Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

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

BALL TIP DISPOSABLE DIRECT

Facility

$1,390.00

Hospital Charge Code	270670711
Hospital Revenue Code	272
Min. Negotiated Rate	$39.48
Max. Negotiated Rate	$695.00
Rate for Payer: Aetna Commercial	$528.20
Rate for Payer: Aetna Medicare Advantage	$417.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$354.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$354.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$354.45
Rate for Payer: Cigna Commercial	$695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.40
Rate for Payer: Oxford Commercial	$278.00
Rate for Payer: Qualcare PPO/HMO/WC	$208.50
Rate for Payer: UnitedHealthcare Commercial	$278.00
Rate for Payer: UnitedHealthcare Community & State	$43.92
Rate for Payer: Wellpoint Medicaid Managed Care	$39.48

BALL TIP DISPOSABLE DIRECT

Facility

$1,390.00

Hospital Charge Code	270670711
Hospital Revenue Code	272
Min. Negotiated Rate	$208.50
Max. Negotiated Rate	$208.50
Rate for Payer: Qualcare PPO/HMO/WC	$208.50

BALL TIP GIDE WIRE 3.0MMX100CM

Facility

$716.15

Hospital Charge Code	270663171
Hospital Revenue Code	270
Min. Negotiated Rate	$20.34
Max. Negotiated Rate	$358.07
Rate for Payer: Aetna Commercial	$272.14
Rate for Payer: Aetna Medicare Advantage	$214.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.62
Rate for Payer: Cigna Commercial	$358.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.20
Rate for Payer: Oxford Commercial	$143.23
Rate for Payer: Qualcare PPO/HMO/WC	$107.42
Rate for Payer: UnitedHealthcare Commercial	$143.23
Rate for Payer: UnitedHealthcare Community & State	$22.63
Rate for Payer: Wellpoint Medicaid Managed Care	$20.34

BALL TIP GIDE WIRE 3.0MMX100CM

Facility

$716.15

Hospital Charge Code	270663171
Hospital Revenue Code	270
Min. Negotiated Rate	$107.42
Max. Negotiated Rate	$107.42
Rate for Payer: Qualcare PPO/HMO/WC	$107.42

BALN EC 10x60x80 AB35W10060080

Facility

$681.10

Service Code	HCPCS C1725
Hospital Charge Code	270644291C
Hospital Revenue Code	278
Min. Negotiated Rate	$19.34
Max. Negotiated Rate	$340.55
Rate for Payer: Aetna Commercial	$258.82
Rate for Payer: Aetna Medicare Advantage	$204.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$173.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$173.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$173.68
Rate for Payer: Cigna Commercial	$340.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.83
Rate for Payer: Qualcare PPO/HMO/WC	$102.17
Rate for Payer: UnitedHealthcare Community & State	$21.52
Rate for Payer: Wellpoint Medicaid Managed Care	$19.34

BALN EC 10x60x80 AB35W10060080

Facility

$681.10

Service Code	HCPCS C1725
Hospital Charge Code	270644291C
Hospital Revenue Code	278
Min. Negotiated Rate	$102.17
Max. Negotiated Rate	$164.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.83
Rate for Payer: Qualcare PPO/HMO/WC	$102.17

BALN EC 10x60x80 AB35W10060080

Facility

$681.10

Service Code	HCPCS C1725
Hospital Charge Code	270644291A
Hospital Revenue Code	278
Min. Negotiated Rate	$102.17
Max. Negotiated Rate	$164.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.83
Rate for Payer: Qualcare PPO/HMO/WC	$102.17

BALN EC 10x60x80 AB35W10060080

Facility

$681.10

Service Code	HCPCS C1725
Hospital Charge Code	270644291A
Hospital Revenue Code	278
Min. Negotiated Rate	$19.34
Max. Negotiated Rate	$340.55
Rate for Payer: Aetna Commercial	$258.82
Rate for Payer: Aetna Medicare Advantage	$204.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$173.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$173.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$173.68
Rate for Payer: Cigna Commercial	$340.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.83
Rate for Payer: Qualcare PPO/HMO/WC	$102.17
Rate for Payer: UnitedHealthcare Community & State	$21.52
Rate for Payer: Wellpoint Medicaid Managed Care	$19.34

BALN EC 12x40x80 AB35W12040080

Facility

$681.10

Service Code	HCPCS C1725
Hospital Charge Code	270644437C
Hospital Revenue Code	278
Min. Negotiated Rate	$19.34
Max. Negotiated Rate	$340.55
Rate for Payer: Aetna Commercial	$258.82
Rate for Payer: Aetna Medicare Advantage	$204.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$173.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$173.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$173.68
Rate for Payer: Cigna Commercial	$340.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.83
Rate for Payer: Qualcare PPO/HMO/WC	$102.17
Rate for Payer: UnitedHealthcare Community & State	$21.52
Rate for Payer: Wellpoint Medicaid Managed Care	$19.34

BALN EC 12x40x80 AB35W12040080

Facility

$681.10

Service Code	HCPCS C1725
Hospital Charge Code	270644437C
Hospital Revenue Code	278
Min. Negotiated Rate	$102.17
Max. Negotiated Rate	$164.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.83
Rate for Payer: Qualcare PPO/HMO/WC	$102.17

BALN EC 12x40x80 AB35W12040080

Facility

$681.10

Service Code	HCPCS C1725
Hospital Charge Code	270644437A
Hospital Revenue Code	278
Min. Negotiated Rate	$19.34
Max. Negotiated Rate	$340.55
Rate for Payer: Aetna Commercial	$258.82
Rate for Payer: Aetna Medicare Advantage	$204.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$173.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$173.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$173.68
Rate for Payer: Cigna Commercial	$340.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.83
Rate for Payer: Qualcare PPO/HMO/WC	$102.17
Rate for Payer: UnitedHealthcare Community & State	$21.52
Rate for Payer: Wellpoint Medicaid Managed Care	$19.34

BALN EC 12x40x80 AB35W12040080

Facility

$681.10

Service Code	HCPCS C1725
Hospital Charge Code	270644437A
Hospital Revenue Code	278
Min. Negotiated Rate	$102.17
Max. Negotiated Rate	$164.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.83
Rate for Payer: Qualcare PPO/HMO/WC	$102.17

BALN EC 12x60x80 AB35W12060080

Facility

$681.10

Service Code	HCPCS C1725
Hospital Charge Code	270644431C
Hospital Revenue Code	278
Min. Negotiated Rate	$19.34
Max. Negotiated Rate	$340.55
Rate for Payer: Aetna Commercial	$258.82
Rate for Payer: Aetna Medicare Advantage	$204.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$173.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$173.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$173.68
Rate for Payer: Cigna Commercial	$340.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.83
Rate for Payer: Qualcare PPO/HMO/WC	$102.17
Rate for Payer: UnitedHealthcare Community & State	$21.52
Rate for Payer: Wellpoint Medicaid Managed Care	$19.34

BALN EC 12x60x80 AB35W12060080

Facility

$681.10

Service Code	HCPCS C1725
Hospital Charge Code	270644431C
Hospital Revenue Code	278
Min. Negotiated Rate	$102.17
Max. Negotiated Rate	$164.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.83
Rate for Payer: Qualcare PPO/HMO/WC	$102.17

BALN EC 12x60x80 AB35W12060080

Facility

$681.10

Service Code	HCPCS C1725
Hospital Charge Code	270644431A
Hospital Revenue Code	278
Min. Negotiated Rate	$19.34
Max. Negotiated Rate	$340.55
Rate for Payer: Aetna Commercial	$258.82
Rate for Payer: Aetna Medicare Advantage	$204.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$173.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$173.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$173.68
Rate for Payer: Cigna Commercial	$340.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.83
Rate for Payer: Qualcare PPO/HMO/WC	$102.17
Rate for Payer: UnitedHealthcare Community & State	$21.52
Rate for Payer: Wellpoint Medicaid Managed Care	$19.34

BALN EC 12x60x80 AB35W12060080

Facility

$681.10

Service Code	HCPCS C1725
Hospital Charge Code	270644431A
Hospital Revenue Code	278
Min. Negotiated Rate	$102.17
Max. Negotiated Rate	$164.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.83
Rate for Payer: Qualcare PPO/HMO/WC	$102.17

BALN EC 8x40x80 AB35W08040080

Facility

$681.10

Service Code	HCPCS C1725
Hospital Charge Code	270644441C
Hospital Revenue Code	278
Min. Negotiated Rate	$19.34
Max. Negotiated Rate	$340.55
Rate for Payer: Aetna Commercial	$258.82
Rate for Payer: Aetna Medicare Advantage	$204.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$173.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$173.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$173.68
Rate for Payer: Cigna Commercial	$340.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.83
Rate for Payer: Qualcare PPO/HMO/WC	$102.17
Rate for Payer: UnitedHealthcare Community & State	$21.52
Rate for Payer: Wellpoint Medicaid Managed Care	$19.34

BALN EC 8x40x80 AB35W08040080

Facility

$681.10

Service Code	HCPCS C1725
Hospital Charge Code	270644441C
Hospital Revenue Code	278
Min. Negotiated Rate	$102.17
Max. Negotiated Rate	$164.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.83
Rate for Payer: Qualcare PPO/HMO/WC	$102.17

BALN EC 8x60x80 AB35W08060080

Facility

$681.10

Service Code	HCPCS C1725
Hospital Charge Code	270644036C
Hospital Revenue Code	278
Min. Negotiated Rate	$19.34
Max. Negotiated Rate	$340.55
Rate for Payer: Aetna Commercial	$258.82
Rate for Payer: Aetna Medicare Advantage	$204.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$173.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$173.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$173.68
Rate for Payer: Cigna Commercial	$340.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.83
Rate for Payer: Qualcare PPO/HMO/WC	$102.17
Rate for Payer: UnitedHealthcare Community & State	$21.52
Rate for Payer: Wellpoint Medicaid Managed Care	$19.34

BALN EC 8x60x80 AB35W08060080

Facility

$681.10

Service Code	HCPCS C1725
Hospital Charge Code	270644036C
Hospital Revenue Code	278
Min. Negotiated Rate	$102.17
Max. Negotiated Rate	$164.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.83
Rate for Payer: Qualcare PPO/HMO/WC	$102.17

BALN IAB 7 5F 34C 068400047901

Facility

$5,075.00

Service Code	HCPCS C1725
Hospital Charge Code	270634433N
Hospital Revenue Code	278
Min. Negotiated Rate	$144.13
Max. Negotiated Rate	$2,537.50
Rate for Payer: Aetna Commercial	$1,928.50
Rate for Payer: Aetna Medicare Advantage	$1,522.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,294.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,294.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,015.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,294.12
Rate for Payer: Cigna Commercial	$2,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,228.15
Rate for Payer: Qualcare PPO/HMO/WC	$761.25
Rate for Payer: UnitedHealthcare Community & State	$160.37
Rate for Payer: Wellpoint Medicaid Managed Care	$144.13

BALN IAB 7 5F 34C 068400047901

Facility

$5,075.00

Service Code	HCPCS C1725
Hospital Charge Code	270634433N
Hospital Revenue Code	278
Min. Negotiated Rate	$761.25
Max. Negotiated Rate	$1,228.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,015.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,228.15
Rate for Payer: Qualcare PPO/HMO/WC	$761.25

BALN IAB 7 5F 34C 068400047901

Facility

$4,313.75

Service Code	HCPCS C1725
Hospital Charge Code	270634433
Hospital Revenue Code	278
Min. Negotiated Rate	$122.51
Max. Negotiated Rate	$2,156.88
Rate for Payer: Aetna Commercial	$1,639.22
Rate for Payer: Aetna Medicare Advantage	$1,294.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,100.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,100.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,100.01
Rate for Payer: Cigna Commercial	$2,156.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,043.93
Rate for Payer: Qualcare PPO/HMO/WC	$647.06
Rate for Payer: UnitedHealthcare Community & State	$136.31
Rate for Payer: Wellpoint Medicaid Managed Care	$122.51

BALN IAB 7 5F 34C 068400047901

Facility

$4,313.75

Service Code	HCPCS C1725
Hospital Charge Code	270634433
Hospital Revenue Code	278
Min. Negotiated Rate	$647.06
Max. Negotiated Rate	$1,043.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,043.93
Rate for Payer: Qualcare PPO/HMO/WC	$647.06

Know your out-of-pocket cost for care.

All Charges