Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CLEANER SKIN CAVILON 8OZ 3380

Facility

$10.00

Hospital Charge Code	270641326W
Hospital Revenue Code	272
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$5.00
Rate for Payer: Aetna Commercial	$3.80
Rate for Payer: Aetna Medicare Advantage	$3.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.55
Rate for Payer: Cigna Commercial	$5.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.60
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.50
Rate for Payer: UnitedHealthcare Commercial	$2.00
Rate for Payer: UnitedHealthcare Community & State	$0.32
Rate for Payer: Wellpoint Medicaid Managed Care	$0.28

CLEANER STAINLESS STEEL 18OZ

Facility

$27.95

Hospital Charge Code	270665154
Hospital Revenue Code	270
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$13.97
Rate for Payer: Aetna Commercial	$10.62
Rate for Payer: Aetna Medicare Advantage	$8.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.13
Rate for Payer: Cigna Commercial	$13.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.27
Rate for Payer: Oxford Commercial	$5.59
Rate for Payer: Qualcare PPO/HMO/WC	$4.19
Rate for Payer: UnitedHealthcare Commercial	$5.59
Rate for Payer: UnitedHealthcare Community & State	$0.88
Rate for Payer: Wellpoint Medicaid Managed Care	$0.79

CLEANER STAINLESS STEEL 18OZ

Facility

$27.95

Hospital Charge Code	270665154
Hospital Revenue Code	270
Min. Negotiated Rate	$4.19
Max. Negotiated Rate	$4.19
Rate for Payer: Qualcare PPO/HMO/WC	$4.19

CLEANERXT THR SYSTEM 6Fx135cm

Facility

$4,250.00

Hospital Charge Code	270678568N
Hospital Revenue Code	272
Min. Negotiated Rate	$637.50
Max. Negotiated Rate	$637.50
Rate for Payer: Qualcare PPO/HMO/WC	$637.50

CLEANERXT THR SYSTEM 6Fx135cm

Facility

$4,250.00

Hospital Charge Code	270678568N
Hospital Revenue Code	272
Min. Negotiated Rate	$120.70
Max. Negotiated Rate	$2,125.00
Rate for Payer: Aetna Commercial	$1,615.00
Rate for Payer: Aetna Medicare Advantage	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,083.75
Rate for Payer: Cigna Commercial	$2,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,105.00
Rate for Payer: Oxford Commercial	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$637.50
Rate for Payer: UnitedHealthcare Commercial	$850.00
Rate for Payer: UnitedHealthcare Community & State	$134.30
Rate for Payer: Wellpoint Medicaid Managed Care	$120.70

CLEANERXT THR SYSTEM 6Fx135cm

Facility

$4,250.00

Hospital Charge Code	270678568
Hospital Revenue Code	272
Min. Negotiated Rate	$120.70
Max. Negotiated Rate	$2,125.00
Rate for Payer: Aetna Commercial	$1,615.00
Rate for Payer: Aetna Medicare Advantage	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,083.75
Rate for Payer: Cigna Commercial	$2,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,105.00
Rate for Payer: Oxford Commercial	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$637.50
Rate for Payer: UnitedHealthcare Commercial	$850.00
Rate for Payer: UnitedHealthcare Community & State	$134.30
Rate for Payer: Wellpoint Medicaid Managed Care	$120.70

CLEANERXT THR SYSTEM 6Fx135cm

Facility

$4,250.00

Hospital Charge Code	270678568
Hospital Revenue Code	272
Min. Negotiated Rate	$637.50
Max. Negotiated Rate	$637.50
Rate for Payer: Qualcare PPO/HMO/WC	$637.50

CLEANERXT THR SYSTEM 6Fx65cm

Facility

$2,750.00

Hospital Charge Code	270678567N
Hospital Revenue Code	272
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

CLEANERXT THR SYSTEM 6Fx65cm

Facility

$2,750.00

Hospital Charge Code	270678567N
Hospital Revenue Code	272
Min. Negotiated Rate	$78.10
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$1,045.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$715.00
Rate for Payer: Oxford Commercial	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50
Rate for Payer: UnitedHealthcare Commercial	$550.00
Rate for Payer: UnitedHealthcare Community & State	$86.90
Rate for Payer: Wellpoint Medicaid Managed Care	$78.10

CLEANERXT THR SYSTEM 6Fx65cm

Facility

$2,750.00

Hospital Charge Code	270678567
Hospital Revenue Code	272
Min. Negotiated Rate	$78.10
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$1,045.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$715.00
Rate for Payer: Oxford Commercial	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50
Rate for Payer: UnitedHealthcare Commercial	$550.00
Rate for Payer: UnitedHealthcare Community & State	$86.90
Rate for Payer: Wellpoint Medicaid Managed Care	$78.10

CLEANERXT THR SYSTEM 6Fx65cm

Facility

$2,750.00

Hospital Charge Code	270678567
Hospital Revenue Code	272
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

CLEANING ADAPTER

Facility

$165.00

Hospital Charge Code	270665253
Hospital Revenue Code	270
Min. Negotiated Rate	$24.75
Max. Negotiated Rate	$24.75
Rate for Payer: Qualcare PPO/HMO/WC	$24.75

CLEANING ADAPTER

Facility

$165.00

Hospital Charge Code	270665253
Hospital Revenue Code	270
Min. Negotiated Rate	$4.69
Max. Negotiated Rate	$82.50
Rate for Payer: Aetna Commercial	$62.70
Rate for Payer: Aetna Medicare Advantage	$49.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.08
Rate for Payer: Cigna Commercial	$82.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.90
Rate for Payer: Oxford Commercial	$33.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.75
Rate for Payer: UnitedHealthcare Commercial	$33.00
Rate for Payer: UnitedHealthcare Community & State	$5.21
Rate for Payer: Wellpoint Medicaid Managed Care	$4.69

CLEAN KIT D

Facility

$939.20

Hospital Charge Code	270665979
Hospital Revenue Code	270
Min. Negotiated Rate	$26.67
Max. Negotiated Rate	$469.60
Rate for Payer: Aetna Commercial	$356.90
Rate for Payer: Aetna Medicare Advantage	$281.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$239.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$239.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$239.50
Rate for Payer: Cigna Commercial	$469.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$244.19
Rate for Payer: Oxford Commercial	$187.84
Rate for Payer: Qualcare PPO/HMO/WC	$140.88
Rate for Payer: UnitedHealthcare Commercial	$187.84
Rate for Payer: UnitedHealthcare Community & State	$29.68
Rate for Payer: Wellpoint Medicaid Managed Care	$26.67

CLEAN KIT D

Facility

$939.20

Hospital Charge Code	270665979
Hospital Revenue Code	270
Min. Negotiated Rate	$140.88
Max. Negotiated Rate	$140.88
Rate for Payer: Qualcare PPO/HMO/WC	$140.88

CLEANSER SKINTEGY 16oz MSC6016

Facility

$20.11

Hospital Charge Code	270640866
Hospital Revenue Code	272
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$10.05
Rate for Payer: Aetna Commercial	$7.64
Rate for Payer: Aetna Medicare Advantage	$6.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.13
Rate for Payer: Cigna Commercial	$10.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.23
Rate for Payer: Oxford Commercial	$4.02
Rate for Payer: Qualcare PPO/HMO/WC	$3.02
Rate for Payer: UnitedHealthcare Commercial	$4.02
Rate for Payer: UnitedHealthcare Community & State	$0.64
Rate for Payer: Wellpoint Medicaid Managed Care	$0.57

CLEANSER SKINTEGY 16oz MSC6016

Facility

$20.11

Hospital Charge Code	270640866
Hospital Revenue Code	272
Min. Negotiated Rate	$3.02
Max. Negotiated Rate	$3.02
Rate for Payer: Qualcare PPO/HMO/WC	$3.02

CLEARCUT SLIT KNIFE

Facility

$245.00

Hospital Charge Code	270659720
Hospital Revenue Code	272
Min. Negotiated Rate	$6.96
Max. Negotiated Rate	$122.50
Rate for Payer: Aetna Commercial	$93.10
Rate for Payer: Aetna Medicare Advantage	$73.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.48
Rate for Payer: Cigna Commercial	$122.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.70
Rate for Payer: Oxford Commercial	$49.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.75
Rate for Payer: UnitedHealthcare Commercial	$49.00
Rate for Payer: UnitedHealthcare Community & State	$7.74
Rate for Payer: Wellpoint Medicaid Managed Care	$6.96

CLEARCUT SLIT KNIFE

Facility

$245.00

Hospital Charge Code	270659720
Hospital Revenue Code	272
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$36.75
Rate for Payer: Qualcare PPO/HMO/WC	$36.75

CLEARMIX SINGLE DOUBLE MIX

Facility

$625.00

Hospital Charge Code	270683515
Hospital Revenue Code	272
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

CLEARMIX SINGLE DOUBLE MIX

Facility

$625.00

Hospital Charge Code	270683515
Hospital Revenue Code	272
Min. Negotiated Rate	$17.75
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.50
Rate for Payer: Oxford Commercial	$125.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Commercial	$125.00
Rate for Payer: UnitedHealthcare Community & State	$19.75
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

CLEARMIX TRIPLE MIX

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270686539
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$175.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

CLEARMIX TRIPLE MIX

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270686539
Hospital Revenue Code	278
Min. Negotiated Rate	$20.59
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$275.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75
Rate for Payer: UnitedHealthcare Community & State	$22.91
Rate for Payer: Wellpoint Medicaid Managed Care	$20.59

CLEFT LIP AND PALATE REPAIR

Facility

$11,410.64

Service Code	APR-DRG 0951
Min. Negotiated Rate	$11,186.90
Max. Negotiated Rate	$11,410.64
Rate for Payer: UnitedHealthcare Community & State	$11,186.90
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,410.64
Rate for Payer: Wellpoint Medicaid Managed Care	$11,186.90

CLEFT LIP AND PALATE REPAIR

Facility

$12,807.96

Service Code	APR-DRG 0952
Min. Negotiated Rate	$12,556.82
Max. Negotiated Rate	$12,807.96
Rate for Payer: UnitedHealthcare Community & State	$12,556.82
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,807.96
Rate for Payer: Wellpoint Medicaid Managed Care	$12,556.82

Know your out-of-pocket cost for care.

All Charges