Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CORNEAL SHIELDS ADULT

Facility

$35.80

Hospital Charge Code	270620339
Hospital Revenue Code	272
Min. Negotiated Rate	$5.37
Max. Negotiated Rate	$5.37
Rate for Payer: Qualcare PPO/HMO/WC	$5.37

CORNEA Sclera, Quarter

Facility

$1,500.00

Hospital Charge Code	270682018
Hospital Revenue Code	278
Min. Negotiated Rate	$42.60
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Community & State	$47.40
Rate for Payer: Wellpoint Medicaid Managed Care	$42.60

CORNEA Sclera, Quarter

Facility

$1,500.00

Hospital Charge Code	270682018
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

CORNEA TISSUE

Facility

$16,000.00

Service Code	HCPCS V2785
Hospital Charge Code	270671570
Hospital Revenue Code	810
Min. Negotiated Rate	$454.40
Max. Negotiated Rate	$8,000.00
Rate for Payer: Aetna Commercial	$6,080.00
Rate for Payer: Aetna Medicare Advantage	$4,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,080.00
Rate for Payer: Cigna Commercial	$8,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,160.00
Rate for Payer: Oxford Commercial	$3,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.00
Rate for Payer: UnitedHealthcare Commercial	$3,200.00
Rate for Payer: UnitedHealthcare Community & State	$505.60
Rate for Payer: Wellpoint Medicaid Managed Care	$454.40

CORNEA TISSUE

Facility

$16,000.00

Service Code	HCPCS V2785
Hospital Charge Code	270671570
Hospital Revenue Code	810
Min. Negotiated Rate	$2,400.00
Max. Negotiated Rate	$2,400.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.00

CORNER CHISEL TMT RAPID RELEAS

Facility

$2,750.00

Hospital Charge Code	270704360
Hospital Revenue Code	272
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

CORNER CHISEL TMT RAPID RELEAS

Facility

$2,750.00

Hospital Charge Code	270704360
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

COROENT LARGE 9X9X28.8 DEGREES

Facility

$26,660.00

Hospital Charge Code	270663771
Hospital Revenue Code	270
Min. Negotiated Rate	$757.14
Max. Negotiated Rate	$13,330.00
Rate for Payer: Aetna Commercial	$10,130.80
Rate for Payer: Aetna Medicare Advantage	$7,998.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,798.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,798.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,798.30
Rate for Payer: Cigna Commercial	$13,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,931.60
Rate for Payer: Oxford Commercial	$5,332.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,999.00
Rate for Payer: UnitedHealthcare Commercial	$5,332.00
Rate for Payer: UnitedHealthcare Community & State	$842.46
Rate for Payer: Wellpoint Medicaid Managed Care	$757.14

COROENT LARGE 9X9X28.8 DEGREES

Facility

$26,660.00

Hospital Charge Code	270663771
Hospital Revenue Code	270
Min. Negotiated Rate	$3,999.00
Max. Negotiated Rate	$3,999.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,999.00

COROENT LARGE MP 9x9x23 4 DEG

Facility

$26,660.00

Service Code	HCPCS C1713
Hospital Charge Code	270672669
Hospital Revenue Code	278
Min. Negotiated Rate	$3,999.00
Max. Negotiated Rate	$6,451.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,332.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,451.72
Rate for Payer: Qualcare PPO/HMO/WC	$3,999.00

COROENT LARGE MP 9x9x23 4 DEG

Facility

$26,660.00

Service Code	HCPCS C1713
Hospital Charge Code	270672669
Hospital Revenue Code	278
Min. Negotiated Rate	$757.14
Max. Negotiated Rate	$13,330.00
Rate for Payer: Aetna Commercial	$10,130.80
Rate for Payer: Aetna Medicare Advantage	$7,998.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,798.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,798.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,332.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,798.30
Rate for Payer: Cigna Commercial	$13,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,451.72
Rate for Payer: Qualcare PPO/HMO/WC	$3,999.00
Rate for Payer: UnitedHealthcare Community & State	$842.46
Rate for Payer: Wellpoint Medicaid Managed Care	$757.14

COROENT LARGE MP TI 10X9X23 MM

Facility

$44,525.00

Service Code	HCPCS C1889
Hospital Charge Code	270691452
Hospital Revenue Code	278
Min. Negotiated Rate	$1,264.51
Max. Negotiated Rate	$22,262.50
Rate for Payer: Aetna Commercial	$16,919.50
Rate for Payer: Aetna Medicare Advantage	$13,357.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,353.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,353.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,905.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,353.88
Rate for Payer: Cigna Commercial	$22,262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,775.05
Rate for Payer: Qualcare PPO/HMO/WC	$6,678.75
Rate for Payer: UnitedHealthcare Community & State	$1,406.99
Rate for Payer: Wellpoint Medicaid Managed Care	$1,264.51

COROENT LARGE MP TI 10X9X23 MM

Facility

$44,525.00

Service Code	HCPCS C1889
Hospital Charge Code	270691452
Hospital Revenue Code	278
Min. Negotiated Rate	$6,678.75
Max. Negotiated Rate	$10,775.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,905.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,775.05
Rate for Payer: Qualcare PPO/HMO/WC	$6,678.75

COROENT LC 14x1x25.8

Facility

$24,955.00

Service Code	HCPCS C1713
Hospital Charge Code	270676534
Hospital Revenue Code	278
Min. Negotiated Rate	$3,743.25
Max. Negotiated Rate	$6,039.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,991.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,039.11
Rate for Payer: Qualcare PPO/HMO/WC	$3,743.25

COROENT LC 14x1x25.8

Facility

$24,955.00

Service Code	HCPCS C1713
Hospital Charge Code	270676534
Hospital Revenue Code	278
Min. Negotiated Rate	$708.72
Max. Negotiated Rate	$12,477.50
Rate for Payer: Aetna Commercial	$9,482.90
Rate for Payer: Aetna Medicare Advantage	$7,486.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,363.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,363.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,991.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,363.52
Rate for Payer: Cigna Commercial	$12,477.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,039.11
Rate for Payer: Qualcare PPO/HMO/WC	$3,743.25
Rate for Payer: UnitedHealthcare Community & State	$788.58
Rate for Payer: Wellpoint Medicaid Managed Care	$708.72

COROENT SI SCRW 4X13MM SELFTAP

Facility

$2,775.00

Service Code	HCPCS C1713
Hospital Charge Code	270692885
Hospital Revenue Code	278
Min. Negotiated Rate	$416.25
Max. Negotiated Rate	$671.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$555.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$671.55
Rate for Payer: Qualcare PPO/HMO/WC	$416.25

COROENT SI SCRW 4X13MM SELFTAP

Facility

$2,775.00

Service Code	HCPCS C1713
Hospital Charge Code	270692885
Hospital Revenue Code	278
Min. Negotiated Rate	$78.81
Max. Negotiated Rate	$1,387.50
Rate for Payer: Aetna Commercial	$1,054.50
Rate for Payer: Aetna Medicare Advantage	$832.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$707.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$707.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$707.62
Rate for Payer: Cigna Commercial	$1,387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$671.55
Rate for Payer: Qualcare PPO/HMO/WC	$416.25
Rate for Payer: UnitedHealthcare Community & State	$87.69
Rate for Payer: Wellpoint Medicaid Managed Care	$78.81

COROENT SM 5X11X14MM 5D LORD

Facility

$9,075.00

Service Code	HCPCS L8699
Hospital Charge Code	270693073
Hospital Revenue Code	278
Min. Negotiated Rate	$257.73
Max. Negotiated Rate	$4,537.50
Rate for Payer: Aetna Commercial	$3,448.50
Rate for Payer: Aetna Medicare Advantage	$2,722.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,314.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,314.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,314.12
Rate for Payer: Cigna Commercial	$4,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,196.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,361.25
Rate for Payer: UnitedHealthcare Community & State	$286.77
Rate for Payer: Wellpoint Medicaid Managed Care	$257.73

COROENT SM 5X11X14MM 5D LORD

Facility

$9,075.00

Service Code	HCPCS L8699
Hospital Charge Code	270693073
Hospital Revenue Code	278
Min. Negotiated Rate	$1,361.25
Max. Negotiated Rate	$2,196.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,815.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,196.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,361.25

COROENT SM INTERLK 7X17X14MM7D

Facility

$17,495.00

Service Code	HCPCS L8699
Hospital Charge Code	270692884
Hospital Revenue Code	278
Min. Negotiated Rate	$496.86
Max. Negotiated Rate	$8,747.50
Rate for Payer: Aetna Commercial	$6,648.10
Rate for Payer: Aetna Medicare Advantage	$5,248.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,461.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,461.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,499.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,461.23
Rate for Payer: Cigna Commercial	$8,747.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,233.79
Rate for Payer: Qualcare PPO/HMO/WC	$2,624.25
Rate for Payer: UnitedHealthcare Community & State	$552.84
Rate for Payer: Wellpoint Medicaid Managed Care	$496.86

COROENT SM INTERLK 7X17X14MM7D

Facility

$17,495.00

Service Code	HCPCS L8699
Hospital Charge Code	270692884
Hospital Revenue Code	278
Min. Negotiated Rate	$2,624.25
Max. Negotiated Rate	$4,233.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,499.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,233.79
Rate for Payer: Qualcare PPO/HMO/WC	$2,624.25

CORONARY ANGIO INJ

Facility

$25,737.16

Service Code	HCPCS 93454
Hospital Charge Code	5100177
Hospital Revenue Code	481
Min. Negotiated Rate	$730.94
Max. Negotiated Rate	$13,971.32
Rate for Payer: Aetna Commercial	$10,476.08
Rate for Payer: Aetna Medicare Advantage	$12,478.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,971.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,971.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,851.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,971.32
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: Cigna Medicare Advantage	$3,851.50
Rate for Payer: Clover Medicare Advantage	$3,658.93
Rate for Payer: EmblemHealth Commercial	$11,554.50
Rate for Payer: Humana Medicare Advantage	$3,967.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,851.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,691.66
Rate for Payer: Oxford Commercial	$11,677.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57
Rate for Payer: UnitedHealthcare Commercial	$12,906.00
Rate for Payer: UnitedHealthcare Community & State	$813.29
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,851.50
Rate for Payer: Wellcare Medicare Advantage	$3,851.50
Rate for Payer: Wellpoint Medicaid Managed Care	$730.94

CORONARY ANGIO INJ

Facility

$25,737.16

Service Code	HCPCS 93454
Hospital Charge Code	5100177
Hospital Revenue Code	481
Min. Negotiated Rate	$3,860.57
Max. Negotiated Rate	$3,860.57
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57

CORONARY ART/GRFT ANGIO S&I

Facility

$16,190.00

Service Code	HCPCS 93455
Hospital Charge Code	5100663
Hospital Revenue Code	481
Min. Negotiated Rate	$459.80
Max. Negotiated Rate	$13,971.32
Rate for Payer: Aetna Commercial	$10,476.08
Rate for Payer: Aetna Medicare Advantage	$12,478.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,971.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,971.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,851.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,971.32
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: Cigna Medicare Advantage	$3,851.50
Rate for Payer: Clover Medicare Advantage	$3,658.93
Rate for Payer: EmblemHealth Commercial	$11,554.50
Rate for Payer: Humana Medicare Advantage	$3,967.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,851.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,209.40
Rate for Payer: Oxford Commercial	$11,677.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,428.50
Rate for Payer: UnitedHealthcare Commercial	$12,906.00
Rate for Payer: UnitedHealthcare Community & State	$511.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,851.50
Rate for Payer: Wellcare Medicare Advantage	$3,851.50
Rate for Payer: Wellpoint Medicaid Managed Care	$459.80

CORONARY ART/GRFT ANGIO S&I

Facility

$16,190.00

Service Code	HCPCS 93455
Hospital Charge Code	5100663
Hospital Revenue Code	481
Min. Negotiated Rate	$2,428.50
Max. Negotiated Rate	$2,428.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,428.50

Know your out-of-pocket cost for care.

All Charges