Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TRAY ERASE ADD-A-CATH

Facility

$52.49

Service Code	HCPCS C1729
Hospital Charge Code	270649649
Hospital Revenue Code	278
Min. Negotiated Rate	$7.87
Max. Negotiated Rate	$12.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.70
Rate for Payer: Qualcare PPO/HMO/WC	$7.87

TRAY ERASE ADD-A-CATH

Facility

$52.49

Service Code	HCPCS C1729
Hospital Charge Code	270649649
Hospital Revenue Code	278
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$26.25
Rate for Payer: Aetna Commercial	$19.95
Rate for Payer: Aetna Medicare Advantage	$15.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.38
Rate for Payer: Cigna Commercial	$26.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.70
Rate for Payer: Qualcare PPO/HMO/WC	$7.87
Rate for Payer: UnitedHealthcare Community & State	$1.66
Rate for Payer: Wellpoint Medicaid Managed Care	$1.49

TRAY ERASE CAUTI 14FR

Facility

$73.37

Hospital Charge Code	270649651
Hospital Revenue Code	278
Min. Negotiated Rate	$11.01
Max. Negotiated Rate	$17.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.76
Rate for Payer: Qualcare PPO/HMO/WC	$11.01

TRAY ERASE CAUTI 14FR

Facility

$73.37

Hospital Charge Code	270649651
Hospital Revenue Code	278
Min. Negotiated Rate	$2.08
Max. Negotiated Rate	$36.69
Rate for Payer: Aetna Commercial	$27.88
Rate for Payer: Aetna Medicare Advantage	$22.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.71
Rate for Payer: Cigna Commercial	$36.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.76
Rate for Payer: Qualcare PPO/HMO/WC	$11.01
Rate for Payer: UnitedHealthcare Community & State	$2.32
Rate for Payer: Wellpoint Medicaid Managed Care	$2.08

TRAY ERASE CAUTI 16FR

Facility

$77.30

Hospital Charge Code	270649652
Hospital Revenue Code	270
Min. Negotiated Rate	$11.60
Max. Negotiated Rate	$11.60
Rate for Payer: Qualcare PPO/HMO/WC	$11.60

TRAY ERASE CAUTI 16FR

Facility

$77.30

Hospital Charge Code	270649652
Hospital Revenue Code	270
Min. Negotiated Rate	$2.20
Max. Negotiated Rate	$38.65
Rate for Payer: Aetna Commercial	$29.37
Rate for Payer: Aetna Medicare Advantage	$23.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.71
Rate for Payer: Cigna Commercial	$38.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.10
Rate for Payer: Oxford Commercial	$15.46
Rate for Payer: Qualcare PPO/HMO/WC	$11.60
Rate for Payer: UnitedHealthcare Commercial	$15.46
Rate for Payer: UnitedHealthcare Community & State	$2.44
Rate for Payer: Wellpoint Medicaid Managed Care	$2.20

TRAY FIRST FRACTURE EXPRESS II

Facility

$14,962.50

Hospital Charge Code	270691562
Hospital Revenue Code	272
Min. Negotiated Rate	$424.94
Max. Negotiated Rate	$7,481.25
Rate for Payer: Aetna Commercial	$5,685.75
Rate for Payer: Aetna Medicare Advantage	$4,488.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,815.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,815.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,815.44
Rate for Payer: Cigna Commercial	$7,481.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,890.25
Rate for Payer: Oxford Commercial	$2,992.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,244.38
Rate for Payer: UnitedHealthcare Commercial	$2,992.50
Rate for Payer: UnitedHealthcare Community & State	$472.81
Rate for Payer: Wellpoint Medicaid Managed Care	$424.94

TRAY FIRST FRACTURE EXPRESS II

Facility

$14,962.50

Hospital Charge Code	270691562
Hospital Revenue Code	272
Min. Negotiated Rate	$2,244.38
Max. Negotiated Rate	$2,244.38
Rate for Payer: Qualcare PPO/HMO/WC	$2,244.38

TRAY FIXED SAIPH KNEE C

Facility

$4,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270680033
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

TRAY FIXED SAIPH KNEE C

Facility

$4,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270680033
Hospital Revenue Code	278
Min. Negotiated Rate	$127.80
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Community & State	$142.20
Rate for Payer: Wellpoint Medicaid Managed Care	$127.80

TRAY FOLEY CATH 16FR

Facility

$81.82

Hospital Charge Code	270649268S
Hospital Revenue Code	272
Min. Negotiated Rate	$2.32
Max. Negotiated Rate	$40.91
Rate for Payer: Aetna Commercial	$31.09
Rate for Payer: Aetna Medicare Advantage	$24.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.86
Rate for Payer: Cigna Commercial	$40.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.27
Rate for Payer: Oxford Commercial	$16.36
Rate for Payer: Qualcare PPO/HMO/WC	$12.27
Rate for Payer: UnitedHealthcare Commercial	$16.36
Rate for Payer: UnitedHealthcare Community & State	$2.59
Rate for Payer: Wellpoint Medicaid Managed Care	$2.32

TRAY FOLEY CATH 16FR

Facility

$81.82

Hospital Charge Code	270649268S
Hospital Revenue Code	272
Min. Negotiated Rate	$12.27
Max. Negotiated Rate	$12.27
Rate for Payer: Qualcare PPO/HMO/WC	$12.27

TRAY FOLEY CATH 18FR

Facility

$57.56

Hospital Charge Code	270649269
Hospital Revenue Code	272
Min. Negotiated Rate	$1.63
Max. Negotiated Rate	$28.78
Rate for Payer: Aetna Commercial	$21.87
Rate for Payer: Aetna Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.68
Rate for Payer: Cigna Commercial	$28.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.97
Rate for Payer: Oxford Commercial	$11.51
Rate for Payer: Qualcare PPO/HMO/WC	$8.63
Rate for Payer: UnitedHealthcare Commercial	$11.51
Rate for Payer: UnitedHealthcare Community & State	$1.82
Rate for Payer: Wellpoint Medicaid Managed Care	$1.63

TRAY FOLEY CATH 18FR

Facility

$57.56

Hospital Charge Code	270649269
Hospital Revenue Code	272
Min. Negotiated Rate	$8.63
Max. Negotiated Rate	$8.63
Rate for Payer: Qualcare PPO/HMO/WC	$8.63

TRAY FOLEY CATHER 16FR

Facility

$81.82

Hospital Charge Code	270649268
Hospital Revenue Code	272
Min. Negotiated Rate	$12.27
Max. Negotiated Rate	$12.27
Rate for Payer: Qualcare PPO/HMO/WC	$12.27

TRAY FOLEY CATHER 16FR

Facility

$62.22

Hospital Charge Code	270649268N
Hospital Revenue Code	272
Min. Negotiated Rate	$1.77
Max. Negotiated Rate	$31.11
Rate for Payer: Aetna Commercial	$23.64
Rate for Payer: Aetna Medicare Advantage	$18.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.87
Rate for Payer: Cigna Commercial	$31.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.18
Rate for Payer: Oxford Commercial	$12.44
Rate for Payer: Qualcare PPO/HMO/WC	$9.33
Rate for Payer: UnitedHealthcare Commercial	$12.44
Rate for Payer: UnitedHealthcare Community & State	$1.97
Rate for Payer: Wellpoint Medicaid Managed Care	$1.77

TRAY FOLEY CATHER 16FR

Facility

$81.82

Hospital Charge Code	270649268
Hospital Revenue Code	272
Min. Negotiated Rate	$2.32
Max. Negotiated Rate	$40.91
Rate for Payer: Aetna Commercial	$31.09
Rate for Payer: Aetna Medicare Advantage	$24.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.86
Rate for Payer: Cigna Commercial	$40.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.27
Rate for Payer: Oxford Commercial	$16.36
Rate for Payer: Qualcare PPO/HMO/WC	$12.27
Rate for Payer: UnitedHealthcare Commercial	$16.36
Rate for Payer: UnitedHealthcare Community & State	$2.59
Rate for Payer: Wellpoint Medicaid Managed Care	$2.32

TRAY FOLEY CATHER 16FR

Facility

$62.22

Hospital Charge Code	270649268N
Hospital Revenue Code	272
Min. Negotiated Rate	$9.33
Max. Negotiated Rate	$9.33
Rate for Payer: Qualcare PPO/HMO/WC	$9.33

TRAY FOLEY ERASE CAUTI SILV 16

Facility

$81.82

Hospital Charge Code	270646407
Hospital Revenue Code	272
Min. Negotiated Rate	$12.27
Max. Negotiated Rate	$12.27
Rate for Payer: Qualcare PPO/HMO/WC	$12.27

TRAY FOLEY ERASE CAUTI SILV 16

Facility

$81.82

Hospital Charge Code	270646407
Hospital Revenue Code	272
Min. Negotiated Rate	$2.32
Max. Negotiated Rate	$40.91
Rate for Payer: Aetna Commercial	$31.09
Rate for Payer: Aetna Medicare Advantage	$24.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.86
Rate for Payer: Cigna Commercial	$40.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.27
Rate for Payer: Oxford Commercial	$16.36
Rate for Payer: Qualcare PPO/HMO/WC	$12.27
Rate for Payer: UnitedHealthcare Commercial	$16.36
Rate for Payer: UnitedHealthcare Community & State	$2.59
Rate for Payer: Wellpoint Medicaid Managed Care	$2.32

TRAY FOLEY PEDIATRIN URI 10FR

Facility

$106.90

Hospital Charge Code	270669765
Hospital Revenue Code	272
Min. Negotiated Rate	$16.04
Max. Negotiated Rate	$16.04
Rate for Payer: Qualcare PPO/HMO/WC	$16.04

TRAY FOLEY PEDIATRIN URI 10FR

Facility

$106.90

Hospital Charge Code	270669765
Hospital Revenue Code	272
Min. Negotiated Rate	$3.04
Max. Negotiated Rate	$53.45
Rate for Payer: Aetna Commercial	$40.62
Rate for Payer: Aetna Medicare Advantage	$32.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.26
Rate for Payer: Cigna Commercial	$53.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.79
Rate for Payer: Oxford Commercial	$21.38
Rate for Payer: Qualcare PPO/HMO/WC	$16.04
Rate for Payer: UnitedHealthcare Commercial	$21.38
Rate for Payer: UnitedHealthcare Community & State	$3.38
Rate for Payer: Wellpoint Medicaid Managed Care	$3.04

TRAY FOLEY PEDIATRIN URI 6FR

Facility

$113.10

Hospital Charge Code	270669766
Hospital Revenue Code	272
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$56.55
Rate for Payer: Aetna Commercial	$42.98
Rate for Payer: Aetna Medicare Advantage	$33.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.84
Rate for Payer: Cigna Commercial	$56.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.41
Rate for Payer: Oxford Commercial	$22.62
Rate for Payer: Qualcare PPO/HMO/WC	$16.96
Rate for Payer: UnitedHealthcare Commercial	$22.62
Rate for Payer: UnitedHealthcare Community & State	$3.57
Rate for Payer: Wellpoint Medicaid Managed Care	$3.21

TRAY FOLEY PEDIATRIN URI 6FR

Facility

$113.10

Hospital Charge Code	270669766
Hospital Revenue Code	272
Min. Negotiated Rate	$16.96
Max. Negotiated Rate	$16.96
Rate for Payer: Qualcare PPO/HMO/WC	$16.96

TRAY FOLEY PEDIATRIN URI 8FR

Facility

$106.90

Hospital Charge Code	270669764
Hospital Revenue Code	272
Min. Negotiated Rate	$3.04
Max. Negotiated Rate	$53.45
Rate for Payer: Aetna Commercial	$40.62
Rate for Payer: Aetna Medicare Advantage	$32.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.26
Rate for Payer: Cigna Commercial	$53.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.79
Rate for Payer: Oxford Commercial	$21.38
Rate for Payer: Qualcare PPO/HMO/WC	$16.04
Rate for Payer: UnitedHealthcare Commercial	$21.38
Rate for Payer: UnitedHealthcare Community & State	$3.38
Rate for Payer: Wellpoint Medicaid Managed Care	$3.04

Know your out-of-pocket cost for care.

All Charges