Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SHEATH URETERAL ACCESS 12FRx35

Facility

$247.50

Hospital Charge Code	270639289
Hospital Revenue Code	272
Min. Negotiated Rate	$7.03
Max. Negotiated Rate	$123.75
Rate for Payer: Aetna Commercial	$94.05
Rate for Payer: Aetna Medicare Advantage	$74.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.11
Rate for Payer: Cigna Commercial	$123.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.35
Rate for Payer: Oxford Commercial	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.12
Rate for Payer: UnitedHealthcare Commercial	$49.50
Rate for Payer: UnitedHealthcare Community & State	$7.82
Rate for Payer: Wellpoint Medicaid Managed Care	$7.03

SHEATH W/HYDROPHILIC COAT 12FR

Facility

$1,300.00

Hospital Charge Code	270663540
Hospital Revenue Code	278
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$314.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.60
Rate for Payer: Qualcare PPO/HMO/WC	$195.00

SHEATH W/HYDROPHILIC COAT 12FR

Facility

$1,300.00

Hospital Charge Code	270663540
Hospital Revenue Code	278
Min. Negotiated Rate	$36.92
Max. Negotiated Rate	$650.00
Rate for Payer: Aetna Commercial	$494.00
Rate for Payer: Aetna Medicare Advantage	$390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$331.50
Rate for Payer: Cigna Commercial	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.60
Rate for Payer: Qualcare PPO/HMO/WC	$195.00
Rate for Payer: UnitedHealthcare Community & State	$41.08
Rate for Payer: Wellpoint Medicaid Managed Care	$36.92

SHEET ANGIOGRAPHIC FEMORAL

Facility

$32.75

Hospital Charge Code	270649504S
Hospital Revenue Code	272
Min. Negotiated Rate	$4.91
Max. Negotiated Rate	$4.91
Rate for Payer: Qualcare PPO/HMO/WC	$4.91

SHEET ANGIOGRAPHIC FEMORAL

Facility

$35.08

Hospital Charge Code	270649504N
Hospital Revenue Code	272
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$17.54
Rate for Payer: Aetna Commercial	$13.33
Rate for Payer: Aetna Medicare Advantage	$10.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.95
Rate for Payer: Cigna Commercial	$17.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.12
Rate for Payer: Oxford Commercial	$7.02
Rate for Payer: Qualcare PPO/HMO/WC	$5.26
Rate for Payer: UnitedHealthcare Commercial	$7.02
Rate for Payer: UnitedHealthcare Community & State	$1.11
Rate for Payer: Wellpoint Medicaid Managed Care	$1.00

SHEET ANGIOGRAPHIC FEMORAL

Facility

$32.75

Hospital Charge Code	270649504S
Hospital Revenue Code	272
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$16.38
Rate for Payer: Aetna Commercial	$12.45
Rate for Payer: Aetna Medicare Advantage	$9.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.35
Rate for Payer: Cigna Commercial	$16.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.52
Rate for Payer: Oxford Commercial	$6.55
Rate for Payer: Qualcare PPO/HMO/WC	$4.91
Rate for Payer: UnitedHealthcare Commercial	$6.55
Rate for Payer: UnitedHealthcare Community & State	$1.03
Rate for Payer: Wellpoint Medicaid Managed Care	$0.93

SHEET ANGIOGRAPHIC FEMORAL

Facility

$32.75

Hospital Charge Code	270649504
Hospital Revenue Code	272
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$16.38
Rate for Payer: Aetna Commercial	$12.45
Rate for Payer: Aetna Medicare Advantage	$9.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.35
Rate for Payer: Cigna Commercial	$16.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.52
Rate for Payer: Oxford Commercial	$6.55
Rate for Payer: Qualcare PPO/HMO/WC	$4.91
Rate for Payer: UnitedHealthcare Commercial	$6.55
Rate for Payer: UnitedHealthcare Community & State	$1.03
Rate for Payer: Wellpoint Medicaid Managed Care	$0.93

SHEET ANGIOGRAPHIC FEMORAL

Facility

$35.08

Hospital Charge Code	270649504N
Hospital Revenue Code	272
Min. Negotiated Rate	$5.26
Max. Negotiated Rate	$5.26
Rate for Payer: Qualcare PPO/HMO/WC	$5.26

SHEET ANGIOGRAPHIC FEMORAL

Facility

$32.75

Hospital Charge Code	270649504
Hospital Revenue Code	272
Min. Negotiated Rate	$4.91
Max. Negotiated Rate	$4.91
Rate for Payer: Qualcare PPO/HMO/WC	$4.91

SHEET BIL LIMB 89291

Facility

$46.45

Hospital Charge Code	270608981
Hospital Revenue Code	272
Min. Negotiated Rate	$1.32
Max. Negotiated Rate	$23.23
Rate for Payer: Aetna Commercial	$17.65
Rate for Payer: Aetna Medicare Advantage	$13.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.84
Rate for Payer: Cigna Commercial	$23.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.08
Rate for Payer: Oxford Commercial	$9.29
Rate for Payer: Qualcare PPO/HMO/WC	$6.97
Rate for Payer: UnitedHealthcare Commercial	$9.29
Rate for Payer: UnitedHealthcare Community & State	$1.47
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

SHEET BIL LIMB 89291

Facility

$46.45

Hospital Charge Code	270608981
Hospital Revenue Code	272
Min. Negotiated Rate	$6.97
Max. Negotiated Rate	$6.97
Rate for Payer: Qualcare PPO/HMO/WC	$6.97

SHEET CONFORM QPACK 45x20x7mm

Facility

$11,550.00

Hospital Charge Code	270665698
Hospital Revenue Code	272
Min. Negotiated Rate	$328.02
Max. Negotiated Rate	$5,775.00
Rate for Payer: Aetna Commercial	$4,389.00
Rate for Payer: Aetna Medicare Advantage	$3,465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,945.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,945.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,945.25
Rate for Payer: Cigna Commercial	$5,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,003.00
Rate for Payer: Oxford Commercial	$2,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,732.50
Rate for Payer: UnitedHealthcare Commercial	$2,310.00
Rate for Payer: UnitedHealthcare Community & State	$364.98
Rate for Payer: Wellpoint Medicaid Managed Care	$328.02

SHEET CONFORM QPACK 45x20x7mm

Facility

$11,550.00

Hospital Charge Code	270665698
Hospital Revenue Code	272
Min. Negotiated Rate	$1,732.50
Max. Negotiated Rate	$1,732.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,732.50

SHEET EXTREMITY W/ISO BAC

Facility

$27.73

Hospital Charge Code	270654100
Hospital Revenue Code	270
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$13.87
Rate for Payer: Aetna Commercial	$10.54
Rate for Payer: Aetna Medicare Advantage	$8.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.07
Rate for Payer: Cigna Commercial	$13.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.21
Rate for Payer: Oxford Commercial	$5.55
Rate for Payer: Qualcare PPO/HMO/WC	$4.16
Rate for Payer: UnitedHealthcare Commercial	$5.55
Rate for Payer: UnitedHealthcare Community & State	$0.88
Rate for Payer: Wellpoint Medicaid Managed Care	$0.79

SHEET EXTREMITY W/ISO BAC

Facility

$27.73

Hospital Charge Code	270654100
Hospital Revenue Code	270
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$4.16
Rate for Payer: Qualcare PPO/HMO/WC	$4.16

SHEETH 11 CM

Facility

$512.05

Hospital Charge Code	270662667
Hospital Revenue Code	270
Min. Negotiated Rate	$76.81
Max. Negotiated Rate	$76.81
Rate for Payer: Qualcare PPO/HMO/WC	$76.81

SHEETH 11 CM

Facility

$512.05

Hospital Charge Code	270662667
Hospital Revenue Code	270
Min. Negotiated Rate	$14.54
Max. Negotiated Rate	$256.02
Rate for Payer: Aetna Commercial	$194.58
Rate for Payer: Aetna Medicare Advantage	$153.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.57
Rate for Payer: Cigna Commercial	$256.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.13
Rate for Payer: Oxford Commercial	$102.41
Rate for Payer: Qualcare PPO/HMO/WC	$76.81
Rate for Payer: UnitedHealthcare Commercial	$102.41
Rate for Payer: UnitedHealthcare Community & State	$16.18
Rate for Payer: Wellpoint Medicaid Managed Care	$14.54

SHEETING SILICON 2x2x1mm

Facility

$101.00

Hospital Charge Code	270640675
Hospital Revenue Code	272
Min. Negotiated Rate	$2.87
Max. Negotiated Rate	$50.50
Rate for Payer: Aetna Commercial	$38.38
Rate for Payer: Aetna Medicare Advantage	$30.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.75
Rate for Payer: Cigna Commercial	$50.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.26
Rate for Payer: Oxford Commercial	$20.20
Rate for Payer: Qualcare PPO/HMO/WC	$15.15
Rate for Payer: UnitedHealthcare Commercial	$20.20
Rate for Payer: UnitedHealthcare Community & State	$3.19
Rate for Payer: Wellpoint Medicaid Managed Care	$2.87

SHEETING SILICON 2x2x1mm

Facility

$101.00

Hospital Charge Code	270640675
Hospital Revenue Code	272
Min. Negotiated Rate	$15.15
Max. Negotiated Rate	$15.15
Rate for Payer: Qualcare PPO/HMO/WC	$15.15

SHEET LAP PEDIATRIC

Facility

$20.27

Hospital Charge Code	270649506
Hospital Revenue Code	272
Min. Negotiated Rate	$3.04
Max. Negotiated Rate	$3.04
Rate for Payer: Qualcare PPO/HMO/WC	$3.04

SHEET LAP PEDIATRIC

Facility

$20.27

Hospital Charge Code	270649506
Hospital Revenue Code	272
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$10.13
Rate for Payer: Aetna Commercial	$7.70
Rate for Payer: Aetna Medicare Advantage	$6.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.17
Rate for Payer: Cigna Commercial	$10.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.27
Rate for Payer: Oxford Commercial	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$3.04
Rate for Payer: UnitedHealthcare Commercial	$4.05
Rate for Payer: UnitedHealthcare Community & State	$0.64
Rate for Payer: Wellpoint Medicaid Managed Care	$0.58

SHELL3 HOLE 50MM

Facility

$15,720.00

Service Code	HCPCS C1713
Hospital Charge Code	270688361
Hospital Revenue Code	278
Min. Negotiated Rate	$446.45
Max. Negotiated Rate	$7,860.00
Rate for Payer: Aetna Commercial	$5,973.60
Rate for Payer: Aetna Medicare Advantage	$4,716.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,008.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,008.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,144.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,008.60
Rate for Payer: Cigna Commercial	$7,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,804.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,358.00
Rate for Payer: UnitedHealthcare Community & State	$496.75
Rate for Payer: Wellpoint Medicaid Managed Care	$446.45

SHELL3 HOLE 50MM

Facility

$15,720.00

Service Code	HCPCS C1713
Hospital Charge Code	270688361
Hospital Revenue Code	278
Min. Negotiated Rate	$2,358.00
Max. Negotiated Rate	$3,804.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,144.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,804.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,358.00

SHELL 3 HOLE G7 FINNED 52E

Facility

$6,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270680806
Hospital Revenue Code	278
Min. Negotiated Rate	$184.60
Max. Negotiated Rate	$3,250.00
Rate for Payer: Aetna Commercial	$2,470.00
Rate for Payer: Aetna Medicare Advantage	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,657.50
Rate for Payer: Cigna Commercial	$3,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00
Rate for Payer: UnitedHealthcare Community & State	$205.40
Rate for Payer: Wellpoint Medicaid Managed Care	$184.60

SHELL 3 HOLE G7 FINNED 52E

Facility

$6,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270680806
Hospital Revenue Code	278
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$1,573.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00

Know your out-of-pocket cost for care.

All Charges