Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

AUTOTOME RX 39

Facility

$1,072.45

Hospital Charge Code	270683532
Hospital Revenue Code	272
Min. Negotiated Rate	$30.46
Max. Negotiated Rate	$536.23
Rate for Payer: Aetna Commercial	$407.53
Rate for Payer: Aetna Medicare Advantage	$321.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$273.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$273.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$273.47
Rate for Payer: Cigna Commercial	$536.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.84
Rate for Payer: Oxford Commercial	$214.49
Rate for Payer: Qualcare PPO/HMO/WC	$160.87
Rate for Payer: UnitedHealthcare Commercial	$214.49
Rate for Payer: UnitedHealthcare Community & State	$33.89
Rate for Payer: Wellpoint Medicaid Managed Care	$30.46

AUTOTOME RX 39

Facility

$1,072.45

Hospital Charge Code	270683532
Hospital Revenue Code	272
Min. Negotiated Rate	$160.87
Max. Negotiated Rate	$160.87
Rate for Payer: Qualcare PPO/HMO/WC	$160.87

AUTOTRANSFUSION INF.PUMP

Facility

$174.00

Hospital Charge Code	270339073
Hospital Revenue Code	272
Min. Negotiated Rate	$26.10
Max. Negotiated Rate	$26.10
Rate for Payer: Qualcare PPO/HMO/WC	$26.10

AUTOTRANSFUSION INF.PUMP

Facility

$174.00

Hospital Charge Code	270339073
Hospital Revenue Code	272
Min. Negotiated Rate	$4.94
Max. Negotiated Rate	$87.00
Rate for Payer: Aetna Commercial	$66.12
Rate for Payer: Aetna Medicare Advantage	$52.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.37
Rate for Payer: Cigna Commercial	$87.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.24
Rate for Payer: Oxford Commercial	$34.80
Rate for Payer: Qualcare PPO/HMO/WC	$26.10
Rate for Payer: UnitedHealthcare Commercial	$34.80
Rate for Payer: UnitedHealthcare Community & State	$5.50
Rate for Payer: Wellpoint Medicaid Managed Care	$4.94

AUTOTRANSFUSION TUBING KIT

Facility

$3,875.00

Hospital Charge Code	270697350
Hospital Revenue Code	272
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$581.25
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

AUTOTRANSFUSION TUBING KIT

Facility

$3,875.00

Hospital Charge Code	270697350
Hospital Revenue Code	272
Min. Negotiated Rate	$110.05
Max. Negotiated Rate	$1,937.50
Rate for Payer: Aetna Commercial	$1,472.50
Rate for Payer: Aetna Medicare Advantage	$1,162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$988.12
Rate for Payer: Cigna Commercial	$1,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,007.50
Rate for Payer: Oxford Commercial	$775.00
Rate for Payer: Qualcare PPO/HMO/WC	$581.25
Rate for Payer: UnitedHealthcare Commercial	$775.00
Rate for Payer: UnitedHealthcare Community & State	$122.45
Rate for Payer: Wellpoint Medicaid Managed Care	$110.05

AUTO TRANS PROCEDURE SCHEDULED

Facility

$3,222.45

Hospital Charge Code	270605796
Hospital Revenue Code	272
Min. Negotiated Rate	$91.52
Max. Negotiated Rate	$1,611.22
Rate for Payer: Aetna Commercial	$1,224.53
Rate for Payer: Aetna Medicare Advantage	$966.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$821.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$821.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$821.72
Rate for Payer: Cigna Commercial	$1,611.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$837.84
Rate for Payer: Oxford Commercial	$644.49
Rate for Payer: Qualcare PPO/HMO/WC	$483.37
Rate for Payer: UnitedHealthcare Commercial	$644.49
Rate for Payer: UnitedHealthcare Community & State	$101.83
Rate for Payer: Wellpoint Medicaid Managed Care	$91.52

AUTO TRANS PROCEDURE SCHEDULED

Facility

$3,222.45

Hospital Charge Code	270605796
Hospital Revenue Code	272
Min. Negotiated Rate	$483.37
Max. Negotiated Rate	$483.37
Rate for Payer: Qualcare PPO/HMO/WC	$483.37

AVALON ELITE 19FR

Facility

$13,969.00

Hospital Charge Code	2703110M
Hospital Revenue Code	272
Min. Negotiated Rate	$2,095.35
Max. Negotiated Rate	$2,095.35
Rate for Payer: Qualcare PPO/HMO/WC	$2,095.35

AVALON ELITE 19FR

Facility

$13,969.00

Hospital Charge Code	2703110M
Hospital Revenue Code	272
Min. Negotiated Rate	$396.72
Max. Negotiated Rate	$6,984.50
Rate for Payer: Aetna Commercial	$5,308.22
Rate for Payer: Aetna Medicare Advantage	$4,190.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,562.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,562.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,562.09
Rate for Payer: Cigna Commercial	$6,984.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,631.94
Rate for Payer: Oxford Commercial	$2,793.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,095.35
Rate for Payer: UnitedHealthcare Commercial	$2,793.80
Rate for Payer: UnitedHealthcare Community & State	$441.42
Rate for Payer: Wellpoint Medicaid Managed Care	$396.72

AVALON ELITE 23FR

Facility

$13,969.00

Hospital Charge Code	2703110N
Hospital Revenue Code	272
Min. Negotiated Rate	$2,095.35
Max. Negotiated Rate	$2,095.35
Rate for Payer: Qualcare PPO/HMO/WC	$2,095.35

AVALON ELITE 23FR

Facility

$13,969.00

Hospital Charge Code	2703110N
Hospital Revenue Code	272
Min. Negotiated Rate	$396.72
Max. Negotiated Rate	$6,984.50
Rate for Payer: Aetna Commercial	$5,308.22
Rate for Payer: Aetna Medicare Advantage	$4,190.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,562.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,562.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,562.09
Rate for Payer: Cigna Commercial	$6,984.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,631.94
Rate for Payer: Oxford Commercial	$2,793.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,095.35
Rate for Payer: UnitedHealthcare Commercial	$2,793.80
Rate for Payer: UnitedHealthcare Community & State	$441.42
Rate for Payer: Wellpoint Medicaid Managed Care	$396.72

AVALON ELITE 27FR

Facility

$13,969.00

Hospital Charge Code	2703110O
Hospital Revenue Code	272
Min. Negotiated Rate	$396.72
Max. Negotiated Rate	$6,984.50
Rate for Payer: Aetna Commercial	$5,308.22
Rate for Payer: Aetna Medicare Advantage	$4,190.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,562.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,562.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,562.09
Rate for Payer: Cigna Commercial	$6,984.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,631.94
Rate for Payer: Oxford Commercial	$2,793.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,095.35
Rate for Payer: UnitedHealthcare Commercial	$2,793.80
Rate for Payer: UnitedHealthcare Community & State	$441.42
Rate for Payer: Wellpoint Medicaid Managed Care	$396.72

AVALON ELITE 27FR

Facility

$13,969.00

Hospital Charge Code	2703110O
Hospital Revenue Code	272
Min. Negotiated Rate	$2,095.35
Max. Negotiated Rate	$2,095.35
Rate for Payer: Qualcare PPO/HMO/WC	$2,095.35

AVALON ELITE 31FR

Facility

$13,969.00

Hospital Charge Code	2703110P
Hospital Revenue Code	272
Min. Negotiated Rate	$396.72
Max. Negotiated Rate	$6,984.50
Rate for Payer: Aetna Commercial	$5,308.22
Rate for Payer: Aetna Medicare Advantage	$4,190.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,562.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,562.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,562.09
Rate for Payer: Cigna Commercial	$6,984.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,631.94
Rate for Payer: Oxford Commercial	$2,793.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,095.35
Rate for Payer: UnitedHealthcare Commercial	$2,793.80
Rate for Payer: UnitedHealthcare Community & State	$441.42
Rate for Payer: Wellpoint Medicaid Managed Care	$396.72

AVALON ELITE 31FR

Facility

$13,969.00

Hospital Charge Code	2703110P
Hospital Revenue Code	272
Min. Negotiated Rate	$2,095.35
Max. Negotiated Rate	$2,095.35
Rate for Payer: Qualcare PPO/HMO/WC	$2,095.35

AVALON ELITE VAS ACC KIT 100CM

Facility

$1,114.80

Hospital Charge Code	2703110Q
Hospital Revenue Code	272
Min. Negotiated Rate	$31.66
Max. Negotiated Rate	$557.40
Rate for Payer: Aetna Commercial	$423.62
Rate for Payer: Aetna Medicare Advantage	$334.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$284.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$284.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$284.27
Rate for Payer: Cigna Commercial	$557.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$289.85
Rate for Payer: Oxford Commercial	$222.96
Rate for Payer: Qualcare PPO/HMO/WC	$167.22
Rate for Payer: UnitedHealthcare Commercial	$222.96
Rate for Payer: UnitedHealthcare Community & State	$35.23
Rate for Payer: Wellpoint Medicaid Managed Care	$31.66

AVALON ELITE VAS ACC KIT 100CM

Facility

$1,114.80

Hospital Charge Code	2703110Q
Hospital Revenue Code	272
Min. Negotiated Rate	$167.22
Max. Negotiated Rate	$167.22
Rate for Payer: Qualcare PPO/HMO/WC	$167.22

AVALON ELITE VAS ACC KIT 210CM

Facility

$4,613.75

Hospital Charge Code	2703110R
Hospital Revenue Code	272
Min. Negotiated Rate	$692.06
Max. Negotiated Rate	$692.06
Rate for Payer: Qualcare PPO/HMO/WC	$692.06

AVALON ELITE VAS ACC KIT 210CM

Facility

$4,613.75

Hospital Charge Code	2703110R
Hospital Revenue Code	272
Min. Negotiated Rate	$131.03
Max. Negotiated Rate	$2,306.88
Rate for Payer: Aetna Commercial	$1,753.22
Rate for Payer: Aetna Medicare Advantage	$1,384.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,176.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,176.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,176.51
Rate for Payer: Cigna Commercial	$2,306.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,199.58
Rate for Payer: Oxford Commercial	$922.75
Rate for Payer: Qualcare PPO/HMO/WC	$692.06
Rate for Payer: UnitedHealthcare Commercial	$922.75
Rate for Payer: UnitedHealthcare Community & State	$145.79
Rate for Payer: Wellpoint Medicaid Managed Care	$131.03

AV ANASTOMOSIS OPEN,ANY SITE

Facility

$38,857.60

Service Code	HCPCS 36821
Hospital Charge Code	16000582
Hospital Revenue Code	360
Min. Negotiated Rate	$5,828.64
Max. Negotiated Rate	$5,828.64
Rate for Payer: Qualcare PPO/HMO/WC	$5,828.64

AV ANASTOMOSIS OPEN,ANY SITE

Facility

$38,857.60

Service Code	HCPCS 36821
Hospital Charge Code	16000582
Hospital Revenue Code	360
Min. Negotiated Rate	$1,103.56
Max. Negotiated Rate	$13,607.37
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
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	$13,607.37
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,102.98
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,828.64
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$1,227.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$1,103.56

AVANCE GRAFT NERVE 1X2X70

Facility

$36,620.00

Service Code	HCPCS C1889
Hospital Charge Code	270690222
Hospital Revenue Code	278
Min. Negotiated Rate	$5,493.00
Max. Negotiated Rate	$8,862.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,324.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,862.04
Rate for Payer: Qualcare PPO/HMO/WC	$5,493.00

AVANCE GRAFT NERVE 1X2X70

Facility

$36,620.00

Service Code	HCPCS C1889
Hospital Charge Code	270690222
Hospital Revenue Code	278
Min. Negotiated Rate	$1,040.01
Max. Negotiated Rate	$18,310.00
Rate for Payer: Aetna Commercial	$13,915.60
Rate for Payer: Aetna Medicare Advantage	$10,986.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,338.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,338.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,324.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,338.10
Rate for Payer: Cigna Commercial	$18,310.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,862.04
Rate for Payer: Qualcare PPO/HMO/WC	$5,493.00
Rate for Payer: UnitedHealthcare Community & State	$1,157.19
Rate for Payer: Wellpoint Medicaid Managed Care	$1,040.01

AVANCE NERVE GRAFT

Facility

$10,625.00

Service Code	HCPCS C1768
Hospital Charge Code	270664250
Hospital Revenue Code	278
Min. Negotiated Rate	$1,593.75
Max. Negotiated Rate	$2,571.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,571.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,593.75

Know your out-of-pocket cost for care.

All Charges