Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

RING FOOT SHORT SALVATION

Facility

$4,185.00

Hospital Charge Code	270684449
Hospital Revenue Code	272
Min. Negotiated Rate	$627.75
Max. Negotiated Rate	$627.75
Rate for Payer: Qualcare PPO/HMO/WC	$627.75

RING G7 HARD BEARING SZ G

Facility

$1,150.00

Service Code	HCPCS C1776
Hospital Charge Code	270695265
Hospital Revenue Code	278
Min. Negotiated Rate	$32.66
Max. Negotiated Rate	$575.00
Rate for Payer: Aetna Commercial	$437.00
Rate for Payer: Aetna Medicare Advantage	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.25
Rate for Payer: Cigna Commercial	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: Qualcare PPO/HMO/WC	$172.50
Rate for Payer: UnitedHealthcare Community & State	$36.34
Rate for Payer: Wellpoint Medicaid Managed Care	$32.66

RING G7 HARD BEARING SZ G

Facility

$1,150.00

Service Code	HCPCS C1776
Hospital Charge Code	270695265
Hospital Revenue Code	278
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$278.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

RING HALF CARBON FIBER 180MM

Facility

$2,660.50

Hospital Charge Code	270678082
Hospital Revenue Code	272
Min. Negotiated Rate	$399.07
Max. Negotiated Rate	$399.07
Rate for Payer: Qualcare PPO/HMO/WC	$399.07

RING HALF CARBON FIBER 180MM

Facility

$2,660.50

Hospital Charge Code	270678082
Hospital Revenue Code	272
Min. Negotiated Rate	$75.56
Max. Negotiated Rate	$1,330.25
Rate for Payer: Aetna Commercial	$1,010.99
Rate for Payer: Aetna Medicare Advantage	$798.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$678.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$678.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$678.43
Rate for Payer: Cigna Commercial	$1,330.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$691.73
Rate for Payer: Oxford Commercial	$532.10
Rate for Payer: Qualcare PPO/HMO/WC	$399.07
Rate for Payer: UnitedHealthcare Commercial	$532.10
Rate for Payer: UnitedHealthcare Community & State	$84.07
Rate for Payer: Wellpoint Medicaid Managed Care	$75.56

RINGLOC 62MM SZ 25

Facility

$16,375.00

Service Code	HCPCS C1776
Hospital Charge Code	270673644
Hospital Revenue Code	278
Min. Negotiated Rate	$2,456.25
Max. Negotiated Rate	$3,962.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,962.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,456.25

RINGLOC 62MM SZ 25

Facility

$16,375.00

Service Code	HCPCS C1776
Hospital Charge Code	270673644
Hospital Revenue Code	278
Min. Negotiated Rate	$465.05
Max. Negotiated Rate	$8,187.50
Rate for Payer: Aetna Commercial	$6,222.50
Rate for Payer: Aetna Medicare Advantage	$4,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,175.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,175.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,175.62
Rate for Payer: Cigna Commercial	$8,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,962.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,456.25
Rate for Payer: UnitedHealthcare Community & State	$517.45
Rate for Payer: Wellpoint Medicaid Managed Care	$465.05

RINGLOC 64MM SZ 26

Facility

$16,375.00

Service Code	HCPCS C1776
Hospital Charge Code	270673599
Hospital Revenue Code	278
Min. Negotiated Rate	$2,456.25
Max. Negotiated Rate	$3,962.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,962.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,456.25

RINGLOC 64MM SZ 26

Facility

$16,375.00

Service Code	HCPCS C1776
Hospital Charge Code	270673599
Hospital Revenue Code	278
Min. Negotiated Rate	$465.05
Max. Negotiated Rate	$8,187.50
Rate for Payer: Aetna Commercial	$6,222.50
Rate for Payer: Aetna Medicare Advantage	$4,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,175.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,175.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,175.62
Rate for Payer: Cigna Commercial	$8,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,962.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,456.25
Rate for Payer: UnitedHealthcare Community & State	$517.45
Rate for Payer: Wellpoint Medicaid Managed Care	$465.05

RINGLOC BI-POLAR 28X51MM

Facility

$5,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270608175
Hospital Revenue Code	278
Min. Negotiated Rate	$149.10
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,995.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50
Rate for Payer: UnitedHealthcare Community & State	$165.90
Rate for Payer: Wellpoint Medicaid Managed Care	$149.10

RINGLOC BI-POLAR 28X51MM

Facility

$5,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270608175
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$1,270.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

RING MALYUGIN

Facility

$625.00

Hospital Charge Code	270660095
Hospital Revenue Code	270
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

RING MALYUGIN

Facility

$625.00

Hospital Charge Code	270660095
Hospital Revenue Code	270
Min. Negotiated Rate	$17.75
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.50
Rate for Payer: Oxford Commercial	$125.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Commercial	$125.00
Rate for Payer: UnitedHealthcare Community & State	$19.75
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

RING MAXFR 180MM 5/8

Facility

$5,691.80

Hospital Charge Code	270693739
Hospital Revenue Code	272
Min. Negotiated Rate	$161.65
Max. Negotiated Rate	$2,845.90
Rate for Payer: Aetna Commercial	$2,162.88
Rate for Payer: Aetna Medicare Advantage	$1,707.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,451.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,451.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,451.41
Rate for Payer: Cigna Commercial	$2,845.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,479.87
Rate for Payer: Oxford Commercial	$1,138.36
Rate for Payer: Qualcare PPO/HMO/WC	$853.77
Rate for Payer: UnitedHealthcare Commercial	$1,138.36
Rate for Payer: UnitedHealthcare Community & State	$179.86
Rate for Payer: Wellpoint Medicaid Managed Care	$161.65

RING MAXFR 180MM 5/8

Facility

$5,691.80

Hospital Charge Code	270693739
Hospital Revenue Code	272
Min. Negotiated Rate	$853.77
Max. Negotiated Rate	$853.77
Rate for Payer: Qualcare PPO/HMO/WC	$853.77

RING TI HALF 150MM

Facility

$2,286.20

Hospital Charge Code	270693740
Hospital Revenue Code	272
Min. Negotiated Rate	$342.93
Max. Negotiated Rate	$342.93
Rate for Payer: Qualcare PPO/HMO/WC	$342.93

RING TI HALF 150MM

Facility

$2,286.20

Hospital Charge Code	270693740
Hospital Revenue Code	272
Min. Negotiated Rate	$64.93
Max. Negotiated Rate	$1,143.10
Rate for Payer: Aetna Commercial	$868.76
Rate for Payer: Aetna Medicare Advantage	$685.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$582.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$582.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$582.98
Rate for Payer: Cigna Commercial	$1,143.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$594.41
Rate for Payer: Oxford Commercial	$457.24
Rate for Payer: Qualcare PPO/HMO/WC	$342.93
Rate for Payer: UnitedHealthcare Commercial	$457.24
Rate for Payer: UnitedHealthcare Community & State	$72.24
Rate for Payer: Wellpoint Medicaid Managed Care	$64.93

RING TOSS

Facility

$119.95

Hospital Charge Code	270663158
Hospital Revenue Code	270
Min. Negotiated Rate	$17.99
Max. Negotiated Rate	$17.99
Rate for Payer: Qualcare PPO/HMO/WC	$17.99

RING TOSS

Facility

$119.95

Hospital Charge Code	270663158
Hospital Revenue Code	270
Min. Negotiated Rate	$3.41
Max. Negotiated Rate	$59.98
Rate for Payer: Aetna Commercial	$45.58
Rate for Payer: Aetna Medicare Advantage	$35.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.59
Rate for Payer: Cigna Commercial	$59.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.19
Rate for Payer: Oxford Commercial	$23.99
Rate for Payer: Qualcare PPO/HMO/WC	$17.99
Rate for Payer: UnitedHealthcare Commercial	$23.99
Rate for Payer: UnitedHealthcare Community & State	$3.79
Rate for Payer: Wellpoint Medicaid Managed Care	$3.41

RING TUB SALVATION 160

Facility

$5,630.00

Hospital Charge Code	270684448
Hospital Revenue Code	272
Min. Negotiated Rate	$159.89
Max. Negotiated Rate	$2,815.00
Rate for Payer: Aetna Commercial	$2,139.40
Rate for Payer: Aetna Medicare Advantage	$1,689.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,435.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,435.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,435.65
Rate for Payer: Cigna Commercial	$2,815.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,463.80
Rate for Payer: Oxford Commercial	$1,126.00
Rate for Payer: Qualcare PPO/HMO/WC	$844.50
Rate for Payer: UnitedHealthcare Commercial	$1,126.00
Rate for Payer: UnitedHealthcare Community & State	$177.91
Rate for Payer: Wellpoint Medicaid Managed Care	$159.89

RING TUB SALVATION 160

Facility

$5,630.00

Hospital Charge Code	270684448
Hospital Revenue Code	272
Min. Negotiated Rate	$844.50
Max. Negotiated Rate	$844.50
Rate for Payer: Qualcare PPO/HMO/WC	$844.50

RIO SYSTEM IRRIGATION TUBE

Facility

$601.25

Hospital Charge Code	270692852
Hospital Revenue Code	272
Min. Negotiated Rate	$90.19
Max. Negotiated Rate	$90.19
Rate for Payer: Qualcare PPO/HMO/WC	$90.19

RIO SYSTEM IRRIGATION TUBE

Facility

$601.25

Hospital Charge Code	270692852
Hospital Revenue Code	272
Min. Negotiated Rate	$17.08
Max. Negotiated Rate	$300.62
Rate for Payer: Aetna Commercial	$228.47
Rate for Payer: Aetna Medicare Advantage	$180.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.32
Rate for Payer: Cigna Commercial	$300.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.32
Rate for Payer: Oxford Commercial	$120.25
Rate for Payer: Qualcare PPO/HMO/WC	$90.19
Rate for Payer: UnitedHealthcare Commercial	$120.25
Rate for Payer: UnitedHealthcare Community & State	$19.00
Rate for Payer: Wellpoint Medicaid Managed Care	$17.08

RISPERDAL CONSTA 25/2 ML MG SY

Facility

$2,744.72

Service Code	HCPCS J2794
Hospital Charge Code	606350957
Hospital Revenue Code	636
Min. Negotiated Rate	$10.26
Max. Negotiated Rate	$664.22
Rate for Payer: Aetna Commercial	$29.38
Rate for Payer: Aetna Medicare Advantage	$34.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.18
Rate for Payer: Cigna Medicare Advantage	$10.80
Rate for Payer: Clover Medicare Advantage	$10.26
Rate for Payer: EmblemHealth Commercial	$32.40
Rate for Payer: Humana Medicare Advantage	$11.12
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$664.22
Rate for Payer: Qualcare PPO/HMO/WC	$411.71
Rate for Payer: UnitedHealthcare Community & State	$86.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.80
Rate for Payer: Wellcare Medicare Advantage	$10.80
Rate for Payer: Wellpoint Medicaid Managed Care	$77.95

RISPERDAL CONSTA 25/2 ML MG SY

Facility

$2,744.72

Service Code	HCPCS J2794
Hospital Charge Code	606350957
Hospital Revenue Code	636
Min. Negotiated Rate	$411.71
Max. Negotiated Rate	$664.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$664.22
Rate for Payer: Qualcare PPO/HMO/WC	$411.71

Know your out-of-pocket cost for care.

All Charges