Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ACCUSTICK SYSTEM INTRODUCER II

Facility

$466.25

Service Code	HCPCS C1894
Hospital Charge Code	270664200
Hospital Revenue Code	278
Min. Negotiated Rate	$69.94
Max. Negotiated Rate	$112.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.83
Rate for Payer: Qualcare PPO/HMO/WC	$69.94

ACCUTYPE IL28B

Facility

$1,499.85

Service Code	HCPCS 81400
Hospital Charge Code	39900025
Hospital Revenue Code	310
Min. Negotiated Rate	$42.60
Max. Negotiated Rate	$749.92
Rate for Payer: Aetna Commercial	$173.97
Rate for Payer: Aetna Medicare Advantage	$207.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$232.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$232.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$63.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$232.01
Rate for Payer: Cigna Commercial	$749.92
Rate for Payer: Cigna Medicare Advantage	$63.96
Rate for Payer: Clover Medicare Advantage	$60.76
Rate for Payer: EmblemHealth Commercial	$191.88
Rate for Payer: Humana Medicare Advantage	$65.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$63.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.96
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$224.98
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$51.17
Rate for Payer: UnitedHealthcare Medicare Advantage	$63.96
Rate for Payer: Wellcare Medicare Advantage	$63.96
Rate for Payer: Wellpoint Medicaid Managed Care	$42.60

ACCUTYPE IL28B

Facility

$1,499.85

Service Code	HCPCS 81400
Hospital Charge Code	39900025
Hospital Revenue Code	310
Min. Negotiated Rate	$224.98
Max. Negotiated Rate	$224.98
Rate for Payer: Qualcare PPO/HMO/WC	$224.98

ACDF SCREW 3.5X14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705433
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

ACDF SCREW 3.5X14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705433
Hospital Revenue Code	278
Min. Negotiated Rate	$28.40
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$31.60
Rate for Payer: Wellpoint Medicaid Managed Care	$28.40

ACDF STANDALONE 14X12X7MM

Facility

$20,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270703787
Hospital Revenue Code	278
Min. Negotiated Rate	$586.46
Max. Negotiated Rate	$10,325.00
Rate for Payer: Aetna Commercial	$7,847.00
Rate for Payer: Aetna Medicare Advantage	$6,195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,265.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,265.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,265.75
Rate for Payer: Cigna Commercial	$10,325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,997.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,097.50
Rate for Payer: UnitedHealthcare Community & State	$652.54
Rate for Payer: Wellpoint Medicaid Managed Care	$586.46

ACDF STANDALONE 14X12X7MM

Facility

$20,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270703787
Hospital Revenue Code	278
Min. Negotiated Rate	$3,097.50
Max. Negotiated Rate	$4,997.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,997.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,097.50

ACDF STANDALONE 14X12X8MM

Facility

$20,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270703788
Hospital Revenue Code	278
Min. Negotiated Rate	$586.46
Max. Negotiated Rate	$10,325.00
Rate for Payer: Aetna Commercial	$7,847.00
Rate for Payer: Aetna Medicare Advantage	$6,195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,265.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,265.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,265.75
Rate for Payer: Cigna Commercial	$10,325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,997.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,097.50
Rate for Payer: UnitedHealthcare Community & State	$652.54
Rate for Payer: Wellpoint Medicaid Managed Care	$586.46

ACDF STANDALONE 14X12X8MM

Facility

$20,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270703788
Hospital Revenue Code	278
Min. Negotiated Rate	$3,097.50
Max. Negotiated Rate	$4,997.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,997.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,097.50

Ace64 Kit

Facility

$13,975.00

Hospital Charge Code	270682964S
Hospital Revenue Code	272
Min. Negotiated Rate	$2,096.25
Max. Negotiated Rate	$2,096.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,096.25

Ace64 Kit

Facility

$13,975.00

Hospital Charge Code	270682964S
Hospital Revenue Code	272
Min. Negotiated Rate	$396.89
Max. Negotiated Rate	$6,987.50
Rate for Payer: Aetna Commercial	$5,310.50
Rate for Payer: Aetna Medicare Advantage	$4,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,563.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,563.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,563.62
Rate for Payer: Cigna Commercial	$6,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,633.50
Rate for Payer: Oxford Commercial	$2,795.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,096.25
Rate for Payer: UnitedHealthcare Commercial	$2,795.00
Rate for Payer: UnitedHealthcare Community & State	$441.61
Rate for Payer: Wellpoint Medicaid Managed Care	$396.89

ACE 64 KIT

Facility

$13,975.00

Hospital Charge Code	270682964N
Hospital Revenue Code	272
Min. Negotiated Rate	$2,096.25
Max. Negotiated Rate	$2,096.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,096.25

ACE 64 KIT

Facility

$13,975.00

Hospital Charge Code	270682964N
Hospital Revenue Code	272
Min. Negotiated Rate	$396.89
Max. Negotiated Rate	$6,987.50
Rate for Payer: Aetna Commercial	$5,310.50
Rate for Payer: Aetna Medicare Advantage	$4,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,563.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,563.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,563.62
Rate for Payer: Cigna Commercial	$6,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,633.50
Rate for Payer: Oxford Commercial	$2,795.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,096.25
Rate for Payer: UnitedHealthcare Commercial	$2,795.00
Rate for Payer: UnitedHealthcare Community & State	$441.61
Rate for Payer: Wellpoint Medicaid Managed Care	$396.89

ACELL MACISTEM P S MATRIX

Facility

$748.00

Hospital Charge Code	270339128
Hospital Revenue Code	636
Min. Negotiated Rate	$21.24
Max. Negotiated Rate	$374.00
Rate for Payer: Aetna Commercial	$284.24
Rate for Payer: Aetna Medicare Advantage	$224.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$190.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$190.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$190.74
Rate for Payer: Cigna Commercial	$374.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.02
Rate for Payer: Qualcare PPO/HMO/WC	$112.20
Rate for Payer: UnitedHealthcare Community & State	$23.64
Rate for Payer: Wellpoint Medicaid Managed Care	$21.24

ACELL MACISTEM P S MATRIX

Facility

$748.00

Hospital Charge Code	270339128
Hospital Revenue Code	636
Min. Negotiated Rate	$112.20
Max. Negotiated Rate	$181.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.02
Rate for Payer: Qualcare PPO/HMO/WC	$112.20

ACELL MATRIX 10CMX15CM-PLST SR

Facility

$4,725.00

Hospital Charge Code	270339122
Hospital Revenue Code	636
Min. Negotiated Rate	$134.19
Max. Negotiated Rate	$2,362.50
Rate for Payer: Aetna Commercial	$1,795.50
Rate for Payer: Aetna Medicare Advantage	$1,417.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,204.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,204.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,204.88
Rate for Payer: Cigna Commercial	$2,362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,143.45
Rate for Payer: Qualcare PPO/HMO/WC	$708.75
Rate for Payer: UnitedHealthcare Community & State	$149.31
Rate for Payer: Wellpoint Medicaid Managed Care	$134.19

ACELL MATRIX 10CMX15CM-PLST SR

Facility

$4,725.00

Hospital Charge Code	270339122
Hospital Revenue Code	636
Min. Negotiated Rate	$708.75
Max. Negotiated Rate	$1,143.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,143.45
Rate for Payer: Qualcare PPO/HMO/WC	$708.75

ACELL MESH-PLAST SURG 7X10

Facility

$11,523.00

Hospital Charge Code	270339113
Hospital Revenue Code	278
Min. Negotiated Rate	$327.25
Max. Negotiated Rate	$5,761.50
Rate for Payer: Aetna Commercial	$4,378.74
Rate for Payer: Aetna Medicare Advantage	$3,456.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,938.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,938.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,304.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,938.36
Rate for Payer: Cigna Commercial	$5,761.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,788.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,728.45
Rate for Payer: UnitedHealthcare Community & State	$364.13
Rate for Payer: Wellpoint Medicaid Managed Care	$327.25

ACELL MESH-PLAST SURG 7X10

Facility

$11,523.00

Hospital Charge Code	270339113
Hospital Revenue Code	278
Min. Negotiated Rate	$1,728.45
Max. Negotiated Rate	$2,788.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,304.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,788.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,728.45

ACELL MICRO MATRIX 100 MG

Facility

$480.00

Hospital Charge Code	270339126
Hospital Revenue Code	636
Min. Negotiated Rate	$13.63
Max. Negotiated Rate	$240.00
Rate for Payer: Aetna Commercial	$182.40
Rate for Payer: Aetna Medicare Advantage	$144.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.40
Rate for Payer: Cigna Commercial	$240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.16
Rate for Payer: Qualcare PPO/HMO/WC	$72.00
Rate for Payer: UnitedHealthcare Community & State	$15.17
Rate for Payer: Wellpoint Medicaid Managed Care	$13.63

ACELL MICRO MATRIX 100 MG

Facility

$480.00

Hospital Charge Code	270339126
Hospital Revenue Code	636
Min. Negotiated Rate	$72.00
Max. Negotiated Rate	$116.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.16
Rate for Payer: Qualcare PPO/HMO/WC	$72.00

ACELL MICROMATRIX 200 MG

Facility

$789.00

Hospital Charge Code	270339127
Hospital Revenue Code	636
Min. Negotiated Rate	$22.41
Max. Negotiated Rate	$394.50
Rate for Payer: Aetna Commercial	$299.82
Rate for Payer: Aetna Medicare Advantage	$236.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.19
Rate for Payer: Cigna Commercial	$394.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$190.94
Rate for Payer: Qualcare PPO/HMO/WC	$118.35
Rate for Payer: UnitedHealthcare Community & State	$24.93
Rate for Payer: Wellpoint Medicaid Managed Care	$22.41

ACELL MICROMATRIX 200 MG

Facility

$789.00

Hospital Charge Code	270339127
Hospital Revenue Code	636
Min. Negotiated Rate	$118.35
Max. Negotiated Rate	$190.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$190.94
Rate for Payer: Qualcare PPO/HMO/WC	$118.35

ACELL MICRO MATRIX 30 MG

Facility

$480.00

Hospital Charge Code	270339125
Hospital Revenue Code	636
Min. Negotiated Rate	$72.00
Max. Negotiated Rate	$116.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.16
Rate for Payer: Qualcare PPO/HMO/WC	$72.00

ACELL MICRO MATRIX 30 MG

Facility

$480.00

Hospital Charge Code	270339125
Hospital Revenue Code	636
Min. Negotiated Rate	$13.63
Max. Negotiated Rate	$240.00
Rate for Payer: Aetna Commercial	$182.40
Rate for Payer: Aetna Medicare Advantage	$144.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.40
Rate for Payer: Cigna Commercial	$240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.16
Rate for Payer: Qualcare PPO/HMO/WC	$72.00
Rate for Payer: UnitedHealthcare Community & State	$15.17
Rate for Payer: Wellpoint Medicaid Managed Care	$13.63

Know your out-of-pocket cost for care.

All Charges