Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CAR SEAT/BED TEST 60 MIN

Facility

$186.45

Service Code	HCPCS 94780
Hospital Charge Code	309094780
Hospital Revenue Code	410
Min. Negotiated Rate	$27.97
Max. Negotiated Rate	$27.97
Rate for Payer: Qualcare PPO/HMO/WC	$27.97

CAR SEAT/BED TEST 60 MIN

Facility

$186.45

Service Code	HCPCS 94780
Hospital Charge Code	309294780
Hospital Revenue Code	410
Min. Negotiated Rate	$5.30
Max. Negotiated Rate	$1,440.00
Rate for Payer: Aetna Commercial	$120.69
Rate for Payer: Aetna Medicare Advantage	$143.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.95
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: Cigna Medicare Advantage	$44.37
Rate for Payer: Clover Medicare Advantage	$42.15
Rate for Payer: EmblemHealth Commercial	$133.11
Rate for Payer: Humana Medicare Advantage	$45.70
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$44.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.48
Rate for Payer: Oxford Commercial	$1,367.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.97
Rate for Payer: UnitedHealthcare Commercial	$1,440.00
Rate for Payer: UnitedHealthcare Community & State	$5.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$44.37
Rate for Payer: Wellcare Medicare Advantage	$44.37
Rate for Payer: Wellpoint Medicaid Managed Care	$5.30

CAR SEAT/BED TEST 60 MIN

Facility

$186.45

Service Code	HCPCS 94780
Hospital Charge Code	309294780
Hospital Revenue Code	410
Min. Negotiated Rate	$27.97
Max. Negotiated Rate	$27.97
Rate for Payer: Qualcare PPO/HMO/WC	$27.97

CAR SEAT/BED TEST 60 MIN

Facility

$186.45

Service Code	HCPCS 94780
Hospital Charge Code	309194780
Hospital Revenue Code	410
Min. Negotiated Rate	$27.97
Max. Negotiated Rate	$27.97
Rate for Payer: Qualcare PPO/HMO/WC	$27.97

CAR SEAT/BED TEST 60 MIN

Facility

$186.45

Service Code	HCPCS 94780
Hospital Charge Code	309094780
Hospital Revenue Code	410
Min. Negotiated Rate	$5.30
Max. Negotiated Rate	$1,440.00
Rate for Payer: Aetna Commercial	$120.69
Rate for Payer: Aetna Medicare Advantage	$143.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.95
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: Cigna Medicare Advantage	$44.37
Rate for Payer: Clover Medicare Advantage	$42.15
Rate for Payer: EmblemHealth Commercial	$133.11
Rate for Payer: Humana Medicare Advantage	$45.70
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$44.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.48
Rate for Payer: Oxford Commercial	$1,367.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.97
Rate for Payer: UnitedHealthcare Commercial	$1,440.00
Rate for Payer: UnitedHealthcare Community & State	$5.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$44.37
Rate for Payer: Wellcare Medicare Advantage	$44.37
Rate for Payer: Wellpoint Medicaid Managed Care	$5.30

CAR SEAT/BED TEST EA ADD 30MIN

Facility

$93.23

Service Code	HCPCS 94781
Hospital Charge Code	309294781
Hospital Revenue Code	410
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$1,440.00
Rate for Payer: Aetna Commercial	$35.43
Rate for Payer: Aetna Medicare Advantage	$27.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.77
Rate for Payer: Cigna Commercial	$46.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.24
Rate for Payer: Oxford Commercial	$1,367.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.98
Rate for Payer: UnitedHealthcare Commercial	$1,440.00
Rate for Payer: UnitedHealthcare Community & State	$2.95
Rate for Payer: Wellpoint Medicaid Managed Care	$2.65

CAR SEAT/BED TEST EA ADD 30MIN

Facility

$93.23

Service Code	HCPCS 94781
Hospital Charge Code	309094781
Hospital Revenue Code	410
Min. Negotiated Rate	$13.98
Max. Negotiated Rate	$13.98
Rate for Payer: Qualcare PPO/HMO/WC	$13.98

CAR SEAT/BED TEST EA ADD 30MIN

Facility

$93.23

Service Code	HCPCS 94781
Hospital Charge Code	309194781
Hospital Revenue Code	410
Min. Negotiated Rate	$13.98
Max. Negotiated Rate	$13.98
Rate for Payer: Qualcare PPO/HMO/WC	$13.98

CAR SEAT/BED TEST EA ADD 30MIN

Facility

$93.23

Service Code	HCPCS 94781
Hospital Charge Code	309194781
Hospital Revenue Code	410
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$1,440.00
Rate for Payer: Aetna Commercial	$35.43
Rate for Payer: Aetna Medicare Advantage	$27.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.77
Rate for Payer: Cigna Commercial	$46.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.24
Rate for Payer: Oxford Commercial	$1,367.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.98
Rate for Payer: UnitedHealthcare Commercial	$1,440.00
Rate for Payer: UnitedHealthcare Community & State	$2.95
Rate for Payer: Wellpoint Medicaid Managed Care	$2.65

CAR SEAT/BED TEST EA ADD 30MIN

Facility

$93.23

Service Code	HCPCS 94781
Hospital Charge Code	309094781
Hospital Revenue Code	410
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$1,440.00
Rate for Payer: Aetna Commercial	$35.43
Rate for Payer: Aetna Medicare Advantage	$27.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.77
Rate for Payer: Cigna Commercial	$46.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.24
Rate for Payer: Oxford Commercial	$1,367.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.98
Rate for Payer: UnitedHealthcare Commercial	$1,440.00
Rate for Payer: UnitedHealthcare Community & State	$2.95
Rate for Payer: Wellpoint Medicaid Managed Care	$2.65

CAR SEAT/BED TEST EA ADD 30MIN

Facility

$93.23

Service Code	HCPCS 94781
Hospital Charge Code	309294781
Hospital Revenue Code	410
Min. Negotiated Rate	$13.98
Max. Negotiated Rate	$13.98
Rate for Payer: Qualcare PPO/HMO/WC	$13.98

Cart Cover for Model SP-30SL C

Facility

$580.00

Hospital Charge Code	270665973
Hospital Revenue Code	270
Min. Negotiated Rate	$16.47
Max. Negotiated Rate	$290.00
Rate for Payer: Aetna Commercial	$220.40
Rate for Payer: Aetna Medicare Advantage	$174.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.90
Rate for Payer: Cigna Commercial	$290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.80
Rate for Payer: Oxford Commercial	$116.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.00
Rate for Payer: UnitedHealthcare Commercial	$116.00
Rate for Payer: UnitedHealthcare Community & State	$18.33
Rate for Payer: Wellpoint Medicaid Managed Care	$16.47

Cart Cover for Model SP-30SL C

Facility

$580.00

Hospital Charge Code	270665973
Hospital Revenue Code	270
Min. Negotiated Rate	$87.00
Max. Negotiated Rate	$87.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.00

CARTDRIDGE NITROUS OXIDE

Facility

$300.00

Hospital Charge Code	270679447
Hospital Revenue Code	272
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

CARTDRIDGE NITROUS OXIDE

Facility

$300.00

Hospital Charge Code	270679447
Hospital Revenue Code	272
Min. Negotiated Rate	$8.52
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.00
Rate for Payer: Oxford Commercial	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$60.00
Rate for Payer: UnitedHealthcare Community & State	$9.48
Rate for Payer: Wellpoint Medicaid Managed Care	$8.52

CARTIFORM 10MM DISC

Facility

$16,050.00

Hospital Charge Code	270677959
Hospital Revenue Code	278
Min. Negotiated Rate	$2,407.50
Max. Negotiated Rate	$3,884.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,884.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,407.50

CARTIFORM 10MM DISC

Facility

$16,050.00

Hospital Charge Code	270677959
Hospital Revenue Code	278
Min. Negotiated Rate	$455.82
Max. Negotiated Rate	$8,025.00
Rate for Payer: Aetna Commercial	$6,099.00
Rate for Payer: Aetna Medicare Advantage	$4,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,092.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,092.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,092.75
Rate for Payer: Cigna Commercial	$8,025.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,884.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,407.50
Rate for Payer: UnitedHealthcare Community & State	$507.18
Rate for Payer: Wellpoint Medicaid Managed Care	$455.82

CARTILAGE FRAFT,N SEPTUM

Facility

$26,848.40

Service Code	HCPCS 20912
Hospital Charge Code	1600000741
Hospital Revenue Code	360
Min. Negotiated Rate	$4,027.26
Max. Negotiated Rate	$4,027.26
Rate for Payer: Qualcare PPO/HMO/WC	$4,027.26

CARTILAGE FRAFT,N SEPTUM

Facility

$26,848.40

Service Code	HCPCS 20912
Hospital Charge Code	1600000741
Hospital Revenue Code	360
Min. Negotiated Rate	$762.49
Max. Negotiated Rate	$15,271.92
Rate for Payer: Aetna Commercial	$11,451.31
Rate for Payer: Aetna Medicare Advantage	$13,640.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,271.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,271.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,210.04
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	$15,271.92
Rate for Payer: Cigna Commercial	$8,439.01
Rate for Payer: Cigna Medicare Advantage	$4,210.04
Rate for Payer: Clover Medicare Advantage	$3,999.54
Rate for Payer: EmblemHealth Commercial	$12,630.12
Rate for Payer: Humana Medicare Advantage	$4,336.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,210.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,980.58
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,027.26
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$848.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,210.04
Rate for Payer: Wellcare Medicare Advantage	$4,210.04
Rate for Payer: Wellpoint Medicaid Managed Care	$762.49

CARTILAGE REMOVER

Facility

$1,386.95

Hospital Charge Code	270691599
Hospital Revenue Code	272
Min. Negotiated Rate	$208.04
Max. Negotiated Rate	$208.04
Rate for Payer: Qualcare PPO/HMO/WC	$208.04

CARTILAGE REMOVER

Facility

$1,386.95

Hospital Charge Code	270691599
Hospital Revenue Code	272
Min. Negotiated Rate	$39.39
Max. Negotiated Rate	$693.48
Rate for Payer: Aetna Commercial	$527.04
Rate for Payer: Aetna Medicare Advantage	$416.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$353.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$353.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$353.67
Rate for Payer: Cigna Commercial	$693.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$360.61
Rate for Payer: Oxford Commercial	$277.39
Rate for Payer: Qualcare PPO/HMO/WC	$208.04
Rate for Payer: UnitedHealthcare Commercial	$277.39
Rate for Payer: UnitedHealthcare Community & State	$43.83
Rate for Payer: Wellpoint Medicaid Managed Care	$39.39

CARTIMAX VIABLE CARTIL ALLOGRA

Facility

$24,750.00

Service Code	HCPCS C1763
Hospital Charge Code	270687924
Hospital Revenue Code	278
Min. Negotiated Rate	$702.90
Max. Negotiated Rate	$12,375.00
Rate for Payer: Aetna Commercial	$9,405.00
Rate for Payer: Aetna Medicare Advantage	$7,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,311.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,311.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,311.25
Rate for Payer: Cigna Commercial	$12,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,989.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,712.50
Rate for Payer: UnitedHealthcare Community & State	$782.10
Rate for Payer: Wellpoint Medicaid Managed Care	$702.90

CARTIMAX VIABLE CARTIL ALLOGRA

Facility

$24,750.00

Service Code	HCPCS C1763
Hospital Charge Code	270687924
Hospital Revenue Code	278
Min. Negotiated Rate	$3,712.50
Max. Negotiated Rate	$5,989.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,989.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,712.50

CARTIVA MTP IMPLANT 8mm

Facility

$18,750.00

Service Code	HCPCS L8641
Hospital Charge Code	270679214
Hospital Revenue Code	278
Min. Negotiated Rate	$532.50
Max. Negotiated Rate	$9,375.00
Rate for Payer: Aetna Commercial	$7,125.00
Rate for Payer: Aetna Medicare Advantage	$5,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,781.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,781.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,781.25
Rate for Payer: Cigna Commercial	$9,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,537.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,812.50
Rate for Payer: UnitedHealthcare Community & State	$592.50
Rate for Payer: Wellpoint Medicaid Managed Care	$532.50

CARTIVA MTP IMPLANT 8mm

Facility

$18,750.00

Service Code	HCPCS L8641
Hospital Charge Code	270679214
Hospital Revenue Code	278
Min. Negotiated Rate	$2,812.50
Max. Negotiated Rate	$4,537.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,537.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,812.50

Know your out-of-pocket cost for care.

All Charges