Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CLAMP RF SPIN DOWN 16MM

Facility

$2,020.00

Hospital Charge Code	270662173
Hospital Revenue Code	272
Min. Negotiated Rate	$303.00
Max. Negotiated Rate	$303.00
Rate for Payer: Qualcare PPO/HMO/WC	$303.00

CLAMP RF SPIN DOWN 16MM

Facility

$2,020.00

Hospital Charge Code	270662173
Hospital Revenue Code	272
Min. Negotiated Rate	$57.37
Max. Negotiated Rate	$1,010.00
Rate for Payer: Aetna Commercial	$767.60
Rate for Payer: Aetna Medicare Advantage	$606.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$515.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$515.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$515.10
Rate for Payer: Cigna Commercial	$1,010.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$525.20
Rate for Payer: Oxford Commercial	$404.00
Rate for Payer: Qualcare PPO/HMO/WC	$303.00
Rate for Payer: UnitedHealthcare Commercial	$404.00
Rate for Payer: UnitedHealthcare Community & State	$63.83
Rate for Payer: Wellpoint Medicaid Managed Care	$57.37

CLAMP RF SPINDOWN 20MM

Facility

$2,270.00

Service Code	HCPCS C1713
Hospital Charge Code	270662174
Hospital Revenue Code	278
Min. Negotiated Rate	$64.47
Max. Negotiated Rate	$1,135.00
Rate for Payer: Aetna Commercial	$862.60
Rate for Payer: Aetna Medicare Advantage	$681.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$578.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$578.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$454.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$578.85
Rate for Payer: Cigna Commercial	$1,135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$549.34
Rate for Payer: Qualcare PPO/HMO/WC	$340.50
Rate for Payer: UnitedHealthcare Community & State	$71.73
Rate for Payer: Wellpoint Medicaid Managed Care	$64.47

CLAMP RF SPINDOWN 20MM

Facility

$2,270.00

Service Code	HCPCS C1713
Hospital Charge Code	270662174
Hospital Revenue Code	278
Min. Negotiated Rate	$340.50
Max. Negotiated Rate	$549.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$454.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$549.34
Rate for Payer: Qualcare PPO/HMO/WC	$340.50

CLAMP ROD ATTACH LG MULTI PIN

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270699323
Hospital Revenue Code	278
Min. Negotiated Rate	$53.25
Max. Negotiated Rate	$937.50
Rate for Payer: Aetna Commercial	$712.50
Rate for Payer: Aetna Medicare Advantage	$562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.12
Rate for Payer: Cigna Commercial	$937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: Qualcare PPO/HMO/WC	$281.25
Rate for Payer: UnitedHealthcare Community & State	$59.25
Rate for Payer: Wellpoint Medicaid Managed Care	$53.25

CLAMP ROD ATTACH LG MULTI PIN

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270699323
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$453.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

CLAMP SM EXT FIX 4x2.5mm

Facility

$1,435.40

Hospital Charge Code	270601817
Hospital Revenue Code	272
Min. Negotiated Rate	$215.31
Max. Negotiated Rate	$215.31
Rate for Payer: Qualcare PPO/HMO/WC	$215.31

CLAMP SM EXT FIX 4x2.5mm

Facility

$1,435.40

Hospital Charge Code	270601817
Hospital Revenue Code	272
Min. Negotiated Rate	$40.77
Max. Negotiated Rate	$717.70
Rate for Payer: Aetna Commercial	$545.45
Rate for Payer: Aetna Medicare Advantage	$430.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$366.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$366.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$366.03
Rate for Payer: Cigna Commercial	$717.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$373.20
Rate for Payer: Oxford Commercial	$287.08
Rate for Payer: Qualcare PPO/HMO/WC	$215.31
Rate for Payer: UnitedHealthcare Commercial	$287.08
Rate for Payer: UnitedHealthcare Community & State	$45.36
Rate for Payer: Wellpoint Medicaid Managed Care	$40.77

CLAMP SOFT JAW SPRING

Facility

$121.00

Hospital Charge Code	270335198
Hospital Revenue Code	272
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$18.15

CLAMP SOFT JAW SPRING

Facility

$121.00

Hospital Charge Code	270335198
Hospital Revenue Code	272
Min. Negotiated Rate	$3.44
Max. Negotiated Rate	$60.50
Rate for Payer: Aetna Commercial	$45.98
Rate for Payer: Aetna Medicare Advantage	$36.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.86
Rate for Payer: Cigna Commercial	$60.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.46
Rate for Payer: Oxford Commercial	$24.20
Rate for Payer: Qualcare PPO/HMO/WC	$18.15
Rate for Payer: UnitedHealthcare Commercial	$24.20
Rate for Payer: UnitedHealthcare Community & State	$3.82
Rate for Payer: Wellpoint Medicaid Managed Care	$3.44

CLAMP TRANSVERSE

Facility

$3,021.00

Hospital Charge Code	270656307
Hospital Revenue Code	272
Min. Negotiated Rate	$453.15
Max. Negotiated Rate	$453.15
Rate for Payer: Qualcare PPO/HMO/WC	$453.15

CLAMP TRANSVERSE

Facility

$3,021.00

Hospital Charge Code	270656307
Hospital Revenue Code	272
Min. Negotiated Rate	$85.80
Max. Negotiated Rate	$1,510.50
Rate for Payer: Aetna Commercial	$1,147.98
Rate for Payer: Aetna Medicare Advantage	$906.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$770.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$770.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$770.36
Rate for Payer: Cigna Commercial	$1,510.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$785.46
Rate for Payer: Oxford Commercial	$604.20
Rate for Payer: Qualcare PPO/HMO/WC	$453.15
Rate for Payer: UnitedHealthcare Commercial	$604.20
Rate for Payer: UnitedHealthcare Community & State	$95.46
Rate for Payer: Wellpoint Medicaid Managed Care	$85.80

CLAMP VACUSTAT ANG 1001-501

Facility

$50.50

Hospital Charge Code	270612954
Hospital Revenue Code	272
Min. Negotiated Rate	$7.58
Max. Negotiated Rate	$7.58
Rate for Payer: Qualcare PPO/HMO/WC	$7.58

CLAMP VACUSTAT ANG 1001-501

Facility

$50.50

Hospital Charge Code	270612954
Hospital Revenue Code	272
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$25.25
Rate for Payer: Aetna Commercial	$19.19
Rate for Payer: Aetna Medicare Advantage	$15.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.88
Rate for Payer: Cigna Commercial	$25.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.13
Rate for Payer: Oxford Commercial	$10.10
Rate for Payer: Qualcare PPO/HMO/WC	$7.58
Rate for Payer: UnitedHealthcare Commercial	$10.10
Rate for Payer: UnitedHealthcare Community & State	$1.60
Rate for Payer: Wellpoint Medicaid Managed Care	$1.43

CLAMP VACUSTAT STR 1001-500

Facility

$34.70

Hospital Charge Code	270612953
Hospital Revenue Code	272
Min. Negotiated Rate	$5.21
Max. Negotiated Rate	$5.21
Rate for Payer: Qualcare PPO/HMO/WC	$5.21

CLAMP VACUSTAT STR 1001-500

Facility

$34.70

Hospital Charge Code	270612953
Hospital Revenue Code	272
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$17.35
Rate for Payer: Aetna Commercial	$13.19
Rate for Payer: Aetna Medicare Advantage	$10.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.85
Rate for Payer: Cigna Commercial	$17.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.02
Rate for Payer: Oxford Commercial	$6.94
Rate for Payer: Qualcare PPO/HMO/WC	$5.21
Rate for Payer: UnitedHealthcare Commercial	$6.94
Rate for Payer: UnitedHealthcare Community & State	$1.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.99

CLAMP W/CRIMP 1.0x750MM

Facility

$2,145.15

Hospital Charge Code	270674357
Hospital Revenue Code	272
Min. Negotiated Rate	$60.92
Max. Negotiated Rate	$1,072.58
Rate for Payer: Aetna Commercial	$815.16
Rate for Payer: Aetna Medicare Advantage	$643.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$547.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$547.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$547.01
Rate for Payer: Cigna Commercial	$1,072.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$557.74
Rate for Payer: Oxford Commercial	$429.03
Rate for Payer: Qualcare PPO/HMO/WC	$321.77
Rate for Payer: UnitedHealthcare Commercial	$429.03
Rate for Payer: UnitedHealthcare Community & State	$67.79
Rate for Payer: Wellpoint Medicaid Managed Care	$60.92

CLAMP W/CRIMP 1.0x750MM

Facility

$2,145.15

Hospital Charge Code	270674357
Hospital Revenue Code	272
Min. Negotiated Rate	$321.77
Max. Negotiated Rate	$321.77
Rate for Payer: Qualcare PPO/HMO/WC	$321.77

CLAMP W/CRIMP 1.0X750MM

Facility

$2,940.55

Hospital Charge Code	674357
Hospital Revenue Code	278
Min. Negotiated Rate	$441.08
Max. Negotiated Rate	$711.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$588.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$711.61
Rate for Payer: Qualcare PPO/HMO/WC	$441.08

CLAMP W/CRIMP 1.0X750MM

Facility

$2,940.55

Hospital Charge Code	674357
Hospital Revenue Code	278
Min. Negotiated Rate	$83.51
Max. Negotiated Rate	$1,470.28
Rate for Payer: Aetna Commercial	$1,117.41
Rate for Payer: Aetna Medicare Advantage	$882.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$749.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$749.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$588.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$749.84
Rate for Payer: Cigna Commercial	$1,470.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$711.61
Rate for Payer: Qualcare PPO/HMO/WC	$441.08
Rate for Payer: UnitedHealthcare Community & State	$92.92
Rate for Payer: Wellpoint Medicaid Managed Care	$83.51

CLARITHROMYCIN 250 MG TAB

Facility

$40.33

Service Code	NDC 781196160
Hospital Charge Code	6016505
Hospital Revenue Code	250
Min. Negotiated Rate	$1.15
Max. Negotiated Rate	$20.16
Rate for Payer: Aetna Commercial	$15.33
Rate for Payer: Aetna Medicare Advantage	$12.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.28
Rate for Payer: Cigna Commercial	$20.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.49
Rate for Payer: Oxford Commercial	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$6.05
Rate for Payer: UnitedHealthcare Commercial	$8.07
Rate for Payer: UnitedHealthcare Community & State	$1.27
Rate for Payer: Wellpoint Medicaid Managed Care	$1.15

CLARITHROMYCIN 250 MG TAB

Facility

$40.33

Service Code	NDC 781196160
Hospital Charge Code	6016505
Hospital Revenue Code	250
Min. Negotiated Rate	$6.05
Max. Negotiated Rate	$6.05
Rate for Payer: Qualcare PPO/HMO/WC	$6.05

CLARITHROMYCIN 500 MG TAB UD

Facility

$30.28

Service Code	NDC 68382076214
Hospital Charge Code	6016513
Hospital Revenue Code	250
Min. Negotiated Rate	$4.54
Max. Negotiated Rate	$4.54
Rate for Payer: Qualcare PPO/HMO/WC	$4.54

CLARITHROMYCIN 500 MG TAB UD

Facility

$30.28

Service Code	NDC 68382076214
Hospital Charge Code	6016513
Hospital Revenue Code	250
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$15.14
Rate for Payer: Aetna Commercial	$11.51
Rate for Payer: Aetna Medicare Advantage	$9.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.72
Rate for Payer: Cigna Commercial	$15.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.87
Rate for Payer: Oxford Commercial	$6.06
Rate for Payer: Qualcare PPO/HMO/WC	$4.54
Rate for Payer: UnitedHealthcare Commercial	$6.06
Rate for Payer: UnitedHealthcare Community & State	$0.96
Rate for Payer: Wellpoint Medicaid Managed Care	$0.86

CLARITHROMYCN SSP 250MG/5ML50M

Facility

$12.19

Service Code	NDC 74318850
Hospital Charge Code	6017388
Hospital Revenue Code	250
Min. Negotiated Rate	$1.83
Max. Negotiated Rate	$1.83
Rate for Payer: Qualcare PPO/HMO/WC	$1.83

Know your out-of-pocket cost for care.

All Charges