Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BURR ROUND 3.5 MM 10 FLUTE

Facility

$330.00

Hospital Charge Code	270691593
Hospital Revenue Code	272
Min. Negotiated Rate	$49.50
Max. Negotiated Rate	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$49.50

BURR ROUND 3.5 MM 10 FLUTE

Facility

$330.00

Hospital Charge Code	270691593
Hospital Revenue Code	272
Min. Negotiated Rate	$9.37
Max. Negotiated Rate	$165.00
Rate for Payer: Aetna Commercial	$125.40
Rate for Payer: Aetna Medicare Advantage	$99.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.15
Rate for Payer: Cigna Commercial	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.80
Rate for Payer: Oxford Commercial	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.50
Rate for Payer: UnitedHealthcare Commercial	$66.00
Rate for Payer: UnitedHealthcare Community & State	$10.43
Rate for Payer: Wellpoint Medicaid Managed Care	$9.37

BURR ROUND 5.0x45MM MINI QC

Facility

$381.50

Hospital Charge Code	270674542
Hospital Revenue Code	272
Min. Negotiated Rate	$57.23
Max. Negotiated Rate	$57.23
Rate for Payer: Qualcare PPO/HMO/WC	$57.23

BURR ROUND 5.0x45MM MINI QC

Facility

$381.50

Hospital Charge Code	270674542
Hospital Revenue Code	272
Min. Negotiated Rate	$10.83
Max. Negotiated Rate	$190.75
Rate for Payer: Aetna Commercial	$144.97
Rate for Payer: Aetna Medicare Advantage	$114.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.28
Rate for Payer: Cigna Commercial	$190.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.19
Rate for Payer: Oxford Commercial	$76.30
Rate for Payer: Qualcare PPO/HMO/WC	$57.23
Rate for Payer: UnitedHealthcare Commercial	$76.30
Rate for Payer: UnitedHealthcare Community & State	$12.06
Rate for Payer: Wellpoint Medicaid Managed Care	$10.83

BURR ROUND 6-FLUTE 4mm

Facility

$200.00

Hospital Charge Code	270601439
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

BURR ROUND 6-FLUTE 4mm

Facility

$200.00

Hospital Charge Code	270601439
Hospital Revenue Code	272
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

BURR ROUND 8 FLUTE 4.0MM X 13

Facility

$295.00

Hospital Charge Code	270688457
Hospital Revenue Code	272
Min. Negotiated Rate	$44.25
Max. Negotiated Rate	$44.25
Rate for Payer: Qualcare PPO/HMO/WC	$44.25

BURR ROUND 8 FLUTE 4.0MM X 13

Facility

$295.00

Hospital Charge Code	270688457
Hospital Revenue Code	272
Min. Negotiated Rate	$8.38
Max. Negotiated Rate	$147.50
Rate for Payer: Aetna Commercial	$112.10
Rate for Payer: Aetna Medicare Advantage	$88.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.22
Rate for Payer: Cigna Commercial	$147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.70
Rate for Payer: Oxford Commercial	$59.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.25
Rate for Payer: UnitedHealthcare Commercial	$59.00
Rate for Payer: UnitedHealthcare Community & State	$9.32
Rate for Payer: Wellpoint Medicaid Managed Care	$8.38

BURR ROUND 8FLUTED

Facility

$295.00

Hospital Charge Code	270688425
Hospital Revenue Code	272
Min. Negotiated Rate	$44.25
Max. Negotiated Rate	$44.25
Rate for Payer: Qualcare PPO/HMO/WC	$44.25

BURR ROUND 8FLUTED

Facility

$295.00

Hospital Charge Code	270688425
Hospital Revenue Code	272
Min. Negotiated Rate	$8.38
Max. Negotiated Rate	$147.50
Rate for Payer: Aetna Commercial	$112.10
Rate for Payer: Aetna Medicare Advantage	$88.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.22
Rate for Payer: Cigna Commercial	$147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.70
Rate for Payer: Oxford Commercial	$59.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.25
Rate for Payer: UnitedHealthcare Commercial	$59.00
Rate for Payer: UnitedHealthcare Community & State	$9.32
Rate for Payer: Wellpoint Medicaid Managed Care	$8.38

BURR ROUNDE 3.0

Facility

$330.00

Hospital Charge Code	270687619
Hospital Revenue Code	272
Min. Negotiated Rate	$49.50
Max. Negotiated Rate	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$49.50

BURR ROUNDE 3.0

Facility

$330.00

Hospital Charge Code	270687619
Hospital Revenue Code	272
Min. Negotiated Rate	$9.37
Max. Negotiated Rate	$165.00
Rate for Payer: Aetna Commercial	$125.40
Rate for Payer: Aetna Medicare Advantage	$99.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.15
Rate for Payer: Cigna Commercial	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.80
Rate for Payer: Oxford Commercial	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.50
Rate for Payer: UnitedHealthcare Commercial	$66.00
Rate for Payer: UnitedHealthcare Community & State	$10.43
Rate for Payer: Wellpoint Medicaid Managed Care	$9.37

BURR ROUNDED DIA. LONG

Facility

$2,472.00

Hospital Charge Code	270665099
Hospital Revenue Code	270
Min. Negotiated Rate	$70.20
Max. Negotiated Rate	$1,236.00
Rate for Payer: Aetna Commercial	$939.36
Rate for Payer: Aetna Medicare Advantage	$741.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$630.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$630.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$630.36
Rate for Payer: Cigna Commercial	$1,236.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$642.72
Rate for Payer: Oxford Commercial	$494.40
Rate for Payer: Qualcare PPO/HMO/WC	$370.80
Rate for Payer: UnitedHealthcare Commercial	$494.40
Rate for Payer: UnitedHealthcare Community & State	$78.12
Rate for Payer: Wellpoint Medicaid Managed Care	$70.20

BURR ROUNDED DIA. LONG

Facility

$2,472.00

Hospital Charge Code	270665099
Hospital Revenue Code	270
Min. Negotiated Rate	$370.80
Max. Negotiated Rate	$370.80
Rate for Payer: Qualcare PPO/HMO/WC	$370.80

BURR ROUND HL FLUTED 5MM 19CM

Facility

$330.00

Hospital Charge Code	270679506
Hospital Revenue Code	272
Min. Negotiated Rate	$9.37
Max. Negotiated Rate	$165.00
Rate for Payer: Aetna Commercial	$125.40
Rate for Payer: Aetna Medicare Advantage	$99.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.15
Rate for Payer: Cigna Commercial	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.80
Rate for Payer: Oxford Commercial	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.50
Rate for Payer: UnitedHealthcare Commercial	$66.00
Rate for Payer: UnitedHealthcare Community & State	$10.43
Rate for Payer: Wellpoint Medicaid Managed Care	$9.37

BURR ROUND HL FLUTED 5MM 19CM

Facility

$330.00

Hospital Charge Code	270679506
Hospital Revenue Code	272
Min. Negotiated Rate	$49.50
Max. Negotiated Rate	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$49.50

BURR ROUND L 1.0MM

Facility

$283.50

Hospital Charge Code	270674387
Hospital Revenue Code	272
Min. Negotiated Rate	$8.05
Max. Negotiated Rate	$141.75
Rate for Payer: Aetna Commercial	$107.73
Rate for Payer: Aetna Medicare Advantage	$85.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.29
Rate for Payer: Cigna Commercial	$141.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.71
Rate for Payer: Oxford Commercial	$56.70
Rate for Payer: Qualcare PPO/HMO/WC	$42.52
Rate for Payer: UnitedHealthcare Commercial	$56.70
Rate for Payer: UnitedHealthcare Community & State	$8.96
Rate for Payer: Wellpoint Medicaid Managed Care	$8.05

BURR ROUND L 1.0MM

Facility

$283.50

Hospital Charge Code	270674387
Hospital Revenue Code	272
Min. Negotiated Rate	$42.52
Max. Negotiated Rate	$42.52
Rate for Payer: Qualcare PPO/HMO/WC	$42.52

BURR ROUND L 1.0MM DIAMOND

Facility

$430.50

Hospital Charge Code	270674411
Hospital Revenue Code	272
Min. Negotiated Rate	$64.58
Max. Negotiated Rate	$64.58
Rate for Payer: Qualcare PPO/HMO/WC	$64.58

BURR ROUND L 1.0MM DIAMOND

Facility

$430.50

Hospital Charge Code	270674411
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 ROUND L 1.5MM

Facility

$283.50

Hospital Charge Code	270674390
Hospital Revenue Code	272
Min. Negotiated Rate	$8.05
Max. Negotiated Rate	$141.75
Rate for Payer: Aetna Commercial	$107.73
Rate for Payer: Aetna Medicare Advantage	$85.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.29
Rate for Payer: Cigna Commercial	$141.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.71
Rate for Payer: Oxford Commercial	$56.70
Rate for Payer: Qualcare PPO/HMO/WC	$42.52
Rate for Payer: UnitedHealthcare Commercial	$56.70
Rate for Payer: UnitedHealthcare Community & State	$8.96
Rate for Payer: Wellpoint Medicaid Managed Care	$8.05

BURR ROUND L 1.5MM

Facility

$283.50

Hospital Charge Code	270674390
Hospital Revenue Code	272
Min. Negotiated Rate	$42.52
Max. Negotiated Rate	$42.52
Rate for Payer: Qualcare PPO/HMO/WC	$42.52

BURR ROUND L 1.5MM DIAMOND

Facility

$430.50

Hospital Charge Code	270674414
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 ROUND L 1.5MM DIAMOND

Facility

$430.50

Hospital Charge Code	270674414
Hospital Revenue Code	272
Min. Negotiated Rate	$64.58
Max. Negotiated Rate	$64.58
Rate for Payer: Qualcare PPO/HMO/WC	$64.58

BURR ROUND L 2.0MM

Facility

$283.50

Hospital Charge Code	270674619
Hospital Revenue Code	272
Min. Negotiated Rate	$42.52
Max. Negotiated Rate	$42.52
Rate for Payer: Qualcare PPO/HMO/WC	$42.52

Know your out-of-pocket cost for care.

All Charges