Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PACK CATARACT ALCON

Facility

$1,487.50

Hospital Charge Code	270651590
Hospital Revenue Code	272
Min. Negotiated Rate	$223.12
Max. Negotiated Rate	$223.12
Rate for Payer: Qualcare PPO/HMO/WC	$223.12

PACK CATARACT AS4544

Facility

$446.90

Hospital Charge Code	270651299
Hospital Revenue Code	272
Min. Negotiated Rate	$12.69
Max. Negotiated Rate	$223.45
Rate for Payer: Aetna Commercial	$169.82
Rate for Payer: Aetna Medicare Advantage	$134.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.96
Rate for Payer: Cigna Commercial	$223.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.19
Rate for Payer: Oxford Commercial	$89.38
Rate for Payer: Qualcare PPO/HMO/WC	$67.03
Rate for Payer: UnitedHealthcare Commercial	$89.38
Rate for Payer: UnitedHealthcare Community & State	$14.12
Rate for Payer: Wellpoint Medicaid Managed Care	$12.69

PACK CATARACT AS4544

Facility

$446.90

Hospital Charge Code	270651299
Hospital Revenue Code	272
Min. Negotiated Rate	$67.03
Max. Negotiated Rate	$67.03
Rate for Payer: Qualcare PPO/HMO/WC	$67.03

PACK CATARACT EXTRACTION

Facility

$742.65

Hospital Charge Code	270651297
Hospital Revenue Code	272
Min. Negotiated Rate	$111.40
Max. Negotiated Rate	$111.40
Rate for Payer: Qualcare PPO/HMO/WC	$111.40

PACK CATARACT EXTRACTION

Facility

$742.65

Hospital Charge Code	270651297
Hospital Revenue Code	272
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$371.32
Rate for Payer: Aetna Commercial	$282.21
Rate for Payer: Aetna Medicare Advantage	$222.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.38
Rate for Payer: Cigna Commercial	$371.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.09
Rate for Payer: Oxford Commercial	$148.53
Rate for Payer: Qualcare PPO/HMO/WC	$111.40
Rate for Payer: UnitedHealthcare Commercial	$148.53
Rate for Payer: UnitedHealthcare Community & State	$23.47
Rate for Payer: Wellpoint Medicaid Managed Care	$21.09

PACK CELL SAVER 125ml SOR125

Facility

$363.75

Hospital Charge Code	270616337
Hospital Revenue Code	272
Min. Negotiated Rate	$10.33
Max. Negotiated Rate	$181.88
Rate for Payer: Aetna Commercial	$138.22
Rate for Payer: Aetna Medicare Advantage	$109.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.76
Rate for Payer: Cigna Commercial	$181.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.58
Rate for Payer: Oxford Commercial	$72.75
Rate for Payer: Qualcare PPO/HMO/WC	$54.56
Rate for Payer: UnitedHealthcare Commercial	$72.75
Rate for Payer: UnitedHealthcare Community & State	$11.49
Rate for Payer: Wellpoint Medicaid Managed Care	$10.33

PACK CELL SAVER 125ml SOR125

Facility

$363.75

Hospital Charge Code	270616337
Hospital Revenue Code	272
Min. Negotiated Rate	$54.56
Max. Negotiated Rate	$54.56
Rate for Payer: Qualcare PPO/HMO/WC	$54.56

PACK CELL SAVER 225CC HAE243

Facility

$342.50

Hospital Charge Code	270605802
Hospital Revenue Code	272
Min. Negotiated Rate	$9.73
Max. Negotiated Rate	$171.25
Rate for Payer: Aetna Commercial	$130.15
Rate for Payer: Aetna Medicare Advantage	$102.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.34
Rate for Payer: Cigna Commercial	$171.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.05
Rate for Payer: Oxford Commercial	$68.50
Rate for Payer: Qualcare PPO/HMO/WC	$51.38
Rate for Payer: UnitedHealthcare Commercial	$68.50
Rate for Payer: UnitedHealthcare Community & State	$10.82
Rate for Payer: Wellpoint Medicaid Managed Care	$9.73

PACK CELL SAVER 225CC HAE243

Facility

$342.50

Hospital Charge Code	270605802
Hospital Revenue Code	272
Min. Negotiated Rate	$51.38
Max. Negotiated Rate	$51.38
Rate for Payer: Qualcare PPO/HMO/WC	$51.38

PACK CT DRAINAGE TRAY

Facility

$285.00

Hospital Charge Code	270653745
Hospital Revenue Code	272
Min. Negotiated Rate	$8.09
Max. Negotiated Rate	$142.50
Rate for Payer: Aetna Commercial	$108.30
Rate for Payer: Aetna Medicare Advantage	$85.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.67
Rate for Payer: Cigna Commercial	$142.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.10
Rate for Payer: Oxford Commercial	$57.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.75
Rate for Payer: UnitedHealthcare Commercial	$57.00
Rate for Payer: UnitedHealthcare Community & State	$9.01
Rate for Payer: Wellpoint Medicaid Managed Care	$8.09

PACK CT DRAINAGE TRAY

Facility

$285.00

Hospital Charge Code	270653745R
Hospital Revenue Code	272
Min. Negotiated Rate	$8.09
Max. Negotiated Rate	$142.50
Rate for Payer: Aetna Commercial	$108.30
Rate for Payer: Aetna Medicare Advantage	$85.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.67
Rate for Payer: Cigna Commercial	$142.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.10
Rate for Payer: Oxford Commercial	$57.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.75
Rate for Payer: UnitedHealthcare Commercial	$57.00
Rate for Payer: UnitedHealthcare Community & State	$9.01
Rate for Payer: Wellpoint Medicaid Managed Care	$8.09

PACK CT DRAINAGE TRAY

Facility

$285.00

Hospital Charge Code	270653745
Hospital Revenue Code	272
Min. Negotiated Rate	$42.75
Max. Negotiated Rate	$42.75
Rate for Payer: Qualcare PPO/HMO/WC	$42.75

PACK CT DRAINAGE TRAY

Facility

$285.00

Hospital Charge Code	270653745R
Hospital Revenue Code	272
Min. Negotiated Rate	$42.75
Max. Negotiated Rate	$42.75
Rate for Payer: Qualcare PPO/HMO/WC	$42.75

PACK CUSTOM ANGIO

Facility

$372.95

Hospital Charge Code	270677787S
Hospital Revenue Code	272
Min. Negotiated Rate	$10.59
Max. Negotiated Rate	$186.47
Rate for Payer: Aetna Commercial	$141.72
Rate for Payer: Aetna Medicare Advantage	$111.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.10
Rate for Payer: Cigna Commercial	$186.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.97
Rate for Payer: Oxford Commercial	$74.59
Rate for Payer: Qualcare PPO/HMO/WC	$55.94
Rate for Payer: UnitedHealthcare Commercial	$74.59
Rate for Payer: UnitedHealthcare Community & State	$11.79
Rate for Payer: Wellpoint Medicaid Managed Care	$10.59

PACK CUSTOM ANGIO

Facility

$372.95

Hospital Charge Code	270677787S
Hospital Revenue Code	272
Min. Negotiated Rate	$55.94
Max. Negotiated Rate	$55.94
Rate for Payer: Qualcare PPO/HMO/WC	$55.94

PACK CUSTOM ANGIO

Facility

$372.95

Hospital Charge Code	270677787
Hospital Revenue Code	272
Min. Negotiated Rate	$55.94
Max. Negotiated Rate	$55.94
Rate for Payer: Qualcare PPO/HMO/WC	$55.94

PACK CUSTOM ANGIO

Facility

$325.00

Hospital Charge Code	270677787N
Hospital Revenue Code	272
Min. Negotiated Rate	$9.23
Max. Negotiated Rate	$162.50
Rate for Payer: Aetna Commercial	$123.50
Rate for Payer: Aetna Medicare Advantage	$97.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.88
Rate for Payer: Cigna Commercial	$162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.50
Rate for Payer: Oxford Commercial	$65.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.75
Rate for Payer: UnitedHealthcare Commercial	$65.00
Rate for Payer: UnitedHealthcare Community & State	$10.27
Rate for Payer: Wellpoint Medicaid Managed Care	$9.23

PACK CUSTOM ANGIO

Facility

$325.00

Hospital Charge Code	270677787N
Hospital Revenue Code	272
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

PACK CUSTOM ANGIO

Facility

$372.95

Hospital Charge Code	270677787
Hospital Revenue Code	272
Min. Negotiated Rate	$10.59
Max. Negotiated Rate	$186.47
Rate for Payer: Aetna Commercial	$141.72
Rate for Payer: Aetna Medicare Advantage	$111.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.10
Rate for Payer: Cigna Commercial	$186.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.97
Rate for Payer: Oxford Commercial	$74.59
Rate for Payer: Qualcare PPO/HMO/WC	$55.94
Rate for Payer: UnitedHealthcare Commercial	$74.59
Rate for Payer: UnitedHealthcare Community & State	$11.79
Rate for Payer: Wellpoint Medicaid Managed Care	$10.59

PACK CUSTOM BASIC EXTREMITY

Facility

$235.25

Hospital Charge Code	270642265
Hospital Revenue Code	272
Min. Negotiated Rate	$35.29
Max. Negotiated Rate	$35.29
Rate for Payer: Qualcare PPO/HMO/WC	$35.29

PACK CUSTOM BASIC EXTREMITY

Facility

$235.25

Hospital Charge Code	270642265
Hospital Revenue Code	272
Min. Negotiated Rate	$6.68
Max. Negotiated Rate	$117.62
Rate for Payer: Aetna Commercial	$89.39
Rate for Payer: Aetna Medicare Advantage	$70.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.99
Rate for Payer: Cigna Commercial	$117.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.16
Rate for Payer: Oxford Commercial	$47.05
Rate for Payer: Qualcare PPO/HMO/WC	$35.29
Rate for Payer: UnitedHealthcare Commercial	$47.05
Rate for Payer: UnitedHealthcare Community & State	$7.43
Rate for Payer: Wellpoint Medicaid Managed Care	$6.68

PACK CUSTOM CATH AVIBMBM00112

Facility

$392.70

Hospital Charge Code	270642262
Hospital Revenue Code	272
Min. Negotiated Rate	$11.15
Max. Negotiated Rate	$196.35
Rate for Payer: Aetna Commercial	$149.23
Rate for Payer: Aetna Medicare Advantage	$117.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.14
Rate for Payer: Cigna Commercial	$196.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.10
Rate for Payer: Oxford Commercial	$78.54
Rate for Payer: Qualcare PPO/HMO/WC	$58.91
Rate for Payer: UnitedHealthcare Commercial	$78.54
Rate for Payer: UnitedHealthcare Community & State	$12.41
Rate for Payer: Wellpoint Medicaid Managed Care	$11.15

PACK CUSTOM CATH AVIBMBM00112

Facility

$392.70

Hospital Charge Code	270642262
Hospital Revenue Code	272
Min. Negotiated Rate	$58.91
Max. Negotiated Rate	$58.91
Rate for Payer: Qualcare PPO/HMO/WC	$58.91

PACK CUSTOM CATHLAB W/CHLORAPR

Facility

$391.25

Hospital Charge Code	270677786S
Hospital Revenue Code	272
Min. Negotiated Rate	$58.69
Max. Negotiated Rate	$58.69
Rate for Payer: Qualcare PPO/HMO/WC	$58.69

PACK CUSTOM CATHLAB W/CHLORAPR

Facility

$352.90

Hospital Charge Code	270677786N
Hospital Revenue Code	272
Min. Negotiated Rate	$52.94
Max. Negotiated Rate	$52.94
Rate for Payer: Qualcare PPO/HMO/WC	$52.94

Know your out-of-pocket cost for care.

All Charges