Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

FOOT - TWO VIEWS-LT

Facility

$6,601.19

Service Code	HCPCS 73620LT
Hospital Charge Code	94061397
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

FOOT - TWO VIEWS-RT

Facility

$6,601.19

Service Code	HCPCS 73620RT
Hospital Charge Code	94061399
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

FOOT - TWO VIEWS-RT

Facility

$6,601.19

Service Code	HCPCS 73620RT
Hospital Charge Code	94061399
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

FORAMEN NEEDLE-LONG

Facility

$2,300.00

Hospital Charge Code	270702024
Hospital Revenue Code	278
Min. Negotiated Rate	$65.32
Max. Negotiated Rate	$1,150.00
Rate for Payer: Aetna Commercial	$874.00
Rate for Payer: Aetna Medicare Advantage	$690.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$586.50
Rate for Payer: Cigna Commercial	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60
Rate for Payer: Qualcare PPO/HMO/WC	$345.00
Rate for Payer: UnitedHealthcare Community & State	$72.68
Rate for Payer: Wellpoint Medicaid Managed Care	$65.32

FORAMEN NEEDLE-LONG

Facility

$2,300.00

Hospital Charge Code	270702024
Hospital Revenue Code	278
Min. Negotiated Rate	$345.00
Max. Negotiated Rate	$556.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60
Rate for Payer: Qualcare PPO/HMO/WC	$345.00

FORCEP APPLYING NON-DETACH CRA

Facility

$1,483.70

Hospital Charge Code	270684904
Hospital Revenue Code	272
Min. Negotiated Rate	$42.14
Max. Negotiated Rate	$741.85
Rate for Payer: Aetna Commercial	$563.81
Rate for Payer: Aetna Medicare Advantage	$445.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$378.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$378.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$378.34
Rate for Payer: Cigna Commercial	$741.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$385.76
Rate for Payer: Oxford Commercial	$296.74
Rate for Payer: Qualcare PPO/HMO/WC	$222.56
Rate for Payer: UnitedHealthcare Commercial	$296.74
Rate for Payer: UnitedHealthcare Community & State	$46.88
Rate for Payer: Wellpoint Medicaid Managed Care	$42.14

FORCEP APPLYING NON-DETACH CRA

Facility

$1,483.70

Hospital Charge Code	270684904
Hospital Revenue Code	272
Min. Negotiated Rate	$222.56
Max. Negotiated Rate	$222.56
Rate for Payer: Qualcare PPO/HMO/WC	$222.56

FORCEP BIOPSY 70 DEG

Facility

$3,504.80

Hospital Charge Code	270689938
Hospital Revenue Code	272
Min. Negotiated Rate	$99.54
Max. Negotiated Rate	$1,752.40
Rate for Payer: Aetna Commercial	$1,331.82
Rate for Payer: Aetna Medicare Advantage	$1,051.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$893.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$893.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$893.72
Rate for Payer: Cigna Commercial	$1,752.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$911.25
Rate for Payer: Oxford Commercial	$700.96
Rate for Payer: Qualcare PPO/HMO/WC	$525.72
Rate for Payer: UnitedHealthcare Commercial	$700.96
Rate for Payer: UnitedHealthcare Community & State	$110.75
Rate for Payer: Wellpoint Medicaid Managed Care	$99.54

FORCEP BIOPSY 70 DEG

Facility

$3,504.80

Hospital Charge Code	270689938
Hospital Revenue Code	272
Min. Negotiated Rate	$525.72
Max. Negotiated Rate	$525.72
Rate for Payer: Qualcare PPO/HMO/WC	$525.72

FORCEP BIOPSY HOT LOWER

Facility

$137.50

Hospital Charge Code	270700218
Hospital Revenue Code	272
Min. Negotiated Rate	$20.62
Max. Negotiated Rate	$20.62
Rate for Payer: Qualcare PPO/HMO/WC	$20.62

FORCEP BIOPSY HOT LOWER

Facility

$137.50

Hospital Charge Code	270700218
Hospital Revenue Code	272
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$68.75
Rate for Payer: Aetna Commercial	$52.25
Rate for Payer: Aetna Medicare Advantage	$41.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.06
Rate for Payer: Cigna Commercial	$68.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.75
Rate for Payer: Oxford Commercial	$27.50
Rate for Payer: Qualcare PPO/HMO/WC	$20.62
Rate for Payer: UnitedHealthcare Commercial	$27.50
Rate for Payer: UnitedHealthcare Community & State	$4.34
Rate for Payer: Wellpoint Medicaid Managed Care	$3.90

FORCEP BIOSPY 230 CM OVAL

Facility

$32.00

Hospital Charge Code	270700217
Hospital Revenue Code	272
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

FORCEP BIOSPY 230 CM OVAL

Facility

$32.00

Hospital Charge Code	270700217
Hospital Revenue Code	272
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna Commercial	$12.16
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.32
Rate for Payer: Oxford Commercial	$6.40
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$6.40
Rate for Payer: UnitedHealthcare Community & State	$1.01
Rate for Payer: Wellpoint Medicaid Managed Care	$0.91

FORCEP BI POLAR BUZZ

Facility

$1,682.75

Hospital Charge Code	270690492
Hospital Revenue Code	272
Min. Negotiated Rate	$47.79
Max. Negotiated Rate	$841.38
Rate for Payer: Aetna Commercial	$639.45
Rate for Payer: Aetna Medicare Advantage	$504.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$429.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$429.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$429.10
Rate for Payer: Cigna Commercial	$841.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$437.51
Rate for Payer: Oxford Commercial	$336.55
Rate for Payer: Qualcare PPO/HMO/WC	$252.41
Rate for Payer: UnitedHealthcare Commercial	$336.55
Rate for Payer: UnitedHealthcare Community & State	$53.17
Rate for Payer: Wellpoint Medicaid Managed Care	$47.79

FORCEP BI POLAR BUZZ

Facility

$1,682.75

Hospital Charge Code	270690492
Hospital Revenue Code	272
Min. Negotiated Rate	$252.41
Max. Negotiated Rate	$252.41
Rate for Payer: Qualcare PPO/HMO/WC	$252.41

FORCEP BLUNT NOSE UP 2.1 MM

Facility

$5,051.00

Hospital Charge Code	270692123
Hospital Revenue Code	272
Min. Negotiated Rate	$143.45
Max. Negotiated Rate	$2,525.50
Rate for Payer: Aetna Commercial	$1,919.38
Rate for Payer: Aetna Medicare Advantage	$1,515.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,288.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,288.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,288.01
Rate for Payer: Cigna Commercial	$2,525.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,313.26
Rate for Payer: Oxford Commercial	$1,010.20
Rate for Payer: Qualcare PPO/HMO/WC	$757.65
Rate for Payer: UnitedHealthcare Commercial	$1,010.20
Rate for Payer: UnitedHealthcare Community & State	$159.61
Rate for Payer: Wellpoint Medicaid Managed Care	$143.45

FORCEP BLUNT NOSE UP 2.1 MM

Facility

$5,051.00

Hospital Charge Code	270692123
Hospital Revenue Code	272
Min. Negotiated Rate	$757.65
Max. Negotiated Rate	$757.65
Rate for Payer: Qualcare PPO/HMO/WC	$757.65

FORCEP BONE SERRATED 18MM

Facility

$3,840.85

Hospital Charge Code	270655151
Hospital Revenue Code	272
Min. Negotiated Rate	$576.13
Max. Negotiated Rate	$576.13
Rate for Payer: Qualcare PPO/HMO/WC	$576.13

FORCEP BONE SERRATED 18MM

Facility

$3,840.85

Hospital Charge Code	270655151
Hospital Revenue Code	272
Min. Negotiated Rate	$109.08
Max. Negotiated Rate	$1,920.42
Rate for Payer: Aetna Commercial	$1,459.52
Rate for Payer: Aetna Medicare Advantage	$1,152.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$979.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$979.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$979.42
Rate for Payer: Cigna Commercial	$1,920.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$998.62
Rate for Payer: Oxford Commercial	$768.17
Rate for Payer: Qualcare PPO/HMO/WC	$576.13
Rate for Payer: UnitedHealthcare Commercial	$768.17
Rate for Payer: UnitedHealthcare Community & State	$121.37
Rate for Payer: Wellpoint Medicaid Managed Care	$109.08

FORCEP BONE SERRATED 23MM

Facility

$4,072.60

Hospital Charge Code	270655152
Hospital Revenue Code	272
Min. Negotiated Rate	$610.89
Max. Negotiated Rate	$610.89
Rate for Payer: Qualcare PPO/HMO/WC	$610.89

FORCEP BONE SERRATED 23MM

Facility

$4,072.60

Hospital Charge Code	270655152
Hospital Revenue Code	272
Min. Negotiated Rate	$115.66
Max. Negotiated Rate	$2,036.30
Rate for Payer: Aetna Commercial	$1,547.59
Rate for Payer: Aetna Medicare Advantage	$1,221.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,038.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,038.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,038.51
Rate for Payer: Cigna Commercial	$2,036.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.88
Rate for Payer: Oxford Commercial	$814.52
Rate for Payer: Qualcare PPO/HMO/WC	$610.89
Rate for Payer: UnitedHealthcare Commercial	$814.52
Rate for Payer: UnitedHealthcare Community & State	$128.69
Rate for Payer: Wellpoint Medicaid Managed Care	$115.66

FORCEP DUAL IRRIGATING 1.0 TIP

Facility

$2,362.00

Hospital Charge Code	270692064
Hospital Revenue Code	272
Min. Negotiated Rate	$354.30
Max. Negotiated Rate	$354.30
Rate for Payer: Qualcare PPO/HMO/WC	$354.30

FORCEP DUAL IRRIGATING 1.0 TIP

Facility

$2,362.00

Hospital Charge Code	270692064
Hospital Revenue Code	272
Min. Negotiated Rate	$67.08
Max. Negotiated Rate	$1,181.00
Rate for Payer: Aetna Commercial	$897.56
Rate for Payer: Aetna Medicare Advantage	$708.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$602.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$602.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$602.31
Rate for Payer: Cigna Commercial	$1,181.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$614.12
Rate for Payer: Oxford Commercial	$472.40
Rate for Payer: Qualcare PPO/HMO/WC	$354.30
Rate for Payer: UnitedHealthcare Commercial	$472.40
Rate for Payer: UnitedHealthcare Community & State	$74.64
Rate for Payer: Wellpoint Medicaid Managed Care	$67.08

FORCEP EVEREST BIPOLAR MACRO

Facility

$920.00

Hospital Charge Code	270654831
Hospital Revenue Code	272
Min. Negotiated Rate	$26.13
Max. Negotiated Rate	$460.00
Rate for Payer: Aetna Commercial	$349.60
Rate for Payer: Aetna Medicare Advantage	$276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$234.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$234.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$234.60
Rate for Payer: Cigna Commercial	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$239.20
Rate for Payer: Oxford Commercial	$184.00
Rate for Payer: Qualcare PPO/HMO/WC	$138.00
Rate for Payer: UnitedHealthcare Commercial	$184.00
Rate for Payer: UnitedHealthcare Community & State	$29.07
Rate for Payer: Wellpoint Medicaid Managed Care	$26.13

FORCEP EVEREST BIPOLAR MACRO

Facility

$920.00

Hospital Charge Code	270654831
Hospital Revenue Code	272
Min. Negotiated Rate	$138.00
Max. Negotiated Rate	$138.00
Rate for Payer: Qualcare PPO/HMO/WC	$138.00

Know your out-of-pocket cost for care.

All Charges