Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

MINI STICK MAX 4FX10 CM STD NI

Facility

$800.00

Hospital Charge Code	270652561
Hospital Revenue Code	272
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

MINI STICK MAX 4FX10 CM STIFF

Facility

$900.00

Hospital Charge Code	270686148N
Hospital Revenue Code	272
Min. Negotiated Rate	$25.56
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.00
Rate for Payer: Oxford Commercial	$180.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Commercial	$180.00
Rate for Payer: UnitedHealthcare Community & State	$28.44
Rate for Payer: Wellpoint Medicaid Managed Care	$25.56

MINI STICK MAX 4FX10 CM STIFF

Facility

$900.00

Hospital Charge Code	270686148
Hospital Revenue Code	272
Min. Negotiated Rate	$25.56
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.00
Rate for Payer: Oxford Commercial	$180.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Commercial	$180.00
Rate for Payer: UnitedHealthcare Community & State	$28.44
Rate for Payer: Wellpoint Medicaid Managed Care	$25.56

MINI STICK MAX 4FX10 CM STIFF

Facility

$900.00

Hospital Charge Code	270686148N
Hospital Revenue Code	272
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$135.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

MINI STICK MAX 4FX10 CM STIFF

Facility

$900.00

Hospital Charge Code	270686148
Hospital Revenue Code	272
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$135.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

MINI STICK MAX 5FX10 CM STD NI

Facility

$800.00

Hospital Charge Code	270686131
Hospital Revenue Code	272
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

MINI STICK MAX 5FX10 CM STD NI

Facility

$800.00

Hospital Charge Code	270686131S
Hospital Revenue Code	272
Min. Negotiated Rate	$22.72
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.00
Rate for Payer: Oxford Commercial	$160.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Commercial	$160.00
Rate for Payer: UnitedHealthcare Community & State	$25.28
Rate for Payer: Wellpoint Medicaid Managed Care	$22.72

MINI STICK MAX 5FX10 CM STD NI

Facility

$800.00

Hospital Charge Code	270686131S
Hospital Revenue Code	272
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

MINI STICK MAX 5FX10 CM STD NI

Facility

$800.00

Hospital Charge Code	270686131N
Hospital Revenue Code	272
Min. Negotiated Rate	$22.72
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.00
Rate for Payer: Oxford Commercial	$160.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Commercial	$160.00
Rate for Payer: UnitedHealthcare Community & State	$25.28
Rate for Payer: Wellpoint Medicaid Managed Care	$22.72

MINI STICK MAX 5FX10 CM STD NI

Facility

$800.00

Hospital Charge Code	270686131
Hospital Revenue Code	272
Min. Negotiated Rate	$22.72
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.00
Rate for Payer: Oxford Commercial	$160.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Commercial	$160.00
Rate for Payer: UnitedHealthcare Community & State	$25.28
Rate for Payer: Wellpoint Medicaid Managed Care	$22.72

MINI STICK MAX 5FX10 CM STD NI

Facility

$800.00

Hospital Charge Code	270686131N
Hospital Revenue Code	272
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

MINI STICK MAX 5FX10 CM STIFF

Facility

$900.00

Hospital Charge Code	270686149
Hospital Revenue Code	272
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$135.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

MINI STICK MAX 5FX10 CM STIFF

Facility

$900.00

Hospital Charge Code	270686149
Hospital Revenue Code	272
Min. Negotiated Rate	$25.56
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.00
Rate for Payer: Oxford Commercial	$180.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Commercial	$180.00
Rate for Payer: UnitedHealthcare Community & State	$28.44
Rate for Payer: Wellpoint Medicaid Managed Care	$25.56

MINI STICK MAX 5FX10 CM STIFF

Facility

$900.00

Hospital Charge Code	270686149N
Hospital Revenue Code	272
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$135.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

MINI STICK MAX 5FX10 CM STIFF

Facility

$900.00

Hospital Charge Code	270686149N
Hospital Revenue Code	272
Min. Negotiated Rate	$25.56
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.00
Rate for Payer: Oxford Commercial	$180.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Commercial	$180.00
Rate for Payer: UnitedHealthcare Community & State	$28.44
Rate for Payer: Wellpoint Medicaid Managed Care	$25.56

MINITAPE BLUE 39.5

Facility

$600.00

Hospital Charge Code	2707220512
Hospital Revenue Code	272
Min. Negotiated Rate	$17.04
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.00
Rate for Payer: Oxford Commercial	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Commercial	$120.00
Rate for Payer: UnitedHealthcare Community & State	$18.96
Rate for Payer: Wellpoint Medicaid Managed Care	$17.04

MINITAPE BLUE 39.5

Facility

$600.00

Hospital Charge Code	2707220512
Hospital Revenue Code	272
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

MINI-TEG WIRE 4MM-2CM

Facility

$2,260.00

Hospital Charge Code	270330594
Hospital Revenue Code	272
Min. Negotiated Rate	$339.00
Max. Negotiated Rate	$339.00
Rate for Payer: Qualcare PPO/HMO/WC	$339.00

MINI-TEG WIRE 4MM-2CM

Facility

$2,260.00

Hospital Charge Code	270330594
Hospital Revenue Code	272
Min. Negotiated Rate	$64.18
Max. Negotiated Rate	$1,130.00
Rate for Payer: Aetna Commercial	$858.80
Rate for Payer: Aetna Medicare Advantage	$678.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$576.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$576.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$576.30
Rate for Payer: Cigna Commercial	$1,130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$587.60
Rate for Payer: Oxford Commercial	$452.00
Rate for Payer: Qualcare PPO/HMO/WC	$339.00
Rate for Payer: UnitedHealthcare Commercial	$452.00
Rate for Payer: UnitedHealthcare Community & State	$71.42
Rate for Payer: Wellpoint Medicaid Managed Care	$64.18

MINI TRAY STD COCR +6 OFFSET

Facility

$10,500.00

Service Code	HCPCS 10500
Hospital Charge Code	270703085
Hospital Revenue Code	278
Min. Negotiated Rate	$298.20
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,990.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00
Rate for Payer: UnitedHealthcare Community & State	$331.80
Rate for Payer: Wellpoint Medicaid Managed Care	$298.20

MINI TRAY STD COCR +6 OFFSET

Facility

$10,500.00

Service Code	HCPCS 10500
Hospital Charge Code	270703085
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

MINOR BLADDER PROCEDURES WITH CC

Facility

$67,493.18

Service Code	MSDRG 663
Min. Negotiated Rate	$20,550.81
Max. Negotiated Rate	$67,493.18
Rate for Payer: Aetna Commercial	$49,927.93
Rate for Payer: Aetna Medicare Advantage	$67,493.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40,449.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40,449.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,632.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40,449.30
Rate for Payer: Cigna Commercial	$33,889.82
Rate for Payer: Cigna Medicare Advantage	$21,632.43
Rate for Payer: Clover Medicare Advantage	$20,550.81
Rate for Payer: EmblemHealth Commercial	$64,897.29
Rate for Payer: Humana Medicare Advantage	$22,281.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21,632.43
Rate for Payer: Oxford Commercial	$26,785.92
Rate for Payer: UnitedHealthcare Commercial	$35,853.92
Rate for Payer: UnitedHealthcare Medicare Advantage	$21,632.43
Rate for Payer: Wellcare Medicare Advantage	$21,632.43

MINOR BLADDER PROCEDURES WITH MCC

Facility

$116,188.33

Service Code	MSDRG 662
Min. Negotiated Rate	$35,377.86
Max. Negotiated Rate	$116,188.33
Rate for Payer: Aetna Commercial	$84,609.20
Rate for Payer: Aetna Medicare Advantage	$116,188.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83,115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83,115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$37,239.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83,115.00
Rate for Payer: Cigna Commercial	$68,250.02
Rate for Payer: Cigna Medicare Advantage	$37,239.85
Rate for Payer: Clover Medicare Advantage	$35,377.86
Rate for Payer: EmblemHealth Commercial	$111,719.55
Rate for Payer: Humana Medicare Advantage	$38,357.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$37,239.85
Rate for Payer: Oxford Commercial	$53,943.63
Rate for Payer: UnitedHealthcare Commercial	$72,205.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$37,239.85
Rate for Payer: Wellcare Medicare Advantage	$37,239.85

MINOR BLADDER PROCEDURES WITHOUT CC/MCC

Facility

$52,539.99

Service Code	MSDRG 664
Min. Negotiated Rate	$15,997.75
Max. Negotiated Rate	$52,539.99
Rate for Payer: Aetna Commercial	$39,278.08
Rate for Payer: Aetna Medicare Advantage	$52,539.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29,367.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29,367.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16,839.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29,367.30
Rate for Payer: Cigna Commercial	$23,338.54
Rate for Payer: Cigna Medicare Advantage	$16,839.74
Rate for Payer: Clover Medicare Advantage	$15,997.75
Rate for Payer: EmblemHealth Commercial	$50,519.22
Rate for Payer: Humana Medicare Advantage	$17,344.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16,839.74
Rate for Payer: Oxford Commercial	$18,446.38
Rate for Payer: UnitedHealthcare Commercial	$24,691.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$16,839.74
Rate for Payer: Wellcare Medicare Advantage	$16,839.74

MINOR SKIN DISORDERS WITH MCC

Facility

$67,272.04

Service Code	MSDRG 606
Min. Negotiated Rate	$20,483.47
Max. Negotiated Rate	$67,272.04
Rate for Payer: Aetna Commercial	$49,770.43
Rate for Payer: Aetna Medicare Advantage	$67,272.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44,050.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44,050.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,561.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44,050.95
Rate for Payer: Cigna Commercial	$33,733.77
Rate for Payer: Cigna Medicare Advantage	$21,561.55
Rate for Payer: Clover Medicare Advantage	$20,483.47
Rate for Payer: EmblemHealth Commercial	$64,684.65
Rate for Payer: Humana Medicare Advantage	$22,208.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21,561.55
Rate for Payer: Oxford Commercial	$26,662.58
Rate for Payer: UnitedHealthcare Commercial	$35,688.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$21,561.55
Rate for Payer: Wellcare Medicare Advantage	$21,561.55

Know your out-of-pocket cost for care.

All Charges