Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

EXCHANGE NEPHROSTOMY CATH RT

Facility

$3,090.18

Service Code	HCPCS 50435RT
Hospital Charge Code	2101159
Hospital Revenue Code	361
Min. Negotiated Rate	$87.76
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,174.27
Rate for Payer: Aetna Medicare Advantage	$927.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$788.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$788.00
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	$788.00
Rate for Payer: Cigna Commercial	$1,545.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$803.45
Rate for Payer: Qualcare PPO/HMO/WC	$463.53
Rate for Payer: UnitedHealthcare Community & State	$97.65
Rate for Payer: Wellpoint Medicaid Managed Care	$87.76

EXCHANGE NEPHROSTOMY CATH RT

Facility

$3,090.18

Service Code	HCPCS 50435RT
Hospital Charge Code	7412036
Hospital Revenue Code	361
Min. Negotiated Rate	$87.76
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,174.27
Rate for Payer: Aetna Medicare Advantage	$927.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$788.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$788.00
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	$788.00
Rate for Payer: Cigna Commercial	$1,545.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$803.45
Rate for Payer: Qualcare PPO/HMO/WC	$463.53
Rate for Payer: UnitedHealthcare Community & State	$97.65
Rate for Payer: Wellpoint Medicaid Managed Care	$87.76

EXCHANGE NEPHROSTOMY CATH RT

Facility

$3,090.18

Service Code	HCPCS 50435RT
Hospital Charge Code	2101159
Hospital Revenue Code	361
Min. Negotiated Rate	$463.53
Max. Negotiated Rate	$463.53
Rate for Payer: Qualcare PPO/HMO/WC	$463.53

EXCHANGE NEPHROSTOMY CATH RT

Facility

$3,090.18

Service Code	HCPCS 50435RT
Hospital Charge Code	2011583
Hospital Revenue Code	361
Min. Negotiated Rate	$87.76
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,174.27
Rate for Payer: Aetna Medicare Advantage	$927.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$788.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$788.00
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	$788.00
Rate for Payer: Cigna Commercial	$1,545.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$803.45
Rate for Payer: Qualcare PPO/HMO/WC	$463.53
Rate for Payer: UnitedHealthcare Community & State	$97.65
Rate for Payer: Wellpoint Medicaid Managed Care	$87.76

EXCHANGE NEPHROSTOMY CATH RT

Facility

$3,090.18

Service Code	HCPCS 50435RT
Hospital Charge Code	7412036
Hospital Revenue Code	361
Min. Negotiated Rate	$463.53
Max. Negotiated Rate	$463.53
Rate for Payer: Qualcare PPO/HMO/WC	$463.53

EXCHANGE NEPHROSTOMY CATH RT

Facility

$3,090.18

Service Code	HCPCS 50435RT
Hospital Charge Code	2011583
Hospital Revenue Code	361
Min. Negotiated Rate	$463.53
Max. Negotiated Rate	$463.53
Rate for Payer: Qualcare PPO/HMO/WC	$463.53

EXCHANGE PIN

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270698725
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

EXCHANGE PIN

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270698725
Hospital Revenue Code	278
Min. Negotiated Rate	$17.75
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Community & State	$19.75
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

EXCHANGE PIN 3.2MM

Facility

$535.00

Hospital Charge Code	270692841
Hospital Revenue Code	272
Min. Negotiated Rate	$15.19
Max. Negotiated Rate	$267.50
Rate for Payer: Aetna Commercial	$203.30
Rate for Payer: Aetna Medicare Advantage	$160.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.43
Rate for Payer: Cigna Commercial	$267.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.10
Rate for Payer: Oxford Commercial	$107.00
Rate for Payer: Qualcare PPO/HMO/WC	$80.25
Rate for Payer: UnitedHealthcare Commercial	$107.00
Rate for Payer: UnitedHealthcare Community & State	$16.91
Rate for Payer: Wellpoint Medicaid Managed Care	$15.19

EXCHANGE PIN 3.2MM

Facility

$535.00

Hospital Charge Code	270692841
Hospital Revenue Code	272
Min. Negotiated Rate	$80.25
Max. Negotiated Rate	$80.25
Rate for Payer: Qualcare PPO/HMO/WC	$80.25

EXCHANGE WIRE 260J

Facility

$48.95

Service Code	HCPCS C1769
Hospital Charge Code	270654358S
Hospital Revenue Code	278
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$24.48
Rate for Payer: Aetna Commercial	$18.60
Rate for Payer: Aetna Medicare Advantage	$14.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.48
Rate for Payer: Cigna Commercial	$24.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.85
Rate for Payer: Qualcare PPO/HMO/WC	$7.34
Rate for Payer: UnitedHealthcare Community & State	$1.55
Rate for Payer: Wellpoint Medicaid Managed Care	$1.39

EXCHANGE WIRE 260J

Facility

$10.50

Service Code	HCPCS C1769
Hospital Charge Code	270654358N
Hospital Revenue Code	278
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$5.25
Rate for Payer: Aetna Commercial	$3.99
Rate for Payer: Aetna Medicare Advantage	$3.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.68
Rate for Payer: Cigna Commercial	$5.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.54
Rate for Payer: Qualcare PPO/HMO/WC	$1.57
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

EXCHANGE WIRE 260J

Facility

$48.95

Service Code	HCPCS C1769
Hospital Charge Code	270654358
Hospital Revenue Code	278
Min. Negotiated Rate	$7.34
Max. Negotiated Rate	$11.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.85
Rate for Payer: Qualcare PPO/HMO/WC	$7.34

EXCHANGE WIRE 260J

Facility

$48.95

Service Code	HCPCS C1769
Hospital Charge Code	270654358S
Hospital Revenue Code	278
Min. Negotiated Rate	$7.34
Max. Negotiated Rate	$11.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.85
Rate for Payer: Qualcare PPO/HMO/WC	$7.34

EXCHANGE WIRE 260J

Facility

$48.95

Service Code	HCPCS C1769
Hospital Charge Code	270654358
Hospital Revenue Code	278
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$24.48
Rate for Payer: Aetna Commercial	$18.60
Rate for Payer: Aetna Medicare Advantage	$14.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.48
Rate for Payer: Cigna Commercial	$24.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.85
Rate for Payer: Qualcare PPO/HMO/WC	$7.34
Rate for Payer: UnitedHealthcare Community & State	$1.55
Rate for Payer: Wellpoint Medicaid Managed Care	$1.39

EXCHANGE WIRE 260J

Facility

$10.50

Service Code	HCPCS C1769
Hospital Charge Code	270654358N
Hospital Revenue Code	278
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$2.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.54
Rate for Payer: Qualcare PPO/HMO/WC	$1.57

EXC HIDRAD AXIL,S/I REP

Facility

$22,280.35

Service Code	HCPCS 11450
Hospital Charge Code	16000405
Hospital Revenue Code	360
Min. Negotiated Rate	$3,342.05
Max. Negotiated Rate	$3,342.05
Rate for Payer: Qualcare PPO/HMO/WC	$3,342.05

EXC HIDRAD AXIL,S/I REP

Facility

$22,280.35

Service Code	HCPCS 11450
Hospital Charge Code	16000405
Hospital Revenue Code	360
Min. Negotiated Rate	$632.76
Max. Negotiated Rate	$12,518.07
Rate for Payer: Aetna Commercial	$9,386.39
Rate for Payer: Aetna Medicare Advantage	$11,180.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,450.88
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	$12,518.07
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: Cigna Medicare Advantage	$3,450.88
Rate for Payer: Clover Medicare Advantage	$3,278.34
Rate for Payer: EmblemHealth Commercial	$10,352.64
Rate for Payer: Humana Medicare Advantage	$3,554.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,450.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,792.89
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,342.05
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$704.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare Medicare Advantage	$3,450.88
Rate for Payer: Wellpoint Medicaid Managed Care	$632.76

EXC HIDRAD UMBIL,S/I REP

Facility

$20,625.50

Service Code	HCPCS 11470
Hospital Charge Code	16000776
Hospital Revenue Code	360
Min. Negotiated Rate	$3,093.82
Max. Negotiated Rate	$3,093.82
Rate for Payer: Qualcare PPO/HMO/WC	$3,093.82

EXC HIDRAD UMBIL,S/I REP

Facility

$20,625.50

Service Code	HCPCS 11470
Hospital Charge Code	16000776
Hospital Revenue Code	360
Min. Negotiated Rate	$585.76
Max. Negotiated Rate	$12,518.07
Rate for Payer: Aetna Commercial	$9,386.39
Rate for Payer: Aetna Medicare Advantage	$11,180.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,450.88
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	$12,518.07
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: Cigna Medicare Advantage	$3,450.88
Rate for Payer: Clover Medicare Advantage	$3,278.34
Rate for Payer: EmblemHealth Commercial	$10,352.64
Rate for Payer: Humana Medicare Advantage	$3,554.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,450.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,362.63
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,093.82
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$651.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare Medicare Advantage	$3,450.88
Rate for Payer: Wellpoint Medicaid Managed Care	$585.76

EXC HIP PELVIS LES SC 3 CM/>

Facility

$20,625.50

Service Code	HCPCS 27043
Hospital Charge Code	16000397
Hospital Revenue Code	360
Min. Negotiated Rate	$585.76
Max. Negotiated Rate	$12,518.07
Rate for Payer: Aetna Commercial	$9,386.39
Rate for Payer: Aetna Medicare Advantage	$11,180.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,450.88
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	$12,518.07
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: Cigna Medicare Advantage	$3,450.88
Rate for Payer: Clover Medicare Advantage	$3,278.34
Rate for Payer: EmblemHealth Commercial	$10,352.64
Rate for Payer: Humana Medicare Advantage	$3,554.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,450.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,362.63
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,093.82
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$651.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare Medicare Advantage	$3,450.88
Rate for Payer: Wellpoint Medicaid Managed Care	$585.76

EXC HIP PELVIS LES SC 3 CM/>

Facility

$20,625.50

Service Code	HCPCS 27043
Hospital Charge Code	16000397
Hospital Revenue Code	360
Min. Negotiated Rate	$3,093.82
Max. Negotiated Rate	$3,093.82
Rate for Payer: Qualcare PPO/HMO/WC	$3,093.82

Exc hip/pelv tum deep 5 cm/>

Facility

$13,482.08

Service Code	HCPCS 27045
Hospital Charge Code	16000170
Hospital Revenue Code	360
Min. Negotiated Rate	$382.89
Max. Negotiated Rate	$12,518.07
Rate for Payer: Aetna Commercial	$9,386.39
Rate for Payer: Aetna Medicare Advantage	$11,180.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,450.88
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	$12,518.07
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: Cigna Medicare Advantage	$3,450.88
Rate for Payer: Clover Medicare Advantage	$3,278.34
Rate for Payer: EmblemHealth Commercial	$10,352.64
Rate for Payer: Humana Medicare Advantage	$3,554.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,450.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,505.34
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,022.31
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$426.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare Medicare Advantage	$3,450.88
Rate for Payer: Wellpoint Medicaid Managed Care	$382.89

Exc hip/pelv tum deep 5 cm/>

Facility

$13,482.08

Service Code	HCPCS 27045
Hospital Charge Code	16000170
Hospital Revenue Code	360
Min. Negotiated Rate	$2,022.31
Max. Negotiated Rate	$2,022.31
Rate for Payer: Qualcare PPO/HMO/WC	$2,022.31

EXC HIP/PELV TUM DEEP < 5 CM

Facility

$16,680.90

Service Code	HCPCS 27048
Hospital Charge Code	16000862
Hospital Revenue Code	360
Min. Negotiated Rate	$2,502.14
Max. Negotiated Rate	$2,502.14
Rate for Payer: Qualcare PPO/HMO/WC	$2,502.14

Know your out-of-pocket cost for care.

All Charges