Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TRAY PREOPERATIVE SKIN PREP

Facility

$16.44

Hospital Charge Code	270620052
Hospital Revenue Code	272
Min. Negotiated Rate	$0.47
Max. Negotiated Rate	$8.22
Rate for Payer: Aetna Commercial	$6.25
Rate for Payer: Aetna Medicare Advantage	$4.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.19
Rate for Payer: Cigna Commercial	$8.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.27
Rate for Payer: Oxford Commercial	$3.29
Rate for Payer: Qualcare PPO/HMO/WC	$2.47
Rate for Payer: UnitedHealthcare Commercial	$3.29
Rate for Payer: UnitedHealthcare Community & State	$0.52
Rate for Payer: Wellpoint Medicaid Managed Care	$0.47

TRAY ROBOTIC PACK

Facility

$565.90

Hospital Charge Code	270664963
Hospital Revenue Code	270
Min. Negotiated Rate	$84.89
Max. Negotiated Rate	$84.89
Rate for Payer: Qualcare PPO/HMO/WC	$84.89

TRAY ROBOTIC PACK

Facility

$565.90

Hospital Charge Code	270664963
Hospital Revenue Code	270
Min. Negotiated Rate	$16.07
Max. Negotiated Rate	$282.95
Rate for Payer: Aetna Commercial	$215.04
Rate for Payer: Aetna Medicare Advantage	$169.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.30
Rate for Payer: Cigna Commercial	$282.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.13
Rate for Payer: Oxford Commercial	$113.18
Rate for Payer: Qualcare PPO/HMO/WC	$84.89
Rate for Payer: UnitedHealthcare Commercial	$113.18
Rate for Payer: UnitedHealthcare Community & State	$17.88
Rate for Payer: Wellpoint Medicaid Managed Care	$16.07

TRAY SINGLE LUM W/ARROW

Facility

$138.00

Hospital Charge Code	270302220
Hospital Revenue Code	272
Min. Negotiated Rate	$20.70
Max. Negotiated Rate	$20.70
Rate for Payer: Qualcare PPO/HMO/WC	$20.70

TRAY SINGLE LUM W/ARROW

Facility

$138.00

Hospital Charge Code	270302220
Hospital Revenue Code	272
Min. Negotiated Rate	$3.92
Max. Negotiated Rate	$69.00
Rate for Payer: Aetna Commercial	$52.44
Rate for Payer: Aetna Medicare Advantage	$41.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.19
Rate for Payer: Cigna Commercial	$69.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.88
Rate for Payer: Oxford Commercial	$27.60
Rate for Payer: Qualcare PPO/HMO/WC	$20.70
Rate for Payer: UnitedHealthcare Commercial	$27.60
Rate for Payer: UnitedHealthcare Community & State	$4.36
Rate for Payer: Wellpoint Medicaid Managed Care	$3.92

TRAY SINGLE SHOT EPIDURAL 20G

Facility

$84.77

Hospital Charge Code	270655731
Hospital Revenue Code	272
Min. Negotiated Rate	$2.41
Max. Negotiated Rate	$42.38
Rate for Payer: Aetna Commercial	$32.21
Rate for Payer: Aetna Medicare Advantage	$25.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.62
Rate for Payer: Cigna Commercial	$42.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.04
Rate for Payer: Oxford Commercial	$16.95
Rate for Payer: Qualcare PPO/HMO/WC	$12.72
Rate for Payer: UnitedHealthcare Commercial	$16.95
Rate for Payer: UnitedHealthcare Community & State	$2.68
Rate for Payer: Wellpoint Medicaid Managed Care	$2.41

TRAY SINGLE SHOT EPIDURAL 20G

Facility

$84.77

Hospital Charge Code	270655731
Hospital Revenue Code	272
Min. Negotiated Rate	$12.72
Max. Negotiated Rate	$12.72
Rate for Payer: Qualcare PPO/HMO/WC	$12.72

TRAY SKIN SCRUB WET

Facility

$19.31

Hospital Charge Code	270649184
Hospital Revenue Code	272
Min. Negotiated Rate	$2.90
Max. Negotiated Rate	$2.90
Rate for Payer: Qualcare PPO/HMO/WC	$2.90

TRAY SKIN SCRUB WET

Facility

$19.31

Hospital Charge Code	270649184
Hospital Revenue Code	272
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$9.65
Rate for Payer: Aetna Commercial	$7.34
Rate for Payer: Aetna Medicare Advantage	$5.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.92
Rate for Payer: Cigna Commercial	$9.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.02
Rate for Payer: Oxford Commercial	$3.86
Rate for Payer: Qualcare PPO/HMO/WC	$2.90
Rate for Payer: UnitedHealthcare Commercial	$3.86
Rate for Payer: UnitedHealthcare Community & State	$0.61
Rate for Payer: Wellpoint Medicaid Managed Care	$0.55

TRAY SOFT TISSUE BX

Facility

$43.95

Hospital Charge Code	270677166N
Hospital Revenue Code	272
Min. Negotiated Rate	$6.59
Max. Negotiated Rate	$6.59
Rate for Payer: Qualcare PPO/HMO/WC	$6.59

TRAY SOFT TISSUE BX

Facility

$43.95

Hospital Charge Code	270677166N
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$21.98
Rate for Payer: Aetna Commercial	$16.70
Rate for Payer: Aetna Medicare Advantage	$13.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.21
Rate for Payer: Cigna Commercial	$21.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.43
Rate for Payer: Oxford Commercial	$8.79
Rate for Payer: Qualcare PPO/HMO/WC	$6.59
Rate for Payer: UnitedHealthcare Commercial	$8.79
Rate for Payer: UnitedHealthcare Community & State	$1.39
Rate for Payer: Wellpoint Medicaid Managed Care	$1.25

TRAY SOFT TISSUE BX

Facility

$43.99

Hospital Charge Code	270677166R
Hospital Revenue Code	272
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

TRAY SOFT TISSUE BX

Facility

$43.99

Hospital Charge Code	270677166
Hospital Revenue Code	272
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

TRAY SOFT TISSUE BX

Facility

$43.99

Hospital Charge Code	270677166
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$22.00
Rate for Payer: Aetna Commercial	$16.72
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.44
Rate for Payer: Oxford Commercial	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$8.80
Rate for Payer: UnitedHealthcare Community & State	$1.39
Rate for Payer: Wellpoint Medicaid Managed Care	$1.25

TRAY SOFT TISSUE BX

Facility

$43.99

Hospital Charge Code	270677166R
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$22.00
Rate for Payer: Aetna Commercial	$16.72
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.44
Rate for Payer: Oxford Commercial	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$8.80
Rate for Payer: UnitedHealthcare Community & State	$1.39
Rate for Payer: Wellpoint Medicaid Managed Care	$1.25

TRAY SPINAL ANESTHESIA

Facility

$65.89

Hospital Charge Code	270649897
Hospital Revenue Code	272
Min. Negotiated Rate	$9.88
Max. Negotiated Rate	$9.88
Rate for Payer: Qualcare PPO/HMO/WC	$9.88

TRAY SPINAL ANESTHESIA

Facility

$65.89

Hospital Charge Code	270649897
Hospital Revenue Code	272
Min. Negotiated Rate	$1.87
Max. Negotiated Rate	$32.95
Rate for Payer: Aetna Commercial	$25.04
Rate for Payer: Aetna Medicare Advantage	$19.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.80
Rate for Payer: Cigna Commercial	$32.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.13
Rate for Payer: Oxford Commercial	$13.18
Rate for Payer: Qualcare PPO/HMO/WC	$9.88
Rate for Payer: UnitedHealthcare Commercial	$13.18
Rate for Payer: UnitedHealthcare Community & State	$2.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.87

TRAY SPINAL PENCAN 24GAX4IN

Facility

$91.77

Service Code	HCPCS A4649
Hospital Charge Code	270698870
Hospital Revenue Code	270
Min. Negotiated Rate	$13.77
Max. Negotiated Rate	$13.77
Rate for Payer: Qualcare PPO/HMO/WC	$13.77

TRAY SPINAL PENCAN 24GAX4IN

Facility

$91.77

Service Code	HCPCS A4649
Hospital Charge Code	270698870
Hospital Revenue Code	270
Min. Negotiated Rate	$2.61
Max. Negotiated Rate	$45.88
Rate for Payer: Aetna Commercial	$34.87
Rate for Payer: Aetna Medicare Advantage	$27.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.40
Rate for Payer: Cigna Commercial	$45.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.86
Rate for Payer: Oxford Commercial	$18.35
Rate for Payer: Qualcare PPO/HMO/WC	$13.77
Rate for Payer: UnitedHealthcare Commercial	$18.35
Rate for Payer: UnitedHealthcare Community & State	$2.90
Rate for Payer: Wellpoint Medicaid Managed Care	$2.61

TRAY SPINAL W/BUPIVCINE 333851

Facility

$94.66

Hospital Charge Code	270645719
Hospital Revenue Code	272
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$14.20
Rate for Payer: Qualcare PPO/HMO/WC	$14.20

TRAY SPINAL W/BUPIVCINE 333851

Facility

$94.66

Hospital Charge Code	270645719
Hospital Revenue Code	272
Min. Negotiated Rate	$2.69
Max. Negotiated Rate	$47.33
Rate for Payer: Aetna Commercial	$35.97
Rate for Payer: Aetna Medicare Advantage	$28.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.14
Rate for Payer: Cigna Commercial	$47.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.61
Rate for Payer: Oxford Commercial	$18.93
Rate for Payer: Qualcare PPO/HMO/WC	$14.20
Rate for Payer: UnitedHealthcare Commercial	$18.93
Rate for Payer: UnitedHealthcare Community & State	$2.99
Rate for Payer: Wellpoint Medicaid Managed Care	$2.69

TRAY SPNL ANESTH SPROT B000110

Facility

$95.29

Hospital Charge Code	270644554
Hospital Revenue Code	272
Min. Negotiated Rate	$14.29
Max. Negotiated Rate	$14.29
Rate for Payer: Qualcare PPO/HMO/WC	$14.29

TRAY SPNL ANESTH SPROT B000110

Facility

$95.29

Hospital Charge Code	270644554
Hospital Revenue Code	272
Min. Negotiated Rate	$2.71
Max. Negotiated Rate	$47.65
Rate for Payer: Aetna Commercial	$36.21
Rate for Payer: Aetna Medicare Advantage	$28.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.30
Rate for Payer: Cigna Commercial	$47.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.78
Rate for Payer: Oxford Commercial	$19.06
Rate for Payer: Qualcare PPO/HMO/WC	$14.29
Rate for Payer: UnitedHealthcare Commercial	$19.06
Rate for Payer: UnitedHealthcare Community & State	$3.01
Rate for Payer: Wellpoint Medicaid Managed Care	$2.71

TRAY SPNL NDL W/TTRACAN 333854

Facility

$86.85

Hospital Charge Code	270635807
Hospital Revenue Code	272
Min. Negotiated Rate	$13.03
Max. Negotiated Rate	$13.03
Rate for Payer: Qualcare PPO/HMO/WC	$13.03

TRAY SPNL NDL W/TTRACAN 333854

Facility

$86.85

Hospital Charge Code	270635807
Hospital Revenue Code	272
Min. Negotiated Rate	$2.47
Max. Negotiated Rate	$43.42
Rate for Payer: Aetna Commercial	$33.00
Rate for Payer: Aetna Medicare Advantage	$26.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.15
Rate for Payer: Cigna Commercial	$43.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.58
Rate for Payer: Oxford Commercial	$17.37
Rate for Payer: Qualcare PPO/HMO/WC	$13.03
Rate for Payer: UnitedHealthcare Commercial	$17.37
Rate for Payer: UnitedHealthcare Community & State	$2.74
Rate for Payer: Wellpoint Medicaid Managed Care	$2.47

Know your out-of-pocket cost for care.

All Charges