Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SYST PICO NEG PRESS 15x30CM

Facility

$1,149.50

Hospital Charge Code	270678298
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 15x30CM

Facility

$1,149.50

Hospital Charge Code	270678298
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 4x11

Facility

$3,448.50

Hospital Charge Code	270678394
Hospital Revenue Code	272
Min. Negotiated Rate	$97.94
Max. Negotiated Rate	$1,724.25
Rate for Payer: Aetna Commercial	$1,310.43
Rate for Payer: Aetna Medicare Advantage	$1,034.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$879.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$879.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$879.37
Rate for Payer: Cigna Commercial	$1,724.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$896.61
Rate for Payer: Oxford Commercial	$689.70
Rate for Payer: Qualcare PPO/HMO/WC	$517.27
Rate for Payer: UnitedHealthcare Commercial	$689.70
Rate for Payer: UnitedHealthcare Community & State	$108.97
Rate for Payer: Wellpoint Medicaid Managed Care	$97.94

SYST PICO NEG PRESS 4x11

Facility

$3,448.50

Hospital Charge Code	270678394
Hospital Revenue Code	272
Min. Negotiated Rate	$517.27
Max. Negotiated Rate	$517.27
Rate for Payer: Qualcare PPO/HMO/WC	$517.27

SYST PICO NEG PRESS 4x16x3/4

Facility

$1,149.50

Hospital Charge Code	270678395
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 4x16x3/4

Facility

$1,149.50

Hospital Charge Code	270678395
Hospital Revenue Code	272
Min. Negotiated Rate	$172.43
Max. Negotiated Rate	$172.43
Rate for Payer: Qualcare PPO/HMO/WC	$172.43

SYST UPHOLD LITE W/CAPIO SLIM

Facility

$11,600.00

Service Code	HCPCS C1763
Hospital Charge Code	270677082
Hospital Revenue Code	278
Min. Negotiated Rate	$329.44
Max. Negotiated Rate	$5,800.00
Rate for Payer: Aetna Commercial	$4,408.00
Rate for Payer: Aetna Medicare Advantage	$3,480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,958.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,958.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,958.00
Rate for Payer: Cigna Commercial	$5,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,807.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,740.00
Rate for Payer: UnitedHealthcare Community & State	$366.56
Rate for Payer: Wellpoint Medicaid Managed Care	$329.44

SYST UPHOLD LITE W/CAPIO SLIM

Facility

$11,600.00

Service Code	HCPCS C1763
Hospital Charge Code	270677082
Hospital Revenue Code	278
Min. Negotiated Rate	$1,740.00
Max. Negotiated Rate	$2,807.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,807.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,740.00

T-15 TAPERED DRIVER

Facility

$2,090.00

Hospital Charge Code	270686087
Hospital Revenue Code	272
Min. Negotiated Rate	$313.50
Max. Negotiated Rate	$313.50
Rate for Payer: Qualcare PPO/HMO/WC	$313.50

T-15 TAPERED DRIVER

Facility

$2,090.00

Hospital Charge Code	270686087
Hospital Revenue Code	272
Min. Negotiated Rate	$59.36
Max. Negotiated Rate	$1,045.00
Rate for Payer: Aetna Commercial	$794.20
Rate for Payer: Aetna Medicare Advantage	$627.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$532.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$532.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$532.95
Rate for Payer: Cigna Commercial	$1,045.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$543.40
Rate for Payer: Oxford Commercial	$418.00
Rate for Payer: Qualcare PPO/HMO/WC	$313.50
Rate for Payer: UnitedHealthcare Commercial	$418.00
Rate for Payer: UnitedHealthcare Community & State	$66.04
Rate for Payer: Wellpoint Medicaid Managed Care	$59.36

T1 CANN TFNA

Facility

$7,919.65

Service Code	HCPCS C1713
Hospital Charge Code	270686307
Hospital Revenue Code	278
Min. Negotiated Rate	$1,187.95
Max. Negotiated Rate	$1,916.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,583.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,916.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.95

T1 CANN TFNA

Facility

$7,919.65

Service Code	HCPCS C1713
Hospital Charge Code	270686307
Hospital Revenue Code	278
Min. Negotiated Rate	$224.92
Max. Negotiated Rate	$3,959.82
Rate for Payer: Aetna Commercial	$3,009.47
Rate for Payer: Aetna Medicare Advantage	$2,375.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,019.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,019.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,583.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,019.51
Rate for Payer: Cigna Commercial	$3,959.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,916.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.95
Rate for Payer: UnitedHealthcare Community & State	$250.26
Rate for Payer: Wellpoint Medicaid Managed Care	$224.92

T1 LAG SCREW 10.5X90MM

Facility

$4,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270656563
Hospital Revenue Code	278
Min. Negotiated Rate	$125.81
Max. Negotiated Rate	$2,215.00
Rate for Payer: Aetna Commercial	$1,683.40
Rate for Payer: Aetna Medicare Advantage	$1,329.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,129.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,129.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$886.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,129.65
Rate for Payer: Cigna Commercial	$2,215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,072.06
Rate for Payer: Qualcare PPO/HMO/WC	$664.50
Rate for Payer: UnitedHealthcare Community & State	$139.99
Rate for Payer: Wellpoint Medicaid Managed Care	$125.81

T1 LAG SCREW 10.5X90MM

Facility

$4,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270656563
Hospital Revenue Code	278
Min. Negotiated Rate	$664.50
Max. Negotiated Rate	$1,072.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$886.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,072.06
Rate for Payer: Qualcare PPO/HMO/WC	$664.50

T30 LOCK SCREW

Facility

$925.00

Service Code	HCPCS C1713
Hospital Charge Code	270695751
Hospital Revenue Code	278
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$223.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.85
Rate for Payer: Qualcare PPO/HMO/WC	$138.75

T30 LOCK SCREW

Facility

$925.00

Service Code	HCPCS C1713
Hospital Charge Code	270695751
Hospital Revenue Code	278
Min. Negotiated Rate	$26.27
Max. Negotiated Rate	$462.50
Rate for Payer: Aetna Commercial	$351.50
Rate for Payer: Aetna Medicare Advantage	$277.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.88
Rate for Payer: Cigna Commercial	$462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.85
Rate for Payer: Qualcare PPO/HMO/WC	$138.75
Rate for Payer: UnitedHealthcare Community & State	$29.23
Rate for Payer: Wellpoint Medicaid Managed Care	$26.27

T3 FREE

Facility

$261.00

Service Code	HCPCS 84481
Hospital Charge Code	38472801
Hospital Revenue Code	301
Min. Negotiated Rate	$7.41
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$46.08
Rate for Payer: Aetna Medicare Advantage	$54.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.45
Rate for Payer: Cigna Commercial	$130.50
Rate for Payer: Cigna Medicare Advantage	$16.94
Rate for Payer: Clover Medicare Advantage	$16.09
Rate for Payer: EmblemHealth Commercial	$50.82
Rate for Payer: Humana Medicare Advantage	$17.45
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.86
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.15
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.94
Rate for Payer: Wellcare Medicare Advantage	$16.94
Rate for Payer: Wellpoint Medicaid Managed Care	$7.41

T3 FREE

Facility

$261.00

Service Code	HCPCS 84481
Hospital Charge Code	38472801
Hospital Revenue Code	301
Min. Negotiated Rate	$39.15
Max. Negotiated Rate	$39.15
Rate for Payer: Qualcare PPO/HMO/WC	$39.15

T3 HEMODIALYS 15X5F 15CM CT ST

Facility

$700.00

Hospital Charge Code	270680502
Hospital Revenue Code	272
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.00
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Commercial	$140.00
Rate for Payer: UnitedHealthcare Community & State	$22.12
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

T3 HEMODIALYS 15X5F 15CM CT ST

Facility

$700.00

Hospital Charge Code	270680502
Hospital Revenue Code	272
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

T3,REVERSE,LC/MS/MS

Facility

$390.00

Service Code	HCPCS 84482
Hospital Charge Code	39900145
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$42.87
Rate for Payer: Aetna Medicare Advantage	$51.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.17
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$15.76
Rate for Payer: Clover Medicare Advantage	$14.97
Rate for Payer: EmblemHealth Commercial	$47.28
Rate for Payer: Humana Medicare Advantage	$16.23
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$12.61
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.76
Rate for Payer: Wellcare Medicare Advantage	$15.76
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

T3,REVERSE,LC/MS/MS

Facility

$390.00

Service Code	HCPCS 84482
Hospital Charge Code	39900145
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

T3 TOTAL

Facility

$667.59

Service Code	HCPCS 84480
Hospital Charge Code	3003712
Hospital Revenue Code	301
Min. Negotiated Rate	$11.34
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$38.57
Rate for Payer: Aetna Medicare Advantage	$45.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.44
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$14.18
Rate for Payer: Clover Medicare Advantage	$13.47
Rate for Payer: EmblemHealth Commercial	$42.54
Rate for Payer: Humana Medicare Advantage	$14.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.57
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$11.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.18
Rate for Payer: Wellcare Medicare Advantage	$14.18
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

T3 TOTAL

Facility

$667.59

Service Code	HCPCS 84480
Hospital Charge Code	3003712
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

T3 (TRIIODOTHYRONINE)

Facility

$295.00

Service Code	HCPCS 84480
Hospital Charge Code	38472623
Hospital Revenue Code	301
Min. Negotiated Rate	$8.38
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$38.57
Rate for Payer: Aetna Medicare Advantage	$45.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.44
Rate for Payer: Cigna Commercial	$147.50
Rate for Payer: Cigna Medicare Advantage	$14.18
Rate for Payer: Clover Medicare Advantage	$13.47
Rate for Payer: EmblemHealth Commercial	$42.54
Rate for Payer: Humana Medicare Advantage	$14.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.70
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.25
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$11.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.18
Rate for Payer: Wellcare Medicare Advantage	$14.18
Rate for Payer: Wellpoint Medicaid Managed Care	$8.38

Know your out-of-pocket cost for care.

All Charges