Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE PYRENEES LVL 1 28MM

Facility

$6,520.00

Hospital Charge Code	270670289
Hospital Revenue Code	278
Min. Negotiated Rate	$185.17
Max. Negotiated Rate	$3,260.00
Rate for Payer: Aetna Commercial	$2,477.60
Rate for Payer: Aetna Medicare Advantage	$1,956.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,662.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,662.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,304.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,662.60
Rate for Payer: Cigna Commercial	$3,260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,577.84
Rate for Payer: Qualcare PPO/HMO/WC	$978.00
Rate for Payer: UnitedHealthcare Community & State	$206.03
Rate for Payer: Wellpoint Medicaid Managed Care	$185.17

PLATE PYRENEES LVL 1 30MM

Facility

$6,520.00

Hospital Charge Code	270670290
Hospital Revenue Code	278
Min. Negotiated Rate	$185.17
Max. Negotiated Rate	$3,260.00
Rate for Payer: Aetna Commercial	$2,477.60
Rate for Payer: Aetna Medicare Advantage	$1,956.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,662.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,662.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,304.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,662.60
Rate for Payer: Cigna Commercial	$3,260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,577.84
Rate for Payer: Qualcare PPO/HMO/WC	$978.00
Rate for Payer: UnitedHealthcare Community & State	$206.03
Rate for Payer: Wellpoint Medicaid Managed Care	$185.17

PLATE PYRENEES LVL 1 30MM

Facility

$6,520.00

Hospital Charge Code	270670290
Hospital Revenue Code	278
Min. Negotiated Rate	$978.00
Max. Negotiated Rate	$1,577.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,304.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,577.84
Rate for Payer: Qualcare PPO/HMO/WC	$978.00

PLATE PYRENEES LVL 1 32MM

Facility

$6,520.00

Hospital Charge Code	270670291
Hospital Revenue Code	278
Min. Negotiated Rate	$978.00
Max. Negotiated Rate	$1,577.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,304.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,577.84
Rate for Payer: Qualcare PPO/HMO/WC	$978.00

PLATE PYRENEES LVL 1 32MM

Facility

$6,520.00

Hospital Charge Code	270670291
Hospital Revenue Code	278
Min. Negotiated Rate	$185.17
Max. Negotiated Rate	$3,260.00
Rate for Payer: Aetna Commercial	$2,477.60
Rate for Payer: Aetna Medicare Advantage	$1,956.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,662.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,662.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,304.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,662.60
Rate for Payer: Cigna Commercial	$3,260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,577.84
Rate for Payer: Qualcare PPO/HMO/WC	$978.00
Rate for Payer: UnitedHealthcare Community & State	$206.03
Rate for Payer: Wellpoint Medicaid Managed Care	$185.17

PLATE PYRENEES LVL 1 34MM

Facility

$6,520.00

Hospital Charge Code	270670292
Hospital Revenue Code	278
Min. Negotiated Rate	$185.17
Max. Negotiated Rate	$3,260.00
Rate for Payer: Aetna Commercial	$2,477.60
Rate for Payer: Aetna Medicare Advantage	$1,956.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,662.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,662.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,304.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,662.60
Rate for Payer: Cigna Commercial	$3,260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,577.84
Rate for Payer: Qualcare PPO/HMO/WC	$978.00
Rate for Payer: UnitedHealthcare Community & State	$206.03
Rate for Payer: Wellpoint Medicaid Managed Care	$185.17

PLATE PYRENEES LVL 1 34MM

Facility

$6,520.00

Hospital Charge Code	270670292
Hospital Revenue Code	278
Min. Negotiated Rate	$978.00
Max. Negotiated Rate	$1,577.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,304.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,577.84
Rate for Payer: Qualcare PPO/HMO/WC	$978.00

PLATE PYRENEES LVL 1 36MM

Facility

$6,520.00

Hospital Charge Code	270670293
Hospital Revenue Code	278
Min. Negotiated Rate	$185.17
Max. Negotiated Rate	$3,260.00
Rate for Payer: Aetna Commercial	$2,477.60
Rate for Payer: Aetna Medicare Advantage	$1,956.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,662.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,662.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,304.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,662.60
Rate for Payer: Cigna Commercial	$3,260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,577.84
Rate for Payer: Qualcare PPO/HMO/WC	$978.00
Rate for Payer: UnitedHealthcare Community & State	$206.03
Rate for Payer: Wellpoint Medicaid Managed Care	$185.17

PLATE PYRENEES LVL 1 36MM

Facility

$6,520.00

Hospital Charge Code	270670293
Hospital Revenue Code	278
Min. Negotiated Rate	$978.00
Max. Negotiated Rate	$1,577.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,304.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,577.84
Rate for Payer: Qualcare PPO/HMO/WC	$978.00

PLATE PYRENEES LVL 2 34MM

Facility

$6,940.00

Hospital Charge Code	270670294
Hospital Revenue Code	278
Min. Negotiated Rate	$197.10
Max. Negotiated Rate	$3,470.00
Rate for Payer: Aetna Commercial	$2,637.20
Rate for Payer: Aetna Medicare Advantage	$2,082.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,769.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,769.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,769.70
Rate for Payer: Cigna Commercial	$3,470.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,679.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.00
Rate for Payer: UnitedHealthcare Community & State	$219.30
Rate for Payer: Wellpoint Medicaid Managed Care	$197.10

PLATE PYRENEES LVL 2 34MM

Facility

$6,940.00

Hospital Charge Code	270670294
Hospital Revenue Code	278
Min. Negotiated Rate	$1,041.00
Max. Negotiated Rate	$1,679.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,679.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.00

PLATE PYRENEES LVL 2 36MM

Facility

$6,940.00

Service Code	HCPCS C1713
Hospital Charge Code	270670295
Hospital Revenue Code	278
Min. Negotiated Rate	$197.10
Max. Negotiated Rate	$3,470.00
Rate for Payer: Aetna Commercial	$2,637.20
Rate for Payer: Aetna Medicare Advantage	$2,082.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,769.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,769.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,769.70
Rate for Payer: Cigna Commercial	$3,470.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,679.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.00
Rate for Payer: UnitedHealthcare Community & State	$219.30
Rate for Payer: Wellpoint Medicaid Managed Care	$197.10

PLATE PYRENEES LVL 2 36MM

Facility

$6,940.00

Service Code	HCPCS C1713
Hospital Charge Code	270670295
Hospital Revenue Code	278
Min. Negotiated Rate	$1,041.00
Max. Negotiated Rate	$1,679.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,679.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.00

PLATE PYRENEES LVL 2 38MM

Facility

$6,940.00

Service Code	HCPCS C1713
Hospital Charge Code	270670296
Hospital Revenue Code	278
Min. Negotiated Rate	$1,041.00
Max. Negotiated Rate	$1,679.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,679.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.00

PLATE PYRENEES LVL 2 38MM

Facility

$6,940.00

Service Code	HCPCS C1713
Hospital Charge Code	270670296
Hospital Revenue Code	278
Min. Negotiated Rate	$197.10
Max. Negotiated Rate	$3,470.00
Rate for Payer: Aetna Commercial	$2,637.20
Rate for Payer: Aetna Medicare Advantage	$2,082.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,769.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,769.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,769.70
Rate for Payer: Cigna Commercial	$3,470.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,679.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.00
Rate for Payer: UnitedHealthcare Community & State	$219.30
Rate for Payer: Wellpoint Medicaid Managed Care	$197.10

PLATE PYRENEES LVL 2 40MM

Facility

$6,940.00

Service Code	HCPCS C1713
Hospital Charge Code	270670297
Hospital Revenue Code	278
Min. Negotiated Rate	$197.10
Max. Negotiated Rate	$3,470.00
Rate for Payer: Aetna Commercial	$2,637.20
Rate for Payer: Aetna Medicare Advantage	$2,082.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,769.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,769.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,769.70
Rate for Payer: Cigna Commercial	$3,470.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,679.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.00
Rate for Payer: UnitedHealthcare Community & State	$219.30
Rate for Payer: Wellpoint Medicaid Managed Care	$197.10

PLATE PYRENEES LVL 2 40MM

Facility

$6,940.00

Service Code	HCPCS C1713
Hospital Charge Code	270670297
Hospital Revenue Code	278
Min. Negotiated Rate	$1,041.00
Max. Negotiated Rate	$1,679.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,679.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.00

PLATE PYRENEES LVL 2 42MM

Facility

$6,940.00

Hospital Charge Code	270670298
Hospital Revenue Code	278
Min. Negotiated Rate	$197.10
Max. Negotiated Rate	$3,470.00
Rate for Payer: Aetna Commercial	$2,637.20
Rate for Payer: Aetna Medicare Advantage	$2,082.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,769.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,769.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,769.70
Rate for Payer: Cigna Commercial	$3,470.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,679.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.00
Rate for Payer: UnitedHealthcare Community & State	$219.30
Rate for Payer: Wellpoint Medicaid Managed Care	$197.10

PLATE PYRENEES LVL 2 42MM

Facility

$6,940.00

Hospital Charge Code	270670298
Hospital Revenue Code	278
Min. Negotiated Rate	$1,041.00
Max. Negotiated Rate	$1,679.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,679.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.00

PLATE PYRENEES LVL 2 44MM

Facility

$6,940.00

Hospital Charge Code	670299
Hospital Revenue Code	278
Min. Negotiated Rate	$1,041.00
Max. Negotiated Rate	$1,679.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,679.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.00

PLATE PYRENEES LVL 2 44MM

Facility

$6,940.00

Hospital Charge Code	670299
Hospital Revenue Code	278
Min. Negotiated Rate	$197.10
Max. Negotiated Rate	$3,470.00
Rate for Payer: Aetna Commercial	$2,637.20
Rate for Payer: Aetna Medicare Advantage	$2,082.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,769.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,769.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,769.70
Rate for Payer: Cigna Commercial	$3,470.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,679.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.00
Rate for Payer: UnitedHealthcare Community & State	$219.30
Rate for Payer: Wellpoint Medicaid Managed Care	$197.10

PLATE PYRENEES LVL 2 46MM

Facility

$6,940.00

Hospital Charge Code	270670300
Hospital Revenue Code	278
Min. Negotiated Rate	$197.10
Max. Negotiated Rate	$3,470.00
Rate for Payer: Aetna Commercial	$2,637.20
Rate for Payer: Aetna Medicare Advantage	$2,082.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,769.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,769.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,769.70
Rate for Payer: Cigna Commercial	$3,470.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,679.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.00
Rate for Payer: UnitedHealthcare Community & State	$219.30
Rate for Payer: Wellpoint Medicaid Managed Care	$197.10

PLATE PYRENEES LVL 2 46MM

Facility

$6,940.00

Hospital Charge Code	270670300
Hospital Revenue Code	278
Min. Negotiated Rate	$1,041.00
Max. Negotiated Rate	$1,679.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,679.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.00

PLATE PYRENEES LVL 2 48MM

Facility

$6,940.00

Hospital Charge Code	270670301
Hospital Revenue Code	278
Min. Negotiated Rate	$197.10
Max. Negotiated Rate	$3,470.00
Rate for Payer: Aetna Commercial	$2,637.20
Rate for Payer: Aetna Medicare Advantage	$2,082.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,769.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,769.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,769.70
Rate for Payer: Cigna Commercial	$3,470.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,679.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.00
Rate for Payer: UnitedHealthcare Community & State	$219.30
Rate for Payer: Wellpoint Medicaid Managed Care	$197.10

PLATE PYRENEES LVL 2 48MM

Facility

$6,940.00

Hospital Charge Code	270670301
Hospital Revenue Code	278
Min. Negotiated Rate	$1,041.00
Max. Negotiated Rate	$1,679.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,679.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.00

Know your out-of-pocket cost for care.

All Charges