Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ER BURN DSG/DEBRID MED W/O ANE

Facility

$612.00

Service Code	HCPCS 16025
Hospital Charge Code	5700542
Hospital Revenue Code	450
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

ER CARDIOVERSION

Facility

$2,208.00

Service Code	HCPCS 92960
Hospital Charge Code	5700260
Hospital Revenue Code	450
Min. Negotiated Rate	$62.71
Max. Negotiated Rate	$2,848.39
Rate for Payer: Aetna Commercial	$2,135.80
Rate for Payer: Aetna Medicare Advantage	$2,544.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,848.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,848.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$785.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,848.39
Rate for Payer: Cigna Commercial	$1,573.96
Rate for Payer: Cigna Medicare Advantage	$785.22
Rate for Payer: Clover Medicare Advantage	$745.96
Rate for Payer: EmblemHealth Commercial	$2,355.66
Rate for Payer: Humana Medicare Advantage	$808.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$785.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$574.08
Rate for Payer: Qualcare PPO/HMO/WC	$331.20
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$785.22
Rate for Payer: Wellcare Medicare Advantage	$785.22
Rate for Payer: Wellpoint Medicaid Managed Care	$62.71

ER CARDIOVERSION

Facility

$2,208.00

Service Code	HCPCS 92960
Hospital Charge Code	5700260
Hospital Revenue Code	450
Min. Negotiated Rate	$331.20
Max. Negotiated Rate	$331.20
Rate for Payer: Qualcare PPO/HMO/WC	$331.20

ER CENTRAL LINE INSERT <5YRS

Facility

$4,649.00

Service Code	HCPCS 36555
Hospital Charge Code	5700779
Hospital Revenue Code	450
Min. Negotiated Rate	$697.35
Max. Negotiated Rate	$697.35
Rate for Payer: Qualcare PPO/HMO/WC	$697.35

ER CENTRAL LINE INSERT <5YRS

Facility

$4,649.00

Service Code	HCPCS 36555
Hospital Charge Code	5700779
Hospital Revenue Code	450
Min. Negotiated Rate	$132.03
Max. Negotiated Rate	$13,607.37
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,607.37
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,208.74
Rate for Payer: Qualcare PPO/HMO/WC	$697.35
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$132.03

ER CENTRAL LINE INSERT>5YRS

Facility

$4,649.00

Service Code	HCPCS 36556
Hospital Charge Code	5700780
Hospital Revenue Code	450
Min. Negotiated Rate	$697.35
Max. Negotiated Rate	$697.35
Rate for Payer: Qualcare PPO/HMO/WC	$697.35

ER CENTRAL LINE INSERT>5YRS

Facility

$4,649.00

Service Code	HCPCS 36556
Hospital Charge Code	5700780
Hospital Revenue Code	450
Min. Negotiated Rate	$132.03
Max. Negotiated Rate	$13,607.37
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,607.37
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,208.74
Rate for Payer: Qualcare PPO/HMO/WC	$697.35
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$132.03

ER CHANGE G TUBE

Facility

$1,515.00

Service Code	HCPCS 43760
Hospital Charge Code	5700293
Hospital Revenue Code	450
Min. Negotiated Rate	$43.03
Max. Negotiated Rate	$781.67
Rate for Payer: Aetna Commercial	$575.70
Rate for Payer: Aetna Medicare Advantage	$454.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$386.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$386.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$386.32
Rate for Payer: Cigna Commercial	$757.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.90
Rate for Payer: Qualcare PPO/HMO/WC	$227.25
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$781.67
Rate for Payer: Wellpoint Medicaid Managed Care	$43.03

ER CHANGE G TUBE

Facility

$1,515.00

Service Code	HCPCS 43760
Hospital Charge Code	5700293
Hospital Revenue Code	450
Min. Negotiated Rate	$227.25
Max. Negotiated Rate	$227.25
Rate for Payer: Qualcare PPO/HMO/WC	$227.25

ER-CHEMCAL CAUTERY TISSUE

Facility

$990.50

Service Code	HCPCS 17250
Hospital Charge Code	5790045
Hospital Revenue Code	450
Min. Negotiated Rate	$28.13
Max. Negotiated Rate	$864.65
Rate for Payer: Aetna Commercial	$648.34
Rate for Payer: Aetna Medicare Advantage	$772.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$864.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$864.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$238.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$864.65
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: Cigna Medicare Advantage	$238.36
Rate for Payer: Clover Medicare Advantage	$226.44
Rate for Payer: EmblemHealth Commercial	$715.08
Rate for Payer: Humana Medicare Advantage	$245.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$238.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.53
Rate for Payer: Qualcare PPO/HMO/WC	$148.57
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$28.13

ER-CHEMCAL CAUTERY TISSUE

Facility

$990.50

Service Code	HCPCS 17250
Hospital Charge Code	5790045
Hospital Revenue Code	450
Min. Negotiated Rate	$148.57
Max. Negotiated Rate	$148.57
Rate for Payer: Qualcare PPO/HMO/WC	$148.57

ER CHEMO IM/SQ NON HORM

Facility

$462.00

Service Code	HCPCS 96401
Hospital Charge Code	5792276
Hospital Revenue Code	331
Min. Negotiated Rate	$13.12
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$310.30
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$59.88
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.12
Rate for Payer: Oxford Commercial	$2,441.00
Rate for Payer: Qualcare PPO/HMO/WC	$69.30
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$14.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$13.12

ER CHEMO IM/SQ NON HORM

Facility

$462.00

Service Code	HCPCS 96401
Hospital Charge Code	5792276
Hospital Revenue Code	331
Min. Negotiated Rate	$69.30
Max. Negotiated Rate	$69.30
Rate for Payer: Qualcare PPO/HMO/WC	$69.30

ER CLD TX METACARPAL W/O ANES

Facility

$645.00

Service Code	HCPCS 26600
Hospital Charge Code	5700461
Hospital Revenue Code	450
Min. Negotiated Rate	$18.32
Max. Negotiated Rate	$1,063.04
Rate for Payer: Aetna Commercial	$797.10
Rate for Payer: Aetna Medicare Advantage	$949.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,063.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,063.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$293.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,063.04
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: Cigna Medicare Advantage	$293.05
Rate for Payer: Clover Medicare Advantage	$278.40
Rate for Payer: EmblemHealth Commercial	$879.15
Rate for Payer: Humana Medicare Advantage	$301.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$293.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.70
Rate for Payer: Qualcare PPO/HMO/WC	$96.75
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$293.05
Rate for Payer: Wellcare Medicare Advantage	$293.05
Rate for Payer: Wellpoint Medicaid Managed Care	$18.32

ER CLD TX METACARPAL W/O ANES

Facility

$645.00

Service Code	HCPCS 26600
Hospital Charge Code	5700461
Hospital Revenue Code	450
Min. Negotiated Rate	$96.75
Max. Negotiated Rate	$96.75
Rate for Payer: Qualcare PPO/HMO/WC	$96.75

ER CLD TX PATELLR DIS W/O ANES

Facility

$889.49

Service Code	HCPCS 27560
Hospital Charge Code	5700460
Hospital Revenue Code	450
Min. Negotiated Rate	$25.26
Max. Negotiated Rate	$1,063.04
Rate for Payer: Aetna Commercial	$797.10
Rate for Payer: Aetna Medicare Advantage	$949.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,063.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,063.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$293.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,063.04
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: Cigna Medicare Advantage	$293.05
Rate for Payer: Clover Medicare Advantage	$278.40
Rate for Payer: EmblemHealth Commercial	$879.15
Rate for Payer: Humana Medicare Advantage	$301.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$293.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.27
Rate for Payer: Qualcare PPO/HMO/WC	$133.42
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$293.05
Rate for Payer: Wellcare Medicare Advantage	$293.05
Rate for Payer: Wellpoint Medicaid Managed Care	$25.26

ER CLD TX PATELLR DIS W/O ANES

Facility

$889.49

Service Code	HCPCS 27560
Hospital Charge Code	5700460
Hospital Revenue Code	450
Min. Negotiated Rate	$133.42
Max. Negotiated Rate	$133.42
Rate for Payer: Qualcare PPO/HMO/WC	$133.42

ER CLECT BLD CNTR PRIPHRL CAT

Facility

$259.00

Service Code	HCPCS 36591
Hospital Charge Code	5700782
Hospital Revenue Code	450
Min. Negotiated Rate	$38.85
Max. Negotiated Rate	$38.85
Rate for Payer: Qualcare PPO/HMO/WC	$38.85

ER CLECT BLD CNTR PRIPHRL CAT

Facility

$259.00

Service Code	HCPCS 36591
Hospital Charge Code	5700782
Hospital Revenue Code	450
Min. Negotiated Rate	$7.36
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) 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	$67.34
Rate for Payer: Qualcare PPO/HMO/WC	$38.85
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	$7.36

ER CLOSED TX BENNET FX

Facility

$2,251.00

Service Code	HCPCS 26645
Hospital Charge Code	5700751
Hospital Revenue Code	450
Min. Negotiated Rate	$337.65
Max. Negotiated Rate	$337.65
Rate for Payer: Qualcare PPO/HMO/WC	$337.65

ER CLOSED TX BENNET FX

Facility

$2,251.00

Service Code	HCPCS 26645
Hospital Charge Code	5700751
Hospital Revenue Code	450
Min. Negotiated Rate	$63.93
Max. Negotiated Rate	$6,929.76
Rate for Payer: Aetna Commercial	$5,196.12
Rate for Payer: Aetna Medicare Advantage	$6,189.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,929.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,929.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,910.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,929.76
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: Cigna Medicare Advantage	$1,910.34
Rate for Payer: Clover Medicare Advantage	$1,814.82
Rate for Payer: EmblemHealth Commercial	$5,731.02
Rate for Payer: Humana Medicare Advantage	$1,967.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,910.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.26
Rate for Payer: Qualcare PPO/HMO/WC	$337.65
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellpoint Medicaid Managed Care	$63.93

ER CLOSED TX MANDIBLE W/O MANI

Facility

$1,453.00

Service Code	HCPCS 21450
Hospital Charge Code	5700727
Hospital Revenue Code	450
Min. Negotiated Rate	$39.93
Max. Negotiated Rate	$2,324.28
Rate for Payer: Aetna Commercial	$1,742.81
Rate for Payer: Aetna Medicare Advantage	$2,076.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,324.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,324.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$640.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,324.28
Rate for Payer: Cigna Commercial	$1,284.36
Rate for Payer: Cigna Medicare Advantage	$640.74
Rate for Payer: Clover Medicare Advantage	$608.70
Rate for Payer: EmblemHealth Commercial	$1,922.22
Rate for Payer: Humana Medicare Advantage	$659.96
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$640.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$377.78
Rate for Payer: Qualcare PPO/HMO/WC	$217.95
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$640.74
Rate for Payer: Wellcare Medicare Advantage	$640.74
Rate for Payer: Wellpoint Medicaid Managed Care	$41.27

ER CLOSED TX MANDIBLE W/O MANI

Facility

$1,453.00

Service Code	HCPCS 21450
Hospital Charge Code	5700727
Hospital Revenue Code	450
Min. Negotiated Rate	$217.95
Max. Negotiated Rate	$217.95
Rate for Payer: Qualcare PPO/HMO/WC	$217.95

ER CLOSED TX NASAL FX W/O ANE

Facility

$1,600.00

Service Code	HCPCS 21310
Hospital Charge Code	5700551
Hospital Revenue Code	450
Min. Negotiated Rate	$240.00
Max. Negotiated Rate	$240.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00

ER CLOSED TX NASAL FX W/O ANE

Facility

$1,600.00

Service Code	HCPCS 21310
Hospital Charge Code	5700551
Hospital Revenue Code	450
Min. Negotiated Rate	$45.44
Max. Negotiated Rate	$800.00
Rate for Payer: Aetna Commercial	$608.00
Rate for Payer: Aetna Medicare Advantage	$480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$408.00
Rate for Payer: Cigna Commercial	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$416.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$45.44

Know your out-of-pocket cost for care.

All Charges