Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CLIPS RANYE DISP.

Facility

$11.59

Hospital Charge Code	270600322
Hospital Revenue Code	272
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$1.74
Rate for Payer: Qualcare PPO/HMO/WC	$1.74

CLIP STIMULATING SAFEOP STER

Facility

$2,437.50

Hospital Charge Code	270698066
Hospital Revenue Code	272
Min. Negotiated Rate	$365.62
Max. Negotiated Rate	$365.62
Rate for Payer: Qualcare PPO/HMO/WC	$365.62

CLIP STIMULATING SAFEOP STER

Facility

$2,437.50

Hospital Charge Code	270698066
Hospital Revenue Code	272
Min. Negotiated Rate	$69.22
Max. Negotiated Rate	$1,218.75
Rate for Payer: Aetna Commercial	$926.25
Rate for Payer: Aetna Medicare Advantage	$731.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$621.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$621.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$621.56
Rate for Payer: Cigna Commercial	$1,218.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$633.75
Rate for Payer: Oxford Commercial	$487.50
Rate for Payer: Qualcare PPO/HMO/WC	$365.62
Rate for Payer: UnitedHealthcare Commercial	$487.50
Rate for Payer: UnitedHealthcare Community & State	$77.03
Rate for Payer: Wellpoint Medicaid Managed Care	$69.22

CLIP SURGICAL SPRING INSERT 6M

Facility

$43.98

Hospital Charge Code	270690348
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$21.99
Rate for Payer: Aetna Commercial	$16.71
Rate for Payer: Aetna Medicare Advantage	$13.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.21
Rate for Payer: Cigna Commercial	$21.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.43
Rate for Payer: Oxford Commercial	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$8.80
Rate for Payer: UnitedHealthcare Community & State	$1.39
Rate for Payer: Wellpoint Medicaid Managed Care	$1.25

CLIP SURGICAL SPRING INSERT 6M

Facility

$43.98

Hospital Charge Code	270690348
Hospital Revenue Code	272
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

CLIP TITANIUM LARGE

Facility

$24.88

Service Code	HCPCS C1713
Hospital Charge Code	270669638
Hospital Revenue Code	278
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$6.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.02
Rate for Payer: Qualcare PPO/HMO/WC	$3.73

CLIP TITANIUM LARGE

Facility

$24.88

Service Code	HCPCS C1713
Hospital Charge Code	270669638
Hospital Revenue Code	278
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$12.44
Rate for Payer: Aetna Commercial	$9.45
Rate for Payer: Aetna Medicare Advantage	$7.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.34
Rate for Payer: Cigna Commercial	$12.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.02
Rate for Payer: Qualcare PPO/HMO/WC	$3.73
Rate for Payer: UnitedHealthcare Community & State	$0.79
Rate for Payer: Wellpoint Medicaid Managed Care	$0.71

CLIP TITANIUM MED/LARGE

Facility

$17.43

Hospital Charge Code	270669637
Hospital Revenue Code	278
Min. Negotiated Rate	$2.61
Max. Negotiated Rate	$4.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.22
Rate for Payer: Qualcare PPO/HMO/WC	$2.61

CLIP TITANIUM MED/LARGE

Facility

$17.43

Hospital Charge Code	270669637
Hospital Revenue Code	278
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$8.71
Rate for Payer: Aetna Commercial	$6.62
Rate for Payer: Aetna Medicare Advantage	$5.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.44
Rate for Payer: Cigna Commercial	$8.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.22
Rate for Payer: Qualcare PPO/HMO/WC	$2.61
Rate for Payer: UnitedHealthcare Community & State	$0.55
Rate for Payer: Wellpoint Medicaid Managed Care	$0.50

CLIP TITANIUM WIDE SMALL

Facility

$40.04

Hospital Charge Code	270669636
Hospital Revenue Code	272
Min. Negotiated Rate	$6.01
Max. Negotiated Rate	$6.01
Rate for Payer: Qualcare PPO/HMO/WC	$6.01

CLIP TITANIUM WIDE SMALL

Facility

$40.04

Hospital Charge Code	270669636
Hospital Revenue Code	272
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$20.02
Rate for Payer: Aetna Commercial	$15.22
Rate for Payer: Aetna Medicare Advantage	$12.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.21
Rate for Payer: Cigna Commercial	$20.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.41
Rate for Payer: Oxford Commercial	$8.01
Rate for Payer: Qualcare PPO/HMO/WC	$6.01
Rate for Payer: UnitedHealthcare Commercial	$8.01
Rate for Payer: UnitedHealthcare Community & State	$1.27
Rate for Payer: Wellpoint Medicaid Managed Care	$1.14

CLIP X-LARGE

Facility

$65.65

Hospital Charge Code	270665215
Hospital Revenue Code	272
Min. Negotiated Rate	$1.86
Max. Negotiated Rate	$32.83
Rate for Payer: Aetna Commercial	$24.95
Rate for Payer: Aetna Medicare Advantage	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.74
Rate for Payer: Cigna Commercial	$32.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.07
Rate for Payer: Oxford Commercial	$13.13
Rate for Payer: Qualcare PPO/HMO/WC	$9.85
Rate for Payer: UnitedHealthcare Commercial	$13.13
Rate for Payer: UnitedHealthcare Community & State	$2.07
Rate for Payer: Wellpoint Medicaid Managed Care	$1.86

CLIP X-LARGE

Facility

$65.65

Hospital Charge Code	270665215
Hospital Revenue Code	272
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$9.85
Rate for Payer: Qualcare PPO/HMO/WC	$9.85

CLL IGVH MUTATION,CELL

Facility

$2,125.00

Service Code	HCPCS 81263
Hospital Charge Code	401081263
Hospital Revenue Code	310
Min. Negotiated Rate	$318.75
Max. Negotiated Rate	$318.75
Rate for Payer: Qualcare PPO/HMO/WC	$318.75

CLL IGVH MUTATION,CELL

Facility

$2,125.00

Service Code	HCPCS 81263
Hospital Charge Code	401081263
Hospital Revenue Code	310
Min. Negotiated Rate	$60.35
Max. Negotiated Rate	$1,068.37
Rate for Payer: Aetna Commercial	$801.09
Rate for Payer: Aetna Medicare Advantage	$954.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,068.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,068.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$294.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,068.37
Rate for Payer: Cigna Commercial	$1,062.50
Rate for Payer: Cigna Medicare Advantage	$294.52
Rate for Payer: Clover Medicare Advantage	$279.79
Rate for Payer: EmblemHealth Commercial	$883.56
Rate for Payer: Humana Medicare Advantage	$303.36
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$294.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.50
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$318.75
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$235.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$294.52
Rate for Payer: Wellcare Medicare Advantage	$294.52
Rate for Payer: Wellpoint Medicaid Managed Care	$60.35

CLMP MULTI PIN LARGE

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270699322
Hospital Revenue Code	278
Min. Negotiated Rate	$56.80
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Community & State	$63.20
Rate for Payer: Wellpoint Medicaid Managed Care	$56.80

CLMP MULTI PIN LARGE

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270699322
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

CLN CONSULTATION MINIMUM

Facility

$290.00

Service Code	HCPCS 99241
Hospital Charge Code	75190235
Hospital Revenue Code	510
Min. Negotiated Rate	$43.50
Max. Negotiated Rate	$43.50
Rate for Payer: Qualcare PPO/HMO/WC	$43.50

CLN CONSULTATION MINIMUM

Facility

$290.00

Service Code	HCPCS 99241
Hospital Charge Code	75190235
Hospital Revenue Code	510
Min. Negotiated Rate	$8.24
Max. Negotiated Rate	$145.00
Rate for Payer: Aetna Commercial	$110.20
Rate for Payer: Aetna Medicare Advantage	$87.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.95
Rate for Payer: Cigna Commercial	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.40
Rate for Payer: Qualcare PPO/HMO/WC	$43.50
Rate for Payer: UnitedHealthcare Community & State	$9.16
Rate for Payer: Wellpoint Medicaid Managed Care	$8.24

CLN DEBRD SKN FULL THICKNESS

Facility

$545.00

Hospital Charge Code	75190015
Hospital Revenue Code	761
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$81.75
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

CLN DEBRD SKN FULL THICKNESS

Facility

$545.00

Hospital Charge Code	75190015
Hospital Revenue Code	761
Min. Negotiated Rate	$15.48
Max. Negotiated Rate	$272.50
Rate for Payer: Aetna Commercial	$207.10
Rate for Payer: Aetna Medicare Advantage	$163.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.97
Rate for Payer: Cigna Commercial	$272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.70
Rate for Payer: Oxford Commercial	$109.00
Rate for Payer: Qualcare PPO/HMO/WC	$81.75
Rate for Payer: UnitedHealthcare Commercial	$109.00
Rate for Payer: UnitedHealthcare Community & State	$17.22
Rate for Payer: Wellpoint Medicaid Managed Care	$15.48

CLN DEBRD SKN PRTL THICKNESS

Facility

$545.00

Service Code	HCPCS 11040
Hospital Charge Code	75190010
Hospital Revenue Code	761
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$81.75
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

CLN DEBRD SKN PRTL THICKNESS

Facility

$545.00

Service Code	HCPCS 11040
Hospital Charge Code	75190010
Hospital Revenue Code	761
Min. Negotiated Rate	$15.48
Max. Negotiated Rate	$272.50
Rate for Payer: Aetna Commercial	$207.10
Rate for Payer: Aetna Medicare Advantage	$163.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.97
Rate for Payer: Cigna Commercial	$272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.70
Rate for Payer: Oxford Commercial	$109.00
Rate for Payer: Qualcare PPO/HMO/WC	$81.75
Rate for Payer: UnitedHealthcare Commercial	$109.00
Rate for Payer: UnitedHealthcare Community & State	$17.22
Rate for Payer: Wellpoint Medicaid Managed Care	$15.48

CLN DEBRD SKN & SUBCUT TISSUE

Facility

$1,117.00

Service Code	HCPCS 11042
Hospital Charge Code	75190020
Hospital Revenue Code	761
Min. Negotiated Rate	$167.55
Max. Negotiated Rate	$167.55
Rate for Payer: Qualcare PPO/HMO/WC	$167.55

CLN DEBRD SKN & SUBCUT TISSUE

Facility

$1,117.00

Service Code	HCPCS 11042
Hospital Charge Code	75190020
Hospital Revenue Code	761
Min. Negotiated Rate	$31.72
Max. Negotiated Rate	$1,751.90
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,751.90
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.42
Rate for Payer: Oxford Commercial	$223.40
Rate for Payer: Qualcare PPO/HMO/WC	$167.55
Rate for Payer: UnitedHealthcare Commercial	$223.40
Rate for Payer: UnitedHealthcare Community & State	$35.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74
Rate for Payer: Wellpoint Medicaid Managed Care	$31.72

Know your out-of-pocket cost for care.

All Charges