Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SEAL SINGLE SITE UNIV

Facility

$75.00

Hospital Charge Code	270677940
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

SEAL SINGLE SITE UNIV

Facility

$75.00

Hospital Charge Code	270677940
Hospital Revenue Code	272
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$2.37
Rate for Payer: Wellpoint Medicaid Managed Care	$2.13

SEAL UNIVERSAL XI 5-8MM

Facility

$90.00

Hospital Charge Code	270668651
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

SEAL UNIVERSAL XI 5-8MM

Facility

$90.00

Hospital Charge Code	270668651
Hospital Revenue Code	272
Min. Negotiated Rate	$2.56
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$34.20
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.40
Rate for Payer: Oxford Commercial	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$18.00
Rate for Payer: UnitedHealthcare Community & State	$2.84
Rate for Payer: Wellpoint Medicaid Managed Care	$2.56

SEAMGARD

Facility

$354.00

Hospital Charge Code	270335728
Hospital Revenue Code	278
Min. Negotiated Rate	$10.05
Max. Negotiated Rate	$177.00
Rate for Payer: Aetna Commercial	$134.52
Rate for Payer: Aetna Medicare Advantage	$106.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$90.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$90.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$90.27
Rate for Payer: Cigna Commercial	$177.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.67
Rate for Payer: Qualcare PPO/HMO/WC	$53.10
Rate for Payer: UnitedHealthcare Community & State	$11.19
Rate for Payer: Wellpoint Medicaid Managed Care	$10.05

SEAMGARD

Facility

$354.00

Hospital Charge Code	270335728
Hospital Revenue Code	278
Min. Negotiated Rate	$53.10
Max. Negotiated Rate	$85.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.67
Rate for Payer: Qualcare PPO/HMO/WC	$53.10

SEAMGUARD 45MM

Facility

$975.00

Hospital Charge Code	270672594
Hospital Revenue Code	272
Min. Negotiated Rate	$27.69
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$253.50
Rate for Payer: Oxford Commercial	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$195.00
Rate for Payer: UnitedHealthcare Community & State	$30.81
Rate for Payer: Wellpoint Medicaid Managed Care	$27.69

SEAMGUARD 45MM

Facility

$975.00

Hospital Charge Code	270672594
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

SEAMGUARD 60MM

Facility

$1,090.00

Hospital Charge Code	270672595
Hospital Revenue Code	272
Min. Negotiated Rate	$30.96
Max. Negotiated Rate	$545.00
Rate for Payer: Aetna Commercial	$414.20
Rate for Payer: Aetna Medicare Advantage	$327.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$277.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$277.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$277.95
Rate for Payer: Cigna Commercial	$545.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$283.40
Rate for Payer: Oxford Commercial	$218.00
Rate for Payer: Qualcare PPO/HMO/WC	$163.50
Rate for Payer: UnitedHealthcare Commercial	$218.00
Rate for Payer: UnitedHealthcare Community & State	$34.44
Rate for Payer: Wellpoint Medicaid Managed Care	$30.96

SEAMGUARD 60MM

Facility

$1,090.00

Hospital Charge Code	270672595
Hospital Revenue Code	272
Min. Negotiated Rate	$163.50
Max. Negotiated Rate	$163.50
Rate for Payer: Qualcare PPO/HMO/WC	$163.50

SEAMGUARD BIOABSRB BLK60

Facility

$835.00

Service Code	HCPCS C1781
Hospital Charge Code	270693068
Hospital Revenue Code	278
Min. Negotiated Rate	$125.25
Max. Negotiated Rate	$202.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$167.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$202.07
Rate for Payer: Qualcare PPO/HMO/WC	$125.25

SEAMGUARD BIOABSRB BLK60

Facility

$835.00

Service Code	HCPCS C1781
Hospital Charge Code	270693068
Hospital Revenue Code	278
Min. Negotiated Rate	$23.71
Max. Negotiated Rate	$417.50
Rate for Payer: Aetna Commercial	$317.30
Rate for Payer: Aetna Medicare Advantage	$250.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$167.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.93
Rate for Payer: Cigna Commercial	$417.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$202.07
Rate for Payer: Qualcare PPO/HMO/WC	$125.25
Rate for Payer: UnitedHealthcare Community & State	$26.39
Rate for Payer: Wellpoint Medicaid Managed Care	$23.71

SEAMGUARD BIOABSRB GRN/BL 60

Facility

$835.00

Service Code	HCPCS C1781
Hospital Charge Code	270693069
Hospital Revenue Code	278
Min. Negotiated Rate	$23.71
Max. Negotiated Rate	$417.50
Rate for Payer: Aetna Commercial	$317.30
Rate for Payer: Aetna Medicare Advantage	$250.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$167.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.93
Rate for Payer: Cigna Commercial	$417.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$202.07
Rate for Payer: Qualcare PPO/HMO/WC	$125.25
Rate for Payer: UnitedHealthcare Community & State	$26.39
Rate for Payer: Wellpoint Medicaid Managed Care	$23.71

SEAMGUARD BIOABSRB GRN/BL 60

Facility

$835.00

Service Code	HCPCS C1781
Hospital Charge Code	270693069
Hospital Revenue Code	278
Min. Negotiated Rate	$125.25
Max. Negotiated Rate	$202.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$167.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$202.07
Rate for Payer: Qualcare PPO/HMO/WC	$125.25

SEATH PINNACLE R/O II INTRODUC

Facility

$31.90

Service Code	HCPCS C1766
Hospital Charge Code	270654359S
Hospital Revenue Code	278
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$15.95
Rate for Payer: Aetna Commercial	$12.12
Rate for Payer: Aetna Medicare Advantage	$9.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.13
Rate for Payer: Cigna Commercial	$15.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.72
Rate for Payer: Qualcare PPO/HMO/WC	$4.79
Rate for Payer: UnitedHealthcare Community & State	$1.01
Rate for Payer: Wellpoint Medicaid Managed Care	$0.91

SEATH PINNACLE R/O II INTRODUC

Facility

$31.90

Service Code	HCPCS C1766
Hospital Charge Code	270654359
Hospital Revenue Code	278
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$15.95
Rate for Payer: Aetna Commercial	$12.12
Rate for Payer: Aetna Medicare Advantage	$9.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.13
Rate for Payer: Cigna Commercial	$15.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.72
Rate for Payer: Qualcare PPO/HMO/WC	$4.79
Rate for Payer: UnitedHealthcare Community & State	$1.01
Rate for Payer: Wellpoint Medicaid Managed Care	$0.91

SEATH PINNACLE R/O II INTRODUC

Facility

$31.90

Service Code	HCPCS C1766
Hospital Charge Code	270654359S
Hospital Revenue Code	278
Min. Negotiated Rate	$4.79
Max. Negotiated Rate	$7.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.72
Rate for Payer: Qualcare PPO/HMO/WC	$4.79

SEATH PINNACLE R/O II INTRODUC

Facility

$31.90

Service Code	HCPCS C1766
Hospital Charge Code	270654359N
Hospital Revenue Code	278
Min. Negotiated Rate	$4.79
Max. Negotiated Rate	$7.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.72
Rate for Payer: Qualcare PPO/HMO/WC	$4.79

SEATH PINNACLE R/O II INTRODUC

Facility

$31.90

Service Code	HCPCS C1766
Hospital Charge Code	270654359N
Hospital Revenue Code	278
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$15.95
Rate for Payer: Aetna Commercial	$12.12
Rate for Payer: Aetna Medicare Advantage	$9.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.13
Rate for Payer: Cigna Commercial	$15.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.72
Rate for Payer: Qualcare PPO/HMO/WC	$4.79
Rate for Payer: UnitedHealthcare Community & State	$1.01
Rate for Payer: Wellpoint Medicaid Managed Care	$0.91

SEATH PINNACLE R/O II INTRODUC

Facility

$31.90

Service Code	HCPCS C1766
Hospital Charge Code	270654359
Hospital Revenue Code	278
Min. Negotiated Rate	$4.79
Max. Negotiated Rate	$7.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.72
Rate for Payer: Qualcare PPO/HMO/WC	$4.79

SEC ANT LUM CAGE H18 10DEG

Facility

$25,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270703855
Hospital Revenue Code	278
Min. Negotiated Rate	$710.00
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$9,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00
Rate for Payer: UnitedHealthcare Community & State	$790.00
Rate for Payer: Wellpoint Medicaid Managed Care	$710.00

SEC ANT LUM CAGE H18 10DEG

Facility

$25,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270703855
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

SEC FT MX 127DEG STEM 10X35

Facility

$11,937.80

Service Code	HCPCS C1776
Hospital Charge Code	270691174
Hospital Revenue Code	278
Min. Negotiated Rate	$1,790.67
Max. Negotiated Rate	$2,888.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,387.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,888.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,790.67

SEC FT MX 127DEG STEM 10X35

Facility

$11,937.80

Service Code	HCPCS C1776
Hospital Charge Code	270691174
Hospital Revenue Code	278
Min. Negotiated Rate	$339.03
Max. Negotiated Rate	$5,968.90
Rate for Payer: Aetna Commercial	$4,536.36
Rate for Payer: Aetna Medicare Advantage	$3,581.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,044.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,044.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,387.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,044.14
Rate for Payer: Cigna Commercial	$5,968.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,888.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,790.67
Rate for Payer: UnitedHealthcare Community & State	$377.23
Rate for Payer: Wellpoint Medicaid Managed Care	$339.03

SECFTMX127DEGSTEMSZ9NK35MMCTPR

Facility

$11,937.80

Service Code	HCPCS C1776
Hospital Charge Code	270691183
Hospital Revenue Code	278
Min. Negotiated Rate	$1,790.67
Max. Negotiated Rate	$2,888.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,387.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,888.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,790.67

Know your out-of-pocket cost for care.

All Charges