Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

MIDFACIAL RECONSTRUCTION KIT

Facility

$10,355.00

Hospital Charge Code	270337860
Hospital Revenue Code	278
Min. Negotiated Rate	$294.08
Max. Negotiated Rate	$5,177.50
Rate for Payer: Aetna Commercial	$3,934.90
Rate for Payer: Aetna Medicare Advantage	$3,106.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,640.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,640.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,640.53
Rate for Payer: Cigna Commercial	$5,177.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,505.91
Rate for Payer: Qualcare PPO/HMO/WC	$1,553.25
Rate for Payer: UnitedHealthcare Community & State	$327.22
Rate for Payer: Wellpoint Medicaid Managed Care	$294.08

MIDFACIAL RECONSTRUCTION KIT

Facility

$10,355.00

Hospital Charge Code	270337860
Hospital Revenue Code	278
Min. Negotiated Rate	$1,553.25
Max. Negotiated Rate	$2,505.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,071.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,505.91
Rate for Payer: Qualcare PPO/HMO/WC	$1,553.25

MIDFOOT FUSU-PLT RT ORT 3DI PL

Facility

$22,036.85

Service Code	HCPCS C1713
Hospital Charge Code	270703974
Hospital Revenue Code	278
Min. Negotiated Rate	$625.85
Max. Negotiated Rate	$11,018.42
Rate for Payer: Aetna Commercial	$8,374.00
Rate for Payer: Aetna Medicare Advantage	$6,611.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,619.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,619.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,407.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,619.40
Rate for Payer: Cigna Commercial	$11,018.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,332.92
Rate for Payer: Qualcare PPO/HMO/WC	$3,305.53
Rate for Payer: UnitedHealthcare Community & State	$696.36
Rate for Payer: Wellpoint Medicaid Managed Care	$625.85

MIDFOOT FUSU-PLT RT ORT 3DI PL

Facility

$22,036.85

Service Code	HCPCS C1713
Hospital Charge Code	270703974
Hospital Revenue Code	278
Min. Negotiated Rate	$3,305.53
Max. Negotiated Rate	$5,332.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,407.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,332.92
Rate for Payer: Qualcare PPO/HMO/WC	$3,305.53

MIDODRINE 10MGTAB

Facility

$33.37

Service Code	NDC 50268056615
Hospital Charge Code	60635680
Hospital Revenue Code	250
Min. Negotiated Rate	$5.01
Max. Negotiated Rate	$5.01
Rate for Payer: Qualcare PPO/HMO/WC	$5.01

MIDODRINE 10MGTAB

Facility

$33.37

Service Code	NDC 50268056615
Hospital Charge Code	60635680
Hospital Revenue Code	250
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$16.68
Rate for Payer: Aetna Commercial	$12.68
Rate for Payer: Aetna Medicare Advantage	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.51
Rate for Payer: Cigna Commercial	$16.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.68
Rate for Payer: Oxford Commercial	$6.67
Rate for Payer: Qualcare PPO/HMO/WC	$5.01
Rate for Payer: UnitedHealthcare Commercial	$6.67
Rate for Payer: UnitedHealthcare Community & State	$1.05
Rate for Payer: Wellpoint Medicaid Managed Care	$0.95

MIDODRINE 2.5 MG TAB

Facility

$17.76

Service Code	NDC 50268056415
Hospital Charge Code	60628534
Hospital Revenue Code	250
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$8.88
Rate for Payer: Aetna Commercial	$6.75
Rate for Payer: Aetna Medicare Advantage	$5.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.53
Rate for Payer: Cigna Commercial	$8.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.62
Rate for Payer: Oxford Commercial	$3.55
Rate for Payer: Qualcare PPO/HMO/WC	$2.66
Rate for Payer: UnitedHealthcare Commercial	$3.55
Rate for Payer: UnitedHealthcare Community & State	$0.56
Rate for Payer: Wellpoint Medicaid Managed Care	$0.50

MIDODRINE 2.5 MG TAB

Facility

$17.76

Service Code	NDC 50268056415
Hospital Charge Code	60628534
Hospital Revenue Code	250
Min. Negotiated Rate	$2.66
Max. Negotiated Rate	$2.66
Rate for Payer: Qualcare PPO/HMO/WC	$2.66

MIDODRINE 5 MG TAB

Facility

$27.87

Service Code	NDC 245021211
Hospital Charge Code	60628653
Hospital Revenue Code	250
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$4.18
Rate for Payer: Qualcare PPO/HMO/WC	$4.18

MIDODRINE 5 MG TAB

Facility

$15.40

Hospital Charge Code	60628653R
Hospital Revenue Code	250
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$7.70
Rate for Payer: Aetna Commercial	$5.85
Rate for Payer: Aetna Medicare Advantage	$4.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.93
Rate for Payer: Cigna Commercial	$7.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.00
Rate for Payer: Oxford Commercial	$3.08
Rate for Payer: Qualcare PPO/HMO/WC	$2.31
Rate for Payer: UnitedHealthcare Commercial	$3.08
Rate for Payer: UnitedHealthcare Community & State	$0.49
Rate for Payer: Wellpoint Medicaid Managed Care	$0.44

MIDODRINE 5 MG TAB

Facility

$15.40

Hospital Charge Code	60628653R
Hospital Revenue Code	250
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$2.31
Rate for Payer: Qualcare PPO/HMO/WC	$2.31

MIDODRINE 5 MG TAB

Facility

$27.87

Service Code	NDC 245021211
Hospital Charge Code	60628653
Hospital Revenue Code	250
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$13.94
Rate for Payer: Aetna Commercial	$10.59
Rate for Payer: Aetna Medicare Advantage	$8.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.11
Rate for Payer: Cigna Commercial	$13.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.25
Rate for Payer: Oxford Commercial	$5.57
Rate for Payer: Qualcare PPO/HMO/WC	$4.18
Rate for Payer: UnitedHealthcare Commercial	$5.57
Rate for Payer: UnitedHealthcare Community & State	$0.88
Rate for Payer: Wellpoint Medicaid Managed Care	$0.79

MIDOS REX BUR AM-8 14-AM

Facility

$926.25

Hospital Charge Code	270663922
Hospital Revenue Code	270
Min. Negotiated Rate	$26.31
Max. Negotiated Rate	$463.12
Rate for Payer: Aetna Commercial	$351.98
Rate for Payer: Aetna Medicare Advantage	$277.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$236.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$236.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$236.19
Rate for Payer: Cigna Commercial	$463.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.82
Rate for Payer: Oxford Commercial	$185.25
Rate for Payer: Qualcare PPO/HMO/WC	$138.94
Rate for Payer: UnitedHealthcare Commercial	$185.25
Rate for Payer: UnitedHealthcare Community & State	$29.27
Rate for Payer: Wellpoint Medicaid Managed Care	$26.31

MIDOS REX BUR AM-8 14-AM

Facility

$926.25

Hospital Charge Code	270663922
Hospital Revenue Code	270
Min. Negotiated Rate	$138.94
Max. Negotiated Rate	$138.94
Rate for Payer: Qualcare PPO/HMO/WC	$138.94

MID-PHALANX FUSION IMPLT.NEXA

Facility

$340.00

Hospital Charge Code	270339448
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

MID-PHALANX FUSION IMPLT.NEXA

Facility

$340.00

Hospital Charge Code	270339448
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

MI-EYE DISP NEEDLESCOPE 95MM

Facility

$3,475.00

Hospital Charge Code	270697110
Hospital Revenue Code	272
Min. Negotiated Rate	$98.69
Max. Negotiated Rate	$1,737.50
Rate for Payer: Aetna Commercial	$1,320.50
Rate for Payer: Aetna Medicare Advantage	$1,042.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$886.12
Rate for Payer: Cigna Commercial	$1,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$903.50
Rate for Payer: Oxford Commercial	$695.00
Rate for Payer: Qualcare PPO/HMO/WC	$521.25
Rate for Payer: UnitedHealthcare Commercial	$695.00
Rate for Payer: UnitedHealthcare Community & State	$109.81
Rate for Payer: Wellpoint Medicaid Managed Care	$98.69

MI-EYE DISP NEEDLESCOPE 95MM

Facility

$3,475.00

Hospital Charge Code	270697110
Hospital Revenue Code	272
Min. Negotiated Rate	$521.25
Max. Negotiated Rate	$521.25
Rate for Payer: Qualcare PPO/HMO/WC	$521.25

MIGRAINE AND OTHER HEADACHES

Facility

$11,577.70

Service Code	APR-DRG 0543
Min. Negotiated Rate	$11,350.69
Max. Negotiated Rate	$11,577.70
Rate for Payer: UnitedHealthcare Community & State	$11,350.69
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,577.70
Rate for Payer: Wellpoint Medicaid Managed Care	$11,350.69

MIGRAINE AND OTHER HEADACHES

Facility

$7,683.40

Service Code	APR-DRG 0541
Min. Negotiated Rate	$7,532.75
Max. Negotiated Rate	$7,683.40
Rate for Payer: UnitedHealthcare Community & State	$7,532.75
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,683.40
Rate for Payer: Wellpoint Medicaid Managed Care	$7,532.75

MIGRAINE AND OTHER HEADACHES

Facility

$9,183.22

Service Code	APR-DRG 0542
Min. Negotiated Rate	$9,003.16
Max. Negotiated Rate	$9,183.22
Rate for Payer: UnitedHealthcare Community & State	$9,003.16
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,183.22
Rate for Payer: Wellpoint Medicaid Managed Care	$9,003.16

MIGRAINE AND OTHER HEADACHES

Facility

$18,956.30

Service Code	APR-DRG 0544
Min. Negotiated Rate	$18,584.61
Max. Negotiated Rate	$18,956.30
Rate for Payer: UnitedHealthcare Community & State	$18,584.61
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$18,956.30
Rate for Payer: Wellpoint Medicaid Managed Care	$18,584.61

MILAGRO ADVANCE SCREW 9 X 30MM

Facility

$2,225.00

Service Code	HCPCS C1713
Hospital Charge Code	270663885
Hospital Revenue Code	278
Min. Negotiated Rate	$63.19
Max. Negotiated Rate	$1,112.50
Rate for Payer: Aetna Commercial	$845.50
Rate for Payer: Aetna Medicare Advantage	$667.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$567.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$567.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$445.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$567.38
Rate for Payer: Cigna Commercial	$1,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$538.45
Rate for Payer: Qualcare PPO/HMO/WC	$333.75
Rate for Payer: UnitedHealthcare Community & State	$70.31
Rate for Payer: Wellpoint Medicaid Managed Care	$63.19

MILAGRO ADVANCE SCREW 9 X 30MM

Facility

$2,225.00

Service Code	HCPCS C1713
Hospital Charge Code	270663885
Hospital Revenue Code	278
Min. Negotiated Rate	$333.75
Max. Negotiated Rate	$538.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$445.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$538.45
Rate for Payer: Qualcare PPO/HMO/WC	$333.75

MILAGRO BR INTERFERENCE SCREW

Facility

$2,490.00

Service Code	HCPCS C1713
Hospital Charge Code	270679989
Hospital Revenue Code	278
Min. Negotiated Rate	$373.50
Max. Negotiated Rate	$602.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$498.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$602.58
Rate for Payer: Qualcare PPO/HMO/WC	$373.50

Know your out-of-pocket cost for care.

All Charges