Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PROBE KIT RF ABLATION

Facility

$21,075.00

Service Code	HCPCS C1886
Hospital Charge Code	270690464
Hospital Revenue Code	278
Min. Negotiated Rate	$598.53
Max. Negotiated Rate	$10,537.50
Rate for Payer: Aetna Commercial	$8,008.50
Rate for Payer: Aetna Medicare Advantage	$6,322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,374.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,374.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,374.12
Rate for Payer: Cigna Commercial	$10,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,100.15
Rate for Payer: Qualcare PPO/HMO/WC	$3,161.25
Rate for Payer: UnitedHealthcare Community & State	$665.97
Rate for Payer: Wellpoint Medicaid Managed Care	$598.53

PROBE LAPARASOPIC 5MM

Facility

$618.00

Hospital Charge Code	270664983
Hospital Revenue Code	272
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$309.00
Rate for Payer: Aetna Commercial	$234.84
Rate for Payer: Aetna Medicare Advantage	$185.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.59
Rate for Payer: Cigna Commercial	$309.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.68
Rate for Payer: Oxford Commercial	$123.60
Rate for Payer: Qualcare PPO/HMO/WC	$92.70
Rate for Payer: UnitedHealthcare Commercial	$123.60
Rate for Payer: UnitedHealthcare Community & State	$19.53
Rate for Payer: Wellpoint Medicaid Managed Care	$17.55

PROBE LAPARASOPIC 5MM

Facility

$618.00

Hospital Charge Code	270664983
Hospital Revenue Code	272
Min. Negotiated Rate	$92.70
Max. Negotiated Rate	$92.70
Rate for Payer: Qualcare PPO/HMO/WC	$92.70

PROBE MCV SWISS 1.6 423 840214

Facility

$3,050.00

Hospital Charge Code	270624051
Hospital Revenue Code	272
Min. Negotiated Rate	$457.50
Max. Negotiated Rate	$457.50
Rate for Payer: Qualcare PPO/HMO/WC	$457.50

PROBE MCV SWISS 1.6 423 840214

Facility

$3,050.00

Hospital Charge Code	270624051
Hospital Revenue Code	272
Min. Negotiated Rate	$86.62
Max. Negotiated Rate	$1,525.00
Rate for Payer: Aetna Commercial	$1,159.00
Rate for Payer: Aetna Medicare Advantage	$915.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$777.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$777.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$777.75
Rate for Payer: Cigna Commercial	$1,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$793.00
Rate for Payer: Oxford Commercial	$610.00
Rate for Payer: Qualcare PPO/HMO/WC	$457.50
Rate for Payer: UnitedHealthcare Commercial	$610.00
Rate for Payer: UnitedHealthcare Community & State	$96.38
Rate for Payer: Wellpoint Medicaid Managed Care	$86.62

PROBENECID 500 MG TAB

Facility

$7.71

Service Code	NDC 378015601
Hospital Charge Code	60627982
Hospital Revenue Code	250
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$1.16
Rate for Payer: Qualcare PPO/HMO/WC	$1.16

PROBENECID 500 MG TAB

Facility

$7.71

Service Code	NDC 378015601
Hospital Charge Code	60627982
Hospital Revenue Code	250
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$3.85
Rate for Payer: Aetna Commercial	$2.93
Rate for Payer: Aetna Medicare Advantage	$2.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.97
Rate for Payer: Cigna Commercial	$3.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.00
Rate for Payer: Oxford Commercial	$1.54
Rate for Payer: Qualcare PPO/HMO/WC	$1.16
Rate for Payer: UnitedHealthcare Commercial	$1.54
Rate for Payer: UnitedHealthcare Community & State	$0.24
Rate for Payer: Wellpoint Medicaid Managed Care	$0.22

PROBE NEURO ALARA NEEDLE KIT

Facility

$1,650.00

Hospital Charge Code	270691876
Hospital Revenue Code	272
Min. Negotiated Rate	$247.50
Max. Negotiated Rate	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$247.50

PROBE NEURO ALARA NEEDLE KIT

Facility

$1,650.00

Hospital Charge Code	270691876
Hospital Revenue Code	272
Min. Negotiated Rate	$46.86
Max. Negotiated Rate	$825.00
Rate for Payer: Aetna Commercial	$627.00
Rate for Payer: Aetna Medicare Advantage	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$420.75
Rate for Payer: Cigna Commercial	$825.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$429.00
Rate for Payer: Oxford Commercial	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$247.50
Rate for Payer: UnitedHealthcare Commercial	$330.00
Rate for Payer: UnitedHealthcare Community & State	$52.14
Rate for Payer: Wellpoint Medicaid Managed Care	$46.86

PROBE NVM5 SINGLE USE

Facility

$2,062.50

Hospital Charge Code	270691827
Hospital Revenue Code	272
Min. Negotiated Rate	$309.38
Max. Negotiated Rate	$309.38
Rate for Payer: Qualcare PPO/HMO/WC	$309.38

PROBE NVM5 SINGLE USE

Facility

$2,062.50

Hospital Charge Code	270691827
Hospital Revenue Code	272
Min. Negotiated Rate	$58.58
Max. Negotiated Rate	$1,031.25
Rate for Payer: Aetna Commercial	$783.75
Rate for Payer: Aetna Medicare Advantage	$618.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$525.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$525.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$525.94
Rate for Payer: Cigna Commercial	$1,031.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$536.25
Rate for Payer: Oxford Commercial	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$309.38
Rate for Payer: UnitedHealthcare Commercial	$412.50
Rate for Payer: UnitedHealthcare Community & State	$65.17
Rate for Payer: Wellpoint Medicaid Managed Care	$58.58

PROBE PEDICLE SCREW

Facility

$24,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688006
Hospital Revenue Code	278
Min. Negotiated Rate	$688.70
Max. Negotiated Rate	$12,125.00
Rate for Payer: Aetna Commercial	$9,215.00
Rate for Payer: Aetna Medicare Advantage	$7,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,183.75
Rate for Payer: Cigna Commercial	$12,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50
Rate for Payer: UnitedHealthcare Community & State	$766.30
Rate for Payer: Wellpoint Medicaid Managed Care	$688.70

PROBE PEDICLE SCREW

Facility

$24,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688006
Hospital Revenue Code	278
Min. Negotiated Rate	$3,637.50
Max. Negotiated Rate	$5,868.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50

PROBE PERCUTANEOUS DISCECTOMY

Facility

$11,916.35

Hospital Charge Code	270692007
Hospital Revenue Code	272
Min. Negotiated Rate	$338.42
Max. Negotiated Rate	$5,958.18
Rate for Payer: Aetna Commercial	$4,528.21
Rate for Payer: Aetna Medicare Advantage	$3,574.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,038.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,038.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,038.67
Rate for Payer: Cigna Commercial	$5,958.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,098.25
Rate for Payer: Oxford Commercial	$2,383.27
Rate for Payer: Qualcare PPO/HMO/WC	$1,787.45
Rate for Payer: UnitedHealthcare Commercial	$2,383.27
Rate for Payer: UnitedHealthcare Community & State	$376.56
Rate for Payer: Wellpoint Medicaid Managed Care	$338.42

PROBE PERCUTANEOUS DISCECTOMY

Facility

$11,916.35

Hospital Charge Code	270692007
Hospital Revenue Code	272
Min. Negotiated Rate	$1,787.45
Max. Negotiated Rate	$1,787.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,787.45

PROBE POSTERIOR LUCENT L 180MM

Facility

$3,200.00

Service Code	HCPCS A4649
Hospital Charge Code	270694865
Hospital Revenue Code	272
Min. Negotiated Rate	$90.88
Max. Negotiated Rate	$1,600.00
Rate for Payer: Aetna Commercial	$1,216.00
Rate for Payer: Aetna Medicare Advantage	$960.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$816.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$816.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$816.00
Rate for Payer: Cigna Commercial	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$832.00
Rate for Payer: Oxford Commercial	$640.00
Rate for Payer: Qualcare PPO/HMO/WC	$480.00
Rate for Payer: UnitedHealthcare Commercial	$640.00
Rate for Payer: UnitedHealthcare Community & State	$101.12
Rate for Payer: Wellpoint Medicaid Managed Care	$90.88

PROBE POSTERIOR LUCENT L 180MM

Facility

$3,200.00

Service Code	HCPCS A4649
Hospital Charge Code	270694865
Hospital Revenue Code	272
Min. Negotiated Rate	$480.00
Max. Negotiated Rate	$480.00
Rate for Payer: Qualcare PPO/HMO/WC	$480.00

PROBE PRASS NERVE STIMULATOR

Facility

$930.00

Hospital Charge Code	270657321
Hospital Revenue Code	272
Min. Negotiated Rate	$26.41
Max. Negotiated Rate	$465.00
Rate for Payer: Aetna Commercial	$353.40
Rate for Payer: Aetna Medicare Advantage	$279.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.15
Rate for Payer: Cigna Commercial	$465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$241.80
Rate for Payer: Oxford Commercial	$186.00
Rate for Payer: Qualcare PPO/HMO/WC	$139.50
Rate for Payer: UnitedHealthcare Commercial	$186.00
Rate for Payer: UnitedHealthcare Community & State	$29.39
Rate for Payer: Wellpoint Medicaid Managed Care	$26.41

PROBE PRASS NERVE STIMULATOR

Facility

$930.00

Hospital Charge Code	270657321
Hospital Revenue Code	272
Min. Negotiated Rate	$139.50
Max. Negotiated Rate	$139.50
Rate for Payer: Qualcare PPO/HMO/WC	$139.50

PROBE RESUABLE ADAPTER

Facility

$107.50

Hospital Charge Code	270669533
Hospital Revenue Code	272
Min. Negotiated Rate	$16.12
Max. Negotiated Rate	$16.12
Rate for Payer: Qualcare PPO/HMO/WC	$16.12

PROBE RESUABLE ADAPTER

Facility

$107.50

Hospital Charge Code	270669533
Hospital Revenue Code	272
Min. Negotiated Rate	$3.05
Max. Negotiated Rate	$53.75
Rate for Payer: Aetna Commercial	$40.85
Rate for Payer: Aetna Medicare Advantage	$32.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.41
Rate for Payer: Cigna Commercial	$53.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.95
Rate for Payer: Oxford Commercial	$21.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.12
Rate for Payer: UnitedHealthcare Commercial	$21.50
Rate for Payer: UnitedHealthcare Community & State	$3.40
Rate for Payer: Wellpoint Medicaid Managed Care	$3.05

PROBE RF2 SERFAS AARDVARK

Facility

$828.75

Hospital Charge Code	270640815
Hospital Revenue Code	272
Min. Negotiated Rate	$23.54
Max. Negotiated Rate	$414.38
Rate for Payer: Aetna Commercial	$314.93
Rate for Payer: Aetna Medicare Advantage	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.33
Rate for Payer: Cigna Commercial	$414.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.47
Rate for Payer: Oxford Commercial	$165.75
Rate for Payer: Qualcare PPO/HMO/WC	$124.31
Rate for Payer: UnitedHealthcare Commercial	$165.75
Rate for Payer: UnitedHealthcare Community & State	$26.19
Rate for Payer: Wellpoint Medicaid Managed Care	$23.54

PROBE RF2 SERFAS AARDVARK

Facility

$828.75

Hospital Charge Code	270640815
Hospital Revenue Code	272
Min. Negotiated Rate	$124.31
Max. Negotiated Rate	$124.31
Rate for Payer: Qualcare PPO/HMO/WC	$124.31

PROBE RF ABLATION DUAL 10MM

Facility

$21,075.00

Hospital Charge Code	270686421O
Hospital Revenue Code	272
Min. Negotiated Rate	$3,161.25
Max. Negotiated Rate	$3,161.25
Rate for Payer: Qualcare PPO/HMO/WC	$3,161.25

PROBE RF ABLATION DUAL 10MM

Facility

$21,075.00

Hospital Charge Code	270686421
Hospital Revenue Code	272
Min. Negotiated Rate	$3,161.25
Max. Negotiated Rate	$3,161.25
Rate for Payer: Qualcare PPO/HMO/WC	$3,161.25

Know your out-of-pocket cost for care.

All Charges