Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

FOLLOWER PHILLIPS 10FR

Facility

$249.80

Hospital Charge Code	270619882
Hospital Revenue Code	272
Min. Negotiated Rate	$7.09
Max. Negotiated Rate	$124.90
Rate for Payer: Aetna Commercial	$94.92
Rate for Payer: Aetna Medicare Advantage	$74.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.70
Rate for Payer: Cigna Commercial	$124.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.95
Rate for Payer: Oxford Commercial	$49.96
Rate for Payer: Qualcare PPO/HMO/WC	$37.47
Rate for Payer: UnitedHealthcare Commercial	$49.96
Rate for Payer: UnitedHealthcare Community & State	$7.89
Rate for Payer: Wellpoint Medicaid Managed Care	$7.09

FOLLOWER PHILLIPS 10FR

Facility

$249.80

Hospital Charge Code	270619882
Hospital Revenue Code	272
Min. Negotiated Rate	$37.47
Max. Negotiated Rate	$37.47
Rate for Payer: Qualcare PPO/HMO/WC	$37.47

FOLLOWER PHILLIPS 12FR

Facility

$249.80

Hospital Charge Code	270600148
Hospital Revenue Code	272
Min. Negotiated Rate	$37.47
Max. Negotiated Rate	$37.47
Rate for Payer: Qualcare PPO/HMO/WC	$37.47

FOLLOWER PHILLIPS 12FR

Facility

$249.80

Hospital Charge Code	270600148
Hospital Revenue Code	272
Min. Negotiated Rate	$7.09
Max. Negotiated Rate	$124.90
Rate for Payer: Aetna Commercial	$94.92
Rate for Payer: Aetna Medicare Advantage	$74.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.70
Rate for Payer: Cigna Commercial	$124.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.95
Rate for Payer: Oxford Commercial	$49.96
Rate for Payer: Qualcare PPO/HMO/WC	$37.47
Rate for Payer: UnitedHealthcare Commercial	$49.96
Rate for Payer: UnitedHealthcare Community & State	$7.89
Rate for Payer: Wellpoint Medicaid Managed Care	$7.09

FOLLOWER PHILLIPS 14FR

Facility

$249.80

Hospital Charge Code	270600284
Hospital Revenue Code	272
Min. Negotiated Rate	$37.47
Max. Negotiated Rate	$37.47
Rate for Payer: Qualcare PPO/HMO/WC	$37.47

FOLLOWER PHILLIPS 14FR

Facility

$249.80

Hospital Charge Code	270600284
Hospital Revenue Code	272
Min. Negotiated Rate	$7.09
Max. Negotiated Rate	$124.90
Rate for Payer: Aetna Commercial	$94.92
Rate for Payer: Aetna Medicare Advantage	$74.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.70
Rate for Payer: Cigna Commercial	$124.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.95
Rate for Payer: Oxford Commercial	$49.96
Rate for Payer: Qualcare PPO/HMO/WC	$37.47
Rate for Payer: UnitedHealthcare Commercial	$49.96
Rate for Payer: UnitedHealthcare Community & State	$7.89
Rate for Payer: Wellpoint Medicaid Managed Care	$7.09

FOLLOWER PHILLIPS 16FR

Facility

$252.20

Hospital Charge Code	270600150
Hospital Revenue Code	272
Min. Negotiated Rate	$7.16
Max. Negotiated Rate	$126.10
Rate for Payer: Aetna Commercial	$95.84
Rate for Payer: Aetna Medicare Advantage	$75.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.31
Rate for Payer: Cigna Commercial	$126.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.57
Rate for Payer: Oxford Commercial	$50.44
Rate for Payer: Qualcare PPO/HMO/WC	$37.83
Rate for Payer: UnitedHealthcare Commercial	$50.44
Rate for Payer: UnitedHealthcare Community & State	$7.97
Rate for Payer: Wellpoint Medicaid Managed Care	$7.16

FOLLOWER PHILLIPS 16FR

Facility

$252.20

Hospital Charge Code	270600150
Hospital Revenue Code	272
Min. Negotiated Rate	$37.83
Max. Negotiated Rate	$37.83
Rate for Payer: Qualcare PPO/HMO/WC	$37.83

FOLLOWER PHILLIPS 18FR

Facility

$252.20

Hospital Charge Code	270600285
Hospital Revenue Code	272
Min. Negotiated Rate	$7.16
Max. Negotiated Rate	$126.10
Rate for Payer: Aetna Commercial	$95.84
Rate for Payer: Aetna Medicare Advantage	$75.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.31
Rate for Payer: Cigna Commercial	$126.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.57
Rate for Payer: Oxford Commercial	$50.44
Rate for Payer: Qualcare PPO/HMO/WC	$37.83
Rate for Payer: UnitedHealthcare Commercial	$50.44
Rate for Payer: UnitedHealthcare Community & State	$7.97
Rate for Payer: Wellpoint Medicaid Managed Care	$7.16

FOLLOWER PHILLIPS 18FR

Facility

$252.20

Hospital Charge Code	270600285
Hospital Revenue Code	272
Min. Negotiated Rate	$37.83
Max. Negotiated Rate	$37.83
Rate for Payer: Qualcare PPO/HMO/WC	$37.83

FOLLOWER PHILLIPS 8FR

Facility

$249.80

Hospital Charge Code	270600280
Hospital Revenue Code	272
Min. Negotiated Rate	$37.47
Max. Negotiated Rate	$37.47
Rate for Payer: Qualcare PPO/HMO/WC	$37.47

FOLLOWER PHILLIPS 8FR

Facility

$249.80

Hospital Charge Code	270600280
Hospital Revenue Code	272
Min. Negotiated Rate	$7.09
Max. Negotiated Rate	$124.90
Rate for Payer: Aetna Commercial	$94.92
Rate for Payer: Aetna Medicare Advantage	$74.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.70
Rate for Payer: Cigna Commercial	$124.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.95
Rate for Payer: Oxford Commercial	$49.96
Rate for Payer: Qualcare PPO/HMO/WC	$37.47
Rate for Payer: UnitedHealthcare Commercial	$49.96
Rate for Payer: UnitedHealthcare Community & State	$7.89
Rate for Payer: Wellpoint Medicaid Managed Care	$7.09

FOLLOWUP HOSP CARE 15MINS

Facility

$350.00

Service Code	HCPCS 99231
Hospital Charge Code	83246210
Hospital Revenue Code	919
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$52.50
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

FOLLOWUP HOSP CARE 15MINS

Facility

$350.00

Service Code	HCPCS 99231
Hospital Charge Code	83246210
Hospital Revenue Code	919
Min. Negotiated Rate	$9.94
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$133.00
Rate for Payer: Aetna Medicare Advantage	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.25
Rate for Payer: Cigna Commercial	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.50
Rate for Payer: UnitedHealthcare Community & State	$11.06
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

FOLLOWUP HOSP CARE 25MINS

Facility

$350.00

Service Code	HCPCS 99232
Hospital Charge Code	83246215
Hospital Revenue Code	919
Min. Negotiated Rate	$9.94
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$133.00
Rate for Payer: Aetna Medicare Advantage	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.25
Rate for Payer: Cigna Commercial	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.50
Rate for Payer: UnitedHealthcare Community & State	$11.06
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

FOLLOWUP HOSP CARE 25MINS

Facility

$350.00

Service Code	HCPCS 99232
Hospital Charge Code	83246215
Hospital Revenue Code	919
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$52.50
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

FOLLOWUP HOSP CARE 35MINS

Facility

$350.00

Service Code	HCPCS 99233
Hospital Charge Code	83246220
Hospital Revenue Code	919
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$52.50
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

FOLLOWUP HOSP CARE 35MINS

Facility

$350.00

Service Code	HCPCS 99233
Hospital Charge Code	83246220
Hospital Revenue Code	919
Min. Negotiated Rate	$9.94
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$133.00
Rate for Payer: Aetna Medicare Advantage	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.25
Rate for Payer: Cigna Commercial	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.50
Rate for Payer: UnitedHealthcare Community & State	$11.06
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

FOMEPIZOLE 1 GM/ML INJ

Facility

$9,144.50

Service Code	HCPCS J1451
Hospital Charge Code	60629078
Hospital Revenue Code	636
Min. Negotiated Rate	$6.21
Max. Negotiated Rate	$2,212.97
Rate for Payer: Aetna Commercial	$17.79
Rate for Payer: Aetna Medicare Advantage	$21.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.72
Rate for Payer: Cigna Medicare Advantage	$6.54
Rate for Payer: Clover Medicare Advantage	$6.21
Rate for Payer: EmblemHealth Commercial	$19.62
Rate for Payer: Humana Medicare Advantage	$6.74
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,212.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,371.67
Rate for Payer: UnitedHealthcare Community & State	$288.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.54
Rate for Payer: Wellcare Medicare Advantage	$6.54
Rate for Payer: Wellpoint Medicaid Managed Care	$259.70

FOMEPIZOLE 1 GM/ML INJ

Facility

$9,144.50

Service Code	HCPCS J1451
Hospital Charge Code	60629078
Hospital Revenue Code	636
Min. Negotiated Rate	$1,371.67
Max. Negotiated Rate	$2,212.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,212.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,371.67

FOOT AND TOE PROCEDURES

Facility

$16,130.73

Service Code	APR-DRG 3142
Min. Negotiated Rate	$15,814.44
Max. Negotiated Rate	$16,130.73
Rate for Payer: UnitedHealthcare Community & State	$15,814.44
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$16,130.73
Rate for Payer: Wellpoint Medicaid Managed Care	$15,814.44

FOOT AND TOE PROCEDURES

Facility

$15,057.79

Service Code	APR-DRG 3141
Min. Negotiated Rate	$14,762.54
Max. Negotiated Rate	$15,057.79
Rate for Payer: UnitedHealthcare Community & State	$14,762.54
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$15,057.79
Rate for Payer: Wellpoint Medicaid Managed Care	$14,762.54

FOOT AND TOE PROCEDURES

Facility

$21,288.98

Service Code	APR-DRG 3143
Min. Negotiated Rate	$20,871.55
Max. Negotiated Rate	$21,288.98
Rate for Payer: UnitedHealthcare Community & State	$20,871.55
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$21,288.98
Rate for Payer: Wellpoint Medicaid Managed Care	$20,871.55

FOOT AND TOE PROCEDURES

Facility

$38,398.60

Service Code	APR-DRG 3144
Min. Negotiated Rate	$37,645.69
Max. Negotiated Rate	$38,398.60
Rate for Payer: UnitedHealthcare Community & State	$37,645.69
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$38,398.60
Rate for Payer: Wellpoint Medicaid Managed Care	$37,645.69

FOOT AP LAT LT

Facility

$6,601.19

Service Code	HCPCS 73620LT
Hospital Charge Code	2002459
Hospital Revenue Code	320
Min. Negotiated Rate	$187.47
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.31
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$208.60
Rate for Payer: Wellpoint Medicaid Managed Care	$187.47

Know your out-of-pocket cost for care.

All Charges