Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ROD CONTOURED 5.5MM 50MM

Facility

$1,430.00

Hospital Charge Code	270670368
Hospital Revenue Code	278
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$346.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: Qualcare PPO/HMO/WC	$214.50

ROD CONTOURED 5.5MM 50MM

Facility

$1,430.00

Hospital Charge Code	270670368
Hospital Revenue Code	278
Min. Negotiated Rate	$40.61
Max. Negotiated Rate	$715.00
Rate for Payer: Aetna Commercial	$543.40
Rate for Payer: Aetna Medicare Advantage	$429.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$364.65
Rate for Payer: Cigna Commercial	$715.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: Qualcare PPO/HMO/WC	$214.50
Rate for Payer: UnitedHealthcare Community & State	$45.19
Rate for Payer: Wellpoint Medicaid Managed Care	$40.61

ROD CONTOURED 5.5MM 55MM

Facility

$1,430.00

Hospital Charge Code	270670370
Hospital Revenue Code	278
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$346.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: Qualcare PPO/HMO/WC	$214.50

ROD CONTOURED 5.5MM 55MM

Facility

$1,430.00

Hospital Charge Code	270670370
Hospital Revenue Code	278
Min. Negotiated Rate	$40.61
Max. Negotiated Rate	$715.00
Rate for Payer: Aetna Commercial	$543.40
Rate for Payer: Aetna Medicare Advantage	$429.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$364.65
Rate for Payer: Cigna Commercial	$715.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: Qualcare PPO/HMO/WC	$214.50
Rate for Payer: UnitedHealthcare Community & State	$45.19
Rate for Payer: Wellpoint Medicaid Managed Care	$40.61

ROD CONTOURED 5.5MM 60MM

Facility

$1,430.00

Hospital Charge Code	270670371
Hospital Revenue Code	278
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$346.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: Qualcare PPO/HMO/WC	$214.50

ROD CONTOURED 5.5MM 60MM

Facility

$1,430.00

Hospital Charge Code	270670371
Hospital Revenue Code	278
Min. Negotiated Rate	$40.61
Max. Negotiated Rate	$715.00
Rate for Payer: Aetna Commercial	$543.40
Rate for Payer: Aetna Medicare Advantage	$429.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$364.65
Rate for Payer: Cigna Commercial	$715.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: Qualcare PPO/HMO/WC	$214.50
Rate for Payer: UnitedHealthcare Community & State	$45.19
Rate for Payer: Wellpoint Medicaid Managed Care	$40.61

ROD CONTOURED 5.5MM 65MM

Facility

$1,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270670372
Hospital Revenue Code	278
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$346.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: Qualcare PPO/HMO/WC	$214.50

ROD CONTOURED 5.5MM 65MM

Facility

$1,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270670372
Hospital Revenue Code	278
Min. Negotiated Rate	$40.61
Max. Negotiated Rate	$715.00
Rate for Payer: Aetna Commercial	$543.40
Rate for Payer: Aetna Medicare Advantage	$429.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$364.65
Rate for Payer: Cigna Commercial	$715.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: Qualcare PPO/HMO/WC	$214.50
Rate for Payer: UnitedHealthcare Community & State	$45.19
Rate for Payer: Wellpoint Medicaid Managed Care	$40.61

ROD CONTOURED 5.5MM 70MM

Facility

$1,430.00

Hospital Charge Code	270670373
Hospital Revenue Code	278
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$346.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: Qualcare PPO/HMO/WC	$214.50

ROD CONTOURED 5.5MM 70MM

Facility

$1,430.00

Hospital Charge Code	270670373
Hospital Revenue Code	278
Min. Negotiated Rate	$40.61
Max. Negotiated Rate	$715.00
Rate for Payer: Aetna Commercial	$543.40
Rate for Payer: Aetna Medicare Advantage	$429.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$364.65
Rate for Payer: Cigna Commercial	$715.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: Qualcare PPO/HMO/WC	$214.50
Rate for Payer: UnitedHealthcare Community & State	$45.19
Rate for Payer: Wellpoint Medicaid Managed Care	$40.61

ROD CONTOURED 5.5MM 75MM

Facility

$1,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270670375
Hospital Revenue Code	278
Min. Negotiated Rate	$40.61
Max. Negotiated Rate	$715.00
Rate for Payer: Aetna Commercial	$543.40
Rate for Payer: Aetna Medicare Advantage	$429.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$364.65
Rate for Payer: Cigna Commercial	$715.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: Qualcare PPO/HMO/WC	$214.50
Rate for Payer: UnitedHealthcare Community & State	$45.19
Rate for Payer: Wellpoint Medicaid Managed Care	$40.61

ROD CONTOURED 5.5MM 75MM

Facility

$1,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270670375
Hospital Revenue Code	278
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$346.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: Qualcare PPO/HMO/WC	$214.50

ROD CONTOURED 5.5MM 80MM

Facility

$1,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270670376
Hospital Revenue Code	278
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$346.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: Qualcare PPO/HMO/WC	$214.50

ROD CONTOURED 5.5MM 80MM

Facility

$1,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270670376
Hospital Revenue Code	278
Min. Negotiated Rate	$40.61
Max. Negotiated Rate	$715.00
Rate for Payer: Aetna Commercial	$543.40
Rate for Payer: Aetna Medicare Advantage	$429.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$364.65
Rate for Payer: Cigna Commercial	$715.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: Qualcare PPO/HMO/WC	$214.50
Rate for Payer: UnitedHealthcare Community & State	$45.19
Rate for Payer: Wellpoint Medicaid Managed Care	$40.61

ROD CONTOURED 5.5MM 85MM

Facility

$1,430.00

Hospital Charge Code	270670377
Hospital Revenue Code	278
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$346.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: Qualcare PPO/HMO/WC	$214.50

ROD CONTOURED 5.5MM 85MM

Facility

$1,430.00

Hospital Charge Code	270670377
Hospital Revenue Code	278
Min. Negotiated Rate	$40.61
Max. Negotiated Rate	$715.00
Rate for Payer: Aetna Commercial	$543.40
Rate for Payer: Aetna Medicare Advantage	$429.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$364.65
Rate for Payer: Cigna Commercial	$715.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: Qualcare PPO/HMO/WC	$214.50
Rate for Payer: UnitedHealthcare Community & State	$45.19
Rate for Payer: Wellpoint Medicaid Managed Care	$40.61

ROD CONTOURED 5.5MM 90MM

Facility

$1,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270670378
Hospital Revenue Code	278
Min. Negotiated Rate	$40.61
Max. Negotiated Rate	$715.00
Rate for Payer: Aetna Commercial	$543.40
Rate for Payer: Aetna Medicare Advantage	$429.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$364.65
Rate for Payer: Cigna Commercial	$715.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: Qualcare PPO/HMO/WC	$214.50
Rate for Payer: UnitedHealthcare Community & State	$45.19
Rate for Payer: Wellpoint Medicaid Managed Care	$40.61

ROD CONTOURED 5.5MM 90MM

Facility

$1,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270670378
Hospital Revenue Code	278
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$346.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: Qualcare PPO/HMO/WC	$214.50

ROD CONTOURED 5.5MM 95MM

Facility

$1,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270670379
Hospital Revenue Code	278
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$346.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: Qualcare PPO/HMO/WC	$214.50

ROD CONTOURED 5.5MM 95MM

Facility

$1,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270670379
Hospital Revenue Code	278
Min. Negotiated Rate	$40.61
Max. Negotiated Rate	$715.00
Rate for Payer: Aetna Commercial	$543.40
Rate for Payer: Aetna Medicare Advantage	$429.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$364.65
Rate for Payer: Cigna Commercial	$715.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: Qualcare PPO/HMO/WC	$214.50
Rate for Payer: UnitedHealthcare Community & State	$45.19
Rate for Payer: Wellpoint Medicaid Managed Care	$40.61

ROD CONTOURED 5.5MM X 60MM

Facility

$2,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270661267
Hospital Revenue Code	278
Min. Negotiated Rate	$82.36
Max. Negotiated Rate	$1,450.00
Rate for Payer: Aetna Commercial	$1,102.00
Rate for Payer: Aetna Medicare Advantage	$870.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$739.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$739.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$580.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$739.50
Rate for Payer: Cigna Commercial	$1,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$701.80
Rate for Payer: Qualcare PPO/HMO/WC	$435.00
Rate for Payer: UnitedHealthcare Community & State	$91.64
Rate for Payer: Wellpoint Medicaid Managed Care	$82.36

ROD CONTOURED 5.5MM X 60MM

Facility

$2,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270661267
Hospital Revenue Code	278
Min. Negotiated Rate	$435.00
Max. Negotiated Rate	$701.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$580.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$701.80
Rate for Payer: Qualcare PPO/HMO/WC	$435.00

ROD CONTOURED 5.5MM X 70MM

Facility

$2,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270661268
Hospital Revenue Code	278
Min. Negotiated Rate	$82.36
Max. Negotiated Rate	$1,450.00
Rate for Payer: Aetna Commercial	$1,102.00
Rate for Payer: Aetna Medicare Advantage	$870.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$739.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$739.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$580.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$739.50
Rate for Payer: Cigna Commercial	$1,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$701.80
Rate for Payer: Qualcare PPO/HMO/WC	$435.00
Rate for Payer: UnitedHealthcare Community & State	$91.64
Rate for Payer: Wellpoint Medicaid Managed Care	$82.36

ROD CONTOURED 5.5MM X 70MM

Facility

$2,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270661268
Hospital Revenue Code	278
Min. Negotiated Rate	$435.00
Max. Negotiated Rate	$701.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$580.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$701.80
Rate for Payer: Qualcare PPO/HMO/WC	$435.00

ROD CONTOURED 6.0MM 100MM

Facility

$1,725.00

Hospital Charge Code	270670394
Hospital Revenue Code	278
Min. Negotiated Rate	$48.99
Max. Negotiated Rate	$862.50
Rate for Payer: Aetna Commercial	$655.50
Rate for Payer: Aetna Medicare Advantage	$517.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.88
Rate for Payer: Cigna Commercial	$862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75
Rate for Payer: UnitedHealthcare Community & State	$54.51
Rate for Payer: Wellpoint Medicaid Managed Care	$48.99

Know your out-of-pocket cost for care.

All Charges