Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SD SCREW 3.5X16MM

Facility

$1,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270704127
Hospital Revenue Code	278
Min. Negotiated Rate	$48.28
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$646.00
Rate for Payer: Aetna Medicare Advantage	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$340.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$433.50
Rate for Payer: Cigna Commercial	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$411.40
Rate for Payer: Qualcare PPO/HMO/WC	$255.00
Rate for Payer: UnitedHealthcare Community & State	$53.72
Rate for Payer: Wellpoint Medicaid Managed Care	$48.28

SDS GLUCOSE CAPILLARY FINGERST

Facility

$390.00

Service Code	HCPCS 82948
Hospital Charge Code	1001182
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SDS GLUCOSE CAPILLARY FINGERST

Facility

$390.00

Service Code	HCPCS 82948
Hospital Charge Code	1001182
Hospital Revenue Code	301
Min. Negotiated Rate	$2.48
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$13.71
Rate for Payer: Aetna Medicare Advantage	$16.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.28
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.04
Rate for Payer: Clover Medicare Advantage	$4.79
Rate for Payer: EmblemHealth Commercial	$15.12
Rate for Payer: Humana Medicare Advantage	$5.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$4.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.04
Rate for Payer: Wellcare Medicare Advantage	$5.04
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

SDS HEMOGLOBIN HGB

Facility

$390.00

Service Code	HCPCS 85018
Hospital Charge Code	1001181
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SDS HEMOGLOBIN HGB

Facility

$390.00

Service Code	HCPCS 85018
Hospital Charge Code	1001181
Hospital Revenue Code	305
Min. Negotiated Rate	$1.90
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$6.45
Rate for Payer: Aetna Medicare Advantage	$7.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.60
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$2.37
Rate for Payer: Clover Medicare Advantage	$2.25
Rate for Payer: EmblemHealth Commercial	$7.11
Rate for Payer: Humana Medicare Advantage	$2.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$1.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.37
Rate for Payer: Wellcare Medicare Advantage	$2.37
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

SDS JELCO QUICKCATH (IV CATH)

Facility

$17.00

Hospital Charge Code	1001184
Hospital Revenue Code	272
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$8.50
Rate for Payer: Aetna Commercial	$6.46
Rate for Payer: Aetna Medicare Advantage	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.33
Rate for Payer: Cigna Commercial	$8.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.42
Rate for Payer: Oxford Commercial	$3.40
Rate for Payer: Qualcare PPO/HMO/WC	$2.55
Rate for Payer: UnitedHealthcare Commercial	$3.40
Rate for Payer: UnitedHealthcare Community & State	$0.54
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

SDS JELCO QUICKCATH (IV CATH)

Facility

$17.00

Hospital Charge Code	1001184
Hospital Revenue Code	272
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$2.55
Rate for Payer: Qualcare PPO/HMO/WC	$2.55

SDS OBSERVATION EA ADD'L 2 HRS

Facility

$270.00

Service Code	HCPCS 99218
Hospital Charge Code	83034001
Hospital Revenue Code	762
Min. Negotiated Rate	$8.53
Max. Negotiated Rate	$10,618.00
Rate for Payer: Aetna Commercial	$102.60
Rate for Payer: Aetna Medicare Advantage	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$930.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.85
Rate for Payer: Cigna Commercial	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.20
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.50
Rate for Payer: UnitedHealthcare Commercial	$10,618.00
Rate for Payer: UnitedHealthcare Community & State	$8.53
Rate for Payer: Wellpoint Medicaid Managed Care	$50.00

SDS OBSERVATION EA ADD'L 2 HRS

Facility

$270.00

Service Code	HCPCS 99218
Hospital Charge Code	83034001
Hospital Revenue Code	762
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$40.50
Rate for Payer: Qualcare PPO/HMO/WC	$40.50

SDS PHASE II RECOV 1 HOUR

Facility

$303.00

Hospital Charge Code	100043
Hospital Revenue Code	710
Min. Negotiated Rate	$45.45
Max. Negotiated Rate	$45.45
Rate for Payer: Qualcare PPO/HMO/WC	$45.45

SDS PHASE II RECOV 1 HOUR

Facility

$303.00

Hospital Charge Code	100043
Hospital Revenue Code	710
Min. Negotiated Rate	$8.61
Max. Negotiated Rate	$151.50
Rate for Payer: Aetna Commercial	$115.14
Rate for Payer: Aetna Medicare Advantage	$90.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.27
Rate for Payer: Cigna Commercial	$151.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.78
Rate for Payer: Oxford Commercial	$60.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.45
Rate for Payer: UnitedHealthcare Commercial	$60.60
Rate for Payer: UnitedHealthcare Community & State	$9.57
Rate for Payer: Wellpoint Medicaid Managed Care	$8.61

SDS PHASE II RECOV ADD1/2 HR

Facility

$551.00

Hospital Charge Code	100044
Hospital Revenue Code	710
Min. Negotiated Rate	$82.65
Max. Negotiated Rate	$82.65
Rate for Payer: Qualcare PPO/HMO/WC	$82.65

SDS PHASE II RECOV ADD1/2 HR

Facility

$551.00

Hospital Charge Code	100044
Hospital Revenue Code	710
Min. Negotiated Rate	$15.65
Max. Negotiated Rate	$275.50
Rate for Payer: Aetna Commercial	$209.38
Rate for Payer: Aetna Medicare Advantage	$165.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.50
Rate for Payer: Cigna Commercial	$275.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.26
Rate for Payer: Oxford Commercial	$110.20
Rate for Payer: Qualcare PPO/HMO/WC	$82.65
Rate for Payer: UnitedHealthcare Commercial	$110.20
Rate for Payer: UnitedHealthcare Community & State	$17.41
Rate for Payer: Wellpoint Medicaid Managed Care	$15.65

SEALANT DURASEAL SYTEM 5ML

Facility

$3,450.00

Hospital Charge Code	270659411
Hospital Revenue Code	270
Min. Negotiated Rate	$517.50
Max. Negotiated Rate	$517.50
Rate for Payer: Qualcare PPO/HMO/WC	$517.50

SEALANT DURASEAL SYTEM 5ML

Facility

$3,450.00

Hospital Charge Code	270659411
Hospital Revenue Code	270
Min. Negotiated Rate	$97.98
Max. Negotiated Rate	$1,725.00
Rate for Payer: Aetna Commercial	$1,311.00
Rate for Payer: Aetna Medicare Advantage	$1,035.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$879.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$879.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$879.75
Rate for Payer: Cigna Commercial	$1,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$897.00
Rate for Payer: Oxford Commercial	$690.00
Rate for Payer: Qualcare PPO/HMO/WC	$517.50
Rate for Payer: UnitedHealthcare Commercial	$690.00
Rate for Payer: UnitedHealthcare Community & State	$109.02
Rate for Payer: Wellpoint Medicaid Managed Care	$97.98

SEALANT FIBRIN 1501238 10ML

Facility

$2,674.00

Hospital Charge Code	270612219
Hospital Revenue Code	272
Min. Negotiated Rate	$75.94
Max. Negotiated Rate	$1,337.00
Rate for Payer: Aetna Commercial	$1,016.12
Rate for Payer: Aetna Medicare Advantage	$802.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$681.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$681.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$681.87
Rate for Payer: Cigna Commercial	$1,337.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$695.24
Rate for Payer: Oxford Commercial	$534.80
Rate for Payer: Qualcare PPO/HMO/WC	$401.10
Rate for Payer: UnitedHealthcare Commercial	$534.80
Rate for Payer: UnitedHealthcare Community & State	$84.50
Rate for Payer: Wellpoint Medicaid Managed Care	$75.94

SEALANT FIBRIN 1501238 10ML

Facility

$2,674.00

Hospital Charge Code	270612219
Hospital Revenue Code	272
Min. Negotiated Rate	$401.10
Max. Negotiated Rate	$401.10
Rate for Payer: Qualcare PPO/HMO/WC	$401.10

SEALANT FIBRIN TISSEAL 4ML

Facility

$1,126.90

Hospital Charge Code	270617194
Hospital Revenue Code	272
Min. Negotiated Rate	$32.00
Max. Negotiated Rate	$563.45
Rate for Payer: Aetna Commercial	$428.22
Rate for Payer: Aetna Medicare Advantage	$338.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$287.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$287.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$287.36
Rate for Payer: Cigna Commercial	$563.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.99
Rate for Payer: Oxford Commercial	$225.38
Rate for Payer: Qualcare PPO/HMO/WC	$169.03
Rate for Payer: UnitedHealthcare Commercial	$225.38
Rate for Payer: UnitedHealthcare Community & State	$35.61
Rate for Payer: Wellpoint Medicaid Managed Care	$32.00

SEALANT FIBRIN TISSEAL 4ML

Facility

$1,126.90

Hospital Charge Code	270617194
Hospital Revenue Code	272
Min. Negotiated Rate	$169.03
Max. Negotiated Rate	$169.03
Rate for Payer: Qualcare PPO/HMO/WC	$169.03

SEALER BIPOLAR AQUAMANTYS 6.0M

Facility

$2,625.00

Hospital Charge Code	270660020
Hospital Revenue Code	272
Min. Negotiated Rate	$393.75
Max. Negotiated Rate	$393.75
Rate for Payer: Qualcare PPO/HMO/WC	$393.75

SEALER BIPOLAR AQUAMANTYS 6.0M

Facility

$2,625.00

Hospital Charge Code	270660020
Hospital Revenue Code	272
Min. Negotiated Rate	$74.55
Max. Negotiated Rate	$1,312.50
Rate for Payer: Aetna Commercial	$997.50
Rate for Payer: Aetna Medicare Advantage	$787.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$669.38
Rate for Payer: Cigna Commercial	$1,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$682.50
Rate for Payer: Oxford Commercial	$525.00
Rate for Payer: Qualcare PPO/HMO/WC	$393.75
Rate for Payer: UnitedHealthcare Commercial	$525.00
Rate for Payer: UnitedHealthcare Community & State	$82.95
Rate for Payer: Wellpoint Medicaid Managed Care	$74.55

SEALING DUETT 624227

Facility

$1,000.00

Service Code	HCPCS C1760
Hospital Charge Code	270624227
Hospital Revenue Code	278
Min. Negotiated Rate	$28.40
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$31.60
Rate for Payer: Wellpoint Medicaid Managed Care	$28.40

SEALING DUETT 624227

Facility

$1,000.00

Service Code	HCPCS C1760
Hospital Charge Code	270624227
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SEAL MYSURE

Facility

$51.50

Hospital Charge Code	270664203
Hospital Revenue Code	270
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$25.75
Rate for Payer: Aetna Commercial	$19.57
Rate for Payer: Aetna Medicare Advantage	$15.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.13
Rate for Payer: Cigna Commercial	$25.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.39
Rate for Payer: Oxford Commercial	$10.30
Rate for Payer: Qualcare PPO/HMO/WC	$7.72
Rate for Payer: UnitedHealthcare Commercial	$10.30
Rate for Payer: UnitedHealthcare Community & State	$1.63
Rate for Payer: Wellpoint Medicaid Managed Care	$1.46

SEAL MYSURE

Facility

$51.50

Hospital Charge Code	270664203
Hospital Revenue Code	270
Min. Negotiated Rate	$7.72
Max. Negotiated Rate	$7.72
Rate for Payer: Qualcare PPO/HMO/WC	$7.72

Know your out-of-pocket cost for care.

All Charges