Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

WAFER DURA PRECUT 1

Facility

$71.25

Hospital Charge Code	270303183
Hospital Revenue Code	272
Min. Negotiated Rate	$10.69
Max. Negotiated Rate	$10.69
Rate for Payer: Qualcare PPO/HMO/WC	$10.69

WAFER DURA PRECUT 1

Facility

$71.25

Hospital Charge Code	270303183
Hospital Revenue Code	272
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$35.62
Rate for Payer: Aetna Commercial	$27.07
Rate for Payer: Aetna Medicare Advantage	$21.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.17
Rate for Payer: Cigna Commercial	$35.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.52
Rate for Payer: Oxford Commercial	$14.25
Rate for Payer: Qualcare PPO/HMO/WC	$10.69
Rate for Payer: UnitedHealthcare Commercial	$14.25
Rate for Payer: UnitedHealthcare Community & State	$2.25
Rate for Payer: Wellpoint Medicaid Managed Care	$2.02

WAFER DURA PRECUT 1 1/8

Facility

$56.00

Hospital Charge Code	270303184
Hospital Revenue Code	272
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.40

WAFER DURA PRECUT 1 1/8

Facility

$56.00

Hospital Charge Code	270303184
Hospital Revenue Code	272
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$28.00
Rate for Payer: Aetna Commercial	$21.28
Rate for Payer: Aetna Medicare Advantage	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.28
Rate for Payer: Cigna Commercial	$28.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.56
Rate for Payer: Oxford Commercial	$11.20
Rate for Payer: Qualcare PPO/HMO/WC	$8.40
Rate for Payer: UnitedHealthcare Commercial	$11.20
Rate for Payer: UnitedHealthcare Community & State	$1.77
Rate for Payer: Wellpoint Medicaid Managed Care	$1.59

WAFER FLEX 2-3/4

Facility

$9.97

Hospital Charge Code	270648562
Hospital Revenue Code	270
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.50

WAFER FLEX 2-3/4

Facility

$9.97

Hospital Charge Code	270648562
Hospital Revenue Code	270
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$4.99
Rate for Payer: Aetna Commercial	$3.79
Rate for Payer: Aetna Medicare Advantage	$2.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.54
Rate for Payer: Cigna Commercial	$4.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.59
Rate for Payer: Oxford Commercial	$1.99
Rate for Payer: Qualcare PPO/HMO/WC	$1.50
Rate for Payer: UnitedHealthcare Commercial	$1.99
Rate for Payer: UnitedHealthcare Community & State	$0.32
Rate for Payer: Wellpoint Medicaid Managed Care	$0.28

WAFER STOMA 4 401906

Facility

$11.75

Service Code	HCPCS A4415
Hospital Charge Code	270303151
Hospital Revenue Code	272
Min. Negotiated Rate	$1.76
Max. Negotiated Rate	$1.76
Rate for Payer: Qualcare PPO/HMO/WC	$1.76

WAFER STOMA 4 401906

Facility

$11.75

Service Code	HCPCS A4415
Hospital Charge Code	270303151
Hospital Revenue Code	272
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$5.88
Rate for Payer: Aetna Commercial	$4.46
Rate for Payer: Aetna Medicare Advantage	$3.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.00
Rate for Payer: Cigna Commercial	$5.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.06
Rate for Payer: Oxford Commercial	$2.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.76
Rate for Payer: UnitedHealthcare Commercial	$2.35
Rate for Payer: UnitedHealthcare Community & State	$0.37
Rate for Payer: Wellpoint Medicaid Managed Care	$0.33

WAFER STOMAHESIVE 2-3/4

Facility

$14.78

Hospital Charge Code	270649672
Hospital Revenue Code	270
Min. Negotiated Rate	$2.22
Max. Negotiated Rate	$2.22
Rate for Payer: Qualcare PPO/HMO/WC	$2.22

WAFER STOMAHESIVE 2-3/4

Facility

$14.78

Hospital Charge Code	270649672
Hospital Revenue Code	270
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$7.39
Rate for Payer: Aetna Commercial	$5.62
Rate for Payer: Aetna Medicare Advantage	$4.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.77
Rate for Payer: Cigna Commercial	$7.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.84
Rate for Payer: Oxford Commercial	$2.96
Rate for Payer: Qualcare PPO/HMO/WC	$2.22
Rate for Payer: UnitedHealthcare Commercial	$2.96
Rate for Payer: UnitedHealthcare Community & State	$0.47
Rate for Payer: Wellpoint Medicaid Managed Care	$0.42

WAGNER CONE 135DEG 17MM

Facility

$17,460.00

Service Code	HCPCS C1776
Hospital Charge Code	270686379
Hospital Revenue Code	278
Min. Negotiated Rate	$495.86
Max. Negotiated Rate	$8,730.00
Rate for Payer: Aetna Commercial	$6,634.80
Rate for Payer: Aetna Medicare Advantage	$5,238.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,452.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,452.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,492.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,452.30
Rate for Payer: Cigna Commercial	$8,730.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,225.32
Rate for Payer: Qualcare PPO/HMO/WC	$2,619.00
Rate for Payer: UnitedHealthcare Community & State	$551.74
Rate for Payer: Wellpoint Medicaid Managed Care	$495.86

WAGNER CONE 135DEG 17MM

Facility

$17,460.00

Service Code	HCPCS C1776
Hospital Charge Code	270686379
Hospital Revenue Code	278
Min. Negotiated Rate	$2,619.00
Max. Negotiated Rate	$4,225.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,492.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,225.32
Rate for Payer: Qualcare PPO/HMO/WC	$2,619.00

WAGNER SL REVISION DIA16/190

Facility

$30,870.45

Service Code	HCPCS C1776
Hospital Charge Code	270704225
Hospital Revenue Code	278
Min. Negotiated Rate	$876.72
Max. Negotiated Rate	$15,435.23
Rate for Payer: Aetna Commercial	$11,730.77
Rate for Payer: Aetna Medicare Advantage	$9,261.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,871.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,871.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,174.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,871.96
Rate for Payer: Cigna Commercial	$15,435.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,470.65
Rate for Payer: Qualcare PPO/HMO/WC	$4,630.57
Rate for Payer: UnitedHealthcare Community & State	$975.51
Rate for Payer: Wellpoint Medicaid Managed Care	$876.72

WAGNER SL REVISION DIA16/190

Facility

$30,870.45

Service Code	HCPCS C1776
Hospital Charge Code	270704225
Hospital Revenue Code	278
Min. Negotiated Rate	$4,630.57
Max. Negotiated Rate	$7,470.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,174.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,470.65
Rate for Payer: Qualcare PPO/HMO/WC	$4,630.57

WALKER BARIATRIC FOLDING

Facility

$162.58

Service Code	HCPCS E0130
Hospital Charge Code	270691277
Hospital Revenue Code	292
Min. Negotiated Rate	$4.62
Max. Negotiated Rate	$81.29
Rate for Payer: Aetna Commercial	$61.78
Rate for Payer: Aetna Medicare Advantage	$48.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.46
Rate for Payer: Cigna Commercial	$81.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.27
Rate for Payer: Qualcare PPO/HMO/WC	$24.39
Rate for Payer: UnitedHealthcare Community & State	$5.14
Rate for Payer: Wellpoint Medicaid Managed Care	$4.62

WALKER BARIATRIC FOLDING

Facility

$162.58

Service Code	HCPCS E0130
Hospital Charge Code	270691277
Hospital Revenue Code	292
Min. Negotiated Rate	$24.39
Max. Negotiated Rate	$24.39
Rate for Payer: Qualcare PPO/HMO/WC	$24.39

WALKER CAM

Facility

$990.00

Hospital Charge Code	270646152
Hospital Revenue Code	270
Min. Negotiated Rate	$28.12
Max. Negotiated Rate	$495.00
Rate for Payer: Aetna Commercial	$376.20
Rate for Payer: Aetna Medicare Advantage	$297.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$252.45
Rate for Payer: Cigna Commercial	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.40
Rate for Payer: Oxford Commercial	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$148.50
Rate for Payer: UnitedHealthcare Commercial	$198.00
Rate for Payer: UnitedHealthcare Community & State	$31.28
Rate for Payer: Wellpoint Medicaid Managed Care	$28.12

WALKER CAM

Facility

$990.00

Hospital Charge Code	270646152
Hospital Revenue Code	270
Min. Negotiated Rate	$148.50
Max. Negotiated Rate	$148.50
Rate for Payer: Qualcare PPO/HMO/WC	$148.50

WALKER EQ LOW TOP SMALL

Facility

$152.00

Hospital Charge Code	270655835
Hospital Revenue Code	270
Min. Negotiated Rate	$4.32
Max. Negotiated Rate	$76.00
Rate for Payer: Aetna Commercial	$57.76
Rate for Payer: Aetna Medicare Advantage	$45.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.76
Rate for Payer: Cigna Commercial	$76.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.52
Rate for Payer: Oxford Commercial	$30.40
Rate for Payer: Qualcare PPO/HMO/WC	$22.80
Rate for Payer: UnitedHealthcare Commercial	$30.40
Rate for Payer: UnitedHealthcare Community & State	$4.80
Rate for Payer: Wellpoint Medicaid Managed Care	$4.32

WALKER EQ LOW TOP SMALL

Facility

$152.00

Hospital Charge Code	270655835
Hospital Revenue Code	270
Min. Negotiated Rate	$22.80
Max. Negotiated Rate	$22.80
Rate for Payer: Qualcare PPO/HMO/WC	$22.80

WALKER EQ LOW TOP X-LAR

Facility

$145.00

Hospital Charge Code	270655836
Hospital Revenue Code	270
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$21.75
Rate for Payer: Qualcare PPO/HMO/WC	$21.75

WALKER EQ LOW TOP X-LAR

Facility

$145.00

Hospital Charge Code	270655836
Hospital Revenue Code	270
Min. Negotiated Rate	$4.12
Max. Negotiated Rate	$72.50
Rate for Payer: Aetna Commercial	$55.10
Rate for Payer: Aetna Medicare Advantage	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.98
Rate for Payer: Cigna Commercial	$72.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.70
Rate for Payer: Oxford Commercial	$29.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.75
Rate for Payer: UnitedHealthcare Commercial	$29.00
Rate for Payer: UnitedHealthcare Community & State	$4.58
Rate for Payer: Wellpoint Medicaid Managed Care	$4.12

WALKER LARGE LOW TOP

Facility

$143.15

Hospital Charge Code	270654884
Hospital Revenue Code	270
Min. Negotiated Rate	$21.47
Max. Negotiated Rate	$21.47
Rate for Payer: Qualcare PPO/HMO/WC	$21.47

WALKER LARGE LOW TOP

Facility

$143.15

Hospital Charge Code	270654884
Hospital Revenue Code	270
Min. Negotiated Rate	$4.07
Max. Negotiated Rate	$71.58
Rate for Payer: Aetna Commercial	$54.40
Rate for Payer: Aetna Medicare Advantage	$42.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.50
Rate for Payer: Cigna Commercial	$71.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.22
Rate for Payer: Oxford Commercial	$28.63
Rate for Payer: Qualcare PPO/HMO/WC	$21.47
Rate for Payer: UnitedHealthcare Commercial	$28.63
Rate for Payer: UnitedHealthcare Community & State	$4.52
Rate for Payer: Wellpoint Medicaid Managed Care	$4.07

WALKER MED LOW TOP

Facility

$143.15

Hospital Charge Code	270654883
Hospital Revenue Code	270
Min. Negotiated Rate	$21.47
Max. Negotiated Rate	$21.47
Rate for Payer: Qualcare PPO/HMO/WC	$21.47

Know your out-of-pocket cost for care.

All Charges