Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

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

CANULA 6 X 75m 214661

Facility

$105.00

Hospital Charge Code	270635851
Hospital Revenue Code	272
Min. Negotiated Rate	$15.75
Max. Negotiated Rate	$15.75
Rate for Payer: Qualcare PPO/HMO/WC	$15.75

CANULA 6 X 75m 214661

Facility

$105.00

Hospital Charge Code	270635851
Hospital Revenue Code	272
Min. Negotiated Rate	$2.98
Max. Negotiated Rate	$52.50
Rate for Payer: Aetna Commercial	$39.90
Rate for Payer: Aetna Medicare Advantage	$31.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.77
Rate for Payer: Cigna Commercial	$52.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.30
Rate for Payer: Oxford Commercial	$21.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.75
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Community & State	$3.32
Rate for Payer: Wellpoint Medicaid Managed Care	$2.98

CAP 14 MM PSN6-9 EF

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270692335
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

CAP 14 MM PSN6-9 EF

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270692335
Hospital Revenue Code	278
Min. Negotiated Rate	$170.40
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$189.60
Rate for Payer: Wellpoint Medicaid Managed Care	$170.40

CAP ASF PSN 10 MM VE 6-9 CD

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270690144
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

CAP ASF PSN 10 MM VE 6-9 CD

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270690144
Hospital Revenue Code	278
Min. Negotiated Rate	$170.40
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$189.60
Rate for Payer: Wellpoint Medicaid Managed Care	$170.40

CAP ASF PSN 12 MM VEL 3

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270690103
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

CAP ASF PSN 12 MM VEL 3

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270690103
Hospital Revenue Code	278
Min. Negotiated Rate	$113.60
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$126.40
Rate for Payer: Wellpoint Medicaid Managed Care	$113.60

CAP BOUFFANT HW 24IN BLUE

Facility

$209.60

Hospital Charge Code	270664786
Hospital Revenue Code	270
Min. Negotiated Rate	$31.44
Max. Negotiated Rate	$31.44
Rate for Payer: Qualcare PPO/HMO/WC	$31.44

CAP BOUFFANT HW 24IN BLUE

Facility

$209.60

Hospital Charge Code	270664786
Hospital Revenue Code	270
Min. Negotiated Rate	$5.95
Max. Negotiated Rate	$104.80
Rate for Payer: Aetna Commercial	$79.65
Rate for Payer: Aetna Medicare Advantage	$62.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.45
Rate for Payer: Cigna Commercial	$104.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.50
Rate for Payer: Oxford Commercial	$41.92
Rate for Payer: Qualcare PPO/HMO/WC	$31.44
Rate for Payer: UnitedHealthcare Commercial	$41.92
Rate for Payer: UnitedHealthcare Community & State	$6.62
Rate for Payer: Wellpoint Medicaid Managed Care	$5.95

CAP END 15MM

Facility

$1,071.00

Hospital Charge Code	270659945
Hospital Revenue Code	278
Min. Negotiated Rate	$160.65
Max. Negotiated Rate	$259.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.18
Rate for Payer: Qualcare PPO/HMO/WC	$160.65

CAP END 15MM

Facility

$1,071.00

Hospital Charge Code	270659945
Hospital Revenue Code	278
Min. Negotiated Rate	$30.42
Max. Negotiated Rate	$535.50
Rate for Payer: Aetna Commercial	$406.98
Rate for Payer: Aetna Medicare Advantage	$321.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$273.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$273.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$273.11
Rate for Payer: Cigna Commercial	$535.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.18
Rate for Payer: Qualcare PPO/HMO/WC	$160.65
Rate for Payer: UnitedHealthcare Community & State	$33.84
Rate for Payer: Wellpoint Medicaid Managed Care	$30.42

CAP END DISTAL STERILE

Facility

$259.50

Hospital Charge Code	270695114
Hospital Revenue Code	272
Min. Negotiated Rate	$7.37
Max. Negotiated Rate	$129.75
Rate for Payer: Aetna Commercial	$98.61
Rate for Payer: Aetna Medicare Advantage	$77.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.17
Rate for Payer: Cigna Commercial	$129.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.47
Rate for Payer: Oxford Commercial	$51.90
Rate for Payer: Qualcare PPO/HMO/WC	$38.92
Rate for Payer: UnitedHealthcare Commercial	$51.90
Rate for Payer: UnitedHealthcare Community & State	$8.20
Rate for Payer: Wellpoint Medicaid Managed Care	$7.37

CAP END DISTAL STERILE

Facility

$259.50

Hospital Charge Code	270695114
Hospital Revenue Code	272
Min. Negotiated Rate	$38.92
Max. Negotiated Rate	$38.92
Rate for Payer: Qualcare PPO/HMO/WC	$38.92

CAP F/11.0mm S.S TUBES & FIBER

Facility

$7.26

Hospital Charge Code	270639895
Hospital Revenue Code	278
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$3.63
Rate for Payer: Aetna Commercial	$2.76
Rate for Payer: Aetna Medicare Advantage	$2.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.85
Rate for Payer: Cigna Commercial	$3.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.76
Rate for Payer: Qualcare PPO/HMO/WC	$1.09
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

CAP F/11.0mm S.S TUBES & FIBER

Facility

$7.26

Hospital Charge Code	270639895
Hospital Revenue Code	278
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.76
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

CAP FLO CLEVER

Facility

$134.75

Hospital Charge Code	270678922
Hospital Revenue Code	272
Min. Negotiated Rate	$3.83
Max. Negotiated Rate	$67.38
Rate for Payer: Aetna Commercial	$51.20
Rate for Payer: Aetna Medicare Advantage	$40.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.36
Rate for Payer: Cigna Commercial	$67.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.03
Rate for Payer: Oxford Commercial	$26.95
Rate for Payer: Qualcare PPO/HMO/WC	$20.21
Rate for Payer: UnitedHealthcare Commercial	$26.95
Rate for Payer: UnitedHealthcare Community & State	$4.26
Rate for Payer: Wellpoint Medicaid Managed Care	$3.83

CAP FLO CLEVER

Facility

$134.75

Hospital Charge Code	270678922
Hospital Revenue Code	272
Min. Negotiated Rate	$20.21
Max. Negotiated Rate	$20.21
Rate for Payer: Qualcare PPO/HMO/WC	$20.21

CAP GAS

Facility

$1,592.80

Hospital Charge Code	270683461
Hospital Revenue Code	272
Min. Negotiated Rate	$45.24
Max. Negotiated Rate	$796.40
Rate for Payer: Aetna Commercial	$605.26
Rate for Payer: Aetna Medicare Advantage	$477.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$406.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$406.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$406.16
Rate for Payer: Cigna Commercial	$796.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$414.13
Rate for Payer: Oxford Commercial	$318.56
Rate for Payer: Qualcare PPO/HMO/WC	$238.92
Rate for Payer: UnitedHealthcare Commercial	$318.56
Rate for Payer: UnitedHealthcare Community & State	$50.33
Rate for Payer: Wellpoint Medicaid Managed Care	$45.24

CAP GAS

Facility

$1,592.80

Hospital Charge Code	270683461
Hospital Revenue Code	272
Min. Negotiated Rate	$238.92
Max. Negotiated Rate	$238.92
Rate for Payer: Qualcare PPO/HMO/WC	$238.92

CAP GREEN

Facility

$54.38

Hospital Charge Code	270662191
Hospital Revenue Code	272
Min. Negotiated Rate	$8.16
Max. Negotiated Rate	$8.16
Rate for Payer: Qualcare PPO/HMO/WC	$8.16

CAP GREEN

Facility

$54.38

Hospital Charge Code	270662191
Hospital Revenue Code	272
Min. Negotiated Rate	$1.54
Max. Negotiated Rate	$27.19
Rate for Payer: Aetna Commercial	$20.66
Rate for Payer: Aetna Medicare Advantage	$16.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.87
Rate for Payer: Cigna Commercial	$27.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.14
Rate for Payer: Oxford Commercial	$10.88
Rate for Payer: Qualcare PPO/HMO/WC	$8.16
Rate for Payer: UnitedHealthcare Commercial	$10.88
Rate for Payer: UnitedHealthcare Community & State	$1.72
Rate for Payer: Wellpoint Medicaid Managed Care	$1.54

CAPHOSOL RINSE

Facility

$5.76

Service Code	NDC 50930009808
Hospital Charge Code	6063943071
Hospital Revenue Code	250
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$0.86
Rate for Payer: Qualcare PPO/HMO/WC	$0.86

CAPHOSOL RINSE

Facility

$5.76

Service Code	NDC 50930009808
Hospital Charge Code	6063943071
Hospital Revenue Code	250
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$2.88
Rate for Payer: Aetna Commercial	$2.19
Rate for Payer: Aetna Medicare Advantage	$1.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.47
Rate for Payer: Cigna Commercial	$2.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.50
Rate for Payer: Oxford Commercial	$1.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.86
Rate for Payer: UnitedHealthcare Commercial	$1.15
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

Know your out-of-pocket cost for care.

All Charges