Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

HFN RH 125 DEG 11MM X 260MM

Facility

$9,825.00

Service Code	HCPCS C1713
Hospital Charge Code	270690403
Hospital Revenue Code	278
Min. Negotiated Rate	$279.03
Max. Negotiated Rate	$4,912.50
Rate for Payer: Aetna Commercial	$3,733.50
Rate for Payer: Aetna Medicare Advantage	$2,947.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,505.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,505.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,965.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,505.38
Rate for Payer: Cigna Commercial	$4,912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,377.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,473.75
Rate for Payer: UnitedHealthcare Community & State	$310.47
Rate for Payer: Wellpoint Medicaid Managed Care	$279.03

HFN RH 125 DEG 11MM X 260MM

Facility

$9,825.00

Service Code	HCPCS C1713
Hospital Charge Code	270690403
Hospital Revenue Code	278
Min. Negotiated Rate	$1,473.75
Max. Negotiated Rate	$2,377.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,965.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,377.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,473.75

HFN RH 125 DEG 11MM X 420MM

Facility

$9,825.00

Service Code	HCPCS C1713
Hospital Charge Code	270684350
Hospital Revenue Code	278
Min. Negotiated Rate	$1,473.75
Max. Negotiated Rate	$2,377.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,965.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,377.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,473.75

HFN RH 125 DEG 11MM X 420MM

Facility

$9,825.00

Service Code	HCPCS C1713
Hospital Charge Code	270684350
Hospital Revenue Code	278
Min. Negotiated Rate	$279.03
Max. Negotiated Rate	$4,912.50
Rate for Payer: Aetna Commercial	$3,733.50
Rate for Payer: Aetna Medicare Advantage	$2,947.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,505.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,505.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,965.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,505.38
Rate for Payer: Cigna Commercial	$4,912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,377.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,473.75
Rate for Payer: UnitedHealthcare Community & State	$310.47
Rate for Payer: Wellpoint Medicaid Managed Care	$279.03

HFN RH 125 DEG 11MM X 95MM

Facility

$14,905.00

Hospital Charge Code	270702734
Hospital Revenue Code	278
Min. Negotiated Rate	$423.30
Max. Negotiated Rate	$7,452.50
Rate for Payer: Aetna Commercial	$5,663.90
Rate for Payer: Aetna Medicare Advantage	$4,471.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,800.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,800.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,981.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,800.78
Rate for Payer: Cigna Commercial	$7,452.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,607.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,235.75
Rate for Payer: UnitedHealthcare Community & State	$471.00
Rate for Payer: Wellpoint Medicaid Managed Care	$423.30

HFN RH 125 DEG 11MM X 95MM

Facility

$14,905.00

Hospital Charge Code	270702734
Hospital Revenue Code	278
Min. Negotiated Rate	$2,235.75
Max. Negotiated Rate	$3,607.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,981.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,607.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,235.75

HFN RH 125 DEG 9MM X 260 MM

Facility

$9,432.00

Service Code	HCPCS C1713
Hospital Charge Code	270682505
Hospital Revenue Code	278
Min. Negotiated Rate	$1,414.80
Max. Negotiated Rate	$2,282.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,886.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,282.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,414.80

HFN RH 125 DEG 9MM X 260 MM

Facility

$9,432.00

Service Code	HCPCS C1713
Hospital Charge Code	270682505
Hospital Revenue Code	278
Min. Negotiated Rate	$267.87
Max. Negotiated Rate	$4,716.00
Rate for Payer: Aetna Commercial	$3,584.16
Rate for Payer: Aetna Medicare Advantage	$2,829.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,405.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,405.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,886.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,405.16
Rate for Payer: Cigna Commercial	$4,716.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,282.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,414.80
Rate for Payer: UnitedHealthcare Community & State	$298.05
Rate for Payer: Wellpoint Medicaid Managed Care	$267.87

HFN RH 125 DEG 9MM X 420MM

Facility

$9,825.00

Service Code	HCPCS C1713
Hospital Charge Code	270688657
Hospital Revenue Code	278
Min. Negotiated Rate	$279.03
Max. Negotiated Rate	$4,912.50
Rate for Payer: Aetna Commercial	$3,733.50
Rate for Payer: Aetna Medicare Advantage	$2,947.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,505.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,505.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,965.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,505.38
Rate for Payer: Cigna Commercial	$4,912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,377.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,473.75
Rate for Payer: UnitedHealthcare Community & State	$310.47
Rate for Payer: Wellpoint Medicaid Managed Care	$279.03

HFN RH 125 DEG 9MM X 420MM

Facility

$9,825.00

Service Code	HCPCS C1713
Hospital Charge Code	270688657
Hospital Revenue Code	278
Min. Negotiated Rate	$1,473.75
Max. Negotiated Rate	$2,377.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,965.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,377.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,473.75

H.F. RESCETION ELECT LOOP 24FR

Facility

$7,777.00

Hospital Charge Code	270655911
Hospital Revenue Code	272
Min. Negotiated Rate	$1,166.55
Max. Negotiated Rate	$1,166.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,166.55

H.F. RESCETION ELECT LOOP 24FR

Facility

$7,777.00

Hospital Charge Code	270655911
Hospital Revenue Code	272
Min. Negotiated Rate	$220.87
Max. Negotiated Rate	$3,888.50
Rate for Payer: Aetna Commercial	$2,955.26
Rate for Payer: Aetna Medicare Advantage	$2,333.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,983.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,983.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,983.13
Rate for Payer: Cigna Commercial	$3,888.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,022.02
Rate for Payer: Oxford Commercial	$1,555.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,166.55
Rate for Payer: UnitedHealthcare Commercial	$1,555.40
Rate for Payer: UnitedHealthcare Community & State	$245.75
Rate for Payer: Wellpoint Medicaid Managed Care	$220.87

H. GALACTOMANNAN ANTIGEN URINE

Facility

$155.14

Service Code	HCPCS 87385
Hospital Charge Code	401187385
Hospital Revenue Code	306
Min. Negotiated Rate	$4.41
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$36.04
Rate for Payer: Aetna Medicare Advantage	$42.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.06
Rate for Payer: Cigna Commercial	$77.57
Rate for Payer: Cigna Medicare Advantage	$13.25
Rate for Payer: Clover Medicare Advantage	$12.59
Rate for Payer: EmblemHealth Commercial	$39.75
Rate for Payer: Humana Medicare Advantage	$13.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.34
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.27
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.25
Rate for Payer: Wellcare Medicare Advantage	$13.25
Rate for Payer: Wellpoint Medicaid Managed Care	$4.41

H. GALACTOMANNAN ANTIGEN URINE

Facility

$155.14

Service Code	HCPCS 87385
Hospital Charge Code	401187385
Hospital Revenue Code	306
Min. Negotiated Rate	$23.27
Max. Negotiated Rate	$23.27
Rate for Payer: Qualcare PPO/HMO/WC	$23.27

H.GALACTOMANNAN ANTIGEN URINE

Facility

$390.00

Service Code	HCPCS 87385
Hospital Charge Code	3847976
Hospital Revenue Code	306
Min. Negotiated Rate	$10.30
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$36.04
Rate for Payer: Aetna Medicare Advantage	$42.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.06
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$13.25
Rate for Payer: Clover Medicare Advantage	$12.59
Rate for Payer: EmblemHealth Commercial	$39.75
Rate for Payer: Humana Medicare Advantage	$13.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.25
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	$10.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.25
Rate for Payer: Wellcare Medicare Advantage	$13.25
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

H.GALACTOMANNAN ANTIGEN URINE

Facility

$390.00

Service Code	HCPCS 87385
Hospital Charge Code	3847976
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HGE AB (IGG,M), I

Facility

$88.55

Service Code	HCPCS 8660991
Hospital Charge Code	39990034A
Hospital Revenue Code	302
Min. Negotiated Rate	$13.28
Max. Negotiated Rate	$13.28
Rate for Payer: Qualcare PPO/HMO/WC	$13.28

HGE AB (IGG,M), I

Facility

$88.55

Service Code	HCPCS 8660991
Hospital Charge Code	39990034A
Hospital Revenue Code	302
Min. Negotiated Rate	$2.51
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$33.65
Rate for Payer: Aetna Medicare Advantage	$26.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.58
Rate for Payer: Cigna Commercial	$44.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.02
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.28
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$2.80
Rate for Payer: Wellpoint Medicaid Managed Care	$2.51

HGE AB (IGG,M), II

Facility

$88.55

Service Code	HCPCS 8660991
Hospital Charge Code	39990034B
Hospital Revenue Code	302
Min. Negotiated Rate	$13.28
Max. Negotiated Rate	$13.28
Rate for Payer: Qualcare PPO/HMO/WC	$13.28

HGE AB (IGG,M), II

Facility

$88.55

Service Code	HCPCS 8660991
Hospital Charge Code	39990034B
Hospital Revenue Code	302
Min. Negotiated Rate	$2.51
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$33.65
Rate for Payer: Aetna Medicare Advantage	$26.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.58
Rate for Payer: Cigna Commercial	$44.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.02
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.28
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$2.80
Rate for Payer: Wellpoint Medicaid Managed Care	$2.51

HGE AB (IGG,M), III

Facility

$69.95

Service Code	HCPCS 8666691
Hospital Charge Code	39990034C
Hospital Revenue Code	302
Min. Negotiated Rate	$1.99
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$26.58
Rate for Payer: Aetna Medicare Advantage	$20.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.84
Rate for Payer: Cigna Commercial	$34.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.19
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.49
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$2.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

HGE AB (IGG,M), III

Facility

$69.95

Service Code	HCPCS 8666691
Hospital Charge Code	39990034C
Hospital Revenue Code	302
Min. Negotiated Rate	$10.49
Max. Negotiated Rate	$10.49
Rate for Payer: Qualcare PPO/HMO/WC	$10.49

HGE AB (IGG,M), IV

Facility

$69.95

Service Code	HCPCS 8666691
Hospital Charge Code	39990034D
Hospital Revenue Code	302
Min. Negotiated Rate	$1.99
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$26.58
Rate for Payer: Aetna Medicare Advantage	$20.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.84
Rate for Payer: Cigna Commercial	$34.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.19
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.49
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$2.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

HGE AB (IGG,M), IV

Facility

$69.95

Service Code	HCPCS 8666691
Hospital Charge Code	39990034D
Hospital Revenue Code	302
Min. Negotiated Rate	$10.49
Max. Negotiated Rate	$10.49
Rate for Payer: Qualcare PPO/HMO/WC	$10.49

H-GENIN CRUSH MIX 5CC

Facility

$9,790.55

Hospital Charge Code	270700316
Hospital Revenue Code	278
Min. Negotiated Rate	$1,468.58
Max. Negotiated Rate	$2,369.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,958.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,369.31
Rate for Payer: Qualcare PPO/HMO/WC	$1,468.58

Know your out-of-pocket cost for care.

All Charges