Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PROTECTOR ALEXIS WND PROTECTOR

Facility

$270.00

Hospital Charge Code	270688645
Hospital Revenue Code	272
Min. Negotiated Rate	$7.67
Max. Negotiated Rate	$135.00
Rate for Payer: Aetna Commercial	$102.60
Rate for Payer: Aetna Medicare Advantage	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.85
Rate for Payer: Cigna Commercial	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.20
Rate for Payer: Oxford Commercial	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.50
Rate for Payer: UnitedHealthcare Commercial	$54.00
Rate for Payer: UnitedHealthcare Community & State	$8.53
Rate for Payer: Wellpoint Medicaid Managed Care	$7.67

PROTECTOR AXOGUARD 2X2MM

Facility

$9,950.00

Service Code	HCPCS C1763
Hospital Charge Code	270696878
Hospital Revenue Code	278
Min. Negotiated Rate	$282.58
Max. Negotiated Rate	$4,975.00
Rate for Payer: Aetna Commercial	$3,781.00
Rate for Payer: Aetna Medicare Advantage	$2,985.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,537.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,537.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,537.25
Rate for Payer: Cigna Commercial	$4,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,407.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,492.50
Rate for Payer: UnitedHealthcare Community & State	$314.42
Rate for Payer: Wellpoint Medicaid Managed Care	$282.58

PROTECTOR AXOGUARD 2X2MM

Facility

$9,950.00

Service Code	HCPCS C1763
Hospital Charge Code	270696878
Hospital Revenue Code	278
Min. Negotiated Rate	$1,492.50
Max. Negotiated Rate	$2,407.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,990.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,407.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,492.50

PROTECTOR AXOGUARD 5x40MM

Facility

$9,400.00

Service Code	HCPCS C1763
Hospital Charge Code	270667301
Hospital Revenue Code	278
Min. Negotiated Rate	$266.96
Max. Negotiated Rate	$4,700.00
Rate for Payer: Aetna Commercial	$3,572.00
Rate for Payer: Aetna Medicare Advantage	$2,820.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,397.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,397.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,880.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,397.00
Rate for Payer: Cigna Commercial	$4,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,274.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,410.00
Rate for Payer: UnitedHealthcare Community & State	$297.04
Rate for Payer: Wellpoint Medicaid Managed Care	$266.96

PROTECTOR AXOGUARD 5x40MM

Facility

$9,400.00

Service Code	HCPCS C1763
Hospital Charge Code	270667301
Hospital Revenue Code	278
Min. Negotiated Rate	$1,410.00
Max. Negotiated Rate	$2,274.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,880.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,274.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,410.00

PROTECTOR EYE OPTI-GARD

Facility

$33.00

Hospital Charge Code	270655049
Hospital Revenue Code	270
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$16.50
Rate for Payer: Aetna Commercial	$12.54
Rate for Payer: Aetna Medicare Advantage	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.41
Rate for Payer: Cigna Commercial	$16.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.58
Rate for Payer: Oxford Commercial	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$4.95
Rate for Payer: UnitedHealthcare Commercial	$6.60
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$0.94

PROTECTOR EYE OPTI-GARD

Facility

$33.00

Hospital Charge Code	270655049
Hospital Revenue Code	270
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$4.95
Rate for Payer: Qualcare PPO/HMO/WC	$4.95

PROTECTOR HEEL/ELBOW LG

Facility

$20.42

Hospital Charge Code	270302855
Hospital Revenue Code	270
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$3.06
Rate for Payer: Qualcare PPO/HMO/WC	$3.06

PROTECTOR HEEL/ELBOW LG

Facility

$20.42

Hospital Charge Code	270302855
Hospital Revenue Code	270
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$10.21
Rate for Payer: Aetna Commercial	$7.76
Rate for Payer: Aetna Medicare Advantage	$6.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.21
Rate for Payer: Cigna Commercial	$10.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.31
Rate for Payer: Oxford Commercial	$4.08
Rate for Payer: Qualcare PPO/HMO/WC	$3.06
Rate for Payer: UnitedHealthcare Commercial	$4.08
Rate for Payer: UnitedHealthcare Community & State	$0.65
Rate for Payer: Wellpoint Medicaid Managed Care	$0.58

PROTECTOR HELL/ELBOW UNIV

Facility

$269.03

Hospital Charge Code	270649488
Hospital Revenue Code	272
Min. Negotiated Rate	$7.64
Max. Negotiated Rate	$134.51
Rate for Payer: Aetna Commercial	$102.23
Rate for Payer: Aetna Medicare Advantage	$80.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.60
Rate for Payer: Cigna Commercial	$134.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.95
Rate for Payer: Oxford Commercial	$53.81
Rate for Payer: Qualcare PPO/HMO/WC	$40.35
Rate for Payer: UnitedHealthcare Commercial	$53.81
Rate for Payer: UnitedHealthcare Community & State	$8.50
Rate for Payer: Wellpoint Medicaid Managed Care	$7.64

PROTECTOR HELL/ELBOW UNIV

Facility

$269.03

Hospital Charge Code	270649488
Hospital Revenue Code	272
Min. Negotiated Rate	$40.35
Max. Negotiated Rate	$40.35
Rate for Payer: Qualcare PPO/HMO/WC	$40.35

PROTECTOR TOOTH DISPOSABLE

Facility

$12.81

Hospital Charge Code	270682850
Hospital Revenue Code	272
Min. Negotiated Rate	$1.92
Max. Negotiated Rate	$1.92
Rate for Payer: Qualcare PPO/HMO/WC	$1.92

PROTECTOR TOOTH DISPOSABLE

Facility

$12.81

Hospital Charge Code	270682850
Hospital Revenue Code	272
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$6.41
Rate for Payer: Aetna Commercial	$4.87
Rate for Payer: Aetna Medicare Advantage	$3.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.27
Rate for Payer: Cigna Commercial	$6.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.33
Rate for Payer: Oxford Commercial	$2.56
Rate for Payer: Qualcare PPO/HMO/WC	$1.92
Rate for Payer: UnitedHealthcare Commercial	$2.56
Rate for Payer: UnitedHealthcare Community & State	$0.40
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

PROTECTOR ULNA NERVE EA/PR FOA

Facility

$10.95

Hospital Charge Code	270664524
Hospital Revenue Code	278
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$2.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.65
Rate for Payer: Qualcare PPO/HMO/WC	$1.64

PROTECTOR ULNA NERVE EA/PR FOA

Facility

$10.95

Hospital Charge Code	270664524
Hospital Revenue Code	278
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$5.47
Rate for Payer: Aetna Commercial	$4.16
Rate for Payer: Aetna Medicare Advantage	$3.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.79
Rate for Payer: Cigna Commercial	$5.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.65
Rate for Payer: Qualcare PPO/HMO/WC	$1.64
Rate for Payer: UnitedHealthcare Community & State	$0.35
Rate for Payer: Wellpoint Medicaid Managed Care	$0.31

PROTEINASE -3

Facility

$390.00

Service Code	HCPCS 86021
Hospital Charge Code	39900509
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PROTEINASE -3

Facility

$390.00

Service Code	HCPCS 86021
Hospital Charge Code	39900509
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$40.94
Rate for Payer: Aetna Medicare Advantage	$48.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.59
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$15.05
Rate for Payer: Clover Medicare Advantage	$14.30
Rate for Payer: EmblemHealth Commercial	$45.15
Rate for Payer: Humana Medicare Advantage	$15.50
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$12.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.05
Rate for Payer: Wellcare Medicare Advantage	$15.05
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

PROTEIN BOUND GLUCOSE

Facility

$51.00

Hospital Charge Code	38472433
Hospital Revenue Code	301
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$19.38
Rate for Payer: Aetna Medicare Advantage	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.01
Rate for Payer: Cigna Commercial	$25.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.26
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.65
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$1.61
Rate for Payer: Wellpoint Medicaid Managed Care	$1.45

PROTEIN BOUND GLUCOSE

Facility

$51.00

Hospital Charge Code	38472433
Hospital Revenue Code	301
Min. Negotiated Rate	$7.65
Max. Negotiated Rate	$7.65
Rate for Payer: Qualcare PPO/HMO/WC	$7.65

PROTEIN C

Facility

$347.00

Service Code	HCPCS 85302
Hospital Charge Code	38473061
Hospital Revenue Code	305
Min. Negotiated Rate	$52.05
Max. Negotiated Rate	$52.05
Rate for Payer: Qualcare PPO/HMO/WC	$52.05

PROTEIN C

Facility

$347.00

Service Code	HCPCS 85302
Hospital Charge Code	38473061
Hospital Revenue Code	305
Min. Negotiated Rate	$9.61
Max. Negotiated Rate	$173.50
Rate for Payer: Aetna Commercial	$32.67
Rate for Payer: Aetna Medicare Advantage	$38.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.57
Rate for Payer: Cigna Commercial	$173.50
Rate for Payer: Cigna Medicare Advantage	$12.01
Rate for Payer: Clover Medicare Advantage	$11.41
Rate for Payer: EmblemHealth Commercial	$36.03
Rate for Payer: Humana Medicare Advantage	$12.37
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.22
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.05
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.61
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.01
Rate for Payer: Wellcare Medicare Advantage	$12.01
Rate for Payer: Wellpoint Medicaid Managed Care	$9.85

PROTEIN C,ACTIVITY

Facility

$667.59

Service Code	HCPCS 85303
Hospital Charge Code	39900166
Hospital Revenue Code	305
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

PROTEIN C,ACTIVITY

Facility

$667.59

Service Code	HCPCS 85303
Hospital Charge Code	39900166
Hospital Revenue Code	305
Min. Negotiated Rate	$11.07
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$37.64
Rate for Payer: Aetna Medicare Advantage	$44.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.20
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$13.84
Rate for Payer: Clover Medicare Advantage	$13.15
Rate for Payer: EmblemHealth Commercial	$41.52
Rate for Payer: Humana Medicare Advantage	$14.26
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.57
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$11.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.84
Rate for Payer: Wellcare Medicare Advantage	$13.84
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

PROTEIN C,ANTIGENIC

Facility

$82.60

Service Code	HCPCS 85302
Hospital Charge Code	39900165
Hospital Revenue Code	305
Min. Negotiated Rate	$2.35
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$32.67
Rate for Payer: Aetna Medicare Advantage	$38.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.57
Rate for Payer: Cigna Commercial	$41.30
Rate for Payer: Cigna Medicare Advantage	$12.01
Rate for Payer: Clover Medicare Advantage	$11.41
Rate for Payer: EmblemHealth Commercial	$36.03
Rate for Payer: Humana Medicare Advantage	$12.37
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.48
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.39
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.61
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.01
Rate for Payer: Wellcare Medicare Advantage	$12.01
Rate for Payer: Wellpoint Medicaid Managed Care	$2.35

PROTEIN C,ANTIGENIC

Facility

$82.60

Service Code	HCPCS 85302
Hospital Charge Code	39900165
Hospital Revenue Code	305
Min. Negotiated Rate	$12.39
Max. Negotiated Rate	$12.39
Rate for Payer: Qualcare PPO/HMO/WC	$12.39

Know your out-of-pocket cost for care.

All Charges