Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PERI VENIPUNCTURE

Facility

$135.80

Service Code	HCPCS 36415
Hospital Charge Code	74308005
Hospital Revenue Code	300
Min. Negotiated Rate	$20.37
Max. Negotiated Rate	$20.37
Rate for Payer: Qualcare PPO/HMO/WC	$20.37

PERLA 5.5X45MM ROD

Facility

$1,750.00

Hospital Charge Code	270702842
Hospital Revenue Code	278
Min. Negotiated Rate	$49.70
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Community & State	$55.30
Rate for Payer: Wellpoint Medicaid Managed Care	$49.70

PERLA 5.5X45MM ROD

Facility

$1,750.00

Hospital Charge Code	270702842
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$423.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

PERLA CORTICAL 6.5X45MM SCREW

Facility

$3,125.00

Hospital Charge Code	270702838
Hospital Revenue Code	278
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$756.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

PERLA CORTICAL 6.5X45MM SCREW

Facility

$3,125.00

Hospital Charge Code	270702838
Hospital Revenue Code	278
Min. Negotiated Rate	$88.75
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$1,187.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Community & State	$98.75
Rate for Payer: Wellpoint Medicaid Managed Care	$88.75

PERLA CORTICAL 7.5X40MM SCREW

Facility

$3,125.00

Hospital Charge Code	270702839
Hospital Revenue Code	278
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$756.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

PERLA CORTICAL 7.5X40MM SCREW

Facility

$3,125.00

Hospital Charge Code	270702839
Hospital Revenue Code	278
Min. Negotiated Rate	$88.75
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$1,187.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Community & State	$98.75
Rate for Payer: Wellpoint Medicaid Managed Care	$88.75

PERLA SET SCREW

Facility

$500.00

Hospital Charge Code	270702841
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

PERLA SET SCREW

Facility

$500.00

Hospital Charge Code	270702841
Hospital Revenue Code	278
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

PERMA CATH DUAL LUMEN 36 CM

Facility

$1,102.50

Hospital Charge Code	270650810
Hospital Revenue Code	272
Min. Negotiated Rate	$31.31
Max. Negotiated Rate	$551.25
Rate for Payer: Aetna Commercial	$418.95
Rate for Payer: Aetna Medicare Advantage	$330.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$281.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$281.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$281.14
Rate for Payer: Cigna Commercial	$551.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$286.65
Rate for Payer: Oxford Commercial	$220.50
Rate for Payer: Qualcare PPO/HMO/WC	$165.38
Rate for Payer: UnitedHealthcare Commercial	$220.50
Rate for Payer: UnitedHealthcare Community & State	$34.84
Rate for Payer: Wellpoint Medicaid Managed Care	$31.31

PERMA CATH DUAL LUMEN 36 CM

Facility

$1,102.50

Hospital Charge Code	270650810
Hospital Revenue Code	272
Min. Negotiated Rate	$165.38
Max. Negotiated Rate	$165.38
Rate for Payer: Qualcare PPO/HMO/WC	$165.38

PERMA CATH DUAL LUMEN 40CM

Facility

$1,320.50

Hospital Charge Code	270650811
Hospital Revenue Code	272
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$660.25
Rate for Payer: Aetna Commercial	$501.79
Rate for Payer: Aetna Medicare Advantage	$396.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$336.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$336.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$336.73
Rate for Payer: Cigna Commercial	$660.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$343.33
Rate for Payer: Oxford Commercial	$264.10
Rate for Payer: Qualcare PPO/HMO/WC	$198.07
Rate for Payer: UnitedHealthcare Commercial	$264.10
Rate for Payer: UnitedHealthcare Community & State	$41.73
Rate for Payer: Wellpoint Medicaid Managed Care	$37.50

PERMA CATH DUAL LUMEN 40CM

Facility

$1,320.50

Hospital Charge Code	270650811
Hospital Revenue Code	272
Min. Negotiated Rate	$198.07
Max. Negotiated Rate	$198.07
Rate for Payer: Qualcare PPO/HMO/WC	$198.07

PERMA CATH DUAL LUMEN 45cm

Facility

$1,146.50

Hospital Charge Code	270655918
Hospital Revenue Code	271
Min. Negotiated Rate	$32.56
Max. Negotiated Rate	$573.25
Rate for Payer: Aetna Commercial	$435.67
Rate for Payer: Aetna Medicare Advantage	$343.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$292.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$292.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$292.36
Rate for Payer: Cigna Commercial	$573.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$298.09
Rate for Payer: Oxford Commercial	$229.30
Rate for Payer: Qualcare PPO/HMO/WC	$171.97
Rate for Payer: UnitedHealthcare Commercial	$229.30
Rate for Payer: UnitedHealthcare Community & State	$36.23
Rate for Payer: Wellpoint Medicaid Managed Care	$32.56

PERMA CATH DUAL LUMEN 45cm

Facility

$1,146.50

Hospital Charge Code	270655918
Hospital Revenue Code	271
Min. Negotiated Rate	$171.97
Max. Negotiated Rate	$171.97
Rate for Payer: Qualcare PPO/HMO/WC	$171.97

PERMACOL 10 X 10 X 1.50

Facility

$11,490.00

Service Code	HCPCS C1781
Hospital Charge Code	270665982
Hospital Revenue Code	278
Min. Negotiated Rate	$1,723.50
Max. Negotiated Rate	$2,780.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,298.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,780.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,723.50

PERMACOL 10 X 10 X 1.50

Facility

$11,490.00

Service Code	HCPCS C1781
Hospital Charge Code	270665982
Hospital Revenue Code	278
Min. Negotiated Rate	$326.32
Max. Negotiated Rate	$5,745.00
Rate for Payer: Aetna Commercial	$4,366.20
Rate for Payer: Aetna Medicare Advantage	$3,447.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,929.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,929.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,298.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,929.95
Rate for Payer: Cigna Commercial	$5,745.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,780.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,723.50
Rate for Payer: UnitedHealthcare Community & State	$363.08
Rate for Payer: Wellpoint Medicaid Managed Care	$326.32

PERMACOL-MESH 10 X 15CMX1.5MM

Facility

$4,225.00

Hospital Charge Code	270335986
Hospital Revenue Code	278
Min. Negotiated Rate	$119.99
Max. Negotiated Rate	$2,112.50
Rate for Payer: Aetna Commercial	$1,605.50
Rate for Payer: Aetna Medicare Advantage	$1,267.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,077.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,077.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,077.38
Rate for Payer: Cigna Commercial	$2,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,022.45
Rate for Payer: Qualcare PPO/HMO/WC	$633.75
Rate for Payer: UnitedHealthcare Community & State	$133.51
Rate for Payer: Wellpoint Medicaid Managed Care	$119.99

PERMACOL-MESH 10 X 15CMX1.5MM

Facility

$4,225.00

Hospital Charge Code	270335986
Hospital Revenue Code	278
Min. Negotiated Rate	$633.75
Max. Negotiated Rate	$1,022.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$845.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,022.45
Rate for Payer: Qualcare PPO/HMO/WC	$633.75

PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK

Facility

$42,936.12

Service Code	APR-DRG 1703
Min. Negotiated Rate	$42,094.24
Max. Negotiated Rate	$42,936.12
Rate for Payer: UnitedHealthcare Community & State	$42,094.24
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$42,936.12
Rate for Payer: Wellpoint Medicaid Managed Care	$42,094.24

PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK

Facility

$31,970.71

Service Code	APR-DRG 1702
Min. Negotiated Rate	$31,343.83
Max. Negotiated Rate	$31,970.71
Rate for Payer: UnitedHealthcare Community & State	$31,343.83
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$31,970.71
Rate for Payer: Wellpoint Medicaid Managed Care	$31,343.83

PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK

Facility

$60,299.94

Service Code	APR-DRG 1704
Min. Negotiated Rate	$59,117.59
Max. Negotiated Rate	$60,299.94
Rate for Payer: UnitedHealthcare Community & State	$59,117.59
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$60,299.94
Rate for Payer: Wellpoint Medicaid Managed Care	$59,117.59

PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK

Facility

$30,806.48

Service Code	APR-DRG 1701
Min. Negotiated Rate	$30,202.43
Max. Negotiated Rate	$30,806.48
Rate for Payer: UnitedHealthcare Community & State	$30,202.43
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$30,806.48
Rate for Payer: Wellpoint Medicaid Managed Care	$30,202.43

PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC

Facility

$86,787.39

Service Code	MSDRG 243
Min. Negotiated Rate	$26,425.65
Max. Negotiated Rate	$86,787.39
Rate for Payer: Aetna Commercial	$63,669.46
Rate for Payer: Aetna Medicare Advantage	$86,787.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63,167.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63,167.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27,816.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63,167.40
Rate for Payer: Cigna Commercial	$47,504.15
Rate for Payer: Cigna Medicare Advantage	$27,816.47
Rate for Payer: Clover Medicare Advantage	$26,425.65
Rate for Payer: EmblemHealth Commercial	$83,449.41
Rate for Payer: Humana Medicare Advantage	$28,650.96
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27,816.47
Rate for Payer: Oxford Commercial	$37,546.46
Rate for Payer: UnitedHealthcare Commercial	$50,257.28
Rate for Payer: UnitedHealthcare Medicare Advantage	$27,816.47
Rate for Payer: Wellcare Medicare Advantage	$27,816.47

PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC

Facility

$120,336.59

Service Code	MSDRG 242
Min. Negotiated Rate	$36,640.95
Max. Negotiated Rate	$120,336.59
Rate for Payer: Aetna Commercial	$87,563.60
Rate for Payer: Aetna Medicare Advantage	$120,336.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95,859.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95,859.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$38,569.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95,859.30
Rate for Payer: Cigna Commercial	$71,177.09
Rate for Payer: Cigna Medicare Advantage	$38,569.42
Rate for Payer: Clover Medicare Advantage	$36,640.95
Rate for Payer: EmblemHealth Commercial	$115,708.26
Rate for Payer: Humana Medicare Advantage	$39,726.50
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$38,569.42
Rate for Payer: Oxford Commercial	$56,257.14
Rate for Payer: UnitedHealthcare Commercial	$75,302.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$38,569.42
Rate for Payer: Wellcare Medicare Advantage	$38,569.42

Know your out-of-pocket cost for care.

All Charges