Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CREP F/G/H/F, 1-2.5CM

Facility

$2,591.60

Service Code	HCPCS 13131
Hospital Charge Code	1600000786
Hospital Revenue Code	360
Min. Negotiated Rate	$73.60
Max. Negotiated Rate	$3,536.00
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	$3,536.00
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	$673.82
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$388.74
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$81.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$73.60

CREP F/G/H/F, 1-2.5CM

Facility

$2,591.60

Service Code	HCPCS 13131
Hospital Charge Code	1600000786
Hospital Revenue Code	360
Min. Negotiated Rate	$388.74
Max. Negotiated Rate	$388.74
Rate for Payer: Qualcare PPO/HMO/WC	$388.74

CREP F/G/H/F,2.6-7.5CM

Facility

$4,862.70

Service Code	HCPCS 13132
Hospital Charge Code	1600000520
Hospital Revenue Code	360
Min. Negotiated Rate	$153.66
Max. Negotiated Rate	$3,536.00
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	$3,536.00
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	$1,264.30
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$729.40
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$153.66
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	$1,037.98

CREP F/G/H/F,2.6-7.5CM

Facility

$4,862.70

Service Code	HCPCS 13132
Hospital Charge Code	1600000520
Hospital Revenue Code	360
Min. Negotiated Rate	$729.40
Max. Negotiated Rate	$729.40
Rate for Payer: Qualcare PPO/HMO/WC	$729.40

CREP H/A/G/EXTR; EA ADD 5 CM/<

Facility

$2,929.20

Service Code	HCPCS 13133
Hospital Charge Code	16000531
Hospital Revenue Code	360
Min. Negotiated Rate	$92.56
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,113.10
Rate for Payer: Aetna Medicare Advantage	$878.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$746.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$746.95
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	$746.95
Rate for Payer: Cigna Commercial	$1,464.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$761.59
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$439.38
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$92.56

CREP H/A/G/EXTR; EA ADD 5 CM/<

Facility

$2,929.20

Service Code	HCPCS 13133
Hospital Charge Code	16000531
Hospital Revenue Code	360
Min. Negotiated Rate	$439.38
Max. Negotiated Rate	$439.38
Rate for Payer: Qualcare PPO/HMO/WC	$439.38

CREP S/A/L,2.6-7.5CM

Facility

$4,862.70

Service Code	HCPCS 13121
Hospital Charge Code	160000237
Hospital Revenue Code	360
Min. Negotiated Rate	$138.10
Max. Negotiated Rate	$3,536.00
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	$3,536.00
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	$1,264.30
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$729.40
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$153.66
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$138.10

CREP S/A/L,2.6-7.5CM

Facility

$4,862.70

Service Code	HCPCS 13121
Hospital Charge Code	160000237
Hospital Revenue Code	360
Min. Negotiated Rate	$729.40
Max. Negotiated Rate	$729.40
Rate for Payer: Qualcare PPO/HMO/WC	$729.40

C REP S/A/L,EA ADD 5 CM/<

Facility

$4,862.70

Service Code	HCPCS 13122
Hospital Charge Code	160000238
Hospital Revenue Code	360
Min. Negotiated Rate	$729.40
Max. Negotiated Rate	$729.40
Rate for Payer: Qualcare PPO/HMO/WC	$729.40

C REP S/A/L,EA ADD 5 CM/<

Facility

$4,862.70

Service Code	HCPCS 13122
Hospital Charge Code	160000238
Hospital Revenue Code	360
Min. Negotiated Rate	$153.66
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,847.83
Rate for Payer: Aetna Medicare Advantage	$1,458.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,239.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,239.99
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	$1,239.99
Rate for Payer: Cigna Commercial	$2,431.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,264.30
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$729.40
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$153.66

CRESCENTIC BLADE 12MM 45x0.6MM

Facility

$2,117.50

Hospital Charge Code	270674686
Hospital Revenue Code	272
Min. Negotiated Rate	$60.14
Max. Negotiated Rate	$1,058.75
Rate for Payer: Aetna Commercial	$804.65
Rate for Payer: Aetna Medicare Advantage	$635.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$539.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$539.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$539.96
Rate for Payer: Cigna Commercial	$1,058.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$550.55
Rate for Payer: Oxford Commercial	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$317.62
Rate for Payer: UnitedHealthcare Commercial	$423.50
Rate for Payer: UnitedHealthcare Community & State	$66.91
Rate for Payer: Wellpoint Medicaid Managed Care	$60.14

CRESCENTIC BLADE 12MM 45x0.6MM

Facility

$2,117.50

Hospital Charge Code	270674686
Hospital Revenue Code	272
Min. Negotiated Rate	$317.62
Max. Negotiated Rate	$317.62
Rate for Payer: Qualcare PPO/HMO/WC	$317.62

CRESCENTIC BLADE 15MM 45x0.6MM

Facility

$2,117.50

Hospital Charge Code	270674687
Hospital Revenue Code	272
Min. Negotiated Rate	$60.14
Max. Negotiated Rate	$1,058.75
Rate for Payer: Aetna Commercial	$804.65
Rate for Payer: Aetna Medicare Advantage	$635.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$539.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$539.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$539.96
Rate for Payer: Cigna Commercial	$1,058.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$550.55
Rate for Payer: Oxford Commercial	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$317.62
Rate for Payer: UnitedHealthcare Commercial	$423.50
Rate for Payer: UnitedHealthcare Community & State	$66.91
Rate for Payer: Wellpoint Medicaid Managed Care	$60.14

CRESCENTIC BLADE 15MM 45x0.6MM

Facility

$2,117.50

Hospital Charge Code	270674687
Hospital Revenue Code	272
Min. Negotiated Rate	$317.62
Max. Negotiated Rate	$317.62
Rate for Payer: Qualcare PPO/HMO/WC	$317.62

CRESCENTIC BLADE 18MM 45x0.6MM

Facility

$2,117.50

Hospital Charge Code	270674688
Hospital Revenue Code	272
Min. Negotiated Rate	$317.62
Max. Negotiated Rate	$317.62
Rate for Payer: Qualcare PPO/HMO/WC	$317.62

CRESCENTIC BLADE 18MM 45x0.6MM

Facility

$2,117.50

Hospital Charge Code	270674688
Hospital Revenue Code	272
Min. Negotiated Rate	$60.14
Max. Negotiated Rate	$1,058.75
Rate for Payer: Aetna Commercial	$804.65
Rate for Payer: Aetna Medicare Advantage	$635.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$539.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$539.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$539.96
Rate for Payer: Cigna Commercial	$1,058.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$550.55
Rate for Payer: Oxford Commercial	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$317.62
Rate for Payer: UnitedHealthcare Commercial	$423.50
Rate for Payer: UnitedHealthcare Community & State	$66.91
Rate for Payer: Wellpoint Medicaid Managed Care	$60.14

CRESCENTIC BLADE 21MM 45x0.6MM

Facility

$2,117.50

Hospital Charge Code	270674689
Hospital Revenue Code	272
Min. Negotiated Rate	$317.62
Max. Negotiated Rate	$317.62
Rate for Payer: Qualcare PPO/HMO/WC	$317.62

CRESCENTIC BLADE 21MM 45x0.6MM

Facility

$2,117.50

Hospital Charge Code	270674689
Hospital Revenue Code	272
Min. Negotiated Rate	$60.14
Max. Negotiated Rate	$1,058.75
Rate for Payer: Aetna Commercial	$804.65
Rate for Payer: Aetna Medicare Advantage	$635.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$539.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$539.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$539.96
Rate for Payer: Cigna Commercial	$1,058.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$550.55
Rate for Payer: Oxford Commercial	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$317.62
Rate for Payer: UnitedHealthcare Commercial	$423.50
Rate for Payer: UnitedHealthcare Community & State	$66.91
Rate for Payer: Wellpoint Medicaid Managed Care	$60.14

CRESCENTIC BLADE 24MM 45x0.6MM

Facility

$2,117.50

Hospital Charge Code	270674690
Hospital Revenue Code	272
Min. Negotiated Rate	$60.14
Max. Negotiated Rate	$1,058.75
Rate for Payer: Aetna Commercial	$804.65
Rate for Payer: Aetna Medicare Advantage	$635.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$539.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$539.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$539.96
Rate for Payer: Cigna Commercial	$1,058.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$550.55
Rate for Payer: Oxford Commercial	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$317.62
Rate for Payer: UnitedHealthcare Commercial	$423.50
Rate for Payer: UnitedHealthcare Community & State	$66.91
Rate for Payer: Wellpoint Medicaid Managed Care	$60.14

CRESCENTIC BLADE 24MM 45x0.6MM

Facility

$2,117.50

Hospital Charge Code	270674690
Hospital Revenue Code	272
Min. Negotiated Rate	$317.62
Max. Negotiated Rate	$317.62
Rate for Payer: Qualcare PPO/HMO/WC	$317.62

CRESCENTIC BLADE 27MM 50x0.6MM

Facility

$2,117.50

Hospital Charge Code	270674691
Hospital Revenue Code	272
Min. Negotiated Rate	$60.14
Max. Negotiated Rate	$1,058.75
Rate for Payer: Aetna Commercial	$804.65
Rate for Payer: Aetna Medicare Advantage	$635.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$539.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$539.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$539.96
Rate for Payer: Cigna Commercial	$1,058.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$550.55
Rate for Payer: Oxford Commercial	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$317.62
Rate for Payer: UnitedHealthcare Commercial	$423.50
Rate for Payer: UnitedHealthcare Community & State	$66.91
Rate for Payer: Wellpoint Medicaid Managed Care	$60.14

CRESCENTIC BLADE 27MM 50x0.6MM

Facility

$2,117.50

Hospital Charge Code	270674691
Hospital Revenue Code	272
Min. Negotiated Rate	$317.62
Max. Negotiated Rate	$317.62
Rate for Payer: Qualcare PPO/HMO/WC	$317.62

CRESCENTIC BLADE 30MM 50x0.6MM

Facility

$2,117.50

Hospital Charge Code	270674692
Hospital Revenue Code	272
Min. Negotiated Rate	$60.14
Max. Negotiated Rate	$1,058.75
Rate for Payer: Aetna Commercial	$804.65
Rate for Payer: Aetna Medicare Advantage	$635.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$539.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$539.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$539.96
Rate for Payer: Cigna Commercial	$1,058.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$550.55
Rate for Payer: Oxford Commercial	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$317.62
Rate for Payer: UnitedHealthcare Commercial	$423.50
Rate for Payer: UnitedHealthcare Community & State	$66.91
Rate for Payer: Wellpoint Medicaid Managed Care	$60.14

CRESCENTIC BLADE 30MM 50x0.6MM

Facility

$2,117.50

Hospital Charge Code	270674692
Hospital Revenue Code	272
Min. Negotiated Rate	$317.62
Max. Negotiated Rate	$317.62
Rate for Payer: Qualcare PPO/HMO/WC	$317.62

CRESCENT SNARE

Facility

$495.00

Hospital Charge Code	270325501
Hospital Revenue Code	272
Min. Negotiated Rate	$74.25
Max. Negotiated Rate	$74.25
Rate for Payer: Qualcare PPO/HMO/WC	$74.25

Know your out-of-pocket cost for care.

All Charges