Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ANCHOR XX BRAID TT 1.2MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270692395
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

ANCHOR XX BRAID TT 1.2MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270692395
Hospital Revenue Code	278
Min. Negotiated Rate	$17.04
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Community & State	$18.96
Rate for Payer: Wellpoint Medicaid Managed Care	$17.04

ANCHR ICONIX 2.3MM W/X-BRAID

Facility

$2,590.00

Hospital Charge Code	270683343
Hospital Revenue Code	272
Min. Negotiated Rate	$73.56
Max. Negotiated Rate	$1,295.00
Rate for Payer: Aetna Commercial	$984.20
Rate for Payer: Aetna Medicare Advantage	$777.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$660.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$660.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$660.45
Rate for Payer: Cigna Commercial	$1,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$673.40
Rate for Payer: Oxford Commercial	$518.00
Rate for Payer: Qualcare PPO/HMO/WC	$388.50
Rate for Payer: UnitedHealthcare Commercial	$518.00
Rate for Payer: UnitedHealthcare Community & State	$81.84
Rate for Payer: Wellpoint Medicaid Managed Care	$73.56

ANCHR ICONIX 2.3MM W/X-BRAID

Facility

$2,590.00

Hospital Charge Code	270683343
Hospital Revenue Code	272
Min. Negotiated Rate	$388.50
Max. Negotiated Rate	$388.50
Rate for Payer: Qualcare PPO/HMO/WC	$388.50

ANDROSTANEDIOL GLUCURONI

Facility

$333.00

Service Code	HCPCS 82154
Hospital Charge Code	38472438
Hospital Revenue Code	301
Min. Negotiated Rate	$9.46
Max. Negotiated Rate	$166.50
Rate for Payer: Aetna Commercial	$78.42
Rate for Payer: Aetna Medicare Advantage	$93.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$104.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$104.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$28.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$104.58
Rate for Payer: Cigna Commercial	$166.50
Rate for Payer: Cigna Medicare Advantage	$28.83
Rate for Payer: Clover Medicare Advantage	$27.39
Rate for Payer: EmblemHealth Commercial	$86.49
Rate for Payer: Humana Medicare Advantage	$29.69
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$28.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.58
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.95
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$23.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$28.83
Rate for Payer: Wellcare Medicare Advantage	$28.83
Rate for Payer: Wellpoint Medicaid Managed Care	$9.46

ANDROSTANEDIOL GLUCURONI

Facility

$333.00

Service Code	HCPCS 82154
Hospital Charge Code	38472438
Hospital Revenue Code	301
Min. Negotiated Rate	$49.95
Max. Negotiated Rate	$49.95
Rate for Payer: Qualcare PPO/HMO/WC	$49.95

ANDROSTENEDIONE

Facility

$487.00

Service Code	HCPCS 82157
Hospital Charge Code	38472107
Hospital Revenue Code	301
Min. Negotiated Rate	$73.05
Max. Negotiated Rate	$73.05
Rate for Payer: Qualcare PPO/HMO/WC	$73.05

ANDROSTENEDIONE

Facility

$390.00

Service Code	HCPCS 82157
Hospital Charge Code	39900507
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$79.64
Rate for Payer: Aetna Medicare Advantage	$94.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.21
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$29.28
Rate for Payer: Clover Medicare Advantage	$27.82
Rate for Payer: EmblemHealth Commercial	$87.84
Rate for Payer: Humana Medicare Advantage	$30.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$29.28
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	$23.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.28
Rate for Payer: Wellcare Medicare Advantage	$29.28
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

ANDROSTENEDIONE

Facility

$390.00

Service Code	HCPCS 82157
Hospital Charge Code	39900507
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ANDROSTENEDIONE

Facility

$487.00

Service Code	HCPCS 82157
Hospital Charge Code	38472107
Hospital Revenue Code	301
Min. Negotiated Rate	$13.83
Max. Negotiated Rate	$243.50
Rate for Payer: Aetna Commercial	$79.64
Rate for Payer: Aetna Medicare Advantage	$94.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.21
Rate for Payer: Cigna Commercial	$243.50
Rate for Payer: Cigna Medicare Advantage	$29.28
Rate for Payer: Clover Medicare Advantage	$27.82
Rate for Payer: EmblemHealth Commercial	$87.84
Rate for Payer: Humana Medicare Advantage	$30.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$29.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.62
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$73.05
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$23.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.28
Rate for Payer: Wellcare Medicare Advantage	$29.28
Rate for Payer: Wellpoint Medicaid Managed Care	$13.83

ANDROSTENEDIONE,LC/MS/MS

Facility

$201.20

Service Code	HCPCS 82157
Hospital Charge Code	39900042
Hospital Revenue Code	301
Min. Negotiated Rate	$30.18
Max. Negotiated Rate	$30.18
Rate for Payer: Qualcare PPO/HMO/WC	$30.18

ANDROSTENEDIONE,LC/MS/MS

Facility

$201.20

Service Code	HCPCS 82157
Hospital Charge Code	39900042
Hospital Revenue Code	301
Min. Negotiated Rate	$5.71
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$79.64
Rate for Payer: Aetna Medicare Advantage	$94.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.21
Rate for Payer: Cigna Commercial	$100.60
Rate for Payer: Cigna Medicare Advantage	$29.28
Rate for Payer: Clover Medicare Advantage	$27.82
Rate for Payer: EmblemHealth Commercial	$87.84
Rate for Payer: Humana Medicare Advantage	$30.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$29.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.31
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.18
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$23.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.28
Rate for Payer: Wellcare Medicare Advantage	$29.28
Rate for Payer: Wellpoint Medicaid Managed Care	$5.71

ANES - C-SECTION

Facility

$2,802.00

Hospital Charge Code	73190158
Hospital Revenue Code	370
Min. Negotiated Rate	$420.30
Max. Negotiated Rate	$420.30
Rate for Payer: Qualcare PPO/HMO/WC	$420.30

ANES - C-SECTION

Facility

$2,802.00

Hospital Charge Code	73190158
Hospital Revenue Code	370
Min. Negotiated Rate	$79.58
Max. Negotiated Rate	$1,401.00
Rate for Payer: Aetna Commercial	$1,064.76
Rate for Payer: Aetna Medicare Advantage	$840.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.51
Rate for Payer: Cigna Commercial	$1,401.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$728.52
Rate for Payer: Oxford Commercial	$560.40
Rate for Payer: Qualcare PPO/HMO/WC	$420.30
Rate for Payer: UnitedHealthcare Commercial	$560.40
Rate for Payer: UnitedHealthcare Community & State	$88.54
Rate for Payer: Wellpoint Medicaid Managed Care	$79.58

ANES - C-SEC W/ PROC

Facility

$3,308.00

Hospital Charge Code	73190159
Hospital Revenue Code	370
Min. Negotiated Rate	$93.95
Max. Negotiated Rate	$1,654.00
Rate for Payer: Aetna Commercial	$1,257.04
Rate for Payer: Aetna Medicare Advantage	$992.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$843.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$843.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$843.54
Rate for Payer: Cigna Commercial	$1,654.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$860.08
Rate for Payer: Oxford Commercial	$661.60
Rate for Payer: Qualcare PPO/HMO/WC	$496.20
Rate for Payer: UnitedHealthcare Commercial	$661.60
Rate for Payer: UnitedHealthcare Community & State	$104.53
Rate for Payer: Wellpoint Medicaid Managed Care	$93.95

ANES - C-SEC W/ PROC

Facility

$3,308.00

Hospital Charge Code	73190159
Hospital Revenue Code	370
Min. Negotiated Rate	$496.20
Max. Negotiated Rate	$496.20
Rate for Payer: Qualcare PPO/HMO/WC	$496.20

ANES FEM NERVE BLOCK

Facility

$3,185.75

Service Code	HCPCS 64447
Hospital Charge Code	1650096
Hospital Revenue Code	361
Min. Negotiated Rate	$477.86
Max. Negotiated Rate	$477.86
Rate for Payer: Qualcare PPO/HMO/WC	$477.86

ANES FEM NERVE BLOCK

Facility

$3,185.75

Service Code	HCPCS 64447
Hospital Charge Code	1650096
Hospital Revenue Code	361
Min. Negotiated Rate	$90.48
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	$828.29
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$477.86
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$100.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$838.61
Rate for Payer: Wellcare Medicare Advantage	$838.61
Rate for Payer: Wellpoint Medicaid Managed Care	$90.48

ANES IV SED FIRST HR

Facility

$1,937.60

Hospital Charge Code	1650015
Hospital Revenue Code	370
Min. Negotiated Rate	$290.64
Max. Negotiated Rate	$290.64
Rate for Payer: Qualcare PPO/HMO/WC	$290.64

ANES IV SED FIRST HR

Facility

$1,937.60

Hospital Charge Code	1650015
Hospital Revenue Code	370
Min. Negotiated Rate	$55.03
Max. Negotiated Rate	$968.80
Rate for Payer: Aetna Commercial	$736.29
Rate for Payer: Aetna Medicare Advantage	$581.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$494.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$494.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$494.09
Rate for Payer: Cigna Commercial	$968.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$503.78
Rate for Payer: Oxford Commercial	$387.52
Rate for Payer: Qualcare PPO/HMO/WC	$290.64
Rate for Payer: UnitedHealthcare Commercial	$387.52
Rate for Payer: UnitedHealthcare Community & State	$61.23
Rate for Payer: Wellpoint Medicaid Managed Care	$55.03

ANES POP NERVE BLOCK

Facility

$3,506.55

Service Code	HCPCS 64450
Hospital Charge Code	1650098
Hospital Revenue Code	361
Min. Negotiated Rate	$99.59
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	$911.70
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.98
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$110.81
Rate for Payer: UnitedHealthcare Medicare Advantage	$838.61
Rate for Payer: Wellcare Medicare Advantage	$838.61
Rate for Payer: Wellpoint Medicaid Managed Care	$99.59

ANES POP NERVE BLOCK

Facility

$3,506.55

Service Code	HCPCS 64450
Hospital Charge Code	1650098
Hospital Revenue Code	361
Min. Negotiated Rate	$525.98
Max. Negotiated Rate	$525.98
Rate for Payer: Qualcare PPO/HMO/WC	$525.98

ANES - PROC ONLY

Facility

$2,802.00

Hospital Charge Code	73190160
Hospital Revenue Code	370
Min. Negotiated Rate	$420.30
Max. Negotiated Rate	$420.30
Rate for Payer: Qualcare PPO/HMO/WC	$420.30

ANES - PROC ONLY

Facility

$2,802.00

Hospital Charge Code	73190160
Hospital Revenue Code	370
Min. Negotiated Rate	$79.58
Max. Negotiated Rate	$1,401.00
Rate for Payer: Aetna Commercial	$1,064.76
Rate for Payer: Aetna Medicare Advantage	$840.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.51
Rate for Payer: Cigna Commercial	$1,401.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$728.52
Rate for Payer: Oxford Commercial	$560.40
Rate for Payer: Qualcare PPO/HMO/WC	$420.30
Rate for Payer: UnitedHealthcare Commercial	$560.40
Rate for Payer: UnitedHealthcare Community & State	$88.54
Rate for Payer: Wellpoint Medicaid Managed Care	$79.58

ANESTHESIA AX BLOCK W US

Facility

$700.00

Hospital Charge Code	1650055
Hospital Revenue Code	370
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.00
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Commercial	$140.00
Rate for Payer: UnitedHealthcare Community & State	$22.12
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

Know your out-of-pocket cost for care.

All Charges