Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

GASTRECTOMY P DIST; W ROUX-EN

Facility

$23,535.00

Service Code	HCPCS 43633
Hospital Charge Code	1600000636
Hospital Revenue Code	360
Min. Negotiated Rate	$3,530.25
Max. Negotiated Rate	$3,530.25
Rate for Payer: Qualcare PPO/HMO/WC	$3,530.25

GASTRHPHY STR PERF DUOD/GASTC

Facility

$16,639.25

Service Code	HCPCS 43840
Hospital Charge Code	16000967
Hospital Revenue Code	360
Min. Negotiated Rate	$2,495.89
Max. Negotiated Rate	$2,495.89
Rate for Payer: Qualcare PPO/HMO/WC	$2,495.89

GASTRHPHY STR PERF DUOD/GASTC

Facility

$16,639.25

Service Code	HCPCS 43840
Hospital Charge Code	16000967
Hospital Revenue Code	360
Min. Negotiated Rate	$472.55
Max. Negotiated Rate	$16,615.40
Rate for Payer: Aetna Commercial	$12,458.69
Rate for Payer: Aetna Medicare Advantage	$14,840.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,615.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,615.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,580.40
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	$16,615.40
Rate for Payer: Cigna Commercial	$9,181.40
Rate for Payer: Cigna Medicare Advantage	$4,580.40
Rate for Payer: Clover Medicare Advantage	$4,351.38
Rate for Payer: EmblemHealth Commercial	$13,741.20
Rate for Payer: Humana Medicare Advantage	$4,717.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,580.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,326.20
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,495.89
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$525.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,580.40
Rate for Payer: Wellcare Medicare Advantage	$4,580.40
Rate for Payer: Wellpoint Medicaid Managed Care	$472.55

GASTRIC FUNDOPLICATION

Facility

$61,903.72

Service Code	APR-DRG 2324
Min. Negotiated Rate	$60,689.92
Max. Negotiated Rate	$61,903.72
Rate for Payer: UnitedHealthcare Community & State	$60,689.92
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$61,903.72
Rate for Payer: Wellpoint Medicaid Managed Care	$60,689.92

GASTRIC FUNDOPLICATION

Facility

$15,568.96

Service Code	APR-DRG 2321
Min. Negotiated Rate	$15,263.69
Max. Negotiated Rate	$15,568.96
Rate for Payer: UnitedHealthcare Community & State	$15,263.69
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$15,568.96
Rate for Payer: Wellpoint Medicaid Managed Care	$15,263.69

GASTRIC FUNDOPLICATION

Facility

$25,764.77

Service Code	APR-DRG 2323
Min. Negotiated Rate	$25,259.58
Max. Negotiated Rate	$25,764.77
Rate for Payer: UnitedHealthcare Community & State	$25,259.58
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$25,764.77
Rate for Payer: Wellpoint Medicaid Managed Care	$25,259.58

GASTRIC FUNDOPLICATION

Facility

$18,533.65

Service Code	APR-DRG 2322
Min. Negotiated Rate	$18,170.25
Max. Negotiated Rate	$18,533.65
Rate for Payer: UnitedHealthcare Community & State	$18,170.25
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$18,533.65
Rate for Payer: Wellpoint Medicaid Managed Care	$18,170.25

GASTRIC TUBE REPLACEMNT DEVICE

Facility

$290.00

Hospital Charge Code	270325686
Hospital Revenue Code	272
Min. Negotiated Rate	$8.24
Max. Negotiated Rate	$145.00
Rate for Payer: Aetna Commercial	$110.20
Rate for Payer: Aetna Medicare Advantage	$87.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.95
Rate for Payer: Cigna Commercial	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.40
Rate for Payer: Oxford Commercial	$58.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.50
Rate for Payer: UnitedHealthcare Commercial	$58.00
Rate for Payer: UnitedHealthcare Community & State	$9.16
Rate for Payer: Wellpoint Medicaid Managed Care	$8.24

GASTRIC TUBE REPLACEMNT DEVICE

Facility

$290.00

Hospital Charge Code	270325686
Hospital Revenue Code	272
Min. Negotiated Rate	$43.50
Max. Negotiated Rate	$43.50
Rate for Payer: Qualcare PPO/HMO/WC	$43.50

GASTRIN

Facility

$622.00

Service Code	HCPCS 82941
Hospital Charge Code	38472293
Hospital Revenue Code	301
Min. Negotiated Rate	$14.10
Max. Negotiated Rate	$311.00
Rate for Payer: Aetna Commercial	$47.95
Rate for Payer: Aetna Medicare Advantage	$57.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.95
Rate for Payer: Cigna Commercial	$311.00
Rate for Payer: Cigna Medicare Advantage	$17.63
Rate for Payer: Clover Medicare Advantage	$16.75
Rate for Payer: EmblemHealth Commercial	$52.89
Rate for Payer: Humana Medicare Advantage	$18.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.72
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.30
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.63
Rate for Payer: Wellcare Medicare Advantage	$17.63
Rate for Payer: Wellpoint Medicaid Managed Care	$17.66

GASTRIN

Facility

$622.00

Service Code	HCPCS 82941
Hospital Charge Code	38472293
Hospital Revenue Code	301
Min. Negotiated Rate	$93.30
Max. Negotiated Rate	$93.30
Rate for Payer: Qualcare PPO/HMO/WC	$93.30

GASTRIN,SERUM

Facility

$667.59

Service Code	HCPCS 82941
Hospital Charge Code	39900084
Hospital Revenue Code	301
Min. Negotiated Rate	$14.10
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$47.95
Rate for Payer: Aetna Medicare Advantage	$57.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.95
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$17.63
Rate for Payer: Clover Medicare Advantage	$16.75
Rate for Payer: EmblemHealth Commercial	$52.89
Rate for Payer: Humana Medicare Advantage	$18.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.57
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.63
Rate for Payer: Wellcare Medicare Advantage	$17.63
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

GASTRIN,SERUM

Facility

$667.59

Service Code	HCPCS 82941
Hospital Charge Code	39900084
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

GASTROGRAFIN 120 ML ORAL

Facility

$534.86

Service Code	NDC 270044540
Hospital Charge Code	606390130
Hospital Revenue Code	250
Min. Negotiated Rate	$15.19
Max. Negotiated Rate	$267.43
Rate for Payer: Aetna Commercial	$203.25
Rate for Payer: Aetna Medicare Advantage	$160.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.39
Rate for Payer: Cigna Commercial	$267.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.06
Rate for Payer: Oxford Commercial	$106.97
Rate for Payer: Qualcare PPO/HMO/WC	$80.23
Rate for Payer: UnitedHealthcare Commercial	$106.97
Rate for Payer: UnitedHealthcare Community & State	$16.90
Rate for Payer: Wellpoint Medicaid Managed Care	$15.19

GASTROGRAFIN 120 ML ORAL

Facility

$534.86

Service Code	NDC 270044540
Hospital Charge Code	606390130
Hospital Revenue Code	250
Min. Negotiated Rate	$80.23
Max. Negotiated Rate	$80.23
Rate for Payer: Qualcare PPO/HMO/WC	$80.23

GASTROINTESTINAL HEMORRHAGE WITH CC

Facility

$50,448.50

Service Code	MSDRG 378
Min. Negotiated Rate	$15,360.92
Max. Negotiated Rate	$50,448.50
Rate for Payer: Aetna Commercial	$37,788.48
Rate for Payer: Aetna Medicare Advantage	$50,448.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27,150.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27,150.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16,169.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27,150.90
Rate for Payer: Cigna Commercial	$21,862.75
Rate for Payer: Cigna Medicare Advantage	$16,169.39
Rate for Payer: Clover Medicare Advantage	$15,360.92
Rate for Payer: EmblemHealth Commercial	$48,508.17
Rate for Payer: Humana Medicare Advantage	$16,654.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16,169.39
Rate for Payer: Oxford Commercial	$17,279.93
Rate for Payer: UnitedHealthcare Commercial	$23,129.81
Rate for Payer: UnitedHealthcare Medicare Advantage	$16,169.39
Rate for Payer: Wellcare Medicare Advantage	$16,169.39

GASTROINTESTINAL HEMORRHAGE WITH MCC

Facility

$77,217.63

Service Code	MSDRG 377
Min. Negotiated Rate	$23,511.78
Max. Negotiated Rate	$77,217.63
Rate for Payer: Aetna Commercial	$56,853.80
Rate for Payer: Aetna Medicare Advantage	$77,217.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,591.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,591.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24,749.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49,591.95
Rate for Payer: Cigna Commercial	$40,751.60
Rate for Payer: Cigna Medicare Advantage	$24,749.24
Rate for Payer: Clover Medicare Advantage	$23,511.78
Rate for Payer: EmblemHealth Commercial	$74,247.72
Rate for Payer: Humana Medicare Advantage	$25,491.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24,749.24
Rate for Payer: Oxford Commercial	$32,209.36
Rate for Payer: UnitedHealthcare Commercial	$43,113.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$24,749.24
Rate for Payer: Wellcare Medicare Advantage	$24,749.24

GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC

Facility

$39,381.23

Service Code	MSDRG 379
Min. Negotiated Rate	$11,107.65
Max. Negotiated Rate	$39,381.23
Rate for Payer: Aetna Commercial	$29,906.28
Rate for Payer: Aetna Medicare Advantage	$39,381.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17,454.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17,454.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,622.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17,454.15
Rate for Payer: Cigna Commercial	$14,053.51
Rate for Payer: Cigna Medicare Advantage	$12,622.19
Rate for Payer: Clover Medicare Advantage	$11,991.08
Rate for Payer: EmblemHealth Commercial	$37,866.57
Rate for Payer: Humana Medicare Advantage	$13,000.86
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,622.19
Rate for Payer: Oxford Commercial	$11,107.65
Rate for Payer: UnitedHealthcare Commercial	$14,867.98
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,622.19
Rate for Payer: Wellcare Medicare Advantage	$12,622.19

GASTROINTESTINAL OBSTRUCTION WITH CC

Facility

$44,417.19

Service Code	MSDRG 389
Min. Negotiated Rate	$13,524.47
Max. Negotiated Rate	$44,417.19
Rate for Payer: Aetna Commercial	$33,492.94
Rate for Payer: Aetna Medicare Advantage	$44,417.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,164.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,164.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14,236.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,164.00
Rate for Payer: Cigna Commercial	$17,607.01
Rate for Payer: Cigna Medicare Advantage	$14,236.28
Rate for Payer: Clover Medicare Advantage	$13,524.47
Rate for Payer: EmblemHealth Commercial	$42,708.84
Rate for Payer: Humana Medicare Advantage	$14,663.37
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14,236.28
Rate for Payer: Oxford Commercial	$13,916.28
Rate for Payer: UnitedHealthcare Commercial	$18,627.43
Rate for Payer: UnitedHealthcare Medicare Advantage	$14,236.28
Rate for Payer: Wellcare Medicare Advantage	$14,236.28

GASTROINTESTINAL OBSTRUCTION WITH MCC

Facility

$66,122.04

Service Code	MSDRG 388
Min. Negotiated Rate	$20,133.31
Max. Negotiated Rate	$66,122.04
Rate for Payer: Aetna Commercial	$48,951.38
Rate for Payer: Aetna Medicare Advantage	$66,122.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40,172.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40,172.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,192.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40,172.25
Rate for Payer: Cigna Commercial	$32,922.30
Rate for Payer: Cigna Medicare Advantage	$21,192.96
Rate for Payer: Clover Medicare Advantage	$20,133.31
Rate for Payer: EmblemHealth Commercial	$63,578.88
Rate for Payer: Humana Medicare Advantage	$21,828.75
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21,192.96
Rate for Payer: Oxford Commercial	$26,021.22
Rate for Payer: UnitedHealthcare Commercial	$34,830.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$21,192.96
Rate for Payer: Wellcare Medicare Advantage	$21,192.96

GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC

Facility

$36,651.54

Service Code	MSDRG 390
Min. Negotiated Rate	$9,585.28
Max. Negotiated Rate	$36,651.54
Rate for Payer: Aetna Commercial	$27,962.15
Rate for Payer: Aetna Medicare Advantage	$36,651.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,514.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,514.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11,747.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,514.80
Rate for Payer: Cigna Commercial	$12,127.39
Rate for Payer: Cigna Medicare Advantage	$11,747.29
Rate for Payer: Clover Medicare Advantage	$11,159.93
Rate for Payer: EmblemHealth Commercial	$35,241.87
Rate for Payer: Humana Medicare Advantage	$12,099.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11,747.29
Rate for Payer: Oxford Commercial	$9,585.28
Rate for Payer: UnitedHealthcare Commercial	$12,830.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$11,747.29
Rate for Payer: Wellcare Medicare Advantage	$11,747.29

GASTROINTESTINAL VASCULAR INSUFFICIENCY

Facility

$10,242.19

Service Code	APR-DRG 2462
Min. Negotiated Rate	$10,041.36
Max. Negotiated Rate	$10,242.19
Rate for Payer: UnitedHealthcare Community & State	$10,041.36
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,242.19
Rate for Payer: Wellpoint Medicaid Managed Care	$10,041.36

GASTROINTESTINAL VASCULAR INSUFFICIENCY

Facility

$8,163.64

Service Code	APR-DRG 2461
Min. Negotiated Rate	$8,003.57
Max. Negotiated Rate	$8,163.64
Rate for Payer: UnitedHealthcare Community & State	$8,003.57
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,163.64
Rate for Payer: Wellpoint Medicaid Managed Care	$8,003.57

GASTROINTESTINAL VASCULAR INSUFFICIENCY

Facility

$14,283.97

Service Code	APR-DRG 2463
Min. Negotiated Rate	$14,003.89
Max. Negotiated Rate	$14,283.97
Rate for Payer: UnitedHealthcare Community & State	$14,003.89
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$14,283.97
Rate for Payer: Wellpoint Medicaid Managed Care	$14,003.89

GASTROINTESTINAL VASCULAR INSUFFICIENCY

Facility

$21,194.93

Service Code	APR-DRG 2464
Min. Negotiated Rate	$20,779.34
Max. Negotiated Rate	$21,194.93
Rate for Payer: UnitedHealthcare Community & State	$20,779.34
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$21,194.93
Rate for Payer: Wellpoint Medicaid Managed Care	$20,779.34

Know your out-of-pocket cost for care.

All Charges