Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

DISSECTOR 3.5MM x 7CM

Facility

$330.00

Hospital Charge Code	270702077
Hospital Revenue Code	272
Min. Negotiated Rate	$49.50
Max. Negotiated Rate	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$49.50

DISSECTOR 3.5MM x 7CM

Facility

$330.00

Hospital Charge Code	270702077
Hospital Revenue Code	272
Min. Negotiated Rate	$9.37
Max. Negotiated Rate	$165.00
Rate for Payer: Aetna Commercial	$125.40
Rate for Payer: Aetna Medicare Advantage	$99.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.15
Rate for Payer: Cigna Commercial	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.80
Rate for Payer: Oxford Commercial	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.50
Rate for Payer: UnitedHealthcare Commercial	$66.00
Rate for Payer: UnitedHealthcare Community & State	$10.43
Rate for Payer: Wellpoint Medicaid Managed Care	$9.37

DISSECTOR BALLOON OVAL

Facility

$2,744.58

Hospital Charge Code	270655645
Hospital Revenue Code	272
Min. Negotiated Rate	$77.95
Max. Negotiated Rate	$1,372.29
Rate for Payer: Aetna Commercial	$1,042.94
Rate for Payer: Aetna Medicare Advantage	$823.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$699.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$699.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$699.87
Rate for Payer: Cigna Commercial	$1,372.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$713.59
Rate for Payer: Oxford Commercial	$548.92
Rate for Payer: Qualcare PPO/HMO/WC	$411.69
Rate for Payer: UnitedHealthcare Commercial	$548.92
Rate for Payer: UnitedHealthcare Community & State	$86.73
Rate for Payer: Wellpoint Medicaid Managed Care	$77.95

DISSECTOR BALLOON OVAL

Facility

$2,744.58

Hospital Charge Code	270655645
Hospital Revenue Code	272
Min. Negotiated Rate	$411.69
Max. Negotiated Rate	$411.69
Rate for Payer: Qualcare PPO/HMO/WC	$411.69

DISSECTOR BALLOON ROUND

Facility

$1,790.60

Service Code	HCPCS C1727
Hospital Charge Code	270665626
Hospital Revenue Code	278
Min. Negotiated Rate	$268.59
Max. Negotiated Rate	$433.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$358.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$433.33
Rate for Payer: Qualcare PPO/HMO/WC	$268.59

DISSECTOR BALLOON ROUND

Facility

$1,790.60

Service Code	HCPCS C1727
Hospital Charge Code	270665626
Hospital Revenue Code	278
Min. Negotiated Rate	$50.85
Max. Negotiated Rate	$895.30
Rate for Payer: Aetna Commercial	$680.43
Rate for Payer: Aetna Medicare Advantage	$537.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$456.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$456.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$358.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$456.60
Rate for Payer: Cigna Commercial	$895.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$433.33
Rate for Payer: Qualcare PPO/HMO/WC	$268.59
Rate for Payer: UnitedHealthcare Community & State	$56.58
Rate for Payer: Wellpoint Medicaid Managed Care	$50.85

DISSECTOR BALLOON SBT ROUND SM

Facility

$6,836.00

Hospital Charge Code	270683704
Hospital Revenue Code	272
Min. Negotiated Rate	$1,025.40
Max. Negotiated Rate	$1,025.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,025.40

DISSECTOR BALLOON SBT ROUND SM

Facility

$6,836.00

Hospital Charge Code	270683704
Hospital Revenue Code	272
Min. Negotiated Rate	$194.14
Max. Negotiated Rate	$3,418.00
Rate for Payer: Aetna Commercial	$2,597.68
Rate for Payer: Aetna Medicare Advantage	$2,050.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,743.18
Rate for Payer: Cigna Commercial	$3,418.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,777.36
Rate for Payer: Oxford Commercial	$1,367.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,025.40
Rate for Payer: UnitedHealthcare Commercial	$1,367.20
Rate for Payer: UnitedHealthcare Community & State	$216.02
Rate for Payer: Wellpoint Medicaid Managed Care	$194.14

DISSECTOR BLUNT TIP 5MM

Facility

$2,249.25

Hospital Charge Code	270637402
Hospital Revenue Code	272
Min. Negotiated Rate	$63.88
Max. Negotiated Rate	$1,124.62
Rate for Payer: Aetna Commercial	$854.72
Rate for Payer: Aetna Medicare Advantage	$674.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.56
Rate for Payer: Cigna Commercial	$1,124.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$584.80
Rate for Payer: Oxford Commercial	$449.85
Rate for Payer: Qualcare PPO/HMO/WC	$337.39
Rate for Payer: UnitedHealthcare Commercial	$449.85
Rate for Payer: UnitedHealthcare Community & State	$71.08
Rate for Payer: Wellpoint Medicaid Managed Care	$63.88

DISSECTOR BLUNT TIP 5MM

Facility

$2,249.25

Hospital Charge Code	270637402
Hospital Revenue Code	272
Min. Negotiated Rate	$337.39
Max. Negotiated Rate	$337.39
Rate for Payer: Qualcare PPO/HMO/WC	$337.39

DISSECTOR CRVD ULTRASONIC 39MM

Facility

$2,440.00

Service Code	HCPCS A4649
Hospital Charge Code	270696236
Hospital Revenue Code	272
Min. Negotiated Rate	$366.00
Max. Negotiated Rate	$366.00
Rate for Payer: Qualcare PPO/HMO/WC	$366.00

DISSECTOR CRVD ULTRASONIC 39MM

Facility

$2,440.00

Service Code	HCPCS A4649
Hospital Charge Code	270696236
Hospital Revenue Code	272
Min. Negotiated Rate	$69.30
Max. Negotiated Rate	$1,220.00
Rate for Payer: Aetna Commercial	$927.20
Rate for Payer: Aetna Medicare Advantage	$732.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$622.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$622.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$622.20
Rate for Payer: Cigna Commercial	$1,220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$634.40
Rate for Payer: Oxford Commercial	$488.00
Rate for Payer: Qualcare PPO/HMO/WC	$366.00
Rate for Payer: UnitedHealthcare Commercial	$488.00
Rate for Payer: UnitedHealthcare Community & State	$77.10
Rate for Payer: Wellpoint Medicaid Managed Care	$69.30

DISSECTOR ENDO ULTRASONIC 39CM

Facility

$2,040.00

Hospital Charge Code	270683165
Hospital Revenue Code	270
Min. Negotiated Rate	$57.94
Max. Negotiated Rate	$1,020.00
Rate for Payer: Aetna Commercial	$775.20
Rate for Payer: Aetna Medicare Advantage	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$520.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$520.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$520.20
Rate for Payer: Cigna Commercial	$1,020.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$530.40
Rate for Payer: Oxford Commercial	$408.00
Rate for Payer: Qualcare PPO/HMO/WC	$306.00
Rate for Payer: UnitedHealthcare Commercial	$408.00
Rate for Payer: UnitedHealthcare Community & State	$64.46
Rate for Payer: Wellpoint Medicaid Managed Care	$57.94

DISSECTOR ENDO ULTRASONIC 39CM

Facility

$2,040.00

Hospital Charge Code	270683165
Hospital Revenue Code	270
Min. Negotiated Rate	$306.00
Max. Negotiated Rate	$306.00
Rate for Payer: Qualcare PPO/HMO/WC	$306.00

DISSECTOR SONICISION 39CM

Facility

$2,074.00

Hospital Charge Code	270696171
Hospital Revenue Code	272
Min. Negotiated Rate	$58.90
Max. Negotiated Rate	$1,037.00
Rate for Payer: Aetna Commercial	$788.12
Rate for Payer: Aetna Medicare Advantage	$622.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$528.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$528.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$528.87
Rate for Payer: Cigna Commercial	$1,037.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$539.24
Rate for Payer: Oxford Commercial	$414.80
Rate for Payer: Qualcare PPO/HMO/WC	$311.10
Rate for Payer: UnitedHealthcare Commercial	$414.80
Rate for Payer: UnitedHealthcare Community & State	$65.54
Rate for Payer: Wellpoint Medicaid Managed Care	$58.90

DISSECTOR SONICISION 39CM

Facility

$2,074.00

Hospital Charge Code	270696171
Hospital Revenue Code	272
Min. Negotiated Rate	$311.10
Max. Negotiated Rate	$311.10
Rate for Payer: Qualcare PPO/HMO/WC	$311.10

DISSECTOR SPACEMAKER BALLOON

Facility

$1,750.00

Hospital Charge Code	270658705
Hospital Revenue Code	272
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

DISSECTOR SPACEMAKER BALLOON

Facility

$1,750.00

Hospital Charge Code	270658705
Hospital Revenue Code	272
Min. Negotiated Rate	$49.70
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$455.00
Rate for Payer: Oxford Commercial	$350.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Commercial	$350.00
Rate for Payer: UnitedHealthcare Community & State	$55.30
Rate for Payer: Wellpoint Medicaid Managed Care	$49.70

DISSOLVE CLOT HEART VESSEL

Facility

$35,998.44

Service Code	HCPCS 93799
Hospital Charge Code	411092975
Hospital Revenue Code	481
Min. Negotiated Rate	$5,399.77
Max. Negotiated Rate	$5,399.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77

DISSOLVE CLOT HEART VESSEL

Facility

$35,998.44

Service Code	HCPCS 93799
Hospital Charge Code	411092975
Hospital Revenue Code	481
Min. Negotiated Rate	$145.23
Max. Negotiated Rate	$9,359.59
Rate for Payer: Aetna Commercial	$415.81
Rate for Payer: Aetna Medicare Advantage	$495.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$554.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$554.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$152.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$554.54
Rate for Payer: Cigna Commercial	$306.43
Rate for Payer: Cigna Medicare Advantage	$152.87
Rate for Payer: Clover Medicare Advantage	$145.23
Rate for Payer: EmblemHealth Commercial	$458.61
Rate for Payer: Humana Medicare Advantage	$157.46
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$152.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,359.59
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$1,137.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$152.87
Rate for Payer: Wellcare Medicare Advantage	$152.87
Rate for Payer: Wellpoint Medicaid Managed Care	$1,022.36

DISTAL 5MM FEMORAL SZ 1

Facility

$3,861.00

Hospital Charge Code	270670057
Hospital Revenue Code	278
Min. Negotiated Rate	$579.15
Max. Negotiated Rate	$934.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$772.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$934.36
Rate for Payer: Qualcare PPO/HMO/WC	$579.15

DISTAL 5MM FEMORAL SZ 1

Facility

$3,861.00

Hospital Charge Code	270670057
Hospital Revenue Code	278
Min. Negotiated Rate	$109.65
Max. Negotiated Rate	$1,930.50
Rate for Payer: Aetna Commercial	$1,467.18
Rate for Payer: Aetna Medicare Advantage	$1,158.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$984.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$984.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$772.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$984.55
Rate for Payer: Cigna Commercial	$1,930.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$934.36
Rate for Payer: Qualcare PPO/HMO/WC	$579.15
Rate for Payer: UnitedHealthcare Community & State	$122.01
Rate for Payer: Wellpoint Medicaid Managed Care	$109.65

DISTAL BICEPS REPAIR IMPLANT

Facility

$7,650.00

Hospital Charge Code	270339530
Hospital Revenue Code	278
Min. Negotiated Rate	$217.26
Max. Negotiated Rate	$3,825.00
Rate for Payer: Aetna Commercial	$2,907.00
Rate for Payer: Aetna Medicare Advantage	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,950.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,950.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,950.75
Rate for Payer: Cigna Commercial	$3,825.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,851.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,147.50
Rate for Payer: UnitedHealthcare Community & State	$241.74
Rate for Payer: Wellpoint Medicaid Managed Care	$217.26

DISTAL BICEPS REPAIR IMPLANT

Facility

$7,650.00

Hospital Charge Code	270339530
Hospital Revenue Code	278
Min. Negotiated Rate	$1,147.50
Max. Negotiated Rate	$1,851.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,530.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,851.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,147.50

DISTAL BICEPS REPAIR IMPLANT

Facility

$4,250.00

Hospital Charge Code	270656505
Hospital Revenue Code	278
Min. Negotiated Rate	$637.50
Max. Negotiated Rate	$1,028.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.50
Rate for Payer: Qualcare PPO/HMO/WC	$637.50

Know your out-of-pocket cost for care.

All Charges