Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TIGHTTOPE WTH FIBER TAG

Facility

$2,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270690695
Hospital Revenue Code	278
Min. Negotiated Rate	$393.75
Max. Negotiated Rate	$635.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$635.25
Rate for Payer: Qualcare PPO/HMO/WC	$393.75

TIGHTTOPE WTH FIBER TAG

Facility

$2,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270690695
Hospital Revenue Code	278
Min. Negotiated Rate	$74.55
Max. Negotiated Rate	$1,312.50
Rate for Payer: Aetna Commercial	$997.50
Rate for Payer: Aetna Medicare Advantage	$787.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$669.38
Rate for Payer: Cigna Commercial	$1,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$635.25
Rate for Payer: Qualcare PPO/HMO/WC	$393.75
Rate for Payer: UnitedHealthcare Community & State	$82.95
Rate for Payer: Wellpoint Medicaid Managed Care	$74.55

TIGRIS VASCULAR STENT

Facility

$7,475.00

Service Code	HCPCS C1874
Hospital Charge Code	270680396
Hospital Revenue Code	278
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,808.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

TIGRIS VASCULAR STENT

Facility

$7,475.00

Service Code	HCPCS C1874
Hospital Charge Code	270680396
Hospital Revenue Code	278
Min. Negotiated Rate	$212.29
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,840.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Community & State	$236.21
Rate for Payer: Wellpoint Medicaid Managed Care	$212.29

TILDA LEAD 45CM

Facility

$2,125.00

Service Code	HCPCS C1898
Hospital Charge Code	270663606
Hospital Revenue Code	278
Min. Negotiated Rate	$318.75
Max. Negotiated Rate	$514.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: Qualcare PPO/HMO/WC	$318.75

TILDA LEAD 45CM

Facility

$2,125.00

Service Code	HCPCS C1898
Hospital Charge Code	270663606
Hospital Revenue Code	278
Min. Negotiated Rate	$60.35
Max. Negotiated Rate	$1,062.50
Rate for Payer: Aetna Commercial	$807.50
Rate for Payer: Aetna Medicare Advantage	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$541.88
Rate for Payer: Cigna Commercial	$1,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: Qualcare PPO/HMO/WC	$318.75
Rate for Payer: UnitedHealthcare Community & State	$67.15
Rate for Payer: Wellpoint Medicaid Managed Care	$60.35

TILDA LEAD 53CM

Facility

$2,125.00

Service Code	HCPCS C1898
Hospital Charge Code	270675292
Hospital Revenue Code	278
Min. Negotiated Rate	$60.35
Max. Negotiated Rate	$1,062.50
Rate for Payer: Aetna Commercial	$807.50
Rate for Payer: Aetna Medicare Advantage	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$541.88
Rate for Payer: Cigna Commercial	$1,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: Qualcare PPO/HMO/WC	$318.75
Rate for Payer: UnitedHealthcare Community & State	$67.15
Rate for Payer: Wellpoint Medicaid Managed Care	$60.35

TILDA LEAD 53CM

Facility

$2,125.00

Service Code	HCPCS C1898
Hospital Charge Code	270675292
Hospital Revenue Code	278
Min. Negotiated Rate	$318.75
Max. Negotiated Rate	$514.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: Qualcare PPO/HMO/WC	$318.75

TILDA LEAD R53

Facility

$2,125.00

Service Code	HCPCS C1898
Hospital Charge Code	270662058
Hospital Revenue Code	278
Min. Negotiated Rate	$318.75
Max. Negotiated Rate	$514.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: Qualcare PPO/HMO/WC	$318.75

TILDA LEAD R53

Facility

$2,125.00

Service Code	HCPCS C1898
Hospital Charge Code	270662058
Hospital Revenue Code	278
Min. Negotiated Rate	$60.35
Max. Negotiated Rate	$1,062.50
Rate for Payer: Aetna Commercial	$807.50
Rate for Payer: Aetna Medicare Advantage	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$541.88
Rate for Payer: Cigna Commercial	$1,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: Qualcare PPO/HMO/WC	$318.75
Rate for Payer: UnitedHealthcare Community & State	$67.15
Rate for Payer: Wellpoint Medicaid Managed Care	$60.35

TILDA R45 RIGHT ATRIAL LEAD

Facility

$2,125.00

Service Code	HCPCS C1898
Hospital Charge Code	270663696
Hospital Revenue Code	275
Min. Negotiated Rate	$60.35
Max. Negotiated Rate	$1,062.50
Rate for Payer: Aetna Commercial	$807.50
Rate for Payer: Aetna Medicare Advantage	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$541.88
Rate for Payer: Cigna Commercial	$1,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: Qualcare PPO/HMO/WC	$318.75
Rate for Payer: UnitedHealthcare Community & State	$67.15
Rate for Payer: Wellpoint Medicaid Managed Care	$60.35

TILDA R45 RIGHT ATRIAL LEAD

Facility

$2,125.00

Service Code	HCPCS C1898
Hospital Charge Code	270663696
Hospital Revenue Code	275
Min. Negotiated Rate	$318.75
Max. Negotiated Rate	$514.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: Qualcare PPO/HMO/WC	$318.75

TI LIFE ANT LORD CERV CAGE SM

Facility

$19,975.00

Hospital Charge Code	270702199
Hospital Revenue Code	278
Min. Negotiated Rate	$567.29
Max. Negotiated Rate	$9,987.50
Rate for Payer: Aetna Commercial	$7,590.50
Rate for Payer: Aetna Medicare Advantage	$5,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,093.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,093.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,093.62
Rate for Payer: Cigna Commercial	$9,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,833.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,996.25
Rate for Payer: UnitedHealthcare Community & State	$631.21
Rate for Payer: Wellpoint Medicaid Managed Care	$567.29

TI LIFE ANT LORD CERV CAGE SM

Facility

$19,975.00

Hospital Charge Code	270702199
Hospital Revenue Code	278
Min. Negotiated Rate	$2,996.25
Max. Negotiated Rate	$4,833.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,833.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,996.25

TI LIFE ANT LORDOTIC CERV CAGE

Facility

$19,975.00

Hospital Charge Code	270702219
Hospital Revenue Code	278
Min. Negotiated Rate	$567.29
Max. Negotiated Rate	$9,987.50
Rate for Payer: Aetna Commercial	$7,590.50
Rate for Payer: Aetna Medicare Advantage	$5,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,093.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,093.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,093.62
Rate for Payer: Cigna Commercial	$9,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,833.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,996.25
Rate for Payer: UnitedHealthcare Community & State	$631.21
Rate for Payer: Wellpoint Medicaid Managed Care	$567.29

TI LIFE ANT LORDOTIC CERV CAGE

Facility

$19,975.00

Hospital Charge Code	270702205
Hospital Revenue Code	278
Min. Negotiated Rate	$567.29
Max. Negotiated Rate	$9,987.50
Rate for Payer: Aetna Commercial	$7,590.50
Rate for Payer: Aetna Medicare Advantage	$5,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,093.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,093.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,093.62
Rate for Payer: Cigna Commercial	$9,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,833.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,996.25
Rate for Payer: UnitedHealthcare Community & State	$631.21
Rate for Payer: Wellpoint Medicaid Managed Care	$567.29

TI LIFE ANT LORDOTIC CERV CAGE

Facility

$19,975.00

Hospital Charge Code	270702205
Hospital Revenue Code	278
Min. Negotiated Rate	$2,996.25
Max. Negotiated Rate	$4,833.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,833.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,996.25

TI LIFE ANT LORDOTIC CERV CAGE

Facility

$19,975.00

Hospital Charge Code	270702219
Hospital Revenue Code	278
Min. Negotiated Rate	$2,996.25
Max. Negotiated Rate	$4,833.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,833.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,996.25

TILT TABLE EVAL

Facility

$1,235.00

Service Code	HCPCS 93660
Hospital Charge Code	366893660
Hospital Revenue Code	482
Min. Negotiated Rate	$35.07
Max. Negotiated Rate	$4,554.00
Rate for Payer: Aetna Commercial	$1,205.83
Rate for Payer: Aetna Medicare Advantage	$1,436.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,608.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,608.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$443.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$631.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,608.14
Rate for Payer: Cigna Commercial	$888.63
Rate for Payer: Cigna Medicare Advantage	$443.32
Rate for Payer: Clover Medicare Advantage	$421.15
Rate for Payer: EmblemHealth Commercial	$1,329.96
Rate for Payer: Humana Medicare Advantage	$456.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$443.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$321.10
Rate for Payer: Oxford Commercial	$4,336.00
Rate for Payer: Qualcare PPO/HMO/WC	$185.25
Rate for Payer: UnitedHealthcare Commercial	$4,554.00
Rate for Payer: UnitedHealthcare Community & State	$39.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$443.32
Rate for Payer: Wellcare Medicare Advantage	$443.32
Rate for Payer: Wellpoint Medicaid Managed Care	$35.07

TILT TABLE EVAL

Facility

$1,235.00

Service Code	HCPCS 93660
Hospital Charge Code	366893660
Hospital Revenue Code	482
Min. Negotiated Rate	$185.25
Max. Negotiated Rate	$185.25
Rate for Payer: Qualcare PPO/HMO/WC	$185.25

TI-MESH 4 X 6-HERNIA

Facility

$162.00

Hospital Charge Code	270338793
Hospital Revenue Code	278
Min. Negotiated Rate	$4.60
Max. Negotiated Rate	$81.00
Rate for Payer: Aetna Commercial	$61.56
Rate for Payer: Aetna Medicare Advantage	$48.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.31
Rate for Payer: Cigna Commercial	$81.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.20
Rate for Payer: Qualcare PPO/HMO/WC	$24.30
Rate for Payer: UnitedHealthcare Community & State	$5.12
Rate for Payer: Wellpoint Medicaid Managed Care	$4.60

TI-MESH 4 X 6-HERNIA

Facility

$162.00

Hospital Charge Code	270338793
Hospital Revenue Code	278
Min. Negotiated Rate	$24.30
Max. Negotiated Rate	$39.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.20
Rate for Payer: Qualcare PPO/HMO/WC	$24.30

TI-MESH 6 X 6 -HERNIA

Facility

$182.00

Hospital Charge Code	270338794
Hospital Revenue Code	278
Min. Negotiated Rate	$27.30
Max. Negotiated Rate	$44.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.04
Rate for Payer: Qualcare PPO/HMO/WC	$27.30

TI-MESH 6 X 6 -HERNIA

Facility

$182.00

Hospital Charge Code	270338794
Hospital Revenue Code	278
Min. Negotiated Rate	$5.17
Max. Negotiated Rate	$91.00
Rate for Payer: Aetna Commercial	$69.16
Rate for Payer: Aetna Medicare Advantage	$54.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.41
Rate for Payer: Cigna Commercial	$91.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.04
Rate for Payer: Qualcare PPO/HMO/WC	$27.30
Rate for Payer: UnitedHealthcare Community & State	$5.75
Rate for Payer: Wellpoint Medicaid Managed Care	$5.17

TI-MESH 6 X 8- HERNIA

Facility

$552.00

Hospital Charge Code	270338795
Hospital Revenue Code	278
Min. Negotiated Rate	$82.80
Max. Negotiated Rate	$133.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.58
Rate for Payer: Qualcare PPO/HMO/WC	$82.80

Know your out-of-pocket cost for care.

All Charges