Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CUFFS ATS DUAL PORT 24 SINGLE

Facility

$378.50

Hospital Charge Code	270645840
Hospital Revenue Code	271
Min. Negotiated Rate	$56.77
Max. Negotiated Rate	$56.77
Rate for Payer: Qualcare PPO/HMO/WC	$56.77

CUFFS ATS DUAL PORT 24 SINGLE

Facility

$378.50

Hospital Charge Code	270645840
Hospital Revenue Code	271
Min. Negotiated Rate	$10.75
Max. Negotiated Rate	$189.25
Rate for Payer: Aetna Commercial	$143.83
Rate for Payer: Aetna Medicare Advantage	$113.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.52
Rate for Payer: Cigna Commercial	$189.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.41
Rate for Payer: Oxford Commercial	$75.70
Rate for Payer: Qualcare PPO/HMO/WC	$56.77
Rate for Payer: UnitedHealthcare Commercial	$75.70
Rate for Payer: UnitedHealthcare Community & State	$11.96
Rate for Payer: Wellpoint Medicaid Managed Care	$10.75

CUFF STD ARM/SINGLE HOSE NAVY

Facility

$172.50

Hospital Charge Code	270658223
Hospital Revenue Code	270
Min. Negotiated Rate	$25.88
Max. Negotiated Rate	$25.88
Rate for Payer: Qualcare PPO/HMO/WC	$25.88

CUFF STD ARM/SINGLE HOSE NAVY

Facility

$172.50

Hospital Charge Code	270658223
Hospital Revenue Code	270
Min. Negotiated Rate	$4.90
Max. Negotiated Rate	$86.25
Rate for Payer: Aetna Commercial	$65.55
Rate for Payer: Aetna Medicare Advantage	$51.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.99
Rate for Payer: Cigna Commercial	$86.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.85
Rate for Payer: Oxford Commercial	$34.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.88
Rate for Payer: UnitedHealthcare Commercial	$34.50
Rate for Payer: UnitedHealthcare Community & State	$5.45
Rate for Payer: Wellpoint Medicaid Managed Care	$4.90

CUFF TOURNIQ DISP 18 2911-18

Facility

$96.90

Hospital Charge Code	270602691
Hospital Revenue Code	272
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$48.45
Rate for Payer: Aetna Commercial	$36.82
Rate for Payer: Aetna Medicare Advantage	$29.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.71
Rate for Payer: Cigna Commercial	$48.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.19
Rate for Payer: Oxford Commercial	$19.38
Rate for Payer: Qualcare PPO/HMO/WC	$14.54
Rate for Payer: UnitedHealthcare Commercial	$19.38
Rate for Payer: UnitedHealthcare Community & State	$3.06
Rate for Payer: Wellpoint Medicaid Managed Care	$2.75

CUFF TOURNIQ DISP 18 2911-18

Facility

$96.90

Hospital Charge Code	270602691
Hospital Revenue Code	272
Min. Negotiated Rate	$14.54
Max. Negotiated Rate	$14.54
Rate for Payer: Qualcare PPO/HMO/WC	$14.54

CUFF TOURNIQ DISP 2911-34

Facility

$139.00

Hospital Charge Code	270600368
Hospital Revenue Code	272
Min. Negotiated Rate	$3.95
Max. Negotiated Rate	$69.50
Rate for Payer: Aetna Commercial	$52.82
Rate for Payer: Aetna Medicare Advantage	$41.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.45
Rate for Payer: Cigna Commercial	$69.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.14
Rate for Payer: Oxford Commercial	$27.80
Rate for Payer: Qualcare PPO/HMO/WC	$20.85
Rate for Payer: UnitedHealthcare Commercial	$27.80
Rate for Payer: UnitedHealthcare Community & State	$4.39
Rate for Payer: Wellpoint Medicaid Managed Care	$3.95

CUFF TOURNIQ DISP 2911-34

Facility

$139.00

Hospital Charge Code	270600368
Hospital Revenue Code	272
Min. Negotiated Rate	$20.85
Max. Negotiated Rate	$20.85
Rate for Payer: Qualcare PPO/HMO/WC	$20.85

CUFF TOURNIQUET DISP 24

Facility

$355.00

Hospital Charge Code	270666472
Hospital Revenue Code	272
Min. Negotiated Rate	$53.25
Max. Negotiated Rate	$53.25
Rate for Payer: Qualcare PPO/HMO/WC	$53.25

CUFF TOURNIQUET DISP 24

Facility

$355.00

Hospital Charge Code	270666472
Hospital Revenue Code	272
Min. Negotiated Rate	$10.08
Max. Negotiated Rate	$177.50
Rate for Payer: Aetna Commercial	$134.90
Rate for Payer: Aetna Medicare Advantage	$106.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$90.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$90.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$90.53
Rate for Payer: Cigna Commercial	$177.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.30
Rate for Payer: Oxford Commercial	$71.00
Rate for Payer: Qualcare PPO/HMO/WC	$53.25
Rate for Payer: UnitedHealthcare Commercial	$71.00
Rate for Payer: UnitedHealthcare Community & State	$11.22
Rate for Payer: Wellpoint Medicaid Managed Care	$10.08

CUFF TOURNIQUET PLC 12 DISP

Facility

$100.96

Hospital Charge Code	270648578
Hospital Revenue Code	272
Min. Negotiated Rate	$15.14
Max. Negotiated Rate	$15.14
Rate for Payer: Qualcare PPO/HMO/WC	$15.14

CUFF TOURNIQUET PLC 12 DISP

Facility

$100.96

Hospital Charge Code	270648578
Hospital Revenue Code	272
Min. Negotiated Rate	$2.87
Max. Negotiated Rate	$50.48
Rate for Payer: Aetna Commercial	$38.36
Rate for Payer: Aetna Medicare Advantage	$30.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.74
Rate for Payer: Cigna Commercial	$50.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.25
Rate for Payer: Oxford Commercial	$20.19
Rate for Payer: Qualcare PPO/HMO/WC	$15.14
Rate for Payer: UnitedHealthcare Commercial	$20.19
Rate for Payer: UnitedHealthcare Community & State	$3.19
Rate for Payer: Wellpoint Medicaid Managed Care	$2.87

CUFF TOURNIQUET PLC 30 DISP

Facility

$139.92

Hospital Charge Code	270639239
Hospital Revenue Code	272
Min. Negotiated Rate	$3.97
Max. Negotiated Rate	$69.96
Rate for Payer: Aetna Commercial	$53.17
Rate for Payer: Aetna Medicare Advantage	$41.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.68
Rate for Payer: Cigna Commercial	$69.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.38
Rate for Payer: Oxford Commercial	$27.98
Rate for Payer: Qualcare PPO/HMO/WC	$20.99
Rate for Payer: UnitedHealthcare Commercial	$27.98
Rate for Payer: UnitedHealthcare Community & State	$4.42
Rate for Payer: Wellpoint Medicaid Managed Care	$3.97

CUFF TOURNIQUET PLC 30 DISP

Facility

$139.92

Hospital Charge Code	270639239
Hospital Revenue Code	272
Min. Negotiated Rate	$20.99
Max. Negotiated Rate	$20.99
Rate for Payer: Qualcare PPO/HMO/WC	$20.99

CUFUNGUS,RESP

Facility

$222.00

Service Code	HCPCS 87102
Hospital Charge Code	38479083
Hospital Revenue Code	309
Min. Negotiated Rate	$33.30
Max. Negotiated Rate	$33.30
Rate for Payer: Qualcare PPO/HMO/WC	$33.30

CUFUNGUS,RESP

Facility

$222.00

Service Code	HCPCS 87102
Hospital Charge Code	38479083
Hospital Revenue Code	309
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$22.88
Rate for Payer: Aetna Medicare Advantage	$27.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.51
Rate for Payer: Cigna Commercial	$111.00
Rate for Payer: Cigna Medicare Advantage	$8.41
Rate for Payer: Clover Medicare Advantage	$7.99
Rate for Payer: EmblemHealth Commercial	$25.23
Rate for Payer: Humana Medicare Advantage	$8.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.72
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.30
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$6.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.41
Rate for Payer: Wellcare Medicare Advantage	$8.41
Rate for Payer: Wellpoint Medicaid Managed Care	$6.30

CULT,FUNG'HAIR'DK,NAIL W/KOH I

Facility

$29.10

Service Code	HCPCS 87220
Hospital Charge Code	3990157B
Hospital Revenue Code	309
Min. Negotiated Rate	$0.83
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$11.61
Rate for Payer: Aetna Medicare Advantage	$13.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.49
Rate for Payer: Cigna Commercial	$14.55
Rate for Payer: Cigna Medicare Advantage	$4.27
Rate for Payer: Clover Medicare Advantage	$4.06
Rate for Payer: EmblemHealth Commercial	$12.81
Rate for Payer: Humana Medicare Advantage	$4.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.57
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.37
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$3.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.27
Rate for Payer: Wellcare Medicare Advantage	$4.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.83

CULT,FUNG'HAIR'DK,NAIL W/KOH I

Facility

$53.00

Service Code	HCPCS 87101
Hospital Charge Code	3990157A
Hospital Revenue Code	309
Min. Negotiated Rate	$7.95
Max. Negotiated Rate	$7.95
Rate for Payer: Qualcare PPO/HMO/WC	$7.95

CULT,FUNG'HAIR'DK,NAIL W/KOH I

Facility

$53.00

Service Code	HCPCS 87101
Hospital Charge Code	3990157A
Hospital Revenue Code	309
Min. Negotiated Rate	$1.51
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$20.97
Rate for Payer: Aetna Medicare Advantage	$24.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.97
Rate for Payer: Cigna Commercial	$26.50
Rate for Payer: Cigna Medicare Advantage	$7.71
Rate for Payer: Clover Medicare Advantage	$7.32
Rate for Payer: EmblemHealth Commercial	$23.13
Rate for Payer: Humana Medicare Advantage	$7.94
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.78
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.95
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$6.17
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.71
Rate for Payer: Wellcare Medicare Advantage	$7.71
Rate for Payer: Wellpoint Medicaid Managed Care	$1.51

CULT,FUNG'HAIR'DK,NAIL W/KOH I

Facility

$29.10

Service Code	HCPCS 87220
Hospital Charge Code	3990157B
Hospital Revenue Code	309
Min. Negotiated Rate	$4.37
Max. Negotiated Rate	$4.37
Rate for Payer: Qualcare PPO/HMO/WC	$4.37

CULT,FUNGUS,TISSUE

Facility

$222.00

Service Code	HCPCS 87102
Hospital Charge Code	38479082
Hospital Revenue Code	309
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$22.88
Rate for Payer: Aetna Medicare Advantage	$27.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.51
Rate for Payer: Cigna Commercial	$111.00
Rate for Payer: Cigna Medicare Advantage	$8.41
Rate for Payer: Clover Medicare Advantage	$7.99
Rate for Payer: EmblemHealth Commercial	$25.23
Rate for Payer: Humana Medicare Advantage	$8.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.72
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.30
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$6.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.41
Rate for Payer: Wellcare Medicare Advantage	$8.41
Rate for Payer: Wellpoint Medicaid Managed Care	$6.30

CULT,FUNGUS,TISSUE

Facility

$222.00

Service Code	HCPCS 87102
Hospital Charge Code	38479082
Hospital Revenue Code	309
Min. Negotiated Rate	$33.30
Max. Negotiated Rate	$33.30
Rate for Payer: Qualcare PPO/HMO/WC	$33.30

CULT SKIN GRAFT F/N/HF/G

Facility

$17,020.00

Service Code	HCPCS 15155
Hospital Charge Code	1600000338
Hospital Revenue Code	360
Min. Negotiated Rate	$2,553.00
Max. Negotiated Rate	$2,553.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,553.00

CULT SKIN GRAFT F/N/HF/G

Facility

$17,020.00

Service Code	HCPCS 15155
Hospital Charge Code	1600000338
Hospital Revenue Code	360
Min. Negotiated Rate	$483.37
Max. Negotiated Rate	$15,271.92
Rate for Payer: Aetna Commercial	$11,451.31
Rate for Payer: Aetna Medicare Advantage	$13,640.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,271.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,271.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,210.04
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	$15,271.92
Rate for Payer: Cigna Commercial	$8,439.01
Rate for Payer: Cigna Medicare Advantage	$4,210.04
Rate for Payer: Clover Medicare Advantage	$3,999.54
Rate for Payer: EmblemHealth Commercial	$12,630.12
Rate for Payer: Humana Medicare Advantage	$4,336.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,210.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,425.20
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,553.00
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$537.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,210.04
Rate for Payer: Wellcare Medicare Advantage	$4,210.04
Rate for Payer: Wellpoint Medicaid Managed Care	$483.37

CULT SKINGRFT T/ARM/LEG

Facility

$10,771.05

Service Code	HCPCS 15150
Hospital Charge Code	1600000277
Hospital Revenue Code	360
Min. Negotiated Rate	$1,615.66
Max. Negotiated Rate	$1,615.66
Rate for Payer: Qualcare PPO/HMO/WC	$1,615.66

Know your out-of-pocket cost for care.

All Charges