Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

DEVICE INFLATION ENCORE

Facility

$188.90

Hospital Charge Code	270623273
Hospital Revenue Code	272
Min. Negotiated Rate	$5.36
Max. Negotiated Rate	$94.45
Rate for Payer: Aetna Commercial	$71.78
Rate for Payer: Aetna Medicare Advantage	$56.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.17
Rate for Payer: Cigna Commercial	$94.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.11
Rate for Payer: Oxford Commercial	$37.78
Rate for Payer: Qualcare PPO/HMO/WC	$28.34
Rate for Payer: UnitedHealthcare Commercial	$37.78
Rate for Payer: UnitedHealthcare Community & State	$5.97
Rate for Payer: Wellpoint Medicaid Managed Care	$5.36

DEVICE INFLATION ENCORE

Facility

$188.90

Hospital Charge Code	270623273
Hospital Revenue Code	272
Min. Negotiated Rate	$28.34
Max. Negotiated Rate	$28.34
Rate for Payer: Qualcare PPO/HMO/WC	$28.34

DEVICE INFLATION ENCORE 26

Facility

$359.20

Hospital Charge Code	270638580
Hospital Revenue Code	272
Min. Negotiated Rate	$10.20
Max. Negotiated Rate	$179.60
Rate for Payer: Aetna Commercial	$136.50
Rate for Payer: Aetna Medicare Advantage	$107.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.60
Rate for Payer: Cigna Commercial	$179.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.39
Rate for Payer: Oxford Commercial	$71.84
Rate for Payer: Qualcare PPO/HMO/WC	$53.88
Rate for Payer: UnitedHealthcare Commercial	$71.84
Rate for Payer: UnitedHealthcare Community & State	$11.35
Rate for Payer: Wellpoint Medicaid Managed Care	$10.20

DEVICE INFLATION ENCORE 26

Facility

$359.20

Hospital Charge Code	270638580
Hospital Revenue Code	272
Min. Negotiated Rate	$53.88
Max. Negotiated Rate	$53.88
Rate for Payer: Qualcare PPO/HMO/WC	$53.88

DEVICE INFLATION ENCORE 26

Facility

$194.50

Hospital Charge Code	270623297
Hospital Revenue Code	278
Min. Negotiated Rate	$5.52
Max. Negotiated Rate	$97.25
Rate for Payer: Aetna Commercial	$73.91
Rate for Payer: Aetna Medicare Advantage	$58.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.60
Rate for Payer: Cigna Commercial	$97.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.07
Rate for Payer: Qualcare PPO/HMO/WC	$29.18
Rate for Payer: UnitedHealthcare Community & State	$6.15
Rate for Payer: Wellpoint Medicaid Managed Care	$5.52

DEVICE INFLATION ENCORE 26

Facility

$194.50

Hospital Charge Code	270623297
Hospital Revenue Code	278
Min. Negotiated Rate	$29.18
Max. Negotiated Rate	$47.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.07
Rate for Payer: Qualcare PPO/HMO/WC	$29.18

DEVICE INFLATION GASTRO 90 CM

Facility

$1,255.80

Service Code	HCPCS C1726
Hospital Charge Code	270687754
Hospital Revenue Code	278
Min. Negotiated Rate	$35.66
Max. Negotiated Rate	$627.90
Rate for Payer: Aetna Commercial	$477.20
Rate for Payer: Aetna Medicare Advantage	$376.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$320.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$320.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$320.23
Rate for Payer: Cigna Commercial	$627.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.90
Rate for Payer: Qualcare PPO/HMO/WC	$188.37
Rate for Payer: UnitedHealthcare Community & State	$39.68
Rate for Payer: Wellpoint Medicaid Managed Care	$35.66

DEVICE INFLATION GASTRO 90 CM

Facility

$1,255.80

Service Code	HCPCS C1726
Hospital Charge Code	270687754
Hospital Revenue Code	278
Min. Negotiated Rate	$188.37
Max. Negotiated Rate	$303.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.90
Rate for Payer: Qualcare PPO/HMO/WC	$188.37

DEVICE INFLATION LEVEEN

Facility

$209.95

Hospital Charge Code	270645619
Hospital Revenue Code	272
Min. Negotiated Rate	$31.49
Max. Negotiated Rate	$31.49
Rate for Payer: Qualcare PPO/HMO/WC	$31.49

DEVICE INFLATION LEVEEN

Facility

$209.95

Hospital Charge Code	270645619
Hospital Revenue Code	272
Min. Negotiated Rate	$5.96
Max. Negotiated Rate	$104.97
Rate for Payer: Aetna Commercial	$79.78
Rate for Payer: Aetna Medicare Advantage	$62.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.54
Rate for Payer: Cigna Commercial	$104.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.59
Rate for Payer: Oxford Commercial	$41.99
Rate for Payer: Qualcare PPO/HMO/WC	$31.49
Rate for Payer: UnitedHealthcare Commercial	$41.99
Rate for Payer: UnitedHealthcare Community & State	$6.63
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

DEVICE INFLATION PRESTO

Facility

$170.00

Hospital Charge Code	270695684
Hospital Revenue Code	272
Min. Negotiated Rate	$4.83
Max. Negotiated Rate	$85.00
Rate for Payer: Aetna Commercial	$64.60
Rate for Payer: Aetna Medicare Advantage	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.35
Rate for Payer: Cigna Commercial	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.20
Rate for Payer: Oxford Commercial	$34.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.50
Rate for Payer: UnitedHealthcare Commercial	$34.00
Rate for Payer: UnitedHealthcare Community & State	$5.37
Rate for Payer: Wellpoint Medicaid Managed Care	$4.83

DEVICE INFLATION PRESTO

Facility

$170.00

Hospital Charge Code	270695684
Hospital Revenue Code	272
Min. Negotiated Rate	$25.50
Max. Negotiated Rate	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.50

DEVICEINTERBDYFUSIONFORTLINK

Facility

$16,475.00

Service Code	HCPCS C1889
Hospital Charge Code	270694166
Hospital Revenue Code	278
Min. Negotiated Rate	$2,471.25
Max. Negotiated Rate	$3,986.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25

DEVICEINTERBDYFUSIONFORTLINK

Facility

$16,475.00

Service Code	HCPCS C1889
Hospital Charge Code	270694166
Hospital Revenue Code	278
Min. Negotiated Rate	$467.89
Max. Negotiated Rate	$8,237.50
Rate for Payer: Aetna Commercial	$6,260.50
Rate for Payer: Aetna Medicare Advantage	$4,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,201.12
Rate for Payer: Cigna Commercial	$8,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25
Rate for Payer: UnitedHealthcare Community & State	$520.61
Rate for Payer: Wellpoint Medicaid Managed Care	$467.89

DEVICE KPN KYPHOPAK FX F05A

Facility

$552.75

Hospital Charge Code	270629407
Hospital Revenue Code	272
Min. Negotiated Rate	$15.70
Max. Negotiated Rate	$276.38
Rate for Payer: Aetna Commercial	$210.04
Rate for Payer: Aetna Medicare Advantage	$165.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.95
Rate for Payer: Cigna Commercial	$276.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.72
Rate for Payer: Oxford Commercial	$110.55
Rate for Payer: Qualcare PPO/HMO/WC	$82.91
Rate for Payer: UnitedHealthcare Commercial	$110.55
Rate for Payer: UnitedHealthcare Community & State	$17.47
Rate for Payer: Wellpoint Medicaid Managed Care	$15.70

DEVICE KPN KYPHOPAK FX F05A

Facility

$552.75

Hospital Charge Code	270629407
Hospital Revenue Code	272
Min. Negotiated Rate	$82.91
Max. Negotiated Rate	$82.91
Rate for Payer: Qualcare PPO/HMO/WC	$82.91

DEVICE LOCKING BX CAP SYST

Facility

$46.13

Hospital Charge Code	270650916
Hospital Revenue Code	272
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$23.07
Rate for Payer: Aetna Commercial	$17.53
Rate for Payer: Aetna Medicare Advantage	$13.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.76
Rate for Payer: Cigna Commercial	$23.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.99
Rate for Payer: Oxford Commercial	$9.23
Rate for Payer: Qualcare PPO/HMO/WC	$6.92
Rate for Payer: UnitedHealthcare Commercial	$9.23
Rate for Payer: UnitedHealthcare Community & State	$1.46
Rate for Payer: Wellpoint Medicaid Managed Care	$1.31

DEVICE LOCKING BX CAP SYST

Facility

$46.13

Hospital Charge Code	270650916
Hospital Revenue Code	272
Min. Negotiated Rate	$6.92
Max. Negotiated Rate	$6.92
Rate for Payer: Qualcare PPO/HMO/WC	$6.92

DEVICE LOOP LIGATING MAJ-254

Facility

$161.65

Hospital Charge Code	270618994
Hospital Revenue Code	272
Min. Negotiated Rate	$4.59
Max. Negotiated Rate	$80.83
Rate for Payer: Aetna Commercial	$61.43
Rate for Payer: Aetna Medicare Advantage	$48.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.22
Rate for Payer: Cigna Commercial	$80.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.03
Rate for Payer: Oxford Commercial	$32.33
Rate for Payer: Qualcare PPO/HMO/WC	$24.25
Rate for Payer: UnitedHealthcare Commercial	$32.33
Rate for Payer: UnitedHealthcare Community & State	$5.11
Rate for Payer: Wellpoint Medicaid Managed Care	$4.59

DEVICE LOOP LIGATING MAJ-254

Facility

$161.65

Hospital Charge Code	270618994
Hospital Revenue Code	272
Min. Negotiated Rate	$24.25
Max. Negotiated Rate	$24.25
Rate for Payer: Qualcare PPO/HMO/WC	$24.25

DEVICE MYOSURE POLYP REMOVAL

Facility

$7,190.10

Hospital Charge Code	270662592
Hospital Revenue Code	272
Min. Negotiated Rate	$1,078.52
Max. Negotiated Rate	$1,078.52
Rate for Payer: Qualcare PPO/HMO/WC	$1,078.52

DEVICE MYOSURE POLYP REMOVAL

Facility

$7,190.10

Hospital Charge Code	270662592
Hospital Revenue Code	272
Min. Negotiated Rate	$204.20
Max. Negotiated Rate	$3,595.05
Rate for Payer: Aetna Commercial	$2,732.24
Rate for Payer: Aetna Medicare Advantage	$2,157.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,833.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,833.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,833.48
Rate for Payer: Cigna Commercial	$3,595.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,869.43
Rate for Payer: Oxford Commercial	$1,438.02
Rate for Payer: Qualcare PPO/HMO/WC	$1,078.52
Rate for Payer: UnitedHealthcare Commercial	$1,438.02
Rate for Payer: UnitedHealthcare Community & State	$227.21
Rate for Payer: Wellpoint Medicaid Managed Care	$204.20

DEVICE NOVASURE DISPOSABLE

Facility

$4,750.00

Hospital Charge Code	270637493
Hospital Revenue Code	272
Min. Negotiated Rate	$134.90
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,805.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,235.00
Rate for Payer: Oxford Commercial	$950.00
Rate for Payer: Qualcare PPO/HMO/WC	$712.50
Rate for Payer: UnitedHealthcare Commercial	$950.00
Rate for Payer: UnitedHealthcare Community & State	$150.10
Rate for Payer: Wellpoint Medicaid Managed Care	$134.90

DEVICE NOVASURE DISPOSABLE

Facility

$4,750.00

Hospital Charge Code	270637493
Hospital Revenue Code	272
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$712.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

DEVICE POLYP REMOVAL MYOSURE

Facility

$3,466.67

Hospital Charge Code	270662591
Hospital Revenue Code	272
Min. Negotiated Rate	$98.45
Max. Negotiated Rate	$1,733.34
Rate for Payer: Aetna Commercial	$1,317.33
Rate for Payer: Aetna Medicare Advantage	$1,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$884.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$884.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$884.00
Rate for Payer: Cigna Commercial	$1,733.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$901.33
Rate for Payer: Oxford Commercial	$693.33
Rate for Payer: Qualcare PPO/HMO/WC	$520.00
Rate for Payer: UnitedHealthcare Commercial	$693.33
Rate for Payer: UnitedHealthcare Community & State	$109.55
Rate for Payer: Wellpoint Medicaid Managed Care	$98.45

Know your out-of-pocket cost for care.

All Charges