Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

IMAGE CATH FLUID COLXN VISC

Facility

$5,392.12

Service Code	HCPCS 49405
Hospital Charge Code	16000386
Hospital Revenue Code	360
Min. Negotiated Rate	$153.14
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,401.95
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$808.82
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$170.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$153.14

IMAGE CATH FLUID COLXN VISC

Facility

$5,392.12

Service Code	HCPCS 49405
Hospital Charge Code	16000386
Hospital Revenue Code	360
Min. Negotiated Rate	$808.82
Max. Negotiated Rate	$808.82
Rate for Payer: Qualcare PPO/HMO/WC	$808.82

IMAGE CATH FLUID COLXN VISC

Facility

$8,054.80

Service Code	HCPCS 49406
Hospital Charge Code	321049406
Hospital Revenue Code	361
Min. Negotiated Rate	$1,208.22
Max. Negotiated Rate	$1,208.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22

IMAGE CATH FLUID COLXN VISC

Facility

$8,054.80

Service Code	HCPCS 49406
Hospital Charge Code	321049406
Hospital Revenue Code	361
Min. Negotiated Rate	$228.76
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,094.25
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$254.53
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$228.76

IMAGE CATH FLUID COLXN VISC

Facility

$8,054.80

Service Code	HCPCS 49406
Hospital Charge Code	2003093
Hospital Revenue Code	361
Min. Negotiated Rate	$228.76
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,094.25
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$254.53
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$228.76

IMAGE CATH FLUID COLXN VISC

Facility

$8,054.80

Service Code	HCPCS 49406
Hospital Charge Code	2003093
Hospital Revenue Code	361
Min. Negotiated Rate	$1,208.22
Max. Negotiated Rate	$1,208.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22

IMAGE CATH FLUID PE/RETRO

Facility

$14,529.00

Service Code	HCPCS 49406
Hospital Charge Code	16000258
Hospital Revenue Code	360
Min. Negotiated Rate	$412.62
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,777.54
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,179.35
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$459.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$412.62

IMAGE CATH FLUID PE/RETRO

Facility

$14,529.00

Service Code	HCPCS 49406
Hospital Charge Code	16000258
Hospital Revenue Code	360
Min. Negotiated Rate	$2,179.35
Max. Negotiated Rate	$2,179.35
Rate for Payer: Qualcare PPO/HMO/WC	$2,179.35

IMAGER II SELECT CATH 4F C1/65

Facility

$279.10

Hospital Charge Code	270679676
Hospital Revenue Code	272
Min. Negotiated Rate	$41.87
Max. Negotiated Rate	$41.87
Rate for Payer: Qualcare PPO/HMO/WC	$41.87

IMAGER II SELECT CATH 4F C1/65

Facility

$279.10

Hospital Charge Code	270679676
Hospital Revenue Code	272
Min. Negotiated Rate	$7.93
Max. Negotiated Rate	$139.55
Rate for Payer: Aetna Commercial	$106.06
Rate for Payer: Aetna Medicare Advantage	$83.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.17
Rate for Payer: Cigna Commercial	$139.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.57
Rate for Payer: Oxford Commercial	$55.82
Rate for Payer: Qualcare PPO/HMO/WC	$41.87
Rate for Payer: UnitedHealthcare Commercial	$55.82
Rate for Payer: UnitedHealthcare Community & State	$8.82
Rate for Payer: Wellpoint Medicaid Managed Care	$7.93

IMAGER II SELECT CATH 4F C2/65

Facility

$279.10

Hospital Charge Code	270679681
Hospital Revenue Code	272
Min. Negotiated Rate	$41.87
Max. Negotiated Rate	$41.87
Rate for Payer: Qualcare PPO/HMO/WC	$41.87

IMAGER II SELECT CATH 4F C2/65

Facility

$279.10

Hospital Charge Code	270679681
Hospital Revenue Code	272
Min. Negotiated Rate	$7.93
Max. Negotiated Rate	$139.55
Rate for Payer: Aetna Commercial	$106.06
Rate for Payer: Aetna Medicare Advantage	$83.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.17
Rate for Payer: Cigna Commercial	$139.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.57
Rate for Payer: Oxford Commercial	$55.82
Rate for Payer: Qualcare PPO/HMO/WC	$41.87
Rate for Payer: UnitedHealthcare Commercial	$55.82
Rate for Payer: UnitedHealthcare Community & State	$8.82
Rate for Payer: Wellpoint Medicaid Managed Care	$7.93

IMAGER II SELECT CATH 5F C1/65

Facility

$268.25

Hospital Charge Code	270679675
Hospital Revenue Code	272
Min. Negotiated Rate	$7.62
Max. Negotiated Rate	$134.12
Rate for Payer: Aetna Commercial	$101.94
Rate for Payer: Aetna Medicare Advantage	$80.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.40
Rate for Payer: Cigna Commercial	$134.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.75
Rate for Payer: Oxford Commercial	$53.65
Rate for Payer: Qualcare PPO/HMO/WC	$40.24
Rate for Payer: UnitedHealthcare Commercial	$53.65
Rate for Payer: UnitedHealthcare Community & State	$8.48
Rate for Payer: Wellpoint Medicaid Managed Care	$7.62

IMAGER II SELECT CATH 5F C1/65

Facility

$268.25

Hospital Charge Code	270679675
Hospital Revenue Code	272
Min. Negotiated Rate	$40.24
Max. Negotiated Rate	$40.24
Rate for Payer: Qualcare PPO/HMO/WC	$40.24

IMAGER II SELECT CATH 5F C2/65

Facility

$55.82

Hospital Charge Code	270627307
Hospital Revenue Code	272
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$27.91
Rate for Payer: Aetna Commercial	$21.21
Rate for Payer: Aetna Medicare Advantage	$16.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.23
Rate for Payer: Cigna Commercial	$27.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.51
Rate for Payer: Oxford Commercial	$11.16
Rate for Payer: Qualcare PPO/HMO/WC	$8.37
Rate for Payer: UnitedHealthcare Commercial	$11.16
Rate for Payer: UnitedHealthcare Community & State	$1.76
Rate for Payer: Wellpoint Medicaid Managed Care	$1.59

IMAGER II SELECT CATH 5F C2/65

Facility

$55.82

Hospital Charge Code	270627307
Hospital Revenue Code	272
Min. Negotiated Rate	$8.37
Max. Negotiated Rate	$8.37
Rate for Payer: Qualcare PPO/HMO/WC	$8.37

IMAG GUID DRAIN/CATH SOFT TISS

Facility

$5,102.15

Service Code	HCPCS 10030
Hospital Charge Code	321010030
Hospital Revenue Code	361
Min. Negotiated Rate	$765.32
Max. Negotiated Rate	$765.32
Rate for Payer: Qualcare PPO/HMO/WC	$765.32

IMAG GUID DRAIN/CATH SOFT TISS

Facility

$5,102.15

Service Code	HCPCS 10030
Hospital Charge Code	323010030
Hospital Revenue Code	450
Min. Negotiated Rate	$765.32
Max. Negotiated Rate	$765.32
Rate for Payer: Qualcare PPO/HMO/WC	$765.32

IMAG GUID DRAIN/CATH SOFT TISS

Facility

$5,102.15

Service Code	HCPCS 10030
Hospital Charge Code	2692120
Hospital Revenue Code	361
Min. Negotiated Rate	$144.90
Max. Negotiated Rate	$3,629.00
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
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	$3,051.74
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.56
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.32
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$161.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$144.90

IMAG GUID DRAIN/CATH SOFT TISS

Facility

$5,102.15

Service Code	HCPCS 10030
Hospital Charge Code	2692120
Hospital Revenue Code	361
Min. Negotiated Rate	$765.32
Max. Negotiated Rate	$765.32
Rate for Payer: Qualcare PPO/HMO/WC	$765.32

IMAG GUID DRAIN/CATH SOFT TISS

Facility

$5,102.15

Service Code	HCPCS 10030
Hospital Charge Code	323010030
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$3,051.74
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,051.74
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.56
Rate for Payer: Qualcare PPO/HMO/WC	$765.32
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$144.90

IMAG GUID DRAIN/CATH SOFT TISS

Facility

$5,102.15

Service Code	HCPCS 10030
Hospital Charge Code	7411332
Hospital Revenue Code	361
Min. Negotiated Rate	$144.90
Max. Negotiated Rate	$3,629.00
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
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	$3,051.74
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.56
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.32
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$161.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$144.90

IMAG GUID DRAIN/CATH SOFT TISS

Facility

$5,102.15

Service Code	HCPCS 10030
Hospital Charge Code	321010030
Hospital Revenue Code	361
Min. Negotiated Rate	$144.90
Max. Negotiated Rate	$3,629.00
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
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	$3,051.74
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.56
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.32
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$161.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$144.90

IMAG GUID DRAIN/CATH SOFT TISS

Facility

$5,102.15

Service Code	HCPCS 10030
Hospital Charge Code	7411332
Hospital Revenue Code	361
Min. Negotiated Rate	$765.32
Max. Negotiated Rate	$765.32
Rate for Payer: Qualcare PPO/HMO/WC	$765.32

IMA INJ

Facility

$440.85

Service Code	HCPCS 93564
Hospital Charge Code	5100136
Hospital Revenue Code	481
Min. Negotiated Rate	$66.13
Max. Negotiated Rate	$66.13
Rate for Payer: Qualcare PPO/HMO/WC	$66.13

Know your out-of-pocket cost for care.

All Charges