Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SLEEVES SCD MEDIUM 358005330

Facility

$44.84

Hospital Charge Code	270301505
Hospital Revenue Code	272
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$22.42
Rate for Payer: Aetna Commercial	$17.04
Rate for Payer: Aetna Medicare Advantage	$13.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.43
Rate for Payer: Cigna Commercial	$22.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.66
Rate for Payer: Oxford Commercial	$8.97
Rate for Payer: Qualcare PPO/HMO/WC	$6.73
Rate for Payer: UnitedHealthcare Commercial	$8.97
Rate for Payer: UnitedHealthcare Community & State	$1.42
Rate for Payer: Wellpoint Medicaid Managed Care	$1.27

SLEEVES SCD MEDIUM 358005330

Facility

$44.84

Hospital Charge Code	270301505
Hospital Revenue Code	272
Min. Negotiated Rate	$6.73
Max. Negotiated Rate	$6.73
Rate for Payer: Qualcare PPO/HMO/WC	$6.73

SLEEVE STABILITY 5Dx100L CB5LT

Facility

$80.00

Hospital Charge Code	270641083
Hospital Revenue Code	272
Min. Negotiated Rate	$2.27
Max. Negotiated Rate	$40.00
Rate for Payer: Aetna Commercial	$30.40
Rate for Payer: Aetna Medicare Advantage	$24.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.40
Rate for Payer: Cigna Commercial	$40.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.80
Rate for Payer: Oxford Commercial	$16.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00
Rate for Payer: UnitedHealthcare Commercial	$16.00
Rate for Payer: UnitedHealthcare Community & State	$2.53
Rate for Payer: Wellpoint Medicaid Managed Care	$2.27

SLEEVE STABILITY 5Dx100L CB5LT

Facility

$80.00

Hospital Charge Code	270641083
Hospital Revenue Code	272
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00

SLEEVE STABILITY XCEL 5mm

Facility

$381.90

Hospital Charge Code	270655638
Hospital Revenue Code	271
Min. Negotiated Rate	$10.85
Max. Negotiated Rate	$190.95
Rate for Payer: Aetna Commercial	$145.12
Rate for Payer: Aetna Medicare Advantage	$114.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.38
Rate for Payer: Cigna Commercial	$190.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.29
Rate for Payer: Oxford Commercial	$76.38
Rate for Payer: Qualcare PPO/HMO/WC	$57.28
Rate for Payer: UnitedHealthcare Commercial	$76.38
Rate for Payer: UnitedHealthcare Community & State	$12.07
Rate for Payer: Wellpoint Medicaid Managed Care	$10.85

SLEEVE STABILITY XCEL 5mm

Facility

$381.90

Hospital Charge Code	270655638
Hospital Revenue Code	271
Min. Negotiated Rate	$57.28
Max. Negotiated Rate	$57.28
Rate for Payer: Qualcare PPO/HMO/WC	$57.28

SLEEVE SUCTION 165 MM

Facility

$207.40

Hospital Charge Code	270689275
Hospital Revenue Code	272
Min. Negotiated Rate	$5.89
Max. Negotiated Rate	$103.70
Rate for Payer: Aetna Commercial	$78.81
Rate for Payer: Aetna Medicare Advantage	$62.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.89
Rate for Payer: Cigna Commercial	$103.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.92
Rate for Payer: Oxford Commercial	$41.48
Rate for Payer: Qualcare PPO/HMO/WC	$31.11
Rate for Payer: UnitedHealthcare Commercial	$41.48
Rate for Payer: UnitedHealthcare Community & State	$6.55
Rate for Payer: Wellpoint Medicaid Managed Care	$5.89

SLEEVE SUCTION 165 MM

Facility

$207.40

Hospital Charge Code	270689275
Hospital Revenue Code	272
Min. Negotiated Rate	$31.11
Max. Negotiated Rate	$31.11
Rate for Payer: Qualcare PPO/HMO/WC	$31.11

SLEEVE SWAN GANZ

Facility

$34.30

Hospital Charge Code	270661619S
Hospital Revenue Code	272
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$17.15
Rate for Payer: Aetna Commercial	$13.03
Rate for Payer: Aetna Medicare Advantage	$10.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.75
Rate for Payer: Cigna Commercial	$17.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.92
Rate for Payer: Oxford Commercial	$6.86
Rate for Payer: Qualcare PPO/HMO/WC	$5.14
Rate for Payer: UnitedHealthcare Commercial	$6.86
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$0.97

SLEEVE SWAN GANZ

Facility

$34.30

Hospital Charge Code	270661619
Hospital Revenue Code	272
Min. Negotiated Rate	$5.14
Max. Negotiated Rate	$5.14
Rate for Payer: Qualcare PPO/HMO/WC	$5.14

SLEEVE SWAN GANZ

Facility

$34.30

Hospital Charge Code	270661619
Hospital Revenue Code	272
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$17.15
Rate for Payer: Aetna Commercial	$13.03
Rate for Payer: Aetna Medicare Advantage	$10.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.75
Rate for Payer: Cigna Commercial	$17.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.92
Rate for Payer: Oxford Commercial	$6.86
Rate for Payer: Qualcare PPO/HMO/WC	$5.14
Rate for Payer: UnitedHealthcare Commercial	$6.86
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$0.97

SLEEVE SWAN GANZ

Facility

$34.30

Hospital Charge Code	270661619N
Hospital Revenue Code	272
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$17.15
Rate for Payer: Aetna Commercial	$13.03
Rate for Payer: Aetna Medicare Advantage	$10.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.75
Rate for Payer: Cigna Commercial	$17.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.92
Rate for Payer: Oxford Commercial	$6.86
Rate for Payer: Qualcare PPO/HMO/WC	$5.14
Rate for Payer: UnitedHealthcare Commercial	$6.86
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$0.97

SLEEVE SWAN GANZ

Facility

$34.30

Hospital Charge Code	270661619S
Hospital Revenue Code	272
Min. Negotiated Rate	$5.14
Max. Negotiated Rate	$5.14
Rate for Payer: Qualcare PPO/HMO/WC	$5.14

SLEEVE SWAN GANZ

Facility

$34.30

Hospital Charge Code	270661619N
Hospital Revenue Code	272
Min. Negotiated Rate	$5.14
Max. Negotiated Rate	$5.14
Rate for Payer: Qualcare PPO/HMO/WC	$5.14

SLEEVE TIBIA MOD PROX OSS 30

Facility

$19,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697009
Hospital Revenue Code	278
Min. Negotiated Rate	$553.80
Max. Negotiated Rate	$9,750.00
Rate for Payer: Aetna Commercial	$7,410.00
Rate for Payer: Aetna Medicare Advantage	$5,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,972.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,972.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,972.50
Rate for Payer: Cigna Commercial	$9,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,719.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,925.00
Rate for Payer: UnitedHealthcare Community & State	$616.20
Rate for Payer: Wellpoint Medicaid Managed Care	$553.80

SLEEVE TIBIA MOD PROX OSS 30

Facility

$19,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697009
Hospital Revenue Code	278
Min. Negotiated Rate	$2,925.00
Max. Negotiated Rate	$4,719.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,719.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,925.00

SLEEVE TROCAR XCEL STABIL 12MM

Facility

$90.00

Hospital Charge Code	270641082
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

SLEEVE TROCAR XCEL STABIL 12MM

Facility

$90.00

Hospital Charge Code	270641082
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

SLEEVE UNIPOLAR L-SERIES +0MM

Facility

$1,625.00

Service Code	HCPCS C1776
Hospital Charge Code	270677229
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

SLEEVE UNIPOLAR L-SERIES +0MM

Facility

$1,625.00

Service Code	HCPCS C1776
Hospital Charge Code	270677229
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

SLEEVE VENODYNE STANDARD

Facility

$202.96

Hospital Charge Code	270653362
Hospital Revenue Code	272
Min. Negotiated Rate	$30.44
Max. Negotiated Rate	$30.44
Rate for Payer: Qualcare PPO/HMO/WC	$30.44

SLEEVE VENODYNE STANDARD

Facility

$202.96

Hospital Charge Code	270653362
Hospital Revenue Code	272
Min. Negotiated Rate	$5.76
Max. Negotiated Rate	$101.48
Rate for Payer: Aetna Commercial	$77.12
Rate for Payer: Aetna Medicare Advantage	$60.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.75
Rate for Payer: Cigna Commercial	$101.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.77
Rate for Payer: Oxford Commercial	$40.59
Rate for Payer: Qualcare PPO/HMO/WC	$30.44
Rate for Payer: UnitedHealthcare Commercial	$40.59
Rate for Payer: UnitedHealthcare Community & State	$6.41
Rate for Payer: Wellpoint Medicaid Managed Care	$5.76

SLIMLINE FIBER LUMENIS 365

Facility

$2,018.75

Hospital Charge Code	270659482
Hospital Revenue Code	270
Min. Negotiated Rate	$57.33
Max. Negotiated Rate	$1,009.38
Rate for Payer: Aetna Commercial	$767.12
Rate for Payer: Aetna Medicare Advantage	$605.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$514.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$514.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$514.78
Rate for Payer: Cigna Commercial	$1,009.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$524.88
Rate for Payer: Oxford Commercial	$403.75
Rate for Payer: Qualcare PPO/HMO/WC	$302.81
Rate for Payer: UnitedHealthcare Commercial	$403.75
Rate for Payer: UnitedHealthcare Community & State	$63.79
Rate for Payer: Wellpoint Medicaid Managed Care	$57.33

SLIMLINE FIBER LUMENIS 365

Facility

$2,018.75

Hospital Charge Code	270659482
Hospital Revenue Code	270
Min. Negotiated Rate	$302.81
Max. Negotiated Rate	$302.81
Rate for Payer: Qualcare PPO/HMO/WC	$302.81

SLIMLINE LASER FIBER LEMENIS

Facility

$4,462.50

Hospital Charge Code	270659488
Hospital Revenue Code	270
Min. Negotiated Rate	$669.38
Max. Negotiated Rate	$669.38
Rate for Payer: Qualcare PPO/HMO/WC	$669.38

Know your out-of-pocket cost for care.

All Charges