Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

INTRO VISTABRITE 8FR 403-8553A

Facility

$281.85

Service Code	HCPCS C1887
Hospital Charge Code	270624374C
Hospital Revenue Code	278
Min. Negotiated Rate	$42.28
Max. Negotiated Rate	$68.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.21
Rate for Payer: Qualcare PPO/HMO/WC	$42.28

INTRO VISTABRITE 8FR 403-8553A

Facility

$281.85

Service Code	HCPCS C1887
Hospital Charge Code	270624374C
Hospital Revenue Code	278
Min. Negotiated Rate	$8.00
Max. Negotiated Rate	$140.93
Rate for Payer: Aetna Commercial	$107.10
Rate for Payer: Aetna Medicare Advantage	$84.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.87
Rate for Payer: Cigna Commercial	$140.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.21
Rate for Payer: Qualcare PPO/HMO/WC	$42.28
Rate for Payer: UnitedHealthcare Community & State	$8.91
Rate for Payer: Wellpoint Medicaid Managed Care	$8.00

INTRPHALANG TOE JNT EXC EA SGL

Facility

$19,998.60

Service Code	HCPCS 28160
Hospital Charge Code	16000402
Hospital Revenue Code	360
Min. Negotiated Rate	$2,999.79
Max. Negotiated Rate	$2,999.79
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79

INTRPHALANG TOE JNT EXC EA SGL

Facility

$19,998.60

Service Code	HCPCS 28160
Hospital Charge Code	16000402
Hospital Revenue Code	360
Min. Negotiated Rate	$567.96
Max. Negotiated Rate	$14,100.89
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
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	$14,100.89
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,199.64
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$631.96
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$567.96

INTRVASC US NONCORONARY 1ST

Facility

$5,170.30

Service Code	HCPCS 37252
Hospital Charge Code	366837252
Hospital Revenue Code	361
Min. Negotiated Rate	$146.84
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,964.71
Rate for Payer: Aetna Medicare Advantage	$1,551.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,318.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,318.43
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	$1,318.43
Rate for Payer: Cigna Commercial	$2,585.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,344.28
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$775.54
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$163.38
Rate for Payer: Wellpoint Medicaid Managed Care	$146.84

INTRVASC US NONCORONARY 1ST

Facility

$5,170.30

Service Code	HCPCS 37252
Hospital Charge Code	366837252
Hospital Revenue Code	361
Min. Negotiated Rate	$775.54
Max. Negotiated Rate	$775.54
Rate for Payer: Qualcare PPO/HMO/WC	$775.54

INTRVASC US NONCORONARY 1ST

Facility

$5,170.30

Service Code	HCPCS 37252
Hospital Charge Code	411037252
Hospital Revenue Code	361
Min. Negotiated Rate	$146.84
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,964.71
Rate for Payer: Aetna Medicare Advantage	$1,551.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,318.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,318.43
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	$1,318.43
Rate for Payer: Cigna Commercial	$2,585.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,344.28
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$775.54
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$163.38
Rate for Payer: Wellpoint Medicaid Managed Care	$146.84

INTRVASC US NONCORONARY 1ST

Facility

$5,170.30

Service Code	HCPCS 37252
Hospital Charge Code	411037252
Hospital Revenue Code	361
Min. Negotiated Rate	$775.54
Max. Negotiated Rate	$775.54
Rate for Payer: Qualcare PPO/HMO/WC	$775.54

INTRVASC US NONCORONARY ADDL

Facility

$5,170.30

Service Code	HCPCS 37253
Hospital Charge Code	366837253
Hospital Revenue Code	361
Min. Negotiated Rate	$775.54
Max. Negotiated Rate	$775.54
Rate for Payer: Qualcare PPO/HMO/WC	$775.54

INTRVASC US NONCORONARY ADDL

Facility

$5,170.30

Service Code	HCPCS 37253
Hospital Charge Code	366837253
Hospital Revenue Code	361
Min. Negotiated Rate	$146.84
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,964.71
Rate for Payer: Aetna Medicare Advantage	$1,551.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,318.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,318.43
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	$1,318.43
Rate for Payer: Cigna Commercial	$2,585.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,344.28
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$775.54
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$163.38
Rate for Payer: Wellpoint Medicaid Managed Care	$146.84

INTRVASC US NONCORONARY ADDL

Facility

$5,170.30

Service Code	HCPCS 37253
Hospital Charge Code	411037253
Hospital Revenue Code	361
Min. Negotiated Rate	$146.84
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,964.71
Rate for Payer: Aetna Medicare Advantage	$1,551.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,318.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,318.43
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	$1,318.43
Rate for Payer: Cigna Commercial	$2,585.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,344.28
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$775.54
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$163.38
Rate for Payer: Wellpoint Medicaid Managed Care	$146.84

INTRVASC US NONCORONARY ADDL

Facility

$5,170.30

Service Code	HCPCS 37253
Hospital Charge Code	411037253
Hospital Revenue Code	361
Min. Negotiated Rate	$775.54
Max. Negotiated Rate	$775.54
Rate for Payer: Qualcare PPO/HMO/WC	$775.54

INT TRANSF PEDICLE FLAP

Facility

$16,584.80

Service Code	HCPCS 15650
Hospital Charge Code	16000370
Hospital Revenue Code	360
Min. Negotiated Rate	$471.01
Max. Negotiated Rate	$8,891.84
Rate for Payer: Aetna Commercial	$6,667.35
Rate for Payer: Aetna Medicare Advantage	$7,941.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,891.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,891.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,451.23
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	$8,891.84
Rate for Payer: Cigna Commercial	$4,913.48
Rate for Payer: Cigna Medicare Advantage	$2,451.23
Rate for Payer: Clover Medicare Advantage	$2,328.67
Rate for Payer: EmblemHealth Commercial	$7,353.69
Rate for Payer: Humana Medicare Advantage	$2,524.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,451.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,312.05
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,487.72
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$524.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,451.23
Rate for Payer: Wellcare Medicare Advantage	$2,451.23
Rate for Payer: Wellpoint Medicaid Managed Care	$471.01

INT TRANSF PEDICLE FLAP

Facility

$16,584.80

Service Code	HCPCS 15650
Hospital Charge Code	16000370
Hospital Revenue Code	360
Min. Negotiated Rate	$2,487.72
Max. Negotiated Rate	$2,487.72
Rate for Payer: Qualcare PPO/HMO/WC	$2,487.72

INTUBATION ENDOTRACHEAL

Facility

$1,278.15

Service Code	HCPCS 31500
Hospital Charge Code	9500055
Hospital Revenue Code	361
Min. Negotiated Rate	$40.39
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$765.35
Rate for Payer: Aetna Medicare Advantage	$911.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$281.38
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	$1,020.71
Rate for Payer: Cigna Commercial	$564.04
Rate for Payer: Cigna Medicare Advantage	$281.38
Rate for Payer: Clover Medicare Advantage	$267.31
Rate for Payer: EmblemHealth Commercial	$844.14
Rate for Payer: Humana Medicare Advantage	$289.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$281.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.32
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$191.72
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$40.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$281.38
Rate for Payer: Wellcare Medicare Advantage	$281.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$640.73
Rate for Payer: Wellpoint Medicaid Managed Care	$628.17

INTUBATION ENDOTRACHEAL

Facility

$1,278.15

Service Code	HCPCS 31500
Hospital Charge Code	9500055
Hospital Revenue Code	361
Min. Negotiated Rate	$191.72
Max. Negotiated Rate	$191.72
Rate for Payer: Qualcare PPO/HMO/WC	$191.72

INTUBATION ENDOTRACHEAL

Facility

$1,278.15

Service Code	HCPCS 31500
Hospital Charge Code	5100662
Hospital Revenue Code	361
Min. Negotiated Rate	$40.39
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$765.35
Rate for Payer: Aetna Medicare Advantage	$911.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$281.38
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	$1,020.71
Rate for Payer: Cigna Commercial	$564.04
Rate for Payer: Cigna Medicare Advantage	$281.38
Rate for Payer: Clover Medicare Advantage	$267.31
Rate for Payer: EmblemHealth Commercial	$844.14
Rate for Payer: Humana Medicare Advantage	$289.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$281.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.32
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$191.72
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$40.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$281.38
Rate for Payer: Wellcare Medicare Advantage	$281.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$640.73
Rate for Payer: Wellpoint Medicaid Managed Care	$628.17

INTUBATION ENDOTRACHEAL

Facility

$1,278.15

Service Code	HCPCS 31500
Hospital Charge Code	5100662
Hospital Revenue Code	361
Min. Negotiated Rate	$191.72
Max. Negotiated Rate	$191.72
Rate for Payer: Qualcare PPO/HMO/WC	$191.72

INTUBATION ET EMERGENT

Facility

$1,991.01

Service Code	HCPCS 31500
Hospital Charge Code	T
Hospital Revenue Code	360
Min. Negotiated Rate	$62.92
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$765.35
Rate for Payer: Aetna Medicare Advantage	$911.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$281.38
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	$1,020.71
Rate for Payer: Cigna Commercial	$564.04
Rate for Payer: Cigna Medicare Advantage	$281.38
Rate for Payer: Clover Medicare Advantage	$267.31
Rate for Payer: EmblemHealth Commercial	$844.14
Rate for Payer: Humana Medicare Advantage	$289.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$281.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$517.66
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$298.65
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$62.92
Rate for Payer: UnitedHealthcare Medicare Advantage	$281.38
Rate for Payer: Wellcare Medicare Advantage	$281.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$640.73
Rate for Payer: Wellpoint Medicaid Managed Care	$628.17

INTUBATION ET EMERGENT

Facility

$1,991.01

Service Code	HCPCS 31500
Hospital Charge Code	1600000667
Hospital Revenue Code	360
Min. Negotiated Rate	$62.92
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$765.35
Rate for Payer: Aetna Medicare Advantage	$911.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$281.38
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	$1,020.71
Rate for Payer: Cigna Commercial	$564.04
Rate for Payer: Cigna Medicare Advantage	$281.38
Rate for Payer: Clover Medicare Advantage	$267.31
Rate for Payer: EmblemHealth Commercial	$844.14
Rate for Payer: Humana Medicare Advantage	$289.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$281.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$517.66
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$298.65
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$62.92
Rate for Payer: UnitedHealthcare Medicare Advantage	$281.38
Rate for Payer: Wellcare Medicare Advantage	$281.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$640.73
Rate for Payer: Wellpoint Medicaid Managed Care	$628.17

INTUBATION ET EMERGENT

Facility

$1,991.01

Service Code	HCPCS 31500
Hospital Charge Code	T
Hospital Revenue Code	360
Min. Negotiated Rate	$298.65
Max. Negotiated Rate	$298.65
Rate for Payer: Qualcare PPO/HMO/WC	$298.65

INTUBATION ET EMERGENT

Facility

$1,991.01

Service Code	HCPCS 31500
Hospital Charge Code	1600000667
Hospital Revenue Code	360
Min. Negotiated Rate	$298.65
Max. Negotiated Rate	$298.65
Rate for Payer: Qualcare PPO/HMO/WC	$298.65

INVEGA SUSTENA 117 MG

Facility

$7,774.95

Service Code	NDC 50458056201
Hospital Charge Code	60634951
Hospital Revenue Code	250
Min. Negotiated Rate	$220.81
Max. Negotiated Rate	$3,887.47
Rate for Payer: Aetna Commercial	$2,954.48
Rate for Payer: Aetna Medicare Advantage	$2,332.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,982.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,982.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,982.61
Rate for Payer: Cigna Commercial	$3,887.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,021.49
Rate for Payer: Oxford Commercial	$1,554.99
Rate for Payer: Qualcare PPO/HMO/WC	$1,166.24
Rate for Payer: UnitedHealthcare Commercial	$1,554.99
Rate for Payer: UnitedHealthcare Community & State	$245.69
Rate for Payer: Wellpoint Medicaid Managed Care	$220.81

INVEGA SUSTENA 117 MG

Facility

$7,774.95

Service Code	NDC 50458056201
Hospital Charge Code	60634951
Hospital Revenue Code	250
Min. Negotiated Rate	$1,166.24
Max. Negotiated Rate	$1,166.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,166.24

INVEGA SUSTENNA 156 MG INJ

Facility

$10,366.91

Service Code	HCPCS J2426
Hospital Charge Code	606350946
Hospital Revenue Code	636
Min. Negotiated Rate	$1,555.04
Max. Negotiated Rate	$2,508.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,508.79
Rate for Payer: Qualcare PPO/HMO/WC	$1,555.04

Know your out-of-pocket cost for care.

All Charges