Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

MESH VENTRIO OVAL SM 3.1x4.7

Facility

$3,253.50

Service Code	HCPCS C1781
Hospital Charge Code	270647195
Hospital Revenue Code	278
Min. Negotiated Rate	$92.40
Max. Negotiated Rate	$1,626.75
Rate for Payer: Aetna Commercial	$1,236.33
Rate for Payer: Aetna Medicare Advantage	$976.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$829.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$829.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$829.64
Rate for Payer: Cigna Commercial	$1,626.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$787.35
Rate for Payer: Qualcare PPO/HMO/WC	$488.02
Rate for Payer: UnitedHealthcare Community & State	$102.81
Rate for Payer: Wellpoint Medicaid Managed Care	$92.40

MESH VENTRIO OVAL SM 3.1x4.7

Facility

$3,253.50

Service Code	HCPCS C1781
Hospital Charge Code	270647195
Hospital Revenue Code	278
Min. Negotiated Rate	$488.02
Max. Negotiated Rate	$787.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$787.35
Rate for Payer: Qualcare PPO/HMO/WC	$488.02

MESH VENTRIO XLG OVAL

Facility

$8,650.00

Service Code	HCPCS C1781
Hospital Charge Code	270664952
Hospital Revenue Code	278
Min. Negotiated Rate	$245.66
Max. Negotiated Rate	$4,325.00
Rate for Payer: Aetna Commercial	$3,287.00
Rate for Payer: Aetna Medicare Advantage	$2,595.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,205.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,205.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,730.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,205.75
Rate for Payer: Cigna Commercial	$4,325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,093.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,297.50
Rate for Payer: UnitedHealthcare Community & State	$273.34
Rate for Payer: Wellpoint Medicaid Managed Care	$245.66

MESH VENTRIO XLG OVAL

Facility

$8,650.00

Service Code	HCPCS C1781
Hospital Charge Code	270664952
Hospital Revenue Code	278
Min. Negotiated Rate	$1,297.50
Max. Negotiated Rate	$2,093.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,730.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,093.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,297.50

MESH VIABAHN 9MM X 39MM 8 FR

Facility

$17,870.00

Service Code	HCPCS C1874
Hospital Charge Code	270692893
Hospital Revenue Code	278
Min. Negotiated Rate	$2,680.50
Max. Negotiated Rate	$4,324.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,574.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,324.54
Rate for Payer: Qualcare PPO/HMO/WC	$2,680.50

MESH VIABAHN 9MM X 39MM 8 FR

Facility

$17,870.00

Service Code	HCPCS C1874
Hospital Charge Code	270692893
Hospital Revenue Code	278
Min. Negotiated Rate	$507.51
Max. Negotiated Rate	$8,935.00
Rate for Payer: Aetna Commercial	$6,790.60
Rate for Payer: Aetna Medicare Advantage	$5,361.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,556.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,556.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,574.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,556.85
Rate for Payer: Cigna Commercial	$8,935.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,324.54
Rate for Payer: Qualcare PPO/HMO/WC	$2,680.50
Rate for Payer: UnitedHealthcare Community & State	$564.69
Rate for Payer: Wellpoint Medicaid Managed Care	$507.51

MESH Y UPSYLON

Facility

$5,550.00

Service Code	HCPCS C1763
Hospital Charge Code	270677083
Hospital Revenue Code	278
Min. Negotiated Rate	$157.62
Max. Negotiated Rate	$2,775.00
Rate for Payer: Aetna Commercial	$2,109.00
Rate for Payer: Aetna Medicare Advantage	$1,665.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,415.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,415.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,415.25
Rate for Payer: Cigna Commercial	$2,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,343.10
Rate for Payer: Qualcare PPO/HMO/WC	$832.50
Rate for Payer: UnitedHealthcare Community & State	$175.38
Rate for Payer: Wellpoint Medicaid Managed Care	$157.62

MESH Y UPSYLON

Facility

$5,550.00

Service Code	HCPCS C1763
Hospital Charge Code	270677083
Hospital Revenue Code	278
Min. Negotiated Rate	$832.50
Max. Negotiated Rate	$1,343.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,343.10
Rate for Payer: Qualcare PPO/HMO/WC	$832.50

MESNA 100 MG/ML INJ (10 ML)

Facility

$1,469.04

Service Code	HCPCS J9209
Hospital Charge Code	60628835
Hospital Revenue Code	636
Min. Negotiated Rate	$220.36
Max. Negotiated Rate	$355.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$355.51
Rate for Payer: Qualcare PPO/HMO/WC	$220.36

MESNA 100 MG/ML INJ (10 ML)

Facility

$1,469.04

Service Code	HCPCS J9209
Hospital Charge Code	60628835
Hospital Revenue Code	636
Min. Negotiated Rate	$41.72
Max. Negotiated Rate	$734.52
Rate for Payer: Aetna Commercial	$558.24
Rate for Payer: Aetna Medicare Advantage	$440.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$374.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$374.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$374.61
Rate for Payer: Cigna Commercial	$734.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$355.51
Rate for Payer: Qualcare PPO/HMO/WC	$220.36
Rate for Payer: UnitedHealthcare Community & State	$46.42
Rate for Payer: Wellpoint Medicaid Managed Care	$41.72

MESNA 400MG TAB

Facility

$63.18

Service Code	NDC 67108356509
Hospital Charge Code	60635803
Hospital Revenue Code	250
Min. Negotiated Rate	$9.48
Max. Negotiated Rate	$9.48
Rate for Payer: Qualcare PPO/HMO/WC	$9.48

MESNA 400MG TAB

Facility

$63.18

Service Code	NDC 67108356509
Hospital Charge Code	60635803
Hospital Revenue Code	250
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$31.59
Rate for Payer: Aetna Commercial	$24.01
Rate for Payer: Aetna Medicare Advantage	$18.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.11
Rate for Payer: Cigna Commercial	$31.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.43
Rate for Payer: Oxford Commercial	$12.64
Rate for Payer: Qualcare PPO/HMO/WC	$9.48
Rate for Payer: UnitedHealthcare Commercial	$12.64
Rate for Payer: UnitedHealthcare Community & State	$2.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1.79

Metal Biliary Stents

Facility

$10,600.00

Service Code	HCPCS C1876
Hospital Charge Code	270685510
Hospital Revenue Code	278
Min. Negotiated Rate	$301.04
Max. Negotiated Rate	$5,300.00
Rate for Payer: Aetna Commercial	$4,028.00
Rate for Payer: Aetna Medicare Advantage	$3,180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,703.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,703.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,703.00
Rate for Payer: Cigna Commercial	$5,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,565.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,590.00
Rate for Payer: UnitedHealthcare Community & State	$334.96
Rate for Payer: Wellpoint Medicaid Managed Care	$301.04

Metal Biliary Stents

Facility

$10,600.00

Service Code	HCPCS C1876
Hospital Charge Code	270685511
Hospital Revenue Code	278
Min. Negotiated Rate	$1,590.00
Max. Negotiated Rate	$2,565.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,565.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,590.00

Metal Biliary Stents

Facility

$10,600.00

Service Code	HCPCS C1876
Hospital Charge Code	270685510
Hospital Revenue Code	278
Min. Negotiated Rate	$1,590.00
Max. Negotiated Rate	$2,565.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,565.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,590.00

Metal Biliary Stents

Facility

$10,600.00

Service Code	HCPCS C1876
Hospital Charge Code	270685511
Hospital Revenue Code	278
Min. Negotiated Rate	$301.04
Max. Negotiated Rate	$5,300.00
Rate for Payer: Aetna Commercial	$4,028.00
Rate for Payer: Aetna Medicare Advantage	$3,180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,703.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,703.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,703.00
Rate for Payer: Cigna Commercial	$5,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,565.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,590.00
Rate for Payer: UnitedHealthcare Community & State	$334.96
Rate for Payer: Wellpoint Medicaid Managed Care	$301.04

METAL HUMERAL HEAD A-42

Facility

$5,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270686876
Hospital Revenue Code	278
Min. Negotiated Rate	$156.20
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Community & State	$173.80
Rate for Payer: Wellpoint Medicaid Managed Care	$156.20

METAL HUMERAL HEAD A-42

Facility

$5,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270686876
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

METANEPHRINE,FRAC,FREE(P)

Facility

$667.59

Service Code	HCPCS 83835
Hospital Charge Code	39900341
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

METANEPHRINE,FRAC,FREE(P)

Facility

$667.59

Service Code	HCPCS 83835
Hospital Charge Code	39900341
Hospital Revenue Code	301
Min. Negotiated Rate	$13.55
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$46.08
Rate for Payer: Aetna Medicare Advantage	$54.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.45
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$16.94
Rate for Payer: Clover Medicare Advantage	$16.09
Rate for Payer: EmblemHealth Commercial	$50.82
Rate for Payer: Humana Medicare Advantage	$17.45
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.57
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.94
Rate for Payer: Wellcare Medicare Advantage	$16.94
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

METANEPHRINES

Facility

$390.00

Service Code	HCPCS 83835
Hospital Charge Code	3036034B
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$46.08
Rate for Payer: Aetna Medicare Advantage	$54.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.45
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$16.94
Rate for Payer: Clover Medicare Advantage	$16.09
Rate for Payer: EmblemHealth Commercial	$50.82
Rate for Payer: Humana Medicare Advantage	$17.45
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.94
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	$13.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.94
Rate for Payer: Wellcare Medicare Advantage	$16.94
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

METANEPHRINES

Facility

$390.00

Service Code	HCPCS 83835
Hospital Charge Code	3036034B
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

METANEPHRINES

Facility

$647.00

Service Code	HCPCS 83835
Hospital Charge Code	38472494
Hospital Revenue Code	301
Min. Negotiated Rate	$13.55
Max. Negotiated Rate	$323.50
Rate for Payer: Aetna Commercial	$46.08
Rate for Payer: Aetna Medicare Advantage	$54.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.45
Rate for Payer: Cigna Commercial	$323.50
Rate for Payer: Cigna Medicare Advantage	$16.94
Rate for Payer: Clover Medicare Advantage	$16.09
Rate for Payer: EmblemHealth Commercial	$50.82
Rate for Payer: Humana Medicare Advantage	$17.45
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.22
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.05
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.94
Rate for Payer: Wellcare Medicare Advantage	$16.94
Rate for Payer: Wellpoint Medicaid Managed Care	$18.37

METANEPHRINES

Facility

$647.00

Service Code	HCPCS 83835
Hospital Charge Code	38472494
Hospital Revenue Code	301
Min. Negotiated Rate	$97.05
Max. Negotiated Rate	$97.05
Rate for Payer: Qualcare PPO/HMO/WC	$97.05

METANEPHRINES,24HR URINE

Facility

$390.00

Service Code	HCPCS 83835
Hospital Charge Code	39900108
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$46.08
Rate for Payer: Aetna Medicare Advantage	$54.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.45
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$16.94
Rate for Payer: Clover Medicare Advantage	$16.09
Rate for Payer: EmblemHealth Commercial	$50.82
Rate for Payer: Humana Medicare Advantage	$17.45
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.94
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	$13.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.94
Rate for Payer: Wellcare Medicare Advantage	$16.94
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

Know your out-of-pocket cost for care.

All Charges