Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BURR CYL FISSURE M 3.0x16MM

Facility

$430.50

Hospital Charge Code	270674474
Hospital Revenue Code	272
Min. Negotiated Rate	$64.58
Max. Negotiated Rate	$64.58
Rate for Payer: Qualcare PPO/HMO/WC	$64.58

BURR CYL FISSURE S 1.6x4.3MM

Facility

$430.50

Hospital Charge Code	270674470
Hospital Revenue Code	272
Min. Negotiated Rate	$64.58
Max. Negotiated Rate	$64.58
Rate for Payer: Qualcare PPO/HMO/WC	$64.58

BURR CYL FISSURE S 1.6x4.3MM

Facility

$430.50

Hospital Charge Code	270674470
Hospital Revenue Code	272
Min. Negotiated Rate	$12.23
Max. Negotiated Rate	$215.25
Rate for Payer: Aetna Commercial	$163.59
Rate for Payer: Aetna Medicare Advantage	$129.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.78
Rate for Payer: Cigna Commercial	$215.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.93
Rate for Payer: Oxford Commercial	$86.10
Rate for Payer: Qualcare PPO/HMO/WC	$64.58
Rate for Payer: UnitedHealthcare Commercial	$86.10
Rate for Payer: UnitedHealthcare Community & State	$13.60
Rate for Payer: Wellpoint Medicaid Managed Care	$12.23

BURR CYL FISSURE S 3.0x16MM

Facility

$430.50

Hospital Charge Code	270674473
Hospital Revenue Code	272
Min. Negotiated Rate	$12.23
Max. Negotiated Rate	$215.25
Rate for Payer: Aetna Commercial	$163.59
Rate for Payer: Aetna Medicare Advantage	$129.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.78
Rate for Payer: Cigna Commercial	$215.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.93
Rate for Payer: Oxford Commercial	$86.10
Rate for Payer: Qualcare PPO/HMO/WC	$64.58
Rate for Payer: UnitedHealthcare Commercial	$86.10
Rate for Payer: UnitedHealthcare Community & State	$13.60
Rate for Payer: Wellpoint Medicaid Managed Care	$12.23

BURR CYL FISSURE S 3.0x16MM

Facility

$430.50

Hospital Charge Code	270674473
Hospital Revenue Code	272
Min. Negotiated Rate	$64.58
Max. Negotiated Rate	$64.58
Rate for Payer: Qualcare PPO/HMO/WC	$64.58

BURR DIAMOND 2mm

Facility

$755.00

Hospital Charge Code	270669540
Hospital Revenue Code	272
Min. Negotiated Rate	$113.25
Max. Negotiated Rate	$113.25
Rate for Payer: Qualcare PPO/HMO/WC	$113.25

BURR DIAMOND 2mm

Facility

$755.00

Hospital Charge Code	270669540
Hospital Revenue Code	272
Min. Negotiated Rate	$21.44
Max. Negotiated Rate	$377.50
Rate for Payer: Aetna Commercial	$286.90
Rate for Payer: Aetna Medicare Advantage	$226.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.53
Rate for Payer: Cigna Commercial	$377.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.30
Rate for Payer: Oxford Commercial	$151.00
Rate for Payer: Qualcare PPO/HMO/WC	$113.25
Rate for Payer: UnitedHealthcare Commercial	$151.00
Rate for Payer: UnitedHealthcare Community & State	$23.86
Rate for Payer: Wellpoint Medicaid Managed Care	$21.44

BURR DIAMOND 3mm

Facility

$755.00

Hospital Charge Code	270669536
Hospital Revenue Code	272
Min. Negotiated Rate	$21.44
Max. Negotiated Rate	$377.50
Rate for Payer: Aetna Commercial	$286.90
Rate for Payer: Aetna Medicare Advantage	$226.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.53
Rate for Payer: Cigna Commercial	$377.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.30
Rate for Payer: Oxford Commercial	$151.00
Rate for Payer: Qualcare PPO/HMO/WC	$113.25
Rate for Payer: UnitedHealthcare Commercial	$151.00
Rate for Payer: UnitedHealthcare Community & State	$23.86
Rate for Payer: Wellpoint Medicaid Managed Care	$21.44

BURR DIAMOND 3mm

Facility

$755.00

Hospital Charge Code	270669536
Hospital Revenue Code	272
Min. Negotiated Rate	$113.25
Max. Negotiated Rate	$113.25
Rate for Payer: Qualcare PPO/HMO/WC	$113.25

BURR DIAMOND 4mm

Facility

$755.00

Hospital Charge Code	270669541
Hospital Revenue Code	272
Min. Negotiated Rate	$113.25
Max. Negotiated Rate	$113.25
Rate for Payer: Qualcare PPO/HMO/WC	$113.25

BURR DIAMOND 4mm

Facility

$755.00

Hospital Charge Code	270669541
Hospital Revenue Code	272
Min. Negotiated Rate	$21.44
Max. Negotiated Rate	$377.50
Rate for Payer: Aetna Commercial	$286.90
Rate for Payer: Aetna Medicare Advantage	$226.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.53
Rate for Payer: Cigna Commercial	$377.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.30
Rate for Payer: Oxford Commercial	$151.00
Rate for Payer: Qualcare PPO/HMO/WC	$113.25
Rate for Payer: UnitedHealthcare Commercial	$151.00
Rate for Payer: UnitedHealthcare Community & State	$23.86
Rate for Payer: Wellpoint Medicaid Managed Care	$21.44

BURR DIAMOND 5.0MM ROUND

Facility

$948.90

Hospital Charge Code	270692940
Hospital Revenue Code	272
Min. Negotiated Rate	$142.34
Max. Negotiated Rate	$142.34
Rate for Payer: Qualcare PPO/HMO/WC	$142.34

BURR DIAMOND 5.0MM ROUND

Facility

$948.90

Hospital Charge Code	270692940
Hospital Revenue Code	272
Min. Negotiated Rate	$26.95
Max. Negotiated Rate	$474.45
Rate for Payer: Aetna Commercial	$360.58
Rate for Payer: Aetna Medicare Advantage	$284.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$241.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$241.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$241.97
Rate for Payer: Cigna Commercial	$474.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.71
Rate for Payer: Oxford Commercial	$189.78
Rate for Payer: Qualcare PPO/HMO/WC	$142.34
Rate for Payer: UnitedHealthcare Commercial	$189.78
Rate for Payer: UnitedHealthcare Community & State	$29.99
Rate for Payer: Wellpoint Medicaid Managed Care	$26.95

BURR DIAMOND 5mm

Facility

$755.00

Hospital Charge Code	270669542
Hospital Revenue Code	272
Min. Negotiated Rate	$113.25
Max. Negotiated Rate	$113.25
Rate for Payer: Qualcare PPO/HMO/WC	$113.25

BURR DIAMOND 5mm

Facility

$755.00

Hospital Charge Code	270669542
Hospital Revenue Code	272
Min. Negotiated Rate	$21.44
Max. Negotiated Rate	$377.50
Rate for Payer: Aetna Commercial	$286.90
Rate for Payer: Aetna Medicare Advantage	$226.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.53
Rate for Payer: Cigna Commercial	$377.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.30
Rate for Payer: Oxford Commercial	$151.00
Rate for Payer: Qualcare PPO/HMO/WC	$113.25
Rate for Payer: UnitedHealthcare Commercial	$151.00
Rate for Payer: UnitedHealthcare Community & State	$23.86
Rate for Payer: Wellpoint Medicaid Managed Care	$21.44

BURR DIAMOND OVAL 3X330MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270703127
Hospital Revenue Code	278
Min. Negotiated Rate	$63.90
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Community & State	$71.10
Rate for Payer: Wellpoint Medicaid Managed Care	$63.90

BURR DIAMOND OVAL 3X330MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270703127
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

BURR DRUM L 4.7MM HD LTH 7.9MM

Facility

$430.50

Hospital Charge Code	270674634
Hospital Revenue Code	272
Min. Negotiated Rate	$12.23
Max. Negotiated Rate	$215.25
Rate for Payer: Aetna Commercial	$163.59
Rate for Payer: Aetna Medicare Advantage	$129.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.78
Rate for Payer: Cigna Commercial	$215.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.93
Rate for Payer: Oxford Commercial	$86.10
Rate for Payer: Qualcare PPO/HMO/WC	$64.58
Rate for Payer: UnitedHealthcare Commercial	$86.10
Rate for Payer: UnitedHealthcare Community & State	$13.60
Rate for Payer: Wellpoint Medicaid Managed Care	$12.23

BURR DRUM L 4.7MM HD LTH 7.9MM

Facility

$430.50

Hospital Charge Code	270674634
Hospital Revenue Code	272
Min. Negotiated Rate	$64.58
Max. Negotiated Rate	$64.58
Rate for Payer: Qualcare PPO/HMO/WC	$64.58

BURR DRUM L 6.0MM HD LTH 7.9MM

Facility

$430.50

Hospital Charge Code	270674481
Hospital Revenue Code	272
Min. Negotiated Rate	$12.23
Max. Negotiated Rate	$215.25
Rate for Payer: Aetna Commercial	$163.59
Rate for Payer: Aetna Medicare Advantage	$129.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.78
Rate for Payer: Cigna Commercial	$215.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.93
Rate for Payer: Oxford Commercial	$86.10
Rate for Payer: Qualcare PPO/HMO/WC	$64.58
Rate for Payer: UnitedHealthcare Commercial	$86.10
Rate for Payer: UnitedHealthcare Community & State	$13.60
Rate for Payer: Wellpoint Medicaid Managed Care	$12.23

BURR DRUM L 6.0MM HD LTH 7.9MM

Facility

$430.50

Hospital Charge Code	270674481
Hospital Revenue Code	272
Min. Negotiated Rate	$64.58
Max. Negotiated Rate	$64.58
Rate for Payer: Qualcare PPO/HMO/WC	$64.58

BURR DRUM L 9.1MM HD LTH 7.9MM

Facility

$430.50

Hospital Charge Code	270674484
Hospital Revenue Code	272
Min. Negotiated Rate	$12.23
Max. Negotiated Rate	$215.25
Rate for Payer: Aetna Commercial	$163.59
Rate for Payer: Aetna Medicare Advantage	$129.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.78
Rate for Payer: Cigna Commercial	$215.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.93
Rate for Payer: Oxford Commercial	$86.10
Rate for Payer: Qualcare PPO/HMO/WC	$64.58
Rate for Payer: UnitedHealthcare Commercial	$86.10
Rate for Payer: UnitedHealthcare Community & State	$13.60
Rate for Payer: Wellpoint Medicaid Managed Care	$12.23

BURR DRUM L 9.1MM HD LTH 7.9MM

Facility

$430.50

Hospital Charge Code	270674484
Hospital Revenue Code	272
Min. Negotiated Rate	$64.58
Max. Negotiated Rate	$64.58
Rate for Payer: Qualcare PPO/HMO/WC	$64.58

BURR DRUM M 4.7MM HD LTH 7.9MM

Facility

$430.50

Hospital Charge Code	270674633
Hospital Revenue Code	272
Min. Negotiated Rate	$64.58
Max. Negotiated Rate	$64.58
Rate for Payer: Qualcare PPO/HMO/WC	$64.58

BURR DRUM M 4.7MM HD LTH 7.9MM

Facility

$430.50

Hospital Charge Code	270674633
Hospital Revenue Code	272
Min. Negotiated Rate	$12.23
Max. Negotiated Rate	$215.25
Rate for Payer: Aetna Commercial	$163.59
Rate for Payer: Aetna Medicare Advantage	$129.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.78
Rate for Payer: Cigna Commercial	$215.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.93
Rate for Payer: Oxford Commercial	$86.10
Rate for Payer: Qualcare PPO/HMO/WC	$64.58
Rate for Payer: UnitedHealthcare Commercial	$86.10
Rate for Payer: UnitedHealthcare Community & State	$13.60
Rate for Payer: Wellpoint Medicaid Managed Care	$12.23

Know your out-of-pocket cost for care.

All Charges