Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CANNULATED TAP F/SCREW 3.5x146

Facility

$1,875.65

Service Code	HCPCS C1713
Hospital Charge Code	270643932
Hospital Revenue Code	278
Min. Negotiated Rate	$281.35
Max. Negotiated Rate	$453.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.91
Rate for Payer: Qualcare PPO/HMO/WC	$281.35

CANNULATED TAP F/SCREW 3.5x146

Facility

$1,875.65

Service Code	HCPCS C1713
Hospital Charge Code	270643932
Hospital Revenue Code	278
Min. Negotiated Rate	$53.27
Max. Negotiated Rate	$937.83
Rate for Payer: Aetna Commercial	$712.75
Rate for Payer: Aetna Medicare Advantage	$562.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.29
Rate for Payer: Cigna Commercial	$937.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.91
Rate for Payer: Qualcare PPO/HMO/WC	$281.35
Rate for Payer: UnitedHealthcare Community & State	$59.27
Rate for Payer: Wellpoint Medicaid Managed Care	$53.27

CANNULATED TAP F/SCREW 4x147MM

Facility

$1,878.00

Hospital Charge Code	270676252
Hospital Revenue Code	278
Min. Negotiated Rate	$281.70
Max. Negotiated Rate	$454.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$454.48
Rate for Payer: Qualcare PPO/HMO/WC	$281.70

CANNULATED TAP F/SCREW 4x147MM

Facility

$1,878.00

Hospital Charge Code	270676252
Hospital Revenue Code	278
Min. Negotiated Rate	$53.34
Max. Negotiated Rate	$939.00
Rate for Payer: Aetna Commercial	$713.64
Rate for Payer: Aetna Medicare Advantage	$563.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.89
Rate for Payer: Cigna Commercial	$939.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$454.48
Rate for Payer: Qualcare PPO/HMO/WC	$281.70
Rate for Payer: UnitedHealthcare Community & State	$59.34
Rate for Payer: Wellpoint Medicaid Managed Care	$53.34

CANNULA THD CLEAR OBT 8.5X90MM

Facility

$830.00

Hospital Charge Code	270670524
Hospital Revenue Code	272
Min. Negotiated Rate	$23.57
Max. Negotiated Rate	$415.00
Rate for Payer: Aetna Commercial	$315.40
Rate for Payer: Aetna Medicare Advantage	$249.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.65
Rate for Payer: Cigna Commercial	$415.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.80
Rate for Payer: Oxford Commercial	$166.00
Rate for Payer: Qualcare PPO/HMO/WC	$124.50
Rate for Payer: UnitedHealthcare Commercial	$166.00
Rate for Payer: UnitedHealthcare Community & State	$26.23
Rate for Payer: Wellpoint Medicaid Managed Care	$23.57

CANNULA THD CLEAR OBT 8.5X90MM

Facility

$830.00

Hospital Charge Code	270670524
Hospital Revenue Code	272
Min. Negotiated Rate	$124.50
Max. Negotiated Rate	$124.50
Rate for Payer: Qualcare PPO/HMO/WC	$124.50

CANNULA THREADED DISO 8.5X72MM

Facility

$156.50

Hospital Charge Code	270681096
Hospital Revenue Code	272
Min. Negotiated Rate	$23.48
Max. Negotiated Rate	$23.48
Rate for Payer: Qualcare PPO/HMO/WC	$23.48

CANNULA THREADED DISO 8.5X72MM

Facility

$156.50

Hospital Charge Code	270681096
Hospital Revenue Code	272
Min. Negotiated Rate	$4.44
Max. Negotiated Rate	$78.25
Rate for Payer: Aetna Commercial	$59.47
Rate for Payer: Aetna Medicare Advantage	$46.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.91
Rate for Payer: Cigna Commercial	$78.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.69
Rate for Payer: Oxford Commercial	$31.30
Rate for Payer: Qualcare PPO/HMO/WC	$23.48
Rate for Payer: UnitedHealthcare Commercial	$31.30
Rate for Payer: UnitedHealthcare Community & State	$4.95
Rate for Payer: Wellpoint Medicaid Managed Care	$4.44

CANNULATOME LL PC LUMEN SPH

Facility

$130.00

Hospital Charge Code	270325609
Hospital Revenue Code	272
Min. Negotiated Rate	$3.69
Max. Negotiated Rate	$65.00
Rate for Payer: Aetna Commercial	$49.40
Rate for Payer: Aetna Medicare Advantage	$39.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.15
Rate for Payer: Cigna Commercial	$65.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.80
Rate for Payer: Oxford Commercial	$26.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.50
Rate for Payer: UnitedHealthcare Commercial	$26.00
Rate for Payer: UnitedHealthcare Community & State	$4.11
Rate for Payer: Wellpoint Medicaid Managed Care	$3.69

CANNULATOME LL PC LUMEN SPH

Facility

$130.00

Hospital Charge Code	270325609
Hospital Revenue Code	272
Min. Negotiated Rate	$19.50
Max. Negotiated Rate	$19.50
Rate for Payer: Qualcare PPO/HMO/WC	$19.50

cannula transport 8mm

Facility

$821.95

Hospital Charge Code	270688489
Hospital Revenue Code	272
Min. Negotiated Rate	$123.29
Max. Negotiated Rate	$123.29
Rate for Payer: Qualcare PPO/HMO/WC	$123.29

cannula transport 8mm

Facility

$821.95

Hospital Charge Code	270688489
Hospital Revenue Code	272
Min. Negotiated Rate	$23.34
Max. Negotiated Rate	$410.98
Rate for Payer: Aetna Commercial	$312.34
Rate for Payer: Aetna Medicare Advantage	$246.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.60
Rate for Payer: Cigna Commercial	$410.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.71
Rate for Payer: Oxford Commercial	$164.39
Rate for Payer: Qualcare PPO/HMO/WC	$123.29
Rate for Payer: UnitedHealthcare Commercial	$164.39
Rate for Payer: UnitedHealthcare Community & State	$25.97
Rate for Payer: Wellpoint Medicaid Managed Care	$23.34

CANNULA TRANSPORT 8MM 4-6

Facility

$473.55

Hospital Charge Code	270670488
Hospital Revenue Code	272
Min. Negotiated Rate	$13.45
Max. Negotiated Rate	$236.78
Rate for Payer: Aetna Commercial	$179.95
Rate for Payer: Aetna Medicare Advantage	$142.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.76
Rate for Payer: Cigna Commercial	$236.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.12
Rate for Payer: Oxford Commercial	$94.71
Rate for Payer: Qualcare PPO/HMO/WC	$71.03
Rate for Payer: UnitedHealthcare Commercial	$94.71
Rate for Payer: UnitedHealthcare Community & State	$14.96
Rate for Payer: Wellpoint Medicaid Managed Care	$13.45

CANNULA TRANSPORT 8MM 4-6

Facility

$473.55

Hospital Charge Code	270670488
Hospital Revenue Code	272
Min. Negotiated Rate	$71.03
Max. Negotiated Rate	$71.03
Rate for Payer: Qualcare PPO/HMO/WC	$71.03

CANNULA TWIST-IN 7MM

Facility

$125.00

Hospital Charge Code	270635387
Hospital Revenue Code	272
Min. Negotiated Rate	$3.55
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$25.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$25.00
Rate for Payer: UnitedHealthcare Community & State	$3.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3.55

CANNULA TWIST-IN 7MM

Facility

$125.00

Hospital Charge Code	270635387
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

CANNULA TWIST IN 8.25MMx9CM

Facility

$125.00

Hospital Charge Code	270672178
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

CANNULA TWIST IN 8.25MMx9CM

Facility

$125.00

Hospital Charge Code	270672178
Hospital Revenue Code	272
Min. Negotiated Rate	$3.55
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$25.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$25.00
Rate for Payer: UnitedHealthcare Community & State	$3.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3.55

CANNULA UNIV KIT 5X76MM 012405

Facility

$121.50

Hospital Charge Code	270612232
Hospital Revenue Code	272
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$60.75
Rate for Payer: Aetna Commercial	$46.17
Rate for Payer: Aetna Medicare Advantage	$36.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.98
Rate for Payer: Cigna Commercial	$60.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.59
Rate for Payer: Oxford Commercial	$24.30
Rate for Payer: Qualcare PPO/HMO/WC	$18.23
Rate for Payer: UnitedHealthcare Commercial	$24.30
Rate for Payer: UnitedHealthcare Community & State	$3.84
Rate for Payer: Wellpoint Medicaid Managed Care	$3.45

CANNULA UNIV KIT 5X76MM 012405

Facility

$121.50

Hospital Charge Code	270612232
Hospital Revenue Code	272
Min. Negotiated Rate	$18.23
Max. Negotiated Rate	$18.23
Rate for Payer: Qualcare PPO/HMO/WC	$18.23

CANNULA UNIV STD FIX 5MM

Facility

$44.70

Hospital Charge Code	270675263
Hospital Revenue Code	272
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$22.35
Rate for Payer: Aetna Commercial	$16.99
Rate for Payer: Aetna Medicare Advantage	$13.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.40
Rate for Payer: Cigna Commercial	$22.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.62
Rate for Payer: Oxford Commercial	$8.94
Rate for Payer: Qualcare PPO/HMO/WC	$6.71
Rate for Payer: UnitedHealthcare Commercial	$8.94
Rate for Payer: UnitedHealthcare Community & State	$1.41
Rate for Payer: Wellpoint Medicaid Managed Care	$1.27

CANNULA UNIV STD FIX 5MM

Facility

$44.70

Hospital Charge Code	270675263
Hospital Revenue Code	272
Min. Negotiated Rate	$6.71
Max. Negotiated Rate	$6.71
Rate for Payer: Qualcare PPO/HMO/WC	$6.71

CANNULE RF NEEDLE 150MM 20G

Facility

$240.70

Hospital Charge Code	270654886
Hospital Revenue Code	272
Min. Negotiated Rate	$6.84
Max. Negotiated Rate	$120.35
Rate for Payer: Aetna Commercial	$91.47
Rate for Payer: Aetna Medicare Advantage	$72.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.38
Rate for Payer: Cigna Commercial	$120.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.58
Rate for Payer: Oxford Commercial	$48.14
Rate for Payer: Qualcare PPO/HMO/WC	$36.10
Rate for Payer: UnitedHealthcare Commercial	$48.14
Rate for Payer: UnitedHealthcare Community & State	$7.61
Rate for Payer: Wellpoint Medicaid Managed Care	$6.84

CANNULE RF NEEDLE 150MM 20G

Facility

$240.70

Hospital Charge Code	270654886
Hospital Revenue Code	272
Min. Negotiated Rate	$36.10
Max. Negotiated Rate	$36.10
Rate for Payer: Qualcare PPO/HMO/WC	$36.10

CANNULLA RF 18G 10X100MM

Facility

$2,665.00

Hospital Charge Code	270691392
Hospital Revenue Code	279
Min. Negotiated Rate	$75.69
Max. Negotiated Rate	$1,332.50
Rate for Payer: Aetna Commercial	$1,012.70
Rate for Payer: Aetna Medicare Advantage	$799.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$679.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$679.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$679.58
Rate for Payer: Cigna Commercial	$1,332.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$692.90
Rate for Payer: Oxford Commercial	$533.00
Rate for Payer: Qualcare PPO/HMO/WC	$399.75
Rate for Payer: UnitedHealthcare Commercial	$533.00
Rate for Payer: UnitedHealthcare Community & State	$84.21
Rate for Payer: Wellpoint Medicaid Managed Care	$75.69

Know your out-of-pocket cost for care.

All Charges