Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

IR ILIAC REVASC

Facility

$25,423.30

Service Code	HCPCS 37254
Hospital Charge Code	411037220
Hospital Revenue Code	361
Min. Negotiated Rate	$3,813.49
Max. Negotiated Rate	$3,813.49
Rate for Payer: Qualcare PPO/HMO/WC	$3,813.49

IR ILIAC REVASC

Facility

$27,397.00

Service Code	HCPCS 37220
Hospital Charge Code	5600201
Hospital Revenue Code	361
Min. Negotiated Rate	$778.07
Max. Negotiated Rate	$14,869.00
Rate for Payer: Aetna Commercial	$10,410.86
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,123.22
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$865.75
Rate for Payer: Wellpoint Medicaid Managed Care	$778.07

IR ILIAC REVASC

Facility

$27,397.00

Service Code	HCPCS 37220
Hospital Charge Code	5600201
Hospital Revenue Code	361
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

IR ILIAC REVASC

Facility

$25,423.30

Service Code	HCPCS 37254
Hospital Charge Code	411037220
Hospital Revenue Code	361
Min. Negotiated Rate	$722.02
Max. Negotiated Rate	$24,528.18
Rate for Payer: Aetna Commercial	$18,391.91
Rate for Payer: Aetna Medicare Advantage	$21,908.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24,528.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24,528.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,761.73
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	$24,528.18
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: Cigna Medicare Advantage	$6,761.73
Rate for Payer: Clover Medicare Advantage	$6,423.64
Rate for Payer: EmblemHealth Commercial	$20,285.19
Rate for Payer: Humana Medicare Advantage	$6,964.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,761.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,610.06
Rate for Payer: Qualcare PPO/HMO/WC	$3,813.49
Rate for Payer: UnitedHealthcare Community & State	$803.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,761.73
Rate for Payer: Wellcare Medicare Advantage	$6,761.73
Rate for Payer: Wellpoint Medicaid Managed Care	$722.02

IR ILIAC REVASC

Facility

$25,423.30

Service Code	HCPCS 37220
Hospital Charge Code	366837220
Hospital Revenue Code	361
Min. Negotiated Rate	$722.02
Max. Negotiated Rate	$14,869.00
Rate for Payer: Aetna Commercial	$9,660.85
Rate for Payer: Aetna Medicare Advantage	$7,626.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,482.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,482.94
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	$6,482.94
Rate for Payer: Cigna Commercial	$12,711.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,610.06
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,813.49
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$803.38
Rate for Payer: Wellpoint Medicaid Managed Care	$722.02

IR ILIAC REVASC

Facility

$25,423.30

Service Code	HCPCS 37220
Hospital Charge Code	366837220
Hospital Revenue Code	361
Min. Negotiated Rate	$3,813.49
Max. Negotiated Rate	$3,813.49
Rate for Payer: Qualcare PPO/HMO/WC	$3,813.49

IR ILIAC REVASC

Facility

$27,397.00

Service Code	HCPCS 37220
Hospital Charge Code	321037220
Hospital Revenue Code	361
Min. Negotiated Rate	$778.07
Max. Negotiated Rate	$14,869.00
Rate for Payer: Aetna Commercial	$10,410.86
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,123.22
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$865.75
Rate for Payer: Wellpoint Medicaid Managed Care	$778.07

IR ILIAC REVASC

Facility

$27,397.00

Service Code	HCPCS 37220
Hospital Charge Code	321037220
Hospital Revenue Code	361
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

IR ILIAC REVASC ADD-ON

Facility

$22,441.40

Service Code	HCPCS 37222
Hospital Charge Code	321037222
Hospital Revenue Code	361
Min. Negotiated Rate	$637.34
Max. Negotiated Rate	$14,869.00
Rate for Payer: Aetna Commercial	$8,527.73
Rate for Payer: Aetna Medicare Advantage	$6,732.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,722.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,722.56
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	$5,722.56
Rate for Payer: Cigna Commercial	$11,220.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,834.76
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$709.15
Rate for Payer: Wellpoint Medicaid Managed Care	$637.34

IR ILIAC REVASC ADD-ON

Facility

$22,441.40

Service Code	HCPCS 37222
Hospital Charge Code	5600203
Hospital Revenue Code	361
Min. Negotiated Rate	$637.34
Max. Negotiated Rate	$14,869.00
Rate for Payer: Aetna Commercial	$8,527.73
Rate for Payer: Aetna Medicare Advantage	$6,732.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,722.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,722.56
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	$5,722.56
Rate for Payer: Cigna Commercial	$11,220.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,834.76
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$709.15
Rate for Payer: Wellpoint Medicaid Managed Care	$637.34

IR ILIAC REVASC ADD-ON

Facility

$22,441.40

Service Code	HCPCS 37222
Hospital Charge Code	5600203
Hospital Revenue Code	361
Min. Negotiated Rate	$3,366.21
Max. Negotiated Rate	$3,366.21
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21

IR ILIAC REVASC ADD-ON

Facility

$22,441.40

Service Code	HCPCS 37255
Hospital Charge Code	411037222
Hospital Revenue Code	361
Min. Negotiated Rate	$637.34
Max. Negotiated Rate	$11,220.70
Rate for Payer: Aetna Commercial	$8,527.73
Rate for Payer: Aetna Medicare Advantage	$6,732.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,722.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,722.56
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	$5,722.56
Rate for Payer: Cigna Commercial	$11,220.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,834.76
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21
Rate for Payer: UnitedHealthcare Community & State	$709.15
Rate for Payer: Wellpoint Medicaid Managed Care	$637.34

IR ILIAC REVASC ADD-ON

Facility

$22,441.40

Service Code	HCPCS 37255
Hospital Charge Code	411037222
Hospital Revenue Code	361
Min. Negotiated Rate	$3,366.21
Max. Negotiated Rate	$3,366.21
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21

IR ILIAC REVASC ADD-ON

Facility

$22,441.40

Service Code	HCPCS 37222
Hospital Charge Code	321037222
Hospital Revenue Code	361
Min. Negotiated Rate	$3,366.21
Max. Negotiated Rate	$3,366.21
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21

IR ILIAC REVASC W/STENT

Facility

$56,620.95

Service Code	HCPCS 37221
Hospital Charge Code	321037221
Hospital Revenue Code	361
Min. Negotiated Rate	$8,493.14
Max. Negotiated Rate	$8,493.14
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14

IR ILIAC REVASC W/STENT

Facility

$56,620.95

Service Code	HCPCS 37221
Hospital Charge Code	5600202
Hospital Revenue Code	361
Min. Negotiated Rate	$1,608.03
Max. Negotiated Rate	$28,310.47
Rate for Payer: Aetna Commercial	$21,515.96
Rate for Payer: Aetna Medicare Advantage	$16,986.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,438.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,438.34
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	$14,438.34
Rate for Payer: Cigna Commercial	$28,310.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,721.45
Rate for Payer: Oxford Commercial	$14,968.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14
Rate for Payer: UnitedHealthcare Commercial	$16,639.00
Rate for Payer: UnitedHealthcare Community & State	$1,789.22
Rate for Payer: Wellpoint Medicaid Managed Care	$1,608.03

IR ILIAC REVASC W/STENT

Facility

$56,620.95

Service Code	HCPCS 37221
Hospital Charge Code	5600202
Hospital Revenue Code	361
Min. Negotiated Rate	$8,493.14
Max. Negotiated Rate	$8,493.14
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14

IR ILIAC REVASC W/STENT

Facility

$56,620.95

Service Code	HCPCS 37221
Hospital Charge Code	321037221
Hospital Revenue Code	361
Min. Negotiated Rate	$1,608.03
Max. Negotiated Rate	$28,310.47
Rate for Payer: Aetna Commercial	$21,515.96
Rate for Payer: Aetna Medicare Advantage	$16,986.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,438.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,438.34
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	$14,438.34
Rate for Payer: Cigna Commercial	$28,310.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,721.45
Rate for Payer: Oxford Commercial	$14,968.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14
Rate for Payer: UnitedHealthcare Commercial	$16,639.00
Rate for Payer: UnitedHealthcare Community & State	$1,789.22
Rate for Payer: Wellpoint Medicaid Managed Care	$1,608.03

IR ILIAC REVASC W/STENT ADD-ON

Facility

$15,877.00

Service Code	HCPCS 37223
Hospital Charge Code	366837223
Hospital Revenue Code	361
Min. Negotiated Rate	$2,381.55
Max. Negotiated Rate	$2,381.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

IR ILIAC REVASC W/STENT ADD-ON

Facility

$35,674.97

Service Code	HCPCS 37223
Hospital Charge Code	321037223
Hospital Revenue Code	361
Min. Negotiated Rate	$5,351.25
Max. Negotiated Rate	$5,351.25
Rate for Payer: Qualcare PPO/HMO/WC	$5,351.25

IR ILIAC REVASC W/STENT ADD-ON

Facility

$15,877.00

Service Code	HCPCS 37259
Hospital Charge Code	411037223
Hospital Revenue Code	361
Min. Negotiated Rate	$2,381.55
Max. Negotiated Rate	$2,381.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

IR ILIAC REVASC W/STENT ADD-ON

Facility

$15,877.00

Service Code	HCPCS 37259
Hospital Charge Code	411037223
Hospital Revenue Code	361
Min. Negotiated Rate	$450.91
Max. Negotiated Rate	$7,938.50
Rate for Payer: Aetna Commercial	$6,033.26
Rate for Payer: Aetna Medicare Advantage	$4,763.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,048.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,048.64
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	$4,048.64
Rate for Payer: Cigna Commercial	$7,938.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,128.02
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55
Rate for Payer: UnitedHealthcare Community & State	$501.71
Rate for Payer: Wellpoint Medicaid Managed Care	$450.91

IR ILIAC REVASC W/STENT ADD-ON

Facility

$35,674.97

Service Code	HCPCS 37223
Hospital Charge Code	5600204
Hospital Revenue Code	361
Min. Negotiated Rate	$1,013.17
Max. Negotiated Rate	$17,837.49
Rate for Payer: Aetna Commercial	$13,556.49
Rate for Payer: Aetna Medicare Advantage	$10,702.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,097.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,097.12
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	$9,097.12
Rate for Payer: Cigna Commercial	$17,837.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,275.49
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,351.25
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,127.33
Rate for Payer: Wellpoint Medicaid Managed Care	$1,013.17

IR ILIAC REVASC W/STENT ADD-ON

Facility

$15,877.00

Service Code	HCPCS 37223
Hospital Charge Code	366837223
Hospital Revenue Code	361
Min. Negotiated Rate	$450.91
Max. Negotiated Rate	$14,869.00
Rate for Payer: Aetna Commercial	$6,033.26
Rate for Payer: Aetna Medicare Advantage	$4,763.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,048.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,048.64
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	$4,048.64
Rate for Payer: Cigna Commercial	$7,938.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,128.02
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$501.71
Rate for Payer: Wellpoint Medicaid Managed Care	$450.91

IR ILIAC REVASC W/STENT ADD-ON

Facility

$35,674.97

Service Code	HCPCS 37223
Hospital Charge Code	5600204
Hospital Revenue Code	361
Min. Negotiated Rate	$5,351.25
Max. Negotiated Rate	$5,351.25
Rate for Payer: Qualcare PPO/HMO/WC	$5,351.25

Know your out-of-pocket cost for care.

All Charges