Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ENDOSCOPY < 1 HR W/ > FIVE BX

Facility

$9,375.00

Hospital Charge Code	2300066
Hospital Revenue Code	750
Min. Negotiated Rate	$266.25
Max. Negotiated Rate	$4,687.50
Rate for Payer: Aetna Commercial	$3,562.50
Rate for Payer: Aetna Medicare Advantage	$2,812.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,390.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,390.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,390.62
Rate for Payer: Cigna Commercial	$4,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,437.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,406.25
Rate for Payer: UnitedHealthcare Community & State	$296.25
Rate for Payer: Wellpoint Medicaid Managed Care	$266.25

ENDOSCOPY < 1 HR WITH FIVE BX

Facility

$8,125.00

Hospital Charge Code	2300065
Hospital Revenue Code	750
Min. Negotiated Rate	$1,218.75
Max. Negotiated Rate	$1,218.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,218.75

ENDOSCOPY < 1 HR WITH FIVE BX

Facility

$8,125.00

Hospital Charge Code	2300065
Hospital Revenue Code	750
Min. Negotiated Rate	$230.75
Max. Negotiated Rate	$4,062.50
Rate for Payer: Aetna Commercial	$3,087.50
Rate for Payer: Aetna Medicare Advantage	$2,437.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,071.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,071.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,071.88
Rate for Payer: Cigna Commercial	$4,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,112.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,218.75
Rate for Payer: UnitedHealthcare Community & State	$256.75
Rate for Payer: Wellpoint Medicaid Managed Care	$230.75

ENDOSCOPY < 1 HR WITH FOUR BX

Facility

$6,875.00

Hospital Charge Code	2300064
Hospital Revenue Code	750
Min. Negotiated Rate	$195.25
Max. Negotiated Rate	$3,437.50
Rate for Payer: Aetna Commercial	$2,612.50
Rate for Payer: Aetna Medicare Advantage	$2,062.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,753.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,753.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,753.12
Rate for Payer: Cigna Commercial	$3,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,787.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,031.25
Rate for Payer: UnitedHealthcare Community & State	$217.25
Rate for Payer: Wellpoint Medicaid Managed Care	$195.25

ENDOSCOPY < 1 HR WITH FOUR BX

Facility

$6,875.00

Hospital Charge Code	2300064
Hospital Revenue Code	750
Min. Negotiated Rate	$1,031.25
Max. Negotiated Rate	$1,031.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,031.25

ENDOSCOPY < 1 HR WITH ONE BX

Facility

$3,125.00

Hospital Charge Code	2300061
Hospital Revenue Code	750
Min. Negotiated Rate	$88.75
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$1,187.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$812.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Community & State	$98.75
Rate for Payer: Wellpoint Medicaid Managed Care	$88.75

ENDOSCOPY < 1 HR WITH ONE BX

Facility

$3,125.00

Hospital Charge Code	2300061
Hospital Revenue Code	750
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$468.75
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

ENDOSCOPY < 1 HR WITHOUT BX

Facility

$1,875.00

Hospital Charge Code	2300060
Hospital Revenue Code	750
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$281.25
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

ENDOSCOPY < 1 HR WITHOUT BX

Facility

$1,875.00

Hospital Charge Code	2300060
Hospital Revenue Code	750
Min. Negotiated Rate	$53.25
Max. Negotiated Rate	$937.50
Rate for Payer: Aetna Commercial	$712.50
Rate for Payer: Aetna Medicare Advantage	$562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.12
Rate for Payer: Cigna Commercial	$937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$487.50
Rate for Payer: Qualcare PPO/HMO/WC	$281.25
Rate for Payer: UnitedHealthcare Community & State	$59.25
Rate for Payer: Wellpoint Medicaid Managed Care	$53.25

ENDOSCOPY < 1 HR WITH THREE BX

Facility

$5,625.00

Hospital Charge Code	2300063
Hospital Revenue Code	750
Min. Negotiated Rate	$159.75
Max. Negotiated Rate	$2,812.50
Rate for Payer: Aetna Commercial	$2,137.50
Rate for Payer: Aetna Medicare Advantage	$1,687.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,434.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,434.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,434.38
Rate for Payer: Cigna Commercial	$2,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,462.50
Rate for Payer: Qualcare PPO/HMO/WC	$843.75
Rate for Payer: UnitedHealthcare Community & State	$177.75
Rate for Payer: Wellpoint Medicaid Managed Care	$159.75

ENDOSCOPY < 1 HR WITH THREE BX

Facility

$5,625.00

Hospital Charge Code	2300063
Hospital Revenue Code	750
Min. Negotiated Rate	$843.75
Max. Negotiated Rate	$843.75
Rate for Payer: Qualcare PPO/HMO/WC	$843.75

ENDOSCOPY < 1 HR WITH TWO BX

Facility

$4,375.00

Hospital Charge Code	2300062
Hospital Revenue Code	750
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$656.25
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

ENDOSCOPY < 1 HR WITH TWO BX

Facility

$4,375.00

Hospital Charge Code	2300062
Hospital Revenue Code	750
Min. Negotiated Rate	$124.25
Max. Negotiated Rate	$2,187.50
Rate for Payer: Aetna Commercial	$1,662.50
Rate for Payer: Aetna Medicare Advantage	$1,312.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,115.62
Rate for Payer: Cigna Commercial	$2,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,137.50
Rate for Payer: Qualcare PPO/HMO/WC	$656.25
Rate for Payer: UnitedHealthcare Community & State	$138.25
Rate for Payer: Wellpoint Medicaid Managed Care	$124.25

ENDOSCOPY 1 PROCEDURE < 1 HR

Facility

$3,125.00

Hospital Charge Code	2300082
Hospital Revenue Code	750
Min. Negotiated Rate	$88.75
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$1,187.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$812.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Community & State	$98.75
Rate for Payer: Wellpoint Medicaid Managed Care	$88.75

ENDOSCOPY 1 PROCEDURE < 1 HR

Facility

$3,125.00

Hospital Charge Code	2300082
Hospital Revenue Code	750
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$468.75
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

ENDOSCOPY 2 PROCEDURES < 1 HR

Facility

$6,250.00

Hospital Charge Code	2300084
Hospital Revenue Code	750
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$937.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

ENDOSCOPY 2 PROCEDURES < 1 HR

Facility

$6,250.00

Hospital Charge Code	2300084
Hospital Revenue Code	750
Min. Negotiated Rate	$177.50
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,625.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Community & State	$197.50
Rate for Payer: Wellpoint Medicaid Managed Care	$177.50

ENDOSCOPY 4 PROCEDURES < 1 HR

Facility

$8,750.00

Hospital Charge Code	2300090
Hospital Revenue Code	750
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$1,312.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

ENDOSCOPY 4 PROCEDURES < 1 HR

Facility

$8,750.00

Hospital Charge Code	2300090
Hospital Revenue Code	750
Min. Negotiated Rate	$248.50
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$3,325.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,275.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Community & State	$276.50
Rate for Payer: Wellpoint Medicaid Managed Care	$248.50

ENDOSCOPY 4 PROCEDURES > 1 HR

Facility

$10,250.00

Hospital Charge Code	2300091
Hospital Revenue Code	750
Min. Negotiated Rate	$291.10
Max. Negotiated Rate	$5,125.00
Rate for Payer: Aetna Commercial	$3,895.00
Rate for Payer: Aetna Medicare Advantage	$3,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,613.75
Rate for Payer: Cigna Commercial	$5,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,665.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50
Rate for Payer: UnitedHealthcare Community & State	$323.90
Rate for Payer: Wellpoint Medicaid Managed Care	$291.10

ENDOSCOPY 4 PROCEDURES > 1 HR

Facility

$10,250.00

Hospital Charge Code	2300091
Hospital Revenue Code	750
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$1,537.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

ENDOSERV CURETAGE W CLAMP & BL

Facility

$2,685.00

Service Code	HCPCS 57505
Hospital Charge Code	87502600
Hospital Revenue Code	761
Min. Negotiated Rate	$28.60
Max. Negotiated Rate	$3,969.32
Rate for Payer: Aetna Commercial	$2,976.31
Rate for Payer: Aetna Medicare Advantage	$3,545.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,969.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,969.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,094.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,969.32
Rate for Payer: Cigna Commercial	$2,193.38
Rate for Payer: Cigna Medicare Advantage	$1,094.23
Rate for Payer: Clover Medicare Advantage	$1,039.52
Rate for Payer: EmblemHealth Commercial	$3,282.69
Rate for Payer: Humana Medicare Advantage	$1,127.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,094.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$698.10
Rate for Payer: Oxford Commercial	$537.00
Rate for Payer: Qualcare PPO/HMO/WC	$402.75
Rate for Payer: UnitedHealthcare Commercial	$537.00
Rate for Payer: UnitedHealthcare Community & State	$84.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,094.23
Rate for Payer: Wellcare Medicare Advantage	$1,094.23
Rate for Payer: Wellpoint Medicaid Managed Care	$76.25

ENDOSERV CURETAGE W CLAMP & BL

Facility

$2,685.00

Service Code	HCPCS 57505
Hospital Charge Code	87502600
Hospital Revenue Code	761
Min. Negotiated Rate	$402.75
Max. Negotiated Rate	$402.75
Rate for Payer: Qualcare PPO/HMO/WC	$402.75

ENDO SHEARS

Facility

$1,405.00

Hospital Charge Code	270332559
Hospital Revenue Code	272
Min. Negotiated Rate	$39.90
Max. Negotiated Rate	$702.50
Rate for Payer: Aetna Commercial	$533.90
Rate for Payer: Aetna Medicare Advantage	$421.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$358.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$358.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$358.27
Rate for Payer: Cigna Commercial	$702.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$365.30
Rate for Payer: Oxford Commercial	$281.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.75
Rate for Payer: UnitedHealthcare Commercial	$281.00
Rate for Payer: UnitedHealthcare Community & State	$44.40
Rate for Payer: Wellpoint Medicaid Managed Care	$39.90

ENDO SHEARS

Facility

$1,405.00

Hospital Charge Code	270332559
Hospital Revenue Code	272
Min. Negotiated Rate	$210.75
Max. Negotiated Rate	$210.75
Rate for Payer: Qualcare PPO/HMO/WC	$210.75

Know your out-of-pocket cost for care.

All Charges