Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

IR-PL CATH ART AD A/P-LT

Facility

$484.00

Service Code	HCPCS 36248LT
Hospital Charge Code	2691270
Hospital Revenue Code	361
Min. Negotiated Rate	$13.75
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$183.92
Rate for Payer: Aetna Medicare Advantage	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.42
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	$123.42
Rate for Payer: Cigna Commercial	$242.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.84
Rate for Payer: Qualcare PPO/HMO/WC	$72.60
Rate for Payer: UnitedHealthcare Community & State	$15.29
Rate for Payer: Wellpoint Medicaid Managed Care	$13.75

IR-PL CATH ART AD A/P-RT

Facility

$484.00

Service Code	HCPCS 36248RT
Hospital Charge Code	2691275
Hospital Revenue Code	361
Min. Negotiated Rate	$13.75
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$183.92
Rate for Payer: Aetna Medicare Advantage	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.42
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	$123.42
Rate for Payer: Cigna Commercial	$242.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.84
Rate for Payer: Qualcare PPO/HMO/WC	$72.60
Rate for Payer: UnitedHealthcare Community & State	$15.29
Rate for Payer: Wellpoint Medicaid Managed Care	$13.75

IR-PL CATH ART AD A/P-RT

Facility

$484.00

Service Code	HCPCS 36248RT
Hospital Charge Code	2691275
Hospital Revenue Code	361
Min. Negotiated Rate	$72.60
Max. Negotiated Rate	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$72.60

IR-PL CATH ART AD A/P-RT

Facility

$484.00

Service Code	HCPCS 36248RT
Hospital Charge Code	321036248R
Hospital Revenue Code	361
Min. Negotiated Rate	$13.75
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$183.92
Rate for Payer: Aetna Medicare Advantage	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.42
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	$123.42
Rate for Payer: Cigna Commercial	$242.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.84
Rate for Payer: Qualcare PPO/HMO/WC	$72.60
Rate for Payer: UnitedHealthcare Community & State	$15.29
Rate for Payer: Wellpoint Medicaid Managed Care	$13.75

IR-PL CATH ART AD A/P-RT

Facility

$484.00

Service Code	HCPCS 36248RT
Hospital Charge Code	321036248R
Hospital Revenue Code	361
Min. Negotiated Rate	$72.60
Max. Negotiated Rate	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$72.60

IR-PL CATH ART AD T/B-BI

Facility

$486.00

Service Code	HCPCS 3621850
Hospital Charge Code	3668362185
Hospital Revenue Code	361
Min. Negotiated Rate	$72.90
Max. Negotiated Rate	$72.90
Rate for Payer: Qualcare PPO/HMO/WC	$72.90

IR-PL CATH ART AD T/B-BI

Facility

$486.00

Service Code	HCPCS 3621850
Hospital Charge Code	3668362185
Hospital Revenue Code	361
Min. Negotiated Rate	$13.80
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$184.68
Rate for Payer: Aetna Medicare Advantage	$145.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.93
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	$123.93
Rate for Payer: Cigna Commercial	$243.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.36
Rate for Payer: Qualcare PPO/HMO/WC	$72.90
Rate for Payer: UnitedHealthcare Community & State	$15.36
Rate for Payer: Wellpoint Medicaid Managed Care	$13.80

IR-PL CATH ART AD T/B-BI

Facility

$486.00

Service Code	HCPCS 3621850
Hospital Charge Code	2690470
Hospital Revenue Code	361
Min. Negotiated Rate	$13.80
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$184.68
Rate for Payer: Aetna Medicare Advantage	$145.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.93
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	$123.93
Rate for Payer: Cigna Commercial	$243.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.36
Rate for Payer: Qualcare PPO/HMO/WC	$72.90
Rate for Payer: UnitedHealthcare Community & State	$15.36
Rate for Payer: Wellpoint Medicaid Managed Care	$13.80

IR-PL CATH ART AD T/B-BI

Facility

$486.00

Service Code	HCPCS 3621850
Hospital Charge Code	2690470
Hospital Revenue Code	361
Min. Negotiated Rate	$72.90
Max. Negotiated Rate	$72.90
Rate for Payer: Qualcare PPO/HMO/WC	$72.90

IR-PL CATH ART AD T/B-BI

Facility

$486.00

Service Code	HCPCS 3621850
Hospital Charge Code	321036218B
Hospital Revenue Code	361
Min. Negotiated Rate	$13.80
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$184.68
Rate for Payer: Aetna Medicare Advantage	$145.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.93
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	$123.93
Rate for Payer: Cigna Commercial	$243.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.36
Rate for Payer: Qualcare PPO/HMO/WC	$72.90
Rate for Payer: UnitedHealthcare Community & State	$15.36
Rate for Payer: Wellpoint Medicaid Managed Care	$13.80

IR-PL CATH ART AD T/B-BI

Facility

$486.00

Service Code	HCPCS 3621850
Hospital Charge Code	411036218
Hospital Revenue Code	361
Min. Negotiated Rate	$72.90
Max. Negotiated Rate	$72.90
Rate for Payer: Qualcare PPO/HMO/WC	$72.90

IR-PL CATH ART AD T/B-BI

Facility

$486.00

Service Code	HCPCS 3621850
Hospital Charge Code	321036218B
Hospital Revenue Code	361
Min. Negotiated Rate	$72.90
Max. Negotiated Rate	$72.90
Rate for Payer: Qualcare PPO/HMO/WC	$72.90

IR-PL CATH ART AD T/B-BI

Facility

$486.00

Service Code	HCPCS 3621850
Hospital Charge Code	411036218
Hospital Revenue Code	361
Min. Negotiated Rate	$13.80
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$184.68
Rate for Payer: Aetna Medicare Advantage	$145.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.93
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	$123.93
Rate for Payer: Cigna Commercial	$243.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.36
Rate for Payer: Qualcare PPO/HMO/WC	$72.90
Rate for Payer: UnitedHealthcare Community & State	$15.36
Rate for Payer: Wellpoint Medicaid Managed Care	$13.80

IR-PLEURA BIOPSY NEEDLE

Facility

$3,981.00

Service Code	HCPCS 32400
Hospital Charge Code	2680120
Hospital Revenue Code	361
Min. Negotiated Rate	$113.06
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,035.06
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$597.15
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$125.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$113.06

IR-PLEURA BIOPSY NEEDLE

Facility

$3,981.00

Service Code	HCPCS 32400
Hospital Charge Code	7411376
Hospital Revenue Code	361
Min. Negotiated Rate	$597.15
Max. Negotiated Rate	$597.15
Rate for Payer: Qualcare PPO/HMO/WC	$597.15

IR-PLEURA BIOPSY NEEDLE

Facility

$3,981.00

Service Code	HCPCS 32400
Hospital Charge Code	2680120
Hospital Revenue Code	361
Min. Negotiated Rate	$597.15
Max. Negotiated Rate	$597.15
Rate for Payer: Qualcare PPO/HMO/WC	$597.15

IR-PLEURA BIOPSY NEEDLE

Facility

$3,981.00

Service Code	HCPCS 32400
Hospital Charge Code	7411376
Hospital Revenue Code	361
Min. Negotiated Rate	$113.06
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,035.06
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$597.15
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$125.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$113.06

IR PNEUMONOSTOMY;W/P/C DRAINAG

Facility

$2,275.00

Service Code	HCPCS 49405
Hospital Charge Code	2680115
Hospital Revenue Code	361
Min. Negotiated Rate	$64.61
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
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	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$64.61

IR PNEUMONOSTOMY;W/P/C DRAINAG

Facility

$2,275.00

Service Code	HCPCS 49405
Hospital Charge Code	2680115
Hospital Revenue Code	361
Min. Negotiated Rate	$341.25
Max. Negotiated Rate	$341.25
Rate for Payer: Qualcare PPO/HMO/WC	$341.25

IR PNEUMONOSTOMY;W/P/C DRAINAG

Facility

$2,275.00

Service Code	HCPCS 49405
Hospital Charge Code	7411582
Hospital Revenue Code	361
Min. Negotiated Rate	$64.61
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
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	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$64.61

IR PNEUMONOSTOMY;W/P/C DRAINAG

Facility

$2,275.00

Service Code	HCPCS 49405
Hospital Charge Code	7411582
Hospital Revenue Code	361
Min. Negotiated Rate	$341.25
Max. Negotiated Rate	$341.25
Rate for Payer: Qualcare PPO/HMO/WC	$341.25

IR-PRE-OP PLCMNT NDDLE LOC WIR

Facility

$996.00

Hospital Charge Code	2680015
Hospital Revenue Code	361
Min. Negotiated Rate	$149.40
Max. Negotiated Rate	$149.40
Rate for Payer: Qualcare PPO/HMO/WC	$149.40

IR-PRE-OP PLCMNT NDDLE LOC WIR

Facility

$996.00

Hospital Charge Code	2680015
Hospital Revenue Code	361
Min. Negotiated Rate	$28.29
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$378.48
Rate for Payer: Aetna Medicare Advantage	$298.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.98
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	$253.98
Rate for Payer: Cigna Commercial	$498.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.96
Rate for Payer: Qualcare PPO/HMO/WC	$149.40
Rate for Payer: UnitedHealthcare Community & State	$31.47
Rate for Payer: Wellpoint Medicaid Managed Care	$28.29

IR PRIMPERC TRAN MEC THROMB AD

Facility

$27,397.00

Service Code	HCPCS 37184
Hospital Charge Code	2001359
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 PRIMPERC TRAN MEC THROMB AD

Facility

$27,397.00

Service Code	HCPCS 37184
Hospital Charge Code	2001359
Hospital Revenue Code	361
Min. Negotiated Rate	$778.07
Max. Negotiated Rate	$79,001.40
Rate for Payer: Aetna Commercial	$59,237.44
Rate for Payer: Aetna Medicare Advantage	$70,562.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79,001.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79,001.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,778.47
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	$79,001.40
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: Cigna Medicare Advantage	$21,778.47
Rate for Payer: Clover Medicare Advantage	$20,689.55
Rate for Payer: EmblemHealth Commercial	$65,335.41
Rate for Payer: Humana Medicare Advantage	$22,431.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21,778.47
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: UnitedHealthcare Medicare Advantage	$21,778.47
Rate for Payer: Wellcare Medicare Advantage	$21,778.47
Rate for Payer: Wellpoint Medicaid Managed Care	$778.07

Know your out-of-pocket cost for care.

All Charges