Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

INSERTION CHEST TUBE PNEUMOTHO

Facility

$2,275.00

Service Code	HCPCS 32422
Hospital Charge Code	5780175
Hospital Revenue Code	450
Min. Negotiated Rate	$64.61
Max. Negotiated Rate	$1,137.50
Rate for Payer: Aetna Commercial	$864.50
Rate for Payer: Aetna Medicare Advantage	$682.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$580.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$580.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$580.12
Rate for Payer: Cigna Commercial	$1,137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$591.50
Rate for Payer: Qualcare PPO/HMO/WC	$341.25
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$64.61

INSERTION CHEST TUBE PNEUMOTHO

Facility

$2,275.00

Service Code	HCPCS 32422
Hospital Charge Code	5780175
Hospital Revenue Code	450
Min. Negotiated Rate	$341.25
Max. Negotiated Rate	$341.25
Rate for Payer: Qualcare PPO/HMO/WC	$341.25

Insertion Guide

Facility

$6,852.35

Hospital Charge Code	270681577
Hospital Revenue Code	272
Min. Negotiated Rate	$194.61
Max. Negotiated Rate	$3,426.18
Rate for Payer: Aetna Commercial	$2,603.89
Rate for Payer: Aetna Medicare Advantage	$2,055.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,747.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,747.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,747.35
Rate for Payer: Cigna Commercial	$3,426.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,781.61
Rate for Payer: Oxford Commercial	$1,370.47
Rate for Payer: Qualcare PPO/HMO/WC	$1,027.85
Rate for Payer: UnitedHealthcare Commercial	$1,370.47
Rate for Payer: UnitedHealthcare Community & State	$216.53
Rate for Payer: Wellpoint Medicaid Managed Care	$194.61

Insertion Guide

Facility

$6,852.35

Hospital Charge Code	270681577
Hospital Revenue Code	272
Min. Negotiated Rate	$1,027.85
Max. Negotiated Rate	$1,027.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,027.85

INSERTION INTRA AORTIC BALLOON

Facility

$22,823.38

Service Code	HCPCS 33967
Hospital Charge Code	83120001
Hospital Revenue Code	361
Min. Negotiated Rate	$648.18
Max. Negotiated Rate	$20,109.00
Rate for Payer: Aetna Commercial	$8,672.88
Rate for Payer: Aetna Medicare Advantage	$6,847.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,819.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,819.96
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	$5,819.96
Rate for Payer: Cigna Commercial	$11,411.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,934.08
Rate for Payer: Oxford Commercial	$18,024.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,423.51
Rate for Payer: UnitedHealthcare Commercial	$20,109.00
Rate for Payer: UnitedHealthcare Community & State	$721.22
Rate for Payer: Wellpoint Medicaid Managed Care	$648.18

INSERTION INTRA AORTIC BALLOON

Facility

$22,823.38

Service Code	HCPCS 33967
Hospital Charge Code	83120001
Hospital Revenue Code	361
Min. Negotiated Rate	$3,423.51
Max. Negotiated Rate	$3,423.51
Rate for Payer: Qualcare PPO/HMO/WC	$3,423.51

INSERTION OF CATHETER VEIN

Facility

$907.20

Service Code	HCPCS 36500
Hospital Charge Code	366836500
Hospital Revenue Code	361
Min. Negotiated Rate	$136.08
Max. Negotiated Rate	$136.08
Rate for Payer: Qualcare PPO/HMO/WC	$136.08

INSERTION OF CATHETER VEIN

Facility

$907.20

Service Code	HCPCS 36500
Hospital Charge Code	366836500
Hospital Revenue Code	361
Min. Negotiated Rate	$25.76
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$344.74
Rate for Payer: Aetna Medicare Advantage	$272.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.34
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	$231.34
Rate for Payer: Cigna Commercial	$453.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.87
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$136.08
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$28.67
Rate for Payer: Wellpoint Medicaid Managed Care	$25.76

INSERTION OF CATHETER VEIN

Facility

$907.20

Service Code	HCPCS 36500
Hospital Charge Code	411036500
Hospital Revenue Code	361
Min. Negotiated Rate	$136.08
Max. Negotiated Rate	$136.08
Rate for Payer: Qualcare PPO/HMO/WC	$136.08

INSERTION OF CATHETER VEIN

Facility

$907.20

Service Code	HCPCS 36500
Hospital Charge Code	411036500
Hospital Revenue Code	361
Min. Negotiated Rate	$25.76
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$344.74
Rate for Payer: Aetna Medicare Advantage	$272.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.34
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	$231.34
Rate for Payer: Cigna Commercial	$453.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.87
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$136.08
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$28.67
Rate for Payer: Wellpoint Medicaid Managed Care	$25.76

INSERTION OF CERVICAL DILATOR

Facility

$1,124.96

Service Code	HCPCS 59200
Hospital Charge Code	73190141
Hospital Revenue Code	720
Min. Negotiated Rate	$168.74
Max. Negotiated Rate	$168.74
Rate for Payer: Qualcare PPO/HMO/WC	$168.74

INSERTION OF CERVICAL DILATOR

Facility

$1,124.96

Service Code	HCPCS 59200
Hospital Charge Code	73190141
Hospital Revenue Code	720
Min. Negotiated Rate	$31.95
Max. Negotiated Rate	$4,601.00
Rate for Payer: Aetna Commercial	$984.72
Rate for Payer: Aetna Medicare Advantage	$1,172.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,313.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,313.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$362.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,313.26
Rate for Payer: Cigna Commercial	$725.69
Rate for Payer: Cigna Medicare Advantage	$362.03
Rate for Payer: Clover Medicare Advantage	$343.93
Rate for Payer: EmblemHealth Commercial	$1,086.09
Rate for Payer: Humana Medicare Advantage	$372.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$362.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.49
Rate for Payer: Oxford Commercial	$4,053.00
Rate for Payer: Qualcare PPO/HMO/WC	$168.74
Rate for Payer: UnitedHealthcare Commercial	$4,601.00
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$362.03
Rate for Payer: Wellcare Medicare Advantage	$362.03
Rate for Payer: Wellpoint Medicaid Managed Care	$31.95

INSERTION OF CHEST TUBE

Facility

$11,525.10

Service Code	HCPCS 32551
Hospital Charge Code	1600000369
Hospital Revenue Code	360
Min. Negotiated Rate	$364.19
Max. Negotiated Rate	$6,783.93
Rate for Payer: Aetna Commercial	$5,086.78
Rate for Payer: Aetna Medicare Advantage	$6,059.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,783.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,783.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,870.14
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	$6,783.93
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: Cigna Medicare Advantage	$1,870.14
Rate for Payer: Clover Medicare Advantage	$1,776.63
Rate for Payer: EmblemHealth Commercial	$5,610.42
Rate for Payer: Humana Medicare Advantage	$1,926.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,870.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,996.53
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,728.77
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$364.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,870.14
Rate for Payer: Wellcare Medicare Advantage	$1,870.14
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$2,475.28
Rate for Payer: Wellpoint Medicaid Managed Care	$2,426.75

INSERTION OF CHEST TUBE

Facility

$11,525.10

Service Code	HCPCS 32551
Hospital Charge Code	1600000369
Hospital Revenue Code	360
Min. Negotiated Rate	$1,728.77
Max. Negotiated Rate	$1,728.77
Rate for Payer: Qualcare PPO/HMO/WC	$1,728.77

INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES

Facility

$27,101.75

Service Code	APR-DRG 1762
Min. Negotiated Rate	$26,570.34
Max. Negotiated Rate	$27,101.75
Rate for Payer: UnitedHealthcare Community & State	$26,570.34
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27,101.75
Rate for Payer: Wellpoint Medicaid Managed Care	$26,570.34

INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES

Facility

$22,633.01

Service Code	APR-DRG 1761
Min. Negotiated Rate	$22,189.23
Max. Negotiated Rate	$22,633.01
Rate for Payer: UnitedHealthcare Community & State	$22,189.23
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$22,633.01
Rate for Payer: Wellpoint Medicaid Managed Care	$22,189.23

INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES

Facility

$40,252.35

Service Code	APR-DRG 1763
Min. Negotiated Rate	$39,463.09
Max. Negotiated Rate	$40,252.35
Rate for Payer: UnitedHealthcare Community & State	$39,463.09
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$40,252.35
Rate for Payer: Wellpoint Medicaid Managed Care	$39,463.09

INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES

Facility

$67,521.24

Service Code	APR-DRG 1764
Min. Negotiated Rate	$66,197.29
Max. Negotiated Rate	$67,521.24
Rate for Payer: UnitedHealthcare Community & State	$66,197.29
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$67,521.24
Rate for Payer: Wellpoint Medicaid Managed Care	$66,197.29

INSERT IUD

Facility

$6,866.80

Service Code	HCPCS 58300
Hospital Charge Code	16001006
Hospital Revenue Code	360
Min. Negotiated Rate	$1,030.02
Max. Negotiated Rate	$1,030.02
Rate for Payer: Qualcare PPO/HMO/WC	$1,030.02

INSERT IUD

Facility

$6,866.80

Service Code	HCPCS 58300
Hospital Charge Code	16001006
Hospital Revenue Code	360
Min. Negotiated Rate	$195.02
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,609.38
Rate for Payer: Aetna Medicare Advantage	$2,060.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,751.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,751.03
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	$1,751.03
Rate for Payer: Cigna Commercial	$3,433.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,785.37
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,030.02
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$216.99
Rate for Payer: Wellpoint Medicaid Managed Care	$195.02

INSERT IVC FILTER

Facility

$13,353.00

Service Code	HCPCS 37191
Hospital Charge Code	366837191
Hospital Revenue Code	361
Min. Negotiated Rate	$379.23
Max. Negotiated Rate	$23,980.53
Rate for Payer: Aetna Commercial	$17,981.27
Rate for Payer: Aetna Medicare Advantage	$21,418.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,610.76
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	$23,980.53
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: Cigna Medicare Advantage	$6,610.76
Rate for Payer: Clover Medicare Advantage	$6,280.22
Rate for Payer: EmblemHealth Commercial	$19,832.28
Rate for Payer: Humana Medicare Advantage	$6,809.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,610.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,471.78
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,002.95
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$421.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,610.76
Rate for Payer: Wellcare Medicare Advantage	$6,610.76
Rate for Payer: Wellpoint Medicaid Managed Care	$379.23

INSERT IVC FILTER

Facility

$13,353.00

Service Code	HCPCS 37191
Hospital Charge Code	366837191
Hospital Revenue Code	361
Min. Negotiated Rate	$2,002.95
Max. Negotiated Rate	$2,002.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,002.95

INSERT KNEE 3D SIZE 8 10MM

Facility

$7,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270692262
Hospital Revenue Code	278
Min. Negotiated Rate	$1,162.50
Max. Negotiated Rate	$1,875.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,162.50

INSERT KNEE 3D SIZE 8 10MM

Facility

$7,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270692262
Hospital Revenue Code	278
Min. Negotiated Rate	$220.10
Max. Negotiated Rate	$3,875.00
Rate for Payer: Aetna Commercial	$2,945.00
Rate for Payer: Aetna Medicare Advantage	$2,325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,976.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,976.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,976.25
Rate for Payer: Cigna Commercial	$3,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,162.50
Rate for Payer: UnitedHealthcare Community & State	$244.90
Rate for Payer: Wellpoint Medicaid Managed Care	$220.10

INSERT LOCKING

Facility

$550.00

Hospital Charge Code	270640258
Hospital Revenue Code	278
Min. Negotiated Rate	$15.62
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$17.38
Rate for Payer: Wellpoint Medicaid Managed Care	$15.62

Know your out-of-pocket cost for care.

All Charges