Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SYSTEM JETSTREAM PV41340

Facility

$16,125.00

Hospital Charge Code	270647519A
Hospital Revenue Code	272
Min. Negotiated Rate	$2,418.75
Max. Negotiated Rate	$2,418.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75

SYSTEM JETSTREAM PV41340

Facility

$16,125.00

Hospital Charge Code	270647519C
Hospital Revenue Code	272
Min. Negotiated Rate	$457.95
Max. Negotiated Rate	$8,062.50
Rate for Payer: Aetna Commercial	$6,127.50
Rate for Payer: Aetna Medicare Advantage	$4,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,111.88
Rate for Payer: Cigna Commercial	$8,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,192.50
Rate for Payer: Oxford Commercial	$3,225.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75
Rate for Payer: UnitedHealthcare Commercial	$3,225.00
Rate for Payer: UnitedHealthcare Community & State	$509.55
Rate for Payer: Wellpoint Medicaid Managed Care	$457.95

SYSTEM JETSTREAM PV41340

Facility

$16,125.00

Hospital Charge Code	270647519A
Hospital Revenue Code	272
Min. Negotiated Rate	$457.95
Max. Negotiated Rate	$8,062.50
Rate for Payer: Aetna Commercial	$6,127.50
Rate for Payer: Aetna Medicare Advantage	$4,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,111.88
Rate for Payer: Cigna Commercial	$8,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,192.50
Rate for Payer: Oxford Commercial	$3,225.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75
Rate for Payer: UnitedHealthcare Commercial	$3,225.00
Rate for Payer: UnitedHealthcare Community & State	$509.55
Rate for Payer: Wellpoint Medicaid Managed Care	$457.95

SYSTEM JETSTREAM PV41340

Facility

$16,125.00

Hospital Charge Code	270647519C
Hospital Revenue Code	272
Min. Negotiated Rate	$2,418.75
Max. Negotiated Rate	$2,418.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75

SYSTEM KIT PREVENA PLUS

Facility

$3,250.00

Hospital Charge Code	270680164
Hospital Revenue Code	272
Min. Negotiated Rate	$92.30
Max. Negotiated Rate	$1,625.00
Rate for Payer: Aetna Commercial	$1,235.00
Rate for Payer: Aetna Medicare Advantage	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$828.75
Rate for Payer: Cigna Commercial	$1,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$845.00
Rate for Payer: Oxford Commercial	$650.00
Rate for Payer: Qualcare PPO/HMO/WC	$487.50
Rate for Payer: UnitedHealthcare Commercial	$650.00
Rate for Payer: UnitedHealthcare Community & State	$102.70
Rate for Payer: Wellpoint Medicaid Managed Care	$92.30

SYSTEM KIT PREVENA PLUS

Facility

$3,250.00

Hospital Charge Code	270680164
Hospital Revenue Code	272
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$487.50
Rate for Payer: Qualcare PPO/HMO/WC	$487.50

SYSTEM, LIF, ILLUMINATION STER

Facility

$1,512.50

Hospital Charge Code	270702573
Hospital Revenue Code	278
Min. Negotiated Rate	$226.88
Max. Negotiated Rate	$366.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$302.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$366.02
Rate for Payer: Qualcare PPO/HMO/WC	$226.88

SYSTEM, LIF, ILLUMINATION STER

Facility

$1,512.50

Hospital Charge Code	270702573
Hospital Revenue Code	278
Min. Negotiated Rate	$42.95
Max. Negotiated Rate	$756.25
Rate for Payer: Aetna Commercial	$574.75
Rate for Payer: Aetna Medicare Advantage	$453.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$385.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$385.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$385.69
Rate for Payer: Cigna Commercial	$756.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$366.02
Rate for Payer: Qualcare PPO/HMO/WC	$226.88
Rate for Payer: UnitedHealthcare Community & State	$47.80
Rate for Payer: Wellpoint Medicaid Managed Care	$42.95

SYSTEM LUMBAR VALVE BROWN

Facility

$6,590.50

Hospital Charge Code	270679119
Hospital Revenue Code	272
Min. Negotiated Rate	$988.58
Max. Negotiated Rate	$988.58
Rate for Payer: Qualcare PPO/HMO/WC	$988.58

SYSTEM LUMBAR VALVE BROWN

Facility

$6,590.50

Hospital Charge Code	270679119
Hospital Revenue Code	272
Min. Negotiated Rate	$187.17
Max. Negotiated Rate	$3,295.25
Rate for Payer: Aetna Commercial	$2,504.39
Rate for Payer: Aetna Medicare Advantage	$1,977.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,680.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,680.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,680.58
Rate for Payer: Cigna Commercial	$3,295.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,713.53
Rate for Payer: Oxford Commercial	$1,318.10
Rate for Payer: Qualcare PPO/HMO/WC	$988.58
Rate for Payer: UnitedHealthcare Commercial	$1,318.10
Rate for Payer: UnitedHealthcare Community & State	$208.26
Rate for Payer: Wellpoint Medicaid Managed Care	$187.17

SYSTEM LUMBAR VALVE GREEN

Facility

$6,590.50

Hospital Charge Code	270679117
Hospital Revenue Code	272
Min. Negotiated Rate	$988.58
Max. Negotiated Rate	$988.58
Rate for Payer: Qualcare PPO/HMO/WC	$988.58

SYSTEM LUMBAR VALVE GREEN

Facility

$6,590.50

Hospital Charge Code	270679117
Hospital Revenue Code	272
Min. Negotiated Rate	$187.17
Max. Negotiated Rate	$3,295.25
Rate for Payer: Aetna Commercial	$2,504.39
Rate for Payer: Aetna Medicare Advantage	$1,977.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,680.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,680.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,680.58
Rate for Payer: Cigna Commercial	$3,295.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,713.53
Rate for Payer: Oxford Commercial	$1,318.10
Rate for Payer: Qualcare PPO/HMO/WC	$988.58
Rate for Payer: UnitedHealthcare Commercial	$1,318.10
Rate for Payer: UnitedHealthcare Community & State	$208.26
Rate for Payer: Wellpoint Medicaid Managed Care	$187.17

SYSTEM LUMBAR VALVE WHITE

Facility

$6,590.50

Hospital Charge Code	270679118
Hospital Revenue Code	272
Min. Negotiated Rate	$988.58
Max. Negotiated Rate	$988.58
Rate for Payer: Qualcare PPO/HMO/WC	$988.58

SYSTEM LUMBAR VALVE WHITE

Facility

$6,590.50

Hospital Charge Code	270679118
Hospital Revenue Code	272
Min. Negotiated Rate	$187.17
Max. Negotiated Rate	$3,295.25
Rate for Payer: Aetna Commercial	$2,504.39
Rate for Payer: Aetna Medicare Advantage	$1,977.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,680.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,680.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,680.58
Rate for Payer: Cigna Commercial	$3,295.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,713.53
Rate for Payer: Oxford Commercial	$1,318.10
Rate for Payer: Qualcare PPO/HMO/WC	$988.58
Rate for Payer: UnitedHealthcare Commercial	$1,318.10
Rate for Payer: UnitedHealthcare Community & State	$208.26
Rate for Payer: Wellpoint Medicaid Managed Care	$187.17

SYSTEM LUMBAR VALVE YELLOW

Facility

$6,590.50

Hospital Charge Code	270679116
Hospital Revenue Code	272
Min. Negotiated Rate	$988.58
Max. Negotiated Rate	$988.58
Rate for Payer: Qualcare PPO/HMO/WC	$988.58

SYSTEM LUMBAR VALVE YELLOW

Facility

$6,590.50

Hospital Charge Code	270679116
Hospital Revenue Code	272
Min. Negotiated Rate	$187.17
Max. Negotiated Rate	$3,295.25
Rate for Payer: Aetna Commercial	$2,504.39
Rate for Payer: Aetna Medicare Advantage	$1,977.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,680.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,680.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,680.58
Rate for Payer: Cigna Commercial	$3,295.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,713.53
Rate for Payer: Oxford Commercial	$1,318.10
Rate for Payer: Qualcare PPO/HMO/WC	$988.58
Rate for Payer: UnitedHealthcare Commercial	$1,318.10
Rate for Payer: UnitedHealthcare Community & State	$208.26
Rate for Payer: Wellpoint Medicaid Managed Care	$187.17

SYSTEM LYNX SUPRAPUBIC

Facility

$6,250.00

Hospital Charge Code	270639478
Hospital Revenue Code	278
Min. Negotiated Rate	$177.50
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Community & State	$197.50
Rate for Payer: Wellpoint Medicaid Managed Care	$177.50

SYSTEM LYNX SUPRAPUBIC

Facility

$6,250.00

Hospital Charge Code	270639478
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

SYSTEM LYNX SUPRAPUBIC

Facility

$6,250.00

Service Code	HCPCS C1771
Hospital Charge Code	270639748
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

SYSTEM LYNX SUPRAPUBIC

Facility

$6,250.00

Service Code	HCPCS C1771
Hospital Charge Code	270639748
Hospital Revenue Code	278
Min. Negotiated Rate	$177.50
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Community & State	$197.50
Rate for Payer: Wellpoint Medicaid Managed Care	$177.50

SYSTEM MYOSURE XL TISSUE

Facility

$5,500.00

Hospital Charge Code	270684280
Hospital Revenue Code	272
Min. Negotiated Rate	$156.20
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,430.00
Rate for Payer: Oxford Commercial	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Commercial	$1,100.00
Rate for Payer: UnitedHealthcare Community & State	$173.80
Rate for Payer: Wellpoint Medicaid Managed Care	$156.20

SYSTEM MYOSURE XL TISSUE

Facility

$5,500.00

Hospital Charge Code	270684280
Hospital Revenue Code	272
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

SYSTEM PEEK ACHILLES SPEEDBRID

Facility

$9,975.00

Hospital Charge Code	270682874
Hospital Revenue Code	272
Min. Negotiated Rate	$283.29
Max. Negotiated Rate	$4,987.50
Rate for Payer: Aetna Commercial	$3,790.50
Rate for Payer: Aetna Medicare Advantage	$2,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,543.62
Rate for Payer: Cigna Commercial	$4,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,593.50
Rate for Payer: Oxford Commercial	$1,995.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25
Rate for Payer: UnitedHealthcare Commercial	$1,995.00
Rate for Payer: UnitedHealthcare Community & State	$315.21
Rate for Payer: Wellpoint Medicaid Managed Care	$283.29

SYSTEM PEEK ACHILLES SPEEDBRID

Facility

$9,975.00

Hospital Charge Code	270682874
Hospital Revenue Code	272
Min. Negotiated Rate	$1,496.25
Max. Negotiated Rate	$1,496.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25

SYSTEM PENUMBRA ENGINE

Facility

$30,000.00

Hospital Charge Code	270689720
Hospital Revenue Code	272
Min. Negotiated Rate	$4,500.00
Max. Negotiated Rate	$4,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,500.00

Know your out-of-pocket cost for care.

All Charges