Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SET COLLECTION SYNEVAC 610

Facility

$26.75

Hospital Charge Code	270612228
Hospital Revenue Code	272
Min. Negotiated Rate	$4.01
Max. Negotiated Rate	$4.01
Rate for Payer: Qualcare PPO/HMO/WC	$4.01

SET COLLECTION SYNEVAC 610

Facility

$26.75

Hospital Charge Code	270612228
Hospital Revenue Code	272
Min. Negotiated Rate	$0.76
Max. Negotiated Rate	$13.38
Rate for Payer: Aetna Commercial	$10.16
Rate for Payer: Aetna Medicare Advantage	$8.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.82
Rate for Payer: Cigna Commercial	$13.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.96
Rate for Payer: Oxford Commercial	$5.35
Rate for Payer: Qualcare PPO/HMO/WC	$4.01
Rate for Payer: UnitedHealthcare Commercial	$5.35
Rate for Payer: UnitedHealthcare Community & State	$0.85
Rate for Payer: Wellpoint Medicaid Managed Care	$0.76

SET CONNECTION ACCEL TUBING

Facility

$9.80

Hospital Charge Code	270703866
Hospital Revenue Code	279
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$4.90
Rate for Payer: Aetna Commercial	$3.72
Rate for Payer: Aetna Medicare Advantage	$2.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.50
Rate for Payer: Cigna Commercial	$4.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.55
Rate for Payer: Oxford Commercial	$1.96
Rate for Payer: Qualcare PPO/HMO/WC	$1.47
Rate for Payer: UnitedHealthcare Commercial	$1.96
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.28

SET CONNECTION ACCEL TUBING

Facility

$9.80

Hospital Charge Code	270703866
Hospital Revenue Code	279
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$1.47
Rate for Payer: Qualcare PPO/HMO/WC	$1.47

SET DRILL AND PIN

Facility

$500.00

Hospital Charge Code	270678374
Hospital Revenue Code	272
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$100.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

SET DRILL AND PIN

Facility

$500.00

Hospital Charge Code	270678374
Hospital Revenue Code	272
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SET FLAP REPAIR SINGLE SHOT

Facility

$1,625.00

Hospital Charge Code	270627256
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$393.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

SET FLAP REPAIR SINGLE SHOT

Facility

$1,625.00

Hospital Charge Code	270627256
Hospital Revenue Code	278
Min. Negotiated Rate	$46.15
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$617.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Community & State	$51.35
Rate for Payer: Wellpoint Medicaid Managed Care	$46.15

SET HYPERINFLATION 3L BAG

Facility

$41.25

Hospital Charge Code	270684594
Hospital Revenue Code	272
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$20.62
Rate for Payer: Aetna Commercial	$15.68
Rate for Payer: Aetna Medicare Advantage	$12.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.52
Rate for Payer: Cigna Commercial	$20.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.72
Rate for Payer: Oxford Commercial	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$6.19
Rate for Payer: UnitedHealthcare Commercial	$8.25
Rate for Payer: UnitedHealthcare Community & State	$1.30
Rate for Payer: Wellpoint Medicaid Managed Care	$1.17

SET HYPERINFLATION 3L BAG

Facility

$41.25

Hospital Charge Code	270684594
Hospital Revenue Code	272
Min. Negotiated Rate	$6.19
Max. Negotiated Rate	$6.19
Rate for Payer: Qualcare PPO/HMO/WC	$6.19

SET,INFANT SUCTION

Facility

$16.00

Hospital Charge Code	270331481
Hospital Revenue Code	272
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$8.00
Rate for Payer: Aetna Commercial	$6.08
Rate for Payer: Aetna Medicare Advantage	$4.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.08
Rate for Payer: Cigna Commercial	$8.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.16
Rate for Payer: Oxford Commercial	$3.20
Rate for Payer: Qualcare PPO/HMO/WC	$2.40
Rate for Payer: UnitedHealthcare Commercial	$3.20
Rate for Payer: UnitedHealthcare Community & State	$0.51
Rate for Payer: Wellpoint Medicaid Managed Care	$0.45

SET,INFANT SUCTION

Facility

$16.00

Hospital Charge Code	270331481
Hospital Revenue Code	272
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$2.40

SET INFILTRATION KLEIN S SPIKE

Facility

$75.00

Hospital Charge Code	270703802
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

SET INFILTRATION KLEIN S SPIKE

Facility

$75.00

Hospital Charge Code	270703802
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

SET INTRODUCER CATH VSTICK 5F

Facility

$116.68

Hospital Charge Code	270676899S
Hospital Revenue Code	272
Min. Negotiated Rate	$17.50
Max. Negotiated Rate	$17.50
Rate for Payer: Qualcare PPO/HMO/WC	$17.50

SET INTRODUCER CATH VSTICK 5F

Facility

$116.68

Hospital Charge Code	270676899S
Hospital Revenue Code	272
Min. Negotiated Rate	$3.31
Max. Negotiated Rate	$58.34
Rate for Payer: Aetna Commercial	$44.34
Rate for Payer: Aetna Medicare Advantage	$35.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.75
Rate for Payer: Cigna Commercial	$58.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.34
Rate for Payer: Oxford Commercial	$23.34
Rate for Payer: Qualcare PPO/HMO/WC	$17.50
Rate for Payer: UnitedHealthcare Commercial	$23.34
Rate for Payer: UnitedHealthcare Community & State	$3.69
Rate for Payer: Wellpoint Medicaid Managed Care	$3.31

SET IV FLUID WARMING L-30

Facility

$99.25

Hospital Charge Code	270617134
Hospital Revenue Code	272
Min. Negotiated Rate	$2.82
Max. Negotiated Rate	$49.62
Rate for Payer: Aetna Commercial	$37.72
Rate for Payer: Aetna Medicare Advantage	$29.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.31
Rate for Payer: Cigna Commercial	$49.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.80
Rate for Payer: Oxford Commercial	$19.85
Rate for Payer: Qualcare PPO/HMO/WC	$14.89
Rate for Payer: UnitedHealthcare Commercial	$19.85
Rate for Payer: UnitedHealthcare Community & State	$3.14
Rate for Payer: Wellpoint Medicaid Managed Care	$2.82

SET IV FLUID WARMING L-30

Facility

$99.25

Hospital Charge Code	270617134
Hospital Revenue Code	272
Min. Negotiated Rate	$14.89
Max. Negotiated Rate	$14.89
Rate for Payer: Qualcare PPO/HMO/WC	$14.89

SET JUGGERKNOT 1.4MM SHORT

Facility

$2,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270661171
Hospital Revenue Code	278
Min. Negotiated Rate	$57.51
Max. Negotiated Rate	$1,012.50
Rate for Payer: Aetna Commercial	$769.50
Rate for Payer: Aetna Medicare Advantage	$607.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$516.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$516.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$405.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$516.38
Rate for Payer: Cigna Commercial	$1,012.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$490.05
Rate for Payer: Qualcare PPO/HMO/WC	$303.75
Rate for Payer: UnitedHealthcare Community & State	$63.99
Rate for Payer: Wellpoint Medicaid Managed Care	$57.51

SET JUGGERKNOT 1.4MM SHORT

Facility

$2,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270661171
Hospital Revenue Code	278
Min. Negotiated Rate	$303.75
Max. Negotiated Rate	$490.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$405.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$490.05
Rate for Payer: Qualcare PPO/HMO/WC	$303.75

SET JUGGERNOT SHRT DISP 912073

Facility

$1,930.00

Service Code	HCPCS C1713
Hospital Charge Code	270661170
Hospital Revenue Code	278
Min. Negotiated Rate	$289.50
Max. Negotiated Rate	$467.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$386.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.06
Rate for Payer: Qualcare PPO/HMO/WC	$289.50

SET JUGGERNOT SHRT DISP 912073

Facility

$1,930.00

Service Code	HCPCS C1713
Hospital Charge Code	270661170
Hospital Revenue Code	278
Min. Negotiated Rate	$54.81
Max. Negotiated Rate	$965.00
Rate for Payer: Aetna Commercial	$733.40
Rate for Payer: Aetna Medicare Advantage	$579.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$492.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$492.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$492.15
Rate for Payer: Cigna Commercial	$965.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.06
Rate for Payer: Qualcare PPO/HMO/WC	$289.50
Rate for Payer: UnitedHealthcare Community & State	$60.99
Rate for Payer: Wellpoint Medicaid Managed Care	$54.81

SET KANGAROO ENTERAL PU

Facility

$22.80

Hospital Charge Code	270301932
Hospital Revenue Code	270
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$11.40
Rate for Payer: Aetna Commercial	$8.66
Rate for Payer: Aetna Medicare Advantage	$6.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.81
Rate for Payer: Cigna Commercial	$11.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.93
Rate for Payer: Oxford Commercial	$4.56
Rate for Payer: Qualcare PPO/HMO/WC	$3.42
Rate for Payer: UnitedHealthcare Commercial	$4.56
Rate for Payer: UnitedHealthcare Community & State	$0.72
Rate for Payer: Wellpoint Medicaid Managed Care	$0.65

SET KANGAROO ENTERAL PU

Facility

$22.80

Hospital Charge Code	270301932
Hospital Revenue Code	270
Min. Negotiated Rate	$3.42
Max. Negotiated Rate	$3.42
Rate for Payer: Qualcare PPO/HMO/WC	$3.42

SET LIVER TRANSJUGULAR ROSCH

Facility

$2,262.00

Hospital Charge Code	270686621
Hospital Revenue Code	272
Min. Negotiated Rate	$339.30
Max. Negotiated Rate	$339.30
Rate for Payer: Qualcare PPO/HMO/WC	$339.30

Know your out-of-pocket cost for care.

All Charges