Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BONE WAX

Facility

$23.90

Hospital Charge Code	270604717
Hospital Revenue Code	272
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$11.95
Rate for Payer: Aetna Commercial	$9.08
Rate for Payer: Aetna Medicare Advantage	$7.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.09
Rate for Payer: Cigna Commercial	$11.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.21
Rate for Payer: Oxford Commercial	$4.78
Rate for Payer: Qualcare PPO/HMO/WC	$3.58
Rate for Payer: UnitedHealthcare Commercial	$4.78
Rate for Payer: UnitedHealthcare Community & State	$0.76
Rate for Payer: Wellpoint Medicaid Managed Care	$0.68

BONE WAX

Facility

$72.00

Hospital Charge Code	270335098
Hospital Revenue Code	272
Min. Negotiated Rate	$2.04
Max. Negotiated Rate	$36.00
Rate for Payer: Aetna Commercial	$27.36
Rate for Payer: Aetna Medicare Advantage	$21.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.36
Rate for Payer: Cigna Commercial	$36.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.72
Rate for Payer: Oxford Commercial	$14.40
Rate for Payer: Qualcare PPO/HMO/WC	$10.80
Rate for Payer: UnitedHealthcare Commercial	$14.40
Rate for Payer: UnitedHealthcare Community & State	$2.28
Rate for Payer: Wellpoint Medicaid Managed Care	$2.04

BONE WAX

Facility

$22.10

Hospital Charge Code	270653366
Hospital Revenue Code	272
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$11.05
Rate for Payer: Aetna Commercial	$8.40
Rate for Payer: Aetna Medicare Advantage	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.64
Rate for Payer: Cigna Commercial	$11.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.75
Rate for Payer: Oxford Commercial	$4.42
Rate for Payer: Qualcare PPO/HMO/WC	$3.31
Rate for Payer: UnitedHealthcare Commercial	$4.42
Rate for Payer: UnitedHealthcare Community & State	$0.70
Rate for Payer: Wellpoint Medicaid Managed Care	$0.63

BONE WAX

Facility

$23.90

Hospital Charge Code	270604717
Hospital Revenue Code	272
Min. Negotiated Rate	$3.58
Max. Negotiated Rate	$3.58
Rate for Payer: Qualcare PPO/HMO/WC	$3.58

BONE WAX 2.5G NON ABSORBABLE

Facility

$46.78

Hospital Charge Code	270651257
Hospital Revenue Code	272
Min. Negotiated Rate	$7.02
Max. Negotiated Rate	$7.02
Rate for Payer: Qualcare PPO/HMO/WC	$7.02

BONE WAX 2.5G NON ABSORBABLE

Facility

$46.78

Hospital Charge Code	270651257
Hospital Revenue Code	272
Min. Negotiated Rate	$1.33
Max. Negotiated Rate	$23.39
Rate for Payer: Aetna Commercial	$17.78
Rate for Payer: Aetna Medicare Advantage	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.93
Rate for Payer: Cigna Commercial	$23.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.16
Rate for Payer: Oxford Commercial	$9.36
Rate for Payer: Qualcare PPO/HMO/WC	$7.02
Rate for Payer: UnitedHealthcare Commercial	$9.36
Rate for Payer: UnitedHealthcare Community & State	$1.48
Rate for Payer: Wellpoint Medicaid Managed Care	$1.33

BONE WEDGE 7X9

Facility

$6,222.00

Hospital Charge Code	270335654
Hospital Revenue Code	278
Min. Negotiated Rate	$176.70
Max. Negotiated Rate	$3,111.00
Rate for Payer: Aetna Commercial	$2,364.36
Rate for Payer: Aetna Medicare Advantage	$1,866.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,586.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,586.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,244.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,586.61
Rate for Payer: Cigna Commercial	$3,111.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,505.72
Rate for Payer: Qualcare PPO/HMO/WC	$933.30
Rate for Payer: UnitedHealthcare Community & State	$196.62
Rate for Payer: Wellpoint Medicaid Managed Care	$176.70

BONE WEDGE 7X9

Facility

$6,222.00

Hospital Charge Code	270335654
Hospital Revenue Code	278
Min. Negotiated Rate	$933.30
Max. Negotiated Rate	$1,505.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,244.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,505.72
Rate for Payer: Qualcare PPO/HMO/WC	$933.30

BONE WEDGE 9X11

Facility

$5,599.00

Hospital Charge Code	270335648
Hospital Revenue Code	278
Min. Negotiated Rate	$159.01
Max. Negotiated Rate	$2,799.50
Rate for Payer: Aetna Commercial	$2,127.62
Rate for Payer: Aetna Medicare Advantage	$1,679.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,427.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,427.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,119.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,427.74
Rate for Payer: Cigna Commercial	$2,799.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,354.96
Rate for Payer: Qualcare PPO/HMO/WC	$839.85
Rate for Payer: UnitedHealthcare Community & State	$176.93
Rate for Payer: Wellpoint Medicaid Managed Care	$159.01

BONE WEDGE 9X11

Facility

$5,599.00

Hospital Charge Code	270335648
Hospital Revenue Code	278
Min. Negotiated Rate	$839.85
Max. Negotiated Rate	$1,354.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,119.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,354.96
Rate for Payer: Qualcare PPO/HMO/WC	$839.85

BOOST CONNECT TISS IMPL 2.0CC

Facility

$10,995.00

Service Code	HCPCS C1763
Hospital Charge Code	270697378
Hospital Revenue Code	278
Min. Negotiated Rate	$312.26
Max. Negotiated Rate	$5,497.50
Rate for Payer: Aetna Commercial	$4,178.10
Rate for Payer: Aetna Medicare Advantage	$3,298.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,803.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,803.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,199.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,803.72
Rate for Payer: Cigna Commercial	$5,497.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,660.79
Rate for Payer: Qualcare PPO/HMO/WC	$1,649.25
Rate for Payer: UnitedHealthcare Community & State	$347.44
Rate for Payer: Wellpoint Medicaid Managed Care	$312.26

BOOST CONNECT TISS IMPL 2.0CC

Facility

$10,995.00

Service Code	HCPCS C1763
Hospital Charge Code	270697378
Hospital Revenue Code	278
Min. Negotiated Rate	$1,649.25
Max. Negotiated Rate	$2,660.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,199.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,660.79
Rate for Payer: Qualcare PPO/HMO/WC	$1,649.25

BOOST HEAD POSITIONER

Facility

$60.00

Hospital Charge Code	270658160
Hospital Revenue Code	270
Min. Negotiated Rate	$1.70
Max. Negotiated Rate	$30.00
Rate for Payer: Aetna Commercial	$22.80
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Commercial	$12.00
Rate for Payer: UnitedHealthcare Community & State	$1.90
Rate for Payer: Wellpoint Medicaid Managed Care	$1.70

BOOST HEAD POSITIONER

Facility

$60.00

Hospital Charge Code	270658160
Hospital Revenue Code	270
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

BOOSTRIX SDV 0.5 ML

Facility

$295.47

Service Code	HCPCS 90715
Hospital Charge Code	60630104
Hospital Revenue Code	636
Min. Negotiated Rate	$44.32
Max. Negotiated Rate	$71.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$44.32

BOOSTRIX SDV 0.5 ML

Facility

$295.47

Service Code	HCPCS 90715
Hospital Charge Code	60630104
Hospital Revenue Code	636
Min. Negotiated Rate	$8.39
Max. Negotiated Rate	$147.74
Rate for Payer: Aetna Commercial	$112.28
Rate for Payer: Aetna Medicare Advantage	$88.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.34
Rate for Payer: Cigna Commercial	$147.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$44.32
Rate for Payer: UnitedHealthcare Community & State	$9.34
Rate for Payer: Wellpoint Medicaid Managed Care	$8.39

BOOSTRIX SDV EX

Facility

$298.89

Service Code	NDC 58160084252
Hospital Charge Code	60630104EX
Hospital Revenue Code	259
Min. Negotiated Rate	$44.83
Max. Negotiated Rate	$44.83
Rate for Payer: Qualcare PPO/HMO/WC	$44.83

BOOSTRIX SDV EX

Facility

$298.89

Service Code	NDC 58160084252
Hospital Charge Code	60630104EX
Hospital Revenue Code	259
Min. Negotiated Rate	$8.49
Max. Negotiated Rate	$149.44
Rate for Payer: Aetna Commercial	$113.58
Rate for Payer: Aetna Medicare Advantage	$89.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.22
Rate for Payer: Cigna Commercial	$149.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.71
Rate for Payer: Oxford Commercial	$59.78
Rate for Payer: Qualcare PPO/HMO/WC	$44.83
Rate for Payer: UnitedHealthcare Commercial	$59.78
Rate for Payer: UnitedHealthcare Community & State	$9.44
Rate for Payer: Wellpoint Medicaid Managed Care	$8.49

BOOT CAMWALKER

Facility

$5.00

Hospital Charge Code	270633897
Hospital Revenue Code	271
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

BOOT CAMWALKER

Facility

$5.00

Hospital Charge Code	270633897
Hospital Revenue Code	271
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.90
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.30
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$1.00
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

BOOT HEEL LIFT SUSPENSION 9949

Facility

$229.90

Hospital Charge Code	270302935
Hospital Revenue Code	272
Min. Negotiated Rate	$34.48
Max. Negotiated Rate	$34.48
Rate for Payer: Qualcare PPO/HMO/WC	$34.48

BOOT HEEL LIFT SUSPENSION 9949

Facility

$229.90

Hospital Charge Code	270302935
Hospital Revenue Code	272
Min. Negotiated Rate	$6.53
Max. Negotiated Rate	$114.95
Rate for Payer: Aetna Commercial	$87.36
Rate for Payer: Aetna Medicare Advantage	$68.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.62
Rate for Payer: Cigna Commercial	$114.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.77
Rate for Payer: Oxford Commercial	$45.98
Rate for Payer: Qualcare PPO/HMO/WC	$34.48
Rate for Payer: UnitedHealthcare Commercial	$45.98
Rate for Payer: UnitedHealthcare Community & State	$7.26
Rate for Payer: Wellpoint Medicaid Managed Care	$6.53

BOOTIES SUTURE AID YELL 30-702

Facility

$5.78

Hospital Charge Code	270646080
Hospital Revenue Code	272
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$0.87
Rate for Payer: Qualcare PPO/HMO/WC	$0.87

BOOTIES SUTURE AID YELL 30-702

Facility

$5.78

Hospital Charge Code	270646080
Hospital Revenue Code	272
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$2.89
Rate for Payer: Aetna Commercial	$2.20
Rate for Payer: Aetna Medicare Advantage	$1.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.47
Rate for Payer: Cigna Commercial	$2.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.50
Rate for Payer: Oxford Commercial	$1.16
Rate for Payer: Qualcare PPO/HMO/WC	$0.87
Rate for Payer: UnitedHealthcare Commercial	$1.16
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

BOOT LEG FLUID PROTECTION

Facility

$106.00

Hospital Charge Code	270335514
Hospital Revenue Code	272
Min. Negotiated Rate	$15.90
Max. Negotiated Rate	$15.90
Rate for Payer: Qualcare PPO/HMO/WC	$15.90

Know your out-of-pocket cost for care.

All Charges