Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CROSS CONNECTOR 48MM

Facility

$7,298.55

Service Code	HCPCS C1713
Hospital Charge Code	270704749
Hospital Revenue Code	278
Min. Negotiated Rate	$1,094.78
Max. Negotiated Rate	$1,766.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,459.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,766.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,094.78

CROSS CONNECT SYMP OCT30TO42

Facility

$5,892.00

Service Code	HCPCS C1713
Hospital Charge Code	270694400
Hospital Revenue Code	278
Min. Negotiated Rate	$883.80
Max. Negotiated Rate	$1,425.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,178.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,425.86
Rate for Payer: Qualcare PPO/HMO/WC	$883.80

CROSS CONNECT SYMP OCT30TO42

Facility

$5,892.00

Service Code	HCPCS C1713
Hospital Charge Code	270694400
Hospital Revenue Code	278
Min. Negotiated Rate	$167.33
Max. Negotiated Rate	$2,946.00
Rate for Payer: Aetna Commercial	$2,238.96
Rate for Payer: Aetna Medicare Advantage	$1,767.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,502.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,502.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,178.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,502.46
Rate for Payer: Cigna Commercial	$2,946.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,425.86
Rate for Payer: Qualcare PPO/HMO/WC	$883.80
Rate for Payer: UnitedHealthcare Community & State	$186.19
Rate for Payer: Wellpoint Medicaid Managed Care	$167.33

CROSS LINK 44-56 MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	278703983
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

CROSS LINK 44-56 MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	278703983
Hospital Revenue Code	278
Min. Negotiated Rate	$63.90
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Community & State	$71.10
Rate for Payer: Wellpoint Medicaid Managed Care	$63.90

CROSS LINK 44-56MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270703983
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

CROSS LINK 44-56MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270703983
Hospital Revenue Code	278
Min. Negotiated Rate	$63.90
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Community & State	$71.10
Rate for Payer: Wellpoint Medicaid Managed Care	$63.90

CROSSLINK #6

Facility

$6,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270687935
Hospital Revenue Code	278
Min. Negotiated Rate	$956.25
Max. Negotiated Rate	$1,542.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,542.75
Rate for Payer: Qualcare PPO/HMO/WC	$956.25

CROSSLINK #6

Facility

$6,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270687935
Hospital Revenue Code	278
Min. Negotiated Rate	$181.05
Max. Negotiated Rate	$3,187.50
Rate for Payer: Aetna Commercial	$2,422.50
Rate for Payer: Aetna Medicare Advantage	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,625.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,625.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,625.62
Rate for Payer: Cigna Commercial	$3,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,542.75
Rate for Payer: Qualcare PPO/HMO/WC	$956.25
Rate for Payer: UnitedHealthcare Community & State	$201.45
Rate for Payer: Wellpoint Medicaid Managed Care	$181.05

CROSSLINK 7 MM ROD ATTACH

Facility

$8,010.00

Service Code	HCPCS C1713
Hospital Charge Code	270683547
Hospital Revenue Code	278
Min. Negotiated Rate	$227.48
Max. Negotiated Rate	$4,005.00
Rate for Payer: Aetna Commercial	$3,043.80
Rate for Payer: Aetna Medicare Advantage	$2,403.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,042.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,042.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,602.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,042.55
Rate for Payer: Cigna Commercial	$4,005.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,938.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,201.50
Rate for Payer: UnitedHealthcare Community & State	$253.12
Rate for Payer: Wellpoint Medicaid Managed Care	$227.48

CROSSLINK 7 MM ROD ATTACH

Facility

$8,010.00

Service Code	HCPCS C1713
Hospital Charge Code	270683547
Hospital Revenue Code	278
Min. Negotiated Rate	$1,201.50
Max. Negotiated Rate	$1,938.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,602.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,938.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,201.50

CROSSLINK A6, SFX, 5.5, TI MED

Facility

$11,600.00

Hospital Charge Code	270667358
Hospital Revenue Code	278
Min. Negotiated Rate	$1,740.00
Max. Negotiated Rate	$2,807.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,807.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,740.00

CROSSLINK A6, SFX, 5.5, TI MED

Facility

$11,600.00

Hospital Charge Code	270667358
Hospital Revenue Code	278
Min. Negotiated Rate	$329.44
Max. Negotiated Rate	$5,800.00
Rate for Payer: Aetna Commercial	$4,408.00
Rate for Payer: Aetna Medicare Advantage	$3,480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,958.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,958.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,958.00
Rate for Payer: Cigna Commercial	$5,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,807.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,740.00
Rate for Payer: UnitedHealthcare Community & State	$366.56
Rate for Payer: Wellpoint Medicaid Managed Care	$329.44

CROSSLINKED POLY BEARING SZ C

Facility

$7,500.00

Hospital Charge Code	270702439
Hospital Revenue Code	278
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$1,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

CROSSLINKED POLY BEARING SZ C

Facility

$7,500.00

Hospital Charge Code	270702439
Hospital Revenue Code	278
Min. Negotiated Rate	$213.00
Max. Negotiated Rate	$3,750.00
Rate for Payer: Aetna Commercial	$2,850.00
Rate for Payer: Aetna Medicare Advantage	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,912.50
Rate for Payer: Cigna Commercial	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00
Rate for Payer: UnitedHealthcare Community & State	$237.00
Rate for Payer: Wellpoint Medicaid Managed Care	$213.00

CROSSMATCH(ANTIGLOBULIN) EACH

Facility

$149.00

Service Code	HCPCS 86922
Hospital Charge Code	38471077
Hospital Revenue Code	309
Min. Negotiated Rate	$4.23
Max. Negotiated Rate	$734.21
Rate for Payer: Aetna Commercial	$550.53
Rate for Payer: Aetna Medicare Advantage	$655.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$734.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$734.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$202.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$734.21
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$202.40
Rate for Payer: Clover Medicare Advantage	$192.28
Rate for Payer: EmblemHealth Commercial	$607.20
Rate for Payer: Humana Medicare Advantage	$208.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$202.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.74
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.35
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$12.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$202.40
Rate for Payer: Wellcare Medicare Advantage	$202.40
Rate for Payer: Wellpoint Medicaid Managed Care	$4.23

CROSSMATCH(ANTIGLOBULIN) EACH

Facility

$149.00

Service Code	HCPCS 86922
Hospital Charge Code	38471077
Hospital Revenue Code	309
Min. Negotiated Rate	$22.35
Max. Negotiated Rate	$22.35
Rate for Payer: Qualcare PPO/HMO/WC	$22.35

CROSSMATCH(IMMED SPIN) EACH

Facility

$126.00

Service Code	HCPCS 86920
Hospital Charge Code	38471075
Hospital Revenue Code	309
Min. Negotiated Rate	$3.58
Max. Negotiated Rate	$734.21
Rate for Payer: Aetna Commercial	$550.53
Rate for Payer: Aetna Medicare Advantage	$655.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$734.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$734.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$202.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$734.21
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$202.40
Rate for Payer: Clover Medicare Advantage	$192.28
Rate for Payer: EmblemHealth Commercial	$607.20
Rate for Payer: Humana Medicare Advantage	$208.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$202.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.76
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.90
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$12.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$202.40
Rate for Payer: Wellcare Medicare Advantage	$202.40
Rate for Payer: Wellpoint Medicaid Managed Care	$3.58

CROSSMATCH(IMMED SPIN) EACH

Facility

$126.00

Service Code	HCPCS 86920
Hospital Charge Code	38471075
Hospital Revenue Code	309
Min. Negotiated Rate	$18.90
Max. Negotiated Rate	$18.90
Rate for Payer: Qualcare PPO/HMO/WC	$18.90

CROSSMATCH (INCUBATION) EACH

Facility

$130.00

Service Code	HCPCS 86921
Hospital Charge Code	38471076
Hospital Revenue Code	309
Min. Negotiated Rate	$19.50
Max. Negotiated Rate	$19.50
Rate for Payer: Qualcare PPO/HMO/WC	$19.50

CROSSMATCH (INCUBATION) EACH

Facility

$130.00

Service Code	HCPCS 86921
Hospital Charge Code	38471076
Hospital Revenue Code	309
Min. Negotiated Rate	$3.69
Max. Negotiated Rate	$734.21
Rate for Payer: Aetna Commercial	$550.53
Rate for Payer: Aetna Medicare Advantage	$655.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$734.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$734.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$202.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$734.21
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$202.40
Rate for Payer: Clover Medicare Advantage	$192.28
Rate for Payer: EmblemHealth Commercial	$607.20
Rate for Payer: Humana Medicare Advantage	$208.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$202.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.80
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$12.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$202.40
Rate for Payer: Wellcare Medicare Advantage	$202.40
Rate for Payer: Wellpoint Medicaid Managed Care	$3.69

CROSSMATCH PRE-WARM EA

Facility

$149.00

Service Code	HCPCS 86922
Hospital Charge Code	38471154
Hospital Revenue Code	309
Min. Negotiated Rate	$22.35
Max. Negotiated Rate	$22.35
Rate for Payer: Qualcare PPO/HMO/WC	$22.35

CROSSMATCH PRE-WARM EA

Facility

$149.00

Service Code	HCPCS 86922
Hospital Charge Code	38471154
Hospital Revenue Code	309
Min. Negotiated Rate	$4.23
Max. Negotiated Rate	$734.21
Rate for Payer: Aetna Commercial	$550.53
Rate for Payer: Aetna Medicare Advantage	$655.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$734.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$734.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$202.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$734.21
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$202.40
Rate for Payer: Clover Medicare Advantage	$192.28
Rate for Payer: EmblemHealth Commercial	$607.20
Rate for Payer: Humana Medicare Advantage	$208.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$202.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.74
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.35
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$12.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$202.40
Rate for Payer: Wellcare Medicare Advantage	$202.40
Rate for Payer: Wellpoint Medicaid Managed Care	$4.23

CROUCH CORNEAL PROTECTOR

Facility

$77.00

Hospital Charge Code	270332125
Hospital Revenue Code	272
Min. Negotiated Rate	$11.55
Max. Negotiated Rate	$11.55
Rate for Payer: Qualcare PPO/HMO/WC	$11.55

CROUCH CORNEAL PROTECTOR

Facility

$77.00

Hospital Charge Code	270332125
Hospital Revenue Code	272
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$38.50
Rate for Payer: Aetna Commercial	$29.26
Rate for Payer: Aetna Medicare Advantage	$23.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.64
Rate for Payer: Cigna Commercial	$38.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.02
Rate for Payer: Oxford Commercial	$15.40
Rate for Payer: Qualcare PPO/HMO/WC	$11.55
Rate for Payer: UnitedHealthcare Commercial	$15.40
Rate for Payer: UnitedHealthcare Community & State	$2.43
Rate for Payer: Wellpoint Medicaid Managed Care	$2.19

Know your out-of-pocket cost for care.

All Charges