Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CAP SCREW ASSEMBLY

Facility

$1,025.00

Hospital Charge Code	270671062
Hospital Revenue Code	272
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$153.75
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

CAP SCREW ASSEMBLY

Facility

$1,025.00

Hospital Charge Code	270671062
Hospital Revenue Code	272
Min. Negotiated Rate	$29.11
Max. Negotiated Rate	$512.50
Rate for Payer: Aetna Commercial	$389.50
Rate for Payer: Aetna Medicare Advantage	$307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.38
Rate for Payer: Cigna Commercial	$512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.50
Rate for Payer: Oxford Commercial	$205.00
Rate for Payer: Qualcare PPO/HMO/WC	$153.75
Rate for Payer: UnitedHealthcare Commercial	$205.00
Rate for Payer: UnitedHealthcare Community & State	$32.39
Rate for Payer: Wellpoint Medicaid Managed Care	$29.11

CAP SCREW LOCKING

Facility

$995.00

Service Code	HCPCS C1713
Hospital Charge Code	270691932
Hospital Revenue Code	278
Min. Negotiated Rate	$149.25
Max. Negotiated Rate	$240.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$199.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.79
Rate for Payer: Qualcare PPO/HMO/WC	$149.25

CAP SCREW LOCKING

Facility

$995.00

Service Code	HCPCS C1713
Hospital Charge Code	270691932
Hospital Revenue Code	278
Min. Negotiated Rate	$28.26
Max. Negotiated Rate	$497.50
Rate for Payer: Aetna Commercial	$378.10
Rate for Payer: Aetna Medicare Advantage	$298.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$199.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.72
Rate for Payer: Cigna Commercial	$497.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.79
Rate for Payer: Qualcare PPO/HMO/WC	$149.25
Rate for Payer: UnitedHealthcare Community & State	$31.44
Rate for Payer: Wellpoint Medicaid Managed Care	$28.26

CAPS LOCKING LINEUM

Facility

$1,075.00

Service Code	HCPCS L8699
Hospital Charge Code	270693060
Hospital Revenue Code	278
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

CAPS LOCKING LINEUM

Facility

$1,075.00

Service Code	HCPCS L8699
Hospital Charge Code	270693060
Hospital Revenue Code	278
Min. Negotiated Rate	$30.53
Max. Negotiated Rate	$537.50
Rate for Payer: Aetna Commercial	$408.50
Rate for Payer: Aetna Medicare Advantage	$322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.12
Rate for Payer: Cigna Commercial	$537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: Qualcare PPO/HMO/WC	$161.25
Rate for Payer: UnitedHealthcare Community & State	$33.97
Rate for Payer: Wellpoint Medicaid Managed Care	$30.53

CAPS SINGLE INNER SETSCREW

Facility

$1,775.00

Hospital Charge Code	270667360
Hospital Revenue Code	278
Min. Negotiated Rate	$50.41
Max. Negotiated Rate	$887.50
Rate for Payer: Aetna Commercial	$674.50
Rate for Payer: Aetna Medicare Advantage	$532.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$452.62
Rate for Payer: Cigna Commercial	$887.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$429.55
Rate for Payer: Qualcare PPO/HMO/WC	$266.25
Rate for Payer: UnitedHealthcare Community & State	$56.09
Rate for Payer: Wellpoint Medicaid Managed Care	$50.41

CAPS SINGLE INNER SETSCREW

Facility

$1,775.00

Hospital Charge Code	270667360
Hospital Revenue Code	278
Min. Negotiated Rate	$266.25
Max. Negotiated Rate	$429.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$355.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$429.55
Rate for Payer: Qualcare PPO/HMO/WC	$266.25

CAP SUCTION

Facility

$222.45

Hospital Charge Code	270676863
Hospital Revenue Code	272
Min. Negotiated Rate	$33.37
Max. Negotiated Rate	$33.37
Rate for Payer: Qualcare PPO/HMO/WC	$33.37

CAP SUCTION

Facility

$222.45

Hospital Charge Code	270676863
Hospital Revenue Code	272
Min. Negotiated Rate	$6.32
Max. Negotiated Rate	$111.22
Rate for Payer: Aetna Commercial	$84.53
Rate for Payer: Aetna Medicare Advantage	$66.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.72
Rate for Payer: Cigna Commercial	$111.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.84
Rate for Payer: Oxford Commercial	$44.49
Rate for Payer: Qualcare PPO/HMO/WC	$33.37
Rate for Payer: UnitedHealthcare Commercial	$44.49
Rate for Payer: UnitedHealthcare Community & State	$7.03
Rate for Payer: Wellpoint Medicaid Managed Care	$6.32

CAPSUCTMY W RELS HIP FLEX MSCL

Facility

$1,457.75

Service Code	HCPCS 11402
Hospital Charge Code	16000704
Hospital Revenue Code	360
Min. Negotiated Rate	$218.66
Max. Negotiated Rate	$218.66
Rate for Payer: Qualcare PPO/HMO/WC	$218.66

CAPSUCTMY W RELS HIP FLEX MSCL

Facility

$1,457.75

Service Code	HCPCS 11402
Hospital Charge Code	16000704
Hospital Revenue Code	360
Min. Negotiated Rate	$41.40
Max. Negotiated Rate	$3,629.00
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,051.74
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$379.01
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$218.66
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$46.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$41.40

CAPSULE FM G3

Facility

$3,175.00

Hospital Charge Code	270683733
Hospital Revenue Code	272
Min. Negotiated Rate	$476.25
Max. Negotiated Rate	$476.25
Rate for Payer: Qualcare PPO/HMO/WC	$476.25

CAPSULE FM G3

Facility

$3,175.00

Hospital Charge Code	270683733
Hospital Revenue Code	272
Min. Negotiated Rate	$90.17
Max. Negotiated Rate	$1,587.50
Rate for Payer: Aetna Commercial	$1,206.50
Rate for Payer: Aetna Medicare Advantage	$952.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$809.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$809.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$809.62
Rate for Payer: Cigna Commercial	$1,587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$825.50
Rate for Payer: Oxford Commercial	$635.00
Rate for Payer: Qualcare PPO/HMO/WC	$476.25
Rate for Payer: UnitedHealthcare Commercial	$635.00
Rate for Payer: UnitedHealthcare Community & State	$100.33
Rate for Payer: Wellpoint Medicaid Managed Care	$90.17

CAPSULE POLISHER

Facility

$52.00

Hospital Charge Code	270335190
Hospital Revenue Code	272
Min. Negotiated Rate	$1.48
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$19.76
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.52
Rate for Payer: Oxford Commercial	$10.40
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$10.40
Rate for Payer: UnitedHealthcare Community & State	$1.64
Rate for Payer: Wellpoint Medicaid Managed Care	$1.48

CAPSULE POLISHER

Facility

$52.00

Hospital Charge Code	270335190
Hospital Revenue Code	272
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

CAPSULOTOMY; IP JNT SGL EA JOI

Facility

$6,728.28

Service Code	HCPCS 28272
Hospital Charge Code	16000264
Hospital Revenue Code	360
Min. Negotiated Rate	$1,009.24
Max. Negotiated Rate	$1,009.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,009.24

CAPSULOTOMY; IP JNT SGL EA JOI

Facility

$6,728.28

Service Code	HCPCS 28272
Hospital Charge Code	16000264
Hospital Revenue Code	360
Min. Negotiated Rate	$191.08
Max. Negotiated Rate	$8,192.00
Rate for Payer: Aetna Commercial	$5,196.12
Rate for Payer: Aetna Medicare Advantage	$6,189.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,929.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,929.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,910.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,929.76
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: Cigna Medicare Advantage	$1,910.34
Rate for Payer: Clover Medicare Advantage	$1,814.82
Rate for Payer: EmblemHealth Commercial	$5,731.02
Rate for Payer: Humana Medicare Advantage	$1,967.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,910.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,749.35
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,009.24
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$212.61
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellpoint Medicaid Managed Care	$191.08

CAPSURE

Facility

$3,150.00

Hospital Charge Code	270685690
Hospital Revenue Code	272
Min. Negotiated Rate	$472.50
Max. Negotiated Rate	$472.50
Rate for Payer: Qualcare PPO/HMO/WC	$472.50

CAPSURE

Facility

$3,150.00

Hospital Charge Code	270685690
Hospital Revenue Code	272
Min. Negotiated Rate	$89.46
Max. Negotiated Rate	$1,575.00
Rate for Payer: Aetna Commercial	$1,197.00
Rate for Payer: Aetna Medicare Advantage	$945.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$803.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$803.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$803.25
Rate for Payer: Cigna Commercial	$1,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$819.00
Rate for Payer: Oxford Commercial	$630.00
Rate for Payer: Qualcare PPO/HMO/WC	$472.50
Rate for Payer: UnitedHealthcare Commercial	$630.00
Rate for Payer: UnitedHealthcare Community & State	$99.54
Rate for Payer: Wellpoint Medicaid Managed Care	$89.46

CAPSURE FIXATION SYSTEM

Facility

$2,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270686021
Hospital Revenue Code	278
Min. Negotiated Rate	$58.22
Max. Negotiated Rate	$1,025.00
Rate for Payer: Aetna Commercial	$779.00
Rate for Payer: Aetna Medicare Advantage	$615.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$522.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$522.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$410.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$522.75
Rate for Payer: Cigna Commercial	$1,025.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$496.10
Rate for Payer: Qualcare PPO/HMO/WC	$307.50
Rate for Payer: UnitedHealthcare Community & State	$64.78
Rate for Payer: Wellpoint Medicaid Managed Care	$58.22

CAPSURE FIXATION SYSTEM

Facility

$2,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270686021
Hospital Revenue Code	278
Min. Negotiated Rate	$307.50
Max. Negotiated Rate	$496.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$496.10
Rate for Payer: Qualcare PPO/HMO/WC	$307.50

CAPTIVATOR EMR DEVICE

Facility

$1,626.05

Hospital Charge Code	270688074
Hospital Revenue Code	272
Min. Negotiated Rate	$46.18
Max. Negotiated Rate	$813.02
Rate for Payer: Aetna Commercial	$617.90
Rate for Payer: Aetna Medicare Advantage	$487.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.64
Rate for Payer: Cigna Commercial	$813.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$422.77
Rate for Payer: Oxford Commercial	$325.21
Rate for Payer: Qualcare PPO/HMO/WC	$243.91
Rate for Payer: UnitedHealthcare Commercial	$325.21
Rate for Payer: UnitedHealthcare Community & State	$51.38
Rate for Payer: Wellpoint Medicaid Managed Care	$46.18

CAPTIVATOR EMR DEVICE

Facility

$1,626.05

Hospital Charge Code	270688074
Hospital Revenue Code	272
Min. Negotiated Rate	$243.91
Max. Negotiated Rate	$243.91
Rate for Payer: Qualcare PPO/HMO/WC	$243.91

CAPTOPRIL 12.5MG TAB

Facility

$44.70

Hospital Charge Code	6063943072
Hospital Revenue Code	250
Min. Negotiated Rate	$6.71
Max. Negotiated Rate	$6.71
Rate for Payer: Qualcare PPO/HMO/WC	$6.71

Know your out-of-pocket cost for care.

All Charges