Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

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	$875.58
Max. Negotiated Rate	$875.58
Rate for Payer: Qualcare PPO/HMO/WC	$875.58

IR PLACE CATH IN VEIN LEFT

Facility

$2,919.00

Service Code	HCPCS 36012LT
Hospital Charge Code	321036012L
Hospital Revenue Code	361
Min. Negotiated Rate	$82.90
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,109.22
Rate for Payer: Aetna Medicare Advantage	$875.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$744.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$744.35
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	$744.35
Rate for Payer: Cigna Commercial	$1,459.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$758.94
Rate for Payer: Qualcare PPO/HMO/WC	$437.85
Rate for Payer: UnitedHealthcare Community & State	$92.24
Rate for Payer: Wellpoint Medicaid Managed Care	$82.90

IR PLACE CATH IN VEIN LEFT

Facility

$2,919.00

Service Code	HCPCS 36012LT
Hospital Charge Code	321036012L
Hospital Revenue Code	361
Min. Negotiated Rate	$437.85
Max. Negotiated Rate	$437.85
Rate for Payer: Qualcare PPO/HMO/WC	$437.85

IR PLACE CATH IN VEIN LEFT

Facility

$2,919.00

Service Code	HCPCS 36012LT
Hospital Charge Code	2600143
Hospital Revenue Code	361
Min. Negotiated Rate	$437.85
Max. Negotiated Rate	$437.85
Rate for Payer: Qualcare PPO/HMO/WC	$437.85

IR PLACE CATH IN VEIN LEFT

Facility

$2,919.00

Service Code	HCPCS 36012LT
Hospital Charge Code	2600143
Hospital Revenue Code	361
Min. Negotiated Rate	$82.90
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,109.22
Rate for Payer: Aetna Medicare Advantage	$875.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$744.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$744.35
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	$744.35
Rate for Payer: Cigna Commercial	$1,459.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$758.94
Rate for Payer: Qualcare PPO/HMO/WC	$437.85
Rate for Payer: UnitedHealthcare Community & State	$92.24
Rate for Payer: Wellpoint Medicaid Managed Care	$82.90

IR PLACE CATH IN VEIN RIGHT

Facility

$2,919.00

Service Code	HCPCS 36012RT
Hospital Charge Code	321036012R
Hospital Revenue Code	361
Min. Negotiated Rate	$437.85
Max. Negotiated Rate	$437.85
Rate for Payer: Qualcare PPO/HMO/WC	$437.85

IR PLACE CATH IN VEIN RIGHT

Facility

$2,919.00

Service Code	HCPCS 36012RT
Hospital Charge Code	321036012R
Hospital Revenue Code	361
Min. Negotiated Rate	$82.90
Max. Negotiated Rate	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$744.35
Rate for Payer: Aetna Commercial	$1,109.22
Rate for Payer: Aetna Medicare Advantage	$875.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$744.35
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	$744.35
Rate for Payer: Cigna Commercial	$1,459.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$758.94
Rate for Payer: Qualcare PPO/HMO/WC	$437.85
Rate for Payer: UnitedHealthcare Community & State	$92.24
Rate for Payer: Wellpoint Medicaid Managed Care	$82.90

IR PLACE CATH IN VEIN RIGHT

Facility

$2,919.00

Service Code	HCPCS 36012RT
Hospital Charge Code	2600144
Hospital Revenue Code	361
Min. Negotiated Rate	$82.90
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,109.22
Rate for Payer: Aetna Medicare Advantage	$875.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$744.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$744.35
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	$744.35
Rate for Payer: Cigna Commercial	$1,459.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$758.94
Rate for Payer: Qualcare PPO/HMO/WC	$437.85
Rate for Payer: UnitedHealthcare Community & State	$92.24
Rate for Payer: Wellpoint Medicaid Managed Care	$82.90

IR PLACE CATH IN VEIN RIGHT

Facility

$2,919.00

Service Code	HCPCS 36012RT
Hospital Charge Code	2600144
Hospital Revenue Code	361
Min. Negotiated Rate	$437.85
Max. Negotiated Rate	$437.85
Rate for Payer: Qualcare PPO/HMO/WC	$437.85

IR-PLACE CATH PULM ART-LT

Facility

$230.00

Service Code	HCPCS 36014LT
Hospital Charge Code	2691170
Hospital Revenue Code	361
Min. Negotiated Rate	$6.53
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$87.40
Rate for Payer: Aetna Medicare Advantage	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.65
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	$58.65
Rate for Payer: Cigna Commercial	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.80
Rate for Payer: Qualcare PPO/HMO/WC	$34.50
Rate for Payer: UnitedHealthcare Community & State	$7.27
Rate for Payer: Wellpoint Medicaid Managed Care	$6.53

IR-PLACE CATH PULM ART-LT

Facility

$230.00

Service Code	HCPCS 36014LT
Hospital Charge Code	2691170
Hospital Revenue Code	361
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$34.50
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

IR-PLACE CATH PULM ART-LT

Facility

$230.00

Service Code	HCPCS 36014LT
Hospital Charge Code	321036014L
Hospital Revenue Code	361
Min. Negotiated Rate	$6.53
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$87.40
Rate for Payer: Aetna Medicare Advantage	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.65
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	$58.65
Rate for Payer: Cigna Commercial	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.80
Rate for Payer: Qualcare PPO/HMO/WC	$34.50
Rate for Payer: UnitedHealthcare Community & State	$7.27
Rate for Payer: Wellpoint Medicaid Managed Care	$6.53

IR-PLACE CATH PULM ART-LT

Facility

$230.00

Service Code	HCPCS 36014LT
Hospital Charge Code	321036014L
Hospital Revenue Code	361
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$34.50
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

IR-PLACE CATH PULM ART-RT

Facility

$230.00

Service Code	HCPCS 36014RT
Hospital Charge Code	321036014R
Hospital Revenue Code	361
Min. Negotiated Rate	$6.53
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$87.40
Rate for Payer: Aetna Medicare Advantage	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.65
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	$58.65
Rate for Payer: Cigna Commercial	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.80
Rate for Payer: Qualcare PPO/HMO/WC	$34.50
Rate for Payer: UnitedHealthcare Community & State	$7.27
Rate for Payer: Wellpoint Medicaid Managed Care	$6.53

IR-PLACE CATH PULM ART-RT

Facility

$230.00

Service Code	HCPCS 36014RT
Hospital Charge Code	321036014R
Hospital Revenue Code	361
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$34.50
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

IR-PLACE CATH PULM ART-RT

Facility

$230.00

Service Code	HCPCS 36014RT
Hospital Charge Code	2691175
Hospital Revenue Code	361
Min. Negotiated Rate	$6.53
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$87.40
Rate for Payer: Aetna Medicare Advantage	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.65
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	$58.65
Rate for Payer: Cigna Commercial	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.80
Rate for Payer: Qualcare PPO/HMO/WC	$34.50
Rate for Payer: UnitedHealthcare Community & State	$7.27
Rate for Payer: Wellpoint Medicaid Managed Care	$6.53

IR-PLACE CATH PULM ART-RT

Facility

$230.00

Service Code	HCPCS 36014RT
Hospital Charge Code	2691175
Hospital Revenue Code	361
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$34.50
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

IR-PLACE CTH PLM ARTRY-RT

Facility

$188.00

Service Code	HCPCS 36013RT
Hospital Charge Code	321036013R
Hospital Revenue Code	361
Min. Negotiated Rate	$28.20
Max. Negotiated Rate	$28.20
Rate for Payer: Qualcare PPO/HMO/WC	$28.20

IR-PLACE CTH PLM ARTRY-RT

Facility

$188.00

Service Code	HCPCS 36013RT
Hospital Charge Code	2691165
Hospital Revenue Code	361
Min. Negotiated Rate	$5.34
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$71.44
Rate for Payer: Aetna Medicare Advantage	$56.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.94
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	$47.94
Rate for Payer: Cigna Commercial	$94.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.88
Rate for Payer: Qualcare PPO/HMO/WC	$28.20
Rate for Payer: UnitedHealthcare Community & State	$5.94
Rate for Payer: Wellpoint Medicaid Managed Care	$5.34

IR-PLACE CTH PLM ARTRY-RT

Facility

$188.00

Service Code	HCPCS 36013RT
Hospital Charge Code	2691165
Hospital Revenue Code	361
Min. Negotiated Rate	$28.20
Max. Negotiated Rate	$28.20
Rate for Payer: Qualcare PPO/HMO/WC	$28.20

IR-PLACE CTH PLM ARTRY-RT

Facility

$188.00

Service Code	HCPCS 36013RT
Hospital Charge Code	321036013R
Hospital Revenue Code	361
Min. Negotiated Rate	$5.34
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$71.44
Rate for Payer: Aetna Medicare Advantage	$56.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.94
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	$47.94
Rate for Payer: Cigna Commercial	$94.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.88
Rate for Payer: Qualcare PPO/HMO/WC	$28.20
Rate for Payer: UnitedHealthcare Community & State	$5.94
Rate for Payer: Wellpoint Medicaid Managed Care	$5.34

IR PLACE GASTROSTOMY TUBE PERC

Facility

$8,686.35

Service Code	HCPCS 49440
Hospital Charge Code	5600159
Hospital Revenue Code	361
Min. Negotiated Rate	$1,302.95
Max. Negotiated Rate	$1,302.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,302.95

IR PLACE GASTROSTOMY TUBE PERC

Facility

$6,674.15

Service Code	HCPCS 49440
Hospital Charge Code	366849440
Hospital Revenue Code	361
Min. Negotiated Rate	$1,001.12
Max. Negotiated Rate	$1,001.12
Rate for Payer: Qualcare PPO/HMO/WC	$1,001.12

IR PLACE GASTROSTOMY TUBE PERC

Facility

$6,674.15

Service Code	HCPCS 49440
Hospital Charge Code	366849440
Hospital Revenue Code	361
Min. Negotiated Rate	$189.55
Max. Negotiated Rate	$8,269.65
Rate for Payer: Aetna Commercial	$6,200.81
Rate for Payer: Aetna Medicare Advantage	$7,386.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,269.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,269.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,279.71
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	$8,269.65
Rate for Payer: Cigna Commercial	$4,569.67
Rate for Payer: Cigna Medicare Advantage	$2,279.71
Rate for Payer: Clover Medicare Advantage	$2,165.72
Rate for Payer: EmblemHealth Commercial	$6,839.13
Rate for Payer: Humana Medicare Advantage	$2,348.10
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,279.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.28
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,001.12
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$210.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,279.71
Rate for Payer: Wellcare Medicare Advantage	$2,279.71
Rate for Payer: Wellpoint Medicaid Managed Care	$189.55

IR PLACE GASTROSTOMY TUBE PERC

Facility

$6,674.15

Service Code	HCPCS 49440
Hospital Charge Code	7411593
Hospital Revenue Code	361
Min. Negotiated Rate	$1,001.12
Max. Negotiated Rate	$1,001.12
Rate for Payer: Qualcare PPO/HMO/WC	$1,001.12

Know your out-of-pocket cost for care.

All Charges