Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BIPOLAR HIP REPLACEMENT

Facility

$15,113.50

Service Code	HCPCS 27236
Hospital Charge Code	16000869
Hospital Revenue Code	360
Min. Negotiated Rate	$429.22
Max. Negotiated Rate	$31,271.12
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,271.12
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,929.51
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,267.03
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$477.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$429.22

BIPOLAR HIP REPLACEMENT

Facility

$15,113.50

Service Code	HCPCS 27236
Hospital Charge Code	16000869
Hospital Revenue Code	360
Min. Negotiated Rate	$2,267.03
Max. Negotiated Rate	$2,267.03
Rate for Payer: Qualcare PPO/HMO/WC	$2,267.03

BIPOLAR LINER 42/43 OD X 22MM

Facility

$1,437.55

Hospital Charge Code	270665069
Hospital Revenue Code	278
Min. Negotiated Rate	$40.83
Max. Negotiated Rate	$718.77
Rate for Payer: Aetna Commercial	$546.27
Rate for Payer: Aetna Medicare Advantage	$431.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$366.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$366.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$287.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$366.58
Rate for Payer: Cigna Commercial	$718.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$347.89
Rate for Payer: Qualcare PPO/HMO/WC	$215.63
Rate for Payer: UnitedHealthcare Community & State	$45.43
Rate for Payer: Wellpoint Medicaid Managed Care	$40.83

BIPOLAR LINER 42/43 OD X 22MM

Facility

$1,437.55

Hospital Charge Code	270665069
Hospital Revenue Code	278
Min. Negotiated Rate	$215.63
Max. Negotiated Rate	$347.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$287.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$347.89
Rate for Payer: Qualcare PPO/HMO/WC	$215.63

BIPOLAR MARYLAND SINGLE SITE

Facility

$1,283.33

Hospital Charge Code	270672906
Hospital Revenue Code	272
Min. Negotiated Rate	$192.50
Max. Negotiated Rate	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$192.50

BIPOLAR MARYLAND SINGLE SITE

Facility

$1,283.33

Hospital Charge Code	270672906
Hospital Revenue Code	272
Min. Negotiated Rate	$36.45
Max. Negotiated Rate	$641.66
Rate for Payer: Aetna Commercial	$487.67
Rate for Payer: Aetna Medicare Advantage	$385.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$327.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$327.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$327.25
Rate for Payer: Cigna Commercial	$641.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.67
Rate for Payer: Oxford Commercial	$256.67
Rate for Payer: Qualcare PPO/HMO/WC	$192.50
Rate for Payer: UnitedHealthcare Commercial	$256.67
Rate for Payer: UnitedHealthcare Community & State	$40.55
Rate for Payer: Wellpoint Medicaid Managed Care	$36.45

BIPOLAR SHELL 42MM OD

Facility

$2,256.50

Hospital Charge Code	270665068
Hospital Revenue Code	278
Min. Negotiated Rate	$338.48
Max. Negotiated Rate	$546.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$546.07
Rate for Payer: Qualcare PPO/HMO/WC	$338.48

BIPOLAR SHELL 42MM OD

Facility

$2,256.50

Hospital Charge Code	270665068
Hospital Revenue Code	278
Min. Negotiated Rate	$64.08
Max. Negotiated Rate	$1,128.25
Rate for Payer: Aetna Commercial	$857.47
Rate for Payer: Aetna Medicare Advantage	$676.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$575.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$575.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$575.41
Rate for Payer: Cigna Commercial	$1,128.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$546.07
Rate for Payer: Qualcare PPO/HMO/WC	$338.48
Rate for Payer: UnitedHealthcare Community & State	$71.31
Rate for Payer: Wellpoint Medicaid Managed Care	$64.08

BIPOLAR TRIGGER FLEA 40 CM PRB

Facility

$3,750.00

Hospital Charge Code	270688728
Hospital Revenue Code	272
Min. Negotiated Rate	$106.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$975.00
Rate for Payer: Oxford Commercial	$750.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Commercial	$750.00
Rate for Payer: UnitedHealthcare Community & State	$118.50
Rate for Payer: Wellpoint Medicaid Managed Care	$106.50

BIPOLAR TRIGGER FLEA 40 CM PRB

Facility

$3,750.00

Hospital Charge Code	270688728
Hospital Revenue Code	272
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$562.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

BIRCH (T3) IGE

Facility

$390.00

Service Code	HCPCS 86003
Hospital Charge Code	39900355
Hospital Revenue Code	305
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.94
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
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	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

BIRCH (T3) IGE

Facility

$390.00

Service Code	HCPCS 86003
Hospital Charge Code	39900355
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

BISACODYL 10 MG SUPP

Facility

$4.00

Service Code	NDC 904505812
Hospital Charge Code	6023048
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

BISACODYL 10 MG SUPP

Facility

$4.00

Service Code	NDC 904505812
Hospital Charge Code	6023048
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

BISACODYL 5MG TABLETS

Facility

$4.00

Service Code	NDC 52959067430
Hospital Charge Code	60628123
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

BISACODYL 5MG TABLETS

Facility

$4.00

Service Code	NDC 52959067430
Hospital Charge Code	60628123
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

BISMUTH SUBSALICYLATE

Facility

$4.00

Service Code	NDC 37000003204
Hospital Charge Code	60628109
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

BISMUTH SUBSALICYLATE

Facility

$4.00

Service Code	NDC 37000003204
Hospital Charge Code	60628109
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

BISOPROLOL 5 MG TAB

Facility

$9.38

Service Code	NDC 29300012613
Hospital Charge Code	60630005
Hospital Revenue Code	250
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$4.69
Rate for Payer: Aetna Commercial	$3.56
Rate for Payer: Aetna Medicare Advantage	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.39
Rate for Payer: Cigna Commercial	$4.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.44
Rate for Payer: Oxford Commercial	$1.88
Rate for Payer: Qualcare PPO/HMO/WC	$1.41
Rate for Payer: UnitedHealthcare Commercial	$1.88
Rate for Payer: UnitedHealthcare Community & State	$0.30
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

BISOPROLOL 5 MG TAB

Facility

$9.38

Service Code	NDC 29300012613
Hospital Charge Code	60630005
Hospital Revenue Code	250
Min. Negotiated Rate	$1.41
Max. Negotiated Rate	$1.41
Rate for Payer: Qualcare PPO/HMO/WC	$1.41

BIT BMT DR 3.2 5.5 35463018

Facility

$610.00

Hospital Charge Code	270612878
Hospital Revenue Code	272
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$91.50
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

BIT BMT DR 3.2 5.5 35463018

Facility

$610.00

Hospital Charge Code	270612878
Hospital Revenue Code	272
Min. Negotiated Rate	$17.32
Max. Negotiated Rate	$305.00
Rate for Payer: Aetna Commercial	$231.80
Rate for Payer: Aetna Medicare Advantage	$183.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.55
Rate for Payer: Cigna Commercial	$305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.60
Rate for Payer: Oxford Commercial	$122.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.50
Rate for Payer: UnitedHealthcare Commercial	$122.00
Rate for Payer: UnitedHealthcare Community & State	$19.28
Rate for Payer: Wellpoint Medicaid Managed Care	$17.32

BIT CRANIAL PERFORATOR DISP LG

Facility

$948.75

Hospital Charge Code	270676207
Hospital Revenue Code	272
Min. Negotiated Rate	$26.94
Max. Negotiated Rate	$474.38
Rate for Payer: Aetna Commercial	$360.52
Rate for Payer: Aetna Medicare Advantage	$284.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$241.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$241.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$241.93
Rate for Payer: Cigna Commercial	$474.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.68
Rate for Payer: Oxford Commercial	$189.75
Rate for Payer: Qualcare PPO/HMO/WC	$142.31
Rate for Payer: UnitedHealthcare Commercial	$189.75
Rate for Payer: UnitedHealthcare Community & State	$29.98
Rate for Payer: Wellpoint Medicaid Managed Care	$26.94

BIT CRANIAL PERFORATOR DISP LG

Facility

$948.75

Hospital Charge Code	270676207
Hospital Revenue Code	272
Min. Negotiated Rate	$142.31
Max. Negotiated Rate	$142.31
Rate for Payer: Qualcare PPO/HMO/WC	$142.31

BIT DRILL

Facility

$260.00

Hospital Charge Code	270656827
Hospital Revenue Code	270
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$130.00
Rate for Payer: Aetna Commercial	$98.80
Rate for Payer: Aetna Medicare Advantage	$78.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.30
Rate for Payer: Cigna Commercial	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.60
Rate for Payer: Oxford Commercial	$52.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.00
Rate for Payer: UnitedHealthcare Commercial	$52.00
Rate for Payer: UnitedHealthcare Community & State	$8.22
Rate for Payer: Wellpoint Medicaid Managed Care	$7.38

Know your out-of-pocket cost for care.

All Charges