Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CABLE BEAD ALLOY 1.6MM

Facility

$2,910.00

Service Code	HCPCS C1713
Hospital Charge Code	270669266
Hospital Revenue Code	278
Min. Negotiated Rate	$82.64
Max. Negotiated Rate	$1,455.00
Rate for Payer: Aetna Commercial	$1,105.80
Rate for Payer: Aetna Medicare Advantage	$873.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$742.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$742.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$582.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$742.05
Rate for Payer: Cigna Commercial	$1,455.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$704.22
Rate for Payer: Qualcare PPO/HMO/WC	$436.50
Rate for Payer: UnitedHealthcare Community & State	$91.96
Rate for Payer: Wellpoint Medicaid Managed Care	$82.64

CABLE BEAD ALLOY 2MM

Facility

$2,910.00

Service Code	HCPCS C1713
Hospital Charge Code	270669265
Hospital Revenue Code	278
Min. Negotiated Rate	$82.64
Max. Negotiated Rate	$1,455.00
Rate for Payer: Aetna Commercial	$1,105.80
Rate for Payer: Aetna Medicare Advantage	$873.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$742.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$742.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$582.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$742.05
Rate for Payer: Cigna Commercial	$1,455.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$704.22
Rate for Payer: Qualcare PPO/HMO/WC	$436.50
Rate for Payer: UnitedHealthcare Community & State	$91.96
Rate for Payer: Wellpoint Medicaid Managed Care	$82.64

CABLE BEAD ALLOY 2MM

Facility

$2,910.00

Service Code	HCPCS C1713
Hospital Charge Code	270669265
Hospital Revenue Code	278
Min. Negotiated Rate	$436.50
Max. Negotiated Rate	$704.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$582.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$704.22
Rate for Payer: Qualcare PPO/HMO/WC	$436.50

CABLE BMT SS 2 750 350800

Facility

$1,450.00

Service Code	HCPCS C1713
Hospital Charge Code	270627428
Hospital Revenue Code	278
Min. Negotiated Rate	$217.50
Max. Negotiated Rate	$350.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.90
Rate for Payer: Qualcare PPO/HMO/WC	$217.50

CABLE BMT SS 2 750 350800

Facility

$1,450.00

Service Code	HCPCS C1713
Hospital Charge Code	270627428
Hospital Revenue Code	278
Min. Negotiated Rate	$41.18
Max. Negotiated Rate	$725.00
Rate for Payer: Aetna Commercial	$551.00
Rate for Payer: Aetna Medicare Advantage	$435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$369.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$369.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$290.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$369.75
Rate for Payer: Cigna Commercial	$725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.90
Rate for Payer: Qualcare PPO/HMO/WC	$217.50
Rate for Payer: UnitedHealthcare Community & State	$45.82
Rate for Payer: Wellpoint Medicaid Managed Care	$41.18

CABLE COCR 1.7MM W/CRIMP 750MM

Facility

$2,133.30

Hospital Charge Code	270668587
Hospital Revenue Code	272
Min. Negotiated Rate	$320.00
Max. Negotiated Rate	$320.00
Rate for Payer: Qualcare PPO/HMO/WC	$320.00

CABLE COCR 1.7MM W/CRIMP 750MM

Facility

$2,133.30

Hospital Charge Code	270668587
Hospital Revenue Code	272
Min. Negotiated Rate	$60.59
Max. Negotiated Rate	$1,066.65
Rate for Payer: Aetna Commercial	$810.65
Rate for Payer: Aetna Medicare Advantage	$639.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$543.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$543.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$543.99
Rate for Payer: Cigna Commercial	$1,066.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$554.66
Rate for Payer: Oxford Commercial	$426.66
Rate for Payer: Qualcare PPO/HMO/WC	$320.00
Rate for Payer: UnitedHealthcare Commercial	$426.66
Rate for Payer: UnitedHealthcare Community & State	$67.41
Rate for Payer: Wellpoint Medicaid Managed Care	$60.59

CABLE CONNECTOR

Facility

$2,465.00

Hospital Charge Code	270681171
Hospital Revenue Code	278
Min. Negotiated Rate	$369.75
Max. Negotiated Rate	$596.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$493.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$596.53
Rate for Payer: Qualcare PPO/HMO/WC	$369.75

CABLE CONNECTOR

Facility

$2,465.00

Hospital Charge Code	270681171
Hospital Revenue Code	278
Min. Negotiated Rate	$70.01
Max. Negotiated Rate	$1,232.50
Rate for Payer: Aetna Commercial	$936.70
Rate for Payer: Aetna Medicare Advantage	$739.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$628.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$628.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$493.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$628.58
Rate for Payer: Cigna Commercial	$1,232.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$596.53
Rate for Payer: Qualcare PPO/HMO/WC	$369.75
Rate for Payer: UnitedHealthcare Community & State	$77.89
Rate for Payer: Wellpoint Medicaid Managed Care	$70.01

CABLE CONNECTOR ASSY MNTR

Facility

$2,465.00

Hospital Charge Code	270677391
Hospital Revenue Code	272
Min. Negotiated Rate	$70.01
Max. Negotiated Rate	$1,232.50
Rate for Payer: Aetna Commercial	$936.70
Rate for Payer: Aetna Medicare Advantage	$739.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$628.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$628.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$628.58
Rate for Payer: Cigna Commercial	$1,232.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$640.90
Rate for Payer: Oxford Commercial	$493.00
Rate for Payer: Qualcare PPO/HMO/WC	$369.75
Rate for Payer: UnitedHealthcare Commercial	$493.00
Rate for Payer: UnitedHealthcare Community & State	$77.89
Rate for Payer: Wellpoint Medicaid Managed Care	$70.01

CABLE CONNECTOR ASSY MNTR

Facility

$2,465.00

Hospital Charge Code	270677391
Hospital Revenue Code	272
Min. Negotiated Rate	$369.75
Max. Negotiated Rate	$369.75
Rate for Payer: Qualcare PPO/HMO/WC	$369.75

CABLE CONNECTORS

Facility

$2,315.00

Service Code	HCPCS C1713
Hospital Charge Code	270690486
Hospital Revenue Code	278
Min. Negotiated Rate	$65.75
Max. Negotiated Rate	$1,157.50
Rate for Payer: Aetna Commercial	$879.70
Rate for Payer: Aetna Medicare Advantage	$694.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$590.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$590.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$463.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$590.33
Rate for Payer: Cigna Commercial	$1,157.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$560.23
Rate for Payer: Qualcare PPO/HMO/WC	$347.25
Rate for Payer: UnitedHealthcare Community & State	$73.15
Rate for Payer: Wellpoint Medicaid Managed Care	$65.75

CABLE CONNECTORS

Facility

$2,315.00

Service Code	HCPCS C1713
Hospital Charge Code	270690486
Hospital Revenue Code	278
Min. Negotiated Rate	$347.25
Max. Negotiated Rate	$560.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$463.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$560.23
Rate for Payer: Qualcare PPO/HMO/WC	$347.25

CABLE DISPOSABLE W/TUBING KIT

Facility

$269.50

Hospital Charge Code	270692060
Hospital Revenue Code	272
Min. Negotiated Rate	$40.42
Max. Negotiated Rate	$40.42
Rate for Payer: Qualcare PPO/HMO/WC	$40.42

CABLE DISPOSABLE W/TUBING KIT

Facility

$269.50

Hospital Charge Code	270692060
Hospital Revenue Code	272
Min. Negotiated Rate	$7.65
Max. Negotiated Rate	$134.75
Rate for Payer: Aetna Commercial	$102.41
Rate for Payer: Aetna Medicare Advantage	$80.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.72
Rate for Payer: Cigna Commercial	$134.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.07
Rate for Payer: Oxford Commercial	$53.90
Rate for Payer: Qualcare PPO/HMO/WC	$40.42
Rate for Payer: UnitedHealthcare Commercial	$53.90
Rate for Payer: UnitedHealthcare Community & State	$8.52
Rate for Payer: Wellpoint Medicaid Managed Care	$7.65

CABLEELECTRCLIPONLEADWIREDISP

Facility

$2,700.00

Hospital Charge Code	270694862
Hospital Revenue Code	272
Min. Negotiated Rate	$405.00
Max. Negotiated Rate	$405.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.00

CABLEELECTRCLIPONLEADWIREDISP

Facility

$2,700.00

Hospital Charge Code	270694862
Hospital Revenue Code	272
Min. Negotiated Rate	$76.68
Max. Negotiated Rate	$1,350.00
Rate for Payer: Aetna Commercial	$1,026.00
Rate for Payer: Aetna Medicare Advantage	$810.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$688.50
Rate for Payer: Cigna Commercial	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$702.00
Rate for Payer: Oxford Commercial	$540.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.00
Rate for Payer: UnitedHealthcare Commercial	$540.00
Rate for Payer: UnitedHealthcare Community & State	$85.32
Rate for Payer: Wellpoint Medicaid Managed Care	$76.68

CABLE GRIP SYS 1.8MM X635M

Facility

$2,860.00

Service Code	HCPCS C1713
Hospital Charge Code	270679952
Hospital Revenue Code	278
Min. Negotiated Rate	$429.00
Max. Negotiated Rate	$692.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$572.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$692.12
Rate for Payer: Qualcare PPO/HMO/WC	$429.00

CABLE GRIP SYS 1.8MM X635M

Facility

$2,860.00

Service Code	HCPCS C1713
Hospital Charge Code	270679952
Hospital Revenue Code	278
Min. Negotiated Rate	$81.22
Max. Negotiated Rate	$1,430.00
Rate for Payer: Aetna Commercial	$1,086.80
Rate for Payer: Aetna Medicare Advantage	$858.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$729.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$729.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$572.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$729.30
Rate for Payer: Cigna Commercial	$1,430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$692.12
Rate for Payer: Qualcare PPO/HMO/WC	$429.00
Rate for Payer: UnitedHealthcare Community & State	$90.38
Rate for Payer: Wellpoint Medicaid Managed Care	$81.22

CABLE INTEGRAL LNG 23X121 MM

Facility

$875.00

Hospital Charge Code	270690881
Hospital Revenue Code	272
Min. Negotiated Rate	$24.85
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$27.65
Rate for Payer: Wellpoint Medicaid Managed Care	$24.85

CABLE INTEGRAL LNG 23X121 MM

Facility

$875.00

Hospital Charge Code	270690881
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

CABLE INTERFACE IBF

Facility

$365.00

Hospital Charge Code	270665867
Hospital Revenue Code	270
Min. Negotiated Rate	$54.75
Max. Negotiated Rate	$54.75
Rate for Payer: Qualcare PPO/HMO/WC	$54.75

CABLE INTERFACE IBF

Facility

$365.00

Hospital Charge Code	270665867
Hospital Revenue Code	270
Min. Negotiated Rate	$10.37
Max. Negotiated Rate	$182.50
Rate for Payer: Aetna Commercial	$138.70
Rate for Payer: Aetna Medicare Advantage	$109.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.08
Rate for Payer: Cigna Commercial	$182.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.90
Rate for Payer: Oxford Commercial	$73.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.75
Rate for Payer: UnitedHealthcare Commercial	$73.00
Rate for Payer: UnitedHealthcare Community & State	$11.53
Rate for Payer: Wellpoint Medicaid Managed Care	$10.37

CABLE MONO PYRENEES 28 MM

Facility

$6,520.00

Service Code	HCPCS C1713
Hospital Charge Code	270690740
Hospital Revenue Code	278
Min. Negotiated Rate	$185.17
Max. Negotiated Rate	$3,260.00
Rate for Payer: Aetna Commercial	$2,477.60
Rate for Payer: Aetna Medicare Advantage	$1,956.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,662.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,662.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,304.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,662.60
Rate for Payer: Cigna Commercial	$3,260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,577.84
Rate for Payer: Qualcare PPO/HMO/WC	$978.00
Rate for Payer: UnitedHealthcare Community & State	$206.03
Rate for Payer: Wellpoint Medicaid Managed Care	$185.17

CABLE MONO PYRENEES 28 MM

Facility

$6,520.00

Service Code	HCPCS C1713
Hospital Charge Code	270690740
Hospital Revenue Code	278
Min. Negotiated Rate	$978.00
Max. Negotiated Rate	$1,577.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,304.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,577.84
Rate for Payer: Qualcare PPO/HMO/WC	$978.00

Know your out-of-pocket cost for care.

All Charges