Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ENDOMETRIAL CRYOABLATION

Facility

$29,715.20

Service Code	HCPCS 58356
Hospital Charge Code	1600000874
Hospital Revenue Code	360
Min. Negotiated Rate	$843.91
Max. Negotiated Rate	$21,558.38
Rate for Payer: Aetna Commercial	$16,165.07
Rate for Payer: Aetna Medicare Advantage	$19,255.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21,558.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21,558.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5,943.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21,558.38
Rate for Payer: Cigna Commercial	$11,912.81
Rate for Payer: Cigna Medicare Advantage	$5,943.04
Rate for Payer: Clover Medicare Advantage	$5,645.89
Rate for Payer: EmblemHealth Commercial	$17,829.12
Rate for Payer: Humana Medicare Advantage	$6,121.33
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5,943.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,725.95
Rate for Payer: Oxford Commercial	$11,677.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,457.28
Rate for Payer: UnitedHealthcare Commercial	$12,906.00
Rate for Payer: UnitedHealthcare Community & State	$939.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5,943.04
Rate for Payer: Wellcare Medicare Advantage	$5,943.04
Rate for Payer: Wellpoint Medicaid Managed Care	$843.91

ENDOMETRIAL SAMPLING BX

Facility

$786.65

Service Code	HCPCS 58110
Hospital Charge Code	412358110
Hospital Revenue Code	761
Min. Negotiated Rate	$118.00
Max. Negotiated Rate	$118.00
Rate for Payer: Qualcare PPO/HMO/WC	$118.00

ENDOMETRIAL SAMPLING BX

Facility

$786.65

Service Code	HCPCS 58110
Hospital Charge Code	412358110
Hospital Revenue Code	761
Min. Negotiated Rate	$22.34
Max. Negotiated Rate	$393.32
Rate for Payer: Aetna Commercial	$298.93
Rate for Payer: Aetna Medicare Advantage	$236.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$200.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$200.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$200.60
Rate for Payer: Cigna Commercial	$393.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$204.53
Rate for Payer: Oxford Commercial	$157.33
Rate for Payer: Qualcare PPO/HMO/WC	$118.00
Rate for Payer: UnitedHealthcare Commercial	$157.33
Rate for Payer: UnitedHealthcare Community & State	$24.86
Rate for Payer: Wellpoint Medicaid Managed Care	$22.34

ENDO MINI SHEARS 5MM SINGLE

Facility

$412.75

Hospital Charge Code	270697813
Hospital Revenue Code	272
Min. Negotiated Rate	$11.72
Max. Negotiated Rate	$206.38
Rate for Payer: Aetna Commercial	$156.84
Rate for Payer: Aetna Medicare Advantage	$123.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.25
Rate for Payer: Cigna Commercial	$206.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.31
Rate for Payer: Oxford Commercial	$82.55
Rate for Payer: Qualcare PPO/HMO/WC	$61.91
Rate for Payer: UnitedHealthcare Commercial	$82.55
Rate for Payer: UnitedHealthcare Community & State	$13.04
Rate for Payer: Wellpoint Medicaid Managed Care	$11.72

ENDO MINI SHEARS 5MM SINGLE

Facility

$412.75

Hospital Charge Code	270697813
Hospital Revenue Code	272
Min. Negotiated Rate	$61.91
Max. Negotiated Rate	$61.91
Rate for Payer: Qualcare PPO/HMO/WC	$61.91

ENDOMYSIAL AB

Facility

$390.00

Service Code	HCPCS 86255
Hospital Charge Code	39900365
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ENDOMYSIAL AB

Facility

$390.00

Service Code	HCPCS 86255
Hospital Charge Code	39900365
Hospital Revenue Code	302
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.71
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

ENDOMYSIAL ANTIBODY

Facility

$333.00

Service Code	HCPCS 86255
Hospital Charge Code	38476261
Hospital Revenue Code	302
Min. Negotiated Rate	$49.95
Max. Negotiated Rate	$49.95
Rate for Payer: Qualcare PPO/HMO/WC	$49.95

ENDOMYSIAL ANTIBODY

Facility

$333.00

Service Code	HCPCS 86255
Hospital Charge Code	38476261
Hospital Revenue Code	302
Min. Negotiated Rate	$9.46
Max. Negotiated Rate	$166.50
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.71
Rate for Payer: Cigna Commercial	$166.50
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.58
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.95
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$9.46

ENDOMYSIAL(IGG)ANTIBDYSCR&TITR

Facility

$120.00

Service Code	HCPCS 86231
Hospital Charge Code	401191985
Hospital Revenue Code	302
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

ENDOMYSIAL(IGG)ANTIBDYSCR&TITR

Facility

$120.00

Service Code	HCPCS 86231
Hospital Charge Code	401191985
Hospital Revenue Code	302
Min. Negotiated Rate	$3.41
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$32.88
Rate for Payer: Aetna Medicare Advantage	$39.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.86
Rate for Payer: Cigna Commercial	$60.00
Rate for Payer: Cigna Medicare Advantage	$12.09
Rate for Payer: Clover Medicare Advantage	$11.49
Rate for Payer: EmblemHealth Commercial	$36.27
Rate for Payer: Humana Medicare Advantage	$12.45
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.20
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.09
Rate for Payer: Wellcare Medicare Advantage	$12.09
Rate for Payer: Wellpoint Medicaid Managed Care	$3.41

ENDOPATH TROCAR 10/11MM

Facility

$612.00

Hospital Charge Code	270334711
Hospital Revenue Code	272
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

ENDOPATH TROCAR 10/11MM

Facility

$612.00

Hospital Charge Code	270334711
Hospital Revenue Code	272
Min. Negotiated Rate	$17.38
Max. Negotiated Rate	$306.00
Rate for Payer: Aetna Commercial	$232.56
Rate for Payer: Aetna Medicare Advantage	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.06
Rate for Payer: Cigna Commercial	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.12
Rate for Payer: Oxford Commercial	$122.40
Rate for Payer: Qualcare PPO/HMO/WC	$91.80
Rate for Payer: UnitedHealthcare Commercial	$122.40
Rate for Payer: UnitedHealthcare Community & State	$19.34
Rate for Payer: Wellpoint Medicaid Managed Care	$17.38

ENDOPROSTHESIS LEG 20MMX9.5CM

Facility

$21,500.00

Hospital Charge Code	270670934
Hospital Revenue Code	278
Min. Negotiated Rate	$610.60
Max. Negotiated Rate	$10,750.00
Rate for Payer: Aetna Commercial	$8,170.00
Rate for Payer: Aetna Medicare Advantage	$6,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,482.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,482.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,482.50
Rate for Payer: Cigna Commercial	$10,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,203.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,225.00
Rate for Payer: UnitedHealthcare Community & State	$679.40
Rate for Payer: Wellpoint Medicaid Managed Care	$610.60

ENDOPROSTHESIS LEG 20MMX9.5CM

Facility

$21,500.00

Hospital Charge Code	270670934
Hospital Revenue Code	278
Min. Negotiated Rate	$3,225.00
Max. Negotiated Rate	$5,203.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,203.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,225.00

ENDO REACH NANAOPASS

Facility

$1,445.00

Hospital Charge Code	270668509
Hospital Revenue Code	272
Min. Negotiated Rate	$216.75
Max. Negotiated Rate	$216.75
Rate for Payer: Qualcare PPO/HMO/WC	$216.75

ENDO REACH NANAOPASS

Facility

$1,445.00

Hospital Charge Code	270668509
Hospital Revenue Code	272
Min. Negotiated Rate	$41.04
Max. Negotiated Rate	$722.50
Rate for Payer: Aetna Commercial	$549.10
Rate for Payer: Aetna Medicare Advantage	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$368.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$368.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$368.48
Rate for Payer: Cigna Commercial	$722.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.70
Rate for Payer: Oxford Commercial	$289.00
Rate for Payer: Qualcare PPO/HMO/WC	$216.75
Rate for Payer: UnitedHealthcare Commercial	$289.00
Rate for Payer: UnitedHealthcare Community & State	$45.66
Rate for Payer: Wellpoint Medicaid Managed Care	$41.04

ENDO RECOVERY EA ADD 30 MIN

Facility

$400.00

Hospital Charge Code	2300915
Hospital Revenue Code	710
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

ENDO RECOVERY EA ADD 30 MIN

Facility

$400.00

Hospital Charge Code	2300915
Hospital Revenue Code	710
Min. Negotiated Rate	$11.36
Max. Negotiated Rate	$200.00
Rate for Payer: Aetna Commercial	$152.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.00
Rate for Payer: Oxford Commercial	$80.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Commercial	$80.00
Rate for Payer: UnitedHealthcare Community & State	$12.64
Rate for Payer: Wellpoint Medicaid Managed Care	$11.36

ENDO RECOVERY UP TO 1 HOUR

Facility

$800.00

Hospital Charge Code	2300914
Hospital Revenue Code	710
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

ENDO RECOVERY UP TO 1 HOUR

Facility

$800.00

Hospital Charge Code	2300914
Hospital Revenue Code	710
Min. Negotiated Rate	$22.72
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.00
Rate for Payer: Oxford Commercial	$160.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Commercial	$160.00
Rate for Payer: UnitedHealthcare Community & State	$25.28
Rate for Payer: Wellpoint Medicaid Managed Care	$22.72

ENDO RETRACT II 10MM 176647

Facility

$1,214.45

Hospital Charge Code	270600114
Hospital Revenue Code	272
Min. Negotiated Rate	$34.49
Max. Negotiated Rate	$607.23
Rate for Payer: Aetna Commercial	$461.49
Rate for Payer: Aetna Medicare Advantage	$364.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$309.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$309.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$309.68
Rate for Payer: Cigna Commercial	$607.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$315.76
Rate for Payer: Oxford Commercial	$242.89
Rate for Payer: Qualcare PPO/HMO/WC	$182.17
Rate for Payer: UnitedHealthcare Commercial	$242.89
Rate for Payer: UnitedHealthcare Community & State	$38.38
Rate for Payer: Wellpoint Medicaid Managed Care	$34.49

ENDO RETRACT II 10MM 176647

Facility

$1,214.45

Hospital Charge Code	270600114
Hospital Revenue Code	272
Min. Negotiated Rate	$182.17
Max. Negotiated Rate	$182.17
Rate for Payer: Qualcare PPO/HMO/WC	$182.17

ENDORPHIN

Facility

$333.00

Service Code	HCPCS 84999
Hospital Charge Code	38472426
Hospital Revenue Code	301
Min. Negotiated Rate	$9.46
Max. Negotiated Rate	$166.50
Rate for Payer: Aetna Commercial	$126.54
Rate for Payer: Aetna Medicare Advantage	$99.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.92
Rate for Payer: Cigna Commercial	$166.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.58
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.95
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.52
Rate for Payer: Wellpoint Medicaid Managed Care	$9.46

ENDORPHIN

Facility

$333.00

Service Code	HCPCS 84999
Hospital Charge Code	38472426
Hospital Revenue Code	301
Min. Negotiated Rate	$49.95
Max. Negotiated Rate	$49.95
Rate for Payer: Qualcare PPO/HMO/WC	$49.95

Know your out-of-pocket cost for care.

All Charges