Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CIRCUIT DUAL 90 IN HME FILTER

Facility

$34.50

Hospital Charge Code	270689034
Hospital Revenue Code	272
Min. Negotiated Rate	$5.17
Max. Negotiated Rate	$5.17
Rate for Payer: Qualcare PPO/HMO/WC	$5.17

CIRCUIT DUAL 90 IN HME FILTER

Facility

$34.50

Hospital Charge Code	270689034
Hospital Revenue Code	272
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$17.25
Rate for Payer: Aetna Commercial	$13.11
Rate for Payer: Aetna Medicare Advantage	$10.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.80
Rate for Payer: Cigna Commercial	$17.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.97
Rate for Payer: Oxford Commercial	$6.90
Rate for Payer: Qualcare PPO/HMO/WC	$5.17
Rate for Payer: UnitedHealthcare Commercial	$6.90
Rate for Payer: UnitedHealthcare Community & State	$1.09
Rate for Payer: Wellpoint Medicaid Managed Care	$0.98

CIRCUIT FLIGHT 60

Facility

$188.70

Hospital Charge Code	270691055
Hospital Revenue Code	270
Min. Negotiated Rate	$5.36
Max. Negotiated Rate	$94.35
Rate for Payer: Aetna Commercial	$71.71
Rate for Payer: Aetna Medicare Advantage	$56.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.12
Rate for Payer: Cigna Commercial	$94.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.06
Rate for Payer: Oxford Commercial	$37.74
Rate for Payer: Qualcare PPO/HMO/WC	$28.30
Rate for Payer: UnitedHealthcare Commercial	$37.74
Rate for Payer: UnitedHealthcare Community & State	$5.96
Rate for Payer: Wellpoint Medicaid Managed Care	$5.36

CIRCUIT FLIGHT 60

Facility

$188.70

Hospital Charge Code	270691055
Hospital Revenue Code	270
Min. Negotiated Rate	$28.30
Max. Negotiated Rate	$28.30
Rate for Payer: Qualcare PPO/HMO/WC	$28.30

CIRCUIT M2M OT CRCT W/O PEEP

Facility

$49.13

Hospital Charge Code	270689055
Hospital Revenue Code	272
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$24.57
Rate for Payer: Aetna Commercial	$18.67
Rate for Payer: Aetna Medicare Advantage	$14.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.53
Rate for Payer: Cigna Commercial	$24.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.77
Rate for Payer: Oxford Commercial	$9.83
Rate for Payer: Qualcare PPO/HMO/WC	$7.37
Rate for Payer: UnitedHealthcare Commercial	$9.83
Rate for Payer: UnitedHealthcare Community & State	$1.55
Rate for Payer: Wellpoint Medicaid Managed Care	$1.40

CIRCUIT M2M OT CRCT W/O PEEP

Facility

$49.13

Hospital Charge Code	270689055
Hospital Revenue Code	272
Min. Negotiated Rate	$7.37
Max. Negotiated Rate	$7.37
Rate for Payer: Qualcare PPO/HMO/WC	$7.37

CIRCUIT M2M OT CRCT W PEEP

Facility

$49.13

Hospital Charge Code	270689046
Hospital Revenue Code	272
Min. Negotiated Rate	$7.37
Max. Negotiated Rate	$7.37
Rate for Payer: Qualcare PPO/HMO/WC	$7.37

CIRCUIT M2M OT CRCT W PEEP

Facility

$49.13

Hospital Charge Code	270689046
Hospital Revenue Code	272
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$24.57
Rate for Payer: Aetna Commercial	$18.67
Rate for Payer: Aetna Medicare Advantage	$14.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.53
Rate for Payer: Cigna Commercial	$24.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.77
Rate for Payer: Oxford Commercial	$9.83
Rate for Payer: Qualcare PPO/HMO/WC	$7.37
Rate for Payer: UnitedHealthcare Commercial	$9.83
Rate for Payer: UnitedHealthcare Community & State	$1.55
Rate for Payer: Wellpoint Medicaid Managed Care	$1.40

CIRCUIT PATIENT HIGH FLOW DISP

Facility

$510.00

Hospital Charge Code	270664879
Hospital Revenue Code	270
Min. Negotiated Rate	$76.50
Max. Negotiated Rate	$76.50
Rate for Payer: Qualcare PPO/HMO/WC	$76.50

CIRCUIT PATIENT HIGH FLOW DISP

Facility

$510.00

Hospital Charge Code	270664879
Hospital Revenue Code	270
Min. Negotiated Rate	$14.48
Max. Negotiated Rate	$255.00
Rate for Payer: Aetna Commercial	$193.80
Rate for Payer: Aetna Medicare Advantage	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.05
Rate for Payer: Cigna Commercial	$255.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.60
Rate for Payer: Oxford Commercial	$102.00
Rate for Payer: Qualcare PPO/HMO/WC	$76.50
Rate for Payer: UnitedHealthcare Commercial	$102.00
Rate for Payer: UnitedHealthcare Community & State	$16.12
Rate for Payer: Wellpoint Medicaid Managed Care	$14.48

CIRCUIT PATIENT LOW FLOW DISP

Facility

$500.00

Hospital Charge Code	270664880
Hospital Revenue Code	270
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

CIRCUIT PATIENT LOW FLOW DISP

Facility

$500.00

Hospital Charge Code	270664880
Hospital Revenue Code	270
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$100.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

CIRCUIT PORT VNT 36HS

Facility

$15.25

Hospital Charge Code	270689036
Hospital Revenue Code	272
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$7.62
Rate for Payer: Aetna Commercial	$5.79
Rate for Payer: Aetna Medicare Advantage	$4.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.89
Rate for Payer: Cigna Commercial	$7.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.96
Rate for Payer: Oxford Commercial	$3.05
Rate for Payer: Qualcare PPO/HMO/WC	$2.29
Rate for Payer: UnitedHealthcare Commercial	$3.05
Rate for Payer: UnitedHealthcare Community & State	$0.48
Rate for Payer: Wellpoint Medicaid Managed Care	$0.43

CIRCUIT PORT VNT 36HS

Facility

$15.25

Hospital Charge Code	270689036
Hospital Revenue Code	272
Min. Negotiated Rate	$2.29
Max. Negotiated Rate	$2.29
Rate for Payer: Qualcare PPO/HMO/WC	$2.29

CIRCUIT PT W/ PEPP 22MM

Facility

$118.00

Hospital Charge Code	270688987
Hospital Revenue Code	272
Min. Negotiated Rate	$3.35
Max. Negotiated Rate	$59.00
Rate for Payer: Aetna Commercial	$44.84
Rate for Payer: Aetna Medicare Advantage	$35.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.09
Rate for Payer: Cigna Commercial	$59.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.68
Rate for Payer: Oxford Commercial	$23.60
Rate for Payer: Qualcare PPO/HMO/WC	$17.70
Rate for Payer: UnitedHealthcare Commercial	$23.60
Rate for Payer: UnitedHealthcare Community & State	$3.73
Rate for Payer: Wellpoint Medicaid Managed Care	$3.35

CIRCUIT PT W/ PEPP 22MM

Facility

$118.00

Hospital Charge Code	270688987
Hospital Revenue Code	272
Min. Negotiated Rate	$17.70
Max. Negotiated Rate	$17.70
Rate for Payer: Qualcare PPO/HMO/WC	$17.70

CIRCUIT RESP HEATED INFANT

Facility

$183.73

Hospital Charge Code	270651823
Hospital Revenue Code	270
Min. Negotiated Rate	$5.22
Max. Negotiated Rate	$91.86
Rate for Payer: Aetna Commercial	$69.82
Rate for Payer: Aetna Medicare Advantage	$55.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.85
Rate for Payer: Cigna Commercial	$91.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.77
Rate for Payer: Oxford Commercial	$36.75
Rate for Payer: Qualcare PPO/HMO/WC	$27.56
Rate for Payer: UnitedHealthcare Commercial	$36.75
Rate for Payer: UnitedHealthcare Community & State	$5.81
Rate for Payer: Wellpoint Medicaid Managed Care	$5.22

CIRCUIT RESP HEATED INFANT

Facility

$183.73

Hospital Charge Code	270651823
Hospital Revenue Code	270
Min. Negotiated Rate	$27.56
Max. Negotiated Rate	$27.56
Rate for Payer: Qualcare PPO/HMO/WC	$27.56

CIRCUIT VENT ADULT CROSS DISP

Facility

$103.35

Hospital Charge Code	270668502
Hospital Revenue Code	270
Min. Negotiated Rate	$2.94
Max. Negotiated Rate	$51.67
Rate for Payer: Aetna Commercial	$39.27
Rate for Payer: Aetna Medicare Advantage	$31.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.35
Rate for Payer: Cigna Commercial	$51.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.87
Rate for Payer: Oxford Commercial	$20.67
Rate for Payer: Qualcare PPO/HMO/WC	$15.50
Rate for Payer: UnitedHealthcare Commercial	$20.67
Rate for Payer: UnitedHealthcare Community & State	$3.27
Rate for Payer: Wellpoint Medicaid Managed Care	$2.94

CIRCUIT VENT ADULT CROSS DISP

Facility

$103.35

Hospital Charge Code	270668502
Hospital Revenue Code	270
Min. Negotiated Rate	$15.50
Max. Negotiated Rate	$15.50
Rate for Payer: Qualcare PPO/HMO/WC	$15.50

CIRCUIT VENTED UNIVERSAL

Facility

$60.00

Hospital Charge Code	270331646
Hospital Revenue Code	272
Min. Negotiated Rate	$1.70
Max. Negotiated Rate	$30.00
Rate for Payer: Aetna Commercial	$22.80
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Commercial	$12.00
Rate for Payer: UnitedHealthcare Community & State	$1.90
Rate for Payer: Wellpoint Medicaid Managed Care	$1.70

CIRCUIT VENTED UNIVERSAL

Facility

$60.00

Hospital Charge Code	270331646
Hospital Revenue Code	272
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

CIRCUIT VENTILATOR ADULT WIRE

Facility

$128.66

Hospital Charge Code	270655447
Hospital Revenue Code	270
Min. Negotiated Rate	$19.30
Max. Negotiated Rate	$19.30
Rate for Payer: Qualcare PPO/HMO/WC	$19.30

CIRCUIT VENTILATOR ADULT WIRE

Facility

$128.66

Hospital Charge Code	270655447
Hospital Revenue Code	270
Min. Negotiated Rate	$3.65
Max. Negotiated Rate	$64.33
Rate for Payer: Aetna Commercial	$48.89
Rate for Payer: Aetna Medicare Advantage	$38.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.81
Rate for Payer: Cigna Commercial	$64.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.45
Rate for Payer: Oxford Commercial	$25.73
Rate for Payer: Qualcare PPO/HMO/WC	$19.30
Rate for Payer: UnitedHealthcare Commercial	$25.73
Rate for Payer: UnitedHealthcare Community & State	$4.07
Rate for Payer: Wellpoint Medicaid Managed Care	$3.65

CIRCUIT VENTILATOR BIPAP

Facility

$33.45

Hospital Charge Code	270655449
Hospital Revenue Code	270
Min. Negotiated Rate	$5.02
Max. Negotiated Rate	$5.02
Rate for Payer: Qualcare PPO/HMO/WC	$5.02

Know your out-of-pocket cost for care.

All Charges