Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

RETRACTOR SHARP PRONG ROLLET 4

Facility

$155.95

Hospital Charge Code	270688725
Hospital Revenue Code	272
Min. Negotiated Rate	$4.43
Max. Negotiated Rate	$77.97
Rate for Payer: Aetna Commercial	$59.26
Rate for Payer: Aetna Medicare Advantage	$46.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.77
Rate for Payer: Cigna Commercial	$77.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.55
Rate for Payer: Oxford Commercial	$31.19
Rate for Payer: Qualcare PPO/HMO/WC	$23.39
Rate for Payer: UnitedHealthcare Commercial	$31.19
Rate for Payer: UnitedHealthcare Community & State	$4.93
Rate for Payer: Wellpoint Medicaid Managed Care	$4.43

RETRACTOR SHARP PRONG ROLLET 4

Facility

$155.95

Hospital Charge Code	270688725
Hospital Revenue Code	272
Min. Negotiated Rate	$23.39
Max. Negotiated Rate	$23.39
Rate for Payer: Qualcare PPO/HMO/WC	$23.39

RETRACTOR SQUARE COLON 14.CMX

Facility

$331.65

Hospital Charge Code	270679384
Hospital Revenue Code	272
Min. Negotiated Rate	$9.42
Max. Negotiated Rate	$165.82
Rate for Payer: Aetna Commercial	$126.03
Rate for Payer: Aetna Medicare Advantage	$99.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.57
Rate for Payer: Cigna Commercial	$165.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.23
Rate for Payer: Oxford Commercial	$66.33
Rate for Payer: Qualcare PPO/HMO/WC	$49.75
Rate for Payer: UnitedHealthcare Commercial	$66.33
Rate for Payer: UnitedHealthcare Community & State	$10.48
Rate for Payer: Wellpoint Medicaid Managed Care	$9.42

RETRACTOR SQUARE COLON 14.CMX

Facility

$331.65

Hospital Charge Code	270679384
Hospital Revenue Code	272
Min. Negotiated Rate	$49.75
Max. Negotiated Rate	$49.75
Rate for Payer: Qualcare PPO/HMO/WC	$49.75

RETRACTOR TRACHEA LUER

Facility

$124.85

Hospital Charge Code	270688724
Hospital Revenue Code	272
Min. Negotiated Rate	$3.55
Max. Negotiated Rate	$62.42
Rate for Payer: Aetna Commercial	$47.44
Rate for Payer: Aetna Medicare Advantage	$37.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.84
Rate for Payer: Cigna Commercial	$62.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.46
Rate for Payer: Oxford Commercial	$24.97
Rate for Payer: Qualcare PPO/HMO/WC	$18.73
Rate for Payer: UnitedHealthcare Commercial	$24.97
Rate for Payer: UnitedHealthcare Community & State	$3.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3.55

RETRACTOR TRACHEA LUER

Facility

$124.85

Hospital Charge Code	270688724
Hospital Revenue Code	272
Min. Negotiated Rate	$18.73
Max. Negotiated Rate	$18.73
Rate for Payer: Qualcare PPO/HMO/WC	$18.73

RETRACTOR VAGINAL V-CARE LG

Facility

$940.19

Hospital Charge Code	270664721
Hospital Revenue Code	270
Min. Negotiated Rate	$141.03
Max. Negotiated Rate	$141.03
Rate for Payer: Qualcare PPO/HMO/WC	$141.03

RETRACTOR VAGINAL V-CARE LG

Facility

$940.19

Hospital Charge Code	270664721
Hospital Revenue Code	270
Min. Negotiated Rate	$26.70
Max. Negotiated Rate	$470.10
Rate for Payer: Aetna Commercial	$357.27
Rate for Payer: Aetna Medicare Advantage	$282.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$239.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$239.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$239.75
Rate for Payer: Cigna Commercial	$470.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$244.45
Rate for Payer: Oxford Commercial	$188.04
Rate for Payer: Qualcare PPO/HMO/WC	$141.03
Rate for Payer: UnitedHealthcare Commercial	$188.04
Rate for Payer: UnitedHealthcare Community & State	$29.71
Rate for Payer: Wellpoint Medicaid Managed Care	$26.70

RETRACTOR VAGINAL V-CARE MED

Facility

$386.28

Hospital Charge Code	270662541
Hospital Revenue Code	272
Min. Negotiated Rate	$10.97
Max. Negotiated Rate	$193.14
Rate for Payer: Aetna Commercial	$146.79
Rate for Payer: Aetna Medicare Advantage	$115.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.50
Rate for Payer: Cigna Commercial	$193.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.43
Rate for Payer: Oxford Commercial	$77.26
Rate for Payer: Qualcare PPO/HMO/WC	$57.94
Rate for Payer: UnitedHealthcare Commercial	$77.26
Rate for Payer: UnitedHealthcare Community & State	$12.21
Rate for Payer: Wellpoint Medicaid Managed Care	$10.97

RETRACTOR VAGINAL V-CARE MED

Facility

$386.28

Hospital Charge Code	270662541
Hospital Revenue Code	272
Min. Negotiated Rate	$57.94
Max. Negotiated Rate	$57.94
Rate for Payer: Qualcare PPO/HMO/WC	$57.94

RETRACTOR VAGINAL V-CARE SM

Facility

$478.47

Hospital Charge Code	270662543
Hospital Revenue Code	272
Min. Negotiated Rate	$13.59
Max. Negotiated Rate	$239.24
Rate for Payer: Aetna Commercial	$181.82
Rate for Payer: Aetna Medicare Advantage	$143.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.01
Rate for Payer: Cigna Commercial	$239.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.40
Rate for Payer: Oxford Commercial	$95.69
Rate for Payer: Qualcare PPO/HMO/WC	$71.77
Rate for Payer: UnitedHealthcare Commercial	$95.69
Rate for Payer: UnitedHealthcare Community & State	$15.12
Rate for Payer: Wellpoint Medicaid Managed Care	$13.59

RETRACTOR VAGINAL V-CARE SM

Facility

$478.47

Hospital Charge Code	270662543
Hospital Revenue Code	272
Min. Negotiated Rate	$71.77
Max. Negotiated Rate	$71.77
Rate for Payer: Qualcare PPO/HMO/WC	$71.77

RETRACTOR Z KNEE

Facility

$820.50

Hospital Charge Code	270692075
Hospital Revenue Code	272
Min. Negotiated Rate	$23.30
Max. Negotiated Rate	$410.25
Rate for Payer: Aetna Commercial	$311.79
Rate for Payer: Aetna Medicare Advantage	$246.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.23
Rate for Payer: Cigna Commercial	$410.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.33
Rate for Payer: Oxford Commercial	$164.10
Rate for Payer: Qualcare PPO/HMO/WC	$123.08
Rate for Payer: UnitedHealthcare Commercial	$164.10
Rate for Payer: UnitedHealthcare Community & State	$25.93
Rate for Payer: Wellpoint Medicaid Managed Care	$23.30

RETRACTOR Z KNEE

Facility

$820.50

Hospital Charge Code	270692075
Hospital Revenue Code	272
Min. Negotiated Rate	$123.08
Max. Negotiated Rate	$123.08
Rate for Payer: Qualcare PPO/HMO/WC	$123.08

RETRIEVAL BALLON

Facility

$172.00

Hospital Charge Code	270325610
Hospital Revenue Code	272
Min. Negotiated Rate	$4.88
Max. Negotiated Rate	$86.00
Rate for Payer: Aetna Commercial	$65.36
Rate for Payer: Aetna Medicare Advantage	$51.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.86
Rate for Payer: Cigna Commercial	$86.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.72
Rate for Payer: Oxford Commercial	$34.40
Rate for Payer: Qualcare PPO/HMO/WC	$25.80
Rate for Payer: UnitedHealthcare Commercial	$34.40
Rate for Payer: UnitedHealthcare Community & State	$5.44
Rate for Payer: Wellpoint Medicaid Managed Care	$4.88

RETRIEVAL BALLON

Facility

$172.00

Hospital Charge Code	270325610
Hospital Revenue Code	272
Min. Negotiated Rate	$25.80
Max. Negotiated Rate	$25.80
Rate for Payer: Qualcare PPO/HMO/WC	$25.80

RETRIEVAL BASKET SPYGLASS

Facility

$2,145.00

Hospital Charge Code	270684734
Hospital Revenue Code	272
Min. Negotiated Rate	$60.92
Max. Negotiated Rate	$1,072.50
Rate for Payer: Aetna Commercial	$815.10
Rate for Payer: Aetna Medicare Advantage	$643.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$546.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$546.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$546.98
Rate for Payer: Cigna Commercial	$1,072.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$557.70
Rate for Payer: Oxford Commercial	$429.00
Rate for Payer: Qualcare PPO/HMO/WC	$321.75
Rate for Payer: UnitedHealthcare Commercial	$429.00
Rate for Payer: UnitedHealthcare Community & State	$67.78
Rate for Payer: Wellpoint Medicaid Managed Care	$60.92

RETRIEVAL BASKET SPYGLASS

Facility

$2,145.00

Hospital Charge Code	270684734
Hospital Revenue Code	272
Min. Negotiated Rate	$321.75
Max. Negotiated Rate	$321.75
Rate for Payer: Qualcare PPO/HMO/WC	$321.75

RETRIEVER FIBERTAPE

Facility

$7,475.00

Hospital Charge Code	270675963
Hospital Revenue Code	272
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,121.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

RETRIEVER FIBERTAPE

Facility

$7,475.00

Hospital Charge Code	270675963
Hospital Revenue Code	272
Min. Negotiated Rate	$212.29
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,840.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,943.50
Rate for Payer: Oxford Commercial	$1,495.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Commercial	$1,495.00
Rate for Payer: UnitedHealthcare Community & State	$236.21
Rate for Payer: Wellpoint Medicaid Managed Care	$212.29

RETRIEVER LVT SUTUER LG 9894

Facility

$165.95

Hospital Charge Code	270611100
Hospital Revenue Code	272
Min. Negotiated Rate	$4.71
Max. Negotiated Rate	$82.97
Rate for Payer: Aetna Commercial	$63.06
Rate for Payer: Aetna Medicare Advantage	$49.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.32
Rate for Payer: Cigna Commercial	$82.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.15
Rate for Payer: Oxford Commercial	$33.19
Rate for Payer: Qualcare PPO/HMO/WC	$24.89
Rate for Payer: UnitedHealthcare Commercial	$33.19
Rate for Payer: UnitedHealthcare Community & State	$5.24
Rate for Payer: Wellpoint Medicaid Managed Care	$4.71

RETRIEVER LVT SUTUER LG 9894

Facility

$165.95

Hospital Charge Code	270611100
Hospital Revenue Code	272
Min. Negotiated Rate	$24.89
Max. Negotiated Rate	$24.89
Rate for Payer: Qualcare PPO/HMO/WC	$24.89

RETRIEVER LVT SUTUER SM 9892

Facility

$165.95

Hospital Charge Code	270611101
Hospital Revenue Code	272
Min. Negotiated Rate	$24.89
Max. Negotiated Rate	$24.89
Rate for Payer: Qualcare PPO/HMO/WC	$24.89

RETRIEVER LVT SUTUER SM 9892

Facility

$165.95

Hospital Charge Code	270611101
Hospital Revenue Code	272
Min. Negotiated Rate	$4.71
Max. Negotiated Rate	$82.97
Rate for Payer: Aetna Commercial	$63.06
Rate for Payer: Aetna Medicare Advantage	$49.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.32
Rate for Payer: Cigna Commercial	$82.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.15
Rate for Payer: Oxford Commercial	$33.19
Rate for Payer: Qualcare PPO/HMO/WC	$24.89
Rate for Payer: UnitedHealthcare Commercial	$33.19
Rate for Payer: UnitedHealthcare Community & State	$5.24
Rate for Payer: Wellpoint Medicaid Managed Care	$4.71

RETRIEVER NET ROTH 2.5mm 230cm

Facility

$500.00

Hospital Charge Code	270684082
Hospital Revenue Code	272
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

Know your out-of-pocket cost for care.

All Charges