Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

MICRO KOVER ZEISS MD 20X56

Facility

$263.00

Hospital Charge Code	270652779
Hospital Revenue Code	270
Min. Negotiated Rate	$7.47
Max. Negotiated Rate	$131.50
Rate for Payer: Aetna Commercial	$99.94
Rate for Payer: Aetna Medicare Advantage	$78.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.06
Rate for Payer: Cigna Commercial	$131.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.38
Rate for Payer: Oxford Commercial	$52.60
Rate for Payer: Qualcare PPO/HMO/WC	$39.45
Rate for Payer: UnitedHealthcare Commercial	$52.60
Rate for Payer: UnitedHealthcare Community & State	$8.31
Rate for Payer: Wellpoint Medicaid Managed Care	$7.47

MICROMATRIX 60MG

Facility

$3,793.50

Service Code	HCPCS Q4118
Hospital Charge Code	270662132
Hospital Revenue Code	278
Min. Negotiated Rate	$569.02
Max. Negotiated Rate	$918.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$758.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$918.03
Rate for Payer: Qualcare PPO/HMO/WC	$569.02

MICROMATRIX 60MG

Facility

$3,793.50

Service Code	HCPCS Q4118
Hospital Charge Code	270662132
Hospital Revenue Code	278
Min. Negotiated Rate	$107.74
Max. Negotiated Rate	$1,896.75
Rate for Payer: Aetna Commercial	$1,441.53
Rate for Payer: Aetna Medicare Advantage	$1,138.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$967.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$967.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$758.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$967.34
Rate for Payer: Cigna Commercial	$1,896.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$918.03
Rate for Payer: Qualcare PPO/HMO/WC	$569.02
Rate for Payer: UnitedHealthcare Community & State	$119.87
Rate for Payer: Wellpoint Medicaid Managed Care	$107.74

MICROMATRIX 60MG/1MG JW

Facility

$63.23

Hospital Charge Code	270662132W
Hospital Revenue Code	636
Min. Negotiated Rate	$9.48
Max. Negotiated Rate	$15.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.30
Rate for Payer: Qualcare PPO/HMO/WC	$9.48

MICROMATRIX 60MG/1MG JW

Facility

$63.23

Hospital Charge Code	270662132W
Hospital Revenue Code	636
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$31.61
Rate for Payer: Aetna Commercial	$24.03
Rate for Payer: Aetna Medicare Advantage	$18.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.12
Rate for Payer: Cigna Commercial	$31.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.30
Rate for Payer: Qualcare PPO/HMO/WC	$9.48
Rate for Payer: UnitedHealthcare Community & State	$2.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1.80

MICRONASE/1.25MG/TAB

Facility

$4.00

Service Code	NDC 23155005601
Hospital Charge Code	60634880
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

MICRONASE/1.25MG/TAB

Facility

$4.00

Service Code	NDC 23155005601
Hospital Charge Code	60634880
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

MICROPUNCTURE INTRO 5FR

Facility

$230.00

Service Code	HCPCS C2629
Hospital Charge Code	270624719
Hospital Revenue Code	278
Min. Negotiated Rate	$6.53
Max. Negotiated Rate	$115.00
Rate for Payer: Aetna Commercial	$87.40
Rate for Payer: Aetna Medicare Advantage	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.65
Rate for Payer: Cigna Commercial	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.66
Rate for Payer: Qualcare PPO/HMO/WC	$34.50
Rate for Payer: UnitedHealthcare Community & State	$7.27
Rate for Payer: Wellpoint Medicaid Managed Care	$6.53

MICROPUNCTURE INTRO 5FR

Facility

$230.00

Service Code	HCPCS C2629
Hospital Charge Code	270624719
Hospital Revenue Code	278
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$55.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.66
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

MICROPUNCTURE INTRO STFND 10cm

Facility

$340.00

Hospital Charge Code	270624179
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$82.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.28
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

MICROPUNCTURE INTRO STFND 10cm

Facility

$340.00

Hospital Charge Code	270624179
Hospital Revenue Code	278
Min. Negotiated Rate	$9.66
Max. Negotiated Rate	$170.00
Rate for Payer: Aetna Commercial	$129.20
Rate for Payer: Aetna Medicare Advantage	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.70
Rate for Payer: Cigna Commercial	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.28
Rate for Payer: Qualcare PPO/HMO/WC	$51.00
Rate for Payer: UnitedHealthcare Community & State	$10.74
Rate for Payer: Wellpoint Medicaid Managed Care	$9.66

MICROPUNCTURE INTRO STFND 15cm

Facility

$345.10

Hospital Charge Code	270629630
Hospital Revenue Code	278
Min. Negotiated Rate	$9.80
Max. Negotiated Rate	$172.55
Rate for Payer: Aetna Commercial	$131.14
Rate for Payer: Aetna Medicare Advantage	$103.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.00
Rate for Payer: Cigna Commercial	$172.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.51
Rate for Payer: Qualcare PPO/HMO/WC	$51.77
Rate for Payer: UnitedHealthcare Community & State	$10.91
Rate for Payer: Wellpoint Medicaid Managed Care	$9.80

MICROPUNCTURE INTRO STFND 15cm

Facility

$345.10

Hospital Charge Code	270629630
Hospital Revenue Code	278
Min. Negotiated Rate	$51.77
Max. Negotiated Rate	$83.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.51
Rate for Payer: Qualcare PPO/HMO/WC	$51.77

MICROPUNCTURE PEDAL 4.0 FRx7cm

Facility

$346.80

Hospital Charge Code	270680365
Hospital Revenue Code	272
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$173.40
Rate for Payer: Aetna Commercial	$131.78
Rate for Payer: Aetna Medicare Advantage	$104.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.43
Rate for Payer: Cigna Commercial	$173.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.17
Rate for Payer: Oxford Commercial	$69.36
Rate for Payer: Qualcare PPO/HMO/WC	$52.02
Rate for Payer: UnitedHealthcare Commercial	$69.36
Rate for Payer: UnitedHealthcare Community & State	$10.96
Rate for Payer: Wellpoint Medicaid Managed Care	$9.85

MICROPUNCTURE PEDAL 4.0 FRx7cm

Facility

$346.80

Hospital Charge Code	270680365
Hospital Revenue Code	272
Min. Negotiated Rate	$52.02
Max. Negotiated Rate	$52.02
Rate for Payer: Qualcare PPO/HMO/WC	$52.02

MICROPUNCTURE PEDAL INTR 2.9/5

Facility

$340.00

Service Code	HCPCS C1894
Hospital Charge Code	270671135S
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$82.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.28
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

MICROPUNCTURE PEDAL INTR 2.9/5

Facility

$340.00

Service Code	HCPCS C1894
Hospital Charge Code	270671135
Hospital Revenue Code	278
Min. Negotiated Rate	$9.66
Max. Negotiated Rate	$170.00
Rate for Payer: Aetna Commercial	$129.20
Rate for Payer: Aetna Medicare Advantage	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.70
Rate for Payer: Cigna Commercial	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.28
Rate for Payer: Qualcare PPO/HMO/WC	$51.00
Rate for Payer: UnitedHealthcare Community & State	$10.74
Rate for Payer: Wellpoint Medicaid Managed Care	$9.66

MICROPUNCTURE PEDAL INTR 2.9/5

Facility

$340.00

Service Code	HCPCS C1894
Hospital Charge Code	270671135N
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$82.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.28
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

MICROPUNCTURE PEDAL INTR 2.9/5

Facility

$340.00

Service Code	HCPCS C1894
Hospital Charge Code	270671135S
Hospital Revenue Code	278
Min. Negotiated Rate	$9.66
Max. Negotiated Rate	$170.00
Rate for Payer: Aetna Commercial	$129.20
Rate for Payer: Aetna Medicare Advantage	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.70
Rate for Payer: Cigna Commercial	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.28
Rate for Payer: Qualcare PPO/HMO/WC	$51.00
Rate for Payer: UnitedHealthcare Community & State	$10.74
Rate for Payer: Wellpoint Medicaid Managed Care	$9.66

MICROPUNCTURE PEDAL INTR 2.9/5

Facility

$340.00

Service Code	HCPCS C1894
Hospital Charge Code	270671135N
Hospital Revenue Code	278
Min. Negotiated Rate	$9.66
Max. Negotiated Rate	$170.00
Rate for Payer: Aetna Commercial	$129.20
Rate for Payer: Aetna Medicare Advantage	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.70
Rate for Payer: Cigna Commercial	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.28
Rate for Payer: Qualcare PPO/HMO/WC	$51.00
Rate for Payer: UnitedHealthcare Community & State	$10.74
Rate for Payer: Wellpoint Medicaid Managed Care	$9.66

MICROPUNCTURE PEDAL INTR 2.9/5

Facility

$340.00

Service Code	HCPCS C1894
Hospital Charge Code	270671135
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$82.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.28
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

MICROPUNCTURE SET 5FR SS

Facility

$87.55

Hospital Charge Code	270654224
Hospital Revenue Code	272
Min. Negotiated Rate	$2.49
Max. Negotiated Rate	$43.77
Rate for Payer: Aetna Commercial	$33.27
Rate for Payer: Aetna Medicare Advantage	$26.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.33
Rate for Payer: Cigna Commercial	$43.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.76
Rate for Payer: Oxford Commercial	$17.51
Rate for Payer: Qualcare PPO/HMO/WC	$13.13
Rate for Payer: UnitedHealthcare Commercial	$17.51
Rate for Payer: UnitedHealthcare Community & State	$2.77
Rate for Payer: Wellpoint Medicaid Managed Care	$2.49

MICROPUNCTURE SET 5FR SS

Facility

$87.55

Hospital Charge Code	270654224S
Hospital Revenue Code	272
Min. Negotiated Rate	$2.49
Max. Negotiated Rate	$43.77
Rate for Payer: Aetna Commercial	$33.27
Rate for Payer: Aetna Medicare Advantage	$26.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.33
Rate for Payer: Cigna Commercial	$43.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.76
Rate for Payer: Oxford Commercial	$17.51
Rate for Payer: Qualcare PPO/HMO/WC	$13.13
Rate for Payer: UnitedHealthcare Commercial	$17.51
Rate for Payer: UnitedHealthcare Community & State	$2.77
Rate for Payer: Wellpoint Medicaid Managed Care	$2.49

MICROPUNCTURE SET 5FR SS

Facility

$87.55

Hospital Charge Code	270654224
Hospital Revenue Code	272
Min. Negotiated Rate	$13.13
Max. Negotiated Rate	$13.13
Rate for Payer: Qualcare PPO/HMO/WC	$13.13

MICROPUNCTURE SET 5FR SS

Facility

$87.55

Hospital Charge Code	270654224S
Hospital Revenue Code	272
Min. Negotiated Rate	$13.13
Max. Negotiated Rate	$13.13
Rate for Payer: Qualcare PPO/HMO/WC	$13.13

Know your out-of-pocket cost for care.

All Charges