Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

STENT ZILVER DES PTX 6x40x125

Facility

$5,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270677111
Hospital Revenue Code	278
Min. Negotiated Rate	$166.85
Max. Negotiated Rate	$2,937.50
Rate for Payer: Aetna Commercial	$2,232.50
Rate for Payer: Aetna Medicare Advantage	$1,762.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,498.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,498.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,498.12
Rate for Payer: Cigna Commercial	$2,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,421.75
Rate for Payer: Qualcare PPO/HMO/WC	$881.25
Rate for Payer: UnitedHealthcare Community & State	$185.65
Rate for Payer: Wellpoint Medicaid Managed Care	$166.85

STENT ZILVER DES PTX 6x40x125

Facility

$5,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270677111N
Hospital Revenue Code	278
Min. Negotiated Rate	$166.85
Max. Negotiated Rate	$2,937.50
Rate for Payer: Aetna Commercial	$2,232.50
Rate for Payer: Aetna Medicare Advantage	$1,762.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,498.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,498.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,498.12
Rate for Payer: Cigna Commercial	$2,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,421.75
Rate for Payer: Qualcare PPO/HMO/WC	$881.25
Rate for Payer: UnitedHealthcare Community & State	$185.65
Rate for Payer: Wellpoint Medicaid Managed Care	$166.85

STENT ZILVER DES PTX 6x60x125

Facility

$7,375.00

Service Code	HCPCS C1876
Hospital Charge Code	270677112N
Hospital Revenue Code	278
Min. Negotiated Rate	$209.45
Max. Negotiated Rate	$3,687.50
Rate for Payer: Aetna Commercial	$2,802.50
Rate for Payer: Aetna Medicare Advantage	$2,212.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,880.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,880.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,880.62
Rate for Payer: Cigna Commercial	$3,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,784.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,106.25
Rate for Payer: UnitedHealthcare Community & State	$233.05
Rate for Payer: Wellpoint Medicaid Managed Care	$209.45

STENT ZILVER DES PTX 6x60x125

Facility

$7,375.00

Service Code	HCPCS C1876
Hospital Charge Code	270677112
Hospital Revenue Code	278
Min. Negotiated Rate	$1,106.25
Max. Negotiated Rate	$1,784.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,784.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,106.25

STENT ZILVER DES PTX 6x60x125

Facility

$7,375.00

Service Code	HCPCS C1876
Hospital Charge Code	270677112N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,106.25
Max. Negotiated Rate	$1,784.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,784.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,106.25

STENT ZILVER DES PTX 6x60x125

Facility

$7,375.00

Service Code	HCPCS C1876
Hospital Charge Code	270677112
Hospital Revenue Code	278
Min. Negotiated Rate	$209.45
Max. Negotiated Rate	$3,687.50
Rate for Payer: Aetna Commercial	$2,802.50
Rate for Payer: Aetna Medicare Advantage	$2,212.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,880.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,880.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,880.62
Rate for Payer: Cigna Commercial	$3,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,784.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,106.25
Rate for Payer: UnitedHealthcare Community & State	$233.05
Rate for Payer: Wellpoint Medicaid Managed Care	$209.45

STENT ZILVER DES PTX 6x80x125

Facility

$8,975.00

Service Code	HCPCS C1876
Hospital Charge Code	270677113N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,346.25
Max. Negotiated Rate	$2,171.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,171.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,346.25

STENT ZILVER DES PTX 6x80x125

Facility

$8,975.00

Service Code	HCPCS C1876
Hospital Charge Code	270677113
Hospital Revenue Code	278
Min. Negotiated Rate	$254.89
Max. Negotiated Rate	$4,487.50
Rate for Payer: Aetna Commercial	$3,410.50
Rate for Payer: Aetna Medicare Advantage	$2,692.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,288.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,288.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,288.62
Rate for Payer: Cigna Commercial	$4,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,171.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,346.25
Rate for Payer: UnitedHealthcare Community & State	$283.61
Rate for Payer: Wellpoint Medicaid Managed Care	$254.89

STENT ZILVER DES PTX 6x80x125

Facility

$8,975.00

Service Code	HCPCS C1876
Hospital Charge Code	270677113N
Hospital Revenue Code	278
Min. Negotiated Rate	$254.89
Max. Negotiated Rate	$4,487.50
Rate for Payer: Aetna Commercial	$3,410.50
Rate for Payer: Aetna Medicare Advantage	$2,692.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,288.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,288.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,288.62
Rate for Payer: Cigna Commercial	$4,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,171.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,346.25
Rate for Payer: UnitedHealthcare Community & State	$283.61
Rate for Payer: Wellpoint Medicaid Managed Care	$254.89

STENT ZILVER DES PTX 6x80x125

Facility

$8,975.00

Service Code	HCPCS C1876
Hospital Charge Code	270677113
Hospital Revenue Code	278
Min. Negotiated Rate	$1,346.25
Max. Negotiated Rate	$2,171.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,171.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,346.25

STENT ZIMM PANCREAT 5x4 G22358

Facility

$360.00

Service Code	HCPCS C2617
Hospital Charge Code	270641699
Hospital Revenue Code	278
Min. Negotiated Rate	$10.22
Max. Negotiated Rate	$180.00
Rate for Payer: Aetna Commercial	$136.80
Rate for Payer: Aetna Medicare Advantage	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.80
Rate for Payer: Cigna Commercial	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.12
Rate for Payer: Qualcare PPO/HMO/WC	$54.00
Rate for Payer: UnitedHealthcare Community & State	$11.38
Rate for Payer: Wellpoint Medicaid Managed Care	$10.22

STENT ZIMM PANCREAT 5x4 G22358

Facility

$360.00

Service Code	HCPCS C2617
Hospital Charge Code	270641699
Hospital Revenue Code	278
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$87.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.12
Rate for Payer: Qualcare PPO/HMO/WC	$54.00

STEPDRILL SOLID FOR LAG SCREW

Facility

$1,845.00

Hospital Charge Code	270670504
Hospital Revenue Code	272
Min. Negotiated Rate	$276.75
Max. Negotiated Rate	$276.75
Rate for Payer: Qualcare PPO/HMO/WC	$276.75

STEPDRILL SOLID FOR LAG SCREW

Facility

$1,845.00

Hospital Charge Code	270670504
Hospital Revenue Code	272
Min. Negotiated Rate	$52.40
Max. Negotiated Rate	$922.50
Rate for Payer: Aetna Commercial	$701.10
Rate for Payer: Aetna Medicare Advantage	$553.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$470.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$470.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$470.48
Rate for Payer: Cigna Commercial	$922.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$479.70
Rate for Payer: Oxford Commercial	$369.00
Rate for Payer: Qualcare PPO/HMO/WC	$276.75
Rate for Payer: UnitedHealthcare Commercial	$369.00
Rate for Payer: UnitedHealthcare Community & State	$58.30
Rate for Payer: Wellpoint Medicaid Managed Care	$52.40

STE PR 6X80X120mm PRB350680120

Facility

$6,624.80

Service Code	HCPCS C1876
Hospital Charge Code	270637004C
Hospital Revenue Code	278
Min. Negotiated Rate	$188.14
Max. Negotiated Rate	$3,312.40
Rate for Payer: Aetna Commercial	$2,517.42
Rate for Payer: Aetna Medicare Advantage	$1,987.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,689.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,689.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,324.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,689.32
Rate for Payer: Cigna Commercial	$3,312.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,603.20
Rate for Payer: Qualcare PPO/HMO/WC	$993.72
Rate for Payer: UnitedHealthcare Community & State	$209.34
Rate for Payer: Wellpoint Medicaid Managed Care	$188.14

STE PR 6X80X120mm PRB350680120

Facility

$6,624.80

Service Code	HCPCS C1876
Hospital Charge Code	270637004C
Hospital Revenue Code	278
Min. Negotiated Rate	$993.72
Max. Negotiated Rate	$1,603.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,324.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,603.20
Rate for Payer: Qualcare PPO/HMO/WC	$993.72

STEP STAPLE 6MM

Facility

$12,070.00

Hospital Charge Code	270700549
Hospital Revenue Code	272
Min. Negotiated Rate	$342.79
Max. Negotiated Rate	$6,035.00
Rate for Payer: Aetna Commercial	$4,586.60
Rate for Payer: Aetna Medicare Advantage	$3,621.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,077.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,077.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,077.85
Rate for Payer: Cigna Commercial	$6,035.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,138.20
Rate for Payer: Oxford Commercial	$2,414.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,810.50
Rate for Payer: UnitedHealthcare Commercial	$2,414.00
Rate for Payer: UnitedHealthcare Community & State	$381.41
Rate for Payer: Wellpoint Medicaid Managed Care	$342.79

STEP STAPLE 6MM

Facility

$12,070.00

Hospital Charge Code	270700549
Hospital Revenue Code	272
Min. Negotiated Rate	$1,810.50
Max. Negotiated Rate	$1,810.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,810.50

STEREO BREAST BX EA ADDL LESIO

Facility

$3,214.70

Service Code	HCPCS 19082
Hospital Charge Code	2700025
Hospital Revenue Code	361
Min. Negotiated Rate	$91.30
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,221.59
Rate for Payer: Aetna Medicare Advantage	$964.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$819.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$819.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$819.75
Rate for Payer: Cigna Commercial	$1,607.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$835.82
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$482.20
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$101.58
Rate for Payer: Wellpoint Medicaid Managed Care	$91.30

STEREO BREAST BX EA ADDL LESIO

Facility

$3,214.70

Service Code	HCPCS 19082
Hospital Charge Code	2700025
Hospital Revenue Code	361
Min. Negotiated Rate	$482.20
Max. Negotiated Rate	$482.20
Rate for Payer: Qualcare PPO/HMO/WC	$482.20

STEREO BREAST BX EA ADDL LESIO

Facility

$3,214.70

Service Code	HCPCS 19082
Hospital Charge Code	87502807
Hospital Revenue Code	361
Min. Negotiated Rate	$482.20
Max. Negotiated Rate	$482.20
Rate for Payer: Qualcare PPO/HMO/WC	$482.20

STEREO BREAST BX EA ADDL LESIO

Facility

$3,214.70

Service Code	HCPCS 19082
Hospital Charge Code	87502807
Hospital Revenue Code	361
Min. Negotiated Rate	$91.30
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,221.59
Rate for Payer: Aetna Medicare Advantage	$964.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$819.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$819.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$819.75
Rate for Payer: Cigna Commercial	$1,607.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$835.82
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$482.20
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$101.58
Rate for Payer: Wellpoint Medicaid Managed Care	$91.30

STEREO BREAST LOCAL EA ADD LES

Facility

$1,184.85

Service Code	HCPCS 19284
Hospital Charge Code	2700027
Hospital Revenue Code	361
Min. Negotiated Rate	$33.65
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$450.24
Rate for Payer: Aetna Medicare Advantage	$355.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$302.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$302.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$302.14
Rate for Payer: Cigna Commercial	$592.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.06
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$177.73
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$37.44
Rate for Payer: Wellpoint Medicaid Managed Care	$33.65

STEREO BREAST LOCAL EA ADD LES

Facility

$1,184.85

Service Code	HCPCS 19284
Hospital Charge Code	2700027
Hospital Revenue Code	361
Min. Negotiated Rate	$177.73
Max. Negotiated Rate	$177.73
Rate for Payer: Qualcare PPO/HMO/WC	$177.73

STEREOTACGUIDEBRSTBIOP1STLESLT

Facility

$4,169.44

Service Code	HCPCS 19081
Hospital Charge Code	94064001L
Hospital Revenue Code	361
Min. Negotiated Rate	$118.41
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,084.05
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$625.42
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$131.75
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$118.41

Know your out-of-pocket cost for care.

All Charges