Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

RESTORIS MCK CONSUMABLES

Facility

$4,330.00

Hospital Charge Code	270668070
Hospital Revenue Code	278
Min. Negotiated Rate	$122.97
Max. Negotiated Rate	$2,165.00
Rate for Payer: Aetna Commercial	$1,645.40
Rate for Payer: Aetna Medicare Advantage	$1,299.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,104.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,104.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$866.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,104.15
Rate for Payer: Cigna Commercial	$2,165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,047.86
Rate for Payer: Qualcare PPO/HMO/WC	$649.50
Rate for Payer: UnitedHealthcare Community & State	$136.83
Rate for Payer: Wellpoint Medicaid Managed Care	$122.97

RESTORIS MCK PFJ

Facility

$16,350.00

Hospital Charge Code	270668064
Hospital Revenue Code	278
Min. Negotiated Rate	$464.34
Max. Negotiated Rate	$8,175.00
Rate for Payer: Aetna Commercial	$6,213.00
Rate for Payer: Aetna Medicare Advantage	$4,905.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,169.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,169.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,169.25
Rate for Payer: Cigna Commercial	$8,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,956.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,452.50
Rate for Payer: UnitedHealthcare Community & State	$516.66
Rate for Payer: Wellpoint Medicaid Managed Care	$464.34

RESTORIS MCK PFJ

Facility

$16,350.00

Hospital Charge Code	270668064
Hospital Revenue Code	278
Min. Negotiated Rate	$2,452.50
Max. Negotiated Rate	$3,956.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,270.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,956.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,452.50

RESTORIS MCK UNI INLAY

Facility

$16,055.00

Hospital Charge Code	270668060
Hospital Revenue Code	278
Min. Negotiated Rate	$455.96
Max. Negotiated Rate	$8,027.50
Rate for Payer: Aetna Commercial	$6,100.90
Rate for Payer: Aetna Medicare Advantage	$4,816.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,094.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,094.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,211.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,094.03
Rate for Payer: Cigna Commercial	$8,027.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,885.31
Rate for Payer: Qualcare PPO/HMO/WC	$2,408.25
Rate for Payer: UnitedHealthcare Community & State	$507.34
Rate for Payer: Wellpoint Medicaid Managed Care	$455.96

RESTORIS MCK UNI INLAY

Facility

$16,055.00

Hospital Charge Code	270668060
Hospital Revenue Code	278
Min. Negotiated Rate	$2,408.25
Max. Negotiated Rate	$3,885.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,211.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,885.31
Rate for Payer: Qualcare PPO/HMO/WC	$2,408.25

RESTORIS MCK UNI ONLAY PLOY PR

Facility

$23,980.00

Hospital Charge Code	270668063
Hospital Revenue Code	278
Min. Negotiated Rate	$3,597.00
Max. Negotiated Rate	$5,803.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,796.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,803.16
Rate for Payer: Qualcare PPO/HMO/WC	$3,597.00

RESTORIS MCK UNI ONLAY PLOY PR

Facility

$23,980.00

Hospital Charge Code	270668063
Hospital Revenue Code	278
Min. Negotiated Rate	$681.03
Max. Negotiated Rate	$11,990.00
Rate for Payer: Aetna Commercial	$9,112.40
Rate for Payer: Aetna Medicare Advantage	$7,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,114.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,114.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,796.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,114.90
Rate for Payer: Cigna Commercial	$11,990.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,803.16
Rate for Payer: Qualcare PPO/HMO/WC	$3,597.00
Rate for Payer: UnitedHealthcare Community & State	$757.77
Rate for Payer: Wellpoint Medicaid Managed Care	$681.03

RESTORIS MCK UNI ONLAY PLOY ST

Facility

$22,480.00

Hospital Charge Code	270668062
Hospital Revenue Code	278
Min. Negotiated Rate	$3,372.00
Max. Negotiated Rate	$5,440.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,496.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,440.16
Rate for Payer: Qualcare PPO/HMO/WC	$3,372.00

RESTORIS MCK UNI ONLAY PLOY ST

Facility

$22,480.00

Hospital Charge Code	270668062
Hospital Revenue Code	278
Min. Negotiated Rate	$638.43
Max. Negotiated Rate	$11,240.00
Rate for Payer: Aetna Commercial	$8,542.40
Rate for Payer: Aetna Medicare Advantage	$6,744.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,732.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,732.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,496.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,732.40
Rate for Payer: Cigna Commercial	$11,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,440.16
Rate for Payer: Qualcare PPO/HMO/WC	$3,372.00
Rate for Payer: UnitedHealthcare Community & State	$710.37
Rate for Payer: Wellpoint Medicaid Managed Care	$638.43

RESTORIS PF CONSUMABLES

Facility

$3,415.00

Hospital Charge Code	270668071
Hospital Revenue Code	278
Min. Negotiated Rate	$96.99
Max. Negotiated Rate	$1,707.50
Rate for Payer: Aetna Commercial	$1,297.70
Rate for Payer: Aetna Medicare Advantage	$1,024.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$870.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$870.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$870.83
Rate for Payer: Cigna Commercial	$1,707.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$826.43
Rate for Payer: Qualcare PPO/HMO/WC	$512.25
Rate for Payer: UnitedHealthcare Community & State	$107.91
Rate for Payer: Wellpoint Medicaid Managed Care	$96.99

RESTORIS PF CONSUMABLES

Facility

$3,415.00

Hospital Charge Code	270668071
Hospital Revenue Code	278
Min. Negotiated Rate	$512.25
Max. Negotiated Rate	$826.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$683.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$826.43
Rate for Payer: Qualcare PPO/HMO/WC	$512.25

RESTORIS PST CERAMIC HEAD

Facility

$28,425.00

Hospital Charge Code	270668069
Hospital Revenue Code	278
Min. Negotiated Rate	$807.27
Max. Negotiated Rate	$14,212.50
Rate for Payer: Aetna Commercial	$10,801.50
Rate for Payer: Aetna Medicare Advantage	$8,527.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,248.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,248.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,685.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,248.38
Rate for Payer: Cigna Commercial	$14,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,878.85
Rate for Payer: Qualcare PPO/HMO/WC	$4,263.75
Rate for Payer: UnitedHealthcare Community & State	$898.23
Rate for Payer: Wellpoint Medicaid Managed Care	$807.27

RESTORIS PST CERAMIC HEAD

Facility

$28,425.00

Hospital Charge Code	270668069
Hospital Revenue Code	278
Min. Negotiated Rate	$4,263.75
Max. Negotiated Rate	$6,878.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,685.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,878.85
Rate for Payer: Qualcare PPO/HMO/WC	$4,263.75

RESTORIS PST METAL HEAD

Facility

$25,615.00

Hospital Charge Code	270668068
Hospital Revenue Code	278
Min. Negotiated Rate	$3,842.25
Max. Negotiated Rate	$6,198.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,123.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,198.83
Rate for Payer: Qualcare PPO/HMO/WC	$3,842.25

RESTORIS PST METAL HEAD

Facility

$25,615.00

Hospital Charge Code	270668068
Hospital Revenue Code	278
Min. Negotiated Rate	$727.47
Max. Negotiated Rate	$12,807.50
Rate for Payer: Aetna Commercial	$9,733.70
Rate for Payer: Aetna Medicare Advantage	$7,684.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,531.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,531.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,123.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,531.82
Rate for Payer: Cigna Commercial	$12,807.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,198.83
Rate for Payer: Qualcare PPO/HMO/WC	$3,842.25
Rate for Payer: UnitedHealthcare Community & State	$809.43
Rate for Payer: Wellpoint Medicaid Managed Care	$727.47

RESTRAINT DISP LIMB HOLDER

Facility

$23.00

Hospital Charge Code	270301035
Hospital Revenue Code	270
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$11.50
Rate for Payer: Aetna Commercial	$8.74
Rate for Payer: Aetna Medicare Advantage	$6.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.87
Rate for Payer: Cigna Commercial	$11.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.98
Rate for Payer: Oxford Commercial	$4.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$4.60
Rate for Payer: UnitedHealthcare Community & State	$0.73
Rate for Payer: Wellpoint Medicaid Managed Care	$0.65

RESTRAINT DISP LIMB HOLDER

Facility

$23.00

Hospital Charge Code	270301035
Hospital Revenue Code	270
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

RESTRAINT SPLINT FREEDOM MED

Facility

$64.85

Hospital Charge Code	270301070
Hospital Revenue Code	270
Min. Negotiated Rate	$9.73
Max. Negotiated Rate	$9.73
Rate for Payer: Qualcare PPO/HMO/WC	$9.73

RESTRAINT SPLINT FREEDOM MED

Facility

$64.85

Hospital Charge Code	270301070
Hospital Revenue Code	270
Min. Negotiated Rate	$1.84
Max. Negotiated Rate	$32.42
Rate for Payer: Aetna Commercial	$24.64
Rate for Payer: Aetna Medicare Advantage	$19.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.54
Rate for Payer: Cigna Commercial	$32.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.86
Rate for Payer: Oxford Commercial	$12.97
Rate for Payer: Qualcare PPO/HMO/WC	$9.73
Rate for Payer: UnitedHealthcare Commercial	$12.97
Rate for Payer: UnitedHealthcare Community & State	$2.05
Rate for Payer: Wellpoint Medicaid Managed Care	$1.84

RESTRAINT TIEBACK VEST LG

Facility

$82.50

Hospital Charge Code	270301050
Hospital Revenue Code	270
Min. Negotiated Rate	$12.38
Max. Negotiated Rate	$12.38
Rate for Payer: Qualcare PPO/HMO/WC	$12.38

RESTRAINT TIEBACK VEST LG

Facility

$82.50

Hospital Charge Code	270301050
Hospital Revenue Code	270
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$41.25
Rate for Payer: Aetna Commercial	$31.35
Rate for Payer: Aetna Medicare Advantage	$24.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.04
Rate for Payer: Cigna Commercial	$41.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.45
Rate for Payer: Oxford Commercial	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$12.38
Rate for Payer: UnitedHealthcare Commercial	$16.50
Rate for Payer: UnitedHealthcare Community & State	$2.61
Rate for Payer: Wellpoint Medicaid Managed Care	$2.34

RESTRATA MESHED 5CMX5CM

Facility

$13,750.00

Service Code	HCPCS C1781
Hospital Charge Code	270704823
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$3,327.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

RESTRATA MESHED 5CMX5CM

Facility

$13,750.00

Service Code	HCPCS C1781
Hospital Charge Code	270704823
Hospital Revenue Code	278
Min. Negotiated Rate	$390.50
Max. Negotiated Rate	$6,875.00
Rate for Payer: Aetna Commercial	$5,225.00
Rate for Payer: Aetna Medicare Advantage	$4,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,506.25
Rate for Payer: Cigna Commercial	$6,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50
Rate for Payer: UnitedHealthcare Community & State	$434.50
Rate for Payer: Wellpoint Medicaid Managed Care	$390.50

RESTRATA MESHED 7.5CMX 7.5CM

Facility

$18,750.00

Service Code	HCPCS C1781
Hospital Charge Code	270704824
Hospital Revenue Code	278
Min. Negotiated Rate	$532.50
Max. Negotiated Rate	$9,375.00
Rate for Payer: Aetna Commercial	$7,125.00
Rate for Payer: Aetna Medicare Advantage	$5,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,781.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,781.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,781.25
Rate for Payer: Cigna Commercial	$9,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,537.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,812.50
Rate for Payer: UnitedHealthcare Community & State	$592.50
Rate for Payer: Wellpoint Medicaid Managed Care	$532.50

RESTRATA MESHED 7.5CMX 7.5CM

Facility

$18,750.00

Service Code	HCPCS C1781
Hospital Charge Code	270704824
Hospital Revenue Code	278
Min. Negotiated Rate	$2,812.50
Max. Negotiated Rate	$4,537.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,537.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,812.50

Know your out-of-pocket cost for care.

All Charges