Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

IR-PERC CHOLECYSTECTOMY

Facility

$17,259.20

Service Code	HCPCS 47490
Hospital Charge Code	2670170
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-PERC CHOLECYSTECTOMY

Facility

$17,259.20

Service Code	HCPCS 47490
Hospital Charge Code	321047490
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-PERC CHOLECYSTECTOMY

Facility

$12,976.00

Service Code	HCPCS 47490
Hospital Charge Code	7411559
Hospital Revenue Code	361
Min. Negotiated Rate	$368.52
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	$3,373.76
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,946.40
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$410.04
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	$368.52

IR-PERC CHOLECYSTECTOMY

Facility

$12,976.00

Service Code	HCPCS 47490
Hospital Charge Code	7411559
Hospital Revenue Code	361
Min. Negotiated Rate	$1,946.40
Max. Negotiated Rate	$1,946.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,946.40

IR-PERC FNA PLEURA-BIL

Facility

$3,604.80

Service Code	HCPCS 1002250
Hospital Charge Code	2690295
Hospital Revenue Code	361
Min. Negotiated Rate	$102.38
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,369.82
Rate for Payer: Aetna Medicare Advantage	$1,081.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$919.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$919.22
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	$919.22
Rate for Payer: Cigna Commercial	$1,802.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.25
Rate for Payer: Qualcare PPO/HMO/WC	$540.72
Rate for Payer: UnitedHealthcare Community & State	$113.91
Rate for Payer: Wellpoint Medicaid Managed Care	$102.38

IR-PERC FNA PLEURA-BIL

Facility

$3,604.80

Service Code	HCPCS 1002250
Hospital Charge Code	2690295
Hospital Revenue Code	361
Min. Negotiated Rate	$540.72
Max. Negotiated Rate	$540.72
Rate for Payer: Qualcare PPO/HMO/WC	$540.72

IR-PERC FNA PLEURA-LT

Facility

$2,403.20

Service Code	HCPCS 10022LT
Hospital Charge Code	2690860
Hospital Revenue Code	361
Min. Negotiated Rate	$68.25
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$913.22
Rate for Payer: Aetna Medicare Advantage	$720.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.82
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	$612.82
Rate for Payer: Cigna Commercial	$1,201.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.83
Rate for Payer: Qualcare PPO/HMO/WC	$360.48
Rate for Payer: UnitedHealthcare Community & State	$75.94
Rate for Payer: Wellpoint Medicaid Managed Care	$68.25

IR-PERC FNA PLEURA-LT

Facility

$2,403.20

Service Code	HCPCS 10022LT
Hospital Charge Code	2690860
Hospital Revenue Code	361
Min. Negotiated Rate	$360.48
Max. Negotiated Rate	$360.48
Rate for Payer: Qualcare PPO/HMO/WC	$360.48

IR-PERC FNA PLEURA-RT

Facility

$2,403.20

Service Code	HCPCS 10022RT
Hospital Charge Code	2690865
Hospital Revenue Code	361
Min. Negotiated Rate	$68.25
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$913.22
Rate for Payer: Aetna Medicare Advantage	$720.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.82
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	$612.82
Rate for Payer: Cigna Commercial	$1,201.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.83
Rate for Payer: Qualcare PPO/HMO/WC	$360.48
Rate for Payer: UnitedHealthcare Community & State	$75.94
Rate for Payer: Wellpoint Medicaid Managed Care	$68.25

IR-PERC FNA PLEURA-RT

Facility

$2,403.20

Service Code	HCPCS 10022RT
Hospital Charge Code	2690865
Hospital Revenue Code	361
Min. Negotiated Rate	$360.48
Max. Negotiated Rate	$360.48
Rate for Payer: Qualcare PPO/HMO/WC	$360.48

IR-PERC INJ RENAL CYST-BI

Facility

$7,064.85

Service Code	HCPCS 5039050
Hospital Charge Code	2690630
Hospital Revenue Code	761
Min. Negotiated Rate	$1,059.73
Max. Negotiated Rate	$1,059.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,059.73

IR-PERC INJ RENAL CYST-BI

Facility

$7,064.85

Service Code	HCPCS 5039050
Hospital Charge Code	3668503905
Hospital Revenue Code	361
Min. Negotiated Rate	$1,059.73
Max. Negotiated Rate	$1,059.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,059.73

IR-PERC INJ RENAL CYST-BI

Facility

$7,064.85

Service Code	HCPCS 5039050
Hospital Charge Code	3668503905
Hospital Revenue Code	361
Min. Negotiated Rate	$200.64
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,684.64
Rate for Payer: Aetna Medicare Advantage	$2,119.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,801.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,801.54
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	$1,801.54
Rate for Payer: Cigna Commercial	$3,532.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,836.86
Rate for Payer: Qualcare PPO/HMO/WC	$1,059.73
Rate for Payer: UnitedHealthcare Community & State	$223.25
Rate for Payer: Wellpoint Medicaid Managed Care	$200.64

IR-PERC INJ RENAL CYST-BI

Facility

$7,064.85

Service Code	HCPCS 5039050
Hospital Charge Code	411050390B
Hospital Revenue Code	361
Min. Negotiated Rate	$200.64
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,684.64
Rate for Payer: Aetna Medicare Advantage	$2,119.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,801.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,801.54
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	$1,801.54
Rate for Payer: Cigna Commercial	$3,532.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,836.86
Rate for Payer: Qualcare PPO/HMO/WC	$1,059.73
Rate for Payer: UnitedHealthcare Community & State	$223.25
Rate for Payer: Wellpoint Medicaid Managed Care	$200.64

IR-PERC INJ RENAL CYST-BI

Facility

$7,064.85

Service Code	HCPCS 5039050
Hospital Charge Code	2690630
Hospital Revenue Code	761
Min. Negotiated Rate	$200.64
Max. Negotiated Rate	$3,532.43
Rate for Payer: Aetna Commercial	$2,684.64
Rate for Payer: Aetna Medicare Advantage	$2,119.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,801.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,801.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,801.54
Rate for Payer: Cigna Commercial	$3,532.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,836.86
Rate for Payer: Oxford Commercial	$1,412.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,059.73
Rate for Payer: UnitedHealthcare Commercial	$1,412.97
Rate for Payer: UnitedHealthcare Community & State	$223.25
Rate for Payer: Wellpoint Medicaid Managed Care	$200.64

IR-PERC INJ RENAL CYST-BI

Facility

$7,064.85

Service Code	HCPCS 5039050
Hospital Charge Code	411050390B
Hospital Revenue Code	361
Min. Negotiated Rate	$1,059.73
Max. Negotiated Rate	$1,059.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,059.73

IR-PERC INJ RENAL CYST-BI

Facility

$7,064.85

Service Code	HCPCS 5039050
Hospital Charge Code	321050390B
Hospital Revenue Code	761
Min. Negotiated Rate	$200.64
Max. Negotiated Rate	$3,532.43
Rate for Payer: Aetna Commercial	$2,684.64
Rate for Payer: Aetna Medicare Advantage	$2,119.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,801.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,801.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,801.54
Rate for Payer: Cigna Commercial	$3,532.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,836.86
Rate for Payer: Oxford Commercial	$1,412.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,059.73
Rate for Payer: UnitedHealthcare Commercial	$1,412.97
Rate for Payer: UnitedHealthcare Community & State	$223.25
Rate for Payer: Wellpoint Medicaid Managed Care	$200.64

IR-PERC INJ RENAL CYST-BI

Facility

$7,064.85

Service Code	HCPCS 5039050
Hospital Charge Code	321050390B
Hospital Revenue Code	761
Min. Negotiated Rate	$1,059.73
Max. Negotiated Rate	$1,059.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,059.73

IR-PERC INJ RENAL CYST-LT

Facility

$4,709.90

Service Code	HCPCS 50390LT
Hospital Charge Code	321050390L
Hospital Revenue Code	361
Min. Negotiated Rate	$706.49
Max. Negotiated Rate	$706.49
Rate for Payer: Qualcare PPO/HMO/WC	$706.49

IR-PERC INJ RENAL CYST-LT

Facility

$4,709.90

Service Code	HCPCS 50390LT
Hospital Charge Code	321050390L
Hospital Revenue Code	361
Min. Negotiated Rate	$133.76
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,789.76
Rate for Payer: Aetna Medicare Advantage	$1,412.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,201.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,201.02
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	$1,201.02
Rate for Payer: Cigna Commercial	$2,354.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,224.57
Rate for Payer: Qualcare PPO/HMO/WC	$706.49
Rate for Payer: UnitedHealthcare Community & State	$148.83
Rate for Payer: Wellpoint Medicaid Managed Care	$133.76

IR-PERC INJ RENAL CYST-LT

Facility

$4,709.90

Service Code	HCPCS 50390LT
Hospital Charge Code	411050390L
Hospital Revenue Code	361
Min. Negotiated Rate	$133.76
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,789.76
Rate for Payer: Aetna Medicare Advantage	$1,412.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,201.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,201.02
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	$1,201.02
Rate for Payer: Cigna Commercial	$2,354.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,224.57
Rate for Payer: Qualcare PPO/HMO/WC	$706.49
Rate for Payer: UnitedHealthcare Community & State	$148.83
Rate for Payer: Wellpoint Medicaid Managed Care	$133.76

IR-PERC INJ RENAL CYST-LT

Facility

$4,709.90

Service Code	HCPCS 50390LT
Hospital Charge Code	366850390L
Hospital Revenue Code	361
Min. Negotiated Rate	$133.76
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,789.76
Rate for Payer: Aetna Medicare Advantage	$1,412.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,201.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,201.02
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	$1,201.02
Rate for Payer: Cigna Commercial	$2,354.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,224.57
Rate for Payer: Qualcare PPO/HMO/WC	$706.49
Rate for Payer: UnitedHealthcare Community & State	$148.83
Rate for Payer: Wellpoint Medicaid Managed Care	$133.76

IR-PERC INJ RENAL CYST-LT

Facility

$4,709.90

Service Code	HCPCS 50390LT
Hospital Charge Code	366850390L
Hospital Revenue Code	361
Min. Negotiated Rate	$706.49
Max. Negotiated Rate	$706.49
Rate for Payer: Qualcare PPO/HMO/WC	$706.49

IR-PERC INJ RENAL CYST-LT

Facility

$4,709.90

Service Code	HCPCS 50390LT
Hospital Charge Code	2691590
Hospital Revenue Code	361
Min. Negotiated Rate	$706.49
Max. Negotiated Rate	$706.49
Rate for Payer: Qualcare PPO/HMO/WC	$706.49

IR-PERC INJ RENAL CYST-LT

Facility

$4,709.90

Service Code	HCPCS 50390LT
Hospital Charge Code	411050390L
Hospital Revenue Code	361
Min. Negotiated Rate	$706.49
Max. Negotiated Rate	$706.49
Rate for Payer: Qualcare PPO/HMO/WC	$706.49

Know your out-of-pocket cost for care.

All Charges