Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

EVACUATOR ELLIK BLADDER DISP.

Facility

$103.00

Hospital Charge Code	270331361
Hospital Revenue Code	272
Min. Negotiated Rate	$15.45
Max. Negotiated Rate	$15.45
Rate for Payer: Qualcare PPO/HMO/WC	$15.45

EVACUATOR MCV BLADDER 730-125

Facility

$194.26

Hospital Charge Code	270621095
Hospital Revenue Code	272
Min. Negotiated Rate	$29.14
Max. Negotiated Rate	$29.14
Rate for Payer: Qualcare PPO/HMO/WC	$29.14

EVACUATOR MCV BLADDER 730-125

Facility

$194.26

Hospital Charge Code	270621095
Hospital Revenue Code	272
Min. Negotiated Rate	$5.52
Max. Negotiated Rate	$97.13
Rate for Payer: Aetna Commercial	$73.82
Rate for Payer: Aetna Medicare Advantage	$58.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.54
Rate for Payer: Cigna Commercial	$97.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.51
Rate for Payer: Oxford Commercial	$38.85
Rate for Payer: Qualcare PPO/HMO/WC	$29.14
Rate for Payer: UnitedHealthcare Commercial	$38.85
Rate for Payer: UnitedHealthcare Community & State	$6.14
Rate for Payer: Wellpoint Medicaid Managed Care	$5.52

EVACUATOR UROVAC BLADDER

Facility

$194.26

Hospital Charge Code	270660163
Hospital Revenue Code	272
Min. Negotiated Rate	$5.52
Max. Negotiated Rate	$97.13
Rate for Payer: Aetna Commercial	$73.82
Rate for Payer: Aetna Medicare Advantage	$58.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.54
Rate for Payer: Cigna Commercial	$97.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.51
Rate for Payer: Oxford Commercial	$38.85
Rate for Payer: Qualcare PPO/HMO/WC	$29.14
Rate for Payer: UnitedHealthcare Commercial	$38.85
Rate for Payer: UnitedHealthcare Community & State	$6.14
Rate for Payer: Wellpoint Medicaid Managed Care	$5.52

EVACUATOR UROVAC BLADDER

Facility

$194.26

Hospital Charge Code	270660163
Hospital Revenue Code	272
Min. Negotiated Rate	$29.14
Max. Negotiated Rate	$29.14
Rate for Payer: Qualcare PPO/HMO/WC	$29.14

EVALUATION FINE NEEDLE ASPIRAT

Facility

$806.00

Service Code	HCPCS 88173
Hospital Charge Code	38474070
Hospital Revenue Code	311
Min. Negotiated Rate	$120.90
Max. Negotiated Rate	$120.90
Rate for Payer: Qualcare PPO/HMO/WC	$120.90

EVALUATION FINE NEEDLE ASPIRAT

Facility

$806.00

Service Code	HCPCS 88173
Hospital Charge Code	38474070
Hospital Revenue Code	311
Min. Negotiated Rate	$22.89
Max. Negotiated Rate	$224.58
Rate for Payer: Aetna Commercial	$168.40
Rate for Payer: Aetna Medicare Advantage	$200.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$61.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.58
Rate for Payer: Cigna Commercial	$124.10
Rate for Payer: Cigna Medicare Advantage	$61.91
Rate for Payer: Clover Medicare Advantage	$58.81
Rate for Payer: EmblemHealth Commercial	$185.73
Rate for Payer: Humana Medicare Advantage	$63.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$61.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.56
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.90
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$135.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$61.91
Rate for Payer: Wellcare Medicare Advantage	$61.91
Rate for Payer: Wellpoint Medicaid Managed Care	$22.89

EVALUATION OF WHEEZING

Facility

$6,100.00

Service Code	HCPCS 94070
Hospital Charge Code	917094070
Hospital Revenue Code	460
Min. Negotiated Rate	$173.24
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$1,205.83
Rate for Payer: Aetna Medicare Advantage	$1,436.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,608.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,608.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$443.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$492.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,608.14
Rate for Payer: Cigna Commercial	$888.63
Rate for Payer: Cigna Medicare Advantage	$443.32
Rate for Payer: Clover Medicare Advantage	$421.15
Rate for Payer: EmblemHealth Commercial	$1,329.96
Rate for Payer: Humana Medicare Advantage	$456.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$443.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,586.00
Rate for Payer: Oxford Commercial	$2,184.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$192.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$443.32
Rate for Payer: Wellcare Medicare Advantage	$443.32
Rate for Payer: Wellpoint Medicaid Managed Care	$173.24

EVALUATION OF WHEEZING

Facility

$6,100.00

Service Code	HCPCS 94070
Hospital Charge Code	917094070
Hospital Revenue Code	460
Min. Negotiated Rate	$915.00
Max. Negotiated Rate	$915.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00

EVANS WEDGE 10MM

Facility

$5,980.00

Hospital Charge Code	270674211
Hospital Revenue Code	278
Min. Negotiated Rate	$897.00
Max. Negotiated Rate	$1,447.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,196.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,447.16
Rate for Payer: Qualcare PPO/HMO/WC	$897.00

EVANS WEDGE 10MM

Facility

$5,980.00

Hospital Charge Code	270674211
Hospital Revenue Code	278
Min. Negotiated Rate	$169.83
Max. Negotiated Rate	$2,990.00
Rate for Payer: Aetna Commercial	$2,272.40
Rate for Payer: Aetna Medicare Advantage	$1,794.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,524.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,524.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,196.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,524.90
Rate for Payer: Cigna Commercial	$2,990.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,447.16
Rate for Payer: Qualcare PPO/HMO/WC	$897.00
Rate for Payer: UnitedHealthcare Community & State	$188.97
Rate for Payer: Wellpoint Medicaid Managed Care	$169.83

EVANS WEDGE 8MM

Facility

$5,980.00

Service Code	HCPCS C1713
Hospital Charge Code	270674213
Hospital Revenue Code	278
Min. Negotiated Rate	$897.00
Max. Negotiated Rate	$1,447.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,196.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,447.16
Rate for Payer: Qualcare PPO/HMO/WC	$897.00

EVANS WEDGE 8MM

Facility

$5,980.00

Service Code	HCPCS C1713
Hospital Charge Code	270674213
Hospital Revenue Code	278
Min. Negotiated Rate	$169.83
Max. Negotiated Rate	$2,990.00
Rate for Payer: Aetna Commercial	$2,272.40
Rate for Payer: Aetna Medicare Advantage	$1,794.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,524.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,524.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,196.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,524.90
Rate for Payer: Cigna Commercial	$2,990.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,447.16
Rate for Payer: Qualcare PPO/HMO/WC	$897.00
Rate for Payer: UnitedHealthcare Community & State	$188.97
Rate for Payer: Wellpoint Medicaid Managed Care	$169.83

EVAN WEDGE 8MM

Facility

$9,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270702706
Hospital Revenue Code	278
Min. Negotiated Rate	$1,496.25
Max. Negotiated Rate	$2,413.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,413.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25

EVAN WEDGE 8MM

Facility

$9,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270702706
Hospital Revenue Code	278
Min. Negotiated Rate	$283.29
Max. Negotiated Rate	$4,987.50
Rate for Payer: Aetna Commercial	$3,790.50
Rate for Payer: Aetna Medicare Advantage	$2,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,543.62
Rate for Payer: Cigna Commercial	$4,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,413.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25
Rate for Payer: UnitedHealthcare Community & State	$315.21
Rate for Payer: Wellpoint Medicaid Managed Care	$283.29

EVASC PRLNG ADMN RX AGNT 1ST

Facility

$61,616.39

Service Code	HCPCS 61650
Hospital Charge Code	366861650
Hospital Revenue Code	361
Min. Negotiated Rate	$1,749.91
Max. Negotiated Rate	$30,808.19
Rate for Payer: Aetna Commercial	$23,414.23
Rate for Payer: Aetna Medicare Advantage	$18,484.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,712.18
Rate for Payer: Cigna Commercial	$30,808.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,020.26
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$1,947.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1,749.91

EVASC PRLNG ADMN RX AGNT 1ST

Facility

$61,616.39

Service Code	HCPCS 61650
Hospital Charge Code	366861650
Hospital Revenue Code	361
Min. Negotiated Rate	$9,242.46
Max. Negotiated Rate	$9,242.46
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

EVASC PRLNG ADMN RX AGNT 1ST

Facility

$61,616.39

Service Code	HCPCS 61650
Hospital Charge Code	411061650
Hospital Revenue Code	361
Min. Negotiated Rate	$9,242.46
Max. Negotiated Rate	$9,242.46
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

EVASC PRLNG ADMN RX AGNT 1ST

Facility

$61,616.39

Service Code	HCPCS 61650
Hospital Charge Code	411061650
Hospital Revenue Code	361
Min. Negotiated Rate	$1,749.91
Max. Negotiated Rate	$30,808.19
Rate for Payer: Aetna Commercial	$23,414.23
Rate for Payer: Aetna Medicare Advantage	$18,484.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,712.18
Rate for Payer: Cigna Commercial	$30,808.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,020.26
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$1,947.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1,749.91

EVASC PRLNG ADMN RX AGNT ADD

Facility

$61,616.39

Service Code	HCPCS 61651
Hospital Charge Code	411061651
Hospital Revenue Code	361
Min. Negotiated Rate	$1,749.91
Max. Negotiated Rate	$30,808.19
Rate for Payer: Aetna Commercial	$23,414.23
Rate for Payer: Aetna Medicare Advantage	$18,484.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,712.18
Rate for Payer: Cigna Commercial	$30,808.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,020.26
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$1,947.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1,749.91

EVASC PRLNG ADMN RX AGNT ADD

Facility

$61,616.39

Service Code	HCPCS 61651
Hospital Charge Code	411061651
Hospital Revenue Code	361
Min. Negotiated Rate	$9,242.46
Max. Negotiated Rate	$9,242.46
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

EVASC PRLNG ADMN RX AGNT ADD

Facility

$61,616.39

Service Code	HCPCS 61651
Hospital Charge Code	366861651
Hospital Revenue Code	361
Min. Negotiated Rate	$9,242.46
Max. Negotiated Rate	$9,242.46
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

EVASC PRLNG ADMN RX AGNT ADD

Facility

$61,616.39

Service Code	HCPCS 61651
Hospital Charge Code	366861651
Hospital Revenue Code	361
Min. Negotiated Rate	$1,749.91
Max. Negotiated Rate	$30,808.19
Rate for Payer: Aetna Commercial	$23,414.23
Rate for Payer: Aetna Medicare Advantage	$18,484.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,712.18
Rate for Payer: Cigna Commercial	$30,808.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,020.26
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$1,947.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1,749.91

EVASC REPAIR A-ILIAC NDGFT

Facility

$2,450.00

Service Code	HCPCS 34717
Hospital Charge Code	404634717
Hospital Revenue Code	361
Min. Negotiated Rate	$367.50
Max. Negotiated Rate	$367.50
Rate for Payer: Qualcare PPO/HMO/WC	$367.50

EVASC REPAIR A-ILIAC NDGFT

Facility

$2,450.00

Service Code	HCPCS 34717
Hospital Charge Code	404634717
Hospital Revenue Code	361
Min. Negotiated Rate	$69.58
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$931.00
Rate for Payer: Aetna Medicare Advantage	$735.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$624.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$624.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$624.75
Rate for Payer: Cigna Commercial	$1,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$637.00
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$367.50
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$77.42
Rate for Payer: Wellpoint Medicaid Managed Care	$69.58

Know your out-of-pocket cost for care.

All Charges