Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

INTM EVAL MD CH/15MIN PH MCAID

Facility

$750.00

Service Code	HCPCS 90832
Hospital Charge Code	4510627
Hospital Revenue Code	914
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$764.93
Rate for Payer: Aetna Commercial	$573.57
Rate for Payer: Aetna Medicare Advantage	$683.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$764.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$764.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$210.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$764.93
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: Cigna Medicare Advantage	$210.87
Rate for Payer: Clover Medicare Advantage	$200.33
Rate for Payer: EmblemHealth Commercial	$632.61
Rate for Payer: Humana Medicare Advantage	$217.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$210.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$23.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$210.87
Rate for Payer: Wellcare Medicare Advantage	$210.87
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$71.39
Rate for Payer: Wellpoint Medicaid Managed Care	$21.30

INTM EVAL MD CH/15MIN PH MCAID

Facility

$750.00

Service Code	HCPCS 90832
Hospital Charge Code	4510627
Hospital Revenue Code	914
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

INTRA-ABD OMENTAL FLAP

Facility

$1,439.84

Service Code	HCPCS 49905
Hospital Charge Code	1600000436
Hospital Revenue Code	360
Min. Negotiated Rate	$40.89
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$547.14
Rate for Payer: Aetna Medicare Advantage	$431.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$367.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$367.16
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	$367.16
Rate for Payer: Cigna Commercial	$719.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$374.36
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$215.98
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$45.50
Rate for Payer: Wellpoint Medicaid Managed Care	$40.89

INTRA-ABD OMENTAL FLAP

Facility

$1,439.84

Service Code	HCPCS 49905
Hospital Charge Code	1600000499
Hospital Revenue Code	360
Min. Negotiated Rate	$215.98
Max. Negotiated Rate	$215.98
Rate for Payer: Qualcare PPO/HMO/WC	$215.98

INTRA-ABD OMENTAL FLAP

Facility

$1,439.84

Service Code	HCPCS 49905
Hospital Charge Code	1600000436
Hospital Revenue Code	360
Min. Negotiated Rate	$215.98
Max. Negotiated Rate	$215.98
Rate for Payer: Qualcare PPO/HMO/WC	$215.98

INTRA-ABD OMENTAL FLAP

Facility

$1,439.84

Service Code	HCPCS 49905
Hospital Charge Code	1600000499
Hospital Revenue Code	360
Min. Negotiated Rate	$40.89
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$547.14
Rate for Payer: Aetna Medicare Advantage	$431.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$367.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$367.16
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	$367.16
Rate for Payer: Cigna Commercial	$719.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$374.36
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$215.98
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$45.50
Rate for Payer: Wellpoint Medicaid Managed Care	$40.89

INTRACATH 16GX8 YELLOW

Facility

$38.00

Hospital Charge Code	270331478
Hospital Revenue Code	272
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$19.00
Rate for Payer: Aetna Commercial	$14.44
Rate for Payer: Aetna Medicare Advantage	$11.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.69
Rate for Payer: Cigna Commercial	$19.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.88
Rate for Payer: Oxford Commercial	$7.60
Rate for Payer: Qualcare PPO/HMO/WC	$5.70
Rate for Payer: UnitedHealthcare Commercial	$7.60
Rate for Payer: UnitedHealthcare Community & State	$1.20
Rate for Payer: Wellpoint Medicaid Managed Care	$1.08

INTRACATH 16GX8 YELLOW

Facility

$38.00

Hospital Charge Code	270331478
Hospital Revenue Code	272
Min. Negotiated Rate	$5.70
Max. Negotiated Rate	$5.70
Rate for Payer: Qualcare PPO/HMO/WC	$5.70

INTRACRAN ANGIOPLASTY W STENT

Facility

$58,920.00

Service Code	HCPCS 61635
Hospital Charge Code	411061635
Hospital Revenue Code	360
Min. Negotiated Rate	$8,838.00
Max. Negotiated Rate	$8,838.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,838.00

INTRACRAN ANGIOPLASTY W STENT

Facility

$58,920.00

Service Code	HCPCS 61635
Hospital Charge Code	411061635
Hospital Revenue Code	360
Min. Negotiated Rate	$1,673.33
Max. Negotiated Rate	$29,460.00
Rate for Payer: Aetna Commercial	$22,389.60
Rate for Payer: Aetna Medicare Advantage	$17,676.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,024.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,024.60
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	$15,024.60
Rate for Payer: Cigna Commercial	$29,460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15,319.20
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,838.00
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$1,861.87
Rate for Payer: Wellpoint Medicaid Managed Care	$1,673.33

INTRACRANIAL ANGIOPLASTY

Facility

$61,616.39

Service Code	HCPCS 61630
Hospital Charge Code	411061630
Hospital Revenue Code	361
Min. Negotiated Rate	$1,749.91
Max. Negotiated Rate	$30,808.19
Rate for Payer: Aetna Commercial	$23,414.23
Rate for Payer: Aetna Medicare Advantage	$18,484.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,712.18
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	$15,712.18
Rate for Payer: Cigna Commercial	$30,808.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,020.26
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$1,947.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1,749.91

INTRACRANIAL ANGIOPLASTY

Facility

$61,616.39

Service Code	HCPCS 61630
Hospital Charge Code	366861630
Hospital Revenue Code	361
Min. Negotiated Rate	$1,749.91
Max. Negotiated Rate	$30,808.19
Rate for Payer: Aetna Commercial	$23,414.23
Rate for Payer: Aetna Medicare Advantage	$18,484.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,712.18
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	$15,712.18
Rate for Payer: Cigna Commercial	$30,808.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,020.26
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$1,947.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1,749.91

INTRACRANIAL ANGIOPLASTY

Facility

$61,616.39

Service Code	HCPCS 61630
Hospital Charge Code	366861630
Hospital Revenue Code	361
Min. Negotiated Rate	$9,242.46
Max. Negotiated Rate	$9,242.46
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

INTRACRANIAL ANGIOPLASTY

Facility

$61,616.39

Service Code	HCPCS 61630
Hospital Charge Code	411061630
Hospital Revenue Code	361
Min. Negotiated Rate	$9,242.46
Max. Negotiated Rate	$9,242.46
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

INTRACRANIAL HEMORRHAGE

Facility

$14,100.01

Service Code	APR-DRG 0442
Min. Negotiated Rate	$13,823.54
Max. Negotiated Rate	$14,100.01
Rate for Payer: UnitedHealthcare Community & State	$13,823.54
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$14,100.01
Rate for Payer: Wellpoint Medicaid Managed Care	$13,823.54

INTRACRANIAL HEMORRHAGE

Facility

$18,396.00

Service Code	APR-DRG 0443
Min. Negotiated Rate	$18,035.29
Max. Negotiated Rate	$18,396.00
Rate for Payer: UnitedHealthcare Community & State	$18,035.29
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$18,396.00
Rate for Payer: Wellpoint Medicaid Managed Care	$18,035.29

INTRACRANIAL HEMORRHAGE

Facility

$21,090.98

Service Code	APR-DRG 0444
Min. Negotiated Rate	$20,677.43
Max. Negotiated Rate	$21,090.98
Rate for Payer: UnitedHealthcare Community & State	$20,677.43
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$21,090.98
Rate for Payer: Wellpoint Medicaid Managed Care	$20,677.43

INTRACRANIAL HEMORRHAGE

Facility

$10,135.39

Service Code	APR-DRG 0441
Min. Negotiated Rate	$9,936.66
Max. Negotiated Rate	$10,135.39
Rate for Payer: UnitedHealthcare Community & State	$9,936.66
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,135.39
Rate for Payer: Wellpoint Medicaid Managed Care	$9,936.66

INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS

Facility

$51,383.62

Service Code	MSDRG 065
Min. Negotiated Rate	$15,645.65
Max. Negotiated Rate	$51,383.62
Rate for Payer: Aetna Medicare Advantage	$51,383.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28,259.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28,259.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16,469.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28,259.10
Rate for Payer: Cigna Commercial	$22,522.62
Rate for Payer: Cigna Medicare Advantage	$16,469.11
Rate for Payer: Clover Medicare Advantage	$15,645.65
Rate for Payer: EmblemHealth Commercial	$49,407.33
Rate for Payer: Humana Medicare Advantage	$16,963.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16,469.11
Rate for Payer: Oxford Commercial	$17,801.49
Rate for Payer: UnitedHealthcare Commercial	$23,827.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$16,469.11
Rate for Payer: Wellcare Medicare Advantage	$16,469.11

INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC

Facility

$82,999.33

Service Code	MSDRG 064
Min. Negotiated Rate	$25,272.23
Max. Negotiated Rate	$82,999.33
Rate for Payer: Aetna Medicare Advantage	$82,999.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55,410.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55,410.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26,602.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55,410.00
Rate for Payer: Cigna Commercial	$44,831.22
Rate for Payer: Cigna Medicare Advantage	$26,602.35
Rate for Payer: Clover Medicare Advantage	$25,272.23
Rate for Payer: EmblemHealth Commercial	$79,807.05
Rate for Payer: Humana Medicare Advantage	$27,400.42
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26,602.35
Rate for Payer: Oxford Commercial	$35,433.82
Rate for Payer: UnitedHealthcare Commercial	$47,429.43
Rate for Payer: UnitedHealthcare Medicare Advantage	$26,602.35
Rate for Payer: Wellcare Medicare Advantage	$26,602.35

INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC

Facility

$41,087.28

Service Code	MSDRG 066
Min. Negotiated Rate	$12,059.13
Max. Negotiated Rate	$41,087.28
Rate for Payer: Aetna Medicare Advantage	$41,087.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19,116.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19,116.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,169.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19,116.45
Rate for Payer: Cigna Commercial	$15,257.33
Rate for Payer: Cigna Medicare Advantage	$13,169.00
Rate for Payer: Clover Medicare Advantage	$12,510.55
Rate for Payer: EmblemHealth Commercial	$39,507.00
Rate for Payer: Humana Medicare Advantage	$13,564.07
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,169.00
Rate for Payer: Oxford Commercial	$12,059.13
Rate for Payer: UnitedHealthcare Commercial	$16,141.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,169.00
Rate for Payer: Wellcare Medicare Advantage	$13,169.00

INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC

Facility

$186,714.62

Service Code	MSDRG 021
Min. Negotiated Rate	$56,852.21
Max. Negotiated Rate	$186,714.62
Rate for Payer: Aetna Medicare Advantage	$186,714.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170,108.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170,108.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$59,844.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170,108.70
Rate for Payer: Cigna Commercial	$118,014.68
Rate for Payer: Cigna Medicare Advantage	$59,844.43
Rate for Payer: Clover Medicare Advantage	$56,852.21
Rate for Payer: EmblemHealth Commercial	$179,533.29
Rate for Payer: Humana Medicare Advantage	$61,639.76
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$59,844.43
Rate for Payer: Oxford Commercial	$93,276.76
Rate for Payer: UnitedHealthcare Commercial	$124,854.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$59,844.43
Rate for Payer: Wellcare Medicare Advantage	$59,844.43

INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC

Facility

$268,068.06

Service Code	MSDRG 020
Min. Negotiated Rate	$81,623.29
Max. Negotiated Rate	$268,068.06
Rate for Payer: Aetna Medicare Advantage	$268,068.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$234,107.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$234,107.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85,919.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$234,107.25
Rate for Payer: Cigna Commercial	$175,419.16
Rate for Payer: Cigna Medicare Advantage	$85,919.25
Rate for Payer: Clover Medicare Advantage	$81,623.29
Rate for Payer: EmblemHealth Commercial	$257,757.75
Rate for Payer: Humana Medicare Advantage	$88,496.83
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85,919.25
Rate for Payer: Oxford Commercial	$138,648.26
Rate for Payer: UnitedHealthcare Commercial	$185,585.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$85,919.25
Rate for Payer: Wellcare Medicare Advantage	$85,919.25

INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC

Facility

$119,850.00

Service Code	MSDRG 022
Min. Negotiated Rate	$36,492.79
Max. Negotiated Rate	$119,850.00
Rate for Payer: Aetna Medicare Advantage	$119,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108,603.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108,603.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$38,413.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108,603.60
Rate for Payer: Cigna Commercial	$68,553.20
Rate for Payer: Cigna Medicare Advantage	$38,413.46
Rate for Payer: Clover Medicare Advantage	$36,492.79
Rate for Payer: EmblemHealth Commercial	$115,240.38
Rate for Payer: Humana Medicare Advantage	$39,565.86
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$38,413.46
Rate for Payer: Oxford Commercial	$54,183.26
Rate for Payer: UnitedHealthcare Commercial	$72,526.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$38,413.46
Rate for Payer: Wellcare Medicare Advantage	$38,413.46

INTRAFIX PEEK TP SCR 8-10x30MM

Facility

$1,420.00

Service Code	HCPCS C1713
Hospital Charge Code	270673367
Hospital Revenue Code	278
Min. Negotiated Rate	$40.33
Max. Negotiated Rate	$710.00
Rate for Payer: Aetna Commercial	$539.60
Rate for Payer: Aetna Medicare Advantage	$426.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$362.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$362.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$362.10
Rate for Payer: Cigna Commercial	$710.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$343.64
Rate for Payer: Qualcare PPO/HMO/WC	$213.00
Rate for Payer: UnitedHealthcare Community & State	$44.87
Rate for Payer: Wellpoint Medicaid Managed Care	$40.33

Know your out-of-pocket cost for care.

All Charges