Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SYSTEM PENUMBRA ENGINE

Facility

$30,000.00

Hospital Charge Code	270689720
Hospital Revenue Code	272
Min. Negotiated Rate	$852.00
Max. Negotiated Rate	$15,000.00
Rate for Payer: Aetna Commercial	$11,400.00
Rate for Payer: Aetna Medicare Advantage	$9,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,650.00
Rate for Payer: Cigna Commercial	$15,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,800.00
Rate for Payer: Oxford Commercial	$6,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,500.00
Rate for Payer: UnitedHealthcare Commercial	$6,000.00
Rate for Payer: UnitedHealthcare Community & State	$948.00
Rate for Payer: Wellpoint Medicaid Managed Care	$852.00

SYSTEMPIPELINE SHIELD 3.5X16MM

Facility

$93,765.00

Service Code	HCPCS C1889
Hospital Charge Code	270700365S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,662.93
Max. Negotiated Rate	$46,882.50
Rate for Payer: Aetna Commercial	$35,630.70
Rate for Payer: Aetna Medicare Advantage	$28,129.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,910.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,910.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18,753.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,910.08
Rate for Payer: Cigna Commercial	$46,882.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22,691.13
Rate for Payer: Qualcare PPO/HMO/WC	$14,064.75
Rate for Payer: UnitedHealthcare Community & State	$2,962.97
Rate for Payer: Wellpoint Medicaid Managed Care	$2,662.93

SYSTEMPIPELINE SHIELD 3.5X16MM

Facility

$93,765.00

Service Code	HCPCS C1889
Hospital Charge Code	270700365S
Hospital Revenue Code	278
Min. Negotiated Rate	$14,064.75
Max. Negotiated Rate	$22,691.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18,753.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22,691.13
Rate for Payer: Qualcare PPO/HMO/WC	$14,064.75

SYSTEM RETRACTOR TLC 8201175

Facility

$625.00

Hospital Charge Code	270633800
Hospital Revenue Code	272
Min. Negotiated Rate	$17.75
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.50
Rate for Payer: Oxford Commercial	$125.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Commercial	$125.00
Rate for Payer: UnitedHealthcare Community & State	$19.75
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

SYSTEM RETRACTOR TLC 8201175

Facility

$625.00

Hospital Charge Code	270633800
Hospital Revenue Code	272
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

SYSTEM SMALL JOINT REAMING

Facility

$2,775.00

Service Code	HCPCS C1776
Hospital Charge Code	270680731
Hospital Revenue Code	278
Min. Negotiated Rate	$78.81
Max. Negotiated Rate	$1,387.50
Rate for Payer: Aetna Commercial	$1,054.50
Rate for Payer: Aetna Medicare Advantage	$832.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$707.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$707.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$707.62
Rate for Payer: Cigna Commercial	$1,387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$671.55
Rate for Payer: Qualcare PPO/HMO/WC	$416.25
Rate for Payer: UnitedHealthcare Community & State	$87.69
Rate for Payer: Wellpoint Medicaid Managed Care	$78.81

SYSTEM SMALL JOINT REAMING

Facility

$2,775.00

Service Code	HCPCS C1776
Hospital Charge Code	270680731
Hospital Revenue Code	278
Min. Negotiated Rate	$416.25
Max. Negotiated Rate	$671.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$555.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$671.55
Rate for Payer: Qualcare PPO/HMO/WC	$416.25

SYSTEM SOLYX SIS

Facility

$9,501.75

Service Code	HCPCS C1771
Hospital Charge Code	270677084
Hospital Revenue Code	278
Min. Negotiated Rate	$269.85
Max. Negotiated Rate	$4,750.88
Rate for Payer: Aetna Commercial	$3,610.66
Rate for Payer: Aetna Medicare Advantage	$2,850.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,422.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,422.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,900.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,422.95
Rate for Payer: Cigna Commercial	$4,750.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,299.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.26
Rate for Payer: UnitedHealthcare Community & State	$300.26
Rate for Payer: Wellpoint Medicaid Managed Care	$269.85

SYSTEM SOLYX SIS

Facility

$9,501.75

Service Code	HCPCS C1771
Hospital Charge Code	270677084
Hospital Revenue Code	278
Min. Negotiated Rate	$1,425.26
Max. Negotiated Rate	$2,299.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,900.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,299.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.26

SYSTEM SPARC SLING

Facility

$4,625.00

Service Code	HCPCS C1771
Hospital Charge Code	270623602
Hospital Revenue Code	278
Min. Negotiated Rate	$131.35
Max. Negotiated Rate	$2,312.50
Rate for Payer: Aetna Commercial	$1,757.50
Rate for Payer: Aetna Medicare Advantage	$1,387.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,179.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,179.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,179.38
Rate for Payer: Cigna Commercial	$2,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,119.25
Rate for Payer: Qualcare PPO/HMO/WC	$693.75
Rate for Payer: UnitedHealthcare Community & State	$146.15
Rate for Payer: Wellpoint Medicaid Managed Care	$131.35

SYSTEM SPARC SLING

Facility

$4,625.00

Service Code	HCPCS C1771
Hospital Charge Code	270623602
Hospital Revenue Code	278
Min. Negotiated Rate	$693.75
Max. Negotiated Rate	$1,119.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,119.25
Rate for Payer: Qualcare PPO/HMO/WC	$693.75

SYSTEM SYMPHONY SINGLE PUMP

Facility

$71.04

Hospital Charge Code	270667339
Hospital Revenue Code	270
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$35.52
Rate for Payer: Aetna Commercial	$27.00
Rate for Payer: Aetna Medicare Advantage	$21.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.12
Rate for Payer: Cigna Commercial	$35.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.47
Rate for Payer: Oxford Commercial	$14.21
Rate for Payer: Qualcare PPO/HMO/WC	$10.66
Rate for Payer: UnitedHealthcare Commercial	$14.21
Rate for Payer: UnitedHealthcare Community & State	$2.24
Rate for Payer: Wellpoint Medicaid Managed Care	$2.02

SYSTEM SYMPHONY SINGLE PUMP

Facility

$71.04

Hospital Charge Code	270667339
Hospital Revenue Code	270
Min. Negotiated Rate	$10.66
Max. Negotiated Rate	$10.66
Rate for Payer: Qualcare PPO/HMO/WC	$10.66

SYSTEM UCL INTERNAL BRACE

Facility

$5,895.00

Hospital Charge Code	270680851
Hospital Revenue Code	278
Min. Negotiated Rate	$884.25
Max. Negotiated Rate	$1,426.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,179.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,426.59
Rate for Payer: Qualcare PPO/HMO/WC	$884.25

SYSTEM UCL INTERNAL BRACE

Facility

$5,895.00

Hospital Charge Code	270680851
Hospital Revenue Code	278
Min. Negotiated Rate	$167.42
Max. Negotiated Rate	$2,947.50
Rate for Payer: Aetna Commercial	$2,240.10
Rate for Payer: Aetna Medicare Advantage	$1,768.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,503.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,503.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,179.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,503.22
Rate for Payer: Cigna Commercial	$2,947.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,426.59
Rate for Payer: Qualcare PPO/HMO/WC	$884.25
Rate for Payer: UnitedHealthcare Community & State	$186.28
Rate for Payer: Wellpoint Medicaid Managed Care	$167.42

SYSTEM UROST 45MM 3/4FL

Facility

$92.00

Hospital Charge Code	270600410
Hospital Revenue Code	272
Min. Negotiated Rate	$13.80
Max. Negotiated Rate	$13.80
Rate for Payer: Qualcare PPO/HMO/WC	$13.80

SYSTEM UROST 45MM 3/4FL

Facility

$92.00

Hospital Charge Code	270600410
Hospital Revenue Code	272
Min. Negotiated Rate	$2.61
Max. Negotiated Rate	$46.00
Rate for Payer: Aetna Commercial	$34.96
Rate for Payer: Aetna Medicare Advantage	$27.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.46
Rate for Payer: Cigna Commercial	$46.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.92
Rate for Payer: Oxford Commercial	$18.40
Rate for Payer: Qualcare PPO/HMO/WC	$13.80
Rate for Payer: UnitedHealthcare Commercial	$18.40
Rate for Payer: UnitedHealthcare Community & State	$2.91
Rate for Payer: Wellpoint Medicaid Managed Care	$2.61

SYST FIXAT LAP W/FASTNERS

Facility

$1,975.00

Hospital Charge Code	270644630
Hospital Revenue Code	272
Min. Negotiated Rate	$56.09
Max. Negotiated Rate	$987.50
Rate for Payer: Aetna Commercial	$750.50
Rate for Payer: Aetna Medicare Advantage	$592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$503.62
Rate for Payer: Cigna Commercial	$987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$513.50
Rate for Payer: Oxford Commercial	$395.00
Rate for Payer: Qualcare PPO/HMO/WC	$296.25
Rate for Payer: UnitedHealthcare Commercial	$395.00
Rate for Payer: UnitedHealthcare Community & State	$62.41
Rate for Payer: Wellpoint Medicaid Managed Care	$56.09

SYST FIXAT LAP W/FASTNERS

Facility

$1,975.00

Hospital Charge Code	270644630
Hospital Revenue Code	272
Min. Negotiated Rate	$296.25
Max. Negotiated Rate	$296.25
Rate for Payer: Qualcare PPO/HMO/WC	$296.25

SYSTM CLLCTION DUAL HYGIENIKIT

Facility

$557.25

Hospital Charge Code	270662661
Hospital Revenue Code	270
Min. Negotiated Rate	$15.83
Max. Negotiated Rate	$278.62
Rate for Payer: Aetna Commercial	$211.75
Rate for Payer: Aetna Medicare Advantage	$167.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.10
Rate for Payer: Cigna Commercial	$278.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.88
Rate for Payer: Oxford Commercial	$111.45
Rate for Payer: Qualcare PPO/HMO/WC	$83.59
Rate for Payer: UnitedHealthcare Commercial	$111.45
Rate for Payer: UnitedHealthcare Community & State	$17.61
Rate for Payer: Wellpoint Medicaid Managed Care	$15.83

SYSTM CLLCTION DUAL HYGIENIKIT

Facility

$557.25

Hospital Charge Code	270662661
Hospital Revenue Code	270
Min. Negotiated Rate	$83.59
Max. Negotiated Rate	$83.59
Rate for Payer: Qualcare PPO/HMO/WC	$83.59

SYST PICO NEG PRESS 10X20CM

Facility

$1,149.50

Hospital Charge Code	270678297
Hospital Revenue Code	272
Min. Negotiated Rate	$172.43
Max. Negotiated Rate	$172.43
Rate for Payer: Qualcare PPO/HMO/WC	$172.43

SYST PICO NEG PRESS 10X20CM

Facility

$1,149.50

Hospital Charge Code	270678297
Hospital Revenue Code	272
Min. Negotiated Rate	$32.65
Max. Negotiated Rate	$574.75
Rate for Payer: Aetna Commercial	$436.81
Rate for Payer: Aetna Medicare Advantage	$344.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.12
Rate for Payer: Cigna Commercial	$574.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$298.87
Rate for Payer: Oxford Commercial	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$172.43
Rate for Payer: UnitedHealthcare Commercial	$229.90
Rate for Payer: UnitedHealthcare Community & State	$36.32
Rate for Payer: Wellpoint Medicaid Managed Care	$32.65

SYST PICO NEG PRESS 15x15CM

Facility

$1,149.50

Hospital Charge Code	270677028
Hospital Revenue Code	272
Min. Negotiated Rate	$172.43
Max. Negotiated Rate	$172.43
Rate for Payer: Qualcare PPO/HMO/WC	$172.43

SYST PICO NEG PRESS 15x15CM

Facility

$1,149.50

Hospital Charge Code	270677028
Hospital Revenue Code	272
Min. Negotiated Rate	$32.65
Max. Negotiated Rate	$574.75
Rate for Payer: Aetna Commercial	$436.81
Rate for Payer: Aetna Medicare Advantage	$344.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.12
Rate for Payer: Cigna Commercial	$574.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$298.87
Rate for Payer: Oxford Commercial	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$172.43
Rate for Payer: UnitedHealthcare Commercial	$229.90
Rate for Payer: UnitedHealthcare Community & State	$36.32
Rate for Payer: Wellpoint Medicaid Managed Care	$32.65

Know your out-of-pocket cost for care.

All Charges