Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TREVO NXT 4MM X 28MM - US

Facility

$37,026.25

Hospital Charge Code	270689896S
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 4MM X 28MM - US

Facility

$37,026.25

Hospital Charge Code	270689896
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 4MM X 28MM - US

Facility

$37,026.25

Hospital Charge Code	270689896
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 4MM X 28MM - US

Facility

$37,026.25

Hospital Charge Code	270689896S
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 4MM X 41MM - US

Facility

$37,026.25

Hospital Charge Code	270689897S
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 4MM X 41MM - US

Facility

$37,026.25

Hospital Charge Code	270689897
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 4MM X 41MM - US

Facility

$37,026.25

Hospital Charge Code	270689897
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 4MM X 41MM - US

Facility

$37,026.25

Hospital Charge Code	270689897S
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 4X28+TRAK21 2-PACK -

Facility

$37,976.25

Hospital Charge Code	270689892
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 4X28+TRAK21 2-PACK -

Facility

$37,976.25

Hospital Charge Code	270689892
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 4X41+TRAK21 2-PACK -

Facility

$37,976.25

Hospital Charge Code	270689893
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 4X41+TRAK21 2-PACK -

Facility

$37,976.25

Hospital Charge Code	270689893
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 6MM X 37MM - US

Facility

$37,026.25

Service Code	HCPCS C1757
Hospital Charge Code	270689898
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 6MM X 37MM - US

Facility

$37,026.25

Service Code	HCPCS C1757
Hospital Charge Code	270689898
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 6X37+TRAK21 2-PACK -

Facility

$37,976.25

Hospital Charge Code	270689894
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 6X37+TRAK21 2-PACK -

Facility

$37,976.25

Hospital Charge Code	270689894
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

TRIAL ADAPTER 12 14 4MM

Facility

$2,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270696891
Hospital Revenue Code	278
Min. Negotiated Rate	$56.80
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Community & State	$63.20
Rate for Payer: Wellpoint Medicaid Managed Care	$56.80

TRIAL ADAPTER 12 14 4MM

Facility

$2,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270696891
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

TRIAL KIT SPECTRA PATIENT

Facility

$575.00

Hospital Charge Code	270673089
Hospital Revenue Code	272
Min. Negotiated Rate	$16.33
Max. Negotiated Rate	$287.50
Rate for Payer: Aetna Commercial	$218.50
Rate for Payer: Aetna Medicare Advantage	$172.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.62
Rate for Payer: Cigna Commercial	$287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.50
Rate for Payer: Oxford Commercial	$115.00
Rate for Payer: Qualcare PPO/HMO/WC	$86.25
Rate for Payer: UnitedHealthcare Commercial	$115.00
Rate for Payer: UnitedHealthcare Community & State	$18.17
Rate for Payer: Wellpoint Medicaid Managed Care	$16.33

TRIAL KIT SPECTRA PATIENT

Facility

$575.00

Hospital Charge Code	270673089
Hospital Revenue Code	272
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$86.25
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

TRIAL LEAD KIT

Facility

$3,875.00

Hospital Charge Code	270705557
Hospital Revenue Code	279
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$581.25
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

TRIAL LEAD KIT

Facility

$3,875.00

Hospital Charge Code	270705557
Hospital Revenue Code	279
Min. Negotiated Rate	$110.05
Max. Negotiated Rate	$1,937.50
Rate for Payer: Aetna Commercial	$1,472.50
Rate for Payer: Aetna Medicare Advantage	$1,162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$988.12
Rate for Payer: Cigna Commercial	$1,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,007.50
Rate for Payer: Oxford Commercial	$775.00
Rate for Payer: Qualcare PPO/HMO/WC	$581.25
Rate for Payer: UnitedHealthcare Commercial	$775.00
Rate for Payer: UnitedHealthcare Community & State	$122.45
Rate for Payer: Wellpoint Medicaid Managed Care	$110.05

TRIAL LEAD LINEAR ST 70CM

Facility

$5,000.00

Service Code	HCPCS C1778
Hospital Charge Code	270673085
Hospital Revenue Code	278
Min. Negotiated Rate	$142.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Community & State	$158.00
Rate for Payer: Wellpoint Medicaid Managed Care	$142.00

TRIAL LEAD LINEAR ST 70CM

Facility

$5,000.00

Service Code	HCPCS C1778
Hospital Charge Code	270673085
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

TRIAL SIMULATOR

Facility

$1,100.00

Hospital Charge Code	270703576
Hospital Revenue Code	270
Min. Negotiated Rate	$31.24
Max. Negotiated Rate	$550.00
Rate for Payer: Aetna Commercial	$418.00
Rate for Payer: Aetna Medicare Advantage	$330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$280.50
Rate for Payer: Cigna Commercial	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$286.00
Rate for Payer: Oxford Commercial	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00
Rate for Payer: UnitedHealthcare Commercial	$220.00
Rate for Payer: UnitedHealthcare Community & State	$34.76
Rate for Payer: Wellpoint Medicaid Managed Care	$31.24

Know your out-of-pocket cost for care.

All Charges