Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CANISTER INVIA 300ML FOR NPWT

Facility

$77.60

Hospital Charge Code	270687287
Hospital Revenue Code	270
Min. Negotiated Rate	$11.64
Max. Negotiated Rate	$11.64
Rate for Payer: Qualcare PPO/HMO/WC	$11.64

CANISTER INVIA 800ML W SOLIDE

Facility

$111.55

Hospital Charge Code	270687288
Hospital Revenue Code	271
Min. Negotiated Rate	$3.17
Max. Negotiated Rate	$55.77
Rate for Payer: Aetna Commercial	$42.39
Rate for Payer: Aetna Medicare Advantage	$33.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.45
Rate for Payer: Cigna Commercial	$55.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.00
Rate for Payer: Oxford Commercial	$22.31
Rate for Payer: Qualcare PPO/HMO/WC	$16.73
Rate for Payer: UnitedHealthcare Commercial	$22.31
Rate for Payer: UnitedHealthcare Community & State	$3.52
Rate for Payer: Wellpoint Medicaid Managed Care	$3.17

CANISTER INVIA 800ML W SOLIDE

Facility

$111.55

Hospital Charge Code	270687288
Hospital Revenue Code	271
Min. Negotiated Rate	$16.73
Max. Negotiated Rate	$16.73
Rate for Payer: Qualcare PPO/HMO/WC	$16.73

Canister Penumbra MAX

Facility

$1,850.00

Hospital Charge Code	270681132N
Hospital Revenue Code	272
Min. Negotiated Rate	$277.50
Max. Negotiated Rate	$277.50
Rate for Payer: Qualcare PPO/HMO/WC	$277.50

Canister Penumbra MAX

Facility

$1,850.00

Hospital Charge Code	270681132O
Hospital Revenue Code	272
Min. Negotiated Rate	$277.50
Max. Negotiated Rate	$277.50
Rate for Payer: Qualcare PPO/HMO/WC	$277.50

Canister Penumbra MAX

Facility

$1,850.00

Hospital Charge Code	270681132O
Hospital Revenue Code	272
Min. Negotiated Rate	$52.54
Max. Negotiated Rate	$925.00
Rate for Payer: Aetna Commercial	$703.00
Rate for Payer: Aetna Medicare Advantage	$555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$471.75
Rate for Payer: Cigna Commercial	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$481.00
Rate for Payer: Oxford Commercial	$370.00
Rate for Payer: Qualcare PPO/HMO/WC	$277.50
Rate for Payer: UnitedHealthcare Commercial	$370.00
Rate for Payer: UnitedHealthcare Community & State	$58.46
Rate for Payer: Wellpoint Medicaid Managed Care	$52.54

Canister Penumbra MAX

Facility

$1,850.00

Hospital Charge Code	270681132N
Hospital Revenue Code	272
Min. Negotiated Rate	$52.54
Max. Negotiated Rate	$925.00
Rate for Payer: Aetna Commercial	$703.00
Rate for Payer: Aetna Medicare Advantage	$555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$471.75
Rate for Payer: Cigna Commercial	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$481.00
Rate for Payer: Oxford Commercial	$370.00
Rate for Payer: Qualcare PPO/HMO/WC	$277.50
Rate for Payer: UnitedHealthcare Commercial	$370.00
Rate for Payer: UnitedHealthcare Community & State	$58.46
Rate for Payer: Wellpoint Medicaid Managed Care	$52.54

CANISTER PENUMBRA MAX

Facility

$1,850.00

Hospital Charge Code	270681132S
Hospital Revenue Code	272
Min. Negotiated Rate	$277.50
Max. Negotiated Rate	$277.50
Rate for Payer: Qualcare PPO/HMO/WC	$277.50

CANISTER PENUMBRA MAX

Facility

$1,825.00

Hospital Charge Code	270681132
Hospital Revenue Code	272
Min. Negotiated Rate	$273.75
Max. Negotiated Rate	$273.75
Rate for Payer: Qualcare PPO/HMO/WC	$273.75

CANISTER PENUMBRA MAX

Facility

$1,825.00

Hospital Charge Code	270681132
Hospital Revenue Code	272
Min. Negotiated Rate	$51.83
Max. Negotiated Rate	$912.50
Rate for Payer: Aetna Commercial	$693.50
Rate for Payer: Aetna Medicare Advantage	$547.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$465.38
Rate for Payer: Cigna Commercial	$912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.50
Rate for Payer: Oxford Commercial	$365.00
Rate for Payer: Qualcare PPO/HMO/WC	$273.75
Rate for Payer: UnitedHealthcare Commercial	$365.00
Rate for Payer: UnitedHealthcare Community & State	$57.67
Rate for Payer: Wellpoint Medicaid Managed Care	$51.83

CANISTER PENUMBRA MAX

Facility

$1,850.00

Hospital Charge Code	270681132S
Hospital Revenue Code	272
Min. Negotiated Rate	$52.54
Max. Negotiated Rate	$925.00
Rate for Payer: Aetna Commercial	$703.00
Rate for Payer: Aetna Medicare Advantage	$555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$471.75
Rate for Payer: Cigna Commercial	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$481.00
Rate for Payer: Oxford Commercial	$370.00
Rate for Payer: Qualcare PPO/HMO/WC	$277.50
Rate for Payer: UnitedHealthcare Commercial	$370.00
Rate for Payer: UnitedHealthcare Community & State	$58.46
Rate for Payer: Wellpoint Medicaid Managed Care	$52.54

CANISTER PUMP

Facility

$1,825.00

Hospital Charge Code	270685330
Hospital Revenue Code	272
Min. Negotiated Rate	$273.75
Max. Negotiated Rate	$273.75
Rate for Payer: Qualcare PPO/HMO/WC	$273.75

CANISTER PUMP

Facility

$1,825.00

Hospital Charge Code	270685330
Hospital Revenue Code	272
Min. Negotiated Rate	$51.83
Max. Negotiated Rate	$912.50
Rate for Payer: Aetna Commercial	$693.50
Rate for Payer: Aetna Medicare Advantage	$547.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$465.38
Rate for Payer: Cigna Commercial	$912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.50
Rate for Payer: Oxford Commercial	$365.00
Rate for Payer: Qualcare PPO/HMO/WC	$273.75
Rate for Payer: UnitedHealthcare Commercial	$365.00
Rate for Payer: UnitedHealthcare Community & State	$57.67
Rate for Payer: Wellpoint Medicaid Managed Care	$51.83

CANISTER RENASYS GO

Facility

$201.75

Hospital Charge Code	270648964
Hospital Revenue Code	272
Min. Negotiated Rate	$30.26
Max. Negotiated Rate	$30.26
Rate for Payer: Qualcare PPO/HMO/WC	$30.26

CANISTER RENASYS GO

Facility

$201.75

Hospital Charge Code	270648964
Hospital Revenue Code	272
Min. Negotiated Rate	$5.73
Max. Negotiated Rate	$100.88
Rate for Payer: Aetna Commercial	$76.67
Rate for Payer: Aetna Medicare Advantage	$60.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.45
Rate for Payer: Cigna Commercial	$100.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.45
Rate for Payer: Oxford Commercial	$40.35
Rate for Payer: Qualcare PPO/HMO/WC	$30.26
Rate for Payer: UnitedHealthcare Commercial	$40.35
Rate for Payer: UnitedHealthcare Community & State	$6.38
Rate for Payer: Wellpoint Medicaid Managed Care	$5.73

CANISTER SUCTION 3000cc

Facility

$7.82

Hospital Charge Code	270648963
Hospital Revenue Code	272
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$1.17
Rate for Payer: Qualcare PPO/HMO/WC	$1.17

CANISTER SUCTION 3000cc

Facility

$7.82

Hospital Charge Code	270648963
Hospital Revenue Code	272
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$3.91
Rate for Payer: Aetna Commercial	$2.97
Rate for Payer: Aetna Medicare Advantage	$2.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.99
Rate for Payer: Cigna Commercial	$3.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.03
Rate for Payer: Oxford Commercial	$1.56
Rate for Payer: Qualcare PPO/HMO/WC	$1.17
Rate for Payer: UnitedHealthcare Commercial	$1.56
Rate for Payer: UnitedHealthcare Community & State	$0.25
Rate for Payer: Wellpoint Medicaid Managed Care	$0.22

CANN 4.0MM AO FITTING SCREW

Facility

$1,865.00

Service Code	HCPCS C1713
Hospital Charge Code	270700428
Hospital Revenue Code	278
Min. Negotiated Rate	$52.97
Max. Negotiated Rate	$932.50
Rate for Payer: Aetna Commercial	$708.70
Rate for Payer: Aetna Medicare Advantage	$559.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$475.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$475.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$373.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$475.57
Rate for Payer: Cigna Commercial	$932.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$451.33
Rate for Payer: Qualcare PPO/HMO/WC	$279.75
Rate for Payer: UnitedHealthcare Community & State	$58.93
Rate for Payer: Wellpoint Medicaid Managed Care	$52.97

CANN 4.0MM AO FITTING SCREW

Facility

$1,865.00

Service Code	HCPCS C1713
Hospital Charge Code	270700428
Hospital Revenue Code	278
Min. Negotiated Rate	$279.75
Max. Negotiated Rate	$451.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$373.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$451.33
Rate for Payer: Qualcare PPO/HMO/WC	$279.75

CANNABINOIDS, URINE

Facility

$190.00

Service Code	HCPCS 80349
Hospital Charge Code	38472501
Hospital Revenue Code	301
Min. Negotiated Rate	$28.50
Max. Negotiated Rate	$28.50
Rate for Payer: Qualcare PPO/HMO/WC	$28.50

CANNABINOIDS, URINE

Facility

$190.00

Service Code	HCPCS 80349
Hospital Charge Code	38472501
Hospital Revenue Code	301
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$72.20
Rate for Payer: Aetna Medicare Advantage	$57.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.45
Rate for Payer: Cigna Commercial	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$22.05
Rate for Payer: Wellpoint Medicaid Managed Care	$5.40

CANNABIN ,URINE,SCREEN

Facility

$190.45

Service Code	HCPCS 80349
Hospital Charge Code	3007614
Hospital Revenue Code	301
Min. Negotiated Rate	$5.41
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$72.37
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.52
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$22.05
Rate for Payer: Wellpoint Medicaid Managed Care	$5.41

CANNABIN ,URINE,SCREEN

Facility

$190.45

Service Code	HCPCS 80349
Hospital Charge Code	3007614
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

CANN COUNTERSINK 4.5/5.5 QC

Facility

$2,585.00

Hospital Charge Code	270698608
Hospital Revenue Code	272
Min. Negotiated Rate	$387.75
Max. Negotiated Rate	$387.75
Rate for Payer: Qualcare PPO/HMO/WC	$387.75

CANN COUNTERSINK 4.5/5.5 QC

Facility

$2,585.00

Hospital Charge Code	270698608
Hospital Revenue Code	272
Min. Negotiated Rate	$73.41
Max. Negotiated Rate	$1,292.50
Rate for Payer: Aetna Commercial	$982.30
Rate for Payer: Aetna Medicare Advantage	$775.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$659.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$659.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$659.17
Rate for Payer: Cigna Commercial	$1,292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$672.10
Rate for Payer: Oxford Commercial	$517.00
Rate for Payer: Qualcare PPO/HMO/WC	$387.75
Rate for Payer: UnitedHealthcare Commercial	$517.00
Rate for Payer: UnitedHealthcare Community & State	$81.69
Rate for Payer: Wellpoint Medicaid Managed Care	$73.41

Know your out-of-pocket cost for care.

All Charges