Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ER JAW RESET DISLOCATION

Facility

$744.46

Service Code	HCPCS 21480
Hospital Charge Code	5700452
Hospital Revenue Code	450
Min. Negotiated Rate	$21.14
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	$41.58
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	$193.56
Rate for Payer: Qualcare PPO/HMO/WC	$111.67
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	$21.14

ER JAW RESET DISLOCATION

Facility

$744.46

Service Code	HCPCS 21480
Hospital Charge Code	5700452
Hospital Revenue Code	450
Min. Negotiated Rate	$111.67
Max. Negotiated Rate	$111.67
Rate for Payer: Qualcare PPO/HMO/WC	$111.67

ER LARYNGO INDIRECT REMOVAL FB

Facility

$1,170.00

Service Code	HCPCS 31511
Hospital Charge Code	5700621
Hospital Revenue Code	450
Min. Negotiated Rate	$33.23
Max. Negotiated Rate	$860.23
Rate for Payer: Aetna Commercial	$645.02
Rate for Payer: Aetna Medicare Advantage	$768.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$860.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$860.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$237.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$860.23
Rate for Payer: Cigna Commercial	$475.34
Rate for Payer: Cigna Medicare Advantage	$237.14
Rate for Payer: Clover Medicare Advantage	$225.28
Rate for Payer: EmblemHealth Commercial	$711.42
Rate for Payer: Humana Medicare Advantage	$244.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$237.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$304.20
Rate for Payer: Qualcare PPO/HMO/WC	$175.50
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$237.14
Rate for Payer: Wellcare Medicare Advantage	$237.14
Rate for Payer: Wellpoint Medicaid Managed Care	$33.23

ER LARYNGO INDIRECT REMOVAL FB

Facility

$1,170.00

Service Code	HCPCS 31511
Hospital Charge Code	5700621
Hospital Revenue Code	450
Min. Negotiated Rate	$175.50
Max. Negotiated Rate	$175.50
Rate for Payer: Qualcare PPO/HMO/WC	$175.50

ER LARYNGOSCOPY DIAGNOSTC FLEX

Facility

$822.00

Service Code	HCPCS 31575
Hospital Charge Code	5700825
Hospital Revenue Code	450
Min. Negotiated Rate	$23.34
Max. Negotiated Rate	$860.23
Rate for Payer: Aetna Commercial	$645.02
Rate for Payer: Aetna Medicare Advantage	$768.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$860.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$860.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$237.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$860.23
Rate for Payer: Cigna Commercial	$475.34
Rate for Payer: Cigna Medicare Advantage	$237.14
Rate for Payer: Clover Medicare Advantage	$225.28
Rate for Payer: EmblemHealth Commercial	$711.42
Rate for Payer: Humana Medicare Advantage	$244.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$237.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.72
Rate for Payer: Qualcare PPO/HMO/WC	$123.30
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$237.14
Rate for Payer: Wellcare Medicare Advantage	$237.14
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$528.97
Rate for Payer: Wellpoint Medicaid Managed Care	$23.34

ER LARYNGOSCOPY DIAGNOSTC FLEX

Facility

$822.00

Service Code	HCPCS 31575
Hospital Charge Code	5700825
Hospital Revenue Code	450
Min. Negotiated Rate	$123.30
Max. Negotiated Rate	$123.30
Rate for Payer: Qualcare PPO/HMO/WC	$123.30

ER LIMITED - II

Facility

$6,172.34

Service Code	HCPCS 99282
Hospital Charge Code	5700117
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$1,179.00
Rate for Payer: Aetna Commercial	$496.16
Rate for Payer: Aetna Medicare Advantage	$591.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$661.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$661.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$182.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$661.69
Rate for Payer: Cigna Commercial	$365.65
Rate for Payer: Cigna Medicare Advantage	$182.41
Rate for Payer: Clover Medicare Advantage	$173.29
Rate for Payer: EmblemHealth Commercial	$547.23
Rate for Payer: Humana Medicare Advantage	$187.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$182.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$553.00
Rate for Payer: Oxford Commercial	$1,040.00
Rate for Payer: Qualcare PPO/HMO/WC	$925.85
Rate for Payer: UnitedHealthcare Commercial	$1,179.00
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$182.41
Rate for Payer: Wellcare Medicare Advantage	$182.41
Rate for Payer: Wellpoint Medicaid Managed Care	$450.00

ER LIMITED - II

Facility

$6,172.34

Service Code	HCPCS 99282
Hospital Charge Code	5700117
Hospital Revenue Code	450
Min. Negotiated Rate	$925.85
Max. Negotiated Rate	$925.85
Rate for Payer: Qualcare PPO/HMO/WC	$925.85

ER LIMITED - II W/O MF

Facility

$3,172.34

Service Code	HCPCS 99282
Hospital Charge Code	5700116
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$1,179.00
Rate for Payer: Aetna Commercial	$496.16
Rate for Payer: Aetna Medicare Advantage	$591.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$661.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$661.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$182.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$661.69
Rate for Payer: Cigna Commercial	$365.65
Rate for Payer: Cigna Medicare Advantage	$182.41
Rate for Payer: Clover Medicare Advantage	$173.29
Rate for Payer: EmblemHealth Commercial	$547.23
Rate for Payer: Humana Medicare Advantage	$187.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$182.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$553.00
Rate for Payer: Oxford Commercial	$1,040.00
Rate for Payer: Qualcare PPO/HMO/WC	$475.85
Rate for Payer: UnitedHealthcare Commercial	$1,179.00
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$182.41
Rate for Payer: Wellcare Medicare Advantage	$182.41
Rate for Payer: Wellpoint Medicaid Managed Care	$450.00

ER LIMITED - II W/O MF

Facility

$3,172.34

Service Code	HCPCS 99282
Hospital Charge Code	5700116
Hospital Revenue Code	450
Min. Negotiated Rate	$475.85
Max. Negotiated Rate	$475.85
Rate for Payer: Qualcare PPO/HMO/WC	$475.85

ER LUMBAR PUNCTURE DIAGNOSTIC

Facility

$3,185.75

Service Code	HCPCS 62270
Hospital Charge Code	5700803
Hospital Revenue Code	450
Min. Negotiated Rate	$90.48
Max. Negotiated Rate	$3,042.06
Rate for Payer: Aetna Commercial	$2,281.02
Rate for Payer: Aetna Medicare Advantage	$2,717.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,042.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,042.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$838.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,042.06
Rate for Payer: Cigna Commercial	$1,680.99
Rate for Payer: Cigna Medicare Advantage	$838.61
Rate for Payer: Clover Medicare Advantage	$796.68
Rate for Payer: EmblemHealth Commercial	$2,515.83
Rate for Payer: Humana Medicare Advantage	$863.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$838.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$828.29
Rate for Payer: Qualcare PPO/HMO/WC	$477.86
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$838.61
Rate for Payer: Wellcare Medicare Advantage	$838.61
Rate for Payer: Wellpoint Medicaid Managed Care	$90.48

ER LUMBAR PUNCTURE DIAGNOSTIC

Facility

$3,185.75

Service Code	HCPCS 62270
Hospital Charge Code	5700803
Hospital Revenue Code	450
Min. Negotiated Rate	$477.86
Max. Negotiated Rate	$477.86
Rate for Payer: Qualcare PPO/HMO/WC	$477.86

ER LWBS WITH DOLLAR CHARGE

Facility

$1.00

Service Code	HCPCS LWBS1
Hospital Charge Code	5700001
Hospital Revenue Code	450
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.15

ER LWBS WITH DOLLAR CHARGE

Facility

$1.00

Service Code	HCPCS LWBS1
Hospital Charge Code	5700001
Hospital Revenue Code	450
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$140.00
Rate for Payer: Aetna Commercial	$0.38
Rate for Payer: Aetna Medicare Advantage	$0.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.26
Rate for Payer: Cigna Commercial	$0.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.26
Rate for Payer: Qualcare PPO/HMO/WC	$0.15
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.03

ER MD VENIPNCTR<AGE 3 FEM/JUG

Facility

$301.00

Service Code	HCPCS 36405
Hospital Charge Code	5700631
Hospital Revenue Code	450
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$150.50
Rate for Payer: Aetna Commercial	$114.38
Rate for Payer: Aetna Medicare Advantage	$90.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.75
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	$76.75
Rate for Payer: Cigna Commercial	$150.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.26
Rate for Payer: Qualcare PPO/HMO/WC	$45.15
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$8.55

ER MD VENIPNCTR<AGE 3 FEM/JUG

Facility

$301.00

Service Code	HCPCS 36405
Hospital Charge Code	5700631
Hospital Revenue Code	450
Min. Negotiated Rate	$45.15
Max. Negotiated Rate	$45.15
Rate for Payer: Qualcare PPO/HMO/WC	$45.15

ER MD VENIPUNCTR <3Y NOT ROUTI

Facility

$301.00

Service Code	HCPCS 36406
Hospital Charge Code	5700778
Hospital Revenue Code	450
Min. Negotiated Rate	$45.15
Max. Negotiated Rate	$45.15
Rate for Payer: Qualcare PPO/HMO/WC	$45.15

ER MD VENIPUNCTR <3Y NOT ROUTI

Facility

$301.00

Service Code	HCPCS 36406
Hospital Charge Code	5700778
Hospital Revenue Code	450
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$150.50
Rate for Payer: Aetna Commercial	$114.38
Rate for Payer: Aetna Medicare Advantage	$90.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.75
Rate for Payer: Cigna Commercial	$150.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.26
Rate for Payer: Qualcare PPO/HMO/WC	$45.15
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$8.55

ER MD VENIPUNCTR FEM/JUG <3YRS

Facility

$301.00

Service Code	HCPCS 36400
Hospital Charge Code	5700777
Hospital Revenue Code	450
Min. Negotiated Rate	$45.15
Max. Negotiated Rate	$45.15
Rate for Payer: Qualcare PPO/HMO/WC	$45.15

ER MD VENIPUNCTR FEM/JUG <3YRS

Facility

$301.00

Service Code	HCPCS 36400
Hospital Charge Code	5700777
Hospital Revenue Code	450
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$150.50
Rate for Payer: Aetna Commercial	$114.38
Rate for Payer: Aetna Medicare Advantage	$90.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.75
Rate for Payer: Cigna Commercial	$150.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.26
Rate for Payer: Qualcare PPO/HMO/WC	$45.15
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$8.55

ER NEWBORN RESUSCITATION

Facility

$968.00

Service Code	HCPCS 99465
Hospital Charge Code	5700820
Hospital Revenue Code	450
Min. Negotiated Rate	$145.20
Max. Negotiated Rate	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$145.20

ER NEWBORN RESUSCITATION

Facility

$968.00

Service Code	HCPCS 99465
Hospital Charge Code	5700820
Hospital Revenue Code	450
Min. Negotiated Rate	$27.49
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) 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	$251.68
Rate for Payer: Qualcare PPO/HMO/WC	$145.20
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	$27.49

ER-NG TUBE INSERTION

Facility

$496.00

Service Code	HCPCS 4375259
Hospital Charge Code	5770045
Hospital Revenue Code	450
Min. Negotiated Rate	$74.40
Max. Negotiated Rate	$74.40
Rate for Payer: Qualcare PPO/HMO/WC	$74.40

ER-NG TUBE INSERTION

Facility

$496.00

Service Code	HCPCS 4375259
Hospital Charge Code	5770045
Hospital Revenue Code	450
Min. Negotiated Rate	$14.09
Max. Negotiated Rate	$248.00
Rate for Payer: Aetna Commercial	$188.48
Rate for Payer: Aetna Medicare Advantage	$148.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.48
Rate for Payer: Cigna Commercial	$248.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.96
Rate for Payer: Qualcare PPO/HMO/WC	$74.40
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$14.09

ER OPEN DIS PHAL FINGER EACH

Facility

$15,508.45

Service Code	HCPCS 26765
Hospital Charge Code	5700672
Hospital Revenue Code	450
Min. Negotiated Rate	$2,326.27
Max. Negotiated Rate	$2,326.27
Rate for Payer: Qualcare PPO/HMO/WC	$2,326.27

Know your out-of-pocket cost for care.

All Charges