Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

STOPCOCK HIGH PRESSURE H3RRC

Facility

$12.00

Hospital Charge Code	270658301N
Hospital Revenue Code	272
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$4.56
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.12
Rate for Payer: Oxford Commercial	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$2.40
Rate for Payer: UnitedHealthcare Community & State	$0.38
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

STOPCOCK HIGH PRESSURE H3RRC

Facility

$12.00

Hospital Charge Code	270658301N
Hospital Revenue Code	272
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

STOPCOCK MICRO 4FT PVC

Facility

$90.00

Hospital Charge Code	270650044
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

STOPCOCK MICRO 4FT PVC

Facility

$90.00

Hospital Charge Code	270650044
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

STOPCOCK ROTATION CANNULA 5.8

Facility

$1,575.50

Hospital Charge Code	270689117
Hospital Revenue Code	270
Min. Negotiated Rate	$44.74
Max. Negotiated Rate	$787.75
Rate for Payer: Aetna Commercial	$598.69
Rate for Payer: Aetna Medicare Advantage	$472.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$401.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$401.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$401.75
Rate for Payer: Cigna Commercial	$787.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$409.63
Rate for Payer: Oxford Commercial	$315.10
Rate for Payer: Qualcare PPO/HMO/WC	$236.32
Rate for Payer: UnitedHealthcare Commercial	$315.10
Rate for Payer: UnitedHealthcare Community & State	$49.79
Rate for Payer: Wellpoint Medicaid Managed Care	$44.74

STOPCOCK ROTATION CANNULA 5.8

Facility

$1,575.50

Hospital Charge Code	270689117
Hospital Revenue Code	270
Min. Negotiated Rate	$236.32
Max. Negotiated Rate	$236.32
Rate for Payer: Qualcare PPO/HMO/WC	$236.32

STOP DRILL

Facility

$875.00

Hospital Charge Code	270679988
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

STOP DRILL

Facility

$875.00

Hospital Charge Code	270679988
Hospital Revenue Code	272
Min. Negotiated Rate	$24.85
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$27.65
Rate for Payer: Wellpoint Medicaid Managed Care	$24.85

STOP DRILL 2.3x14MM

Facility

$820.00

Hospital Charge Code	270680170
Hospital Revenue Code	272
Min. Negotiated Rate	$23.29
Max. Negotiated Rate	$410.00
Rate for Payer: Aetna Commercial	$311.60
Rate for Payer: Aetna Medicare Advantage	$246.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.10
Rate for Payer: Cigna Commercial	$410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.20
Rate for Payer: Oxford Commercial	$164.00
Rate for Payer: Qualcare PPO/HMO/WC	$123.00
Rate for Payer: UnitedHealthcare Commercial	$164.00
Rate for Payer: UnitedHealthcare Community & State	$25.91
Rate for Payer: Wellpoint Medicaid Managed Care	$23.29

STOP DRILL 2.3x14MM

Facility

$820.00

Hospital Charge Code	270680170
Hospital Revenue Code	272
Min. Negotiated Rate	$123.00
Max. Negotiated Rate	$123.00
Rate for Payer: Qualcare PPO/HMO/WC	$123.00

STOPPER FOR LISS INSERT GUIDES

Facility

$136.50

Hospital Charge Code	270671203
Hospital Revenue Code	272
Min. Negotiated Rate	$3.88
Max. Negotiated Rate	$68.25
Rate for Payer: Aetna Commercial	$51.87
Rate for Payer: Aetna Medicare Advantage	$40.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.81
Rate for Payer: Cigna Commercial	$68.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.49
Rate for Payer: Oxford Commercial	$27.30
Rate for Payer: Qualcare PPO/HMO/WC	$20.48
Rate for Payer: UnitedHealthcare Commercial	$27.30
Rate for Payer: UnitedHealthcare Community & State	$4.31
Rate for Payer: Wellpoint Medicaid Managed Care	$3.88

STOPPER FOR LISS INSERT GUIDES

Facility

$136.50

Hospital Charge Code	270671203
Hospital Revenue Code	272
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$20.48
Rate for Payer: Qualcare PPO/HMO/WC	$20.48

ST POLY LINER

Facility

$6,362.25

Service Code	HCPCS C1776
Hospital Charge Code	270688879
Hospital Revenue Code	278
Min. Negotiated Rate	$954.34
Max. Negotiated Rate	$1,539.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,272.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,539.66
Rate for Payer: Qualcare PPO/HMO/WC	$954.34

ST POLY LINER

Facility

$6,362.25

Service Code	HCPCS C1776
Hospital Charge Code	270688879
Hospital Revenue Code	278
Min. Negotiated Rate	$180.69
Max. Negotiated Rate	$3,181.12
Rate for Payer: Aetna Commercial	$2,417.66
Rate for Payer: Aetna Medicare Advantage	$1,908.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,622.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,622.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,272.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,622.37
Rate for Payer: Cigna Commercial	$3,181.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,539.66
Rate for Payer: Qualcare PPO/HMO/WC	$954.34
Rate for Payer: UnitedHealthcare Community & State	$201.05
Rate for Payer: Wellpoint Medicaid Managed Care	$180.69

ST PR GPS6FR6x40m6506X40X120

Facility

$1,395.00

Service Code	HCPCS C2617
Hospital Charge Code	270636673N
Hospital Revenue Code	278
Min. Negotiated Rate	$39.62
Max. Negotiated Rate	$697.50
Rate for Payer: Aetna Commercial	$530.10
Rate for Payer: Aetna Medicare Advantage	$418.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$355.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$355.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$279.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$355.73
Rate for Payer: Cigna Commercial	$697.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$337.59
Rate for Payer: Qualcare PPO/HMO/WC	$209.25
Rate for Payer: UnitedHealthcare Community & State	$44.08
Rate for Payer: Wellpoint Medicaid Managed Care	$39.62

ST PR GPS6FR6x40m6506X40X120

Facility

$1,395.00

Service Code	HCPCS C2617
Hospital Charge Code	270636673S
Hospital Revenue Code	278
Min. Negotiated Rate	$39.62
Max. Negotiated Rate	$697.50
Rate for Payer: Aetna Commercial	$530.10
Rate for Payer: Aetna Medicare Advantage	$418.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$355.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$355.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$279.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$355.73
Rate for Payer: Cigna Commercial	$697.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$337.59
Rate for Payer: Qualcare PPO/HMO/WC	$209.25
Rate for Payer: UnitedHealthcare Community & State	$44.08
Rate for Payer: Wellpoint Medicaid Managed Care	$39.62

ST PR GPS6FR6x40m6506X40X120

Facility

$6,624.80

Service Code	HCPCS C2617
Hospital Charge Code	270636673
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

ST PR GPS6FR6x40m6506X40X120

Facility

$1,395.00

Service Code	HCPCS C2617
Hospital Charge Code	270636673N
Hospital Revenue Code	278
Min. Negotiated Rate	$209.25
Max. Negotiated Rate	$337.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$279.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$337.59
Rate for Payer: Qualcare PPO/HMO/WC	$209.25

ST PR GPS6FR6x40m6506X40X120

Facility

$1,395.00

Service Code	HCPCS C2617
Hospital Charge Code	270636673S
Hospital Revenue Code	278
Min. Negotiated Rate	$209.25
Max. Negotiated Rate	$337.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$279.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$337.59
Rate for Payer: Qualcare PPO/HMO/WC	$209.25

ST PR GPS6FR6x40m6506X40X120

Facility

$6,624.80

Service Code	HCPCS C2617
Hospital Charge Code	270636673
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

STRAIGHT ATTACHMENT ARM

Facility

$643.75

Hospital Charge Code	270702325
Hospital Revenue Code	278
Min. Negotiated Rate	$96.56
Max. Negotiated Rate	$155.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.79
Rate for Payer: Qualcare PPO/HMO/WC	$96.56

STRAIGHT ATTACHMENT ARM

Facility

$643.75

Hospital Charge Code	270702325
Hospital Revenue Code	278
Min. Negotiated Rate	$18.28
Max. Negotiated Rate	$321.88
Rate for Payer: Aetna Commercial	$244.62
Rate for Payer: Aetna Medicare Advantage	$193.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$164.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$164.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$164.16
Rate for Payer: Cigna Commercial	$321.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.79
Rate for Payer: Qualcare PPO/HMO/WC	$96.56
Rate for Payer: UnitedHealthcare Community & State	$20.34
Rate for Payer: Wellpoint Medicaid Managed Care	$18.28

STRAIGHT CATHETER EXCHANGE

Facility

$1,026.00

Hospital Charge Code	270331661
Hospital Revenue Code	272
Min. Negotiated Rate	$29.14
Max. Negotiated Rate	$513.00
Rate for Payer: Aetna Commercial	$389.88
Rate for Payer: Aetna Medicare Advantage	$307.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.63
Rate for Payer: Cigna Commercial	$513.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.76
Rate for Payer: Oxford Commercial	$205.20
Rate for Payer: Qualcare PPO/HMO/WC	$153.90
Rate for Payer: UnitedHealthcare Commercial	$205.20
Rate for Payer: UnitedHealthcare Community & State	$32.42
Rate for Payer: Wellpoint Medicaid Managed Care	$29.14

STRAIGHT CATHETER EXCHANGE

Facility

$1,026.00

Hospital Charge Code	270331661
Hospital Revenue Code	272
Min. Negotiated Rate	$153.90
Max. Negotiated Rate	$153.90
Rate for Payer: Qualcare PPO/HMO/WC	$153.90

STRAIGHT C/D STRUT

Facility

$3,340.00

Hospital Charge Code	270339504
Hospital Revenue Code	278
Min. Negotiated Rate	$94.86
Max. Negotiated Rate	$1,670.00
Rate for Payer: Aetna Commercial	$1,269.20
Rate for Payer: Aetna Medicare Advantage	$1,002.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$851.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$851.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$668.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$851.70
Rate for Payer: Cigna Commercial	$1,670.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$808.28
Rate for Payer: Qualcare PPO/HMO/WC	$501.00
Rate for Payer: UnitedHealthcare Community & State	$105.54
Rate for Payer: Wellpoint Medicaid Managed Care	$94.86

Know your out-of-pocket cost for care.

All Charges