Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

HOLDING SLEEVE

Facility

$1,590.00

Hospital Charge Code	270654605
Hospital Revenue Code	272
Min. Negotiated Rate	$45.16
Max. Negotiated Rate	$795.00
Rate for Payer: Aetna Commercial	$604.20
Rate for Payer: Aetna Medicare Advantage	$477.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$405.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$405.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$405.45
Rate for Payer: Cigna Commercial	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$413.40
Rate for Payer: Oxford Commercial	$318.00
Rate for Payer: Qualcare PPO/HMO/WC	$238.50
Rate for Payer: UnitedHealthcare Commercial	$318.00
Rate for Payer: UnitedHealthcare Community & State	$50.24
Rate for Payer: Wellpoint Medicaid Managed Care	$45.16

HOLDING SLEEVE

Facility

$1,590.00

Hospital Charge Code	270654605
Hospital Revenue Code	272
Min. Negotiated Rate	$238.50
Max. Negotiated Rate	$238.50
Rate for Payer: Qualcare PPO/HMO/WC	$238.50

HOLDING SLEEVE FOR STARDRIVE

Facility

$3,344.05

Hospital Charge Code	270688592
Hospital Revenue Code	272
Min. Negotiated Rate	$501.61
Max. Negotiated Rate	$501.61
Rate for Payer: Qualcare PPO/HMO/WC	$501.61

HOLDING SLEEVE FOR STARDRIVE

Facility

$3,344.05

Hospital Charge Code	270688592
Hospital Revenue Code	272
Min. Negotiated Rate	$94.97
Max. Negotiated Rate	$1,672.03
Rate for Payer: Aetna Commercial	$1,270.74
Rate for Payer: Aetna Medicare Advantage	$1,003.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$852.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$852.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$852.73
Rate for Payer: Cigna Commercial	$1,672.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$869.45
Rate for Payer: Oxford Commercial	$668.81
Rate for Payer: Qualcare PPO/HMO/WC	$501.61
Rate for Payer: UnitedHealthcare Commercial	$668.81
Rate for Payer: UnitedHealthcare Community & State	$105.67
Rate for Payer: Wellpoint Medicaid Managed Care	$94.97

HOLMIUM 1000MICRON LASER FIBER

Facility

$1,610.00

Hospital Charge Code	270632053
Hospital Revenue Code	272
Min. Negotiated Rate	$45.72
Max. Negotiated Rate	$805.00
Rate for Payer: Aetna Commercial	$611.80
Rate for Payer: Aetna Medicare Advantage	$483.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$410.55
Rate for Payer: Cigna Commercial	$805.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$418.60
Rate for Payer: Oxford Commercial	$322.00
Rate for Payer: Qualcare PPO/HMO/WC	$241.50
Rate for Payer: UnitedHealthcare Commercial	$322.00
Rate for Payer: UnitedHealthcare Community & State	$50.88
Rate for Payer: Wellpoint Medicaid Managed Care	$45.72

HOLMIUM 1000MICRON LASER FIBER

Facility

$1,610.00

Hospital Charge Code	270632053
Hospital Revenue Code	272
Min. Negotiated Rate	$241.50
Max. Negotiated Rate	$241.50
Rate for Payer: Qualcare PPO/HMO/WC	$241.50

HOLMIUM FIBER

Facility

$1,610.00

Hospital Charge Code	270684297
Hospital Revenue Code	272
Min. Negotiated Rate	$241.50
Max. Negotiated Rate	$241.50
Rate for Payer: Qualcare PPO/HMO/WC	$241.50

HOLMIUM FIBER

Facility

$1,610.00

Hospital Charge Code	270684297
Hospital Revenue Code	272
Min. Negotiated Rate	$45.72
Max. Negotiated Rate	$805.00
Rate for Payer: Aetna Commercial	$611.80
Rate for Payer: Aetna Medicare Advantage	$483.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$410.55
Rate for Payer: Cigna Commercial	$805.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$418.60
Rate for Payer: Oxford Commercial	$322.00
Rate for Payer: Qualcare PPO/HMO/WC	$241.50
Rate for Payer: UnitedHealthcare Commercial	$322.00
Rate for Payer: UnitedHealthcare Community & State	$50.88
Rate for Payer: Wellpoint Medicaid Managed Care	$45.72

HOLMIUM FIBER 1000 MICRON

Facility

$1,500.00

Hospital Charge Code	270683939
Hospital Revenue Code	272
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

HOLMIUM FIBER 1000 MICRON

Facility

$1,500.00

Hospital Charge Code	270683939
Hospital Revenue Code	272
Min. Negotiated Rate	$42.60
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.00
Rate for Payer: Oxford Commercial	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Commercial	$300.00
Rate for Payer: UnitedHealthcare Community & State	$47.40
Rate for Payer: Wellpoint Medicaid Managed Care	$42.60

HOLTER MONITOR RECORDING

Facility

$5,400.00

Service Code	HCPCS 93225
Hospital Charge Code	3654000
Hospital Revenue Code	731
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$810.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

HOLTER MONITOR RECORDING

Facility

$5,400.00

Service Code	HCPCS 93225
Hospital Charge Code	3654000
Hospital Revenue Code	731
Min. Negotiated Rate	$150.16
Max. Negotiated Rate	$2,460.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.36
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,404.00
Rate for Payer: Oxford Commercial	$2,169.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00
Rate for Payer: UnitedHealthcare Commercial	$2,460.00
Rate for Payer: UnitedHealthcare Community & State	$170.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$153.36

HOLTER MONITOR RECORDING

Facility

$1,007.00

Service Code	HCPCS 93225
Hospital Charge Code	36540008
Hospital Revenue Code	731
Min. Negotiated Rate	$28.60
Max. Negotiated Rate	$2,460.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.36
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.82
Rate for Payer: Oxford Commercial	$2,169.00
Rate for Payer: Qualcare PPO/HMO/WC	$151.05
Rate for Payer: UnitedHealthcare Commercial	$2,460.00
Rate for Payer: UnitedHealthcare Community & State	$31.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$28.60

HOLTER MONITOR RECORDING

Facility

$1,007.00

Service Code	HCPCS 93225
Hospital Charge Code	36540008
Hospital Revenue Code	731
Min. Negotiated Rate	$151.05
Max. Negotiated Rate	$151.05
Rate for Payer: Qualcare PPO/HMO/WC	$151.05

HOLTER MONITOR SCAN ANALYS RPT

Facility

$1,776.00

Service Code	HCPCS 93226
Hospital Charge Code	36540007
Hospital Revenue Code	731
Min. Negotiated Rate	$50.44
Max. Negotiated Rate	$2,460.00
Rate for Payer: Aetna Commercial	$190.62
Rate for Payer: Aetna Medicare Advantage	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$254.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$254.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$70.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$234.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$254.22
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: Cigna Medicare Advantage	$70.08
Rate for Payer: Clover Medicare Advantage	$66.58
Rate for Payer: EmblemHealth Commercial	$210.24
Rate for Payer: Humana Medicare Advantage	$72.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$70.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$461.76
Rate for Payer: Oxford Commercial	$2,169.00
Rate for Payer: Qualcare PPO/HMO/WC	$266.40
Rate for Payer: UnitedHealthcare Commercial	$2,460.00
Rate for Payer: UnitedHealthcare Community & State	$56.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$70.08
Rate for Payer: Wellcare Medicare Advantage	$70.08
Rate for Payer: Wellpoint Medicaid Managed Care	$50.44

HOLTER MONITOR SCAN ANALYS RPT

Facility

$1,776.00

Service Code	HCPCS 93226
Hospital Charge Code	36540007
Hospital Revenue Code	731
Min. Negotiated Rate	$266.40
Max. Negotiated Rate	$266.40
Rate for Payer: Qualcare PPO/HMO/WC	$266.40

HOLTER MONITOR SCANNING & RPT

Facility

$5,400.00

Service Code	HCPCS 93226
Hospital Charge Code	74115013
Hospital Revenue Code	731
Min. Negotiated Rate	$66.58
Max. Negotiated Rate	$2,460.00
Rate for Payer: Aetna Commercial	$190.62
Rate for Payer: Aetna Medicare Advantage	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$254.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$254.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$70.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$234.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$254.22
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: Cigna Medicare Advantage	$70.08
Rate for Payer: Clover Medicare Advantage	$66.58
Rate for Payer: EmblemHealth Commercial	$210.24
Rate for Payer: Humana Medicare Advantage	$72.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$70.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,404.00
Rate for Payer: Oxford Commercial	$2,169.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00
Rate for Payer: UnitedHealthcare Commercial	$2,460.00
Rate for Payer: UnitedHealthcare Community & State	$170.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$70.08
Rate for Payer: Wellcare Medicare Advantage	$70.08
Rate for Payer: Wellpoint Medicaid Managed Care	$153.36

HOLTER MONITOR SCANNING & RPT

Facility

$5,400.00

Service Code	HCPCS 93226
Hospital Charge Code	5300042
Hospital Revenue Code	731
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$810.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

HOLTER MONITOR SCANNING & RPT

Facility

$5,400.00

Service Code	HCPCS 93226
Hospital Charge Code	5300042
Hospital Revenue Code	731
Min. Negotiated Rate	$66.58
Max. Negotiated Rate	$2,460.00
Rate for Payer: Aetna Commercial	$190.62
Rate for Payer: Aetna Medicare Advantage	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$254.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$254.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$70.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$234.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$254.22
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: Cigna Medicare Advantage	$70.08
Rate for Payer: Clover Medicare Advantage	$66.58
Rate for Payer: EmblemHealth Commercial	$210.24
Rate for Payer: Humana Medicare Advantage	$72.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$70.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,404.00
Rate for Payer: Oxford Commercial	$2,169.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00
Rate for Payer: UnitedHealthcare Commercial	$2,460.00
Rate for Payer: UnitedHealthcare Community & State	$170.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$70.08
Rate for Payer: Wellcare Medicare Advantage	$70.08
Rate for Payer: Wellpoint Medicaid Managed Care	$153.36

HOLTER MONITOR SCANNING & RPT

Facility

$5,400.00

Service Code	HCPCS 93226
Hospital Charge Code	74116013
Hospital Revenue Code	731
Min. Negotiated Rate	$66.58
Max. Negotiated Rate	$2,460.00
Rate for Payer: Aetna Commercial	$190.62
Rate for Payer: Aetna Medicare Advantage	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$254.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$254.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$70.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$234.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$254.22
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: Cigna Medicare Advantage	$70.08
Rate for Payer: Clover Medicare Advantage	$66.58
Rate for Payer: EmblemHealth Commercial	$210.24
Rate for Payer: Humana Medicare Advantage	$72.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$70.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,404.00
Rate for Payer: Oxford Commercial	$2,169.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00
Rate for Payer: UnitedHealthcare Commercial	$2,460.00
Rate for Payer: UnitedHealthcare Community & State	$170.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$70.08
Rate for Payer: Wellcare Medicare Advantage	$70.08
Rate for Payer: Wellpoint Medicaid Managed Care	$153.36

HOLTER MONITOR SCANNING & RPT

Facility

$5,400.00

Service Code	HCPCS 93226
Hospital Charge Code	74116013
Hospital Revenue Code	731
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$810.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

HOLTER MONITOR SCANNING & RPT

Facility

$5,400.00

Service Code	HCPCS 93226
Hospital Charge Code	74117013
Hospital Revenue Code	731
Min. Negotiated Rate	$66.58
Max. Negotiated Rate	$2,460.00
Rate for Payer: Aetna Commercial	$190.62
Rate for Payer: Aetna Medicare Advantage	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$254.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$254.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$70.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$234.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$254.22
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: Cigna Medicare Advantage	$70.08
Rate for Payer: Clover Medicare Advantage	$66.58
Rate for Payer: EmblemHealth Commercial	$210.24
Rate for Payer: Humana Medicare Advantage	$72.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$70.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,404.00
Rate for Payer: Oxford Commercial	$2,169.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00
Rate for Payer: UnitedHealthcare Commercial	$2,460.00
Rate for Payer: UnitedHealthcare Community & State	$170.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$70.08
Rate for Payer: Wellcare Medicare Advantage	$70.08
Rate for Payer: Wellpoint Medicaid Managed Care	$153.36

HOLTER MONITOR SCANNING & RPT

Facility

$5,400.00

Service Code	HCPCS 93226
Hospital Charge Code	74115013
Hospital Revenue Code	731
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$810.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

HOLTER MONITOR SCANNING & RPT

Facility

$5,400.00

Service Code	HCPCS 93226
Hospital Charge Code	74117013
Hospital Revenue Code	731
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$810.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

HOLTER MONITOR SCAN, RPT, SET

Facility

$5,400.00

Service Code	HCPCS 93225
Hospital Charge Code	74115012
Hospital Revenue Code	731
Min. Negotiated Rate	$150.16
Max. Negotiated Rate	$2,460.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.36
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,404.00
Rate for Payer: Oxford Commercial	$2,169.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00
Rate for Payer: UnitedHealthcare Commercial	$2,460.00
Rate for Payer: UnitedHealthcare Community & State	$170.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$153.36

Know your out-of-pocket cost for care.

All Charges