Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BLADE TFNA HELICAL 85MM STERIL

Facility

$3,290.85

Service Code	HCPCS C1713
Hospital Charge Code	270677571
Hospital Revenue Code	278
Min. Negotiated Rate	$93.46
Max. Negotiated Rate	$1,645.42
Rate for Payer: Aetna Commercial	$1,250.52
Rate for Payer: Aetna Medicare Advantage	$987.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$839.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$839.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$658.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$839.17
Rate for Payer: Cigna Commercial	$1,645.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$796.39
Rate for Payer: Qualcare PPO/HMO/WC	$493.63
Rate for Payer: UnitedHealthcare Community & State	$103.99
Rate for Payer: Wellpoint Medicaid Managed Care	$93.46

BLADE TFNA HELICAL 85MM STERIL

Facility

$3,290.85

Service Code	HCPCS C1713
Hospital Charge Code	270677571
Hospital Revenue Code	278
Min. Negotiated Rate	$493.63
Max. Negotiated Rate	$796.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$658.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$796.39
Rate for Payer: Qualcare PPO/HMO/WC	$493.63

BLADE TFNA HELICAL 90MM STER

Facility

$3,389.60

Service Code	HCPCS C1713
Hospital Charge Code	270677009
Hospital Revenue Code	272
Min. Negotiated Rate	$508.44
Max. Negotiated Rate	$508.44
Rate for Payer: Qualcare PPO/HMO/WC	$508.44

BLADE TFNA HELICAL 90MM STER

Facility

$3,389.60

Service Code	HCPCS C1713
Hospital Charge Code	270677009
Hospital Revenue Code	272
Min. Negotiated Rate	$96.26
Max. Negotiated Rate	$1,694.80
Rate for Payer: Aetna Commercial	$1,288.05
Rate for Payer: Aetna Medicare Advantage	$1,016.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$864.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$864.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$864.35
Rate for Payer: Cigna Commercial	$1,694.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$881.30
Rate for Payer: Oxford Commercial	$677.92
Rate for Payer: Qualcare PPO/HMO/WC	$508.44
Rate for Payer: UnitedHealthcare Commercial	$677.92
Rate for Payer: UnitedHealthcare Community & State	$107.11
Rate for Payer: Wellpoint Medicaid Managed Care	$96.26

BLADE TFNA HELICAL 95MM STER

Facility

$3,389.60

Hospital Charge Code	270675943
Hospital Revenue Code	272
Min. Negotiated Rate	$96.26
Max. Negotiated Rate	$1,694.80
Rate for Payer: Aetna Commercial	$1,288.05
Rate for Payer: Aetna Medicare Advantage	$1,016.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$864.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$864.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$864.35
Rate for Payer: Cigna Commercial	$1,694.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$881.30
Rate for Payer: Oxford Commercial	$677.92
Rate for Payer: Qualcare PPO/HMO/WC	$508.44
Rate for Payer: UnitedHealthcare Commercial	$677.92
Rate for Payer: UnitedHealthcare Community & State	$107.11
Rate for Payer: Wellpoint Medicaid Managed Care	$96.26

BLADE TFNA HELICAL 95MM STER

Facility

$3,389.60

Hospital Charge Code	270675943
Hospital Revenue Code	272
Min. Negotiated Rate	$508.44
Max. Negotiated Rate	$508.44
Rate for Payer: Qualcare PPO/HMO/WC	$508.44

BLADE THIN OSTEOTOME 10MM

Facility

$825.00

Hospital Charge Code	270664298
Hospital Revenue Code	272
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$123.75
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

BLADE THIN OSTEOTOME 10MM

Facility

$825.00

Hospital Charge Code	270664298
Hospital Revenue Code	272
Min. Negotiated Rate	$23.43
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.50
Rate for Payer: Oxford Commercial	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Commercial	$165.00
Rate for Payer: UnitedHealthcare Community & State	$26.07
Rate for Payer: Wellpoint Medicaid Managed Care	$23.43

BLADE TOMCAT SHAVER SM J 3.5mm

Facility

$200.00

Hospital Charge Code	270640299
Hospital Revenue Code	272
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$100.00
Rate for Payer: Aetna Commercial	$76.00
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.00
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.00
Rate for Payer: Oxford Commercial	$40.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00
Rate for Payer: UnitedHealthcare Commercial	$40.00
Rate for Payer: UnitedHealthcare Community & State	$6.32
Rate for Payer: Wellpoint Medicaid Managed Care	$5.68

BLADE TOMCAT SHAVER SM J 3.5mm

Facility

$200.00

Hospital Charge Code	270640299
Hospital Revenue Code	272
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

BLADE TRICUT 4mm 1884004HR

Facility

$830.00

Hospital Charge Code	270639580
Hospital Revenue Code	272
Min. Negotiated Rate	$124.50
Max. Negotiated Rate	$124.50
Rate for Payer: Qualcare PPO/HMO/WC	$124.50

BLADE TRICUT 4mm 1884004HR

Facility

$830.00

Hospital Charge Code	270639580
Hospital Revenue Code	272
Min. Negotiated Rate	$23.57
Max. Negotiated Rate	$415.00
Rate for Payer: Aetna Commercial	$315.40
Rate for Payer: Aetna Medicare Advantage	$249.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.65
Rate for Payer: Cigna Commercial	$415.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.80
Rate for Payer: Oxford Commercial	$166.00
Rate for Payer: Qualcare PPO/HMO/WC	$124.50
Rate for Payer: UnitedHealthcare Commercial	$166.00
Rate for Payer: UnitedHealthcare Community & State	$26.23
Rate for Payer: Wellpoint Medicaid Managed Care	$23.57

BLADE TRUNICATED 64MM EXPLANT

Facility

$3,420.00

Hospital Charge Code	270690964
Hospital Revenue Code	272
Min. Negotiated Rate	$97.13
Max. Negotiated Rate	$1,710.00
Rate for Payer: Aetna Commercial	$1,299.60
Rate for Payer: Aetna Medicare Advantage	$1,026.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$872.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$872.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$872.10
Rate for Payer: Cigna Commercial	$1,710.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$889.20
Rate for Payer: Oxford Commercial	$684.00
Rate for Payer: Qualcare PPO/HMO/WC	$513.00
Rate for Payer: UnitedHealthcare Commercial	$684.00
Rate for Payer: UnitedHealthcare Community & State	$108.07
Rate for Payer: Wellpoint Medicaid Managed Care	$97.13

BLADE TRUNICATED 64MM EXPLANT

Facility

$3,420.00

Hospital Charge Code	270690964
Hospital Revenue Code	272
Min. Negotiated Rate	$513.00
Max. Negotiated Rate	$513.00
Rate for Payer: Qualcare PPO/HMO/WC	$513.00

BLADE UNIVERSAL FOR MEDICLIP

Facility

$10.96

Hospital Charge Code	270645783C
Hospital Revenue Code	272
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$1.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.64

BLADE UNIVERSAL FOR MEDICLIP

Facility

$10.96

Hospital Charge Code	270645783C
Hospital Revenue Code	272
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$5.48
Rate for Payer: Aetna Commercial	$4.16
Rate for Payer: Aetna Medicare Advantage	$3.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.79
Rate for Payer: Cigna Commercial	$5.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.85
Rate for Payer: Oxford Commercial	$2.19
Rate for Payer: Qualcare PPO/HMO/WC	$1.64
Rate for Payer: UnitedHealthcare Commercial	$2.19
Rate for Payer: UnitedHealthcare Community & State	$0.35
Rate for Payer: Wellpoint Medicaid Managed Care	$0.31

BLADE XTRACT FULL 62MM

Facility

$3,420.00

Service Code	HCPCS A4649
Hospital Charge Code	270697340
Hospital Revenue Code	272
Min. Negotiated Rate	$97.13
Max. Negotiated Rate	$1,710.00
Rate for Payer: Aetna Commercial	$1,299.60
Rate for Payer: Aetna Medicare Advantage	$1,026.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$872.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$872.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$872.10
Rate for Payer: Cigna Commercial	$1,710.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$889.20
Rate for Payer: Oxford Commercial	$684.00
Rate for Payer: Qualcare PPO/HMO/WC	$513.00
Rate for Payer: UnitedHealthcare Commercial	$684.00
Rate for Payer: UnitedHealthcare Community & State	$108.07
Rate for Payer: Wellpoint Medicaid Managed Care	$97.13

BLADE XTRACT FULL 62MM

Facility

$3,420.00

Service Code	HCPCS A4649
Hospital Charge Code	270697340
Hospital Revenue Code	272
Min. Negotiated Rate	$513.00
Max. Negotiated Rate	$513.00
Rate for Payer: Qualcare PPO/HMO/WC	$513.00

BLADE XTRACT TRUNC 62MM

Facility

$3,420.00

Service Code	HCPCS A4649
Hospital Charge Code	270697339
Hospital Revenue Code	272
Min. Negotiated Rate	$513.00
Max. Negotiated Rate	$513.00
Rate for Payer: Qualcare PPO/HMO/WC	$513.00

BLADE XTRACT TRUNC 62MM

Facility

$3,420.00

Service Code	HCPCS A4649
Hospital Charge Code	270697339
Hospital Revenue Code	272
Min. Negotiated Rate	$97.13
Max. Negotiated Rate	$1,710.00
Rate for Payer: Aetna Commercial	$1,299.60
Rate for Payer: Aetna Medicare Advantage	$1,026.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$872.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$872.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$872.10
Rate for Payer: Cigna Commercial	$1,710.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$889.20
Rate for Payer: Oxford Commercial	$684.00
Rate for Payer: Qualcare PPO/HMO/WC	$513.00
Rate for Payer: UnitedHealthcare Commercial	$684.00
Rate for Payer: UnitedHealthcare Community & State	$108.07
Rate for Payer: Wellpoint Medicaid Managed Care	$97.13

BLADE ZIM 6.5/25.5MM 5023-232

Facility

$46.35

Hospital Charge Code	270601042
Hospital Revenue Code	272
Min. Negotiated Rate	$1.32
Max. Negotiated Rate	$23.18
Rate for Payer: Aetna Commercial	$17.61
Rate for Payer: Aetna Medicare Advantage	$13.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.82
Rate for Payer: Cigna Commercial	$23.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.05
Rate for Payer: Oxford Commercial	$9.27
Rate for Payer: Qualcare PPO/HMO/WC	$6.95
Rate for Payer: UnitedHealthcare Commercial	$9.27
Rate for Payer: UnitedHealthcare Community & State	$1.46
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

BLADE ZIM 6.5/25.5MM 5023-232

Facility

$46.35

Hospital Charge Code	270601042
Hospital Revenue Code	272
Min. Negotiated Rate	$6.95
Max. Negotiated Rate	$6.95
Rate for Payer: Qualcare PPO/HMO/WC	$6.95

BLADE ZIM 9.5/25.5MM 5023-238

Facility

$46.35

Hospital Charge Code	270601048
Hospital Revenue Code	272
Min. Negotiated Rate	$1.32
Max. Negotiated Rate	$23.18
Rate for Payer: Aetna Commercial	$17.61
Rate for Payer: Aetna Medicare Advantage	$13.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.82
Rate for Payer: Cigna Commercial	$23.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.05
Rate for Payer: Oxford Commercial	$9.27
Rate for Payer: Qualcare PPO/HMO/WC	$6.95
Rate for Payer: UnitedHealthcare Commercial	$9.27
Rate for Payer: UnitedHealthcare Community & State	$1.46
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

BLADE ZIM 9.5/25.5MM 5023-238

Facility

$46.35

Hospital Charge Code	270601048
Hospital Revenue Code	272
Min. Negotiated Rate	$6.95
Max. Negotiated Rate	$6.95
Rate for Payer: Qualcare PPO/HMO/WC	$6.95

BLADE ZIM OSCIL LG BN 5071-551

Facility

$51.50

Hospital Charge Code	270601059
Hospital Revenue Code	272
Min. Negotiated Rate	$7.72
Max. Negotiated Rate	$7.72
Rate for Payer: Qualcare PPO/HMO/WC	$7.72

Know your out-of-pocket cost for care.

All Charges