Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TAPERLOC TYPE 1 PPS 9X137MM

Facility

$10,815.00

Service Code	HCPCS C1776
Hospital Charge Code	270700153
Hospital Revenue Code	278
Min. Negotiated Rate	$1,622.25
Max. Negotiated Rate	$2,617.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,163.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,617.23
Rate for Payer: Qualcare PPO/HMO/WC	$1,622.25

TAPERLOC TYPE PPS 11 MM

Facility

$12,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270678812
Hospital Revenue Code	278
Min. Negotiated Rate	$347.90
Max. Negotiated Rate	$6,125.00
Rate for Payer: Aetna Commercial	$4,655.00
Rate for Payer: Aetna Medicare Advantage	$3,675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,123.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,123.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,123.75
Rate for Payer: Cigna Commercial	$6,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,964.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,837.50
Rate for Payer: UnitedHealthcare Community & State	$387.10
Rate for Payer: Wellpoint Medicaid Managed Care	$347.90

TAPERLOC TYPE PPS 11 MM

Facility

$12,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270678812
Hospital Revenue Code	278
Min. Negotiated Rate	$1,837.50
Max. Negotiated Rate	$2,964.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,964.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,837.50

TAPER M/L 5 STD

Facility

$15,360.00

Hospital Charge Code	270666887
Hospital Revenue Code	278
Min. Negotiated Rate	$2,304.00
Max. Negotiated Rate	$3,717.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,072.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,717.12
Rate for Payer: Qualcare PPO/HMO/WC	$2,304.00

TAPER M/L 5 STD

Facility

$15,360.00

Hospital Charge Code	270666887
Hospital Revenue Code	278
Min. Negotiated Rate	$436.22
Max. Negotiated Rate	$7,680.00
Rate for Payer: Aetna Commercial	$5,836.80
Rate for Payer: Aetna Medicare Advantage	$4,608.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,916.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,916.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,072.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,916.80
Rate for Payer: Cigna Commercial	$7,680.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,717.12
Rate for Payer: Qualcare PPO/HMO/WC	$2,304.00
Rate for Payer: UnitedHealthcare Community & State	$485.38
Rate for Payer: Wellpoint Medicaid Managed Care	$436.22

TAPER POST12X32MM,SHOULDER,OVO

Facility

$4,710.00

Service Code	HCPCS C1776
Hospital Charge Code	270687342
Hospital Revenue Code	278
Min. Negotiated Rate	$706.50
Max. Negotiated Rate	$1,139.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$942.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,139.82
Rate for Payer: Qualcare PPO/HMO/WC	$706.50

TAPER POST12X32MM,SHOULDER,OVO

Facility

$4,710.00

Service Code	HCPCS C1776
Hospital Charge Code	270687342
Hospital Revenue Code	278
Min. Negotiated Rate	$133.76
Max. Negotiated Rate	$2,355.00
Rate for Payer: Aetna Commercial	$1,789.80
Rate for Payer: Aetna Medicare Advantage	$1,413.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,201.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,201.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$942.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,201.05
Rate for Payer: Cigna Commercial	$2,355.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,139.82
Rate for Payer: Qualcare PPO/HMO/WC	$706.50
Rate for Payer: UnitedHealthcare Community & State	$148.84
Rate for Payer: Wellpoint Medicaid Managed Care	$133.76

TAPER POST 9.5MM TITANIUM

Facility

$1,029.00

Hospital Charge Code	270337855
Hospital Revenue Code	278
Min. Negotiated Rate	$154.35
Max. Negotiated Rate	$249.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.02
Rate for Payer: Qualcare PPO/HMO/WC	$154.35

TAPER POST 9.5MM TITANIUM

Facility

$1,029.00

Hospital Charge Code	270337855
Hospital Revenue Code	278
Min. Negotiated Rate	$29.22
Max. Negotiated Rate	$514.50
Rate for Payer: Aetna Commercial	$391.02
Rate for Payer: Aetna Medicare Advantage	$308.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$262.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$262.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$262.39
Rate for Payer: Cigna Commercial	$514.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.02
Rate for Payer: Qualcare PPO/HMO/WC	$154.35
Rate for Payer: UnitedHealthcare Community & State	$32.52
Rate for Payer: Wellpoint Medicaid Managed Care	$29.22

TAPER ROUTER 2.3X 19MM

Facility

$395.00

Hospital Charge Code	270691574
Hospital Revenue Code	272
Min. Negotiated Rate	$11.22
Max. Negotiated Rate	$197.50
Rate for Payer: Aetna Commercial	$150.10
Rate for Payer: Aetna Medicare Advantage	$118.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.72
Rate for Payer: Cigna Commercial	$197.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.70
Rate for Payer: Oxford Commercial	$79.00
Rate for Payer: Qualcare PPO/HMO/WC	$59.25
Rate for Payer: UnitedHealthcare Commercial	$79.00
Rate for Payer: UnitedHealthcare Community & State	$12.48
Rate for Payer: Wellpoint Medicaid Managed Care	$11.22

TAPER ROUTER 2.3X 19MM

Facility

$395.00

Hospital Charge Code	270691574
Hospital Revenue Code	272
Min. Negotiated Rate	$59.25
Max. Negotiated Rate	$59.25
Rate for Payer: Qualcare PPO/HMO/WC	$59.25

TAPE SCOTCHCAST SYNTH 5X4 YD

Facility

$20.55

Hospital Charge Code	270654217
Hospital Revenue Code	270
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$3.08
Rate for Payer: Qualcare PPO/HMO/WC	$3.08

TAPE SCOTCHCAST SYNTH 5X4 YD

Facility

$20.55

Hospital Charge Code	270654217
Hospital Revenue Code	270
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$10.28
Rate for Payer: Aetna Commercial	$7.81
Rate for Payer: Aetna Medicare Advantage	$6.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.24
Rate for Payer: Cigna Commercial	$10.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.34
Rate for Payer: Oxford Commercial	$4.11
Rate for Payer: Qualcare PPO/HMO/WC	$3.08
Rate for Payer: UnitedHealthcare Commercial	$4.11
Rate for Payer: UnitedHealthcare Community & State	$0.65
Rate for Payer: Wellpoint Medicaid Managed Care	$0.58

TAPESTRY BIOINTEG IMP 40X30MM

Facility

$17,250.00

Service Code	HCPCS C1763
Hospital Charge Code	270698253
Hospital Revenue Code	278
Min. Negotiated Rate	$2,587.50
Max. Negotiated Rate	$4,174.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50

TAPESTRY BIOINTEG IMP 40X30MM

Facility

$17,250.00

Service Code	HCPCS C1763
Hospital Charge Code	270698253
Hospital Revenue Code	278
Min. Negotiated Rate	$489.90
Max. Negotiated Rate	$8,625.00
Rate for Payer: Aetna Commercial	$6,555.00
Rate for Payer: Aetna Medicare Advantage	$5,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,398.75
Rate for Payer: Cigna Commercial	$8,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50
Rate for Payer: UnitedHealthcare Community & State	$545.10
Rate for Payer: Wellpoint Medicaid Managed Care	$489.90

TAPESTRY BIOINT IMP 50X40X25MM

Facility

$15,550.00

Service Code	HCPCS C1763
Hospital Charge Code	270699888
Hospital Revenue Code	278
Min. Negotiated Rate	$2,332.50
Max. Negotiated Rate	$3,763.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,763.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,332.50

TAPESTRY BIOINT IMP 50X40X25MM

Facility

$15,550.00

Service Code	HCPCS C1763
Hospital Charge Code	270699888
Hospital Revenue Code	278
Min. Negotiated Rate	$441.62
Max. Negotiated Rate	$7,775.00
Rate for Payer: Aetna Commercial	$5,909.00
Rate for Payer: Aetna Medicare Advantage	$4,665.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,965.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,965.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,965.25
Rate for Payer: Cigna Commercial	$7,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,763.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,332.50
Rate for Payer: UnitedHealthcare Community & State	$491.38
Rate for Payer: Wellpoint Medicaid Managed Care	$441.62

TAPE SURGICAL 3X5-1/2YD

Facility

$50.00

Hospital Charge Code	270331213
Hospital Revenue Code	272
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

TAPE SURGICAL 3X5-1/2YD

Facility

$50.00

Hospital Charge Code	270331213
Hospital Revenue Code	272
Min. Negotiated Rate	$1.42
Max. Negotiated Rate	$25.00
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.00
Rate for Payer: Oxford Commercial	$10.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$10.00
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.42

TAPE SURGICAL DURAPORE 3X10YD

Facility

$24.00

Hospital Charge Code	270331214
Hospital Revenue Code	272
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$12.00
Rate for Payer: Aetna Commercial	$9.12
Rate for Payer: Aetna Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.12
Rate for Payer: Cigna Commercial	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.24
Rate for Payer: Oxford Commercial	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$3.60
Rate for Payer: UnitedHealthcare Commercial	$4.80
Rate for Payer: UnitedHealthcare Community & State	$0.76
Rate for Payer: Wellpoint Medicaid Managed Care	$0.68

TAPE SURGICAL DURAPORE 3X10YD

Facility

$24.00

Hospital Charge Code	270331214
Hospital Revenue Code	272
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.60

TAPE TIGER

Facility

$250.00

Hospital Charge Code	270665746
Hospital Revenue Code	272
Min. Negotiated Rate	$7.10
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$95.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.00
Rate for Payer: Oxford Commercial	$50.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$50.00
Rate for Payer: UnitedHealthcare Community & State	$7.90
Rate for Payer: Wellpoint Medicaid Managed Care	$7.10

TAPE TIGER

Facility

$250.00

Hospital Charge Code	270665746
Hospital Revenue Code	272
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

TAPE UMBILICAL COTTON 2x30x1/8

Facility

$4.15

Hospital Charge Code	270656087
Hospital Revenue Code	272
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.08
Rate for Payer: Aetna Commercial	$1.58
Rate for Payer: Aetna Medicare Advantage	$1.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.06
Rate for Payer: Cigna Commercial	$2.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.08
Rate for Payer: Oxford Commercial	$0.83
Rate for Payer: Qualcare PPO/HMO/WC	$0.62
Rate for Payer: UnitedHealthcare Commercial	$0.83
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.12

TAPE UMBILICAL COTTON 2x30x1/8

Facility

$4.15

Hospital Charge Code	270656087
Hospital Revenue Code	272
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$0.62
Rate for Payer: Qualcare PPO/HMO/WC	$0.62

Know your out-of-pocket cost for care.

All Charges