Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ACRYSOFT LENS 28.5

Facility

$745.00

Hospital Charge Code	270669986
Hospital Revenue Code	276
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$180.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75

ACRYSOFT LENS 28.5

Facility

$745.00

Hospital Charge Code	270669986
Hospital Revenue Code	276
Min. Negotiated Rate	$21.16
Max. Negotiated Rate	$372.50
Rate for Payer: Aetna Commercial	$283.10
Rate for Payer: Aetna Medicare Advantage	$223.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.97
Rate for Payer: Cigna Commercial	$372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75
Rate for Payer: UnitedHealthcare Community & State	$23.54
Rate for Payer: Wellpoint Medicaid Managed Care	$21.16

ACS SD VAR 15MM

Facility

$730.00

Service Code	HCPCS C1713
Hospital Charge Code	270705058
Hospital Revenue Code	278
Min. Negotiated Rate	$20.73
Max. Negotiated Rate	$365.00
Rate for Payer: Aetna Commercial	$277.40
Rate for Payer: Aetna Medicare Advantage	$219.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$186.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$186.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$186.15
Rate for Payer: Cigna Commercial	$365.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.66
Rate for Payer: Qualcare PPO/HMO/WC	$109.50
Rate for Payer: UnitedHealthcare Community & State	$23.07
Rate for Payer: Wellpoint Medicaid Managed Care	$20.73

ACS SD VAR 15MM

Facility

$730.00

Service Code	HCPCS C1713
Hospital Charge Code	270705058
Hospital Revenue Code	278
Min. Negotiated Rate	$109.50
Max. Negotiated Rate	$176.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.66
Rate for Payer: Qualcare PPO/HMO/WC	$109.50

ACS SD VAR 17MM

Facility

$730.00

Service Code	HCPCS C1713
Hospital Charge Code	270705059
Hospital Revenue Code	278
Min. Negotiated Rate	$20.73
Max. Negotiated Rate	$365.00
Rate for Payer: Aetna Commercial	$277.40
Rate for Payer: Aetna Medicare Advantage	$219.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$186.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$186.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$186.15
Rate for Payer: Cigna Commercial	$365.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.66
Rate for Payer: Qualcare PPO/HMO/WC	$109.50
Rate for Payer: UnitedHealthcare Community & State	$23.07
Rate for Payer: Wellpoint Medicaid Managed Care	$20.73

ACS SD VAR 17MM

Facility

$730.00

Service Code	HCPCS C1713
Hospital Charge Code	270705059
Hospital Revenue Code	278
Min. Negotiated Rate	$109.50
Max. Negotiated Rate	$176.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.66
Rate for Payer: Qualcare PPO/HMO/WC	$109.50

ACTAB LINER G7 VE NEUT 40 MM

Facility

$12,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270698346
Hospital Revenue Code	278
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$2,904.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

ACTAB LINER G7 VE NEUT 40 MM

Facility

$12,000.00

Service Code	HCPCS C1776
Hospital Charge Code	698346
Hospital Revenue Code	278
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$2,904.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

ACTAB LINER G7 VE NEUT 40 MM

Facility

$12,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270698346
Hospital Revenue Code	278
Min. Negotiated Rate	$340.80
Max. Negotiated Rate	$6,000.00
Rate for Payer: Aetna Commercial	$4,560.00
Rate for Payer: Aetna Medicare Advantage	$3,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,060.00
Rate for Payer: Cigna Commercial	$6,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00
Rate for Payer: UnitedHealthcare Community & State	$379.20
Rate for Payer: Wellpoint Medicaid Managed Care	$340.80

ACTAB LINER G7 VE NEUT 40 MM

Facility

$12,000.00

Service Code	HCPCS C1776
Hospital Charge Code	698346
Hospital Revenue Code	278
Min. Negotiated Rate	$340.80
Max. Negotiated Rate	$6,000.00
Rate for Payer: Aetna Commercial	$4,560.00
Rate for Payer: Aetna Medicare Advantage	$3,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,060.00
Rate for Payer: Cigna Commercial	$6,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00
Rate for Payer: UnitedHealthcare Community & State	$379.20
Rate for Payer: Wellpoint Medicaid Managed Care	$340.80

ACT ARTC HD ARCOM XL 28X42MM

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270681099
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

ACT ARTC HD ARCOM XL 28X42MM

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270681099
Hospital Revenue Code	278
Min. Negotiated Rate	$106.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$118.50
Rate for Payer: Wellpoint Medicaid Managed Care	$106.50

ACT ARTIC E1 HIP BRG 28 X40MM

Facility

$13,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690414
Hospital Revenue Code	278
Min. Negotiated Rate	$383.40
Max. Negotiated Rate	$6,750.00
Rate for Payer: Aetna Commercial	$5,130.00
Rate for Payer: Aetna Medicare Advantage	$4,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,442.50
Rate for Payer: Cigna Commercial	$6,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00
Rate for Payer: UnitedHealthcare Community & State	$426.60
Rate for Payer: Wellpoint Medicaid Managed Care	$383.40

ACT ARTIC E1 HIP BRG 28 X40MM

Facility

$13,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690414
Hospital Revenue Code	278
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$3,267.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

ACT ARTIC E1 HIP BRG 28 X 46MM

Facility

$13,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270686417
Hospital Revenue Code	278
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$3,267.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

ACT ARTIC E1 HIP BRG 28 X 46MM

Facility

$13,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270686417
Hospital Revenue Code	278
Min. Negotiated Rate	$383.40
Max. Negotiated Rate	$6,750.00
Rate for Payer: Aetna Commercial	$5,130.00
Rate for Payer: Aetna Medicare Advantage	$4,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,442.50
Rate for Payer: Cigna Commercial	$6,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00
Rate for Payer: UnitedHealthcare Community & State	$426.60
Rate for Payer: Wellpoint Medicaid Managed Care	$383.40

ACT ARTIC EL HP BRG 28 X 44MM

Facility

$18,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270681906
Hospital Revenue Code	278
Min. Negotiated Rate	$511.20
Max. Negotiated Rate	$9,000.00
Rate for Payer: Aetna Commercial	$6,840.00
Rate for Payer: Aetna Medicare Advantage	$5,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,590.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,590.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,590.00
Rate for Payer: Cigna Commercial	$9,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,356.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,700.00
Rate for Payer: UnitedHealthcare Community & State	$568.80
Rate for Payer: Wellpoint Medicaid Managed Care	$511.20

ACT ARTIC EL HP BRG 28 X 44MM

Facility

$18,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270681906
Hospital Revenue Code	278
Min. Negotiated Rate	$2,700.00
Max. Negotiated Rate	$4,356.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,356.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,700.00

ACT ARTIC HD ARCOM XL 28X42MM

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270681045
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

ACT ARTIC HD ARCOM XL 28X42MM

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270681045
Hospital Revenue Code	278
Min. Negotiated Rate	$106.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$118.50
Rate for Payer: Wellpoint Medicaid Managed Care	$106.50

ACT-EA SUBSEQ DAILY

Facility

$390.00

Service Code	HCPCS 8534791
Hospital Charge Code	3668853479
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ACT-EA SUBSEQ DAILY

Facility

$390.00

Service Code	HCPCS 8534791
Hospital Charge Code	7411177
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ACT-EA SUBSEQ DAILY

Facility

$390.00

Service Code	HCPCS 8534791
Hospital Charge Code	3668853479
Hospital Revenue Code	305
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

ACT-EA SUBSEQ DAILY

Facility

$390.00

Service Code	HCPCS 8534791
Hospital Charge Code	7411177
Hospital Revenue Code	305
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

ACTEMRA 162MG/0.9ML SYRINGE

Facility

$8,399.32

Service Code	HCPCS J3262
Hospital Charge Code	606390312
Hospital Revenue Code	636
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$2,032.64
Rate for Payer: Aetna Commercial	$15.04
Rate for Payer: Aetna Medicare Advantage	$17.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.06
Rate for Payer: Cigna Medicare Advantage	$5.53
Rate for Payer: Clover Medicare Advantage	$5.25
Rate for Payer: EmblemHealth Commercial	$16.59
Rate for Payer: Humana Medicare Advantage	$5.70
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,032.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,259.90
Rate for Payer: UnitedHealthcare Community & State	$265.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.53
Rate for Payer: Wellcare Medicare Advantage	$5.53
Rate for Payer: Wellpoint Medicaid Managed Care	$238.54

Know your out-of-pocket cost for care.

All Charges