Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

MILAGRO BR INTERFERENCE SCREW

Facility

$2,490.00

Service Code	HCPCS C1713
Hospital Charge Code	270679989
Hospital Revenue Code	278
Min. Negotiated Rate	$70.72
Max. Negotiated Rate	$1,245.00
Rate for Payer: Aetna Commercial	$946.20
Rate for Payer: Aetna Medicare Advantage	$747.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$634.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$634.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$498.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$634.95
Rate for Payer: Cigna Commercial	$1,245.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$602.58
Rate for Payer: Qualcare PPO/HMO/WC	$373.50
Rate for Payer: UnitedHealthcare Community & State	$78.68
Rate for Payer: Wellpoint Medicaid Managed Care	$70.72

MILD KIT DEVICE MIN INVASIVE 2

Facility

$17,500.00

Hospital Charge Code	270704246
Hospital Revenue Code	279
Min. Negotiated Rate	$497.00
Max. Negotiated Rate	$8,750.00
Rate for Payer: Aetna Commercial	$6,650.00
Rate for Payer: Aetna Medicare Advantage	$5,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,462.50
Rate for Payer: Cigna Commercial	$8,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,550.00
Rate for Payer: Oxford Commercial	$3,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00
Rate for Payer: UnitedHealthcare Commercial	$3,500.00
Rate for Payer: UnitedHealthcare Community & State	$553.00
Rate for Payer: Wellpoint Medicaid Managed Care	$497.00

MILD KIT DEVICE MIN INVASIVE 2

Facility

$17,500.00

Hospital Charge Code	270704246
Hospital Revenue Code	279
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$2,625.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

MILK HINGE FREE LUBE

Facility

$76.25

Hospital Charge Code	270665153
Hospital Revenue Code	270
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$38.12
Rate for Payer: Aetna Commercial	$28.98
Rate for Payer: Aetna Medicare Advantage	$22.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.44
Rate for Payer: Cigna Commercial	$38.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.82
Rate for Payer: Oxford Commercial	$15.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.44
Rate for Payer: UnitedHealthcare Commercial	$15.25
Rate for Payer: UnitedHealthcare Community & State	$2.41
Rate for Payer: Wellpoint Medicaid Managed Care	$2.17

MILK HINGE FREE LUBE

Facility

$76.25

Hospital Charge Code	270665153
Hospital Revenue Code	270
Min. Negotiated Rate	$11.44
Max. Negotiated Rate	$11.44
Rate for Payer: Qualcare PPO/HMO/WC	$11.44

MILLER TYPE FOOT REVIS

Facility

$57,834.50

Service Code	HCPCS 28737
Hospital Charge Code	1600000815
Hospital Revenue Code	360
Min. Negotiated Rate	$1,642.50
Max. Negotiated Rate	$55,329.13
Rate for Payer: Aetna Commercial	$41,487.32
Rate for Payer: Aetna Medicare Advantage	$49,418.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55,329.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55,329.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,252.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55,329.13
Rate for Payer: Cigna Commercial	$30,573.98
Rate for Payer: Cigna Medicare Advantage	$15,252.69
Rate for Payer: Clover Medicare Advantage	$14,490.06
Rate for Payer: EmblemHealth Commercial	$45,758.07
Rate for Payer: Humana Medicare Advantage	$15,710.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,252.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15,036.97
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,675.17
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,827.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,252.69
Rate for Payer: Wellcare Medicare Advantage	$15,252.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1,642.50

MILLER TYPE FOOT REVIS

Facility

$57,834.50

Service Code	HCPCS 28737
Hospital Charge Code	1600000815
Hospital Revenue Code	360
Min. Negotiated Rate	$8,675.17
Max. Negotiated Rate	$8,675.17
Rate for Payer: Qualcare PPO/HMO/WC	$8,675.17

MILRINONE 1 MG/ML INJ

Facility

$78.52

Service Code	HCPCS J2260
Hospital Charge Code	60627585
Hospital Revenue Code	636
Min. Negotiated Rate	$2.23
Max. Negotiated Rate	$39.26
Rate for Payer: Aetna Commercial	$29.84
Rate for Payer: Aetna Medicare Advantage	$23.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.02
Rate for Payer: Cigna Commercial	$39.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.78
Rate for Payer: UnitedHealthcare Community & State	$2.48
Rate for Payer: Wellpoint Medicaid Managed Care	$2.23

MILRINONE 1 MG/ML INJ

Facility

$78.52

Service Code	HCPCS J2260
Hospital Charge Code	60627585
Hospital Revenue Code	636
Min. Negotiated Rate	$11.78
Max. Negotiated Rate	$19.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.78

MINERAL OIL 1 ENEMA

Facility

$23.58

Service Code	NDC 132030140
Hospital Charge Code	60628131
Hospital Revenue Code	250
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$11.79
Rate for Payer: Aetna Commercial	$8.96
Rate for Payer: Aetna Medicare Advantage	$7.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.01
Rate for Payer: Cigna Commercial	$11.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.13
Rate for Payer: Oxford Commercial	$4.72
Rate for Payer: Qualcare PPO/HMO/WC	$3.54
Rate for Payer: UnitedHealthcare Commercial	$4.72
Rate for Payer: UnitedHealthcare Community & State	$0.75
Rate for Payer: Wellpoint Medicaid Managed Care	$0.67

MINERAL OIL 1 ENEMA

Facility

$23.58

Service Code	NDC 132030140
Hospital Charge Code	60628131
Hospital Revenue Code	250
Min. Negotiated Rate	$3.54
Max. Negotiated Rate	$3.54
Rate for Payer: Qualcare PPO/HMO/WC	$3.54

MINERAL OIL/30ML

Facility

$43.82

Service Code	NDC 54162018501
Hospital Charge Code	60633432
Hospital Revenue Code	250
Min. Negotiated Rate	$6.57
Max. Negotiated Rate	$6.57
Rate for Payer: Qualcare PPO/HMO/WC	$6.57

MINERAL OIL/30ML

Facility

$43.82

Service Code	NDC 54162018501
Hospital Charge Code	60633432
Hospital Revenue Code	250
Min. Negotiated Rate	$1.24
Max. Negotiated Rate	$21.91
Rate for Payer: Aetna Commercial	$16.65
Rate for Payer: Aetna Medicare Advantage	$13.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.17
Rate for Payer: Cigna Commercial	$21.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.39
Rate for Payer: Oxford Commercial	$8.76
Rate for Payer: Qualcare PPO/HMO/WC	$6.57
Rate for Payer: UnitedHealthcare Commercial	$8.76
Rate for Payer: UnitedHealthcare Community & State	$1.38
Rate for Payer: Wellpoint Medicaid Managed Care	$1.24

MINERAL OIL 30 ML OIL

Facility

$36.52

Service Code	NDC 54162018525
Hospital Charge Code	60628132
Hospital Revenue Code	250
Min. Negotiated Rate	$5.48
Max. Negotiated Rate	$5.48
Rate for Payer: Qualcare PPO/HMO/WC	$5.48

MINERAL OIL 30 ML OIL

Facility

$36.52

Service Code	NDC 54162018525
Hospital Charge Code	60628132
Hospital Revenue Code	250
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$18.26
Rate for Payer: Aetna Commercial	$13.88
Rate for Payer: Aetna Medicare Advantage	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.31
Rate for Payer: Cigna Commercial	$18.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.50
Rate for Payer: Oxford Commercial	$7.30
Rate for Payer: Qualcare PPO/HMO/WC	$5.48
Rate for Payer: UnitedHealthcare Commercial	$7.30
Rate for Payer: UnitedHealthcare Community & State	$1.15
Rate for Payer: Wellpoint Medicaid Managed Care	$1.04

MINERCA CO2 CANNISTER

Facility

$55.00

Hospital Charge Code	270704554
Hospital Revenue Code	272
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$27.50
Rate for Payer: Aetna Commercial	$20.90
Rate for Payer: Aetna Medicare Advantage	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.03
Rate for Payer: Cigna Commercial	$27.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.30
Rate for Payer: Oxford Commercial	$11.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.25
Rate for Payer: UnitedHealthcare Commercial	$11.00
Rate for Payer: UnitedHealthcare Community & State	$1.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1.56

MINERCA CO2 CANNISTER

Facility

$55.00

Hospital Charge Code	270704554
Hospital Revenue Code	272
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

MINERVA ARGON CANNISTER

Facility

$85.00

Hospital Charge Code	270704553
Hospital Revenue Code	272
Min. Negotiated Rate	$12.75
Max. Negotiated Rate	$12.75
Rate for Payer: Qualcare PPO/HMO/WC	$12.75

MINERVA ARGON CANNISTER

Facility

$85.00

Hospital Charge Code	270704553
Hospital Revenue Code	272
Min. Negotiated Rate	$2.41
Max. Negotiated Rate	$42.50
Rate for Payer: Aetna Commercial	$32.30
Rate for Payer: Aetna Medicare Advantage	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.68
Rate for Payer: Cigna Commercial	$42.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.10
Rate for Payer: Oxford Commercial	$17.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.75
Rate for Payer: UnitedHealthcare Commercial	$17.00
Rate for Payer: UnitedHealthcare Community & State	$2.69
Rate for Payer: Wellpoint Medicaid Managed Care	$2.41

MINERVA HANDPIECE

Facility

$5,000.00

Hospital Charge Code	270704552
Hospital Revenue Code	272
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$750.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

MINERVA HANDPIECE

Facility

$5,000.00

Hospital Charge Code	270704552
Hospital Revenue Code	272
Min. Negotiated Rate	$142.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.00
Rate for Payer: Oxford Commercial	$1,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Commercial	$1,000.00
Rate for Payer: UnitedHealthcare Community & State	$158.00
Rate for Payer: Wellpoint Medicaid Managed Care	$142.00

MINIAR PIECISE

Facility

$8,615.00

Hospital Charge Code	270669794
Hospital Revenue Code	272
Min. Negotiated Rate	$1,292.25
Max. Negotiated Rate	$1,292.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,292.25

MINIAR PIECISE

Facility

$8,615.00

Hospital Charge Code	270669794
Hospital Revenue Code	272
Min. Negotiated Rate	$244.67
Max. Negotiated Rate	$4,307.50
Rate for Payer: Aetna Commercial	$3,273.70
Rate for Payer: Aetna Medicare Advantage	$2,584.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,196.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,196.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,196.82
Rate for Payer: Cigna Commercial	$4,307.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,239.90
Rate for Payer: Oxford Commercial	$1,723.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,292.25
Rate for Payer: UnitedHealthcare Commercial	$1,723.00
Rate for Payer: UnitedHealthcare Community & State	$272.23
Rate for Payer: Wellpoint Medicaid Managed Care	$244.67

MINI BIO ANCHOR

Facility

$437.00

Hospital Charge Code	270335686
Hospital Revenue Code	278
Min. Negotiated Rate	$65.55
Max. Negotiated Rate	$105.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.75
Rate for Payer: Qualcare PPO/HMO/WC	$65.55

MINI BIO ANCHOR

Facility

$437.00

Hospital Charge Code	270335686
Hospital Revenue Code	278
Min. Negotiated Rate	$12.41
Max. Negotiated Rate	$218.50
Rate for Payer: Aetna Commercial	$166.06
Rate for Payer: Aetna Medicare Advantage	$131.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.44
Rate for Payer: Cigna Commercial	$218.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.75
Rate for Payer: Qualcare PPO/HMO/WC	$65.55
Rate for Payer: UnitedHealthcare Community & State	$13.81
Rate for Payer: Wellpoint Medicaid Managed Care	$12.41

Know your out-of-pocket cost for care.

All Charges