Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

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	$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 INCISION OF GALL BLADDER

Facility

$17,259.20

Service Code	HCPCS 47490
Hospital Charge Code	2011281
Hospital Revenue Code	361
Min. Negotiated Rate	$2,588.88
Max. Negotiated Rate	$2,588.88
Rate for Payer: Qualcare PPO/HMO/WC	$2,588.88

IR INCISION OF GALL BLADDER

Facility

$17,259.20

Service Code	HCPCS 47490
Hospital Charge Code	2011281
Hospital Revenue Code	361
Min. Negotiated Rate	$490.16
Max. Negotiated Rate	$15,429.97
Rate for Payer: Aetna Commercial	$11,569.82
Rate for Payer: Aetna Medicare Advantage	$13,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,429.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,429.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,253.61
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	$15,429.97
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: Cigna Medicare Advantage	$4,253.61
Rate for Payer: Clover Medicare Advantage	$4,040.93
Rate for Payer: EmblemHealth Commercial	$12,760.83
Rate for Payer: Humana Medicare Advantage	$4,381.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,253.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,487.39
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,588.88
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$545.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,253.61
Rate for Payer: Wellcare Medicare Advantage	$4,253.61
Rate for Payer: Wellpoint Medicaid Managed Care	$490.16

IR INCISION OF GALL BLADDER

Facility

$10,885.55

Service Code	HCPCS 47490
Hospital Charge Code	7411558
Hospital Revenue Code	360
Min. Negotiated Rate	$309.15
Max. Negotiated Rate	$15,429.97
Rate for Payer: Aetna Commercial	$11,569.82
Rate for Payer: Aetna Medicare Advantage	$13,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,429.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,429.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,253.61
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	$15,429.97
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: Cigna Medicare Advantage	$4,253.61
Rate for Payer: Clover Medicare Advantage	$4,040.93
Rate for Payer: EmblemHealth Commercial	$12,760.83
Rate for Payer: Humana Medicare Advantage	$4,381.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,253.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,830.24
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,632.83
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$343.98
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,253.61
Rate for Payer: Wellcare Medicare Advantage	$4,253.61
Rate for Payer: Wellpoint Medicaid Managed Care	$309.15

IR INCISION OF GALL BLADDER

Facility

$10,885.55

Service Code	HCPCS 47490
Hospital Charge Code	7411558
Hospital Revenue Code	360
Min. Negotiated Rate	$1,632.83
Max. Negotiated Rate	$1,632.83
Rate for Payer: Qualcare PPO/HMO/WC	$1,632.83

IR INFUSION THERAPY ANY METHOD

Facility

$3,539.00

Hospital Charge Code	2600089
Hospital Revenue Code	320
Min. Negotiated Rate	$100.51
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$1,344.82
Rate for Payer: Aetna Medicare Advantage	$1,061.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$902.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$902.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$902.45
Rate for Payer: Cigna Commercial	$1,769.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$920.14
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$530.85
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$111.83
Rate for Payer: Wellpoint Medicaid Managed Care	$100.51

IR INFUSION THERAPY ANY METHOD

Facility

$3,539.00

Hospital Charge Code	2600089
Hospital Revenue Code	320
Min. Negotiated Rate	$530.85
Max. Negotiated Rate	$530.85
Rate for Payer: Qualcare PPO/HMO/WC	$530.85

IR INF VENACAVAGRAM

Facility

$15,468.50

Service Code	HCPCS 75825
Hospital Charge Code	321075825
Hospital Revenue Code	320
Min. Negotiated Rate	$194.04
Max. Negotiated Rate	$13,607.37
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$194.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,607.37
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$2,625.82
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,021.81
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$488.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$439.31

IR INF VENACAVAGRAM

Facility

$15,468.50

Service Code	HCPCS 75825
Hospital Charge Code	321075825
Hospital Revenue Code	320
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

IR INF VENACAVAGRAM

Facility

$15,468.50

Service Code	HCPCS 75825
Hospital Charge Code	2001154
Hospital Revenue Code	320
Min. Negotiated Rate	$194.04
Max. Negotiated Rate	$13,607.37
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$194.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,607.37
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$2,625.82
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,021.81
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$488.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$439.31

IR INF VENACAVAGRAM

Facility

$15,468.50

Service Code	HCPCS 75825
Hospital Charge Code	2001154
Hospital Revenue Code	320
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

IR INJ CHOL THROUGH EXIST CATH

Facility

$2,178.00

Hospital Charge Code	2004741
Hospital Revenue Code	361
Min. Negotiated Rate	$326.70
Max. Negotiated Rate	$326.70
Rate for Payer: Qualcare PPO/HMO/WC	$326.70

IR INJ CHOL THROUGH EXIST CATH

Facility

$2,178.00

Hospital Charge Code	2004741
Hospital Revenue Code	361
Min. Negotiated Rate	$61.86
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$827.64
Rate for Payer: Aetna Medicare Advantage	$653.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$555.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$555.39
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	$555.39
Rate for Payer: Cigna Commercial	$1,089.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$566.28
Rate for Payer: Qualcare PPO/HMO/WC	$326.70
Rate for Payer: UnitedHealthcare Community & State	$68.82
Rate for Payer: Wellpoint Medicaid Managed Care	$61.86

IR-INJECT WRIST ARTHRO-LT

Facility

$638.00

Service Code	HCPCS 25246LT
Hospital Charge Code	321025246L
Hospital Revenue Code	361
Min. Negotiated Rate	$95.70
Max. Negotiated Rate	$95.70
Rate for Payer: Qualcare PPO/HMO/WC	$95.70

IR-INJECT WRIST ARTHRO-LT

Facility

$638.00

Service Code	HCPCS 25246LT
Hospital Charge Code	2690950
Hospital Revenue Code	361
Min. Negotiated Rate	$95.70
Max. Negotiated Rate	$95.70
Rate for Payer: Qualcare PPO/HMO/WC	$95.70

IR-INJECT WRIST ARTHRO-LT

Facility

$638.00

Service Code	HCPCS 25246LT
Hospital Charge Code	2690950
Hospital Revenue Code	361
Min. Negotiated Rate	$18.12
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$242.44
Rate for Payer: Aetna Medicare Advantage	$191.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$162.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$162.69
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	$162.69
Rate for Payer: Cigna Commercial	$319.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.88
Rate for Payer: Qualcare PPO/HMO/WC	$95.70
Rate for Payer: UnitedHealthcare Community & State	$20.16
Rate for Payer: Wellpoint Medicaid Managed Care	$18.12

IR-INJECT WRIST ARTHRO-LT

Facility

$638.00

Service Code	HCPCS 25246LT
Hospital Charge Code	321025246L
Hospital Revenue Code	361
Min. Negotiated Rate	$18.12
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$242.44
Rate for Payer: Aetna Medicare Advantage	$191.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$162.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$162.69
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	$162.69
Rate for Payer: Cigna Commercial	$319.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.88
Rate for Payer: Qualcare PPO/HMO/WC	$95.70
Rate for Payer: UnitedHealthcare Community & State	$20.16
Rate for Payer: Wellpoint Medicaid Managed Care	$18.12

IR-INJ ELBOW ARTHRO-RT

Facility

$646.00

Service Code	HCPCS 24220RT
Hospital Charge Code	321024220R
Hospital Revenue Code	361
Min. Negotiated Rate	$18.35
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$245.48
Rate for Payer: Aetna Medicare Advantage	$193.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$164.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$164.73
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	$164.73
Rate for Payer: Cigna Commercial	$323.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.96
Rate for Payer: Qualcare PPO/HMO/WC	$96.90
Rate for Payer: UnitedHealthcare Community & State	$20.41
Rate for Payer: Wellpoint Medicaid Managed Care	$18.35

IR-INJ ELBOW ARTHRO-RT

Facility

$646.00

Service Code	HCPCS 24220RT
Hospital Charge Code	2690945
Hospital Revenue Code	361
Min. Negotiated Rate	$96.90
Max. Negotiated Rate	$96.90
Rate for Payer: Qualcare PPO/HMO/WC	$96.90

IR-INJ ELBOW ARTHRO-RT

Facility

$646.00

Service Code	HCPCS 24220RT
Hospital Charge Code	2690945
Hospital Revenue Code	361
Min. Negotiated Rate	$18.35
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$245.48
Rate for Payer: Aetna Medicare Advantage	$193.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$164.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$164.73
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	$164.73
Rate for Payer: Cigna Commercial	$323.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.96
Rate for Payer: Qualcare PPO/HMO/WC	$96.90
Rate for Payer: UnitedHealthcare Community & State	$20.41
Rate for Payer: Wellpoint Medicaid Managed Care	$18.35

IR-INJ ELBOW ARTHRO-RT

Facility

$646.00

Service Code	HCPCS 24220RT
Hospital Charge Code	321024220R
Hospital Revenue Code	361
Min. Negotiated Rate	$96.90
Max. Negotiated Rate	$96.90
Rate for Payer: Qualcare PPO/HMO/WC	$96.90

IR-INJ/EVAL PERITONEAL SHUNT

Facility

$266.00

Service Code	HCPCS 49427
Hospital Charge Code	2670145
Hospital Revenue Code	361
Min. Negotiated Rate	$39.90
Max. Negotiated Rate	$39.90
Rate for Payer: Qualcare PPO/HMO/WC	$39.90

IR-INJ/EVAL PERITONEAL SHUNT

Facility

$266.00

Service Code	HCPCS 49427
Hospital Charge Code	2670145
Hospital Revenue Code	361
Min. Negotiated Rate	$7.55
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$101.08
Rate for Payer: Aetna Medicare Advantage	$79.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.83
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	$67.83
Rate for Payer: Cigna Commercial	$133.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.16
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.90
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$8.41
Rate for Payer: Wellpoint Medicaid Managed Care	$7.55

IR-INJ/EVAL PERITONEAL SHUNT

Facility

$266.00

Service Code	HCPCS 49427
Hospital Charge Code	7411592
Hospital Revenue Code	361
Min. Negotiated Rate	$39.90
Max. Negotiated Rate	$39.90
Rate for Payer: Qualcare PPO/HMO/WC	$39.90

IR-INJ/EVAL PERITONEAL SHUNT

Facility

$266.00

Service Code	HCPCS 49427
Hospital Charge Code	7411592
Hospital Revenue Code	361
Min. Negotiated Rate	$7.55
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$101.08
Rate for Payer: Aetna Medicare Advantage	$79.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.83
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	$67.83
Rate for Payer: Cigna Commercial	$133.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.16
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.90
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$8.41
Rate for Payer: Wellpoint Medicaid Managed Care	$7.55

Know your out-of-pocket cost for care.

All Charges