Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

EKG 12 LEADS

Facility

$2,050.00

Service Code	HCPCS 93005
Hospital Charge Code	36540001
Hospital Revenue Code	730
Min. Negotiated Rate	$58.22
Max. Negotiated Rate	$879.00
Rate for Payer: Aetna Commercial	$190.62
Rate for Payer: Aetna Medicare Advantage	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$254.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$254.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$70.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$254.22
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: Cigna Medicare Advantage	$70.08
Rate for Payer: Clover Medicare Advantage	$66.58
Rate for Payer: EmblemHealth Commercial	$210.24
Rate for Payer: Humana Medicare Advantage	$72.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$70.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$533.00
Rate for Payer: Oxford Commercial	$659.00
Rate for Payer: Qualcare PPO/HMO/WC	$307.50
Rate for Payer: UnitedHealthcare Commercial	$879.00
Rate for Payer: UnitedHealthcare Community & State	$64.78
Rate for Payer: UnitedHealthcare Medicare Advantage	$70.08
Rate for Payer: Wellcare Medicare Advantage	$70.08
Rate for Payer: Wellpoint Medicaid Managed Care	$58.22

EKG 12 LEADS

Facility

$2,050.00

Service Code	HCPCS 93005
Hospital Charge Code	36540001
Hospital Revenue Code	730
Min. Negotiated Rate	$307.50
Max. Negotiated Rate	$307.50
Rate for Payer: Qualcare PPO/HMO/WC	$307.50

ELASTIC BANDAGE

Facility

$40.00

Hospital Charge Code	84202110
Hospital Revenue Code	270
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$20.00
Rate for Payer: Aetna Commercial	$15.20
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.40
Rate for Payer: Oxford Commercial	$8.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$8.00
Rate for Payer: UnitedHealthcare Community & State	$1.26
Rate for Payer: Wellpoint Medicaid Managed Care	$1.14

ELASTIC BANDAGE

Facility

$40.00

Hospital Charge Code	84202110
Hospital Revenue Code	270
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

ELASTIKON 4X 5YD

Facility

$55.00

Hospital Charge Code	270331857
Hospital Revenue Code	272
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$27.50
Rate for Payer: Aetna Commercial	$20.90
Rate for Payer: Aetna Medicare Advantage	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.03
Rate for Payer: Cigna Commercial	$27.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.30
Rate for Payer: Oxford Commercial	$11.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.25
Rate for Payer: UnitedHealthcare Commercial	$11.00
Rate for Payer: UnitedHealthcare Community & State	$1.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1.56

ELASTIKON 4X 5YD

Facility

$55.00

Hospital Charge Code	270331857
Hospital Revenue Code	272
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

ELBOW 3 VIEWS-BILAT

Facility

$6,601.19

Service Code	HCPCS 7308050
Hospital Charge Code	94061221
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

ELBOW 3 VIEWS-BILAT

Facility

$6,601.19

Service Code	HCPCS 7308050
Hospital Charge Code	94061221
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

ELBOW 3 VIEWS-LT

Facility

$6,601.19

Service Code	HCPCS 73080LT
Hospital Charge Code	94061301
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

ELBOW 3 VIEWS-LT

Facility

$6,601.19

Service Code	HCPCS 73080LT
Hospital Charge Code	94061301
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

ELBOW 3 VIEWS-RT

Facility

$6,601.19

Service Code	HCPCS 73080RT
Hospital Charge Code	94061303
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

ELBOW 3 VIEWS-RT

Facility

$6,601.19

Service Code	HCPCS 73080RT
Hospital Charge Code	94061303
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

ELBOW - TWO VIEWS-BIL

Facility

$5,100.00

Service Code	HCPCS 7307050
Hospital Charge Code	94061219
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

ELBOW - TWO VIEWS-BIL

Facility

$5,100.00

Service Code	HCPCS 7307050
Hospital Charge Code	94061219
Hospital Revenue Code	320
Min. Negotiated Rate	$144.84
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.00
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$161.16
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

ELBOW - TWO VIEWS-LT

Facility

$5,100.00

Service Code	HCPCS 73070LT
Hospital Charge Code	94061297
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

ELBOW - TWO VIEWS-LT

Facility

$5,100.00

Service Code	HCPCS 73070LT
Hospital Charge Code	94061297
Hospital Revenue Code	320
Min. Negotiated Rate	$144.84
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.00
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$161.16
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

ELBOW - TWO VIEWS-RT

Facility

$5,100.00

Service Code	HCPCS 73070RT
Hospital Charge Code	94061299
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

ELBOW - TWO VIEWS-RT

Facility

$5,100.00

Service Code	HCPCS 73070RT
Hospital Charge Code	94061299
Hospital Revenue Code	320
Min. Negotiated Rate	$144.84
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.00
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$161.16
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

ELECRODE PAIRED 4 CHANNEL SET

Facility

$910.00

Hospital Charge Code	270690260
Hospital Revenue Code	272
Min. Negotiated Rate	$136.50
Max. Negotiated Rate	$136.50
Rate for Payer: Qualcare PPO/HMO/WC	$136.50

ELECRODE PAIRED 4 CHANNEL SET

Facility

$910.00

Hospital Charge Code	270690260
Hospital Revenue Code	272
Min. Negotiated Rate	$25.84
Max. Negotiated Rate	$455.00
Rate for Payer: Aetna Commercial	$345.80
Rate for Payer: Aetna Medicare Advantage	$273.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$232.05
Rate for Payer: Cigna Commercial	$455.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.60
Rate for Payer: Oxford Commercial	$182.00
Rate for Payer: Qualcare PPO/HMO/WC	$136.50
Rate for Payer: UnitedHealthcare Commercial	$182.00
Rate for Payer: UnitedHealthcare Community & State	$28.76
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

ELECTIVE HIP JOINT REPLACEMENT

Facility

$20,147.25

Service Code	APR-DRG 3241
Min. Negotiated Rate	$19,752.21
Max. Negotiated Rate	$20,147.25
Rate for Payer: UnitedHealthcare Community & State	$19,752.21
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$20,147.25
Rate for Payer: Wellpoint Medicaid Managed Care	$19,752.21

ELECTIVE HIP JOINT REPLACEMENT

Facility

$21,951.86

Service Code	APR-DRG 3242
Min. Negotiated Rate	$21,521.43
Max. Negotiated Rate	$21,951.86
Rate for Payer: UnitedHealthcare Community & State	$21,521.43
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$21,951.86
Rate for Payer: Wellpoint Medicaid Managed Care	$21,521.43

ELECTIVE HIP JOINT REPLACEMENT

Facility

$30,123.95

Service Code	APR-DRG 3243
Min. Negotiated Rate	$29,533.28
Max. Negotiated Rate	$30,123.95
Rate for Payer: UnitedHealthcare Community & State	$29,533.28
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$30,123.95
Rate for Payer: Wellpoint Medicaid Managed Care	$29,533.28

ELECTIVE HIP JOINT REPLACEMENT

Facility

$47,958.25

Service Code	APR-DRG 3244
Min. Negotiated Rate	$47,017.89
Max. Negotiated Rate	$47,958.25
Rate for Payer: UnitedHealthcare Community & State	$47,017.89
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$47,958.25
Rate for Payer: Wellpoint Medicaid Managed Care	$47,017.89

ELECTIVE KNEE JOINT REPLACEMENT

Facility

$20,051.74

Service Code	APR-DRG 3261
Min. Negotiated Rate	$19,658.57
Max. Negotiated Rate	$20,051.74
Rate for Payer: UnitedHealthcare Community & State	$19,658.57
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$20,051.74
Rate for Payer: Wellpoint Medicaid Managed Care	$19,658.57

Know your out-of-pocket cost for care.

All Charges