Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CORKSCREW TIGERTAIL 4.5x14MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270674130
Hospital Revenue Code	278
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$417.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

CORKSCREW TIGERTAIL 4.5x14MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270674130
Hospital Revenue Code	278
Min. Negotiated Rate	$48.99
Max. Negotiated Rate	$862.50
Rate for Payer: Aetna Commercial	$655.50
Rate for Payer: Aetna Medicare Advantage	$517.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.88
Rate for Payer: Cigna Commercial	$862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75
Rate for Payer: UnitedHealthcare Community & State	$54.51
Rate for Payer: Wellpoint Medicaid Managed Care	$48.99

CORKSCREW W/SUTURE TAPE 5.5MM

Facility

$1,775.00

Hospital Charge Code	270679782
Hospital Revenue Code	272
Min. Negotiated Rate	$266.25
Max. Negotiated Rate	$266.25
Rate for Payer: Qualcare PPO/HMO/WC	$266.25

CORKSCREW W/SUTURE TAPE 5.5MM

Facility

$1,775.00

Hospital Charge Code	270679782
Hospital Revenue Code	272
Min. Negotiated Rate	$50.41
Max. Negotiated Rate	$887.50
Rate for Payer: Aetna Commercial	$674.50
Rate for Payer: Aetna Medicare Advantage	$532.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$452.62
Rate for Payer: Cigna Commercial	$887.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$461.50
Rate for Payer: Oxford Commercial	$355.00
Rate for Payer: Qualcare PPO/HMO/WC	$266.25
Rate for Payer: UnitedHealthcare Commercial	$355.00
Rate for Payer: UnitedHealthcare Community & State	$56.09
Rate for Payer: Wellpoint Medicaid Managed Care	$50.41

CORNEA

Facility

$19,000.00

Service Code	HCPCS V2785
Hospital Charge Code	270671147
Hospital Revenue Code	810
Min. Negotiated Rate	$539.60
Max. Negotiated Rate	$9,500.00
Rate for Payer: Aetna Commercial	$7,220.00
Rate for Payer: Aetna Medicare Advantage	$5,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,845.00
Rate for Payer: Cigna Commercial	$9,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,940.00
Rate for Payer: Oxford Commercial	$3,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00
Rate for Payer: UnitedHealthcare Commercial	$3,800.00
Rate for Payer: UnitedHealthcare Community & State	$600.40
Rate for Payer: Wellpoint Medicaid Managed Care	$539.60

CORNEA

Facility

$19,000.00

Service Code	HCPCS V2785
Hospital Charge Code	270671147
Hospital Revenue Code	810
Min. Negotiated Rate	$2,850.00
Max. Negotiated Rate	$2,850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00

CORNEA

Facility

$17,500.00

Service Code	HCPCS V2785
Hospital Charge Code	270678203
Hospital Revenue Code	810
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$2,625.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

CORNEA

Facility

$17,500.00

Service Code	HCPCS V2785
Hospital Charge Code	270678203
Hospital Revenue Code	810
Min. Negotiated Rate	$497.00
Max. Negotiated Rate	$8,750.00
Rate for Payer: Aetna Commercial	$6,650.00
Rate for Payer: Aetna Medicare Advantage	$5,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,462.50
Rate for Payer: Cigna Commercial	$8,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,550.00
Rate for Payer: Oxford Commercial	$3,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00
Rate for Payer: UnitedHealthcare Commercial	$3,500.00
Rate for Payer: UnitedHealthcare Community & State	$553.00
Rate for Payer: Wellpoint Medicaid Managed Care	$497.00

CORNEA

Facility

$19,000.00

Service Code	HCPCS V2785
Hospital Charge Code	270679263
Hospital Revenue Code	810
Min. Negotiated Rate	$2,850.00
Max. Negotiated Rate	$2,850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00

CORNEA

Facility

$19,000.00

Service Code	HCPCS V2785
Hospital Charge Code	270679263
Hospital Revenue Code	810
Min. Negotiated Rate	$539.60
Max. Negotiated Rate	$9,500.00
Rate for Payer: Aetna Commercial	$7,220.00
Rate for Payer: Aetna Medicare Advantage	$5,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,845.00
Rate for Payer: Cigna Commercial	$9,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,940.00
Rate for Payer: Oxford Commercial	$3,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00
Rate for Payer: UnitedHealthcare Commercial	$3,800.00
Rate for Payer: UnitedHealthcare Community & State	$600.40
Rate for Payer: Wellpoint Medicaid Managed Care	$539.60

CORNEA - 0509-13-01

Facility

$15,500.00

Service Code	HCPCS V2785
Hospital Charge Code	270660412
Hospital Revenue Code	278
Min. Negotiated Rate	$2,325.00
Max. Negotiated Rate	$3,751.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,751.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,325.00

CORNEA - 0509-13-01

Facility

$15,500.00

Service Code	HCPCS V2785
Hospital Charge Code	270660412
Hospital Revenue Code	278
Min. Negotiated Rate	$440.20
Max. Negotiated Rate	$7,750.00
Rate for Payer: Aetna Commercial	$5,890.00
Rate for Payer: Aetna Medicare Advantage	$4,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,952.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,952.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,952.50
Rate for Payer: Cigna Commercial	$7,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,751.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,325.00
Rate for Payer: UnitedHealthcare Community & State	$489.80
Rate for Payer: Wellpoint Medicaid Managed Care	$440.20

CORNEA FULL THICKNES

Facility

$16,750.00

Hospital Charge Code	270678916
Hospital Revenue Code	278
Min. Negotiated Rate	$475.70
Max. Negotiated Rate	$8,375.00
Rate for Payer: Aetna Commercial	$6,365.00
Rate for Payer: Aetna Medicare Advantage	$5,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,271.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,271.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,271.25
Rate for Payer: Cigna Commercial	$8,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,053.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,512.50
Rate for Payer: UnitedHealthcare Community & State	$529.30
Rate for Payer: Wellpoint Medicaid Managed Care	$475.70

CORNEA FULL THICKNES

Facility

$16,750.00

Hospital Charge Code	270678916
Hospital Revenue Code	278
Min. Negotiated Rate	$2,512.50
Max. Negotiated Rate	$4,053.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,053.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,512.50

CORNEA GRAFT DSEK K002-DS

Facility

$21,500.00

Service Code	HCPCS V2785
Hospital Charge Code	270687298
Hospital Revenue Code	810
Min. Negotiated Rate	$610.60
Max. Negotiated Rate	$10,750.00
Rate for Payer: Aetna Commercial	$8,170.00
Rate for Payer: Aetna Medicare Advantage	$6,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,482.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,482.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,482.50
Rate for Payer: Cigna Commercial	$10,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,590.00
Rate for Payer: Oxford Commercial	$4,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,225.00
Rate for Payer: UnitedHealthcare Commercial	$4,300.00
Rate for Payer: UnitedHealthcare Community & State	$679.40
Rate for Payer: Wellpoint Medicaid Managed Care	$610.60

CORNEA GRAFT DSEK K002-DS

Facility

$21,500.00

Service Code	HCPCS V2785
Hospital Charge Code	270687298
Hospital Revenue Code	810
Min. Negotiated Rate	$3,225.00
Max. Negotiated Rate	$3,225.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,225.00

CORNEA HUMAN TISSUE

Facility

$19,000.00

Service Code	HCPCS V2785
Hospital Charge Code	270670868
Hospital Revenue Code	810
Min. Negotiated Rate	$539.60
Max. Negotiated Rate	$9,500.00
Rate for Payer: Aetna Commercial	$7,220.00
Rate for Payer: Aetna Medicare Advantage	$5,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,845.00
Rate for Payer: Cigna Commercial	$9,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,940.00
Rate for Payer: Oxford Commercial	$3,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00
Rate for Payer: UnitedHealthcare Commercial	$3,800.00
Rate for Payer: UnitedHealthcare Community & State	$600.40
Rate for Payer: Wellpoint Medicaid Managed Care	$539.60

CORNEA HUMAN TISSUE

Facility

$19,000.00

Service Code	HCPCS V2785
Hospital Charge Code	270670868
Hospital Revenue Code	810
Min. Negotiated Rate	$2,850.00
Max. Negotiated Rate	$2,850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00

CORNEAL COLLAGEN SHIELD 24HR

Facility

$180.35

Hospital Charge Code	270650815
Hospital Revenue Code	272
Min. Negotiated Rate	$27.05
Max. Negotiated Rate	$27.05
Rate for Payer: Qualcare PPO/HMO/WC	$27.05

CORNEAL COLLAGEN SHIELD 24HR

Facility

$180.35

Hospital Charge Code	270650815
Hospital Revenue Code	272
Min. Negotiated Rate	$5.12
Max. Negotiated Rate	$90.17
Rate for Payer: Aetna Commercial	$68.53
Rate for Payer: Aetna Medicare Advantage	$54.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.99
Rate for Payer: Cigna Commercial	$90.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.89
Rate for Payer: Oxford Commercial	$36.07
Rate for Payer: Qualcare PPO/HMO/WC	$27.05
Rate for Payer: UnitedHealthcare Commercial	$36.07
Rate for Payer: UnitedHealthcare Community & State	$5.70
Rate for Payer: Wellpoint Medicaid Managed Care	$5.12

CORNEAL COLLAGEN SHIELD OASIS

Facility

$16.25

Hospital Charge Code	270655273
Hospital Revenue Code	270
Min. Negotiated Rate	$2.44
Max. Negotiated Rate	$2.44
Rate for Payer: Qualcare PPO/HMO/WC	$2.44

CORNEAL COLLAGEN SHIELD OASIS

Facility

$16.25

Hospital Charge Code	270655273
Hospital Revenue Code	270
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$8.12
Rate for Payer: Aetna Commercial	$6.17
Rate for Payer: Aetna Medicare Advantage	$4.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.14
Rate for Payer: Cigna Commercial	$8.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.22
Rate for Payer: Oxford Commercial	$3.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.44
Rate for Payer: UnitedHealthcare Commercial	$3.25
Rate for Payer: UnitedHealthcare Community & State	$0.51
Rate for Payer: Wellpoint Medicaid Managed Care	$0.46

CORNEAL PROTECTORS

Facility

$66.00

Hospital Charge Code	270335129
Hospital Revenue Code	272
Min. Negotiated Rate	$9.90
Max. Negotiated Rate	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$9.90

CORNEAL PROTECTORS

Facility

$66.00

Hospital Charge Code	270335129
Hospital Revenue Code	272
Min. Negotiated Rate	$1.87
Max. Negotiated Rate	$33.00
Rate for Payer: Aetna Commercial	$25.08
Rate for Payer: Aetna Medicare Advantage	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.83
Rate for Payer: Cigna Commercial	$33.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.16
Rate for Payer: Oxford Commercial	$13.20
Rate for Payer: Qualcare PPO/HMO/WC	$9.90
Rate for Payer: UnitedHealthcare Commercial	$13.20
Rate for Payer: UnitedHealthcare Community & State	$2.09
Rate for Payer: Wellpoint Medicaid Managed Care	$1.87

CORNEAL SHIELDS ADULT

Facility

$35.80

Hospital Charge Code	270620339
Hospital Revenue Code	272
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$17.90
Rate for Payer: Aetna Commercial	$13.60
Rate for Payer: Aetna Medicare Advantage	$10.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.13
Rate for Payer: Cigna Commercial	$17.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.31
Rate for Payer: Oxford Commercial	$7.16
Rate for Payer: Qualcare PPO/HMO/WC	$5.37
Rate for Payer: UnitedHealthcare Commercial	$7.16
Rate for Payer: UnitedHealthcare Community & State	$1.13
Rate for Payer: Wellpoint Medicaid Managed Care	$1.02

Know your out-of-pocket cost for care.

All Charges