Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

POWDER SURGICEL 3.0 GM

Facility

$848.13

Hospital Charge Code	270688736
Hospital Revenue Code	272
Min. Negotiated Rate	$24.09
Max. Negotiated Rate	$424.06
Rate for Payer: Aetna Commercial	$322.29
Rate for Payer: Aetna Medicare Advantage	$254.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.27
Rate for Payer: Cigna Commercial	$424.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.51
Rate for Payer: Oxford Commercial	$169.63
Rate for Payer: Qualcare PPO/HMO/WC	$127.22
Rate for Payer: UnitedHealthcare Commercial	$169.63
Rate for Payer: UnitedHealthcare Community & State	$26.80
Rate for Payer: Wellpoint Medicaid Managed Care	$24.09

POWDER SURGICEL 3.0 GM

Facility

$848.13

Hospital Charge Code	270688736
Hospital Revenue Code	272
Min. Negotiated Rate	$127.22
Max. Negotiated Rate	$127.22
Rate for Payer: Qualcare PPO/HMO/WC	$127.22

POWER GLIDE PRO FLEX 20 GX 10

Facility

$5,050.00

Service Code	HCPCS C1751
Hospital Charge Code	270680295
Hospital Revenue Code	278
Min. Negotiated Rate	$757.50
Max. Negotiated Rate	$1,222.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,010.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,222.10
Rate for Payer: Qualcare PPO/HMO/WC	$757.50

POWER GLIDE PRO FLEX 20 GX 10

Facility

$5,050.00

Service Code	HCPCS C1751
Hospital Charge Code	270680295
Hospital Revenue Code	278
Min. Negotiated Rate	$143.42
Max. Negotiated Rate	$2,525.00
Rate for Payer: Aetna Commercial	$1,919.00
Rate for Payer: Aetna Medicare Advantage	$1,515.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,287.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,287.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,287.75
Rate for Payer: Cigna Commercial	$2,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,222.10
Rate for Payer: Qualcare PPO/HMO/WC	$757.50
Rate for Payer: UnitedHealthcare Community & State	$159.58
Rate for Payer: Wellpoint Medicaid Managed Care	$143.42

POWERGLIDE PROFLEX TEMP20G10CM

Facility

$290.00

Hospital Charge Code	270686348S
Hospital Revenue Code	272
Min. Negotiated Rate	$8.24
Max. Negotiated Rate	$145.00
Rate for Payer: Aetna Commercial	$110.20
Rate for Payer: Aetna Medicare Advantage	$87.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.95
Rate for Payer: Cigna Commercial	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.40
Rate for Payer: Oxford Commercial	$58.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.50
Rate for Payer: UnitedHealthcare Commercial	$58.00
Rate for Payer: UnitedHealthcare Community & State	$9.16
Rate for Payer: Wellpoint Medicaid Managed Care	$8.24

POWERGLIDE PROFLEX TEMP20G10CM

Facility

$290.00

Hospital Charge Code	270686348S
Hospital Revenue Code	272
Min. Negotiated Rate	$43.50
Max. Negotiated Rate	$43.50
Rate for Payer: Qualcare PPO/HMO/WC	$43.50

POWER PICC BARD

Facility

$415.00

Service Code	HCPCS C1751
Hospital Charge Code	270664895
Hospital Revenue Code	278
Min. Negotiated Rate	$62.25
Max. Negotiated Rate	$100.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$83.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.43
Rate for Payer: Qualcare PPO/HMO/WC	$62.25

POWER PICC BARD

Facility

$415.00

Service Code	HCPCS C1751
Hospital Charge Code	270664895
Hospital Revenue Code	278
Min. Negotiated Rate	$11.79
Max. Negotiated Rate	$207.50
Rate for Payer: Aetna Commercial	$157.70
Rate for Payer: Aetna Medicare Advantage	$124.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$83.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.83
Rate for Payer: Cigna Commercial	$207.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.43
Rate for Payer: Qualcare PPO/HMO/WC	$62.25
Rate for Payer: UnitedHealthcare Community & State	$13.11
Rate for Payer: Wellpoint Medicaid Managed Care	$11.79

POWER PICC BARD

Facility

$3,780.00

Service Code	HCPCS C1751
Hospital Charge Code	270664895O
Hospital Revenue Code	278
Min. Negotiated Rate	$567.00
Max. Negotiated Rate	$914.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$756.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$914.76
Rate for Payer: Qualcare PPO/HMO/WC	$567.00

POWER PICC BARD

Facility

$3,780.00

Service Code	HCPCS C1751
Hospital Charge Code	270664895O
Hospital Revenue Code	278
Min. Negotiated Rate	$107.35
Max. Negotiated Rate	$1,890.00
Rate for Payer: Aetna Commercial	$1,436.40
Rate for Payer: Aetna Medicare Advantage	$1,134.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$963.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$963.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$756.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$963.90
Rate for Payer: Cigna Commercial	$1,890.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$914.76
Rate for Payer: Qualcare PPO/HMO/WC	$567.00
Rate for Payer: UnitedHealthcare Community & State	$119.45
Rate for Payer: Wellpoint Medicaid Managed Care	$107.35

POWERPICC SV CATHETER 4 FR

Facility

$1,150.00

Service Code	HCPCS C1751
Hospital Charge Code	270686571
Hospital Revenue Code	278
Min. Negotiated Rate	$32.66
Max. Negotiated Rate	$575.00
Rate for Payer: Aetna Commercial	$437.00
Rate for Payer: Aetna Medicare Advantage	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.25
Rate for Payer: Cigna Commercial	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: Qualcare PPO/HMO/WC	$172.50
Rate for Payer: UnitedHealthcare Community & State	$36.34
Rate for Payer: Wellpoint Medicaid Managed Care	$32.66

POWERPICC SV CATHETER 4 FR

Facility

$1,150.00

Service Code	HCPCS C1751
Hospital Charge Code	270686571
Hospital Revenue Code	278
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$278.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

POWERPICK 45 DEG 6MM

Facility

$505.00

Service Code	HCPCS C1751
Hospital Charge Code	270681576
Hospital Revenue Code	278
Min. Negotiated Rate	$14.34
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$191.90
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: Qualcare PPO/HMO/WC	$75.75
Rate for Payer: UnitedHealthcare Community & State	$15.96
Rate for Payer: Wellpoint Medicaid Managed Care	$14.34

POWERPICK 45 DEG 6MM

Facility

$505.00

Service Code	HCPCS C1751
Hospital Charge Code	270681576
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$122.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

POWERPICK 45 DEG SMALL HUB

Facility

$505.00

Hospital Charge Code	270691052
Hospital Revenue Code	272
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$75.75
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

POWERPICK 45 DEG SMALL HUB

Facility

$505.00

Hospital Charge Code	270691052
Hospital Revenue Code	272
Min. Negotiated Rate	$14.34
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$191.90
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.75
Rate for Payer: UnitedHealthcare Commercial	$101.00
Rate for Payer: UnitedHealthcare Community & State	$15.96
Rate for Payer: Wellpoint Medicaid Managed Care	$14.34

POWER PORT 6.6FR XCELRA

Facility

$1.25

Service Code	HCPCS C1788
Hospital Charge Code	270639788
Hospital Revenue Code	278
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$0.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.19

POWER PORT 6.6FR XCELRA

Facility

$1.25

Service Code	HCPCS C1788
Hospital Charge Code	270639788
Hospital Revenue Code	278
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.63
Rate for Payer: Aetna Commercial	$0.48
Rate for Payer: Aetna Medicare Advantage	$0.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.32
Rate for Payer: Cigna Commercial	$0.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.19
Rate for Payer: UnitedHealthcare Community & State	$0.04
Rate for Payer: Wellpoint Medicaid Managed Care	$0.04

POWER PORT 8 FR VUE

Facility

$1,750.00

Service Code	HCPCS C1788
Hospital Charge Code	270654845
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

POWER PORT 8 FR VUE

Facility

$1,895.50

Service Code	HCPCS C1788
Hospital Charge Code	270654845N
Hospital Revenue Code	278
Min. Negotiated Rate	$284.32
Max. Negotiated Rate	$458.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$458.71
Rate for Payer: Qualcare PPO/HMO/WC	$284.32

POWER PORT 8 FR VUE

Facility

$1,750.00

Service Code	HCPCS C1788
Hospital Charge Code	270654845S
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

POWER PORT 8 FR VUE

Facility

$1,750.00

Service Code	HCPCS C1788
Hospital Charge Code	270654845
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

POWER PORT 8 FR VUE

Facility

$1,895.50

Service Code	HCPCS C1788
Hospital Charge Code	270654845N
Hospital Revenue Code	278
Min. Negotiated Rate	$53.83
Max. Negotiated Rate	$947.75
Rate for Payer: Aetna Commercial	$720.29
Rate for Payer: Aetna Medicare Advantage	$568.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$483.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$483.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$483.35
Rate for Payer: Cigna Commercial	$947.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$458.71
Rate for Payer: Qualcare PPO/HMO/WC	$284.32
Rate for Payer: UnitedHealthcare Community & State	$59.90
Rate for Payer: Wellpoint Medicaid Managed Care	$53.83

POWER PORT 8 FR VUE

Facility

$1,750.00

Service Code	HCPCS C1788
Hospital Charge Code	270654845S
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

POWER PORT DUO IMPLANT (BARD

Facility

$3,980.00

Service Code	HCPCS C1788
Hospital Charge Code	270660216
Hospital Revenue Code	278
Min. Negotiated Rate	$113.03
Max. Negotiated Rate	$1,990.00
Rate for Payer: Aetna Commercial	$1,512.40
Rate for Payer: Aetna Medicare Advantage	$1,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,014.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,014.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$796.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,014.90
Rate for Payer: Cigna Commercial	$1,990.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$963.16
Rate for Payer: Qualcare PPO/HMO/WC	$597.00
Rate for Payer: UnitedHealthcare Community & State	$125.77
Rate for Payer: Wellpoint Medicaid Managed Care	$113.03

Know your out-of-pocket cost for care.

All Charges