Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ADAPTERS/ACCESSORIES

Facility

$2,000.00

Hospital Charge Code	270702508
Hospital Revenue Code	270
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

ADAPTERS/ACCESSORIES

Facility

$2,000.00

Hospital Charge Code	270702508
Hospital Revenue Code	270
Min. Negotiated Rate	$56.80
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$520.00
Rate for Payer: Oxford Commercial	$400.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Commercial	$400.00
Rate for Payer: UnitedHealthcare Community & State	$63.20
Rate for Payer: Wellpoint Medicaid Managed Care	$56.80

ADAPTER & SCREW CC 5 STEM EXT

Facility

$1,406.25

Service Code	HCPCS C1713
Hospital Charge Code	270668743
Hospital Revenue Code	278
Min. Negotiated Rate	$210.94
Max. Negotiated Rate	$340.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$281.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$340.31
Rate for Payer: Qualcare PPO/HMO/WC	$210.94

ADAPTER & SCREW CC 5 STEM EXT

Facility

$1,406.25

Service Code	HCPCS C1713
Hospital Charge Code	270668743
Hospital Revenue Code	278
Min. Negotiated Rate	$39.94
Max. Negotiated Rate	$703.12
Rate for Payer: Aetna Commercial	$534.38
Rate for Payer: Aetna Medicare Advantage	$421.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$358.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$358.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$281.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$358.59
Rate for Payer: Cigna Commercial	$703.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$340.31
Rate for Payer: Qualcare PPO/HMO/WC	$210.94
Rate for Payer: UnitedHealthcare Community & State	$44.44
Rate for Payer: Wellpoint Medicaid Managed Care	$39.94

ADAPTER SLEEVE FEMR HD +0MM

Facility

$3,000.00

Hospital Charge Code	270672502
Hospital Revenue Code	278
Min. Negotiated Rate	$85.20
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$94.80
Rate for Payer: Wellpoint Medicaid Managed Care	$85.20

ADAPTER SLEEVE FEMR HD +0MM

Facility

$3,000.00

Hospital Charge Code	270672502
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

ADAPTER SLEEVE FEMR HD +3.5MM

Facility

$3,000.00

Hospital Charge Code	270672503
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

ADAPTER SLEEVE FEMR HD +3.5MM

Facility

$3,000.00

Hospital Charge Code	270672503
Hospital Revenue Code	278
Min. Negotiated Rate	$85.20
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$94.80
Rate for Payer: Wellpoint Medicaid Managed Care	$85.20

ADAPTER SLEEVE FEMR HD -3.5MM

Facility

$3,000.00

Hospital Charge Code	270672500
Hospital Revenue Code	278
Min. Negotiated Rate	$85.20
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$94.80
Rate for Payer: Wellpoint Medicaid Managed Care	$85.20

ADAPTER SLEEVE FEMR HD -3.5MM

Facility

$3,000.00

Hospital Charge Code	270672500
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

ADAPTER SLEEVE FEMR HD +7MM

Facility

$3,000.00

Hospital Charge Code	270672504
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

ADAPTER SLEEVE FEMR HD +7MM

Facility

$3,000.00

Hospital Charge Code	270672504
Hospital Revenue Code	278
Min. Negotiated Rate	$85.20
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$94.80
Rate for Payer: Wellpoint Medicaid Managed Care	$85.20

ADAPTER STEM OFFSET 6MM

Facility

$1,284.00

Service Code	HCPCS C1776
Hospital Charge Code	270676880
Hospital Revenue Code	278
Min. Negotiated Rate	$36.47
Max. Negotiated Rate	$642.00
Rate for Payer: Aetna Commercial	$487.92
Rate for Payer: Aetna Medicare Advantage	$385.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$327.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$327.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$256.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$327.42
Rate for Payer: Cigna Commercial	$642.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.73
Rate for Payer: Qualcare PPO/HMO/WC	$192.60
Rate for Payer: UnitedHealthcare Community & State	$40.57
Rate for Payer: Wellpoint Medicaid Managed Care	$36.47

ADAPTER STEM OFFSET 6MM

Facility

$1,284.00

Service Code	HCPCS C1776
Hospital Charge Code	270676880
Hospital Revenue Code	278
Min. Negotiated Rate	$192.60
Max. Negotiated Rate	$310.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$256.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.73
Rate for Payer: Qualcare PPO/HMO/WC	$192.60

ADAPTER SWIVEL ANGLE PEEP

Facility

$8.71

Hospital Charge Code	270660203
Hospital Revenue Code	270
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$4.36
Rate for Payer: Aetna Commercial	$3.31
Rate for Payer: Aetna Medicare Advantage	$2.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.22
Rate for Payer: Cigna Commercial	$4.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.26
Rate for Payer: Oxford Commercial	$1.74
Rate for Payer: Qualcare PPO/HMO/WC	$1.31
Rate for Payer: UnitedHealthcare Commercial	$1.74
Rate for Payer: UnitedHealthcare Community & State	$0.28
Rate for Payer: Wellpoint Medicaid Managed Care	$0.25

ADAPTER SWIVEL ANGLE PEEP

Facility

$8.71

Hospital Charge Code	270660203
Hospital Revenue Code	270
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$1.31
Rate for Payer: Qualcare PPO/HMO/WC	$1.31

ADAPTER SWIVEL FIBEROPTIC

Facility

$87.20

Hospital Charge Code	270655451
Hospital Revenue Code	270
Min. Negotiated Rate	$2.48
Max. Negotiated Rate	$43.60
Rate for Payer: Aetna Commercial	$33.14
Rate for Payer: Aetna Medicare Advantage	$26.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.24
Rate for Payer: Cigna Commercial	$43.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.67
Rate for Payer: Oxford Commercial	$17.44
Rate for Payer: Qualcare PPO/HMO/WC	$13.08
Rate for Payer: UnitedHealthcare Commercial	$17.44
Rate for Payer: UnitedHealthcare Community & State	$2.76
Rate for Payer: Wellpoint Medicaid Managed Care	$2.48

ADAPTER SWIVEL FIBEROPTIC

Facility

$87.20

Hospital Charge Code	270655451
Hospital Revenue Code	270
Min. Negotiated Rate	$13.08
Max. Negotiated Rate	$13.08
Rate for Payer: Qualcare PPO/HMO/WC	$13.08

ADAPTER T 15MM X 15MM VALVED

Facility

$232.95

Hospital Charge Code	270651381
Hospital Revenue Code	270
Min. Negotiated Rate	$6.62
Max. Negotiated Rate	$116.47
Rate for Payer: Aetna Commercial	$88.52
Rate for Payer: Aetna Medicare Advantage	$69.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.40
Rate for Payer: Cigna Commercial	$116.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.57
Rate for Payer: Oxford Commercial	$46.59
Rate for Payer: Qualcare PPO/HMO/WC	$34.94
Rate for Payer: UnitedHealthcare Commercial	$46.59
Rate for Payer: UnitedHealthcare Community & State	$7.36
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

ADAPTER T 15MM X 15MM VALVED

Facility

$232.95

Hospital Charge Code	270651381
Hospital Revenue Code	270
Min. Negotiated Rate	$34.94
Max. Negotiated Rate	$34.94
Rate for Payer: Qualcare PPO/HMO/WC	$34.94

ADAPTER T 22MM X 22MM VALVED

Facility

$227.90

Hospital Charge Code	270651380
Hospital Revenue Code	270
Min. Negotiated Rate	$6.47
Max. Negotiated Rate	$113.95
Rate for Payer: Aetna Commercial	$86.60
Rate for Payer: Aetna Medicare Advantage	$68.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.11
Rate for Payer: Cigna Commercial	$113.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.25
Rate for Payer: Oxford Commercial	$45.58
Rate for Payer: Qualcare PPO/HMO/WC	$34.19
Rate for Payer: UnitedHealthcare Commercial	$45.58
Rate for Payer: UnitedHealthcare Community & State	$7.20
Rate for Payer: Wellpoint Medicaid Managed Care	$6.47

ADAPTER T 22MM X 22MM VALVED

Facility

$227.90

Hospital Charge Code	270651380
Hospital Revenue Code	270
Min. Negotiated Rate	$34.19
Max. Negotiated Rate	$34.19
Rate for Payer: Qualcare PPO/HMO/WC	$34.19

ADAPTER TAPER ECCENTRICAL 2MM

Facility

$2,335.00

Service Code	HCPCS C1776
Hospital Charge Code	270666202
Hospital Revenue Code	278
Min. Negotiated Rate	$350.25
Max. Negotiated Rate	$565.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$467.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$565.07
Rate for Payer: Qualcare PPO/HMO/WC	$350.25

ADAPTER TAPER ECCENTRICAL 2MM

Facility

$2,335.00

Service Code	HCPCS C1776
Hospital Charge Code	270666202
Hospital Revenue Code	278
Min. Negotiated Rate	$66.31
Max. Negotiated Rate	$1,167.50
Rate for Payer: Aetna Commercial	$887.30
Rate for Payer: Aetna Medicare Advantage	$700.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$595.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$595.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$467.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$595.42
Rate for Payer: Cigna Commercial	$1,167.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$565.07
Rate for Payer: Qualcare PPO/HMO/WC	$350.25
Rate for Payer: UnitedHealthcare Community & State	$73.79
Rate for Payer: Wellpoint Medicaid Managed Care	$66.31

ADAPTER TAPER NEUTRAL

Facility

$1,500.00

Hospital Charge Code	270676241
Hospital Revenue Code	272
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

Know your out-of-pocket cost for care.

All Charges