Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TRAY HSG

Facility

$506.00

Hospital Charge Code	270655987
Hospital Revenue Code	272
Min. Negotiated Rate	$14.37
Max. Negotiated Rate	$253.00
Rate for Payer: Aetna Commercial	$192.28
Rate for Payer: Aetna Medicare Advantage	$151.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$129.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$129.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$129.03
Rate for Payer: Cigna Commercial	$253.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.56
Rate for Payer: Oxford Commercial	$101.20
Rate for Payer: Qualcare PPO/HMO/WC	$75.90
Rate for Payer: UnitedHealthcare Commercial	$101.20
Rate for Payer: UnitedHealthcare Community & State	$15.99
Rate for Payer: Wellpoint Medicaid Managed Care	$14.37

TRAY HSG

Facility

$506.00

Hospital Charge Code	270655987
Hospital Revenue Code	272
Min. Negotiated Rate	$75.90
Max. Negotiated Rate	$75.90
Rate for Payer: Qualcare PPO/HMO/WC	$75.90

TRAY HUMERAL REVERSE EXT 6MM

Facility

$12,075.00

Service Code	HCPCS C1776
Hospital Charge Code	270700196
Hospital Revenue Code	278
Min. Negotiated Rate	$1,811.25
Max. Negotiated Rate	$2,922.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,415.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,922.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,811.25

TRAY HUMERAL REVERSE EXT 6MM

Facility

$12,075.00

Service Code	HCPCS C1776
Hospital Charge Code	270700196
Hospital Revenue Code	278
Min. Negotiated Rate	$342.93
Max. Negotiated Rate	$6,037.50
Rate for Payer: Aetna Commercial	$4,588.50
Rate for Payer: Aetna Medicare Advantage	$3,622.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,079.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,079.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,415.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,079.12
Rate for Payer: Cigna Commercial	$6,037.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,922.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,811.25
Rate for Payer: UnitedHealthcare Community & State	$381.57
Rate for Payer: Wellpoint Medicaid Managed Care	$342.93

TRAY HUMERAL STD PLUS 10 40MM

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270694049
Hospital Revenue Code	278
Min. Negotiated Rate	$170.40
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$189.60
Rate for Payer: Wellpoint Medicaid Managed Care	$170.40

TRAY HUMERAL STD PLUS 10 40MM

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270694049
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

TRAY INSTRUMENTS POLYVAC CRANO

Facility

$1,699.35

Hospital Charge Code	270684905
Hospital Revenue Code	272
Min. Negotiated Rate	$254.90
Max. Negotiated Rate	$254.90
Rate for Payer: Qualcare PPO/HMO/WC	$254.90

TRAY INSTRUMENTS POLYVAC CRANO

Facility

$1,699.35

Hospital Charge Code	270684905
Hospital Revenue Code	272
Min. Negotiated Rate	$48.26
Max. Negotiated Rate	$849.67
Rate for Payer: Aetna Commercial	$645.75
Rate for Payer: Aetna Medicare Advantage	$509.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$433.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$433.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$433.33
Rate for Payer: Cigna Commercial	$849.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$441.83
Rate for Payer: Oxford Commercial	$339.87
Rate for Payer: Qualcare PPO/HMO/WC	$254.90
Rate for Payer: UnitedHealthcare Commercial	$339.87
Rate for Payer: UnitedHealthcare Community & State	$53.70
Rate for Payer: Wellpoint Medicaid Managed Care	$48.26

TRAY INTRO PERCUTANEOUS

Facility

$269.04

Hospital Charge Code	270110051
Hospital Revenue Code	272
Min. Negotiated Rate	$7.64
Max. Negotiated Rate	$134.52
Rate for Payer: Aetna Commercial	$102.24
Rate for Payer: Aetna Medicare Advantage	$80.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.61
Rate for Payer: Cigna Commercial	$134.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.95
Rate for Payer: Oxford Commercial	$53.81
Rate for Payer: Qualcare PPO/HMO/WC	$40.36
Rate for Payer: UnitedHealthcare Commercial	$53.81
Rate for Payer: UnitedHealthcare Community & State	$8.50
Rate for Payer: Wellpoint Medicaid Managed Care	$7.64

TRAY INTRO PERCUTANEOUS

Facility

$269.04

Hospital Charge Code	270110051
Hospital Revenue Code	272
Min. Negotiated Rate	$40.36
Max. Negotiated Rate	$40.36
Rate for Payer: Qualcare PPO/HMO/WC	$40.36

TRAY IRRIGATION PISTON

Facility

$6.07

Hospital Charge Code	270302231
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.04
Rate for Payer: Aetna Commercial	$2.31
Rate for Payer: Aetna Medicare Advantage	$1.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.55
Rate for Payer: Cigna Commercial	$3.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.58
Rate for Payer: Oxford Commercial	$1.21
Rate for Payer: Qualcare PPO/HMO/WC	$0.91
Rate for Payer: UnitedHealthcare Commercial	$1.21
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.17

TRAY IRRIGATION PISTON

Facility

$6.07

Hospital Charge Code	270302231
Hospital Revenue Code	272
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$0.91
Rate for Payer: Qualcare PPO/HMO/WC	$0.91

TRAY KNEE ARTHROSCOPY

Facility

$295.45

Hospital Charge Code	270654114
Hospital Revenue Code	270
Min. Negotiated Rate	$44.32
Max. Negotiated Rate	$44.32
Rate for Payer: Qualcare PPO/HMO/WC	$44.32

TRAY KNEE ARTHROSCOPY

Facility

$295.45

Hospital Charge Code	270654114
Hospital Revenue Code	270
Min. Negotiated Rate	$8.39
Max. Negotiated Rate	$147.72
Rate for Payer: Aetna Commercial	$112.27
Rate for Payer: Aetna Medicare Advantage	$88.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.34
Rate for Payer: Cigna Commercial	$147.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.82
Rate for Payer: Oxford Commercial	$59.09
Rate for Payer: Qualcare PPO/HMO/WC	$44.32
Rate for Payer: UnitedHealthcare Commercial	$59.09
Rate for Payer: UnitedHealthcare Community & State	$9.34
Rate for Payer: Wellpoint Medicaid Managed Care	$8.39

TRAY KYPHOPAK

Facility

$14,968.80

Hospital Charge Code	270648849S
Hospital Revenue Code	272
Min. Negotiated Rate	$2,245.32
Max. Negotiated Rate	$2,245.32
Rate for Payer: Qualcare PPO/HMO/WC	$2,245.32

TRAY KYPHOPAK

Facility

$14,968.80

Hospital Charge Code	270648849C
Hospital Revenue Code	270
Min. Negotiated Rate	$2,245.32
Max. Negotiated Rate	$2,245.32
Rate for Payer: Qualcare PPO/HMO/WC	$2,245.32

TRAY KYPHOPAK

Facility

$14,968.80

Hospital Charge Code	270648849C
Hospital Revenue Code	270
Min. Negotiated Rate	$425.11
Max. Negotiated Rate	$7,484.40
Rate for Payer: Aetna Commercial	$5,688.14
Rate for Payer: Aetna Medicare Advantage	$4,490.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,817.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,817.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,817.04
Rate for Payer: Cigna Commercial	$7,484.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,891.89
Rate for Payer: Oxford Commercial	$2,993.76
Rate for Payer: Qualcare PPO/HMO/WC	$2,245.32
Rate for Payer: UnitedHealthcare Commercial	$2,993.76
Rate for Payer: UnitedHealthcare Community & State	$473.01
Rate for Payer: Wellpoint Medicaid Managed Care	$425.11

TRAY KYPHOPAK

Facility

$19,000.00

Hospital Charge Code	270648849N
Hospital Revenue Code	272
Min. Negotiated Rate	$539.60
Max. Negotiated Rate	$9,500.00
Rate for Payer: Aetna Commercial	$7,220.00
Rate for Payer: Aetna Medicare Advantage	$5,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,845.00
Rate for Payer: Cigna Commercial	$9,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,940.00
Rate for Payer: Oxford Commercial	$3,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00
Rate for Payer: UnitedHealthcare Commercial	$3,800.00
Rate for Payer: UnitedHealthcare Community & State	$600.40
Rate for Payer: Wellpoint Medicaid Managed Care	$539.60

TRAY KYPHOPAK

Facility

$14,968.80

Hospital Charge Code	270648849S
Hospital Revenue Code	272
Min. Negotiated Rate	$425.11
Max. Negotiated Rate	$7,484.40
Rate for Payer: Aetna Commercial	$5,688.14
Rate for Payer: Aetna Medicare Advantage	$4,490.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,817.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,817.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,817.04
Rate for Payer: Cigna Commercial	$7,484.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,891.89
Rate for Payer: Oxford Commercial	$2,993.76
Rate for Payer: Qualcare PPO/HMO/WC	$2,245.32
Rate for Payer: UnitedHealthcare Commercial	$2,993.76
Rate for Payer: UnitedHealthcare Community & State	$473.01
Rate for Payer: Wellpoint Medicaid Managed Care	$425.11

TRAY KYPHOPAK

Facility

$14,968.80

Hospital Charge Code	270648849
Hospital Revenue Code	272
Min. Negotiated Rate	$2,245.32
Max. Negotiated Rate	$2,245.32
Rate for Payer: Qualcare PPO/HMO/WC	$2,245.32

TRAY KYPHOPAK

Facility

$14,968.80

Hospital Charge Code	270648849
Hospital Revenue Code	272
Min. Negotiated Rate	$425.11
Max. Negotiated Rate	$7,484.40
Rate for Payer: Aetna Commercial	$5,688.14
Rate for Payer: Aetna Medicare Advantage	$4,490.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,817.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,817.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,817.04
Rate for Payer: Cigna Commercial	$7,484.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,891.89
Rate for Payer: Oxford Commercial	$2,993.76
Rate for Payer: Qualcare PPO/HMO/WC	$2,245.32
Rate for Payer: UnitedHealthcare Commercial	$2,993.76
Rate for Payer: UnitedHealthcare Community & State	$473.01
Rate for Payer: Wellpoint Medicaid Managed Care	$425.11

TRAY KYPHOPAK

Facility

$19,000.00

Hospital Charge Code	270648849N
Hospital Revenue Code	272
Min. Negotiated Rate	$2,850.00
Max. Negotiated Rate	$2,850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00

TRAY KYPHOPAK PB

Facility

$14,968.80

Service Code	HCPCS C1713
Hospital Charge Code	270680226
Hospital Revenue Code	278
Min. Negotiated Rate	$2,245.32
Max. Negotiated Rate	$3,622.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,993.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,622.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,245.32

TRAY KYPHOPAK PB

Facility

$14,968.80

Service Code	HCPCS C1713
Hospital Charge Code	270680226
Hospital Revenue Code	278
Min. Negotiated Rate	$425.11
Max. Negotiated Rate	$7,484.40
Rate for Payer: Aetna Commercial	$5,688.14
Rate for Payer: Aetna Medicare Advantage	$4,490.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,817.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,817.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,993.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,817.04
Rate for Payer: Cigna Commercial	$7,484.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,622.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,245.32
Rate for Payer: UnitedHealthcare Community & State	$473.01
Rate for Payer: Wellpoint Medicaid Managed Care	$425.11

TRAY LUMBAR PUNCTURE

Facility

$96.78

Hospital Charge Code	270302245
Hospital Revenue Code	272
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$48.39
Rate for Payer: Aetna Commercial	$36.78
Rate for Payer: Aetna Medicare Advantage	$29.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.68
Rate for Payer: Cigna Commercial	$48.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.16
Rate for Payer: Oxford Commercial	$19.36
Rate for Payer: Qualcare PPO/HMO/WC	$14.52
Rate for Payer: UnitedHealthcare Commercial	$19.36
Rate for Payer: UnitedHealthcare Community & State	$3.06
Rate for Payer: Wellpoint Medicaid Managed Care	$2.75

Know your out-of-pocket cost for care.

All Charges