Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

DISP.MIXING BOWL W/SPATULA

Facility

$75.00

Hospital Charge Code	270331843
Hospital Revenue Code	272
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$2.37
Rate for Payer: Wellpoint Medicaid Managed Care	$2.13

DISP.MIXING BOWL W/SPATULA

Facility

$75.00

Hospital Charge Code	270331843
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

DISPOSABLE ACTIVE CORD

Facility

$209.00

Hospital Charge Code	270332324
Hospital Revenue Code	272
Min. Negotiated Rate	$5.94
Max. Negotiated Rate	$104.50
Rate for Payer: Aetna Commercial	$79.42
Rate for Payer: Aetna Medicare Advantage	$62.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.30
Rate for Payer: Cigna Commercial	$104.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.34
Rate for Payer: Oxford Commercial	$41.80
Rate for Payer: Qualcare PPO/HMO/WC	$31.35
Rate for Payer: UnitedHealthcare Commercial	$41.80
Rate for Payer: UnitedHealthcare Community & State	$6.60
Rate for Payer: Wellpoint Medicaid Managed Care	$5.94

DISPOSABLE ACTIVE CORD

Facility

$209.00

Hospital Charge Code	270332324
Hospital Revenue Code	272
Min. Negotiated Rate	$31.35
Max. Negotiated Rate	$31.35
Rate for Payer: Qualcare PPO/HMO/WC	$31.35

DISPOSABLE CLIP FIXING DEVICE

Facility

$385.00

Hospital Charge Code	270325605
Hospital Revenue Code	272
Min. Negotiated Rate	$10.93
Max. Negotiated Rate	$192.50
Rate for Payer: Aetna Commercial	$146.30
Rate for Payer: Aetna Medicare Advantage	$115.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.17
Rate for Payer: Cigna Commercial	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.10
Rate for Payer: Oxford Commercial	$77.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.75
Rate for Payer: UnitedHealthcare Commercial	$77.00
Rate for Payer: UnitedHealthcare Community & State	$12.17
Rate for Payer: Wellpoint Medicaid Managed Care	$10.93

DISPOSABLE CLIP FIXING DEVICE

Facility

$385.00

Hospital Charge Code	270325605
Hospital Revenue Code	272
Min. Negotiated Rate	$57.75
Max. Negotiated Rate	$57.75
Rate for Payer: Qualcare PPO/HMO/WC	$57.75

DISPOSABLE CRANIAL PERFORATOR

Facility

$860.00

Hospital Charge Code	270657297
Hospital Revenue Code	270
Min. Negotiated Rate	$129.00
Max. Negotiated Rate	$129.00
Rate for Payer: Qualcare PPO/HMO/WC	$129.00

DISPOSABLE CRANIAL PERFORATOR

Facility

$860.00

Hospital Charge Code	270657297
Hospital Revenue Code	270
Min. Negotiated Rate	$24.42
Max. Negotiated Rate	$430.00
Rate for Payer: Aetna Commercial	$326.80
Rate for Payer: Aetna Medicare Advantage	$258.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.30
Rate for Payer: Cigna Commercial	$430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.60
Rate for Payer: Oxford Commercial	$172.00
Rate for Payer: Qualcare PPO/HMO/WC	$129.00
Rate for Payer: UnitedHealthcare Commercial	$172.00
Rate for Payer: UnitedHealthcare Community & State	$27.18
Rate for Payer: Wellpoint Medicaid Managed Care	$24.42

DISPOSABLE DIALATOR SET

Facility

$4,375.00

Hospital Charge Code	270694232
Hospital Revenue Code	272
Min. Negotiated Rate	$124.25
Max. Negotiated Rate	$2,187.50
Rate for Payer: Aetna Commercial	$1,662.50
Rate for Payer: Aetna Medicare Advantage	$1,312.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,115.62
Rate for Payer: Cigna Commercial	$2,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,137.50
Rate for Payer: Oxford Commercial	$875.00
Rate for Payer: Qualcare PPO/HMO/WC	$656.25
Rate for Payer: UnitedHealthcare Commercial	$875.00
Rate for Payer: UnitedHealthcare Community & State	$138.25
Rate for Payer: Wellpoint Medicaid Managed Care	$124.25

DISPOSABLE DIALATOR SET

Facility

$4,375.00

Hospital Charge Code	270694232
Hospital Revenue Code	272
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$656.25
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

DISPOSABLE DILATORS NIM STIM

Facility

$4,125.00

Hospital Charge Code	270692668
Hospital Revenue Code	272
Min. Negotiated Rate	$618.75
Max. Negotiated Rate	$618.75
Rate for Payer: Qualcare PPO/HMO/WC	$618.75

DISPOSABLE DILATORS NIM STIM

Facility

$4,125.00

Hospital Charge Code	270692668
Hospital Revenue Code	272
Min. Negotiated Rate	$117.15
Max. Negotiated Rate	$2,062.50
Rate for Payer: Aetna Commercial	$1,567.50
Rate for Payer: Aetna Medicare Advantage	$1,237.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,051.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,051.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,051.88
Rate for Payer: Cigna Commercial	$2,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,072.50
Rate for Payer: Oxford Commercial	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$618.75
Rate for Payer: UnitedHealthcare Commercial	$825.00
Rate for Payer: UnitedHealthcare Community & State	$130.35
Rate for Payer: Wellpoint Medicaid Managed Care	$117.15

DISPOSABLE DISSECTING HOOK

Facility

$580.00

Hospital Charge Code	270335521
Hospital Revenue Code	272
Min. Negotiated Rate	$87.00
Max. Negotiated Rate	$87.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.00

DISPOSABLE DISSECTING HOOK

Facility

$580.00

Hospital Charge Code	270335521
Hospital Revenue Code	272
Min. Negotiated Rate	$16.47
Max. Negotiated Rate	$290.00
Rate for Payer: Aetna Commercial	$220.40
Rate for Payer: Aetna Medicare Advantage	$174.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.90
Rate for Payer: Cigna Commercial	$290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.80
Rate for Payer: Oxford Commercial	$116.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.00
Rate for Payer: UnitedHealthcare Commercial	$116.00
Rate for Payer: UnitedHealthcare Community & State	$18.33
Rate for Payer: Wellpoint Medicaid Managed Care	$16.47

DISPOSABLE INNER CANNULA SZ.4

Facility

$44.00

Hospital Charge Code	270331692
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$22.00
Rate for Payer: Aetna Commercial	$16.72
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.44
Rate for Payer: Oxford Commercial	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$8.80
Rate for Payer: UnitedHealthcare Community & State	$1.39
Rate for Payer: Wellpoint Medicaid Managed Care	$1.25

DISPOSABLE INNER CANNULA SZ.4

Facility

$44.00

Hospital Charge Code	270331692
Hospital Revenue Code	272
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

DISPOSABLE KIT, 11MM

Facility

$21.40

Hospital Charge Code	270665048
Hospital Revenue Code	270
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$10.70
Rate for Payer: Aetna Commercial	$8.13
Rate for Payer: Aetna Medicare Advantage	$6.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.46
Rate for Payer: Cigna Commercial	$10.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.56
Rate for Payer: Oxford Commercial	$4.28
Rate for Payer: Qualcare PPO/HMO/WC	$3.21
Rate for Payer: UnitedHealthcare Commercial	$4.28
Rate for Payer: UnitedHealthcare Community & State	$0.68
Rate for Payer: Wellpoint Medicaid Managed Care	$0.61

DISPOSABLE KIT, 11MM

Facility

$21.40

Hospital Charge Code	270665048
Hospital Revenue Code	270
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$3.21
Rate for Payer: Qualcare PPO/HMO/WC	$3.21

DISPOSABLE KIT,HIP

Facility

$1,000.00

Hospital Charge Code	270679624
Hospital Revenue Code	272
Min. Negotiated Rate	$28.40
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Oxford Commercial	$200.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$200.00
Rate for Payer: UnitedHealthcare Community & State	$31.60
Rate for Payer: Wellpoint Medicaid Managed Care	$28.40

DISPOSABLE KIT,HIP

Facility

$1,000.00

Hospital Charge Code	270679624
Hospital Revenue Code	272
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

DISPOSABLE KIT STERILE

Facility

$2,875.00

Hospital Charge Code	270680750
Hospital Revenue Code	272
Min. Negotiated Rate	$431.25
Max. Negotiated Rate	$431.25
Rate for Payer: Qualcare PPO/HMO/WC	$431.25

DISPOSABLE KIT STERILE

Facility

$2,875.00

Hospital Charge Code	270680750
Hospital Revenue Code	272
Min. Negotiated Rate	$81.65
Max. Negotiated Rate	$1,437.50
Rate for Payer: Aetna Commercial	$1,092.50
Rate for Payer: Aetna Medicare Advantage	$862.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$733.12
Rate for Payer: Cigna Commercial	$1,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$747.50
Rate for Payer: Oxford Commercial	$575.00
Rate for Payer: Qualcare PPO/HMO/WC	$431.25
Rate for Payer: UnitedHealthcare Commercial	$575.00
Rate for Payer: UnitedHealthcare Community & State	$90.85
Rate for Payer: Wellpoint Medicaid Managed Care	$81.65

DISPOSABLE LIGHT

Facility

$1,822.05

Hospital Charge Code	270701764
Hospital Revenue Code	279
Min. Negotiated Rate	$273.31
Max. Negotiated Rate	$273.31
Rate for Payer: Qualcare PPO/HMO/WC	$273.31

DISPOSABLE LIGHT

Facility

$1,822.05

Hospital Charge Code	270701764
Hospital Revenue Code	279
Min. Negotiated Rate	$51.75
Max. Negotiated Rate	$911.02
Rate for Payer: Aetna Commercial	$692.38
Rate for Payer: Aetna Medicare Advantage	$546.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$464.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$464.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$464.62
Rate for Payer: Cigna Commercial	$911.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$473.73
Rate for Payer: Oxford Commercial	$364.41
Rate for Payer: Qualcare PPO/HMO/WC	$273.31
Rate for Payer: UnitedHealthcare Commercial	$364.41
Rate for Payer: UnitedHealthcare Community & State	$57.58
Rate for Payer: Wellpoint Medicaid Managed Care	$51.75

DISPOSABLE LIGHT CABLE

Facility

$2,500.00

Hospital Charge Code	270694229
Hospital Revenue Code	272
Min. Negotiated Rate	$71.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$650.00
Rate for Payer: Oxford Commercial	$500.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Commercial	$500.00
Rate for Payer: UnitedHealthcare Community & State	$79.00
Rate for Payer: Wellpoint Medicaid Managed Care	$71.00

Know your out-of-pocket cost for care.

All Charges