Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

EMG-3 EXTREMITIES

Facility

$5,700.00

Hospital Charge Code	9109055
Hospital Revenue Code	922
Min. Negotiated Rate	$855.00
Max. Negotiated Rate	$855.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00

EMG-4 EXTREMITIES

Facility

$5,700.00

Hospital Charge Code	9109060
Hospital Revenue Code	922
Min. Negotiated Rate	$161.88
Max. Negotiated Rate	$2,850.00
Rate for Payer: Aetna Commercial	$2,166.00
Rate for Payer: Aetna Medicare Advantage	$1,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,453.50
Rate for Payer: Cigna Commercial	$2,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,482.00
Rate for Payer: Oxford Commercial	$2,277.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00
Rate for Payer: UnitedHealthcare Commercial	$2,585.00
Rate for Payer: UnitedHealthcare Community & State	$180.12
Rate for Payer: Wellpoint Medicaid Managed Care	$161.88

EMG-4 EXTREMITIES

Facility

$5,700.00

Hospital Charge Code	9109060
Hospital Revenue Code	922
Min. Negotiated Rate	$855.00
Max. Negotiated Rate	$855.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00

EMG-CRANIAL NERV MSCL-BIL

Facility

$5,700.00

Hospital Charge Code	9109070
Hospital Revenue Code	922
Min. Negotiated Rate	$161.88
Max. Negotiated Rate	$2,850.00
Rate for Payer: Aetna Commercial	$2,166.00
Rate for Payer: Aetna Medicare Advantage	$1,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,453.50
Rate for Payer: Cigna Commercial	$2,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,482.00
Rate for Payer: Oxford Commercial	$2,277.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00
Rate for Payer: UnitedHealthcare Commercial	$2,585.00
Rate for Payer: UnitedHealthcare Community & State	$180.12
Rate for Payer: Wellpoint Medicaid Managed Care	$161.88

EMG-CRANIAL NERV MSCL-BIL

Facility

$5,700.00

Hospital Charge Code	9109070
Hospital Revenue Code	922
Min. Negotiated Rate	$855.00
Max. Negotiated Rate	$855.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00

EMG-CRANIAL NERV MSCL-UNI

Facility

$5,700.00

Hospital Charge Code	9109065
Hospital Revenue Code	922
Min. Negotiated Rate	$161.88
Max. Negotiated Rate	$2,850.00
Rate for Payer: Aetna Commercial	$2,166.00
Rate for Payer: Aetna Medicare Advantage	$1,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,453.50
Rate for Payer: Cigna Commercial	$2,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,482.00
Rate for Payer: Oxford Commercial	$2,277.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00
Rate for Payer: UnitedHealthcare Commercial	$2,585.00
Rate for Payer: UnitedHealthcare Community & State	$180.12
Rate for Payer: Wellpoint Medicaid Managed Care	$161.88

EMG-CRANIAL NERV MSCL-UNI

Facility

$5,700.00

Hospital Charge Code	9109065
Hospital Revenue Code	922
Min. Negotiated Rate	$855.00
Max. Negotiated Rate	$855.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00

EMG NEEDLE NERVE MODULE

Facility

$7,850.00

Hospital Charge Code	270656582
Hospital Revenue Code	270
Min. Negotiated Rate	$222.94
Max. Negotiated Rate	$3,925.00
Rate for Payer: Aetna Commercial	$2,983.00
Rate for Payer: Aetna Medicare Advantage	$2,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,001.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,001.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,001.75
Rate for Payer: Cigna Commercial	$3,925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,041.00
Rate for Payer: Oxford Commercial	$1,570.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,177.50
Rate for Payer: UnitedHealthcare Commercial	$1,570.00
Rate for Payer: UnitedHealthcare Community & State	$248.06
Rate for Payer: Wellpoint Medicaid Managed Care	$222.94

EMG NEEDLE NERVE MODULE

Facility

$7,850.00

Hospital Charge Code	270656582
Hospital Revenue Code	270
Min. Negotiated Rate	$1,177.50
Max. Negotiated Rate	$1,177.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,177.50

EMG-SINGLE FIBER

Facility

$5,700.00

Hospital Charge Code	9109080
Hospital Revenue Code	922
Min. Negotiated Rate	$161.88
Max. Negotiated Rate	$2,850.00
Rate for Payer: Aetna Commercial	$2,166.00
Rate for Payer: Aetna Medicare Advantage	$1,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,453.50
Rate for Payer: Cigna Commercial	$2,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,482.00
Rate for Payer: Oxford Commercial	$2,277.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00
Rate for Payer: UnitedHealthcare Commercial	$2,585.00
Rate for Payer: UnitedHealthcare Community & State	$180.12
Rate for Payer: Wellpoint Medicaid Managed Care	$161.88

EMG-SINGLE FIBER

Facility

$5,700.00

Hospital Charge Code	9109080
Hospital Revenue Code	922
Min. Negotiated Rate	$855.00
Max. Negotiated Rate	$855.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00

EMG-THORACIC SPINAL MSCL

Facility

$5,700.00

Hospital Charge Code	9109075
Hospital Revenue Code	922
Min. Negotiated Rate	$161.88
Max. Negotiated Rate	$2,850.00
Rate for Payer: Aetna Commercial	$2,166.00
Rate for Payer: Aetna Medicare Advantage	$1,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,453.50
Rate for Payer: Cigna Commercial	$2,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,482.00
Rate for Payer: Oxford Commercial	$2,277.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00
Rate for Payer: UnitedHealthcare Commercial	$2,585.00
Rate for Payer: UnitedHealthcare Community & State	$180.12
Rate for Payer: Wellpoint Medicaid Managed Care	$161.88

EMG-THORACIC SPINAL MSCL

Facility

$5,700.00

Hospital Charge Code	9109075
Hospital Revenue Code	922
Min. Negotiated Rate	$855.00
Max. Negotiated Rate	$855.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00

EMLA CREAM 30 GM

Facility

$269.50

Hospital Charge Code	60628418W
Hospital Revenue Code	250
Min. Negotiated Rate	$40.42
Max. Negotiated Rate	$40.42
Rate for Payer: Qualcare PPO/HMO/WC	$40.42

EMLA CREAM 30 GM

Facility

$269.50

Hospital Charge Code	60628418W
Hospital Revenue Code	250
Min. Negotiated Rate	$7.65
Max. Negotiated Rate	$134.75
Rate for Payer: Aetna Commercial	$102.41
Rate for Payer: Aetna Medicare Advantage	$80.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.72
Rate for Payer: Cigna Commercial	$134.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.07
Rate for Payer: Oxford Commercial	$53.90
Rate for Payer: Qualcare PPO/HMO/WC	$40.42
Rate for Payer: UnitedHealthcare Commercial	$53.90
Rate for Payer: UnitedHealthcare Community & State	$8.52
Rate for Payer: Wellpoint Medicaid Managed Care	$7.65

E&M LEVEL 10 MINS

Facility

$433.40

Service Code	HCPCS 99201
Hospital Charge Code	84511029
Hospital Revenue Code	513
Min. Negotiated Rate	$12.31
Max. Negotiated Rate	$216.70
Rate for Payer: Aetna Commercial	$164.69
Rate for Payer: Aetna Medicare Advantage	$130.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.52
Rate for Payer: Cigna Commercial	$216.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.68
Rate for Payer: Qualcare PPO/HMO/WC	$65.01
Rate for Payer: UnitedHealthcare Community & State	$13.70
Rate for Payer: Wellpoint Medicaid Managed Care	$12.31

E&M LEVEL 10 MINS

Facility

$433.40

Service Code	HCPCS 99201
Hospital Charge Code	84517029
Hospital Revenue Code	513
Min. Negotiated Rate	$65.01
Max. Negotiated Rate	$65.01
Rate for Payer: Qualcare PPO/HMO/WC	$65.01

E&M LEVEL 10 MINS

Facility

$433.40

Service Code	HCPCS 99201
Hospital Charge Code	84509029
Hospital Revenue Code	513
Min. Negotiated Rate	$12.31
Max. Negotiated Rate	$216.70
Rate for Payer: Aetna Commercial	$164.69
Rate for Payer: Aetna Medicare Advantage	$130.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.52
Rate for Payer: Cigna Commercial	$216.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.68
Rate for Payer: Qualcare PPO/HMO/WC	$65.01
Rate for Payer: UnitedHealthcare Community & State	$13.70
Rate for Payer: Wellpoint Medicaid Managed Care	$12.31

E&M LEVEL 10 MINS

Facility

$433.40

Service Code	HCPCS 99201
Hospital Charge Code	84518029
Hospital Revenue Code	513
Min. Negotiated Rate	$65.01
Max. Negotiated Rate	$65.01
Rate for Payer: Qualcare PPO/HMO/WC	$65.01

E&M LEVEL 10 MINS

Facility

$433.40

Service Code	HCPCS 99201
Hospital Charge Code	84517029
Hospital Revenue Code	513
Min. Negotiated Rate	$12.31
Max. Negotiated Rate	$216.70
Rate for Payer: Aetna Commercial	$164.69
Rate for Payer: Aetna Medicare Advantage	$130.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.52
Rate for Payer: Cigna Commercial	$216.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.68
Rate for Payer: Qualcare PPO/HMO/WC	$65.01
Rate for Payer: UnitedHealthcare Community & State	$13.70
Rate for Payer: Wellpoint Medicaid Managed Care	$12.31

E&M LEVEL 10 MINS

Facility

$433.40

Service Code	HCPCS 99201
Hospital Charge Code	84518029
Hospital Revenue Code	513
Min. Negotiated Rate	$12.31
Max. Negotiated Rate	$216.70
Rate for Payer: Aetna Commercial	$164.69
Rate for Payer: Aetna Medicare Advantage	$130.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.52
Rate for Payer: Cigna Commercial	$216.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.68
Rate for Payer: Qualcare PPO/HMO/WC	$65.01
Rate for Payer: UnitedHealthcare Community & State	$13.70
Rate for Payer: Wellpoint Medicaid Managed Care	$12.31

E&M LEVEL 10 MINS

Facility

$433.40

Service Code	HCPCS 99201
Hospital Charge Code	84511029
Hospital Revenue Code	513
Min. Negotiated Rate	$65.01
Max. Negotiated Rate	$65.01
Rate for Payer: Qualcare PPO/HMO/WC	$65.01

E&M LEVEL 10 MINS

Facility

$433.40

Service Code	HCPCS 99201
Hospital Charge Code	84509029
Hospital Revenue Code	513
Min. Negotiated Rate	$65.01
Max. Negotiated Rate	$65.01
Rate for Payer: Qualcare PPO/HMO/WC	$65.01

E&M LEVEL 1 10 MINS

Facility

$367.85

Service Code	HCPCS 99201
Hospital Charge Code	87504080
Hospital Revenue Code	513
Min. Negotiated Rate	$10.45
Max. Negotiated Rate	$183.93
Rate for Payer: Aetna Commercial	$139.78
Rate for Payer: Aetna Medicare Advantage	$110.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.80
Rate for Payer: Cigna Commercial	$183.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.64
Rate for Payer: Qualcare PPO/HMO/WC	$55.18
Rate for Payer: UnitedHealthcare Community & State	$11.62
Rate for Payer: Wellpoint Medicaid Managed Care	$10.45

E&M LEVEL 1 10 MINS

Facility

$367.85

Service Code	HCPCS 99201
Hospital Charge Code	87504080
Hospital Revenue Code	513
Min. Negotiated Rate	$55.18
Max. Negotiated Rate	$55.18
Rate for Payer: Qualcare PPO/HMO/WC	$55.18

Know your out-of-pocket cost for care.

All Charges