Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BALLOON U/TH DIAMOND 12x2x75cm

Facility

$857.50

Hospital Charge Code	270630611
Hospital Revenue Code	278
Min. Negotiated Rate	$128.62
Max. Negotiated Rate	$207.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: Qualcare PPO/HMO/WC	$128.62

BALLOON U/TH DIAMOND 12x2x75cm

Facility

$857.50

Hospital Charge Code	270630611
Hospital Revenue Code	278
Min. Negotiated Rate	$24.35
Max. Negotiated Rate	$428.75
Rate for Payer: Aetna Commercial	$325.85
Rate for Payer: Aetna Medicare Advantage	$257.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$218.66
Rate for Payer: Cigna Commercial	$428.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: Qualcare PPO/HMO/WC	$128.62
Rate for Payer: UnitedHealthcare Community & State	$27.10
Rate for Payer: Wellpoint Medicaid Managed Care	$24.35

BALLOON U/TH DIAMOND 4x4x75cm

Facility

$857.50

Hospital Charge Code	270618561
Hospital Revenue Code	278
Min. Negotiated Rate	$128.62
Max. Negotiated Rate	$207.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: Qualcare PPO/HMO/WC	$128.62

BALLOON U/TH DIAMOND 4x4x75cm

Facility

$857.50

Hospital Charge Code	270618561
Hospital Revenue Code	278
Min. Negotiated Rate	$24.35
Max. Negotiated Rate	$428.75
Rate for Payer: Aetna Commercial	$325.85
Rate for Payer: Aetna Medicare Advantage	$257.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$218.66
Rate for Payer: Cigna Commercial	$428.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: Qualcare PPO/HMO/WC	$128.62
Rate for Payer: UnitedHealthcare Community & State	$27.10
Rate for Payer: Wellpoint Medicaid Managed Care	$24.35

BALLOON U/TH DIAMOND 5x2x75cm

Facility

$857.50

Hospital Charge Code	270628314
Hospital Revenue Code	278
Min. Negotiated Rate	$128.62
Max. Negotiated Rate	$207.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: Qualcare PPO/HMO/WC	$128.62

BALLOON U/TH DIAMOND 5x2x75cm

Facility

$857.50

Hospital Charge Code	270628314
Hospital Revenue Code	278
Min. Negotiated Rate	$24.35
Max. Negotiated Rate	$428.75
Rate for Payer: Aetna Commercial	$325.85
Rate for Payer: Aetna Medicare Advantage	$257.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$218.66
Rate for Payer: Cigna Commercial	$428.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: Qualcare PPO/HMO/WC	$128.62
Rate for Payer: UnitedHealthcare Community & State	$27.10
Rate for Payer: Wellpoint Medicaid Managed Care	$24.35

BALLOON U/TH DIAMOND 5x4x75cm

Facility

$857.50

Hospital Charge Code	270618562
Hospital Revenue Code	278
Min. Negotiated Rate	$128.62
Max. Negotiated Rate	$207.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: Qualcare PPO/HMO/WC	$128.62

BALLOON U/TH DIAMOND 5x4x75cm

Facility

$857.50

Hospital Charge Code	270618562
Hospital Revenue Code	278
Min. Negotiated Rate	$24.35
Max. Negotiated Rate	$428.75
Rate for Payer: Aetna Commercial	$325.85
Rate for Payer: Aetna Medicare Advantage	$257.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$218.66
Rate for Payer: Cigna Commercial	$428.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: Qualcare PPO/HMO/WC	$128.62
Rate for Payer: UnitedHealthcare Community & State	$27.10
Rate for Payer: Wellpoint Medicaid Managed Care	$24.35

BALLOON U/TH DIAMOND 6x2x75cm

Facility

$857.50

Hospital Charge Code	270629350
Hospital Revenue Code	278
Min. Negotiated Rate	$24.35
Max. Negotiated Rate	$428.75
Rate for Payer: Aetna Commercial	$325.85
Rate for Payer: Aetna Medicare Advantage	$257.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$218.66
Rate for Payer: Cigna Commercial	$428.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: Qualcare PPO/HMO/WC	$128.62
Rate for Payer: UnitedHealthcare Community & State	$27.10
Rate for Payer: Wellpoint Medicaid Managed Care	$24.35

BALLOON U/TH DIAMOND 6x2x75cm

Facility

$857.50

Hospital Charge Code	270629350
Hospital Revenue Code	278
Min. Negotiated Rate	$128.62
Max. Negotiated Rate	$207.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: Qualcare PPO/HMO/WC	$128.62

BALLOON U/TH DIAMOND 6x4x75cm

Facility

$857.50

Service Code	HCPCS C1725
Hospital Charge Code	270618563
Hospital Revenue Code	278
Min. Negotiated Rate	$24.35
Max. Negotiated Rate	$428.75
Rate for Payer: Aetna Commercial	$325.85
Rate for Payer: Aetna Medicare Advantage	$257.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$218.66
Rate for Payer: Cigna Commercial	$428.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: Qualcare PPO/HMO/WC	$128.62
Rate for Payer: UnitedHealthcare Community & State	$27.10
Rate for Payer: Wellpoint Medicaid Managed Care	$24.35

BALLOON U/TH DIAMOND 6x4x75cm

Facility

$857.50

Service Code	HCPCS C1725
Hospital Charge Code	270618563
Hospital Revenue Code	278
Min. Negotiated Rate	$128.62
Max. Negotiated Rate	$207.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: Qualcare PPO/HMO/WC	$128.62

BALLOON U/TH DIAMOND 7x10x75cm

Facility

$857.50

Hospital Charge Code	270639337
Hospital Revenue Code	278
Min. Negotiated Rate	$24.35
Max. Negotiated Rate	$428.75
Rate for Payer: Aetna Commercial	$325.85
Rate for Payer: Aetna Medicare Advantage	$257.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$218.66
Rate for Payer: Cigna Commercial	$428.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: Qualcare PPO/HMO/WC	$128.62
Rate for Payer: UnitedHealthcare Community & State	$27.10
Rate for Payer: Wellpoint Medicaid Managed Care	$24.35

BALLOON U/TH DIAMOND 7x10x75cm

Facility

$857.50

Hospital Charge Code	270639337
Hospital Revenue Code	278
Min. Negotiated Rate	$128.62
Max. Negotiated Rate	$207.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: Qualcare PPO/HMO/WC	$128.62

BALLOON U/TH DIAMOND 7x2x75cm

Facility

$857.50

Hospital Charge Code	270629351
Hospital Revenue Code	278
Min. Negotiated Rate	$24.35
Max. Negotiated Rate	$428.75
Rate for Payer: Aetna Commercial	$325.85
Rate for Payer: Aetna Medicare Advantage	$257.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$218.66
Rate for Payer: Cigna Commercial	$428.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: Qualcare PPO/HMO/WC	$128.62
Rate for Payer: UnitedHealthcare Community & State	$27.10
Rate for Payer: Wellpoint Medicaid Managed Care	$24.35

BALLOON U/TH DIAMOND 7x2x75cm

Facility

$857.50

Hospital Charge Code	270629351
Hospital Revenue Code	278
Min. Negotiated Rate	$128.62
Max. Negotiated Rate	$207.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: Qualcare PPO/HMO/WC	$128.62

BALLOON U/TH DIAMOND 7x4x75cm

Facility

$857.50

Hospital Charge Code	270618564
Hospital Revenue Code	278
Min. Negotiated Rate	$128.62
Max. Negotiated Rate	$207.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: Qualcare PPO/HMO/WC	$128.62

BALLOON U/TH DIAMOND 7x4x75cm

Facility

$857.50

Hospital Charge Code	270618564
Hospital Revenue Code	278
Min. Negotiated Rate	$24.35
Max. Negotiated Rate	$428.75
Rate for Payer: Aetna Commercial	$325.85
Rate for Payer: Aetna Medicare Advantage	$257.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$218.66
Rate for Payer: Cigna Commercial	$428.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: Qualcare PPO/HMO/WC	$128.62
Rate for Payer: UnitedHealthcare Community & State	$27.10
Rate for Payer: Wellpoint Medicaid Managed Care	$24.35

BALLOON U/TH DIAMOND 8x4x75cm

Facility

$857.50

Service Code	HCPCS C1725
Hospital Charge Code	270616370
Hospital Revenue Code	278
Min. Negotiated Rate	$24.35
Max. Negotiated Rate	$428.75
Rate for Payer: Aetna Commercial	$325.85
Rate for Payer: Aetna Medicare Advantage	$257.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$218.66
Rate for Payer: Cigna Commercial	$428.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: Qualcare PPO/HMO/WC	$128.62
Rate for Payer: UnitedHealthcare Community & State	$27.10
Rate for Payer: Wellpoint Medicaid Managed Care	$24.35

BALLOON U/TH DIAMOND 8x4x75cm

Facility

$857.50

Service Code	HCPCS C1725
Hospital Charge Code	270616370
Hospital Revenue Code	278
Min. Negotiated Rate	$128.62
Max. Negotiated Rate	$207.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: Qualcare PPO/HMO/WC	$128.62

BALLOON U/TH DIAMOND 8x8x75cm

Facility

$857.50

Hospital Charge Code	270639338
Hospital Revenue Code	278
Min. Negotiated Rate	$128.62
Max. Negotiated Rate	$207.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: Qualcare PPO/HMO/WC	$128.62

BALLOON U/TH DIAMOND 8x8x75cm

Facility

$857.50

Hospital Charge Code	270639338
Hospital Revenue Code	278
Min. Negotiated Rate	$24.35
Max. Negotiated Rate	$428.75
Rate for Payer: Aetna Commercial	$325.85
Rate for Payer: Aetna Medicare Advantage	$257.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$218.66
Rate for Payer: Cigna Commercial	$428.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: Qualcare PPO/HMO/WC	$128.62
Rate for Payer: UnitedHealthcare Community & State	$27.10
Rate for Payer: Wellpoint Medicaid Managed Care	$24.35

BALLOON U/TH DIAMOND 9x2x75cm

Facility

$857.50

Service Code	HCPCS C1725
Hospital Charge Code	270629353
Hospital Revenue Code	278
Min. Negotiated Rate	$24.35
Max. Negotiated Rate	$428.75
Rate for Payer: Aetna Commercial	$325.85
Rate for Payer: Aetna Medicare Advantage	$257.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$218.66
Rate for Payer: Cigna Commercial	$428.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: Qualcare PPO/HMO/WC	$128.62
Rate for Payer: UnitedHealthcare Community & State	$27.10
Rate for Payer: Wellpoint Medicaid Managed Care	$24.35

BALLOON U/TH DIAMOND 9x2x75cm

Facility

$857.50

Service Code	HCPCS C1725
Hospital Charge Code	270629353
Hospital Revenue Code	278
Min. Negotiated Rate	$128.62
Max. Negotiated Rate	$207.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: Qualcare PPO/HMO/WC	$128.62

BALLOON U/TH DIAMOND 9x4x75cm

Facility

$857.50

Service Code	HCPCS C1725
Hospital Charge Code	270623524
Hospital Revenue Code	278
Min. Negotiated Rate	$24.35
Max. Negotiated Rate	$428.75
Rate for Payer: Aetna Commercial	$325.85
Rate for Payer: Aetna Medicare Advantage	$257.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$218.66
Rate for Payer: Cigna Commercial	$428.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: Qualcare PPO/HMO/WC	$128.62
Rate for Payer: UnitedHealthcare Community & State	$27.10
Rate for Payer: Wellpoint Medicaid Managed Care	$24.35

Know your out-of-pocket cost for care.

All Charges