Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ER COLL BLOOD VAD IMPLANT

Facility

$694.20

Service Code	HCPCS 36591
Hospital Charge Code	5700781
Hospital Revenue Code	450
Min. Negotiated Rate	$104.13
Max. Negotiated Rate	$104.13
Rate for Payer: Qualcare PPO/HMO/WC	$104.13

ER COLL BLOOD VAD IMPLANT

Facility

$694.20

Service Code	HCPCS 36591
Hospital Charge Code	5700781
Hospital Revenue Code	450
Min. Negotiated Rate	$19.72
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	$180.49
Rate for Payer: Qualcare PPO/HMO/WC	$104.13
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	$19.72

ER COLLECTION CAP BLOOD SPEC

Facility

$14.00

Service Code	HCPCS 36416
Hospital Charge Code	5700831
Hospital Revenue Code	450
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$2.10
Rate for Payer: Qualcare PPO/HMO/WC	$2.10

ER COLLECTION CAP BLOOD SPEC

Facility

$14.00

Service Code	HCPCS 36416
Hospital Charge Code	5700831
Hospital Revenue Code	450
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$140.00
Rate for Payer: Aetna Commercial	$5.32
Rate for Payer: Aetna Medicare Advantage	$4.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.57
Rate for Payer: Cigna Commercial	$7.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.64
Rate for Payer: Qualcare PPO/HMO/WC	$2.10
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

ER COMPREHENSIVE - V

Facility

$21,839.90

Service Code	HCPCS 99285
Hospital Charge Code	5700109
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$3,833.00
Rate for Payer: Aetna Commercial	$1,924.43
Rate for Payer: Aetna Medicare Advantage	$2,292.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,566.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,566.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$707.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$766.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,566.49
Rate for Payer: Cigna Commercial	$1,418.20
Rate for Payer: Cigna Medicare Advantage	$707.51
Rate for Payer: Clover Medicare Advantage	$672.13
Rate for Payer: EmblemHealth Commercial	$2,122.53
Rate for Payer: Humana Medicare Advantage	$728.74
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$707.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,064.00
Rate for Payer: Oxford Commercial	$3,377.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,275.99
Rate for Payer: UnitedHealthcare Commercial	$3,833.00
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$707.51
Rate for Payer: Wellcare Medicare Advantage	$707.51
Rate for Payer: Wellpoint Medicaid Managed Care	$450.00

ER COMPREHENSIVE - V

Facility

$21,839.90

Service Code	HCPCS 99285
Hospital Charge Code	5700109
Hospital Revenue Code	450
Min. Negotiated Rate	$3,275.99
Max. Negotiated Rate	$3,275.99
Rate for Payer: Qualcare PPO/HMO/WC	$3,275.99

ER COMPREHENSIVE - V W/O MF

Facility

$21,654.71

Service Code	HCPCS 99285
Hospital Charge Code	5700108
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$3,833.00
Rate for Payer: Aetna Commercial	$1,924.43
Rate for Payer: Aetna Medicare Advantage	$2,292.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,566.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,566.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$707.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$766.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,566.49
Rate for Payer: Cigna Commercial	$1,418.20
Rate for Payer: Cigna Medicare Advantage	$707.51
Rate for Payer: Clover Medicare Advantage	$672.13
Rate for Payer: EmblemHealth Commercial	$2,122.53
Rate for Payer: Humana Medicare Advantage	$728.74
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$707.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,064.00
Rate for Payer: Oxford Commercial	$3,377.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,248.21
Rate for Payer: UnitedHealthcare Commercial	$3,833.00
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$707.51
Rate for Payer: Wellcare Medicare Advantage	$707.51
Rate for Payer: Wellpoint Medicaid Managed Care	$450.00

ER COMPREHENSIVE - V W/O MF

Facility

$21,654.71

Service Code	HCPCS 99285
Hospital Charge Code	5700108
Hospital Revenue Code	450
Min. Negotiated Rate	$3,248.21
Max. Negotiated Rate	$3,248.21
Rate for Payer: Qualcare PPO/HMO/WC	$3,248.21

ER COMP REP FACE 2.6-7.5 CM

Facility

$2,341.51

Service Code	HCPCS 13152
Hospital Charge Code	5700499
Hospital Revenue Code	450
Min. Negotiated Rate	$66.50
Max. Negotiated Rate	$3,185.09
Rate for Payer: Aetna Commercial	$2,388.27
Rate for Payer: Aetna Medicare Advantage	$2,844.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,185.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,185.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$878.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,185.09
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: Cigna Medicare Advantage	$878.04
Rate for Payer: Clover Medicare Advantage	$834.14
Rate for Payer: EmblemHealth Commercial	$2,634.12
Rate for Payer: Humana Medicare Advantage	$904.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$878.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$608.79
Rate for Payer: Qualcare PPO/HMO/WC	$351.23
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$878.04
Rate for Payer: Wellcare Medicare Advantage	$878.04
Rate for Payer: Wellpoint Medicaid Managed Care	$66.50

ER COMP REP FACE 2.6-7.5 CM

Facility

$2,341.51

Service Code	HCPCS 13152
Hospital Charge Code	5700499
Hospital Revenue Code	450
Min. Negotiated Rate	$351.23
Max. Negotiated Rate	$351.23
Rate for Payer: Qualcare PPO/HMO/WC	$351.23

ER COMP REP FACE >7.6 EA ADDL

Facility

$1,293.00

Service Code	HCPCS 13153
Hospital Charge Code	5700720
Hospital Revenue Code	450
Min. Negotiated Rate	$36.72
Max. Negotiated Rate	$646.50
Rate for Payer: Aetna Commercial	$491.34
Rate for Payer: Aetna Medicare Advantage	$387.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$329.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$329.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$329.71
Rate for Payer: Cigna Commercial	$646.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$336.18
Rate for Payer: Qualcare PPO/HMO/WC	$193.95
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$36.72

ER COMP REP FACE >7.6 EA ADDL

Facility

$1,293.00

Service Code	HCPCS 13153
Hospital Charge Code	5700720
Hospital Revenue Code	450
Min. Negotiated Rate	$193.95
Max. Negotiated Rate	$193.95
Rate for Payer: Qualcare PPO/HMO/WC	$193.95

ER COM REP FACE 1.1-2.5

Facility

$3,400.00

Service Code	HCPCS 13151
Hospital Charge Code	5700540
Hospital Revenue Code	450
Min. Negotiated Rate	$96.56
Max. Negotiated Rate	$3,185.09
Rate for Payer: Aetna Commercial	$2,388.27
Rate for Payer: Aetna Medicare Advantage	$2,844.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,185.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,185.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$878.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,185.09
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: Cigna Medicare Advantage	$878.04
Rate for Payer: Clover Medicare Advantage	$834.14
Rate for Payer: EmblemHealth Commercial	$2,634.12
Rate for Payer: Humana Medicare Advantage	$904.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$878.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$884.00
Rate for Payer: Qualcare PPO/HMO/WC	$510.00
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$878.04
Rate for Payer: Wellcare Medicare Advantage	$878.04
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,639.38
Rate for Payer: Wellpoint Medicaid Managed Care	$96.56

ER COM REP FACE 1.1-2.5

Facility

$3,400.00

Service Code	HCPCS 13151
Hospital Charge Code	5700540
Hospital Revenue Code	450
Min. Negotiated Rate	$510.00
Max. Negotiated Rate	$510.00
Rate for Payer: Qualcare PPO/HMO/WC	$510.00

ER COM REP FACE HAND FEET 2.5

Facility

$2,500.00

Service Code	HCPCS 13132
Hospital Charge Code	5700539
Hospital Revenue Code	450
Min. Negotiated Rate	$71.00
Max. Negotiated Rate	$1,751.90
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,751.90
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$650.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74
Rate for Payer: Wellpoint Medicaid Managed Care	$71.00

ER COM REP FACE HAND FEET 2.5

Facility

$2,500.00

Service Code	HCPCS 13132
Hospital Charge Code	5700539
Hospital Revenue Code	450
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

ER COM REP FACE UP TO 1.00

Facility

$3,300.00

Hospital Charge Code	5700719
Hospital Revenue Code	450
Min. Negotiated Rate	$93.72
Max. Negotiated Rate	$1,650.00
Rate for Payer: Aetna Commercial	$1,254.00
Rate for Payer: Aetna Medicare Advantage	$990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$841.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$841.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$841.50
Rate for Payer: Cigna Commercial	$1,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$858.00
Rate for Payer: Qualcare PPO/HMO/WC	$495.00
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$93.72

ER COM REP FACE UP TO 1.00

Facility

$3,300.00

Hospital Charge Code	5700719
Hospital Revenue Code	450
Min. Negotiated Rate	$495.00
Max. Negotiated Rate	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$495.00

ER COM REP FAC HAD FET EA ADD5

Facility

$3,000.00

Service Code	HCPCS 13133
Hospital Charge Code	5700718
Hospital Revenue Code	450
Min. Negotiated Rate	$55.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
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	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$780.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$85.20

ER COM REP FAC HAD FET EA ADD5

Facility

$3,000.00

Service Code	HCPCS 13133
Hospital Charge Code	5700718
Hospital Revenue Code	450
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$450.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

ER COM REP TRUNK 1.1-2.5CM

Facility

$1,898.00

Service Code	HCPCS 13100
Hospital Charge Code	5700715
Hospital Revenue Code	450
Min. Negotiated Rate	$284.70
Max. Negotiated Rate	$284.70
Rate for Payer: Qualcare PPO/HMO/WC	$284.70

ER COM REP TRUNK 1.1-2.5CM

Facility

$1,898.00

Service Code	HCPCS 13100
Hospital Charge Code	5700715
Hospital Revenue Code	450
Min. Negotiated Rate	$53.90
Max. Negotiated Rate	$3,185.09
Rate for Payer: Aetna Commercial	$2,388.27
Rate for Payer: Aetna Medicare Advantage	$2,844.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,185.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,185.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$878.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$78.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,185.09
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: Cigna Medicare Advantage	$878.04
Rate for Payer: Clover Medicare Advantage	$834.14
Rate for Payer: EmblemHealth Commercial	$2,634.12
Rate for Payer: Humana Medicare Advantage	$904.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$878.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$493.48
Rate for Payer: Qualcare PPO/HMO/WC	$284.70
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$878.04
Rate for Payer: Wellcare Medicare Advantage	$878.04
Rate for Payer: Wellpoint Medicaid Managed Care	$53.90

ER COM REP TRUNK 2.6CM-7.5CM

Facility

$1,898.00

Service Code	HCPCS 13101
Hospital Charge Code	5700284
Hospital Revenue Code	450
Min. Negotiated Rate	$53.90
Max. Negotiated Rate	$3,185.09
Rate for Payer: Aetna Commercial	$2,388.27
Rate for Payer: Aetna Medicare Advantage	$2,844.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,185.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,185.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$878.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,185.09
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: Cigna Medicare Advantage	$878.04
Rate for Payer: Clover Medicare Advantage	$834.14
Rate for Payer: EmblemHealth Commercial	$2,634.12
Rate for Payer: Humana Medicare Advantage	$904.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$878.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$493.48
Rate for Payer: Qualcare PPO/HMO/WC	$284.70
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$878.04
Rate for Payer: Wellcare Medicare Advantage	$878.04
Rate for Payer: Wellpoint Medicaid Managed Care	$53.90

ER COM REP TRUNK 2.6CM-7.5CM

Facility

$1,898.00

Service Code	HCPCS 13101
Hospital Charge Code	5700284
Hospital Revenue Code	450
Min. Negotiated Rate	$284.70
Max. Negotiated Rate	$284.70
Rate for Payer: Qualcare PPO/HMO/WC	$284.70

ER COM REP TRUNK >7.6EA ADDL 5

Facility

$1,898.00

Service Code	HCPCS 13102
Hospital Charge Code	5700716
Hospital Revenue Code	450
Min. Negotiated Rate	$37.40
Max. Negotiated Rate	$949.00
Rate for Payer: Aetna Commercial	$721.24
Rate for Payer: Aetna Medicare Advantage	$569.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$483.99
Rate for Payer: Cigna Commercial	$949.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$493.48
Rate for Payer: Qualcare PPO/HMO/WC	$284.70
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$53.90

Know your out-of-pocket cost for care.

All Charges