Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TRAY CHOLANG LAPARO W/TROCAR

Facility

$650.00

Hospital Charge Code	270649267
Hospital Revenue Code	272
Min. Negotiated Rate	$18.46
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.00
Rate for Payer: Oxford Commercial	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Commercial	$130.00
Rate for Payer: UnitedHealthcare Community & State	$20.54
Rate for Payer: Wellpoint Medicaid Managed Care	$18.46

TRAY COAXIAL BIOPSY 6CM 11G

Facility

$4,091.65

Service Code	HCPCS C1830
Hospital Charge Code	270688549
Hospital Revenue Code	272
Min. Negotiated Rate	$613.75
Max. Negotiated Rate	$613.75
Rate for Payer: Qualcare PPO/HMO/WC	$613.75

TRAY COAXIAL BIOPSY 6CM 11G

Facility

$4,091.65

Service Code	HCPCS C1830
Hospital Charge Code	270688549
Hospital Revenue Code	272
Min. Negotiated Rate	$116.20
Max. Negotiated Rate	$2,045.83
Rate for Payer: Aetna Commercial	$1,554.83
Rate for Payer: Aetna Medicare Advantage	$1,227.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,043.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,043.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,043.37
Rate for Payer: Cigna Commercial	$2,045.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,063.83
Rate for Payer: Oxford Commercial	$818.33
Rate for Payer: Qualcare PPO/HMO/WC	$613.75
Rate for Payer: UnitedHealthcare Commercial	$818.33
Rate for Payer: UnitedHealthcare Community & State	$129.30
Rate for Payer: Wellpoint Medicaid Managed Care	$116.20

TRAY CRANIOTOMY

Facility

$565.60

Hospital Charge Code	270667449
Hospital Revenue Code	270
Min. Negotiated Rate	$84.84
Max. Negotiated Rate	$84.84
Rate for Payer: Qualcare PPO/HMO/WC	$84.84

TRAY CRANIOTOMY

Facility

$565.60

Hospital Charge Code	270667449
Hospital Revenue Code	270
Min. Negotiated Rate	$16.06
Max. Negotiated Rate	$282.80
Rate for Payer: Aetna Commercial	$214.93
Rate for Payer: Aetna Medicare Advantage	$169.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.23
Rate for Payer: Cigna Commercial	$282.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.06
Rate for Payer: Oxford Commercial	$113.12
Rate for Payer: Qualcare PPO/HMO/WC	$84.84
Rate for Payer: UnitedHealthcare Commercial	$113.12
Rate for Payer: UnitedHealthcare Community & State	$17.87
Rate for Payer: Wellpoint Medicaid Managed Care	$16.06

TRAY CYSTO

Facility

$90.35

Hospital Charge Code	270654145
Hospital Revenue Code	270
Min. Negotiated Rate	$13.55
Max. Negotiated Rate	$13.55
Rate for Payer: Qualcare PPO/HMO/WC	$13.55

TRAY CYSTO

Facility

$90.35

Hospital Charge Code	270654145
Hospital Revenue Code	270
Min. Negotiated Rate	$2.57
Max. Negotiated Rate	$45.17
Rate for Payer: Aetna Commercial	$34.33
Rate for Payer: Aetna Medicare Advantage	$27.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.04
Rate for Payer: Cigna Commercial	$45.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.49
Rate for Payer: Oxford Commercial	$18.07
Rate for Payer: Qualcare PPO/HMO/WC	$13.55
Rate for Payer: UnitedHealthcare Commercial	$18.07
Rate for Payer: UnitedHealthcare Community & State	$2.86
Rate for Payer: Wellpoint Medicaid Managed Care	$2.57

TRAY DIALYSIS 3 LUMEN CV

Facility

$367.32

Hospital Charge Code	270649140
Hospital Revenue Code	272
Min. Negotiated Rate	$55.10
Max. Negotiated Rate	$55.10
Rate for Payer: Qualcare PPO/HMO/WC	$55.10

TRAY DIALYSIS 3 LUMEN CV

Facility

$367.32

Hospital Charge Code	270649140
Hospital Revenue Code	272
Min. Negotiated Rate	$10.43
Max. Negotiated Rate	$183.66
Rate for Payer: Aetna Commercial	$139.58
Rate for Payer: Aetna Medicare Advantage	$110.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.67
Rate for Payer: Cigna Commercial	$183.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.50
Rate for Payer: Oxford Commercial	$73.46
Rate for Payer: Qualcare PPO/HMO/WC	$55.10
Rate for Payer: UnitedHealthcare Commercial	$73.46
Rate for Payer: UnitedHealthcare Community & State	$11.61
Rate for Payer: Wellpoint Medicaid Managed Care	$10.43

TRAY DRSG CHG CENTRAL LINE

Facility

$20.80

Hospital Charge Code	270302225
Hospital Revenue Code	272
Min. Negotiated Rate	$0.59
Max. Negotiated Rate	$10.40
Rate for Payer: Aetna Commercial	$7.90
Rate for Payer: Aetna Medicare Advantage	$6.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.30
Rate for Payer: Cigna Commercial	$10.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.41
Rate for Payer: Oxford Commercial	$4.16
Rate for Payer: Qualcare PPO/HMO/WC	$3.12
Rate for Payer: UnitedHealthcare Commercial	$4.16
Rate for Payer: UnitedHealthcare Community & State	$0.66
Rate for Payer: Wellpoint Medicaid Managed Care	$0.59

TRAY DRSG CHG CENTRAL LINE

Facility

$20.80

Hospital Charge Code	270302225
Hospital Revenue Code	272
Min. Negotiated Rate	$3.12
Max. Negotiated Rate	$3.12
Rate for Payer: Qualcare PPO/HMO/WC	$3.12

TRAY EPIDURAL 18G

Facility

$100.44

Hospital Charge Code	270649872
Hospital Revenue Code	272
Min. Negotiated Rate	$2.85
Max. Negotiated Rate	$50.22
Rate for Payer: Aetna Commercial	$38.17
Rate for Payer: Aetna Medicare Advantage	$30.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.61
Rate for Payer: Cigna Commercial	$50.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.11
Rate for Payer: Oxford Commercial	$20.09
Rate for Payer: Qualcare PPO/HMO/WC	$15.07
Rate for Payer: UnitedHealthcare Commercial	$20.09
Rate for Payer: UnitedHealthcare Community & State	$3.17
Rate for Payer: Wellpoint Medicaid Managed Care	$2.85

TRAY EPIDURAL 18G

Facility

$100.44

Hospital Charge Code	270649872
Hospital Revenue Code	272
Min. Negotiated Rate	$15.07
Max. Negotiated Rate	$15.07
Rate for Payer: Qualcare PPO/HMO/WC	$15.07

TRAY EPIDURAL CONTINOUS

Facility

$107.48

Hospital Charge Code	270621149
Hospital Revenue Code	272
Min. Negotiated Rate	$3.05
Max. Negotiated Rate	$53.74
Rate for Payer: Aetna Commercial	$40.84
Rate for Payer: Aetna Medicare Advantage	$32.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.41
Rate for Payer: Cigna Commercial	$53.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.94
Rate for Payer: Oxford Commercial	$21.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.12
Rate for Payer: UnitedHealthcare Commercial	$21.50
Rate for Payer: UnitedHealthcare Community & State	$3.40
Rate for Payer: Wellpoint Medicaid Managed Care	$3.05

TRAY EPIDURAL CONTINOUS

Facility

$107.48

Hospital Charge Code	270621149
Hospital Revenue Code	272
Min. Negotiated Rate	$16.12
Max. Negotiated Rate	$16.12
Rate for Payer: Qualcare PPO/HMO/WC	$16.12

TRAY EPIDURAL PERIFIX 20G

Facility

$120.59

Hospital Charge Code	270692059
Hospital Revenue Code	272
Min. Negotiated Rate	$3.42
Max. Negotiated Rate	$60.30
Rate for Payer: Aetna Commercial	$45.82
Rate for Payer: Aetna Medicare Advantage	$36.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.75
Rate for Payer: Cigna Commercial	$60.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.35
Rate for Payer: Oxford Commercial	$24.12
Rate for Payer: Qualcare PPO/HMO/WC	$18.09
Rate for Payer: UnitedHealthcare Commercial	$24.12
Rate for Payer: UnitedHealthcare Community & State	$3.81
Rate for Payer: Wellpoint Medicaid Managed Care	$3.42

TRAY EPIDURAL PERIFIX 20G

Facility

$120.59

Hospital Charge Code	270692059
Hospital Revenue Code	272
Min. Negotiated Rate	$18.09
Max. Negotiated Rate	$18.09
Rate for Payer: Qualcare PPO/HMO/WC	$18.09

TRAY EPIDURAL SHOT SINGLE

Facility

$227.32

Hospital Charge Code	270655432
Hospital Revenue Code	270
Min. Negotiated Rate	$6.46
Max. Negotiated Rate	$113.66
Rate for Payer: Aetna Commercial	$86.38
Rate for Payer: Aetna Medicare Advantage	$68.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.97
Rate for Payer: Cigna Commercial	$113.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.10
Rate for Payer: Oxford Commercial	$45.46
Rate for Payer: Qualcare PPO/HMO/WC	$34.10
Rate for Payer: UnitedHealthcare Commercial	$45.46
Rate for Payer: UnitedHealthcare Community & State	$7.18
Rate for Payer: Wellpoint Medicaid Managed Care	$6.46

TRAY EPIDURAL SHOT SINGLE

Facility

$227.32

Hospital Charge Code	270655432
Hospital Revenue Code	270
Min. Negotiated Rate	$34.10
Max. Negotiated Rate	$34.10
Rate for Payer: Qualcare PPO/HMO/WC	$34.10

TRAY EPIDURAL SINGLE SHOT 17G

Facility

$124.00

Hospital Charge Code	270331215
Hospital Revenue Code	272
Min. Negotiated Rate	$3.52
Max. Negotiated Rate	$62.00
Rate for Payer: Aetna Commercial	$47.12
Rate for Payer: Aetna Medicare Advantage	$37.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.62
Rate for Payer: Cigna Commercial	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.24
Rate for Payer: Oxford Commercial	$24.80
Rate for Payer: Qualcare PPO/HMO/WC	$18.60
Rate for Payer: UnitedHealthcare Commercial	$24.80
Rate for Payer: UnitedHealthcare Community & State	$3.92
Rate for Payer: Wellpoint Medicaid Managed Care	$3.52

TRAY EPIDURAL SINGLE SHOT 17G

Facility

$124.00

Hospital Charge Code	270331215
Hospital Revenue Code	272
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$18.60
Rate for Payer: Qualcare PPO/HMO/WC	$18.60

TRAY EPIDURAL W/TUOHY

Facility

$141.70

Hospital Charge Code	270677807
Hospital Revenue Code	272
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$21.25
Rate for Payer: Qualcare PPO/HMO/WC	$21.25

TRAY EPIDURAL W/TUOHY

Facility

$141.70

Hospital Charge Code	270677807
Hospital Revenue Code	272
Min. Negotiated Rate	$4.02
Max. Negotiated Rate	$70.85
Rate for Payer: Aetna Commercial	$53.85
Rate for Payer: Aetna Medicare Advantage	$42.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.13
Rate for Payer: Cigna Commercial	$70.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.84
Rate for Payer: Oxford Commercial	$28.34
Rate for Payer: Qualcare PPO/HMO/WC	$21.25
Rate for Payer: UnitedHealthcare Commercial	$28.34
Rate for Payer: UnitedHealthcare Community & State	$4.48
Rate for Payer: Wellpoint Medicaid Managed Care	$4.02

TRAY EPIDUR SNG SHOT A2532-20

Facility

$70.79

Hospital Charge Code	270626734
Hospital Revenue Code	272
Min. Negotiated Rate	$10.62
Max. Negotiated Rate	$10.62
Rate for Payer: Qualcare PPO/HMO/WC	$10.62

TRAY EPIDUR SNG SHOT A2532-20

Facility

$70.79

Hospital Charge Code	270626734
Hospital Revenue Code	272
Min. Negotiated Rate	$2.01
Max. Negotiated Rate	$35.40
Rate for Payer: Aetna Commercial	$26.90
Rate for Payer: Aetna Medicare Advantage	$21.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.05
Rate for Payer: Cigna Commercial	$35.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.41
Rate for Payer: Oxford Commercial	$14.16
Rate for Payer: Qualcare PPO/HMO/WC	$10.62
Rate for Payer: UnitedHealthcare Commercial	$14.16
Rate for Payer: UnitedHealthcare Community & State	$2.24
Rate for Payer: Wellpoint Medicaid Managed Care	$2.01

Know your out-of-pocket cost for care.

All Charges