Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BRIDGE 12CC (SINGLE)

Facility

$10,383.75

Hospital Charge Code	671263
Hospital Revenue Code	278
Min. Negotiated Rate	$1,557.56
Max. Negotiated Rate	$2,512.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,076.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,512.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,557.56

BRIDGE 12CC (SINGLE)

Facility

$10,383.75

Hospital Charge Code	270671263
Hospital Revenue Code	278
Min. Negotiated Rate	$1,557.56
Max. Negotiated Rate	$2,512.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,076.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,512.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,557.56

BRIDGE 12CC (SINGLE)

Facility

$10,383.75

Hospital Charge Code	671263
Hospital Revenue Code	278
Min. Negotiated Rate	$294.90
Max. Negotiated Rate	$5,191.88
Rate for Payer: Aetna Commercial	$3,945.82
Rate for Payer: Aetna Medicare Advantage	$3,115.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,647.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,647.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,076.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,647.86
Rate for Payer: Cigna Commercial	$5,191.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,512.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,557.56
Rate for Payer: UnitedHealthcare Community & State	$328.13
Rate for Payer: Wellpoint Medicaid Managed Care	$294.90

BRIDGE 24CC

Facility

$12,487.50

Hospital Charge Code	270671264
Hospital Revenue Code	278
Min. Negotiated Rate	$1,873.12
Max. Negotiated Rate	$3,021.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,497.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,021.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,873.12

BRIDGE 24CC

Facility

$12,487.50

Hospital Charge Code	270671264
Hospital Revenue Code	278
Min. Negotiated Rate	$354.64
Max. Negotiated Rate	$6,243.75
Rate for Payer: Aetna Commercial	$4,745.25
Rate for Payer: Aetna Medicare Advantage	$3,746.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,184.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,184.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,497.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,184.31
Rate for Payer: Cigna Commercial	$6,243.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,021.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,873.12
Rate for Payer: UnitedHealthcare Community & State	$394.61
Rate for Payer: Wellpoint Medicaid Managed Care	$354.64

BRIDGE 46CC

Facility

$17,850.00

Hospital Charge Code	270671265
Hospital Revenue Code	278
Min. Negotiated Rate	$506.94
Max. Negotiated Rate	$8,925.00
Rate for Payer: Aetna Commercial	$6,783.00
Rate for Payer: Aetna Medicare Advantage	$5,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,551.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,551.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,551.75
Rate for Payer: Cigna Commercial	$8,925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,319.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,677.50
Rate for Payer: UnitedHealthcare Community & State	$564.06
Rate for Payer: Wellpoint Medicaid Managed Care	$506.94

BRIDGE 46CC

Facility

$17,850.00

Hospital Charge Code	270671265
Hospital Revenue Code	278
Min. Negotiated Rate	$2,677.50
Max. Negotiated Rate	$4,319.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,570.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,319.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,677.50

BRIEF EMOTIONAL/BEHAV ASSMT

Facility

$232.00

Service Code	HCPCS 96127
Hospital Charge Code	412396127
Hospital Revenue Code	510
Min. Negotiated Rate	$6.59
Max. Negotiated Rate	$160.95
Rate for Payer: Aetna Commercial	$120.69
Rate for Payer: Aetna Medicare Advantage	$143.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.95
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: Cigna Medicare Advantage	$44.37
Rate for Payer: Clover Medicare Advantage	$42.15
Rate for Payer: EmblemHealth Commercial	$133.11
Rate for Payer: Humana Medicare Advantage	$45.70
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$44.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.32
Rate for Payer: Qualcare PPO/HMO/WC	$34.80
Rate for Payer: UnitedHealthcare Community & State	$7.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$44.37
Rate for Payer: Wellcare Medicare Advantage	$44.37
Rate for Payer: Wellpoint Medicaid Managed Care	$6.59

BRIEF EMOTIONAL/BEHAV ASSMT

Facility

$232.00

Service Code	HCPCS 96127
Hospital Charge Code	412396127
Hospital Revenue Code	510
Min. Negotiated Rate	$34.80
Max. Negotiated Rate	$34.80
Rate for Payer: Qualcare PPO/HMO/WC	$34.80

BRILINTA 60 MG (TICAGRELOR)

Facility

$36.45

Service Code	NDC 186077660
Hospital Charge Code	606390095
Hospital Revenue Code	250
Min. Negotiated Rate	$5.47
Max. Negotiated Rate	$5.47
Rate for Payer: Qualcare PPO/HMO/WC	$5.47

BRILINTA 60 MG (TICAGRELOR)

Facility

$36.45

Service Code	NDC 186077660
Hospital Charge Code	606390095
Hospital Revenue Code	250
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$18.23
Rate for Payer: Aetna Commercial	$13.85
Rate for Payer: Aetna Medicare Advantage	$10.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.29
Rate for Payer: Cigna Commercial	$18.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.48
Rate for Payer: Oxford Commercial	$7.29
Rate for Payer: Qualcare PPO/HMO/WC	$5.47
Rate for Payer: UnitedHealthcare Commercial	$7.29
Rate for Payer: UnitedHealthcare Community & State	$1.15
Rate for Payer: Wellpoint Medicaid Managed Care	$1.04

BRILL BIT 2.0MM

Facility

$1,370.00

Hospital Charge Code	270661009
Hospital Revenue Code	272
Min. Negotiated Rate	$38.91
Max. Negotiated Rate	$685.00
Rate for Payer: Aetna Commercial	$520.60
Rate for Payer: Aetna Medicare Advantage	$411.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$349.35
Rate for Payer: Cigna Commercial	$685.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.20
Rate for Payer: Oxford Commercial	$274.00
Rate for Payer: Qualcare PPO/HMO/WC	$205.50
Rate for Payer: UnitedHealthcare Commercial	$274.00
Rate for Payer: UnitedHealthcare Community & State	$43.29
Rate for Payer: Wellpoint Medicaid Managed Care	$38.91

BRILL BIT 2.0MM

Facility

$1,370.00

Hospital Charge Code	270661009
Hospital Revenue Code	272
Min. Negotiated Rate	$205.50
Max. Negotiated Rate	$205.50
Rate for Payer: Qualcare PPO/HMO/WC	$205.50

BROACH BODY OFFSET

Facility

$39,720.00

Service Code	HCPCS C1776
Hospital Charge Code	270689650
Hospital Revenue Code	278
Min. Negotiated Rate	$1,128.05
Max. Negotiated Rate	$19,860.00
Rate for Payer: Aetna Commercial	$15,093.60
Rate for Payer: Aetna Medicare Advantage	$11,916.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,128.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,128.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,944.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,128.60
Rate for Payer: Cigna Commercial	$19,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,612.24
Rate for Payer: Qualcare PPO/HMO/WC	$5,958.00
Rate for Payer: UnitedHealthcare Community & State	$1,255.15
Rate for Payer: Wellpoint Medicaid Managed Care	$1,128.05

BROACH BODY OFFSET

Facility

$39,720.00

Service Code	HCPCS C1776
Hospital Charge Code	270689650
Hospital Revenue Code	278
Min. Negotiated Rate	$5,958.00
Max. Negotiated Rate	$9,612.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,944.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,612.24
Rate for Payer: Qualcare PPO/HMO/WC	$5,958.00

BROACH BODY STD ARCOS 13X175MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690469
Hospital Revenue Code	278
Min. Negotiated Rate	$298.20
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,990.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00
Rate for Payer: UnitedHealthcare Community & State	$331.80
Rate for Payer: Wellpoint Medicaid Managed Care	$298.20

BROACH BODY STD ARCOS 13X175MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690469
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

BROACHED BODIES SZ #4

Facility

$36,100.00

Service Code	HCPCS C1776
Hospital Charge Code	270676120
Hospital Revenue Code	278
Min. Negotiated Rate	$5,415.00
Max. Negotiated Rate	$8,736.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,736.20
Rate for Payer: Qualcare PPO/HMO/WC	$5,415.00

BROACHED BODIES SZ #4

Facility

$36,100.00

Service Code	HCPCS C1776
Hospital Charge Code	270676120
Hospital Revenue Code	278
Min. Negotiated Rate	$1,025.24
Max. Negotiated Rate	$18,050.00
Rate for Payer: Aetna Commercial	$13,718.00
Rate for Payer: Aetna Medicare Advantage	$10,830.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,205.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,205.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,220.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,205.50
Rate for Payer: Cigna Commercial	$18,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,736.20
Rate for Payer: Qualcare PPO/HMO/WC	$5,415.00
Rate for Payer: UnitedHealthcare Community & State	$1,140.76
Rate for Payer: Wellpoint Medicaid Managed Care	$1,025.24

BROACH SM DISTAL 16x6x6MM

Facility

$1,351.00

Hospital Charge Code	270674685
Hospital Revenue Code	272
Min. Negotiated Rate	$38.37
Max. Negotiated Rate	$675.50
Rate for Payer: Aetna Commercial	$513.38
Rate for Payer: Aetna Medicare Advantage	$405.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$344.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$344.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$344.50
Rate for Payer: Cigna Commercial	$675.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$351.26
Rate for Payer: Oxford Commercial	$270.20
Rate for Payer: Qualcare PPO/HMO/WC	$202.65
Rate for Payer: UnitedHealthcare Commercial	$270.20
Rate for Payer: UnitedHealthcare Community & State	$42.69
Rate for Payer: Wellpoint Medicaid Managed Care	$38.37

BROACH SM DISTAL 16x6x6MM

Facility

$1,351.00

Hospital Charge Code	270674685
Hospital Revenue Code	272
Min. Negotiated Rate	$202.65
Max. Negotiated Rate	$202.65
Rate for Payer: Qualcare PPO/HMO/WC	$202.65

BROACH SM PROXI 19x4.5x4.5MM

Facility

$1,351.00

Hospital Charge Code	270674684
Hospital Revenue Code	272
Min. Negotiated Rate	$202.65
Max. Negotiated Rate	$202.65
Rate for Payer: Qualcare PPO/HMO/WC	$202.65

BROACH SM PROXI 19x4.5x4.5MM

Facility

$1,351.00

Hospital Charge Code	270674684
Hospital Revenue Code	272
Min. Negotiated Rate	$38.37
Max. Negotiated Rate	$675.50
Rate for Payer: Aetna Commercial	$513.38
Rate for Payer: Aetna Medicare Advantage	$405.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$344.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$344.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$344.50
Rate for Payer: Cigna Commercial	$675.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$351.26
Rate for Payer: Oxford Commercial	$270.20
Rate for Payer: Qualcare PPO/HMO/WC	$202.65
Rate for Payer: UnitedHealthcare Commercial	$270.20
Rate for Payer: UnitedHealthcare Community & State	$42.69
Rate for Payer: Wellpoint Medicaid Managed Care	$38.37

BROKEN SCREW EXTRACTOR 5MM

Facility

$1,550.00

Hospital Charge Code	270690525
Hospital Revenue Code	270
Min. Negotiated Rate	$44.02
Max. Negotiated Rate	$775.00
Rate for Payer: Aetna Commercial	$589.00
Rate for Payer: Aetna Medicare Advantage	$465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$395.25
Rate for Payer: Cigna Commercial	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$403.00
Rate for Payer: Oxford Commercial	$310.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.50
Rate for Payer: UnitedHealthcare Commercial	$310.00
Rate for Payer: UnitedHealthcare Community & State	$48.98
Rate for Payer: Wellpoint Medicaid Managed Care	$44.02

BROKEN SCREW EXTRACTOR 5MM

Facility

$1,550.00

Hospital Charge Code	270690525
Hospital Revenue Code	270
Min. Negotiated Rate	$232.50
Max. Negotiated Rate	$232.50
Rate for Payer: Qualcare PPO/HMO/WC	$232.50

Know your out-of-pocket cost for care.

All Charges