Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

STAPLE MEMOFIX 25x22x22MM

Facility

$7,980.00

Hospital Charge Code	270674853
Hospital Revenue Code	272
Min. Negotiated Rate	$1,197.00
Max. Negotiated Rate	$1,197.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,197.00

STAPLE MEMOFIX 25x22x22MM

Facility

$7,980.00

Hospital Charge Code	270674853
Hospital Revenue Code	272
Min. Negotiated Rate	$226.63
Max. Negotiated Rate	$3,990.00
Rate for Payer: Aetna Commercial	$3,032.40
Rate for Payer: Aetna Medicare Advantage	$2,394.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,034.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,034.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,034.90
Rate for Payer: Cigna Commercial	$3,990.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,074.80
Rate for Payer: Oxford Commercial	$1,596.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,197.00
Rate for Payer: UnitedHealthcare Commercial	$1,596.00
Rate for Payer: UnitedHealthcare Community & State	$252.17
Rate for Payer: Wellpoint Medicaid Managed Care	$226.63

STAPLE MEMOSTEP 2MM OFFSET

Facility

$10,605.00

Hospital Charge Code	270671587
Hospital Revenue Code	272
Min. Negotiated Rate	$1,590.75
Max. Negotiated Rate	$1,590.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,590.75

STAPLE MEMOSTEP 2MM OFFSET

Facility

$10,605.00

Hospital Charge Code	270671587
Hospital Revenue Code	272
Min. Negotiated Rate	$301.18
Max. Negotiated Rate	$5,302.50
Rate for Payer: Aetna Commercial	$4,029.90
Rate for Payer: Aetna Medicare Advantage	$3,181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,704.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,704.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,704.28
Rate for Payer: Cigna Commercial	$5,302.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,757.30
Rate for Payer: Oxford Commercial	$2,121.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,590.75
Rate for Payer: UnitedHealthcare Commercial	$2,121.00
Rate for Payer: UnitedHealthcare Community & State	$335.12
Rate for Payer: Wellpoint Medicaid Managed Care	$301.18

STAPLEMOTOCLIPMAXFIX9X9X9MM

Facility

$10,470.00

Service Code	HCPCS C1713
Hospital Charge Code	270687543
Hospital Revenue Code	278
Min. Negotiated Rate	$297.35
Max. Negotiated Rate	$5,235.00
Rate for Payer: Aetna Commercial	$3,978.60
Rate for Payer: Aetna Medicare Advantage	$3,141.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,669.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,669.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,094.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,669.85
Rate for Payer: Cigna Commercial	$5,235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,533.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,570.50
Rate for Payer: UnitedHealthcare Community & State	$330.85
Rate for Payer: Wellpoint Medicaid Managed Care	$297.35

STAPLEMOTOCLIPMAXFIX9X9X9MM

Facility

$10,470.00

Service Code	HCPCS C1713
Hospital Charge Code	270687543
Hospital Revenue Code	278
Min. Negotiated Rate	$1,570.50
Max. Negotiated Rate	$2,533.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,094.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,533.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,570.50

STAPLE NITINOL FUSEFORCE 8X8MM

Facility

$6,555.00

Service Code	HCPCS C1713
Hospital Charge Code	270698995
Hospital Revenue Code	278
Min. Negotiated Rate	$186.16
Max. Negotiated Rate	$3,277.50
Rate for Payer: Aetna Commercial	$2,490.90
Rate for Payer: Aetna Medicare Advantage	$1,966.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,671.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,671.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,311.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,671.53
Rate for Payer: Cigna Commercial	$3,277.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,586.31
Rate for Payer: Qualcare PPO/HMO/WC	$983.25
Rate for Payer: UnitedHealthcare Community & State	$207.14
Rate for Payer: Wellpoint Medicaid Managed Care	$186.16

STAPLE NITINOL FUSEFORCE 8X8MM

Facility

$6,555.00

Service Code	HCPCS C1713
Hospital Charge Code	270698995
Hospital Revenue Code	278
Min. Negotiated Rate	$983.25
Max. Negotiated Rate	$1,586.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,311.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,586.31
Rate for Payer: Qualcare PPO/HMO/WC	$983.25

STAPLER

Facility

$4,475.00

Hospital Charge Code	270656975
Hospital Revenue Code	272
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$671.25
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

STAPLER

Facility

$4,475.00

Hospital Charge Code	270656975
Hospital Revenue Code	272
Min. Negotiated Rate	$127.09
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,700.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,163.50
Rate for Payer: Oxford Commercial	$895.00
Rate for Payer: Qualcare PPO/HMO/WC	$671.25
Rate for Payer: UnitedHealthcare Commercial	$895.00
Rate for Payer: UnitedHealthcare Community & State	$141.41
Rate for Payer: Wellpoint Medicaid Managed Care	$127.09

STAPLER 106MM H 3.8MM

Facility

$1,250.30

Hospital Charge Code	270697918
Hospital Revenue Code	272
Min. Negotiated Rate	$187.54
Max. Negotiated Rate	$187.54
Rate for Payer: Qualcare PPO/HMO/WC	$187.54

STAPLER 106MM H 3.8MM

Facility

$1,250.30

Hospital Charge Code	270697918
Hospital Revenue Code	272
Min. Negotiated Rate	$35.51
Max. Negotiated Rate	$625.15
Rate for Payer: Aetna Commercial	$475.11
Rate for Payer: Aetna Medicare Advantage	$375.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.83
Rate for Payer: Cigna Commercial	$625.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$325.08
Rate for Payer: Oxford Commercial	$250.06
Rate for Payer: Qualcare PPO/HMO/WC	$187.54
Rate for Payer: UnitedHealthcare Commercial	$250.06
Rate for Payer: UnitedHealthcare Community & State	$39.51
Rate for Payer: Wellpoint Medicaid Managed Care	$35.51

STAPLER 25MM SINGLE USE

Facility

$1,434.02

Hospital Charge Code	270658622
Hospital Revenue Code	272
Min. Negotiated Rate	$40.73
Max. Negotiated Rate	$717.01
Rate for Payer: Aetna Commercial	$544.93
Rate for Payer: Aetna Medicare Advantage	$430.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$365.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$365.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$365.68
Rate for Payer: Cigna Commercial	$717.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.85
Rate for Payer: Oxford Commercial	$286.80
Rate for Payer: Qualcare PPO/HMO/WC	$215.10
Rate for Payer: UnitedHealthcare Commercial	$286.80
Rate for Payer: UnitedHealthcare Community & State	$45.32
Rate for Payer: Wellpoint Medicaid Managed Care	$40.73

STAPLER 25MM SINGLE USE

Facility

$1,434.02

Hospital Charge Code	270658622
Hospital Revenue Code	272
Min. Negotiated Rate	$215.10
Max. Negotiated Rate	$215.10
Rate for Payer: Qualcare PPO/HMO/WC	$215.10

STAPLER 25MM USE W/3.5MM SNGL

Facility

$1,829.63

Hospital Charge Code	270641794
Hospital Revenue Code	272
Min. Negotiated Rate	$51.96
Max. Negotiated Rate	$914.82
Rate for Payer: Aetna Commercial	$695.26
Rate for Payer: Aetna Medicare Advantage	$548.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$466.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$466.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$466.56
Rate for Payer: Cigna Commercial	$914.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$475.70
Rate for Payer: Oxford Commercial	$365.93
Rate for Payer: Qualcare PPO/HMO/WC	$274.44
Rate for Payer: UnitedHealthcare Commercial	$365.93
Rate for Payer: UnitedHealthcare Community & State	$57.82
Rate for Payer: Wellpoint Medicaid Managed Care	$51.96

STAPLER 25MM USE W/3.5MM SNGL

Facility

$1,829.63

Hospital Charge Code	270641794
Hospital Revenue Code	272
Min. Negotiated Rate	$274.44
Max. Negotiated Rate	$274.44
Rate for Payer: Qualcare PPO/HMO/WC	$274.44

STAPLER 28MM SINGLE USE

Facility

$1,434.02

Hospital Charge Code	270641888
Hospital Revenue Code	272
Min. Negotiated Rate	$215.10
Max. Negotiated Rate	$215.10
Rate for Payer: Qualcare PPO/HMO/WC	$215.10

STAPLER 28MM SINGLE USE

Facility

$1,434.02

Hospital Charge Code	270641888
Hospital Revenue Code	272
Min. Negotiated Rate	$40.73
Max. Negotiated Rate	$717.01
Rate for Payer: Aetna Commercial	$544.93
Rate for Payer: Aetna Medicare Advantage	$430.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$365.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$365.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$365.68
Rate for Payer: Cigna Commercial	$717.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.85
Rate for Payer: Oxford Commercial	$286.80
Rate for Payer: Qualcare PPO/HMO/WC	$215.10
Rate for Payer: UnitedHealthcare Commercial	$286.80
Rate for Payer: UnitedHealthcare Community & State	$45.32
Rate for Payer: Wellpoint Medicaid Managed Care	$40.73

STAPLER 33MM SINGLE USE

Facility

$1,577.43

Hospital Charge Code	270668368
Hospital Revenue Code	272
Min. Negotiated Rate	$236.61
Max. Negotiated Rate	$236.61
Rate for Payer: Qualcare PPO/HMO/WC	$236.61

STAPLER 33MM SINGLE USE

Facility

$1,577.43

Hospital Charge Code	270668368
Hospital Revenue Code	272
Min. Negotiated Rate	$44.80
Max. Negotiated Rate	$788.72
Rate for Payer: Aetna Commercial	$599.42
Rate for Payer: Aetna Medicare Advantage	$473.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$402.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$402.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$402.24
Rate for Payer: Cigna Commercial	$788.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$410.13
Rate for Payer: Oxford Commercial	$315.49
Rate for Payer: Qualcare PPO/HMO/WC	$236.61
Rate for Payer: UnitedHealthcare Commercial	$315.49
Rate for Payer: UnitedHealthcare Community & State	$49.85
Rate for Payer: Wellpoint Medicaid Managed Care	$44.80

STAPLER 45 BLUE RELOAD ENDO

Facility

$900.00

Hospital Charge Code	270674977
Hospital Revenue Code	272
Min. Negotiated Rate	$25.56
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.00
Rate for Payer: Oxford Commercial	$180.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Commercial	$180.00
Rate for Payer: UnitedHealthcare Community & State	$28.44
Rate for Payer: Wellpoint Medicaid Managed Care	$25.56

STAPLER 45 BLUE RELOAD ENDO

Facility

$900.00

Hospital Charge Code	270674977
Hospital Revenue Code	272
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$135.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

STAPLER 45 GREEN RELOAD ENDO

Facility

$900.00

Hospital Charge Code	270674976
Hospital Revenue Code	272
Min. Negotiated Rate	$25.56
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.00
Rate for Payer: Oxford Commercial	$180.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Commercial	$180.00
Rate for Payer: UnitedHealthcare Community & State	$28.44
Rate for Payer: Wellpoint Medicaid Managed Care	$25.56

STAPLER 45 GREEN RELOAD ENDO

Facility

$900.00

Hospital Charge Code	270674976
Hospital Revenue Code	272
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$135.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

STAPLER 45 INSTRUMENT ENDO

Facility

$35,000.00

Hospital Charge Code	270674974
Hospital Revenue Code	272
Min. Negotiated Rate	$5,250.00
Max. Negotiated Rate	$5,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,250.00

Know your out-of-pocket cost for care.

All Charges