Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

IR PERC VAC ASST BREAST BIOPSY

Facility

$6,096.00

Hospital Charge Code	26702042
Hospital Revenue Code	361
Min. Negotiated Rate	$173.13
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,316.48
Rate for Payer: Aetna Medicare Advantage	$1,828.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,554.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,554.48
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	$1,554.48
Rate for Payer: Cigna Commercial	$3,048.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,584.96
Rate for Payer: Qualcare PPO/HMO/WC	$914.40
Rate for Payer: UnitedHealthcare Community & State	$192.63
Rate for Payer: Wellpoint Medicaid Managed Care	$173.13

IR PERC VAC ASST BREAST BIOPSY

Facility

$6,096.00

Hospital Charge Code	26702042
Hospital Revenue Code	361
Min. Negotiated Rate	$914.40
Max. Negotiated Rate	$914.40
Rate for Payer: Qualcare PPO/HMO/WC	$914.40

IR PERICARDIOCENTESIS INITIAL

Facility

$6,404.20

Service Code	HCPCS 33010
Hospital Charge Code	321033010
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

IR PERICARDIOCENTESIS INITIAL

Facility

$6,404.20

Service Code	HCPCS 33010
Hospital Charge Code	2680135
Hospital Revenue Code	361
Min. Negotiated Rate	$181.88
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,433.60
Rate for Payer: Aetna Medicare Advantage	$1,921.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.07
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	$1,633.07
Rate for Payer: Cigna Commercial	$3,202.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,665.09
Rate for Payer: Qualcare PPO/HMO/WC	$960.63
Rate for Payer: UnitedHealthcare Community & State	$202.37
Rate for Payer: Wellpoint Medicaid Managed Care	$181.88

IR PERICARDIOCENTESIS INITIAL

Facility

$6,404.20

Service Code	HCPCS 33010
Hospital Charge Code	2680135
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

IR PERICARDIOCENTESIS INITIAL

Facility

$6,404.20

Service Code	HCPCS 33010
Hospital Charge Code	321033010
Hospital Revenue Code	361
Min. Negotiated Rate	$181.88
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,433.60
Rate for Payer: Aetna Medicare Advantage	$1,921.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.07
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	$1,633.07
Rate for Payer: Cigna Commercial	$3,202.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,665.09
Rate for Payer: Qualcare PPO/HMO/WC	$960.63
Rate for Payer: UnitedHealthcare Community & State	$202.37
Rate for Payer: Wellpoint Medicaid Managed Care	$181.88

IR PERICARDIOCENTESIS SUBSEQUE

Facility

$2,275.00

Service Code	HCPCS 33011
Hospital Charge Code	2680140
Hospital Revenue Code	361
Min. Negotiated Rate	$341.25
Max. Negotiated Rate	$341.25
Rate for Payer: Qualcare PPO/HMO/WC	$341.25

IR PERICARDIOCENTESIS SUBSEQUE

Facility

$2,275.00

Service Code	HCPCS 33011
Hospital Charge Code	2680140
Hospital Revenue Code	361
Min. Negotiated Rate	$64.61
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$864.50
Rate for Payer: Aetna Medicare Advantage	$682.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$580.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$580.12
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	$580.12
Rate for Payer: Cigna Commercial	$1,137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$591.50
Rate for Payer: Qualcare PPO/HMO/WC	$341.25
Rate for Payer: UnitedHealthcare Community & State	$71.89
Rate for Payer: Wellpoint Medicaid Managed Care	$64.61

IR PERITONEAL LAVAGE W/IMG

Facility

$2,275.00

Service Code	HCPCS 49084
Hospital Charge Code	2670110
Hospital Revenue Code	361
Min. Negotiated Rate	$341.25
Max. Negotiated Rate	$341.25
Rate for Payer: Qualcare PPO/HMO/WC	$341.25

IR PERITONEAL LAVAGE W/IMG

Facility

$2,275.00

Service Code	HCPCS 49084
Hospital Charge Code	7411577
Hospital Revenue Code	361
Min. Negotiated Rate	$341.25
Max. Negotiated Rate	$341.25
Rate for Payer: Qualcare PPO/HMO/WC	$341.25

IR PERITONEAL LAVAGE W/IMG

Facility

$2,275.00

Service Code	HCPCS 49084
Hospital Charge Code	2670110
Hospital Revenue Code	361
Min. Negotiated Rate	$64.61
Max. Negotiated Rate	$5,347.00
Rate for Payer: Aetna Commercial	$2,930.85
Rate for Payer: Aetna Medicare Advantage	$3,491.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,908.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,908.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,077.52
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	$3,908.70
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: Cigna Medicare Advantage	$1,077.52
Rate for Payer: Clover Medicare Advantage	$1,023.64
Rate for Payer: EmblemHealth Commercial	$3,232.56
Rate for Payer: Humana Medicare Advantage	$1,109.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,077.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$591.50
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$341.25
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$71.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,077.52
Rate for Payer: Wellcare Medicare Advantage	$1,077.52
Rate for Payer: Wellpoint Medicaid Managed Care	$64.61

IR PERITONEAL LAVAGE W/IMG

Facility

$2,275.00

Service Code	HCPCS 49084
Hospital Charge Code	7411577
Hospital Revenue Code	361
Min. Negotiated Rate	$64.61
Max. Negotiated Rate	$5,347.00
Rate for Payer: Aetna Commercial	$2,930.85
Rate for Payer: Aetna Medicare Advantage	$3,491.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,908.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,908.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,077.52
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	$3,908.70
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: Cigna Medicare Advantage	$1,077.52
Rate for Payer: Clover Medicare Advantage	$1,023.64
Rate for Payer: EmblemHealth Commercial	$3,232.56
Rate for Payer: Humana Medicare Advantage	$1,109.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,077.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$591.50
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$341.25
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$71.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,077.52
Rate for Payer: Wellcare Medicare Advantage	$1,077.52
Rate for Payer: Wellpoint Medicaid Managed Care	$64.61

IR PERQ STENT CHEST VERT ART

Facility

$37,614.35

Service Code	HCPCS 0075T
Hospital Charge Code	5700214
Hospital Revenue Code	361
Min. Negotiated Rate	$5,642.15
Max. Negotiated Rate	$5,642.15
Rate for Payer: Qualcare PPO/HMO/WC	$5,642.15

IR PERQ STENT CHEST VERT ART

Facility

$37,614.35

Service Code	HCPCS 0075T
Hospital Charge Code	32100075T
Hospital Revenue Code	361
Min. Negotiated Rate	$5,642.15
Max. Negotiated Rate	$5,642.15
Rate for Payer: Qualcare PPO/HMO/WC	$5,642.15

IR PERQ STENT CHEST VERT ART

Facility

$37,614.35

Service Code	HCPCS 0075T
Hospital Charge Code	5700214
Hospital Revenue Code	361
Min. Negotiated Rate	$1,068.25
Max. Negotiated Rate	$18,807.17
Rate for Payer: Aetna Commercial	$14,293.45
Rate for Payer: Aetna Medicare Advantage	$11,284.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,591.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,591.66
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	$9,591.66
Rate for Payer: Cigna Commercial	$18,807.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,779.73
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,642.15
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$1,188.61
Rate for Payer: Wellpoint Medicaid Managed Care	$1,068.25

IR PERQ STENT CHEST VERT ART

Facility

$37,614.35

Service Code	HCPCS 0075T
Hospital Charge Code	41100075T
Hospital Revenue Code	361
Min. Negotiated Rate	$5,642.15
Max. Negotiated Rate	$5,642.15
Rate for Payer: Qualcare PPO/HMO/WC	$5,642.15

IR PERQ STENT CHEST VERT ART

Facility

$37,614.35

Service Code	HCPCS 0075T
Hospital Charge Code	32100075T
Hospital Revenue Code	361
Min. Negotiated Rate	$1,068.25
Max. Negotiated Rate	$18,807.17
Rate for Payer: Aetna Commercial	$14,293.45
Rate for Payer: Aetna Medicare Advantage	$11,284.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,591.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,591.66
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	$9,591.66
Rate for Payer: Cigna Commercial	$18,807.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,779.73
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,642.15
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$1,188.61
Rate for Payer: Wellpoint Medicaid Managed Care	$1,068.25

IR PERQ STENT CHEST VERT ART

Facility

$37,614.35

Service Code	HCPCS 0075T
Hospital Charge Code	36680075T
Hospital Revenue Code	361
Min. Negotiated Rate	$1,068.25
Max. Negotiated Rate	$18,807.17
Rate for Payer: Aetna Commercial	$14,293.45
Rate for Payer: Aetna Medicare Advantage	$11,284.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,591.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,591.66
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	$9,591.66
Rate for Payer: Cigna Commercial	$18,807.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,779.73
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,642.15
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$1,188.61
Rate for Payer: Wellpoint Medicaid Managed Care	$1,068.25

IR PERQ STENT CHEST VERT ART

Facility

$37,614.35

Service Code	HCPCS 0075T
Hospital Charge Code	36680075T
Hospital Revenue Code	361
Min. Negotiated Rate	$5,642.15
Max. Negotiated Rate	$5,642.15
Rate for Payer: Qualcare PPO/HMO/WC	$5,642.15

IR PERQ STENT CHEST VERT ART

Facility

$37,614.35

Service Code	HCPCS 0075T
Hospital Charge Code	41100075T
Hospital Revenue Code	361
Min. Negotiated Rate	$1,068.25
Max. Negotiated Rate	$18,807.17
Rate for Payer: Aetna Commercial	$14,293.45
Rate for Payer: Aetna Medicare Advantage	$11,284.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,591.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,591.66
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	$9,591.66
Rate for Payer: Cigna Commercial	$18,807.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,779.73
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,642.15
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$1,188.61
Rate for Payer: Wellpoint Medicaid Managed Care	$1,068.25

IR PICC TRAY

Facility

$43.00

Hospital Charge Code	7412026
Hospital Revenue Code	272
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$16.34
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.18
Rate for Payer: Oxford Commercial	$8.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$8.60
Rate for Payer: UnitedHealthcare Community & State	$1.36
Rate for Payer: Wellpoint Medicaid Managed Care	$1.22

IR PICC TRAY

Facility

$43.00

Hospital Charge Code	7412026
Hospital Revenue Code	272
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

IR PICC TRAY

Facility

$43.00

Service Code	HCPCS A4310
Hospital Charge Code	2680395
Hospital Revenue Code	272
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$16.34
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.18
Rate for Payer: Oxford Commercial	$8.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$8.60
Rate for Payer: UnitedHealthcare Community & State	$1.36
Rate for Payer: Wellpoint Medicaid Managed Care	$1.22

IR PICC TRAY

Facility

$43.00

Service Code	HCPCS A4310
Hospital Charge Code	2680395
Hospital Revenue Code	272
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

IR PLACE CATH IN VEIN BILATRL

Facility

$5,837.20

Service Code	HCPCS 3601250
Hospital Charge Code	2004950
Hospital Revenue Code	361
Min. Negotiated Rate	$165.78
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,218.14
Rate for Payer: Aetna Medicare Advantage	$1,751.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,488.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,488.49
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	$1,488.49
Rate for Payer: Cigna Commercial	$2,918.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,517.67
Rate for Payer: Qualcare PPO/HMO/WC	$875.58
Rate for Payer: UnitedHealthcare Community & State	$184.46
Rate for Payer: Wellpoint Medicaid Managed Care	$165.78

Know your out-of-pocket cost for care.

All Charges