Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ESTAB PATIENT LEV 4 >=30 MINS

Facility

$550.00

Service Code	HCPCS 99214
Hospital Charge Code	4518718
Hospital Revenue Code	913
Min. Negotiated Rate	$15.62
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$17.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$118.08
Rate for Payer: Wellpoint Medicaid Managed Care	$15.62

ESTAB PATIENT LEV 4 >=30 MINS

Facility

$828.80

Service Code	HCPCS 99214
Hospital Charge Code	83652409
Hospital Revenue Code	514
Min. Negotiated Rate	$124.32
Max. Negotiated Rate	$124.32
Rate for Payer: Qualcare PPO/HMO/WC	$124.32

ESTAB PATIENT LEV 4 >=30 MINS

Facility

$550.00

Service Code	HCPCS 99214
Hospital Charge Code	4504718
Hospital Revenue Code	913
Min. Negotiated Rate	$15.62
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$17.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$118.08
Rate for Payer: Wellpoint Medicaid Managed Care	$15.62

ESTAB PATIENT LEV 4 >=30 MINS

Facility

$550.00

Service Code	HCPCS 99214
Hospital Charge Code	4535718
Hospital Revenue Code	913
Min. Negotiated Rate	$15.62
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$17.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$118.08
Rate for Payer: Wellpoint Medicaid Managed Care	$15.62

ESTAB PATIENT LEV 4 >=30 MINS

Facility

$828.80

Service Code	HCPCS 99214
Hospital Charge Code	93950149
Hospital Revenue Code	510
Min. Negotiated Rate	$23.54
Max. Negotiated Rate	$414.40
Rate for Payer: Aetna Commercial	$314.94
Rate for Payer: Aetna Medicare Advantage	$248.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.34
Rate for Payer: Cigna Commercial	$414.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.49
Rate for Payer: Qualcare PPO/HMO/WC	$124.32
Rate for Payer: UnitedHealthcare Community & State	$26.19
Rate for Payer: Wellpoint Medicaid Managed Care	$23.54

ESTAB PATIENT LEV 4 >=30 MINS

Facility

$550.00

Service Code	HCPCS 99214
Hospital Charge Code	4502718
Hospital Revenue Code	913
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

ESTAB PATIENT LEV 4 >=30 MINS

Facility

$550.00

Service Code	HCPCS 99214
Hospital Charge Code	4502718
Hospital Revenue Code	913
Min. Negotiated Rate	$15.62
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$17.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$118.08
Rate for Payer: Wellpoint Medicaid Managed Care	$15.62

ESTAB PATIENT LEV 4 >=30 MINS

Facility

$828.80

Service Code	HCPCS 99214
Hospital Charge Code	83652409
Hospital Revenue Code	514
Min. Negotiated Rate	$23.54
Max. Negotiated Rate	$414.40
Rate for Payer: Aetna Commercial	$314.94
Rate for Payer: Aetna Medicare Advantage	$248.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.34
Rate for Payer: Cigna Commercial	$414.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.49
Rate for Payer: Qualcare PPO/HMO/WC	$124.32
Rate for Payer: UnitedHealthcare Community & State	$26.19
Rate for Payer: Wellpoint Medicaid Managed Care	$23.54

ESTAB PATIENT LEV 4 >=30 MINS

Facility

$828.80

Service Code	HCPCS 99214
Hospital Charge Code	93950149
Hospital Revenue Code	510
Min. Negotiated Rate	$124.32
Max. Negotiated Rate	$124.32
Rate for Payer: Qualcare PPO/HMO/WC	$124.32

ESTAB PATIENT LEV 4 >=30 MINS

Facility

$550.00

Service Code	HCPCS 99214
Hospital Charge Code	4517718
Hospital Revenue Code	913
Min. Negotiated Rate	$15.62
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$17.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$118.08
Rate for Payer: Wellpoint Medicaid Managed Care	$15.62

ESTAB PATIENT LEV 4 >=30 MINS

Facility

$550.00

Service Code	HCPCS 99214
Hospital Charge Code	4504718
Hospital Revenue Code	913
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

ESTAB PATIENT LEV 4 >=30 MINS

Facility

$550.00

Service Code	HCPCS 99214
Hospital Charge Code	4518718
Hospital Revenue Code	913
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

ESTAB PATIENT LEV 4 >=30 MINS

Facility

$828.80

Service Code	HCPCS 99214
Hospital Charge Code	421599214
Hospital Revenue Code	510
Min. Negotiated Rate	$23.54
Max. Negotiated Rate	$414.40
Rate for Payer: Aetna Commercial	$314.94
Rate for Payer: Aetna Medicare Advantage	$248.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.34
Rate for Payer: Cigna Commercial	$414.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.49
Rate for Payer: Qualcare PPO/HMO/WC	$124.32
Rate for Payer: UnitedHealthcare Community & State	$26.19
Rate for Payer: Wellpoint Medicaid Managed Care	$23.54

ESTAB PATIENT LEV 4 >=30 MINS

Facility

$678.40

Service Code	HCPCS 99214
Hospital Charge Code	84511045
Hospital Revenue Code	513
Min. Negotiated Rate	$19.27
Max. Negotiated Rate	$339.20
Rate for Payer: Aetna Commercial	$257.79
Rate for Payer: Aetna Medicare Advantage	$203.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.99
Rate for Payer: Cigna Commercial	$339.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.38
Rate for Payer: Qualcare PPO/HMO/WC	$101.76
Rate for Payer: UnitedHealthcare Community & State	$21.44
Rate for Payer: Wellpoint Medicaid Managed Care	$19.27

ESTAB PATIENT LEV 4 >=30 MINS

Facility

$828.80

Service Code	HCPCS 99214
Hospital Charge Code	421599214
Hospital Revenue Code	510
Min. Negotiated Rate	$124.32
Max. Negotiated Rate	$124.32
Rate for Payer: Qualcare PPO/HMO/WC	$124.32

ESTAB PATIENT LEV 4 >=30 MINS

Facility

$550.00

Service Code	HCPCS 99214
Hospital Charge Code	4822718
Hospital Revenue Code	913
Min. Negotiated Rate	$15.62
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$17.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$118.08
Rate for Payer: Wellpoint Medicaid Managed Care	$15.62

ESTAB PATIENT LEV 4 >=30 MINS

Facility

$550.00

Service Code	HCPCS 99214
Hospital Charge Code	4822718
Hospital Revenue Code	913
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

ESTAB PATIENT LEV 4 >=30 MINS

Facility

$550.00

Service Code	HCPCS 99214
Hospital Charge Code	4818718
Hospital Revenue Code	913
Min. Negotiated Rate	$15.62
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$17.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$118.08
Rate for Payer: Wellpoint Medicaid Managed Care	$15.62

ESTAB PATIENT LEV 4 >=30 MINS

Facility

$550.00

Service Code	HCPCS 99214
Hospital Charge Code	4510718
Hospital Revenue Code	913
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

ESTAB PATIENT LEV 4 >=30 MINS

Facility

$550.00

Service Code	HCPCS 99214
Hospital Charge Code	4510718
Hospital Revenue Code	913
Min. Negotiated Rate	$15.62
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$17.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$118.08
Rate for Payer: Wellpoint Medicaid Managed Care	$15.62

ESTAB PATIENT LEV 4 >=30 MINS

Facility

$550.00

Service Code	HCPCS 99214
Hospital Charge Code	4527718
Hospital Revenue Code	913
Min. Negotiated Rate	$15.62
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$17.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$118.08
Rate for Payer: Wellpoint Medicaid Managed Care	$15.62

ESTAB PATIENT LEV 4 >=30 MINS

Facility

$484.05

Service Code	HCPCS 99214
Hospital Charge Code	87506085
Hospital Revenue Code	513
Min. Negotiated Rate	$13.75
Max. Negotiated Rate	$242.03
Rate for Payer: Aetna Commercial	$183.94
Rate for Payer: Aetna Medicare Advantage	$145.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$123.43
Rate for Payer: Cigna Commercial	$242.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.85
Rate for Payer: Qualcare PPO/HMO/WC	$72.61
Rate for Payer: UnitedHealthcare Community & State	$15.30
Rate for Payer: Wellpoint Medicaid Managed Care	$13.75

ESTAB PATIENT LEV 4 >=30 MINS

Facility

$828.80

Service Code	HCPCS 99214
Hospital Charge Code	421099214
Hospital Revenue Code	510
Min. Negotiated Rate	$23.54
Max. Negotiated Rate	$414.40
Rate for Payer: Aetna Commercial	$314.94
Rate for Payer: Aetna Medicare Advantage	$248.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.34
Rate for Payer: Cigna Commercial	$414.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.49
Rate for Payer: Qualcare PPO/HMO/WC	$124.32
Rate for Payer: UnitedHealthcare Community & State	$26.19
Rate for Payer: Wellpoint Medicaid Managed Care	$23.54

ESTAB PATIENT LEV 4 >=30 MINS

Facility

$550.00

Service Code	HCPCS 99214
Hospital Charge Code	4824718
Hospital Revenue Code	913
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

ESTAB PATIENT LEV 4 >=30 MINS

Facility

$828.80

Service Code	HCPCS 99214
Hospital Charge Code	84208280
Hospital Revenue Code	510
Min. Negotiated Rate	$124.32
Max. Negotiated Rate	$124.32
Rate for Payer: Qualcare PPO/HMO/WC	$124.32

Know your out-of-pocket cost for care.

All Charges