Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

HEAVY METALS BLOOD III

Facility

$111.75

Service Code	HCPCS 83825
Hospital Charge Code	39990142C
Hospital Revenue Code	301
Min. Negotiated Rate	$16.76
Max. Negotiated Rate	$16.76
Rate for Payer: Qualcare PPO/HMO/WC	$16.76

HEAVY METALS BLOOD III

Facility

$111.75

Service Code	HCPCS 83825
Hospital Charge Code	39990142C
Hospital Revenue Code	301
Min. Negotiated Rate	$3.17
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$44.23
Rate for Payer: Aetna Medicare Advantage	$52.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.98
Rate for Payer: Cigna Commercial	$55.88
Rate for Payer: Cigna Medicare Advantage	$16.26
Rate for Payer: Clover Medicare Advantage	$15.45
Rate for Payer: EmblemHealth Commercial	$48.78
Rate for Payer: Humana Medicare Advantage	$16.75
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.05
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.76
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.26
Rate for Payer: Wellcare Medicare Advantage	$16.26
Rate for Payer: Wellpoint Medicaid Managed Care	$3.17

HEAVY METALS PROFILE BLOOD I

Facility

$390.00

Service Code	HCPCS 82175
Hospital Charge Code	3038536A
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$51.60
Rate for Payer: Aetna Medicare Advantage	$61.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.81
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$18.97
Rate for Payer: Clover Medicare Advantage	$18.02
Rate for Payer: EmblemHealth Commercial	$56.91
Rate for Payer: Humana Medicare Advantage	$19.54
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$15.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.97
Rate for Payer: Wellcare Medicare Advantage	$18.97
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

HEAVY METALS PROFILE BLOOD I

Facility

$390.00

Service Code	HCPCS 82175
Hospital Charge Code	3038536A
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HEAVY METALS PROFILE BLOOD II

Facility

$390.00

Service Code	HCPCS 83825
Hospital Charge Code	3038536C
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HEAVY METALS PROFILE BLOOD II

Facility

$390.00

Service Code	HCPCS 83655
Hospital Charge Code	3038536B
Hospital Revenue Code	301
Min. Negotiated Rate	$9.69
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$32.94
Rate for Payer: Aetna Medicare Advantage	$39.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.93
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.11
Rate for Payer: Clover Medicare Advantage	$11.50
Rate for Payer: EmblemHealth Commercial	$36.33
Rate for Payer: Humana Medicare Advantage	$12.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.11
Rate for Payer: Wellcare Medicare Advantage	$12.11
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

HEAVY METALS PROFILE BLOOD II

Facility

$390.00

Service Code	HCPCS 83825
Hospital Charge Code	3038536C
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$44.23
Rate for Payer: Aetna Medicare Advantage	$52.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.98
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$16.26
Rate for Payer: Clover Medicare Advantage	$15.45
Rate for Payer: EmblemHealth Commercial	$48.78
Rate for Payer: Humana Medicare Advantage	$16.75
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.26
Rate for Payer: Wellcare Medicare Advantage	$16.26
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

HEAVY METALS PROFILE BLOOD II

Facility

$390.00

Service Code	HCPCS 83655
Hospital Charge Code	3038536B
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HEAVY METALS,URINE

Facility

$460.00

Service Code	HCPCS 83015
Hospital Charge Code	38472389
Hospital Revenue Code	301
Min. Negotiated Rate	$69.00
Max. Negotiated Rate	$69.00
Rate for Payer: Qualcare PPO/HMO/WC	$69.00

HEAVY METALS,URINE

Facility

$460.00

Service Code	HCPCS 83015
Hospital Charge Code	38472389
Hospital Revenue Code	301
Min. Negotiated Rate	$13.06
Max. Negotiated Rate	$230.00
Rate for Payer: Aetna Commercial	$56.96
Rate for Payer: Aetna Medicare Advantage	$67.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.96
Rate for Payer: Cigna Commercial	$230.00
Rate for Payer: Cigna Medicare Advantage	$20.94
Rate for Payer: Clover Medicare Advantage	$19.89
Rate for Payer: EmblemHealth Commercial	$62.82
Rate for Payer: Humana Medicare Advantage	$21.57
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.60
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$69.00
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$16.75
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.94
Rate for Payer: Wellcare Medicare Advantage	$20.94
Rate for Payer: Wellpoint Medicaid Managed Care	$13.06

HEDRON IA SPACER 26X34, 13MM,

Facility

$30,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705494
Hospital Revenue Code	278
Min. Negotiated Rate	$4,500.00
Max. Negotiated Rate	$7,260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,260.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,500.00

HEDRON IA SPACER 26X34, 13MM,

Facility

$30,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705491
Hospital Revenue Code	278
Min. Negotiated Rate	$4,500.00
Max. Negotiated Rate	$7,260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,260.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,500.00

HEDRON IA SPACER 26X34, 13MM,

Facility

$30,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705494
Hospital Revenue Code	278
Min. Negotiated Rate	$852.00
Max. Negotiated Rate	$15,000.00
Rate for Payer: Aetna Commercial	$11,400.00
Rate for Payer: Aetna Medicare Advantage	$9,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,650.00
Rate for Payer: Cigna Commercial	$15,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,260.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,500.00
Rate for Payer: UnitedHealthcare Community & State	$948.00
Rate for Payer: Wellpoint Medicaid Managed Care	$852.00

HEDRON IA SPACER 26X34, 13MM,

Facility

$30,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705491
Hospital Revenue Code	278
Min. Negotiated Rate	$852.00
Max. Negotiated Rate	$15,000.00
Rate for Payer: Aetna Commercial	$11,400.00
Rate for Payer: Aetna Medicare Advantage	$9,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,650.00
Rate for Payer: Cigna Commercial	$15,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,260.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,500.00
Rate for Payer: UnitedHealthcare Community & State	$948.00
Rate for Payer: Wellpoint Medicaid Managed Care	$852.00

HEEL 2 VIEWS-BILAT

Facility

$5,100.00

Service Code	HCPCS 7365050
Hospital Charge Code	94061255
Hospital Revenue Code	320
Min. Negotiated Rate	$144.84
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.00
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$161.16
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

HEEL 2 VIEWS-BILAT

Facility

$5,100.00

Service Code	HCPCS 7365050
Hospital Charge Code	94061255
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

HEEL 2 VIEWS-LT

Facility

$5,100.00

Service Code	HCPCS 73650LT
Hospital Charge Code	94061405
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

HEEL 2 VIEWS-LT

Facility

$5,100.00

Service Code	HCPCS 73650LT
Hospital Charge Code	94061405
Hospital Revenue Code	320
Min. Negotiated Rate	$144.84
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.00
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$161.16
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

HEEL 2 VIEWS-RT

Facility

$5,100.00

Service Code	HCPCS 73650RT
Hospital Charge Code	94061407
Hospital Revenue Code	320
Min. Negotiated Rate	$144.84
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.00
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$161.16
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

HEEL 2 VIEWS-RT

Facility

$5,100.00

Service Code	HCPCS 73650RT
Hospital Charge Code	94061407
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

HEEL & ANKLE PROTECTORS PAIRS

Facility

$35.00

Hospital Charge Code	270331532
Hospital Revenue Code	272
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$5.25
Rate for Payer: Qualcare PPO/HMO/WC	$5.25

HEEL & ANKLE PROTECTORS PAIRS

Facility

$35.00

Hospital Charge Code	270331532
Hospital Revenue Code	272
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$17.50
Rate for Payer: Aetna Commercial	$13.30
Rate for Payer: Aetna Medicare Advantage	$10.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.93
Rate for Payer: Cigna Commercial	$17.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.10
Rate for Payer: Oxford Commercial	$7.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.25
Rate for Payer: UnitedHealthcare Commercial	$7.00
Rate for Payer: UnitedHealthcare Community & State	$1.11
Rate for Payer: Wellpoint Medicaid Managed Care	$0.99

HEEL/ELBOW PROTECTORS UNI SIZE

Facility

$6.42

Hospital Charge Code	270649752
Hospital Revenue Code	270
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$0.96
Rate for Payer: Qualcare PPO/HMO/WC	$0.96

HEEL/ELBOW PROTECTORS UNI SIZE

Facility

$6.42

Hospital Charge Code	270649752
Hospital Revenue Code	270
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.21
Rate for Payer: Aetna Commercial	$2.44
Rate for Payer: Aetna Medicare Advantage	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.64
Rate for Payer: Cigna Commercial	$3.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.67
Rate for Payer: Oxford Commercial	$1.28
Rate for Payer: Qualcare PPO/HMO/WC	$0.96
Rate for Payer: UnitedHealthcare Commercial	$1.28
Rate for Payer: UnitedHealthcare Community & State	$0.20
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

HEEL RELIEF SH

Facility

$94.75

Hospital Charge Code	270629862
Hospital Revenue Code	271
Min. Negotiated Rate	$2.69
Max. Negotiated Rate	$47.38
Rate for Payer: Aetna Commercial	$36.01
Rate for Payer: Aetna Medicare Advantage	$28.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.16
Rate for Payer: Cigna Commercial	$47.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.64
Rate for Payer: Oxford Commercial	$18.95
Rate for Payer: Qualcare PPO/HMO/WC	$14.21
Rate for Payer: UnitedHealthcare Commercial	$18.95
Rate for Payer: UnitedHealthcare Community & State	$2.99
Rate for Payer: Wellpoint Medicaid Managed Care	$2.69

Know your out-of-pocket cost for care.

All Charges