Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ER-ABDOMEN PROCEDURE

Facility

$5,904.00

Service Code	HCPCS 49999
Hospital Charge Code	5790160
Hospital Revenue Code	450
Min. Negotiated Rate	$885.60
Max. Negotiated Rate	$885.60
Rate for Payer: Qualcare PPO/HMO/WC	$885.60

ER ADMIN BLOOD TRANSFUSION

Facility

$1,403.75

Service Code	HCPCS 36430
Hospital Charge Code	5700032
Hospital Revenue Code	391
Min. Negotiated Rate	$39.87
Max. Negotiated Rate	$1,901.28
Rate for Payer: Aetna Commercial	$1,425.63
Rate for Payer: Aetna Medicare Advantage	$1,698.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,901.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,901.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$524.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,901.28
Rate for Payer: Cigna Commercial	$1,050.61
Rate for Payer: Cigna Medicare Advantage	$524.13
Rate for Payer: Clover Medicare Advantage	$497.92
Rate for Payer: EmblemHealth Commercial	$1,572.39
Rate for Payer: Humana Medicare Advantage	$539.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$524.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.98
Rate for Payer: Oxford Commercial	$1,028.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.56
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$44.36
Rate for Payer: UnitedHealthcare Medicare Advantage	$524.13
Rate for Payer: Wellcare Medicare Advantage	$524.13
Rate for Payer: Wellpoint Medicaid Managed Care	$39.87

ER ADMIN BLOOD TRANSFUSION

Facility

$1,403.75

Service Code	HCPCS 36430
Hospital Charge Code	5700032
Hospital Revenue Code	391
Min. Negotiated Rate	$210.56
Max. Negotiated Rate	$210.56
Rate for Payer: Qualcare PPO/HMO/WC	$210.56

ER AIRWAY INHALATION TREATMENT

Facility

$503.00

Service Code	HCPCS 94640
Hospital Charge Code	5700655
Hospital Revenue Code	410
Min. Negotiated Rate	$75.45
Max. Negotiated Rate	$75.45
Rate for Payer: Qualcare PPO/HMO/WC	$75.45

ER AIRWAY INHALATION TREATMENT

Facility

$503.00

Service Code	HCPCS 94640
Hospital Charge Code	5700655
Hospital Revenue Code	410
Min. Negotiated Rate	$14.29
Max. Negotiated Rate	$1,440.00
Rate for Payer: Aetna Commercial	$707.61
Rate for Payer: Aetna Medicare Advantage	$842.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$943.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$943.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$943.69
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: Cigna Medicare Advantage	$260.15
Rate for Payer: Clover Medicare Advantage	$247.14
Rate for Payer: EmblemHealth Commercial	$780.45
Rate for Payer: Humana Medicare Advantage	$267.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$260.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.78
Rate for Payer: Oxford Commercial	$1,367.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.45
Rate for Payer: UnitedHealthcare Commercial	$1,440.00
Rate for Payer: UnitedHealthcare Community & State	$15.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$260.15
Rate for Payer: Wellcare Medicare Advantage	$260.15
Rate for Payer: Wellpoint Medicaid Managed Care	$14.29

ER AIRWAY INHALATION TX SUBSEQ

Facility

$467.85

Service Code	HCPCS 9464076
Hospital Charge Code	5701016
Hospital Revenue Code	410
Min. Negotiated Rate	$13.29
Max. Negotiated Rate	$1,440.00
Rate for Payer: Aetna Commercial	$177.78
Rate for Payer: Aetna Medicare Advantage	$140.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.30
Rate for Payer: Cigna Commercial	$233.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.64
Rate for Payer: Oxford Commercial	$1,367.00
Rate for Payer: Qualcare PPO/HMO/WC	$70.18
Rate for Payer: UnitedHealthcare Commercial	$1,440.00
Rate for Payer: UnitedHealthcare Community & State	$14.78
Rate for Payer: Wellpoint Medicaid Managed Care	$13.29

ER AIRWAY INHALATION TX SUBSEQ

Facility

$467.85

Service Code	HCPCS 9464076
Hospital Charge Code	5701016
Hospital Revenue Code	410
Min. Negotiated Rate	$70.18
Max. Negotiated Rate	$70.18
Rate for Payer: Qualcare PPO/HMO/WC	$70.18

ER APPLICATION FINGER SPLINT

Facility

$322.82

Service Code	HCPCS 29130
Hospital Charge Code	5700310
Hospital Revenue Code	450
Min. Negotiated Rate	$9.17
Max. Negotiated Rate	$573.36
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.36
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.93
Rate for Payer: Qualcare PPO/HMO/WC	$48.42
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$9.17

ER APPLICATION FINGER SPLINT

Facility

$322.82

Service Code	HCPCS 29130
Hospital Charge Code	5700310
Hospital Revenue Code	450
Min. Negotiated Rate	$48.42
Max. Negotiated Rate	$48.42
Rate for Payer: Qualcare PPO/HMO/WC	$48.42

ER APPLICATION FOREARM SPLINT

Facility

$988.72

Service Code	HCPCS 29125
Hospital Charge Code	5700305
Hospital Revenue Code	450
Min. Negotiated Rate	$28.08
Max. Negotiated Rate	$573.36
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.36
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.07
Rate for Payer: Qualcare PPO/HMO/WC	$148.31
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$28.08

ER APPLICATION FOREARM SPLINT

Facility

$988.72

Service Code	HCPCS 29125
Hospital Charge Code	5700305
Hospital Revenue Code	450
Min. Negotiated Rate	$148.31
Max. Negotiated Rate	$148.31
Rate for Payer: Qualcare PPO/HMO/WC	$148.31

ER APPLICATION HAND/WRIST CAST

Facility

$475.00

Service Code	HCPCS 29085
Hospital Charge Code	5700365
Hospital Revenue Code	450
Min. Negotiated Rate	$13.49
Max. Negotiated Rate	$700.29
Rate for Payer: Aetna Commercial	$525.10
Rate for Payer: Aetna Medicare Advantage	$625.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$700.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$700.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$193.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$700.29
Rate for Payer: Cigna Commercial	$386.97
Rate for Payer: Cigna Medicare Advantage	$193.05
Rate for Payer: Clover Medicare Advantage	$183.40
Rate for Payer: EmblemHealth Commercial	$579.15
Rate for Payer: Humana Medicare Advantage	$198.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$193.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.50
Rate for Payer: Qualcare PPO/HMO/WC	$71.25
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$193.05
Rate for Payer: Wellcare Medicare Advantage	$193.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.49

ER APPLICATION HAND/WRIST CAST

Facility

$475.00

Service Code	HCPCS 29085
Hospital Charge Code	5700365
Hospital Revenue Code	450
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$71.25
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

ER APPLICATION LONG ARM CAST

Facility

$1,360.45

Service Code	HCPCS 29065
Hospital Charge Code	5700372
Hospital Revenue Code	450
Min. Negotiated Rate	$38.64
Max. Negotiated Rate	$1,205.35
Rate for Payer: Aetna Commercial	$903.80
Rate for Payer: Aetna Medicare Advantage	$1,076.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,205.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,205.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$332.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,205.35
Rate for Payer: Cigna Commercial	$666.07
Rate for Payer: Cigna Medicare Advantage	$332.28
Rate for Payer: Clover Medicare Advantage	$315.67
Rate for Payer: EmblemHealth Commercial	$996.84
Rate for Payer: Humana Medicare Advantage	$342.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$332.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$353.72
Rate for Payer: Qualcare PPO/HMO/WC	$204.07
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$332.28
Rate for Payer: Wellcare Medicare Advantage	$332.28
Rate for Payer: Wellpoint Medicaid Managed Care	$38.64

ER APPLICATION LONG ARM CAST

Facility

$1,360.45

Service Code	HCPCS 29065
Hospital Charge Code	5700372
Hospital Revenue Code	450
Min. Negotiated Rate	$204.07
Max. Negotiated Rate	$204.07
Rate for Payer: Qualcare PPO/HMO/WC	$204.07

ER APPLICATION LONG ARM SPLINT

Facility

$777.42

Service Code	HCPCS 29105
Hospital Charge Code	5700330
Hospital Revenue Code	450
Min. Negotiated Rate	$22.08
Max. Negotiated Rate	$700.29
Rate for Payer: Aetna Commercial	$525.10
Rate for Payer: Aetna Medicare Advantage	$625.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$700.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$700.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$193.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$700.29
Rate for Payer: Cigna Commercial	$386.97
Rate for Payer: Cigna Medicare Advantage	$193.05
Rate for Payer: Clover Medicare Advantage	$183.40
Rate for Payer: EmblemHealth Commercial	$579.15
Rate for Payer: Humana Medicare Advantage	$198.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$193.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$202.13
Rate for Payer: Qualcare PPO/HMO/WC	$116.61
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$193.05
Rate for Payer: Wellcare Medicare Advantage	$193.05
Rate for Payer: Wellpoint Medicaid Managed Care	$22.08

ER APPLICATION LONG ARM SPLINT

Facility

$777.42

Service Code	HCPCS 29105
Hospital Charge Code	5700330
Hospital Revenue Code	450
Min. Negotiated Rate	$116.61
Max. Negotiated Rate	$116.61
Rate for Payer: Qualcare PPO/HMO/WC	$116.61

ER APPLICATION LONG LEG CAST

Facility

$1,360.45

Service Code	HCPCS 29345
Hospital Charge Code	5700355
Hospital Revenue Code	450
Min. Negotiated Rate	$38.64
Max. Negotiated Rate	$1,205.35
Rate for Payer: Aetna Commercial	$903.80
Rate for Payer: Aetna Medicare Advantage	$1,076.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,205.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,205.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$332.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,205.35
Rate for Payer: Cigna Commercial	$666.07
Rate for Payer: Cigna Medicare Advantage	$332.28
Rate for Payer: Clover Medicare Advantage	$315.67
Rate for Payer: EmblemHealth Commercial	$996.84
Rate for Payer: Humana Medicare Advantage	$342.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$332.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$353.72
Rate for Payer: Qualcare PPO/HMO/WC	$204.07
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$332.28
Rate for Payer: Wellcare Medicare Advantage	$332.28
Rate for Payer: Wellpoint Medicaid Managed Care	$38.64

ER APPLICATION LONG LEG CAST

Facility

$1,360.45

Service Code	HCPCS 29345
Hospital Charge Code	5700355
Hospital Revenue Code	450
Min. Negotiated Rate	$204.07
Max. Negotiated Rate	$204.07
Rate for Payer: Qualcare PPO/HMO/WC	$204.07

ER APPLICATION SHORT LEG CAST

Facility

$1,360.45

Service Code	HCPCS 29405
Hospital Charge Code	5700370
Hospital Revenue Code	450
Min. Negotiated Rate	$204.07
Max. Negotiated Rate	$204.07
Rate for Payer: Qualcare PPO/HMO/WC	$204.07

ER APPLICATION SHORT LEG CAST

Facility

$1,360.45

Service Code	HCPCS 29405
Hospital Charge Code	5700370
Hospital Revenue Code	450
Min. Negotiated Rate	$38.64
Max. Negotiated Rate	$1,205.35
Rate for Payer: Aetna Commercial	$903.80
Rate for Payer: Aetna Medicare Advantage	$1,076.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,205.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,205.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$332.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,205.35
Rate for Payer: Cigna Commercial	$666.07
Rate for Payer: Cigna Medicare Advantage	$332.28
Rate for Payer: Clover Medicare Advantage	$315.67
Rate for Payer: EmblemHealth Commercial	$996.84
Rate for Payer: Humana Medicare Advantage	$342.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$332.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$353.72
Rate for Payer: Qualcare PPO/HMO/WC	$204.07
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$332.28
Rate for Payer: Wellcare Medicare Advantage	$332.28
Rate for Payer: Wellpoint Medicaid Managed Care	$38.64

ER APPLICATION SHRT LEG SPLINT

Facility

$1,250.02

Service Code	HCPCS 29515
Hospital Charge Code	5700320
Hospital Revenue Code	450
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

ER APPLICATION SHRT LEG SPLINT

Facility

$1,250.02

Service Code	HCPCS 29515
Hospital Charge Code	5700320
Hospital Revenue Code	450
Min. Negotiated Rate	$35.50
Max. Negotiated Rate	$700.29
Rate for Payer: Aetna Commercial	$525.10
Rate for Payer: Aetna Medicare Advantage	$625.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$700.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$700.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$193.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$700.29
Rate for Payer: Cigna Commercial	$386.97
Rate for Payer: Cigna Medicare Advantage	$193.05
Rate for Payer: Clover Medicare Advantage	$183.40
Rate for Payer: EmblemHealth Commercial	$579.15
Rate for Payer: Humana Medicare Advantage	$198.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$193.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$325.01
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$193.05
Rate for Payer: Wellcare Medicare Advantage	$193.05
Rate for Payer: Wellpoint Medicaid Managed Care	$35.50

ER AR/PULSE OXIMETRY SINGLE DE

Facility

$503.00

Service Code	HCPCS 94760
Hospital Charge Code	5780300
Hospital Revenue Code	460
Min. Negotiated Rate	$14.29
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$191.14
Rate for Payer: Aetna Medicare Advantage	$150.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.26
Rate for Payer: Cigna Commercial	$251.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.78
Rate for Payer: Oxford Commercial	$2,184.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.45
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$15.89
Rate for Payer: Wellpoint Medicaid Managed Care	$14.29

ER AR/PULSE OXIMETRY SINGLE DE

Facility

$503.00

Service Code	HCPCS 94760
Hospital Charge Code	5780300
Hospital Revenue Code	460
Min. Negotiated Rate	$75.45
Max. Negotiated Rate	$75.45
Rate for Payer: Qualcare PPO/HMO/WC	$75.45

Know your out-of-pocket cost for care.

All Charges