Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TREPHINE 8.5MM

Facility

$1,483.75

Hospital Charge Code	270691602
Hospital Revenue Code	272
Min. Negotiated Rate	$222.56
Max. Negotiated Rate	$222.56
Rate for Payer: Qualcare PPO/HMO/WC	$222.56

TREPHINE BLADES

Facility

$300.00

Hospital Charge Code	270332558
Hospital Revenue Code	272
Min. Negotiated Rate	$8.52
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.00
Rate for Payer: Oxford Commercial	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$60.00
Rate for Payer: UnitedHealthcare Community & State	$9.48
Rate for Payer: Wellpoint Medicaid Managed Care	$8.52

TREPHINE BLADES

Facility

$300.00

Hospital Charge Code	270332558
Hospital Revenue Code	272
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

TREPHINE MRI 11.5MM ID N/S

Facility

$2,550.00

Hospital Charge Code	270675771
Hospital Revenue Code	272
Min. Negotiated Rate	$72.42
Max. Negotiated Rate	$1,275.00
Rate for Payer: Aetna Commercial	$969.00
Rate for Payer: Aetna Medicare Advantage	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$650.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$650.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$650.25
Rate for Payer: Cigna Commercial	$1,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$510.00
Rate for Payer: Qualcare PPO/HMO/WC	$382.50
Rate for Payer: UnitedHealthcare Commercial	$510.00
Rate for Payer: UnitedHealthcare Community & State	$80.58
Rate for Payer: Wellpoint Medicaid Managed Care	$72.42

TREPHINE MRI 11.5MM ID N/S

Facility

$2,550.00

Hospital Charge Code	270675771
Hospital Revenue Code	272
Min. Negotiated Rate	$382.50
Max. Negotiated Rate	$382.50
Rate for Payer: Qualcare PPO/HMO/WC	$382.50

TREPHINE MRI 11MM ID N/S

Facility

$2,550.00

Hospital Charge Code	270675770
Hospital Revenue Code	272
Min. Negotiated Rate	$72.42
Max. Negotiated Rate	$1,275.00
Rate for Payer: Aetna Commercial	$969.00
Rate for Payer: Aetna Medicare Advantage	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$650.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$650.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$650.25
Rate for Payer: Cigna Commercial	$1,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$510.00
Rate for Payer: Qualcare PPO/HMO/WC	$382.50
Rate for Payer: UnitedHealthcare Commercial	$510.00
Rate for Payer: UnitedHealthcare Community & State	$80.58
Rate for Payer: Wellpoint Medicaid Managed Care	$72.42

TREPHINE MRI 11MM ID N/S

Facility

$2,550.00

Hospital Charge Code	270675770
Hospital Revenue Code	272
Min. Negotiated Rate	$382.50
Max. Negotiated Rate	$382.50
Rate for Payer: Qualcare PPO/HMO/WC	$382.50

TREPHINE MRI 21 MM

Facility

$2,350.00

Hospital Charge Code	270690279
Hospital Revenue Code	272
Min. Negotiated Rate	$66.74
Max. Negotiated Rate	$1,175.00
Rate for Payer: Aetna Commercial	$893.00
Rate for Payer: Aetna Medicare Advantage	$705.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$599.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$599.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$599.25
Rate for Payer: Cigna Commercial	$1,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$611.00
Rate for Payer: Oxford Commercial	$470.00
Rate for Payer: Qualcare PPO/HMO/WC	$352.50
Rate for Payer: UnitedHealthcare Commercial	$470.00
Rate for Payer: UnitedHealthcare Community & State	$74.26
Rate for Payer: Wellpoint Medicaid Managed Care	$66.74

TREPHINE MRI 21 MM

Facility

$2,350.00

Hospital Charge Code	270690279
Hospital Revenue Code	272
Min. Negotiated Rate	$352.50
Max. Negotiated Rate	$352.50
Rate for Payer: Qualcare PPO/HMO/WC	$352.50

TREPHIN GUIDE WIRE

Facility

$283.20

Service Code	HCPCS C1713
Hospital Charge Code	270691600
Hospital Revenue Code	278
Min. Negotiated Rate	$8.04
Max. Negotiated Rate	$141.60
Rate for Payer: Aetna Commercial	$107.62
Rate for Payer: Aetna Medicare Advantage	$84.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.22
Rate for Payer: Cigna Commercial	$141.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.53
Rate for Payer: Qualcare PPO/HMO/WC	$42.48
Rate for Payer: UnitedHealthcare Community & State	$8.95
Rate for Payer: Wellpoint Medicaid Managed Care	$8.04

TREPHIN GUIDE WIRE

Facility

$283.20

Service Code	HCPCS C1713
Hospital Charge Code	270691600
Hospital Revenue Code	278
Min. Negotiated Rate	$42.48
Max. Negotiated Rate	$68.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.53
Rate for Payer: Qualcare PPO/HMO/WC	$42.48

TREPONEMA PALLIDUM AB PA

Facility

$390.00

Service Code	HCPCS 86780
Hospital Charge Code	39708008
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TREPONEMA PALLIDUM AB PA

Facility

$390.00

Service Code	HCPCS 86780
Hospital Charge Code	39708008
Hospital Revenue Code	302
Min. Negotiated Rate	$10.59
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$36.01
Rate for Payer: Aetna Medicare Advantage	$42.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.03
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$13.24
Rate for Payer: Clover Medicare Advantage	$12.58
Rate for Payer: EmblemHealth Commercial	$39.72
Rate for Payer: Humana Medicare Advantage	$13.64
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.24
Rate for Payer: Wellcare Medicare Advantage	$13.24
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

Trevo 3x20

Facility

$39,975.00

Hospital Charge Code	270685068N
Hospital Revenue Code	272
Min. Negotiated Rate	$5,996.25
Max. Negotiated Rate	$5,996.25
Rate for Payer: Qualcare PPO/HMO/WC	$5,996.25

Trevo 3x20

Facility

$39,975.00

Hospital Charge Code	270685068N
Hospital Revenue Code	272
Min. Negotiated Rate	$1,135.29
Max. Negotiated Rate	$19,987.50
Rate for Payer: Aetna Commercial	$15,190.50
Rate for Payer: Aetna Medicare Advantage	$11,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,193.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,193.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,193.62
Rate for Payer: Cigna Commercial	$19,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,393.50
Rate for Payer: Oxford Commercial	$7,995.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,996.25
Rate for Payer: UnitedHealthcare Commercial	$7,995.00
Rate for Payer: UnitedHealthcare Community & State	$1,263.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1,135.29

Trevo 3x20

Facility

$39,975.00

Hospital Charge Code	270685068S
Hospital Revenue Code	272
Min. Negotiated Rate	$5,996.25
Max. Negotiated Rate	$5,996.25
Rate for Payer: Qualcare PPO/HMO/WC	$5,996.25

Trevo 3x20

Facility

$39,975.00

Hospital Charge Code	270685068S
Hospital Revenue Code	272
Min. Negotiated Rate	$1,135.29
Max. Negotiated Rate	$19,987.50
Rate for Payer: Aetna Commercial	$15,190.50
Rate for Payer: Aetna Medicare Advantage	$11,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,193.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,193.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,193.62
Rate for Payer: Cigna Commercial	$19,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,393.50
Rate for Payer: Oxford Commercial	$7,995.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,996.25
Rate for Payer: UnitedHealthcare Commercial	$7,995.00
Rate for Payer: UnitedHealthcare Community & State	$1,263.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1,135.29

TREVO NXT 3MM X 32MM - US

Facility

$37,026.25

Hospital Charge Code	270689895
Hospital Revenue Code	278
Min. Negotiated Rate	$5,553.94
Max. Negotiated Rate	$8,960.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94

TREVO NXT 3MM X 32MM - US

Facility

$37,026.25

Hospital Charge Code	270689895
Hospital Revenue Code	278
Min. Negotiated Rate	$1,051.55
Max. Negotiated Rate	$18,513.12
Rate for Payer: Aetna Commercial	$14,069.98
Rate for Payer: Aetna Medicare Advantage	$11,107.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,441.69
Rate for Payer: Cigna Commercial	$18,513.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94
Rate for Payer: UnitedHealthcare Community & State	$1,170.03
Rate for Payer: Wellpoint Medicaid Managed Care	$1,051.55

TREVO NXT 3MM X 32MM - US

Facility

$37,026.25

Hospital Charge Code	270689895S
Hospital Revenue Code	278
Min. Negotiated Rate	$5,553.94
Max. Negotiated Rate	$8,960.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94

TREVO NXT 3MM X 32MM - US

Facility

$37,026.25

Hospital Charge Code	270689895S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,051.55
Max. Negotiated Rate	$18,513.12
Rate for Payer: Aetna Commercial	$14,069.98
Rate for Payer: Aetna Medicare Advantage	$11,107.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,441.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,405.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,441.69
Rate for Payer: Cigna Commercial	$18,513.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,960.35
Rate for Payer: Qualcare PPO/HMO/WC	$5,553.94
Rate for Payer: UnitedHealthcare Community & State	$1,170.03
Rate for Payer: Wellpoint Medicaid Managed Care	$1,051.55

TREVO NXT 3X32+TRAK21 2-PACK

Facility

$37,976.25

Hospital Charge Code	270689891S
Hospital Revenue Code	278
Min. Negotiated Rate	$5,696.44
Max. Negotiated Rate	$9,190.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,595.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,190.25
Rate for Payer: Qualcare PPO/HMO/WC	$5,696.44

TREVO NXT 3X32+TRAK21 2-PACK

Facility

$37,976.25

Hospital Charge Code	270689891S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,078.53
Max. Negotiated Rate	$18,988.12
Rate for Payer: Aetna Commercial	$14,430.98
Rate for Payer: Aetna Medicare Advantage	$11,392.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,683.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,683.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,595.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,683.94
Rate for Payer: Cigna Commercial	$18,988.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,190.25
Rate for Payer: Qualcare PPO/HMO/WC	$5,696.44
Rate for Payer: UnitedHealthcare Community & State	$1,200.05
Rate for Payer: Wellpoint Medicaid Managed Care	$1,078.53

TREVO NXT 3X32+TRAK21 2-PACK -

Facility

$37,976.25

Hospital Charge Code	270689891
Hospital Revenue Code	278
Min. Negotiated Rate	$1,078.53
Max. Negotiated Rate	$18,988.12
Rate for Payer: Aetna Commercial	$14,430.98
Rate for Payer: Aetna Medicare Advantage	$11,392.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,683.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,683.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,595.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,683.94
Rate for Payer: Cigna Commercial	$18,988.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,190.25
Rate for Payer: Qualcare PPO/HMO/WC	$5,696.44
Rate for Payer: UnitedHealthcare Community & State	$1,200.05
Rate for Payer: Wellpoint Medicaid Managed Care	$1,078.53

TREVO NXT 3X32+TRAK21 2-PACK -

Facility

$37,976.25

Hospital Charge Code	270689891
Hospital Revenue Code	278
Min. Negotiated Rate	$5,696.44
Max. Negotiated Rate	$9,190.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,595.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,190.25
Rate for Payer: Qualcare PPO/HMO/WC	$5,696.44

Know your out-of-pocket cost for care.

All Charges