Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BUR FLUTED RND SFT TOUCH 5MM

Facility

$621.00

Hospital Charge Code	270669956
Hospital Revenue Code	272
Min. Negotiated Rate	$93.15
Max. Negotiated Rate	$93.15
Rate for Payer: Qualcare PPO/HMO/WC	$93.15

BUR FLUTED RND SFT TOUCH 5MM

Facility

$621.00

Hospital Charge Code	270669956
Hospital Revenue Code	272
Min. Negotiated Rate	$17.64
Max. Negotiated Rate	$310.50
Rate for Payer: Aetna Commercial	$235.98
Rate for Payer: Aetna Medicare Advantage	$186.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.35
Rate for Payer: Cigna Commercial	$310.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.46
Rate for Payer: Oxford Commercial	$124.20
Rate for Payer: Qualcare PPO/HMO/WC	$93.15
Rate for Payer: UnitedHealthcare Commercial	$124.20
Rate for Payer: UnitedHealthcare Community & State	$19.62
Rate for Payer: Wellpoint Medicaid Managed Care	$17.64

BUR FLUTED RND SFT TOUCH 6MM

Facility

$621.00

Hospital Charge Code	270672680
Hospital Revenue Code	272
Min. Negotiated Rate	$93.15
Max. Negotiated Rate	$93.15
Rate for Payer: Qualcare PPO/HMO/WC	$93.15

BUR FLUTED RND SFT TOUCH 6MM

Facility

$621.00

Hospital Charge Code	270672680
Hospital Revenue Code	272
Min. Negotiated Rate	$17.64
Max. Negotiated Rate	$310.50
Rate for Payer: Aetna Commercial	$235.98
Rate for Payer: Aetna Medicare Advantage	$186.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.35
Rate for Payer: Cigna Commercial	$310.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.46
Rate for Payer: Oxford Commercial	$124.20
Rate for Payer: Qualcare PPO/HMO/WC	$93.15
Rate for Payer: UnitedHealthcare Commercial	$124.20
Rate for Payer: UnitedHealthcare Community & State	$19.62
Rate for Payer: Wellpoint Medicaid Managed Care	$17.64

BURG SURG OVAL 5.5MM DIA 10MML

Facility

$197.50

Hospital Charge Code	270655943
Hospital Revenue Code	271
Min. Negotiated Rate	$5.61
Max. Negotiated Rate	$98.75
Rate for Payer: Aetna Commercial	$75.05
Rate for Payer: Aetna Medicare Advantage	$59.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.36
Rate for Payer: Cigna Commercial	$98.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.35
Rate for Payer: Oxford Commercial	$39.50
Rate for Payer: Qualcare PPO/HMO/WC	$29.62
Rate for Payer: UnitedHealthcare Commercial	$39.50
Rate for Payer: UnitedHealthcare Community & State	$6.24
Rate for Payer: Wellpoint Medicaid Managed Care	$5.61

BURG SURG OVAL 5.5MM DIA 10MML

Facility

$197.50

Hospital Charge Code	270655943
Hospital Revenue Code	271
Min. Negotiated Rate	$29.62
Max. Negotiated Rate	$29.62
Rate for Payer: Qualcare PPO/HMO/WC	$29.62

BUR LEGEND 10CM 6MM MIDAS REX

Facility

$731.50

Hospital Charge Code	270660510
Hospital Revenue Code	272
Min. Negotiated Rate	$20.77
Max. Negotiated Rate	$365.75
Rate for Payer: Aetna Commercial	$277.97
Rate for Payer: Aetna Medicare Advantage	$219.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$186.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$186.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$186.53
Rate for Payer: Cigna Commercial	$365.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$190.19
Rate for Payer: Oxford Commercial	$146.30
Rate for Payer: Qualcare PPO/HMO/WC	$109.72
Rate for Payer: UnitedHealthcare Commercial	$146.30
Rate for Payer: UnitedHealthcare Community & State	$23.12
Rate for Payer: Wellpoint Medicaid Managed Care	$20.77

BUR LEGEND 10CM 6MM MIDAS REX

Facility

$731.50

Hospital Charge Code	270660510
Hospital Revenue Code	272
Min. Negotiated Rate	$109.72
Max. Negotiated Rate	$109.72
Rate for Payer: Qualcare PPO/HMO/WC	$109.72

BUR LVT CRB RND 4 30 5056119

Facility

$495.00

Hospital Charge Code	270622535
Hospital Revenue Code	272
Min. Negotiated Rate	$74.25
Max. Negotiated Rate	$74.25
Rate for Payer: Qualcare PPO/HMO/WC	$74.25

BUR LVT CRB RND 4 30 5056119

Facility

$495.00

Hospital Charge Code	270622535
Hospital Revenue Code	272
Min. Negotiated Rate	$14.06
Max. Negotiated Rate	$247.50
Rate for Payer: Aetna Commercial	$188.10
Rate for Payer: Aetna Medicare Advantage	$148.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.22
Rate for Payer: Cigna Commercial	$247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.70
Rate for Payer: Oxford Commercial	$99.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.25
Rate for Payer: UnitedHealthcare Commercial	$99.00
Rate for Payer: UnitedHealthcare Community & State	$15.64
Rate for Payer: Wellpoint Medicaid Managed Care	$14.06

BUR LVT CRB RND 5 30 5056118

Facility

$423.70

Hospital Charge Code	270621858
Hospital Revenue Code	272
Min. Negotiated Rate	$12.03
Max. Negotiated Rate	$211.85
Rate for Payer: Aetna Commercial	$161.01
Rate for Payer: Aetna Medicare Advantage	$127.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.04
Rate for Payer: Cigna Commercial	$211.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.16
Rate for Payer: Oxford Commercial	$84.74
Rate for Payer: Qualcare PPO/HMO/WC	$63.55
Rate for Payer: UnitedHealthcare Commercial	$84.74
Rate for Payer: UnitedHealthcare Community & State	$13.39
Rate for Payer: Wellpoint Medicaid Managed Care	$12.03

BUR LVT CRB RND 5 30 5056118

Facility

$423.70

Hospital Charge Code	270621858
Hospital Revenue Code	272
Min. Negotiated Rate	$63.55
Max. Negotiated Rate	$63.55
Rate for Payer: Qualcare PPO/HMO/WC	$63.55

BUR LVT CRB RND 6.5 30 5056117

Facility

$495.00

Hospital Charge Code	270622534
Hospital Revenue Code	272
Min. Negotiated Rate	$14.06
Max. Negotiated Rate	$247.50
Rate for Payer: Aetna Commercial	$188.10
Rate for Payer: Aetna Medicare Advantage	$148.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.22
Rate for Payer: Cigna Commercial	$247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.70
Rate for Payer: Oxford Commercial	$99.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.25
Rate for Payer: UnitedHealthcare Commercial	$99.00
Rate for Payer: UnitedHealthcare Community & State	$15.64
Rate for Payer: Wellpoint Medicaid Managed Care	$14.06

BUR LVT CRB RND 6.5 30 5056117

Facility

$495.00

Hospital Charge Code	270622534
Hospital Revenue Code	272
Min. Negotiated Rate	$74.25
Max. Negotiated Rate	$74.25
Rate for Payer: Qualcare PPO/HMO/WC	$74.25

BUR LVT DMD RND 4 38 5056148

Facility

$565.00

Hospital Charge Code	270622538
Hospital Revenue Code	272
Min. Negotiated Rate	$84.75
Max. Negotiated Rate	$84.75
Rate for Payer: Qualcare PPO/HMO/WC	$84.75

BUR LVT DMD RND 4 38 5056148

Facility

$565.00

Hospital Charge Code	270622538
Hospital Revenue Code	272
Min. Negotiated Rate	$16.05
Max. Negotiated Rate	$282.50
Rate for Payer: Aetna Commercial	$214.70
Rate for Payer: Aetna Medicare Advantage	$169.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.07
Rate for Payer: Cigna Commercial	$282.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.90
Rate for Payer: Oxford Commercial	$113.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.75
Rate for Payer: UnitedHealthcare Commercial	$113.00
Rate for Payer: UnitedHealthcare Community & State	$17.85
Rate for Payer: Wellpoint Medicaid Managed Care	$16.05

BUR MACH 3MM 15CM

Facility

$1,350.00

Hospital Charge Code	270692470
Hospital Revenue Code	272
Min. Negotiated Rate	$202.50
Max. Negotiated Rate	$202.50
Rate for Payer: Qualcare PPO/HMO/WC	$202.50

BUR MACH 3MM 15CM

Facility

$1,350.00

Hospital Charge Code	270692470
Hospital Revenue Code	272
Min. Negotiated Rate	$38.34
Max. Negotiated Rate	$675.00
Rate for Payer: Aetna Commercial	$513.00
Rate for Payer: Aetna Medicare Advantage	$405.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$344.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$344.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$344.25
Rate for Payer: Cigna Commercial	$675.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$351.00
Rate for Payer: Oxford Commercial	$270.00
Rate for Payer: Qualcare PPO/HMO/WC	$202.50
Rate for Payer: UnitedHealthcare Commercial	$270.00
Rate for Payer: UnitedHealthcare Community & State	$42.66
Rate for Payer: Wellpoint Medicaid Managed Care	$38.34

BUR MED ROUND END

Facility

$207.50

Hospital Charge Code	270675968
Hospital Revenue Code	272
Min. Negotiated Rate	$5.89
Max. Negotiated Rate	$103.75
Rate for Payer: Aetna Commercial	$78.85
Rate for Payer: Aetna Medicare Advantage	$62.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.91
Rate for Payer: Cigna Commercial	$103.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.95
Rate for Payer: Oxford Commercial	$41.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.12
Rate for Payer: UnitedHealthcare Commercial	$41.50
Rate for Payer: UnitedHealthcare Community & State	$6.56
Rate for Payer: Wellpoint Medicaid Managed Care	$5.89

BUR MED ROUND END

Facility

$207.50

Hospital Charge Code	270675968
Hospital Revenue Code	272
Min. Negotiated Rate	$31.12
Max. Negotiated Rate	$31.12
Rate for Payer: Qualcare PPO/HMO/WC	$31.12

BUR MIDAS REX TOOL 10CM 4MM

Facility

$745.75

Hospital Charge Code	270654985
Hospital Revenue Code	272
Min. Negotiated Rate	$21.18
Max. Negotiated Rate	$372.88
Rate for Payer: Aetna Commercial	$283.38
Rate for Payer: Aetna Medicare Advantage	$223.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$190.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$190.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$190.17
Rate for Payer: Cigna Commercial	$372.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.90
Rate for Payer: Oxford Commercial	$149.15
Rate for Payer: Qualcare PPO/HMO/WC	$111.86
Rate for Payer: UnitedHealthcare Commercial	$149.15
Rate for Payer: UnitedHealthcare Community & State	$23.57
Rate for Payer: Wellpoint Medicaid Managed Care	$21.18

BUR MIDAS REX TOOL 10CM 4MM

Facility

$745.75

Hospital Charge Code	270654985
Hospital Revenue Code	272
Min. Negotiated Rate	$111.86
Max. Negotiated Rate	$111.86
Rate for Payer: Qualcare PPO/HMO/WC	$111.86

BUR MIDUS REX TOOL 10CM 5MM

Facility

$149.00

Hospital Charge Code	270654834
Hospital Revenue Code	272
Min. Negotiated Rate	$22.35
Max. Negotiated Rate	$22.35
Rate for Payer: Qualcare PPO/HMO/WC	$22.35

BUR MIDUS REX TOOL 10CM 5MM

Facility

$149.00

Hospital Charge Code	270654834
Hospital Revenue Code	272
Min. Negotiated Rate	$4.23
Max. Negotiated Rate	$74.50
Rate for Payer: Aetna Commercial	$56.62
Rate for Payer: Aetna Medicare Advantage	$44.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.99
Rate for Payer: Cigna Commercial	$74.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.74
Rate for Payer: Oxford Commercial	$29.80
Rate for Payer: Qualcare PPO/HMO/WC	$22.35
Rate for Payer: UnitedHealthcare Commercial	$29.80
Rate for Payer: UnitedHealthcare Community & State	$4.71
Rate for Payer: Wellpoint Medicaid Managed Care	$4.23

BUR NEURO PRECISION 3x3.8MM

Facility

$621.00

Hospital Charge Code	270672681
Hospital Revenue Code	272
Min. Negotiated Rate	$17.64
Max. Negotiated Rate	$310.50
Rate for Payer: Aetna Commercial	$235.98
Rate for Payer: Aetna Medicare Advantage	$186.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.35
Rate for Payer: Cigna Commercial	$310.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.46
Rate for Payer: Oxford Commercial	$124.20
Rate for Payer: Qualcare PPO/HMO/WC	$93.15
Rate for Payer: UnitedHealthcare Commercial	$124.20
Rate for Payer: UnitedHealthcare Community & State	$19.62
Rate for Payer: Wellpoint Medicaid Managed Care	$17.64

Know your out-of-pocket cost for care.

All Charges