Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

DX-DIL OF NEPHROSTOMY-RT

Facility

$10,187.80

Service Code	HCPCS 74485RT
Hospital Charge Code	366874485R
Hospital Revenue Code	320
Min. Negotiated Rate	$289.33
Max. Negotiated Rate	$5,093.90
Rate for Payer: Aetna Commercial	$3,871.36
Rate for Payer: Aetna Medicare Advantage	$3,056.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,597.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,597.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,597.89
Rate for Payer: Cigna Commercial	$5,093.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,648.83
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$321.93
Rate for Payer: Wellpoint Medicaid Managed Care	$289.33

DX-DIL OF NEPHROSTOMY-RT

Facility

$10,187.80

Service Code	HCPCS 74485RT
Hospital Charge Code	366874485R
Hospital Revenue Code	320
Min. Negotiated Rate	$1,528.17
Max. Negotiated Rate	$1,528.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

DX ELBOW AP AND LAT - BILAT

Facility

$244.00

Service Code	HCPCS 73070
Hospital Charge Code	2011520
Hospital Revenue Code	320
Min. Negotiated Rate	$36.60
Max. Negotiated Rate	$36.60
Rate for Payer: Qualcare PPO/HMO/WC	$36.60

DX ELBOW AP AND LAT - BILAT

Facility

$244.00

Service Code	HCPCS 73070
Hospital Charge Code	2011520
Hospital Revenue Code	320
Min. Negotiated Rate	$6.93
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$281.22
Rate for Payer: Aetna Medicare Advantage	$334.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$375.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$375.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$103.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$375.05
Rate for Payer: Cigna Commercial	$207.24
Rate for Payer: Cigna Medicare Advantage	$72.37
Rate for Payer: Clover Medicare Advantage	$98.22
Rate for Payer: EmblemHealth Commercial	$310.17
Rate for Payer: Humana Medicare Advantage	$106.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$103.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.44
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.60
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$7.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$103.39
Rate for Payer: Wellcare Medicare Advantage	$103.39
Rate for Payer: Wellpoint Medicaid Managed Care	$6.93

DX ER ANKLE COMPLETE RT

Facility

$6,601.19

Service Code	HCPCS 73610RT
Hospital Charge Code	94270225
Hospital Revenue Code	320
Min. Negotiated Rate	$187.47
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.31
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$208.60
Rate for Payer: Wellpoint Medicaid Managed Care	$187.47

DX ER ANKLE COMPLETE RT

Facility

$6,601.19

Service Code	HCPCS 73610RT
Hospital Charge Code	94270225
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

DX-ERCP COMMON BILE DUCT

Facility

$1,927.00

Service Code	HCPCS 74328
Hospital Charge Code	2007001
Hospital Revenue Code	320
Min. Negotiated Rate	$54.73
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$732.26
Rate for Payer: Aetna Medicare Advantage	$578.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$491.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$491.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$491.38
Rate for Payer: Cigna Commercial	$963.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$501.02
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$289.05
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$60.89
Rate for Payer: Wellpoint Medicaid Managed Care	$54.73

DX-ERCP COMMON BILE DUCT

Facility

$1,927.00

Service Code	HCPCS 74328
Hospital Charge Code	2007001
Hospital Revenue Code	320
Min. Negotiated Rate	$289.05
Max. Negotiated Rate	$289.05
Rate for Payer: Qualcare PPO/HMO/WC	$289.05

DX ERCP PANCREATIC

Facility

$1,927.00

Service Code	HCPCS 74329
Hospital Charge Code	2011535
Hospital Revenue Code	320
Min. Negotiated Rate	$54.73
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$732.26
Rate for Payer: Aetna Medicare Advantage	$578.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$491.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$491.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$491.38
Rate for Payer: Cigna Commercial	$963.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$501.02
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$289.05
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$60.89
Rate for Payer: Wellpoint Medicaid Managed Care	$54.73

DX ERCP PANCREATIC

Facility

$1,927.00

Service Code	HCPCS 74329
Hospital Charge Code	2011535
Hospital Revenue Code	320
Min. Negotiated Rate	$289.05
Max. Negotiated Rate	$289.05
Rate for Payer: Qualcare PPO/HMO/WC	$289.05

DX ER HAND 3 VIEWS RT

Facility

$6,601.19

Service Code	HCPCS 73130RT
Hospital Charge Code	94270169
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

DX ER HAND 3 VIEWS RT

Facility

$6,601.19

Service Code	HCPCS 73130RT
Hospital Charge Code	94270169
Hospital Revenue Code	320
Min. Negotiated Rate	$187.47
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.31
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$208.60
Rate for Payer: Wellpoint Medicaid Managed Care	$187.47

DX-GI SERIES

Facility

$1,173.00

Service Code	HCPCS 74240
Hospital Charge Code	2007045
Hospital Revenue Code	320
Min. Negotiated Rate	$175.95
Max. Negotiated Rate	$175.95
Rate for Payer: Qualcare PPO/HMO/WC	$175.95

DX-GI SERIES

Facility

$1,173.00

Service Code	HCPCS 74240
Hospital Charge Code	2007045
Hospital Revenue Code	320
Min. Negotiated Rate	$33.31
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$566.79
Rate for Payer: Aetna Medicare Advantage	$675.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$755.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$755.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$208.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$755.90
Rate for Payer: Cigna Commercial	$417.70
Rate for Payer: Cigna Medicare Advantage	$145.87
Rate for Payer: Clover Medicare Advantage	$197.96
Rate for Payer: EmblemHealth Commercial	$625.14
Rate for Payer: Humana Medicare Advantage	$214.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$208.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$304.98
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$175.95
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$37.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$208.38
Rate for Payer: Wellcare Medicare Advantage	$208.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.88
Rate for Payer: Wellpoint Medicaid Managed Care	$33.31

DX-HIP 1 VIEW-RT

Facility

$267.00

Hospital Charge Code	2008015
Hospital Revenue Code	320
Min. Negotiated Rate	$40.05
Max. Negotiated Rate	$40.05
Rate for Payer: Qualcare PPO/HMO/WC	$40.05

DX-HIP 1 VIEW-RT

Facility

$267.00

Hospital Charge Code	2008015
Hospital Revenue Code	320
Min. Negotiated Rate	$7.58
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$101.46
Rate for Payer: Aetna Medicare Advantage	$80.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.08
Rate for Payer: Cigna Commercial	$133.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.42
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.05
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$8.44
Rate for Payer: Wellpoint Medicaid Managed Care	$7.58

DX HIP O.R. RT

Facility

$585.00

Hospital Charge Code	2011025
Hospital Revenue Code	320
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$87.75
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

DX HIP O.R. RT

Facility

$585.00

Hospital Charge Code	2011025
Hospital Revenue Code	320
Min. Negotiated Rate	$16.61
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$222.30
Rate for Payer: Aetna Medicare Advantage	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.18
Rate for Payer: Cigna Commercial	$292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.10
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.75
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$18.49
Rate for Payer: Wellpoint Medicaid Managed Care	$16.61

DX-INTERNAL MAMMARY-LT

Facility

$15,468.50

Service Code	HCPCS 75756LT
Hospital Charge Code	2691905
Hospital Revenue Code	320
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

DX-INTERNAL MAMMARY-LT

Facility

$15,468.50

Service Code	HCPCS 75756LT
Hospital Charge Code	2691905
Hospital Revenue Code	320
Min. Negotiated Rate	$439.31
Max. Negotiated Rate	$7,734.25
Rate for Payer: Aetna Commercial	$5,878.03
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,944.47
Rate for Payer: Cigna Commercial	$7,734.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,021.81
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$488.80
Rate for Payer: Wellpoint Medicaid Managed Care	$439.31

DX-INTERNAL MAMMARY-LT

Facility

$15,468.50

Service Code	HCPCS 75756LT
Hospital Charge Code	321075756L
Hospital Revenue Code	320
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

DX-INTERNAL MAMMARY-LT

Facility

$15,468.50

Service Code	HCPCS 75756LT
Hospital Charge Code	321075756L
Hospital Revenue Code	320
Min. Negotiated Rate	$439.31
Max. Negotiated Rate	$7,734.25
Rate for Payer: Aetna Commercial	$5,878.03
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,944.47
Rate for Payer: Cigna Commercial	$7,734.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,021.81
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$488.80
Rate for Payer: Wellpoint Medicaid Managed Care	$439.31

DX-INTERNAL MAMMARY-RT

Facility

$15,468.50

Service Code	HCPCS 75756RT
Hospital Charge Code	321075756R
Hospital Revenue Code	320
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

DX-INTERNAL MAMMARY-RT

Facility

$15,468.50

Service Code	HCPCS 75756RT
Hospital Charge Code	321075756R
Hospital Revenue Code	320
Min. Negotiated Rate	$439.31
Max. Negotiated Rate	$7,734.25
Rate for Payer: Aetna Commercial	$5,878.03
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,944.47
Rate for Payer: Cigna Commercial	$7,734.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,021.81
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$488.80
Rate for Payer: Wellpoint Medicaid Managed Care	$439.31

DX-INTERNAL MAMMARY-RT

Facility

$15,468.50

Service Code	HCPCS 75756RT
Hospital Charge Code	2691910
Hospital Revenue Code	320
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

Know your out-of-pocket cost for care.

All Charges