Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

WIRE ZIM K .045 186-02-69

Facility

$36.81

Service Code	HCPCS C1769
Hospital Charge Code	270601917
Hospital Revenue Code	278
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$18.41
Rate for Payer: Aetna Commercial	$13.99
Rate for Payer: Aetna Medicare Advantage	$11.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.39
Rate for Payer: Cigna Commercial	$18.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.91
Rate for Payer: Qualcare PPO/HMO/WC	$5.52
Rate for Payer: UnitedHealthcare Community & State	$1.16
Rate for Payer: Wellpoint Medicaid Managed Care	$1.05

WIRE ZIM K .062 186-03-69

Facility

$39.56

Service Code	HCPCS C1769
Hospital Charge Code	270609825
Hospital Revenue Code	278
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$19.78
Rate for Payer: Aetna Commercial	$15.03
Rate for Payer: Aetna Medicare Advantage	$11.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.09
Rate for Payer: Cigna Commercial	$19.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.57
Rate for Payer: Qualcare PPO/HMO/WC	$5.93
Rate for Payer: UnitedHealthcare Community & State	$1.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1.12

WIRE ZIM K .062 186-03-69

Facility

$39.56

Service Code	HCPCS C1769
Hospital Charge Code	270609825
Hospital Revenue Code	278
Min. Negotiated Rate	$5.93
Max. Negotiated Rate	$9.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.57
Rate for Payer: Qualcare PPO/HMO/WC	$5.93

WIRE ZIM K 1 1.1MM 47-186-60

Facility

$61.92

Service Code	HCPCS C1769
Hospital Charge Code	270610637
Hospital Revenue Code	278
Min. Negotiated Rate	$9.29
Max. Negotiated Rate	$14.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.98
Rate for Payer: Qualcare PPO/HMO/WC	$9.29

WIRE ZIM K 1 1.1MM 47-186-60

Facility

$61.92

Service Code	HCPCS C1769
Hospital Charge Code	270610637
Hospital Revenue Code	278
Min. Negotiated Rate	$1.76
Max. Negotiated Rate	$30.96
Rate for Payer: Aetna Commercial	$23.53
Rate for Payer: Aetna Medicare Advantage	$18.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.79
Rate for Payer: Cigna Commercial	$30.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.98
Rate for Payer: Qualcare PPO/HMO/WC	$9.29
Rate for Payer: UnitedHealthcare Community & State	$1.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1.76

WIRE ZIM K 1 1.6MM 47-186-76

Facility

$447.25

Service Code	HCPCS C1769
Hospital Charge Code	270610638
Hospital Revenue Code	278
Min. Negotiated Rate	$12.70
Max. Negotiated Rate	$223.62
Rate for Payer: Aetna Commercial	$169.96
Rate for Payer: Aetna Medicare Advantage	$134.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$89.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.05
Rate for Payer: Cigna Commercial	$223.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.23
Rate for Payer: Qualcare PPO/HMO/WC	$67.09
Rate for Payer: UnitedHealthcare Community & State	$14.13
Rate for Payer: Wellpoint Medicaid Managed Care	$12.70

WIRE ZIM K 1 1.6MM 47-186-76

Facility

$447.25

Service Code	HCPCS C1769
Hospital Charge Code	270610638
Hospital Revenue Code	278
Min. Negotiated Rate	$67.09
Max. Negotiated Rate	$108.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$89.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.23
Rate for Payer: Qualcare PPO/HMO/WC	$67.09

WIRE ZIM K 1.1MM 186-27-16

Facility

$24.85

Service Code	HCPCS C1769
Hospital Charge Code	270610289
Hospital Revenue Code	278
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$12.43
Rate for Payer: Aetna Commercial	$9.44
Rate for Payer: Aetna Medicare Advantage	$7.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.34
Rate for Payer: Cigna Commercial	$12.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.01
Rate for Payer: Qualcare PPO/HMO/WC	$3.73
Rate for Payer: UnitedHealthcare Community & State	$0.79
Rate for Payer: Wellpoint Medicaid Managed Care	$0.71

WIRE ZIM K 1.1MM 186-27-16

Facility

$24.85

Service Code	HCPCS C1769
Hospital Charge Code	270610289
Hospital Revenue Code	278
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$6.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.01
Rate for Payer: Qualcare PPO/HMO/WC	$3.73

WIRE ZIM K DBL .045 186-02-79

Facility

$46.45

Hospital Charge Code	270606052
Hospital Revenue Code	272
Min. Negotiated Rate	$1.32
Max. Negotiated Rate	$23.23
Rate for Payer: Aetna Commercial	$17.65
Rate for Payer: Aetna Medicare Advantage	$13.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.84
Rate for Payer: Cigna Commercial	$23.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.08
Rate for Payer: Oxford Commercial	$9.29
Rate for Payer: Qualcare PPO/HMO/WC	$6.97
Rate for Payer: UnitedHealthcare Commercial	$9.29
Rate for Payer: UnitedHealthcare Community & State	$1.47
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

WIRE ZIM K DBL .045 186-02-79

Facility

$46.45

Hospital Charge Code	270606052
Hospital Revenue Code	272
Min. Negotiated Rate	$6.97
Max. Negotiated Rate	$6.97
Rate for Payer: Qualcare PPO/HMO/WC	$6.97

WIRE ZIM K PT 2.5 1142-01-25

Facility

$72.52

Service Code	HCPCS C1769
Hospital Charge Code	270617347
Hospital Revenue Code	278
Min. Negotiated Rate	$10.88
Max. Negotiated Rate	$17.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.55
Rate for Payer: Qualcare PPO/HMO/WC	$10.88

WIRE ZIM K PT 2.5 1142-01-25

Facility

$72.52

Service Code	HCPCS C1769
Hospital Charge Code	270617347
Hospital Revenue Code	278
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$36.26
Rate for Payer: Aetna Commercial	$27.56
Rate for Payer: Aetna Medicare Advantage	$21.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.49
Rate for Payer: Cigna Commercial	$36.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.55
Rate for Payer: Qualcare PPO/HMO/WC	$10.88
Rate for Payer: UnitedHealthcare Community & State	$2.29
Rate for Payer: Wellpoint Medicaid Managed Care	$2.06

WIRE ZIM K THRD .062 262-08-04

Facility

$63.13

Service Code	HCPCS C1769
Hospital Charge Code	270601916
Hospital Revenue Code	278
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$31.57
Rate for Payer: Aetna Commercial	$23.99
Rate for Payer: Aetna Medicare Advantage	$18.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.10
Rate for Payer: Cigna Commercial	$31.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.28
Rate for Payer: Qualcare PPO/HMO/WC	$9.47
Rate for Payer: UnitedHealthcare Community & State	$1.99
Rate for Payer: Wellpoint Medicaid Managed Care	$1.79

WIRE ZIM K THRD .062 262-08-04

Facility

$63.13

Service Code	HCPCS C1769
Hospital Charge Code	270601916
Hospital Revenue Code	278
Min. Negotiated Rate	$9.47
Max. Negotiated Rate	$15.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.28
Rate for Payer: Qualcare PPO/HMO/WC	$9.47

WIRE ZIM SPOOL .97 4.9 191-38

Facility

$110.00

Service Code	HCPCS C1769
Hospital Charge Code	270619387
Hospital Revenue Code	278
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$26.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.62
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

WIRE ZIM SPOOL .97 4.9 191-38

Facility

$110.00

Service Code	HCPCS C1769
Hospital Charge Code	270619387
Hospital Revenue Code	278
Min. Negotiated Rate	$3.12
Max. Negotiated Rate	$55.00
Rate for Payer: Aetna Commercial	$41.80
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.62
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Community & State	$3.48
Rate for Payer: Wellpoint Medicaid Managed Care	$3.12

WND MATRX MULTILR 5X5CM/SQCMJW

Facility

$153.00

Hospital Charge Code	270666030W
Hospital Revenue Code	636
Min. Negotiated Rate	$22.95
Max. Negotiated Rate	$37.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.03
Rate for Payer: Qualcare PPO/HMO/WC	$22.95

WND MATRX MULTILR 5X5CM/SQCMJW

Facility

$153.00

Hospital Charge Code	270666030W
Hospital Revenue Code	636
Min. Negotiated Rate	$4.35
Max. Negotiated Rate	$76.50
Rate for Payer: Aetna Commercial	$58.14
Rate for Payer: Aetna Medicare Advantage	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.02
Rate for Payer: Cigna Commercial	$76.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.03
Rate for Payer: Qualcare PPO/HMO/WC	$22.95
Rate for Payer: UnitedHealthcare Community & State	$4.83
Rate for Payer: Wellpoint Medicaid Managed Care	$4.35

WND MATRX MULTILYR 5X5CM

Facility

$3,995.00

Service Code	HCPCS Q4166
Hospital Charge Code	270666030
Hospital Revenue Code	278
Min. Negotiated Rate	$599.25
Max. Negotiated Rate	$966.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$799.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$966.79
Rate for Payer: Qualcare PPO/HMO/WC	$599.25

WND MATRX MULTILYR 5X5CM

Facility

$3,995.00

Service Code	HCPCS Q4166
Hospital Charge Code	270666030
Hospital Revenue Code	278
Min. Negotiated Rate	$113.46
Max. Negotiated Rate	$966.79
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$799.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$536.29
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$966.79
Rate for Payer: Qualcare PPO/HMO/WC	$599.25
Rate for Payer: UnitedHealthcare Community & State	$126.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$113.46

WND PRP TRK/ARM/LEG 100SQCM/1B

Facility

$4,862.70

Service Code	HCPCS 15002
Hospital Charge Code	1600000380
Hospital Revenue Code	360
Min. Negotiated Rate	$153.66
Max. Negotiated Rate	$5,347.00
Rate for Payer: Aetna Commercial	$2,388.27
Rate for Payer: Aetna Medicare Advantage	$2,844.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,185.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,185.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$878.04
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	$3,185.09
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: Cigna Medicare Advantage	$878.04
Rate for Payer: Clover Medicare Advantage	$834.14
Rate for Payer: EmblemHealth Commercial	$2,634.12
Rate for Payer: Humana Medicare Advantage	$904.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$878.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,264.30
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$729.40
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$153.66
Rate for Payer: UnitedHealthcare Medicare Advantage	$878.04
Rate for Payer: Wellcare Medicare Advantage	$878.04
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,165.88
Rate for Payer: Wellpoint Medicaid Managed Care	$5,064.59

WND PRP TRK/ARM/LEG 100SQCM/1B

Facility

$4,862.70

Service Code	HCPCS 15002
Hospital Charge Code	1600000380
Hospital Revenue Code	360
Min. Negotiated Rate	$729.40
Max. Negotiated Rate	$729.40
Rate for Payer: Qualcare PPO/HMO/WC	$729.40

WOODEN BEE, BUTTERFLY + LADYBU

Facility

$74.95

Hospital Charge Code	270663164
Hospital Revenue Code	270
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$37.48
Rate for Payer: Aetna Commercial	$28.48
Rate for Payer: Aetna Medicare Advantage	$22.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.11
Rate for Payer: Cigna Commercial	$37.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.49
Rate for Payer: Oxford Commercial	$14.99
Rate for Payer: Qualcare PPO/HMO/WC	$11.24
Rate for Payer: UnitedHealthcare Commercial	$14.99
Rate for Payer: UnitedHealthcare Community & State	$2.37
Rate for Payer: Wellpoint Medicaid Managed Care	$2.13

WOODEN BEE, BUTTERFLY + LADYBU

Facility

$74.95

Hospital Charge Code	270663164
Hospital Revenue Code	270
Min. Negotiated Rate	$11.24
Max. Negotiated Rate	$11.24
Rate for Payer: Qualcare PPO/HMO/WC	$11.24

Know your out-of-pocket cost for care.

All Charges