Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

COVER PROBE GENERAL PURPOSE

Facility

$29.08

Hospital Charge Code	270648023
Hospital Revenue Code	270
Min. Negotiated Rate	$4.36
Max. Negotiated Rate	$4.36
Rate for Payer: Qualcare PPO/HMO/WC	$4.36

COVER SHOE NONCNDTVE XLG 77727

Facility

$46.30

Hospital Charge Code	270060675C
Hospital Revenue Code	272
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$23.15
Rate for Payer: Aetna Commercial	$17.59
Rate for Payer: Aetna Medicare Advantage	$13.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.81
Rate for Payer: Cigna Commercial	$23.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.04
Rate for Payer: Oxford Commercial	$9.26
Rate for Payer: Qualcare PPO/HMO/WC	$6.95
Rate for Payer: UnitedHealthcare Commercial	$9.26
Rate for Payer: UnitedHealthcare Community & State	$1.46
Rate for Payer: Wellpoint Medicaid Managed Care	$1.31

COVER SHOE NONCNDTVE XLG 77727

Facility

$46.30

Hospital Charge Code	270060675C
Hospital Revenue Code	272
Min. Negotiated Rate	$6.95
Max. Negotiated Rate	$6.95
Rate for Payer: Qualcare PPO/HMO/WC	$6.95

COVER SITERITE

Facility

$47.50

Hospital Charge Code	270658265
Hospital Revenue Code	270
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$23.75
Rate for Payer: Aetna Commercial	$18.05
Rate for Payer: Aetna Medicare Advantage	$14.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.11
Rate for Payer: Cigna Commercial	$23.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.35
Rate for Payer: Oxford Commercial	$9.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.12
Rate for Payer: UnitedHealthcare Commercial	$9.50
Rate for Payer: UnitedHealthcare Community & State	$1.50
Rate for Payer: Wellpoint Medicaid Managed Care	$1.35

COVER SITERITE

Facility

$47.50

Hospital Charge Code	270658265
Hospital Revenue Code	270
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$7.12
Rate for Payer: Qualcare PPO/HMO/WC	$7.12

COVER SNAP KAP DOME 26 DEPTH

Facility

$7.39

Hospital Charge Code	270667869
Hospital Revenue Code	272
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$3.69
Rate for Payer: Aetna Commercial	$2.81
Rate for Payer: Aetna Medicare Advantage	$2.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.88
Rate for Payer: Cigna Commercial	$3.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.92
Rate for Payer: Oxford Commercial	$1.48
Rate for Payer: Qualcare PPO/HMO/WC	$1.11
Rate for Payer: UnitedHealthcare Commercial	$1.48
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

COVER SNAP KAP DOME 26 DEPTH

Facility

$7.39

Hospital Charge Code	270667869
Hospital Revenue Code	272
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$1.11
Rate for Payer: Qualcare PPO/HMO/WC	$1.11

COVER STENT VBX ENDOPRO 10X79

Facility

$18,295.00

Service Code	HCPCS C1874
Hospital Charge Code	270683405N
Hospital Revenue Code	278
Min. Negotiated Rate	$519.58
Max. Negotiated Rate	$9,147.50
Rate for Payer: Aetna Commercial	$6,952.10
Rate for Payer: Aetna Medicare Advantage	$5,488.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,665.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,665.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,659.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,665.23
Rate for Payer: Cigna Commercial	$9,147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,427.39
Rate for Payer: Qualcare PPO/HMO/WC	$2,744.25
Rate for Payer: UnitedHealthcare Community & State	$578.12
Rate for Payer: Wellpoint Medicaid Managed Care	$519.58

COVER STENT VBX ENDOPRO 10X79

Facility

$18,295.00

Service Code	HCPCS C1874
Hospital Charge Code	270683405
Hospital Revenue Code	278
Min. Negotiated Rate	$519.58
Max. Negotiated Rate	$9,147.50
Rate for Payer: Aetna Commercial	$6,952.10
Rate for Payer: Aetna Medicare Advantage	$5,488.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,665.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,665.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,659.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,665.23
Rate for Payer: Cigna Commercial	$9,147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,427.39
Rate for Payer: Qualcare PPO/HMO/WC	$2,744.25
Rate for Payer: UnitedHealthcare Community & State	$578.12
Rate for Payer: Wellpoint Medicaid Managed Care	$519.58

COVER STENT VBX ENDOPRO 10X79

Facility

$18,295.00

Service Code	HCPCS C1874
Hospital Charge Code	270683405
Hospital Revenue Code	278
Min. Negotiated Rate	$2,744.25
Max. Negotiated Rate	$4,427.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,659.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,427.39
Rate for Payer: Qualcare PPO/HMO/WC	$2,744.25

COVER STENT VBX ENDOPRO 10X79

Facility

$18,295.00

Service Code	HCPCS C1874
Hospital Charge Code	270683405N
Hospital Revenue Code	278
Min. Negotiated Rate	$2,744.25
Max. Negotiated Rate	$4,427.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,659.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,427.39
Rate for Payer: Qualcare PPO/HMO/WC	$2,744.25

COVER STENT VBX ENDOPRO 8X79

Facility

$18,295.00

Service Code	HCPCS C1874
Hospital Charge Code	270679679N
Hospital Revenue Code	278
Min. Negotiated Rate	$519.58
Max. Negotiated Rate	$9,147.50
Rate for Payer: Aetna Commercial	$6,952.10
Rate for Payer: Aetna Medicare Advantage	$5,488.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,665.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,665.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,659.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,665.23
Rate for Payer: Cigna Commercial	$9,147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,427.39
Rate for Payer: Qualcare PPO/HMO/WC	$2,744.25
Rate for Payer: UnitedHealthcare Community & State	$578.12
Rate for Payer: Wellpoint Medicaid Managed Care	$519.58

COVER STENT VBX ENDOPRO 8X79

Facility

$18,295.00

Service Code	HCPCS C1874
Hospital Charge Code	270679679N
Hospital Revenue Code	278
Min. Negotiated Rate	$2,744.25
Max. Negotiated Rate	$4,427.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,659.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,427.39
Rate for Payer: Qualcare PPO/HMO/WC	$2,744.25

COVER STENT VBX ENDOPRO 8X79

Facility

$18,295.00

Service Code	HCPCS C1874
Hospital Charge Code	270679679
Hospital Revenue Code	278
Min. Negotiated Rate	$519.58
Max. Negotiated Rate	$9,147.50
Rate for Payer: Aetna Commercial	$6,952.10
Rate for Payer: Aetna Medicare Advantage	$5,488.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,665.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,665.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,659.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,665.23
Rate for Payer: Cigna Commercial	$9,147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,427.39
Rate for Payer: Qualcare PPO/HMO/WC	$2,744.25
Rate for Payer: UnitedHealthcare Community & State	$578.12
Rate for Payer: Wellpoint Medicaid Managed Care	$519.58

COVER STENT VBX ENDOPRO 8X79

Facility

$18,295.00

Service Code	HCPCS C1874
Hospital Charge Code	270679679
Hospital Revenue Code	278
Min. Negotiated Rate	$2,744.25
Max. Negotiated Rate	$4,427.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,659.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,427.39
Rate for Payer: Qualcare PPO/HMO/WC	$2,744.25

COVER STENT VBX ENDOPRO 9X79

Facility

$18,295.00

Service Code	HCPCS C1874
Hospital Charge Code	270683404N
Hospital Revenue Code	278
Min. Negotiated Rate	$519.58
Max. Negotiated Rate	$9,147.50
Rate for Payer: Aetna Commercial	$6,952.10
Rate for Payer: Aetna Medicare Advantage	$5,488.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,665.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,665.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,659.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,665.23
Rate for Payer: Cigna Commercial	$9,147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,427.39
Rate for Payer: Qualcare PPO/HMO/WC	$2,744.25
Rate for Payer: UnitedHealthcare Community & State	$578.12
Rate for Payer: Wellpoint Medicaid Managed Care	$519.58

COVER STENT VBX ENDOPRO 9X79

Facility

$18,295.00

Service Code	HCPCS C1874
Hospital Charge Code	270683404
Hospital Revenue Code	278
Min. Negotiated Rate	$519.58
Max. Negotiated Rate	$9,147.50
Rate for Payer: Aetna Commercial	$6,952.10
Rate for Payer: Aetna Medicare Advantage	$5,488.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,665.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,665.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,659.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,665.23
Rate for Payer: Cigna Commercial	$9,147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,427.39
Rate for Payer: Qualcare PPO/HMO/WC	$2,744.25
Rate for Payer: UnitedHealthcare Community & State	$578.12
Rate for Payer: Wellpoint Medicaid Managed Care	$519.58

COVER STENT VBX ENDOPRO 9X79

Facility

$18,295.00

Service Code	HCPCS C1874
Hospital Charge Code	270683404N
Hospital Revenue Code	278
Min. Negotiated Rate	$2,744.25
Max. Negotiated Rate	$4,427.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,659.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,427.39
Rate for Payer: Qualcare PPO/HMO/WC	$2,744.25

COVER STENT VBX ENDOPRO 9X79

Facility

$18,295.00

Service Code	HCPCS C1874
Hospital Charge Code	270683404
Hospital Revenue Code	278
Min. Negotiated Rate	$2,744.25
Max. Negotiated Rate	$4,427.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,659.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,427.39
Rate for Payer: Qualcare PPO/HMO/WC	$2,744.25

COVER TIP MONOPOLAR CRVD SCISS

Facility

$100.00

Hospital Charge Code	270664000
Hospital Revenue Code	272
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

COVER TIP MONOPOLAR CRVD SCISS

Facility

$100.00

Hospital Charge Code	270664000
Hospital Revenue Code	272
Min. Negotiated Rate	$2.84
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Commercial	$38.00
Rate for Payer: Aetna Medicare Advantage	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.50
Rate for Payer: Cigna Commercial	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.00
Rate for Payer: Oxford Commercial	$20.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$20.00
Rate for Payer: UnitedHealthcare Community & State	$3.16
Rate for Payer: Wellpoint Medicaid Managed Care	$2.84

COVER TRANDUCER NEOGUARD

Facility

$24.58

Hospital Charge Code	270663366
Hospital Revenue Code	270
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$12.29
Rate for Payer: Aetna Commercial	$9.34
Rate for Payer: Aetna Medicare Advantage	$7.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.27
Rate for Payer: Cigna Commercial	$12.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.39
Rate for Payer: Oxford Commercial	$4.92
Rate for Payer: Qualcare PPO/HMO/WC	$3.69
Rate for Payer: UnitedHealthcare Commercial	$4.92
Rate for Payer: UnitedHealthcare Community & State	$0.78
Rate for Payer: Wellpoint Medicaid Managed Care	$0.70

COVER TRANDUCER NEOGUARD

Facility

$24.58

Hospital Charge Code	270663366
Hospital Revenue Code	270
Min. Negotiated Rate	$3.69
Max. Negotiated Rate	$3.69
Rate for Payer: Qualcare PPO/HMO/WC	$3.69

COVER TRANSDUCER GEN PURPOSE

Facility

$52.00

Service Code	HCPCS E1575
Hospital Charge Code	2008155
Hospital Revenue Code	271
Min. Negotiated Rate	$1.48
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$19.76
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.52
Rate for Payer: Oxford Commercial	$10.40
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$10.40
Rate for Payer: UnitedHealthcare Community & State	$1.64
Rate for Payer: Wellpoint Medicaid Managed Care	$1.48

COVER TRANSDUCER GEN PURPOSE

Facility

$52.00

Service Code	HCPCS E1575
Hospital Charge Code	2008155
Hospital Revenue Code	271
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

Know your out-of-pocket cost for care.

All Charges