Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

INJECTOR CT SYRINGE FL SINGLE

Facility

$35.80

Hospital Charge Code	270690350
Hospital Revenue Code	272
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$17.90
Rate for Payer: Aetna Commercial	$13.60
Rate for Payer: Aetna Medicare Advantage	$10.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.13
Rate for Payer: Cigna Commercial	$17.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.31
Rate for Payer: Oxford Commercial	$7.16
Rate for Payer: Qualcare PPO/HMO/WC	$5.37
Rate for Payer: UnitedHealthcare Commercial	$7.16
Rate for Payer: UnitedHealthcare Community & State	$1.13
Rate for Payer: Wellpoint Medicaid Managed Care	$1.02

INJECTOR SYRINGE FASTLOAD MR

Facility

$66.00

Hospital Charge Code	270690351
Hospital Revenue Code	272
Min. Negotiated Rate	$9.90
Max. Negotiated Rate	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$9.90

INJECTOR SYRINGE FASTLOAD MR

Facility

$66.00

Hospital Charge Code	270690351
Hospital Revenue Code	272
Min. Negotiated Rate	$1.87
Max. Negotiated Rate	$33.00
Rate for Payer: Aetna Commercial	$25.08
Rate for Payer: Aetna Medicare Advantage	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.83
Rate for Payer: Cigna Commercial	$33.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.16
Rate for Payer: Oxford Commercial	$13.20
Rate for Payer: Qualcare PPO/HMO/WC	$9.90
Rate for Payer: UnitedHealthcare Commercial	$13.20
Rate for Payer: UnitedHealthcare Community & State	$2.09
Rate for Payer: Wellpoint Medicaid Managed Care	$1.87

INJECT R VENTR/ATRIAL ANGIO

Facility

$6,070.00

Service Code	HCPCS 93566
Hospital Charge Code	411093566
Hospital Revenue Code	481
Min. Negotiated Rate	$910.50
Max. Negotiated Rate	$910.50
Rate for Payer: Qualcare PPO/HMO/WC	$910.50

INJECT R VENTR/ATRIAL ANGIO

Facility

$6,070.00

Service Code	HCPCS 93566
Hospital Charge Code	411093566
Hospital Revenue Code	481
Min. Negotiated Rate	$172.39
Max. Negotiated Rate	$4,213.00
Rate for Payer: Aetna Commercial	$2,306.60
Rate for Payer: Aetna Medicare Advantage	$1,821.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,547.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,547.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,547.85
Rate for Payer: Cigna Commercial	$3,035.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,578.20
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$910.50
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$191.81
Rate for Payer: Wellpoint Medicaid Managed Care	$172.39

INJECT SACROILIAC JOINT

Facility

$3,087.00

Service Code	HCPCS G0259
Hospital Charge Code	3215G0259
Hospital Revenue Code	361
Min. Negotiated Rate	$87.67
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,173.06
Rate for Payer: Aetna Medicare Advantage	$926.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$787.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$787.18
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	$787.18
Rate for Payer: Cigna Commercial	$1,543.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$802.62
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$463.05
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$97.55
Rate for Payer: Wellpoint Medicaid Managed Care	$87.67

INJECT SACROILIAC JOINT

Facility

$12,825.00

Service Code	HCPCS 27096
Hospital Charge Code	16000706
Hospital Revenue Code	360
Min. Negotiated Rate	$364.23
Max. Negotiated Rate	$6,412.50
Rate for Payer: Aetna Commercial	$4,873.50
Rate for Payer: Aetna Medicare Advantage	$3,847.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,270.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,270.38
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	$3,270.38
Rate for Payer: Cigna Commercial	$6,412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,334.50
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,923.75
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$405.27
Rate for Payer: Wellpoint Medicaid Managed Care	$364.23

INJECT SACROILIAC JOINT

Facility

$12,825.00

Service Code	HCPCS 27096
Hospital Charge Code	16000706
Hospital Revenue Code	360
Min. Negotiated Rate	$1,923.75
Max. Negotiated Rate	$1,923.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,923.75

INJECT SACROILIAC JOINT

Facility

$3,087.00

Service Code	HCPCS G0259
Hospital Charge Code	3215G0259
Hospital Revenue Code	361
Min. Negotiated Rate	$463.05
Max. Negotiated Rate	$463.05
Rate for Payer: Qualcare PPO/HMO/WC	$463.05

INJECT SKIN LESIONS </= 7

Facility

$1,033.25

Service Code	HCPCS 11900
Hospital Charge Code	412311900
Hospital Revenue Code	361
Min. Negotiated Rate	$154.99
Max. Negotiated Rate	$154.99
Rate for Payer: Qualcare PPO/HMO/WC	$154.99

INJECT SKIN LESIONS </= 7

Facility

$1,033.25

Service Code	HCPCS 11900
Hospital Charge Code	412311900
Hospital Revenue Code	361
Min. Negotiated Rate	$29.34
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$648.34
Rate for Payer: Aetna Medicare Advantage	$772.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$864.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$864.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$238.36
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	$864.65
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: Cigna Medicare Advantage	$238.36
Rate for Payer: Clover Medicare Advantage	$226.44
Rate for Payer: EmblemHealth Commercial	$715.08
Rate for Payer: Humana Medicare Advantage	$245.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$238.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.64
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$154.99
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$32.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$29.34

INJECT SKIN LESIONS >7

Facility

$1,033.25

Service Code	HCPCS 11901
Hospital Charge Code	412311901
Hospital Revenue Code	361
Min. Negotiated Rate	$29.34
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$648.34
Rate for Payer: Aetna Medicare Advantage	$772.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$864.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$864.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$238.36
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	$864.65
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: Cigna Medicare Advantage	$238.36
Rate for Payer: Clover Medicare Advantage	$226.44
Rate for Payer: EmblemHealth Commercial	$715.08
Rate for Payer: Humana Medicare Advantage	$245.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$238.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.64
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$154.99
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$32.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$29.34

INJECT SKIN LESIONS >7

Facility

$1,033.25

Service Code	HCPCS 11901
Hospital Charge Code	412311901
Hospital Revenue Code	361
Min. Negotiated Rate	$154.99
Max. Negotiated Rate	$154.99
Rate for Payer: Qualcare PPO/HMO/WC	$154.99

INJECT SPINE C/T

Facility

$3,466.32

Service Code	HCPCS 62320
Hospital Charge Code	16000767
Hospital Revenue Code	360
Min. Negotiated Rate	$109.54
Max. Negotiated Rate	$3,629.00
Rate for Payer: Aetna Commercial	$2,281.02
Rate for Payer: Aetna Medicare Advantage	$2,717.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,042.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,042.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$838.61
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	$3,042.06
Rate for Payer: Cigna Commercial	$1,680.99
Rate for Payer: Cigna Medicare Advantage	$838.61
Rate for Payer: Clover Medicare Advantage	$796.68
Rate for Payer: EmblemHealth Commercial	$2,515.83
Rate for Payer: Humana Medicare Advantage	$863.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$838.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$901.24
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$519.95
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$109.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$838.61
Rate for Payer: Wellcare Medicare Advantage	$838.61

INJECT SPINE C/T

Facility

$3,466.32

Service Code	HCPCS 62320
Hospital Charge Code	16000767
Hospital Revenue Code	360
Min. Negotiated Rate	$519.95
Max. Negotiated Rate	$519.95
Rate for Payer: Qualcare PPO/HMO/WC	$519.95

INJECT SPINE DISK X-RAY LUMBAR

Facility

$6,095.00

Service Code	HCPCS 62290
Hospital Charge Code	16000523
Hospital Revenue Code	360
Min. Negotiated Rate	$173.10
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,316.10
Rate for Payer: Aetna Medicare Advantage	$1,828.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,554.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,554.22
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	$1,554.22
Rate for Payer: Cigna Commercial	$3,047.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,584.70
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$914.25
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$192.60
Rate for Payer: Wellpoint Medicaid Managed Care	$173.10

INJECT SPINE DISK X-RAY LUMBAR

Facility

$6,095.00

Service Code	HCPCS 62290
Hospital Charge Code	16000523
Hospital Revenue Code	360
Min. Negotiated Rate	$914.25
Max. Negotiated Rate	$914.25
Rate for Payer: Qualcare PPO/HMO/WC	$914.25

INJECT TGGER POINTS =/>3

Facility

$4,088.04

Service Code	HCPCS 20553
Hospital Charge Code	1600000442
Hospital Revenue Code	360
Min. Negotiated Rate	$613.21
Max. Negotiated Rate	$613.21
Rate for Payer: Qualcare PPO/HMO/WC	$613.21

INJECT TGGER POINTS =/>3

Facility

$4,088.04

Service Code	HCPCS 20553
Hospital Charge Code	1600000442
Hospital Revenue Code	360
Min. Negotiated Rate	$116.10
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$991.90
Rate for Payer: Aetna Medicare Advantage	$1,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,322.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,322.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$364.67
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	$1,322.84
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: Cigna Medicare Advantage	$364.67
Rate for Payer: Clover Medicare Advantage	$346.44
Rate for Payer: EmblemHealth Commercial	$1,094.01
Rate for Payer: Humana Medicare Advantage	$375.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$364.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,062.89
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$613.21
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$129.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$364.67
Rate for Payer: Wellcare Medicare Advantage	$364.67
Rate for Payer: Wellpoint Medicaid Managed Care	$116.10

INJ ERCP

Facility

$10,268.63

Hospital Charge Code	2011500
Hospital Revenue Code	361
Min. Negotiated Rate	$1,540.29
Max. Negotiated Rate	$1,540.29
Rate for Payer: Qualcare PPO/HMO/WC	$1,540.29

INJ ERCP

Facility

$10,268.63

Hospital Charge Code	2011500
Hospital Revenue Code	361
Min. Negotiated Rate	$291.63
Max. Negotiated Rate	$5,134.31
Rate for Payer: Aetna Commercial	$3,902.08
Rate for Payer: Aetna Medicare Advantage	$3,080.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,618.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,618.50
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	$2,618.50
Rate for Payer: Cigna Commercial	$5,134.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,669.84
Rate for Payer: Qualcare PPO/HMO/WC	$1,540.29
Rate for Payer: UnitedHealthcare Community & State	$324.49
Rate for Payer: Wellpoint Medicaid Managed Care	$291.63

INJETAK ADJUSTABLE NEEDLE 70CM

Facility

$1,196.00

Hospital Charge Code	270702238
Hospital Revenue Code	279
Min. Negotiated Rate	$179.40
Max. Negotiated Rate	$179.40
Rate for Payer: Qualcare PPO/HMO/WC	$179.40

INJETAK ADJUSTABLE NEEDLE 70CM

Facility

$1,196.00

Hospital Charge Code	270702238
Hospital Revenue Code	279
Min. Negotiated Rate	$33.97
Max. Negotiated Rate	$598.00
Rate for Payer: Aetna Commercial	$454.48
Rate for Payer: Aetna Medicare Advantage	$358.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$304.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$304.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$304.98
Rate for Payer: Cigna Commercial	$598.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.96
Rate for Payer: Oxford Commercial	$239.20
Rate for Payer: Qualcare PPO/HMO/WC	$179.40
Rate for Payer: UnitedHealthcare Commercial	$239.20
Rate for Payer: UnitedHealthcare Community & State	$37.79
Rate for Payer: Wellpoint Medicaid Managed Care	$33.97

INJ FORAMEN EPIDURAL ADD-ON

Facility

$3,152.73

Service Code	HCPCS 64484
Hospital Charge Code	1600000459
Hospital Revenue Code	360
Min. Negotiated Rate	$99.63
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,198.04
Rate for Payer: Aetna Medicare Advantage	$945.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$803.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$803.95
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	$803.95
Rate for Payer: Cigna Commercial	$1,576.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$819.71
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$472.91
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$99.63

INJ FORAMEN EPIDURAL ADD-ON

Facility

$3,152.73

Service Code	HCPCS 64484
Hospital Charge Code	1600000459
Hospital Revenue Code	360
Min. Negotiated Rate	$472.91
Max. Negotiated Rate	$472.91
Rate for Payer: Qualcare PPO/HMO/WC	$472.91

Know your out-of-pocket cost for care.

All Charges