Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SYS CLOS PERCLOSE PGLIDE 12673

Facility

$1,075.00

Service Code	HCPCS C1760
Hospital Charge Code	270634327S
Hospital Revenue Code	278
Min. Negotiated Rate	$30.53
Max. Negotiated Rate	$537.50
Rate for Payer: Aetna Commercial	$408.50
Rate for Payer: Aetna Medicare Advantage	$322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.12
Rate for Payer: Cigna Commercial	$537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: Qualcare PPO/HMO/WC	$161.25
Rate for Payer: UnitedHealthcare Community & State	$33.97
Rate for Payer: Wellpoint Medicaid Managed Care	$30.53

SYS CLOS PERCLOSE PGLIDE 12673

Facility

$1,075.00

Service Code	HCPCS C1760
Hospital Charge Code	270634327
Hospital Revenue Code	278
Min. Negotiated Rate	$30.53
Max. Negotiated Rate	$537.50
Rate for Payer: Aetna Commercial	$408.50
Rate for Payer: Aetna Medicare Advantage	$322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.12
Rate for Payer: Cigna Commercial	$537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: Qualcare PPO/HMO/WC	$161.25
Rate for Payer: UnitedHealthcare Community & State	$33.97
Rate for Payer: Wellpoint Medicaid Managed Care	$30.53

SYS CLOS PERCLOSE PGLIDE 12673

Facility

$1,075.00

Service Code	HCPCS C1760
Hospital Charge Code	270634327
Hospital Revenue Code	278
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

SYS CLOS PERCLOSE PGLIDE 12673

Facility

$1,075.00

Service Code	HCPCS C1760
Hospital Charge Code	270634327S
Hospital Revenue Code	278
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

SYS DEVICE CLOSURE RAD ARTERY

Facility

$135.00

Service Code	HCPCS C1760
Hospital Charge Code	270658210
Hospital Revenue Code	278
Min. Negotiated Rate	$20.25
Max. Negotiated Rate	$32.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.67
Rate for Payer: Qualcare PPO/HMO/WC	$20.25

SYS DEVICE CLOSURE RAD ARTERY

Facility

$135.00

Service Code	HCPCS C1760
Hospital Charge Code	270658210
Hospital Revenue Code	278
Min. Negotiated Rate	$3.83
Max. Negotiated Rate	$67.50
Rate for Payer: Aetna Commercial	$51.30
Rate for Payer: Aetna Medicare Advantage	$40.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.42
Rate for Payer: Cigna Commercial	$67.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.67
Rate for Payer: Qualcare PPO/HMO/WC	$20.25
Rate for Payer: UnitedHealthcare Community & State	$4.27
Rate for Payer: Wellpoint Medicaid Managed Care	$3.83

SYS SMALL BONE FIXATION

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270652902
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

SYS SMALL BONE FIXATION

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270652902
Hospital Revenue Code	278
Min. Negotiated Rate	$63.90
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Community & State	$71.10
Rate for Payer: Wellpoint Medicaid Managed Care	$63.90

SYSTEM ACCUMIX MIXING

Facility

$1,350.00

Hospital Charge Code	270678976
Hospital Revenue Code	272
Min. Negotiated Rate	$202.50
Max. Negotiated Rate	$202.50
Rate for Payer: Qualcare PPO/HMO/WC	$202.50

SYSTEM ACCUMIX MIXING

Facility

$1,350.00

Hospital Charge Code	270678976
Hospital Revenue Code	272
Min. Negotiated Rate	$38.34
Max. Negotiated Rate	$675.00
Rate for Payer: Aetna Commercial	$513.00
Rate for Payer: Aetna Medicare Advantage	$405.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$344.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$344.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$344.25
Rate for Payer: Cigna Commercial	$675.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$351.00
Rate for Payer: Oxford Commercial	$270.00
Rate for Payer: Qualcare PPO/HMO/WC	$202.50
Rate for Payer: UnitedHealthcare Commercial	$270.00
Rate for Payer: UnitedHealthcare Community & State	$42.66
Rate for Payer: Wellpoint Medicaid Managed Care	$38.34

SYSTEM ASPIRATION SEPARATOR 12

Facility

$9,725.00

Hospital Charge Code	270689718
Hospital Revenue Code	272
Min. Negotiated Rate	$1,458.75
Max. Negotiated Rate	$1,458.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,458.75

SYSTEM ASPIRATION SEPARATOR 12

Facility

$9,725.00

Hospital Charge Code	270689718
Hospital Revenue Code	272
Min. Negotiated Rate	$276.19
Max. Negotiated Rate	$4,862.50
Rate for Payer: Aetna Commercial	$3,695.50
Rate for Payer: Aetna Medicare Advantage	$2,917.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,479.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,479.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,479.88
Rate for Payer: Cigna Commercial	$4,862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,528.50
Rate for Payer: Oxford Commercial	$1,945.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,458.75
Rate for Payer: UnitedHealthcare Commercial	$1,945.00
Rate for Payer: UnitedHealthcare Community & State	$307.31
Rate for Payer: Wellpoint Medicaid Managed Care	$276.19

SYSTEM CHARGING

Facility

$6,450.00

Service Code	HCPCS C1820
Hospital Charge Code	270665900
Hospital Revenue Code	278
Min. Negotiated Rate	$967.50
Max. Negotiated Rate	$1,560.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.90
Rate for Payer: Qualcare PPO/HMO/WC	$967.50

SYSTEM CHARGING

Facility

$6,450.00

Service Code	HCPCS C1820
Hospital Charge Code	270665900
Hospital Revenue Code	278
Min. Negotiated Rate	$183.18
Max. Negotiated Rate	$3,225.00
Rate for Payer: Aetna Commercial	$2,451.00
Rate for Payer: Aetna Medicare Advantage	$1,935.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,644.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,644.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,290.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,644.75
Rate for Payer: Cigna Commercial	$3,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.90
Rate for Payer: Qualcare PPO/HMO/WC	$967.50
Rate for Payer: UnitedHealthcare Community & State	$203.82
Rate for Payer: Wellpoint Medicaid Managed Care	$183.18

SYSTEM COLOS/ILEOST 45MM

Facility

$72.85

Hospital Charge Code	270600412
Hospital Revenue Code	272
Min. Negotiated Rate	$2.07
Max. Negotiated Rate	$36.42
Rate for Payer: Aetna Commercial	$27.68
Rate for Payer: Aetna Medicare Advantage	$21.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.58
Rate for Payer: Cigna Commercial	$36.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.94
Rate for Payer: Oxford Commercial	$14.57
Rate for Payer: Qualcare PPO/HMO/WC	$10.93
Rate for Payer: UnitedHealthcare Commercial	$14.57
Rate for Payer: UnitedHealthcare Community & State	$2.30
Rate for Payer: Wellpoint Medicaid Managed Care	$2.07

SYSTEM COLOS/ILEOST 45MM

Facility

$72.85

Hospital Charge Code	270600412
Hospital Revenue Code	272
Min. Negotiated Rate	$10.93
Max. Negotiated Rate	$10.93
Rate for Payer: Qualcare PPO/HMO/WC	$10.93

SYSTEM COLOS/ILEOST 70MM

Facility

$72.85

Hospital Charge Code	270600413
Hospital Revenue Code	272
Min. Negotiated Rate	$10.93
Max. Negotiated Rate	$10.93
Rate for Payer: Qualcare PPO/HMO/WC	$10.93

SYSTEM COLOS/ILEOST 70MM

Facility

$72.85

Hospital Charge Code	270600413
Hospital Revenue Code	272
Min. Negotiated Rate	$2.07
Max. Negotiated Rate	$36.42
Rate for Payer: Aetna Commercial	$27.68
Rate for Payer: Aetna Medicare Advantage	$21.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.58
Rate for Payer: Cigna Commercial	$36.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.94
Rate for Payer: Oxford Commercial	$14.57
Rate for Payer: Qualcare PPO/HMO/WC	$10.93
Rate for Payer: UnitedHealthcare Commercial	$14.57
Rate for Payer: UnitedHealthcare Community & State	$2.30
Rate for Payer: Wellpoint Medicaid Managed Care	$2.07

SYSTEM DEEP SCROTAL RETRACTION

Facility

$2,105.00

Hospital Charge Code	270641451
Hospital Revenue Code	272
Min. Negotiated Rate	$59.78
Max. Negotiated Rate	$1,052.50
Rate for Payer: Aetna Commercial	$799.90
Rate for Payer: Aetna Medicare Advantage	$631.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$536.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$536.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$536.77
Rate for Payer: Cigna Commercial	$1,052.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$547.30
Rate for Payer: Oxford Commercial	$421.00
Rate for Payer: Qualcare PPO/HMO/WC	$315.75
Rate for Payer: UnitedHealthcare Commercial	$421.00
Rate for Payer: UnitedHealthcare Community & State	$66.52
Rate for Payer: Wellpoint Medicaid Managed Care	$59.78

SYSTEM DEEP SCROTAL RETRACTION

Facility

$2,105.00

Hospital Charge Code	270641451
Hospital Revenue Code	272
Min. Negotiated Rate	$315.75
Max. Negotiated Rate	$315.75
Rate for Payer: Qualcare PPO/HMO/WC	$315.75

SYSTEM FIBULINK SYNDESMOSIS

Facility

$6,016.00

Service Code	HCPCS C1713
Hospital Charge Code	270690528
Hospital Revenue Code	278
Min. Negotiated Rate	$902.40
Max. Negotiated Rate	$1,455.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,203.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,455.87
Rate for Payer: Qualcare PPO/HMO/WC	$902.40

SYSTEM FIBULINK SYNDESMOSIS

Facility

$6,016.00

Service Code	HCPCS C1713
Hospital Charge Code	270690528
Hospital Revenue Code	278
Min. Negotiated Rate	$170.85
Max. Negotiated Rate	$3,008.00
Rate for Payer: Aetna Commercial	$2,286.08
Rate for Payer: Aetna Medicare Advantage	$1,804.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,534.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,534.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,203.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,534.08
Rate for Payer: Cigna Commercial	$3,008.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,455.87
Rate for Payer: Qualcare PPO/HMO/WC	$902.40
Rate for Payer: UnitedHealthcare Community & State	$190.11
Rate for Payer: Wellpoint Medicaid Managed Care	$170.85

SYSTEM FIXATION MENISCAL ULTRA

Facility

$1,595.00

Hospital Charge Code	270656314
Hospital Revenue Code	272
Min. Negotiated Rate	$45.30
Max. Negotiated Rate	$797.50
Rate for Payer: Aetna Commercial	$606.10
Rate for Payer: Aetna Medicare Advantage	$478.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$406.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$406.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$406.73
Rate for Payer: Cigna Commercial	$797.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$414.70
Rate for Payer: Oxford Commercial	$319.00
Rate for Payer: Qualcare PPO/HMO/WC	$239.25
Rate for Payer: UnitedHealthcare Commercial	$319.00
Rate for Payer: UnitedHealthcare Community & State	$50.40
Rate for Payer: Wellpoint Medicaid Managed Care	$45.30

SYSTEM FIXATION MENISCAL ULTRA

Facility

$1,595.00

Hospital Charge Code	270656314
Hospital Revenue Code	272
Min. Negotiated Rate	$239.25
Max. Negotiated Rate	$239.25
Rate for Payer: Qualcare PPO/HMO/WC	$239.25

SYSTEM FIXATION MENISCAL ULTRA

Facility

$1,595.00

Hospital Charge Code	270656316
Hospital Revenue Code	272
Min. Negotiated Rate	$239.25
Max. Negotiated Rate	$239.25
Rate for Payer: Qualcare PPO/HMO/WC	$239.25

Know your out-of-pocket cost for care.

All Charges