANER FEE ARTHOSCOPY TRAY

Facility

$1,000.00

Hospital Charge Code	270661562
Hospital Revenue Code	270
Min. Negotiated Rate	$28.40
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Oxford Commercial	$200.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$200.00
Rate for Payer: UnitedHealthcare Community & State	$31.60
Rate for Payer: Wellpoint Medicaid Managed Care	$28.40

LOANER FEE ARTHOSCOPY TRAY

Facility

$1,000.00

Hospital Charge Code	270661562
Hospital Revenue Code	270
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

LOBSTER IGE

Facility

$390.00

Service Code	HCPCS 86003
Hospital Charge Code	401186003E
Hospital Revenue Code	302
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.94
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
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	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

LOBSTER IGE

Facility

$390.00

Service Code	HCPCS 86003
Hospital Charge Code	401186003E
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC

Facility

$76,456.29

Service Code	MSDRG 496
Min. Negotiated Rate	$23,279.96
Max. Negotiated Rate	$76,456.29
Rate for Payer: Aetna Commercial	$56,311.54
Rate for Payer: Aetna Medicare Advantage	$76,456.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55,132.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55,132.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24,505.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55,132.95
Rate for Payer: Cigna Commercial	$40,214.34
Rate for Payer: Cigna Medicare Advantage	$24,505.22
Rate for Payer: Clover Medicare Advantage	$23,279.96
Rate for Payer: EmblemHealth Commercial	$73,515.66
Rate for Payer: Humana Medicare Advantage	$25,240.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24,505.22
Rate for Payer: Oxford Commercial	$31,784.72
Rate for Payer: UnitedHealthcare Commercial	$42,544.98
Rate for Payer: UnitedHealthcare Medicare Advantage	$24,505.22
Rate for Payer: Wellcare Medicare Advantage	$24,505.22

LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC

Facility

$134,013.42

Service Code	MSDRG 495
Min. Negotiated Rate	$40,805.37
Max. Negotiated Rate	$134,013.42
Rate for Payer: Aetna Commercial	$97,304.41
Rate for Payer: Aetna Medicare Advantage	$134,013.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99,183.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99,183.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$42,953.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99,183.90
Rate for Payer: Cigna Commercial	$80,827.73
Rate for Payer: Cigna Medicare Advantage	$42,953.02
Rate for Payer: Clover Medicare Advantage	$40,805.37
Rate for Payer: EmblemHealth Commercial	$128,859.06
Rate for Payer: Humana Medicare Advantage	$44,241.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$42,953.02
Rate for Payer: Oxford Commercial	$63,884.83
Rate for Payer: UnitedHealthcare Commercial	$85,512.13
Rate for Payer: UnitedHealthcare Medicare Advantage	$42,953.02
Rate for Payer: Wellcare Medicare Advantage	$42,953.02

LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC

Facility

$57,639.19

Service Code	MSDRG 497
Min. Negotiated Rate	$17,550.40
Max. Negotiated Rate	$57,639.19
Rate for Payer: Aetna Commercial	$42,909.78
Rate for Payer: Aetna Medicare Advantage	$57,639.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39,618.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39,618.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18,474.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39,618.15
Rate for Payer: Cigna Commercial	$25,674.85
Rate for Payer: Cigna Medicare Advantage	$18,474.10
Rate for Payer: Clover Medicare Advantage	$17,550.40
Rate for Payer: EmblemHealth Commercial	$55,422.30
Rate for Payer: Humana Medicare Advantage	$19,028.32
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18,474.10
Rate for Payer: Oxford Commercial	$20,292.95
Rate for Payer: UnitedHealthcare Commercial	$27,162.84
Rate for Payer: UnitedHealthcare Medicare Advantage	$18,474.10
Rate for Payer: Wellcare Medicare Advantage	$18,474.10

LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC

Facility

$114,776.10

Service Code	MSDRG 498
Min. Negotiated Rate	$34,947.85
Max. Negotiated Rate	$114,776.10
Rate for Payer: Aetna Commercial	$83,603.37
Rate for Payer: Aetna Medicare Advantage	$114,776.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72,310.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72,310.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$36,787.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72,310.05
Rate for Payer: Cigna Commercial	$67,253.52
Rate for Payer: Cigna Medicare Advantage	$36,787.21
Rate for Payer: Clover Medicare Advantage	$34,947.85
Rate for Payer: EmblemHealth Commercial	$110,361.63
Rate for Payer: Humana Medicare Advantage	$37,890.83
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$36,787.21
Rate for Payer: Oxford Commercial	$53,156.02
Rate for Payer: UnitedHealthcare Commercial	$71,151.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$36,787.21
Rate for Payer: Wellcare Medicare Advantage	$36,787.21

LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC

Facility

$83,119.33

Service Code	MSDRG 499
Min. Negotiated Rate	$25,308.77
Max. Negotiated Rate	$83,119.33
Rate for Payer: Aetna Commercial	$61,057.05
Rate for Payer: Aetna Medicare Advantage	$83,119.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35,739.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35,739.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26,640.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35,739.45
Rate for Payer: Cigna Commercial	$44,915.94
Rate for Payer: Cigna Medicare Advantage	$26,640.81
Rate for Payer: Clover Medicare Advantage	$25,308.77
Rate for Payer: EmblemHealth Commercial	$79,922.43
Rate for Payer: Humana Medicare Advantage	$27,440.03
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26,640.81
Rate for Payer: Oxford Commercial	$35,500.78
Rate for Payer: UnitedHealthcare Commercial	$47,519.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$26,640.81
Rate for Payer: Wellcare Medicare Advantage	$26,640.81

LOCALIZATION NEEDLE BREAST 7.5

Facility

$180.00

Hospital Charge Code	270665028
Hospital Revenue Code	270
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

LOCALIZATION NEEDLE BREAST 7.5

Facility

$180.00

Hospital Charge Code	270665028
Hospital Revenue Code	270
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00

LOCALIZATION NEEDLE HARDWIRE 2

Facility

$140.00

Service Code	HCPCS A4648
Hospital Charge Code	270665151
Hospital Revenue Code	278
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$33.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.88
Rate for Payer: Qualcare PPO/HMO/WC	$21.00

LOCALIZATION NEEDLE HARDWIRE 2

Facility

$140.00

Service Code	HCPCS A4648
Hospital Charge Code	270665151
Hospital Revenue Code	278
Min. Negotiated Rate	$3.98
Max. Negotiated Rate	$70.00
Rate for Payer: Aetna Commercial	$53.20
Rate for Payer: Aetna Medicare Advantage	$42.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.70
Rate for Payer: Cigna Commercial	$70.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.88
Rate for Payer: Qualcare PPO/HMO/WC	$21.00
Rate for Payer: UnitedHealthcare Community & State	$4.42
Rate for Payer: Wellpoint Medicaid Managed Care	$3.98

LOCAL KIT

Facility

$46.00

Hospital Charge Code	270338745
Hospital Revenue Code	272
Min. Negotiated Rate	$6.90
Max. Negotiated Rate	$6.90
Rate for Payer: Qualcare PPO/HMO/WC	$6.90

LOCAL KIT

Facility

$46.00

Hospital Charge Code	270338745
Hospital Revenue Code	272
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$23.00
Rate for Payer: Aetna Commercial	$17.48
Rate for Payer: Aetna Medicare Advantage	$13.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.73
Rate for Payer: Cigna Commercial	$23.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.96
Rate for Payer: Oxford Commercial	$9.20
Rate for Payer: Qualcare PPO/HMO/WC	$6.90
Rate for Payer: UnitedHealthcare Commercial	$9.20
Rate for Payer: UnitedHealthcare Community & State	$1.45
Rate for Payer: Wellpoint Medicaid Managed Care	$1.31

LOCK DIST FIBULA PLT SS RT 6H

Facility

$3,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270663095
Hospital Revenue Code	278
Min. Negotiated Rate	$543.75
Max. Negotiated Rate	$877.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.25
Rate for Payer: Qualcare PPO/HMO/WC	$543.75

LOCK DIST FIBULA PLT SS RT 6H

Facility

$3,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270663095
Hospital Revenue Code	278
Min. Negotiated Rate	$102.95
Max. Negotiated Rate	$1,812.50
Rate for Payer: Aetna Commercial	$1,377.50
Rate for Payer: Aetna Medicare Advantage	$1,087.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$924.38
Rate for Payer: Cigna Commercial	$1,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.25
Rate for Payer: Qualcare PPO/HMO/WC	$543.75
Rate for Payer: UnitedHealthcare Community & State	$114.55
Rate for Payer: Wellpoint Medicaid Managed Care	$102.95

LOCK IMPLANT SYS TENOESIS CONV

Facility

$975.00

Hospital Charge Code	270676732
Hospital Revenue Code	272
Min. Negotiated Rate	$27.69
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$253.50
Rate for Payer: Oxford Commercial	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$195.00
Rate for Payer: UnitedHealthcare Community & State	$30.81
Rate for Payer: Wellpoint Medicaid Managed Care	$27.69

LOCK IMPLANT SYS TENOESIS CONV

Facility

$975.00

Hospital Charge Code	270676732
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

LOCKING CAPS

Facility

$400.00

Service Code	HCPCS C1713
Hospital Charge Code	270705531
Hospital Revenue Code	278
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$96.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

LOCKING CAPS

Facility

$520.00

Service Code	HCPCS C1713
Hospital Charge Code	270704008
Hospital Revenue Code	278
Min. Negotiated Rate	$14.77
Max. Negotiated Rate	$260.00
Rate for Payer: Aetna Commercial	$197.60
Rate for Payer: Aetna Medicare Advantage	$156.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.60
Rate for Payer: Cigna Commercial	$260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.84
Rate for Payer: Qualcare PPO/HMO/WC	$78.00
Rate for Payer: UnitedHealthcare Community & State	$16.43
Rate for Payer: Wellpoint Medicaid Managed Care	$14.77

LOCKING CAPS

Facility

$400.00

Service Code	HCPCS C1713
Hospital Charge Code	270705531
Hospital Revenue Code	278
Min. Negotiated Rate	$11.36
Max. Negotiated Rate	$200.00
Rate for Payer: Aetna Commercial	$152.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Community & State	$12.64
Rate for Payer: Wellpoint Medicaid Managed Care	$11.36

Know your out-of-pocket cost for care.

All Charges