Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CPM SOFT GOODS

Facility

$115.00

Hospital Charge Code	270633426
Hospital Revenue Code	271
Min. Negotiated Rate	$3.27
Max. Negotiated Rate	$57.50
Rate for Payer: Aetna Commercial	$43.70
Rate for Payer: Aetna Medicare Advantage	$34.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.32
Rate for Payer: Cigna Commercial	$57.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.90
Rate for Payer: Oxford Commercial	$23.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.25
Rate for Payer: UnitedHealthcare Commercial	$23.00
Rate for Payer: UnitedHealthcare Community & State	$3.63
Rate for Payer: Wellpoint Medicaid Managed Care	$3.27

CPM SOFT GOODS

Facility

$115.00

Hospital Charge Code	270633426
Hospital Revenue Code	271
Min. Negotiated Rate	$17.25
Max. Negotiated Rate	$17.25
Rate for Payer: Qualcare PPO/HMO/WC	$17.25

CPM SOFTGOODS

Facility

$95.00

Hospital Charge Code	270624513
Hospital Revenue Code	271
Min. Negotiated Rate	$14.25
Max. Negotiated Rate	$14.25
Rate for Payer: Qualcare PPO/HMO/WC	$14.25

CPM SOFTGOODS

Facility

$95.00

Hospital Charge Code	270624513
Hospital Revenue Code	271
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$47.50
Rate for Payer: Aetna Commercial	$36.10
Rate for Payer: Aetna Medicare Advantage	$28.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.23
Rate for Payer: Cigna Commercial	$47.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.70
Rate for Payer: Oxford Commercial	$19.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.25
Rate for Payer: UnitedHealthcare Commercial	$19.00
Rate for Payer: UnitedHealthcare Community & State	$3.00
Rate for Payer: Wellpoint Medicaid Managed Care	$2.70

C.PNEUMONIAE AB (IGG,A,M) I

Facility

$390.00

Service Code	HCPCS 8663191
Hospital Charge Code	39990089A
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

C.PNEUMONIAE AB (IGG,A,M) I

Facility

$390.00

Service Code	HCPCS 8663191
Hospital Charge Code	39990089B
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

C.PNEUMONIAE AB (IGG,A,M) I

Facility

$390.00

Service Code	HCPCS 8663191
Hospital Charge Code	39990089A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

C.PNEUMONIAE AB (IGG,A,M) I

Facility

$390.00

Service Code	HCPCS 86632
Hospital Charge Code	39990089C
Hospital Revenue Code	302
Min. Negotiated Rate	$10.14
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$34.49
Rate for Payer: Aetna Medicare Advantage	$41.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.00
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.68
Rate for Payer: Clover Medicare Advantage	$12.05
Rate for Payer: EmblemHealth Commercial	$38.04
Rate for Payer: Humana Medicare Advantage	$13.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.68
Rate for Payer: Wellcare Medicare Advantage	$12.68
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

C.PNEUMONIAE AB (IGG,A,M) I

Facility

$390.00

Service Code	HCPCS 86632
Hospital Charge Code	39990089C
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

C.PNEUMONIAE AB (IGG,A,M) I

Facility

$390.00

Service Code	HCPCS 8663191
Hospital Charge Code	39990089B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CPR

Facility

$1,613.00

Service Code	HCPCS 92950
Hospital Charge Code	9500065
Hospital Revenue Code	480
Min. Negotiated Rate	$241.95
Max. Negotiated Rate	$241.95
Rate for Payer: Qualcare PPO/HMO/WC	$241.95

CPR

Facility

$1,613.00

Service Code	HCPCS 92950
Hospital Charge Code	9500065
Hospital Revenue Code	480
Min. Negotiated Rate	$45.81
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$930.53
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$419.38
Rate for Payer: Oxford Commercial	$2,441.00
Rate for Payer: Qualcare PPO/HMO/WC	$241.95
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$50.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$45.81

CPR VIPER IMPLANT SYSTEM

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270676107
Hospital Revenue Code	278
Min. Negotiated Rate	$134.90
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,805.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50
Rate for Payer: UnitedHealthcare Community & State	$150.10
Rate for Payer: Wellpoint Medicaid Managed Care	$134.90

CPR VIPER IMPLANT SYSTEM

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270676107
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

CPS FIXED BEARING ARTICULAR SU

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704571
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

CPS FIXED BEARING ARTICULAR SU

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704571
Hospital Revenue Code	278
Min. Negotiated Rate	$170.40
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$189.60
Rate for Payer: Wellpoint Medicaid Managed Care	$170.40

C PSITTACI AB

Facility

$390.00

Service Code	HCPCS 86631
Hospital Charge Code	39708048A
Hospital Revenue Code	302
Min. Negotiated Rate	$9.46
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$32.15
Rate for Payer: Aetna Medicare Advantage	$38.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.88
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$11.82
Rate for Payer: Clover Medicare Advantage	$11.23
Rate for Payer: EmblemHealth Commercial	$35.46
Rate for Payer: Humana Medicare Advantage	$12.17
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.82
Rate for Payer: Wellcare Medicare Advantage	$11.82
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

C PSITTACI AB

Facility

$390.00

Service Code	HCPCS 86631
Hospital Charge Code	39708048A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

C PSITTACI IGM

Facility

$390.00

Service Code	HCPCS 86632
Hospital Charge Code	39708048B
Hospital Revenue Code	302
Min. Negotiated Rate	$10.14
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$34.49
Rate for Payer: Aetna Medicare Advantage	$41.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.00
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.68
Rate for Payer: Clover Medicare Advantage	$12.05
Rate for Payer: EmblemHealth Commercial	$38.04
Rate for Payer: Humana Medicare Advantage	$13.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.68
Rate for Payer: Wellcare Medicare Advantage	$12.68
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

C PSITTACI IGM

Facility

$390.00

Service Code	HCPCS 86632
Hospital Charge Code	39708048B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CPTR-ASST DIR MS PX

Facility

$1,772.70

Service Code	HCPCS 20985
Hospital Charge Code	16000670
Hospital Revenue Code	360
Min. Negotiated Rate	$50.34
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$673.63
Rate for Payer: Aetna Medicare Advantage	$531.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$452.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$452.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$452.04
Rate for Payer: Cigna Commercial	$886.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$460.90
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$265.90
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$56.02
Rate for Payer: Wellpoint Medicaid Managed Care	$50.34

CPTR-ASST DIR MS PX

Facility

$1,772.70

Service Code	HCPCS 20985
Hospital Charge Code	16000670
Hospital Revenue Code	360
Min. Negotiated Rate	$265.90
Max. Negotiated Rate	$265.90
Rate for Payer: Qualcare PPO/HMO/WC	$265.90

C-QUR V-PATCH MED RND 6.4CM

Facility

$2,211.15

Hospital Charge Code	270653390
Hospital Revenue Code	278
Min. Negotiated Rate	$331.67
Max. Negotiated Rate	$535.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$442.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$535.10
Rate for Payer: Qualcare PPO/HMO/WC	$331.67

C-QUR V-PATCH MED RND 6.4CM

Facility

$2,211.15

Hospital Charge Code	270653390
Hospital Revenue Code	278
Min. Negotiated Rate	$62.80
Max. Negotiated Rate	$1,105.58
Rate for Payer: Aetna Commercial	$840.24
Rate for Payer: Aetna Medicare Advantage	$663.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$563.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$563.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$442.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$563.84
Rate for Payer: Cigna Commercial	$1,105.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$535.10
Rate for Payer: Qualcare PPO/HMO/WC	$331.67
Rate for Payer: UnitedHealthcare Community & State	$69.87
Rate for Payer: Wellpoint Medicaid Managed Care	$62.80

C-QUR V-PATCH SML RND 4.3CM

Facility

$1,757.50

Hospital Charge Code	270653389
Hospital Revenue Code	278
Min. Negotiated Rate	$49.91
Max. Negotiated Rate	$878.75
Rate for Payer: Aetna Commercial	$667.85
Rate for Payer: Aetna Medicare Advantage	$527.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$351.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.16
Rate for Payer: Cigna Commercial	$878.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$425.31
Rate for Payer: Qualcare PPO/HMO/WC	$263.62
Rate for Payer: UnitedHealthcare Community & State	$55.54
Rate for Payer: Wellpoint Medicaid Managed Care	$49.91

Know your out-of-pocket cost for care.

All Charges