Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

IR ASP BLADDER W INS SUPRAPUB

Facility

$8,477.85

Service Code	HCPCS 51102
Hospital Charge Code	411051102
Hospital Revenue Code	361
Min. Negotiated Rate	$240.77
Max. Negotiated Rate	$9,008.64
Rate for Payer: Aetna Commercial	$6,754.93
Rate for Payer: Aetna Medicare Advantage	$8,046.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,008.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,008.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,483.43
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	$9,008.64
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: Cigna Medicare Advantage	$2,483.43
Rate for Payer: Clover Medicare Advantage	$2,359.26
Rate for Payer: EmblemHealth Commercial	$7,450.29
Rate for Payer: Humana Medicare Advantage	$2,557.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,483.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,204.24
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,271.68
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$267.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,483.43
Rate for Payer: Wellcare Medicare Advantage	$2,483.43
Rate for Payer: Wellpoint Medicaid Managed Care	$240.77

IR ASP BLADDER W INS SUPRAPUB

Facility

$8,477.85

Service Code	HCPCS 51102
Hospital Charge Code	366851102
Hospital Revenue Code	361
Min. Negotiated Rate	$1,271.68
Max. Negotiated Rate	$1,271.68
Rate for Payer: Qualcare PPO/HMO/WC	$1,271.68

IR ASP BLADDER W INS SUPRAPUB

Facility

$8,477.85

Service Code	HCPCS 51102
Hospital Charge Code	366851102
Hospital Revenue Code	361
Min. Negotiated Rate	$240.77
Max. Negotiated Rate	$9,008.64
Rate for Payer: Aetna Commercial	$6,754.93
Rate for Payer: Aetna Medicare Advantage	$8,046.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,008.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,008.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,483.43
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	$9,008.64
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: Cigna Medicare Advantage	$2,483.43
Rate for Payer: Clover Medicare Advantage	$2,359.26
Rate for Payer: EmblemHealth Commercial	$7,450.29
Rate for Payer: Humana Medicare Advantage	$2,557.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,483.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,204.24
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,271.68
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$267.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,483.43
Rate for Payer: Wellcare Medicare Advantage	$2,483.43
Rate for Payer: Wellpoint Medicaid Managed Care	$240.77

IR-ATHERECTOMY-FEM POP-BI

Facility

$86,028.15

Service Code	HCPCS 3722550
Hospital Charge Code	321037225B
Hospital Revenue Code	361
Min. Negotiated Rate	$2,443.20
Max. Negotiated Rate	$43,014.07
Rate for Payer: Aetna Commercial	$32,690.70
Rate for Payer: Aetna Medicare Advantage	$25,808.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21,937.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21,937.18
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	$21,937.18
Rate for Payer: Cigna Commercial	$43,014.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22,367.32
Rate for Payer: Qualcare PPO/HMO/WC	$12,904.22
Rate for Payer: UnitedHealthcare Community & State	$2,718.49
Rate for Payer: Wellpoint Medicaid Managed Care	$2,443.20

IR-ATHERECTOMY-FEM POP-BI

Facility

$86,028.15

Service Code	HCPCS 3722550
Hospital Charge Code	2690520
Hospital Revenue Code	361
Min. Negotiated Rate	$12,904.22
Max. Negotiated Rate	$12,904.22
Rate for Payer: Qualcare PPO/HMO/WC	$12,904.22

IR-ATHERECTOMY-FEM POP-BI

Facility

$86,028.15

Service Code	HCPCS 3722550
Hospital Charge Code	2690520
Hospital Revenue Code	361
Min. Negotiated Rate	$2,443.20
Max. Negotiated Rate	$43,014.07
Rate for Payer: Aetna Commercial	$32,690.70
Rate for Payer: Aetna Medicare Advantage	$25,808.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21,937.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21,937.18
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	$21,937.18
Rate for Payer: Cigna Commercial	$43,014.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22,367.32
Rate for Payer: Qualcare PPO/HMO/WC	$12,904.22
Rate for Payer: UnitedHealthcare Community & State	$2,718.49
Rate for Payer: Wellpoint Medicaid Managed Care	$2,443.20

IR-ATHERECTOMY-FEM POP-BI

Facility

$86,028.15

Service Code	HCPCS 3722550
Hospital Charge Code	3668372255
Hospital Revenue Code	361
Min. Negotiated Rate	$2,443.20
Max. Negotiated Rate	$43,014.07
Rate for Payer: Aetna Commercial	$32,690.70
Rate for Payer: Aetna Medicare Advantage	$25,808.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21,937.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21,937.18
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	$21,937.18
Rate for Payer: Cigna Commercial	$43,014.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22,367.32
Rate for Payer: Qualcare PPO/HMO/WC	$12,904.22
Rate for Payer: UnitedHealthcare Community & State	$2,718.49
Rate for Payer: Wellpoint Medicaid Managed Care	$2,443.20

IR-ATHERECTOMY-FEM POP-BI

Facility

$86,028.15

Service Code	HCPCS 3722550
Hospital Charge Code	3668372255
Hospital Revenue Code	361
Min. Negotiated Rate	$12,904.22
Max. Negotiated Rate	$12,904.22
Rate for Payer: Qualcare PPO/HMO/WC	$12,904.22

IR-ATHERECTOMY-FEM POP-BI

Facility

$75,737.34

Service Code	HCPCS 3722550
Hospital Charge Code	7411803
Hospital Revenue Code	361
Min. Negotiated Rate	$11,360.60
Max. Negotiated Rate	$11,360.60
Rate for Payer: Qualcare PPO/HMO/WC	$11,360.60

IR-ATHERECTOMY-FEM POP-BI

Facility

$75,737.34

Service Code	HCPCS 3722550
Hospital Charge Code	7411803
Hospital Revenue Code	361
Min. Negotiated Rate	$2,150.94
Max. Negotiated Rate	$37,868.67
Rate for Payer: Aetna Commercial	$28,780.19
Rate for Payer: Aetna Medicare Advantage	$22,721.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19,313.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19,313.02
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	$19,313.02
Rate for Payer: Cigna Commercial	$37,868.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19,691.71
Rate for Payer: Qualcare PPO/HMO/WC	$11,360.60
Rate for Payer: UnitedHealthcare Community & State	$2,393.30
Rate for Payer: Wellpoint Medicaid Managed Care	$2,150.94

IR-ATHERECTOMY-FEM POP-BI

Facility

$86,028.15

Service Code	HCPCS 3722550
Hospital Charge Code	321037225B
Hospital Revenue Code	361
Min. Negotiated Rate	$12,904.22
Max. Negotiated Rate	$12,904.22
Rate for Payer: Qualcare PPO/HMO/WC	$12,904.22

IR-ATHERECTOMY-FEM POP-BI

Facility

$86,028.15

Service Code	HCPCS 3722550
Hospital Charge Code	411037225B
Hospital Revenue Code	361
Min. Negotiated Rate	$12,904.22
Max. Negotiated Rate	$12,904.22
Rate for Payer: Qualcare PPO/HMO/WC	$12,904.22

IR-ATHERECTOMY-FEM POP-BI

Facility

$86,028.15

Service Code	HCPCS 3722550
Hospital Charge Code	411037225B
Hospital Revenue Code	361
Min. Negotiated Rate	$2,443.20
Max. Negotiated Rate	$43,014.07
Rate for Payer: Aetna Commercial	$32,690.70
Rate for Payer: Aetna Medicare Advantage	$25,808.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21,937.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21,937.18
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	$21,937.18
Rate for Payer: Cigna Commercial	$43,014.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22,367.32
Rate for Payer: Qualcare PPO/HMO/WC	$12,904.22
Rate for Payer: UnitedHealthcare Community & State	$2,718.49
Rate for Payer: Wellpoint Medicaid Managed Care	$2,443.20

IR-ATHERECTOMY-FEM POP-LT

Facility

$61,616.39

Service Code	HCPCS 37225LT
Hospital Charge Code	366837225L
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

IR-ATHERECTOMY-FEM POP-LT

Facility

$61,616.39

Service Code	HCPCS 37225LT
Hospital Charge Code	2691370
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

IR-ATHERECTOMY-FEM POP-LT

Facility

$61,616.39

Service Code	HCPCS 37225LT
Hospital Charge Code	2691370
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: Qualcare PPO/HMO/WC	$9,242.46
Rate for Payer: UnitedHealthcare Community & State	$1,947.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1,749.91

IR-ATHERECTOMY-FEM POP-LT

Facility

$61,616.39

Service Code	HCPCS 37225LT
Hospital Charge Code	7411926
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: Qualcare PPO/HMO/WC	$9,242.46
Rate for Payer: UnitedHealthcare Community & State	$1,947.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1,749.91

IR-ATHERECTOMY-FEM POP-LT

Facility

$61,616.39

Service Code	HCPCS 37225LT
Hospital Charge Code	321037225L
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

IR-ATHERECTOMY-FEM POP-LT

Facility

$47,711.75

Service Code	HCPCS 37225LT
Hospital Charge Code	7412042
Hospital Revenue Code	361
Min. Negotiated Rate	$1,355.01
Max. Negotiated Rate	$23,855.88
Rate for Payer: Aetna Commercial	$18,130.47
Rate for Payer: Aetna Medicare Advantage	$14,313.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,166.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,166.50
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	$12,166.50
Rate for Payer: Cigna Commercial	$23,855.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,405.06
Rate for Payer: Qualcare PPO/HMO/WC	$7,156.76
Rate for Payer: UnitedHealthcare Community & State	$1,507.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1,355.01

IR-ATHERECTOMY-FEM POP-LT

Facility

$61,616.39

Service Code	HCPCS 37225LT
Hospital Charge Code	366837225L
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: Qualcare PPO/HMO/WC	$9,242.46
Rate for Payer: UnitedHealthcare Community & State	$1,947.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1,749.91

IR-ATHERECTOMY-FEM POP-LT

Facility

$61,616.39

Service Code	HCPCS 37225LT
Hospital Charge Code	7411926
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

IR-ATHERECTOMY-FEM POP-LT

Facility

$47,711.75

Service Code	HCPCS 37225LT
Hospital Charge Code	7412042
Hospital Revenue Code	361
Min. Negotiated Rate	$7,156.76
Max. Negotiated Rate	$7,156.76
Rate for Payer: Qualcare PPO/HMO/WC	$7,156.76

IR-ATHERECTOMY-FEM POP-LT

Facility

$61,616.39

Service Code	HCPCS 37225LT
Hospital Charge Code	321037225L
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: Qualcare PPO/HMO/WC	$9,242.46
Rate for Payer: UnitedHealthcare Community & State	$1,947.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1,749.91

IR-ATHERECTOMY-FEM POP-RT

Facility

$61,616.39

Service Code	HCPCS 37225RT
Hospital Charge Code	321037225R
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

IR-ATHERECTOMY-FEM POP-RT

Facility

$61,616.39

Service Code	HCPCS 37225RT
Hospital Charge Code	7411928
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

Know your out-of-pocket cost for care.

All Charges