Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ELECTRIC STIMULATION THERAPY 1

Facility

$352.64

Service Code	HCPCS 97014
Hospital Charge Code	409297014
Hospital Revenue Code	420
Min. Negotiated Rate	$10.01
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$134.00
Rate for Payer: Aetna Medicare Advantage	$105.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.92
Rate for Payer: Cigna Commercial	$176.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.69
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.90
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$11.14
Rate for Payer: Wellpoint Medicaid Managed Care	$10.01

ELECTRIC STIMULATION THERAPY 1

Facility

$352.64

Service Code	HCPCS 97014
Hospital Charge Code	409297014
Hospital Revenue Code	420
Min. Negotiated Rate	$52.90
Max. Negotiated Rate	$52.90
Rate for Payer: Qualcare PPO/HMO/WC	$52.90

ELECTROCARDIOGRAM

Facility

$2,050.00

Service Code	HCPCS 93005
Hospital Charge Code	94053025
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

ELECTROCARDIOGRAM

Facility

$2,050.00

Service Code	HCPCS 93005
Hospital Charge Code	94053025
Hospital Revenue Code	730
Min. Negotiated Rate	$307.50
Max. Negotiated Rate	$307.50
Rate for Payer: Qualcare PPO/HMO/WC	$307.50

ELECTROCARDIOGRAM

Facility

$2,050.00

Service Code	HCPCS 93005
Hospital Charge Code	5300017
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

ELECTROCARDIOGRAM

Facility

$2,050.00

Service Code	HCPCS 93005
Hospital Charge Code	5300017
Hospital Revenue Code	730
Min. Negotiated Rate	$307.50
Max. Negotiated Rate	$307.50
Rate for Payer: Qualcare PPO/HMO/WC	$307.50

ELECTRODE adlt zll fnctin mlti

Facility

$18.65

Hospital Charge Code	270649729
Hospital Revenue Code	271
Min. Negotiated Rate	$0.53
Max. Negotiated Rate	$9.32
Rate for Payer: Aetna Commercial	$7.09
Rate for Payer: Aetna Medicare Advantage	$5.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.76
Rate for Payer: Cigna Commercial	$9.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.85
Rate for Payer: Oxford Commercial	$3.73
Rate for Payer: Qualcare PPO/HMO/WC	$2.80
Rate for Payer: UnitedHealthcare Commercial	$3.73
Rate for Payer: UnitedHealthcare Community & State	$0.59
Rate for Payer: Wellpoint Medicaid Managed Care	$0.53

ELECTRODE adlt zll fnctin mlti

Facility

$18.65

Hospital Charge Code	270649729
Hospital Revenue Code	271
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$2.80
Rate for Payer: Qualcare PPO/HMO/WC	$2.80

ELECTRODE ADULT MONITORING

Facility

$19.16

Hospital Charge Code	270649192
Hospital Revenue Code	272
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$9.58
Rate for Payer: Aetna Commercial	$7.28
Rate for Payer: Aetna Medicare Advantage	$5.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.89
Rate for Payer: Cigna Commercial	$9.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.98
Rate for Payer: Oxford Commercial	$3.83
Rate for Payer: Qualcare PPO/HMO/WC	$2.87
Rate for Payer: UnitedHealthcare Commercial	$3.83
Rate for Payer: UnitedHealthcare Community & State	$0.61
Rate for Payer: Wellpoint Medicaid Managed Care	$0.54

ELECTRODE ADULT MONITORING

Facility

$19.16

Hospital Charge Code	270649192
Hospital Revenue Code	272
Min. Negotiated Rate	$2.87
Max. Negotiated Rate	$2.87
Rate for Payer: Qualcare PPO/HMO/WC	$2.87

ELECTRODE AXS DISP LS211

Facility

$967.09

Hospital Charge Code	270623965
Hospital Revenue Code	272
Min. Negotiated Rate	$145.06
Max. Negotiated Rate	$145.06
Rate for Payer: Qualcare PPO/HMO/WC	$145.06

ELECTRODE AXS DISP LS211

Facility

$967.09

Hospital Charge Code	270623965
Hospital Revenue Code	272
Min. Negotiated Rate	$27.47
Max. Negotiated Rate	$483.55
Rate for Payer: Aetna Commercial	$367.49
Rate for Payer: Aetna Medicare Advantage	$290.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$246.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$246.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$246.61
Rate for Payer: Cigna Commercial	$483.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$251.44
Rate for Payer: Oxford Commercial	$193.42
Rate for Payer: Qualcare PPO/HMO/WC	$145.06
Rate for Payer: UnitedHealthcare Commercial	$193.42
Rate for Payer: UnitedHealthcare Community & State	$30.56
Rate for Payer: Wellpoint Medicaid Managed Care	$27.47

ELECTRODE BALL TIP

Facility

$409.50

Hospital Charge Code	270658547
Hospital Revenue Code	270
Min. Negotiated Rate	$61.42
Max. Negotiated Rate	$61.42
Rate for Payer: Qualcare PPO/HMO/WC	$61.42

ELECTRODE BALL TIP

Facility

$409.50

Hospital Charge Code	270658547
Hospital Revenue Code	270
Min. Negotiated Rate	$11.63
Max. Negotiated Rate	$204.75
Rate for Payer: Aetna Commercial	$155.61
Rate for Payer: Aetna Medicare Advantage	$122.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$104.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$104.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$104.42
Rate for Payer: Cigna Commercial	$204.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.47
Rate for Payer: Oxford Commercial	$81.90
Rate for Payer: Qualcare PPO/HMO/WC	$61.42
Rate for Payer: UnitedHealthcare Commercial	$81.90
Rate for Payer: UnitedHealthcare Community & State	$12.94
Rate for Payer: Wellpoint Medicaid Managed Care	$11.63

ELECTRODE BALL TIP 0.5cm

Facility

$5.69

Hospital Charge Code	270651086
Hospital Revenue Code	272
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$2.85
Rate for Payer: Aetna Commercial	$2.16
Rate for Payer: Aetna Medicare Advantage	$1.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.45
Rate for Payer: Cigna Commercial	$2.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.48
Rate for Payer: Oxford Commercial	$1.14
Rate for Payer: Qualcare PPO/HMO/WC	$0.85
Rate for Payer: UnitedHealthcare Commercial	$1.14
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

ELECTRODE BALL TIP 0.5cm

Facility

$5.69

Hospital Charge Code	270651086
Hospital Revenue Code	272
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.85

ELECTRODE BIPOLAR PACING 7FR

Facility

$906.40

Hospital Charge Code	270650551
Hospital Revenue Code	278
Min. Negotiated Rate	$25.74
Max. Negotiated Rate	$453.20
Rate for Payer: Aetna Commercial	$344.43
Rate for Payer: Aetna Medicare Advantage	$271.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.13
Rate for Payer: Cigna Commercial	$453.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.35
Rate for Payer: Qualcare PPO/HMO/WC	$135.96
Rate for Payer: UnitedHealthcare Community & State	$28.64
Rate for Payer: Wellpoint Medicaid Managed Care	$25.74

ELECTRODE BIPOLAR PACING 7FR

Facility

$906.40

Hospital Charge Code	270650551
Hospital Revenue Code	278
Min. Negotiated Rate	$135.96
Max. Negotiated Rate	$219.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.35
Rate for Payer: Qualcare PPO/HMO/WC	$135.96

ELECTRODE BLADE EXTENDER

Facility

$24.49

Hospital Charge Code	270649194
Hospital Revenue Code	272
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$12.24
Rate for Payer: Aetna Commercial	$9.31
Rate for Payer: Aetna Medicare Advantage	$7.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.24
Rate for Payer: Cigna Commercial	$12.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.37
Rate for Payer: Oxford Commercial	$4.90
Rate for Payer: Qualcare PPO/HMO/WC	$3.67
Rate for Payer: UnitedHealthcare Commercial	$4.90
Rate for Payer: UnitedHealthcare Community & State	$0.77
Rate for Payer: Wellpoint Medicaid Managed Care	$0.70

ELECTRODE BLADE EXTENDER

Facility

$24.49

Hospital Charge Code	270649194
Hospital Revenue Code	272
Min. Negotiated Rate	$3.67
Max. Negotiated Rate	$3.67
Rate for Payer: Qualcare PPO/HMO/WC	$3.67

ELECTRODE COAG BALL 24FR 5MM

Facility

$561.75

Hospital Charge Code	270601412
Hospital Revenue Code	272
Min. Negotiated Rate	$15.95
Max. Negotiated Rate	$280.88
Rate for Payer: Aetna Commercial	$213.47
Rate for Payer: Aetna Medicare Advantage	$168.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.25
Rate for Payer: Cigna Commercial	$280.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.06
Rate for Payer: Oxford Commercial	$112.35
Rate for Payer: Qualcare PPO/HMO/WC	$84.26
Rate for Payer: UnitedHealthcare Commercial	$112.35
Rate for Payer: UnitedHealthcare Community & State	$17.75
Rate for Payer: Wellpoint Medicaid Managed Care	$15.95

ELECTRODE COAG BALL 24FR 5MM

Facility

$561.75

Hospital Charge Code	270601412
Hospital Revenue Code	272
Min. Negotiated Rate	$84.26
Max. Negotiated Rate	$84.26
Rate for Payer: Qualcare PPO/HMO/WC	$84.26

ELECTRODE COAG BALL END 6 FR

Facility

$700.00

Hospital Charge Code	270660116
Hospital Revenue Code	270
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.00
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Commercial	$140.00
Rate for Payer: UnitedHealthcare Community & State	$22.12
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

ELECTRODE COAG BALL END 6 FR

Facility

$700.00

Hospital Charge Code	270660116
Hospital Revenue Code	270
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

ELECTRODE CUTTING LOOP 24FR

Facility

$364.58

Hospital Charge Code	270655404
Hospital Revenue Code	271
Min. Negotiated Rate	$10.35
Max. Negotiated Rate	$182.29
Rate for Payer: Aetna Commercial	$138.54
Rate for Payer: Aetna Medicare Advantage	$109.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.97
Rate for Payer: Cigna Commercial	$182.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.79
Rate for Payer: Oxford Commercial	$72.92
Rate for Payer: Qualcare PPO/HMO/WC	$54.69
Rate for Payer: UnitedHealthcare Commercial	$72.92
Rate for Payer: UnitedHealthcare Community & State	$11.52
Rate for Payer: Wellpoint Medicaid Managed Care	$10.35

Know your out-of-pocket cost for care.

All Charges