Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

RELOAD UNIT ENDO GIA 60 MULTIF

Facility

$656.00

Hospital Charge Code	270335156
Hospital Revenue Code	272
Min. Negotiated Rate	$18.63
Max. Negotiated Rate	$328.00
Rate for Payer: Aetna Commercial	$249.28
Rate for Payer: Aetna Medicare Advantage	$196.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$167.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$167.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$167.28
Rate for Payer: Cigna Commercial	$328.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.56
Rate for Payer: Oxford Commercial	$131.20
Rate for Payer: Qualcare PPO/HMO/WC	$98.40
Rate for Payer: UnitedHealthcare Commercial	$131.20
Rate for Payer: UnitedHealthcare Community & State	$20.73
Rate for Payer: Wellpoint Medicaid Managed Care	$18.63

RELOAD UNIT ENDO GIA 60 MULTIF

Facility

$656.00

Hospital Charge Code	270335156
Hospital Revenue Code	272
Min. Negotiated Rate	$98.40
Max. Negotiated Rate	$98.40
Rate for Payer: Qualcare PPO/HMO/WC	$98.40

RELOAD VAS. STAPLER 30MM

Facility

$82.00

Hospital Charge Code	270338701
Hospital Revenue Code	272
Min. Negotiated Rate	$12.30
Max. Negotiated Rate	$12.30
Rate for Payer: Qualcare PPO/HMO/WC	$12.30

RELOAD VAS. STAPLER 30MM

Facility

$82.00

Hospital Charge Code	270338701
Hospital Revenue Code	272
Min. Negotiated Rate	$2.33
Max. Negotiated Rate	$41.00
Rate for Payer: Aetna Commercial	$31.16
Rate for Payer: Aetna Medicare Advantage	$24.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.91
Rate for Payer: Cigna Commercial	$41.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.32
Rate for Payer: Oxford Commercial	$16.40
Rate for Payer: Qualcare PPO/HMO/WC	$12.30
Rate for Payer: UnitedHealthcare Commercial	$16.40
Rate for Payer: UnitedHealthcare Community & State	$2.59
Rate for Payer: Wellpoint Medicaid Managed Care	$2.33

REM ANT SEGMENT INSTRUMENT

Facility

$12,585.60

Service Code	HCPCS 22855
Hospital Charge Code	1600000451
Hospital Revenue Code	360
Min. Negotiated Rate	$357.43
Max. Negotiated Rate	$31,271.12
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,271.12
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,272.26
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.84
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$397.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$357.43

REM ANT SEGMENT INSTRUMENT

Facility

$12,585.60

Service Code	HCPCS 22855
Hospital Charge Code	1600000451
Hospital Revenue Code	360
Min. Negotiated Rate	$1,887.84
Max. Negotiated Rate	$1,887.84
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.84

REM COREAL FB W/O SLIT LAM

Facility

$397.00

Service Code	HCPCS 65220
Hospital Charge Code	5780245
Hospital Revenue Code	450
Min. Negotiated Rate	$59.55
Max. Negotiated Rate	$59.55
Rate for Payer: Qualcare PPO/HMO/WC	$59.55

REM COREAL FB W/O SLIT LAM

Facility

$397.00

Service Code	HCPCS 65220
Hospital Charge Code	5780245
Hospital Revenue Code	450
Min. Negotiated Rate	$11.27
Max. Negotiated Rate	$1,925.19
Rate for Payer: Aetna Commercial	$1,443.56
Rate for Payer: Aetna Medicare Advantage	$1,719.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,925.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,925.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$530.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,925.19
Rate for Payer: Cigna Commercial	$1,063.82
Rate for Payer: Cigna Medicare Advantage	$530.72
Rate for Payer: Clover Medicare Advantage	$504.18
Rate for Payer: EmblemHealth Commercial	$1,592.16
Rate for Payer: Humana Medicare Advantage	$546.64
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$530.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.22
Rate for Payer: Qualcare PPO/HMO/WC	$59.55
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$530.72
Rate for Payer: Wellcare Medicare Advantage	$530.72
Rate for Payer: Wellpoint Medicaid Managed Care	$11.27

REM DEEP FB THIGH OR KNEE

Facility

$20,625.50

Service Code	HCPCS 27372
Hospital Charge Code	1600000331
Hospital Revenue Code	360
Min. Negotiated Rate	$585.76
Max. Negotiated Rate	$12,518.07
Rate for Payer: Aetna Commercial	$9,386.39
Rate for Payer: Aetna Medicare Advantage	$11,180.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,450.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,518.07
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: Cigna Medicare Advantage	$3,450.88
Rate for Payer: Clover Medicare Advantage	$3,278.34
Rate for Payer: EmblemHealth Commercial	$10,352.64
Rate for Payer: Humana Medicare Advantage	$3,554.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,450.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,362.63
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,093.82
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$651.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare Medicare Advantage	$3,450.88
Rate for Payer: Wellpoint Medicaid Managed Care	$585.76

REM DEEP FB THIGH OR KNEE

Facility

$20,625.50

Service Code	HCPCS 27372
Hospital Charge Code	1600000331
Hospital Revenue Code	360
Min. Negotiated Rate	$3,093.82
Max. Negotiated Rate	$3,093.82
Rate for Payer: Qualcare PPO/HMO/WC	$3,093.82

REMEDY MOISTURE BARRIER 4oz

Facility

$12.99

Hospital Charge Code	270302495W
Hospital Revenue Code	270
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$4.94
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.38
Rate for Payer: Oxford Commercial	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$2.60
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

REMEDY MOISTURE BARRIER 4oz

Facility

$12.99

Hospital Charge Code	270302495W
Hospital Revenue Code	270
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

REMEDY PROTECT NUTRASHIELD 2oz

Facility

$12.36

Hospital Charge Code	270302485
Hospital Revenue Code	270
Min. Negotiated Rate	$1.85
Max. Negotiated Rate	$1.85
Rate for Payer: Qualcare PPO/HMO/WC	$1.85

REMEDY PROTECT NUTRASHIELD 2oz

Facility

$12.36

Hospital Charge Code	270302485
Hospital Revenue Code	270
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$6.18
Rate for Payer: Aetna Commercial	$4.70
Rate for Payer: Aetna Medicare Advantage	$3.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.15
Rate for Payer: Cigna Commercial	$6.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.21
Rate for Payer: Oxford Commercial	$2.47
Rate for Payer: Qualcare PPO/HMO/WC	$1.85
Rate for Payer: UnitedHealthcare Commercial	$2.47
Rate for Payer: UnitedHealthcare Community & State	$0.39
Rate for Payer: Wellpoint Medicaid Managed Care	$0.35

REM EMBEDDED SUB CONJUNCTVL FB

Facility

$397.00

Service Code	HCPCS 65210
Hospital Charge Code	5780240
Hospital Revenue Code	450
Min. Negotiated Rate	$59.55
Max. Negotiated Rate	$59.55
Rate for Payer: Qualcare PPO/HMO/WC	$59.55

REM EMBEDDED SUB CONJUNCTVL FB

Facility

$397.00

Service Code	HCPCS 65210
Hospital Charge Code	5780240
Hospital Revenue Code	450
Min. Negotiated Rate	$11.27
Max. Negotiated Rate	$1,925.19
Rate for Payer: Aetna Commercial	$1,443.56
Rate for Payer: Aetna Medicare Advantage	$1,719.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,925.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,925.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$530.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,925.19
Rate for Payer: Cigna Commercial	$1,063.82
Rate for Payer: Cigna Medicare Advantage	$530.72
Rate for Payer: Clover Medicare Advantage	$504.18
Rate for Payer: EmblemHealth Commercial	$1,592.16
Rate for Payer: Humana Medicare Advantage	$546.64
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$530.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.22
Rate for Payer: Qualcare PPO/HMO/WC	$59.55
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$530.72
Rate for Payer: Wellcare Medicare Advantage	$530.72
Rate for Payer: Wellpoint Medicaid Managed Care	$11.27

REM EXT FIX SYS W ANESTH

Facility

$27,488.40

Service Code	HCPCS 20694
Hospital Charge Code	16000408
Hospital Revenue Code	360
Min. Negotiated Rate	$4,123.26
Max. Negotiated Rate	$4,123.26
Rate for Payer: Qualcare PPO/HMO/WC	$4,123.26

REM EXT FIX SYS W ANESTH

Facility

$27,488.40

Service Code	HCPCS 20694
Hospital Charge Code	16000408
Hospital Revenue Code	360
Min. Negotiated Rate	$780.67
Max. Negotiated Rate	$7,146.98
Rate for Payer: Aetna Commercial	$5,196.12
Rate for Payer: Aetna Medicare Advantage	$6,189.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,929.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,929.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,910.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,929.76
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: Cigna Medicare Advantage	$1,910.34
Rate for Payer: Clover Medicare Advantage	$1,814.82
Rate for Payer: EmblemHealth Commercial	$5,731.02
Rate for Payer: Humana Medicare Advantage	$1,967.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,910.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,146.98
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,123.26
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$868.63
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellpoint Medicaid Managed Care	$780.67

REM FB EXT AUDIT CNL,W ANESTH

Facility

$29,357.70

Service Code	HCPCS 69205
Hospital Charge Code	16000207
Hospital Revenue Code	360
Min. Negotiated Rate	$4,403.65
Max. Negotiated Rate	$4,403.65
Rate for Payer: Qualcare PPO/HMO/WC	$4,403.65

REM FB EXT AUDIT CNL,W ANESTH

Facility

$29,357.70

Service Code	HCPCS 69205
Hospital Charge Code	16000207
Hospital Revenue Code	360
Min. Negotiated Rate	$833.76
Max. Negotiated Rate	$7,633.00
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,633.00
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,403.65
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$927.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$833.76

REM FB FOOT; SQ

Facility

$7,992.92

Service Code	HCPCS 28190
Hospital Charge Code	160000216
Hospital Revenue Code	360
Min. Negotiated Rate	$227.00
Max. Negotiated Rate	$3,629.00
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,051.74
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,078.16
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,198.94
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$252.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$227.00

REM FB FOOT; SQ

Facility

$7,992.92

Service Code	HCPCS 28190
Hospital Charge Code	160000216
Hospital Revenue Code	360
Min. Negotiated Rate	$1,198.94
Max. Negotiated Rate	$1,198.94
Rate for Payer: Qualcare PPO/HMO/WC	$1,198.94

REMIFENTANIL I MG VIAL

Facility

$321.13

Service Code	NDC 72078003401
Hospital Charge Code	60632221
Hospital Revenue Code	250
Min. Negotiated Rate	$9.12
Max. Negotiated Rate	$160.56
Rate for Payer: Aetna Commercial	$122.03
Rate for Payer: Aetna Medicare Advantage	$96.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.89
Rate for Payer: Cigna Commercial	$160.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.49
Rate for Payer: Oxford Commercial	$64.23
Rate for Payer: Qualcare PPO/HMO/WC	$48.17
Rate for Payer: UnitedHealthcare Commercial	$64.23
Rate for Payer: UnitedHealthcare Community & State	$10.15
Rate for Payer: Wellpoint Medicaid Managed Care	$9.12

REMIFENTANIL I MG VIAL

Facility

$321.13

Service Code	NDC 72078003401
Hospital Charge Code	60632221
Hospital Revenue Code	250
Min. Negotiated Rate	$48.17
Max. Negotiated Rate	$48.17
Rate for Payer: Qualcare PPO/HMO/WC	$48.17

REM IMP CERUMEN/IRRIG UNI

Facility

$329.60

Service Code	HCPCS 69209
Hospital Charge Code	5792275
Hospital Revenue Code	450
Min. Negotiated Rate	$7.97
Max. Negotiated Rate	$254.22
Rate for Payer: Aetna Commercial	$190.62
Rate for Payer: Aetna Medicare Advantage	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$254.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$254.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$70.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$254.22
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: Cigna Medicare Advantage	$70.08
Rate for Payer: Clover Medicare Advantage	$66.58
Rate for Payer: EmblemHealth Commercial	$210.24
Rate for Payer: Humana Medicare Advantage	$72.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$70.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.70
Rate for Payer: Qualcare PPO/HMO/WC	$49.44
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$70.08
Rate for Payer: Wellcare Medicare Advantage	$70.08
Rate for Payer: Wellpoint Medicaid Managed Care	$9.36

Know your out-of-pocket cost for care.

All Charges