Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

IR PRIMPERC TRAN MEC THROMB AD

Facility

$27,397.00

Service Code	HCPCS 37184
Hospital Charge Code	321037184
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	321037184
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

IR PRIMPERC TRAN MEC THROMB SG

Facility

$12,129.00

Service Code	HCPCS 37185
Hospital Charge Code	321037185
Hospital Revenue Code	361
Min. Negotiated Rate	$1,819.35
Max. Negotiated Rate	$1,819.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,819.35

IR PRIMPERC TRAN MEC THROMB SG

Facility

$12,129.00

Service Code	HCPCS 37185
Hospital Charge Code	321037185
Hospital Revenue Code	361
Min. Negotiated Rate	$344.46
Max. Negotiated Rate	$6,064.50
Rate for Payer: Aetna Commercial	$4,609.02
Rate for Payer: Aetna Medicare Advantage	$3,638.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,092.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,092.89
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	$3,092.89
Rate for Payer: Cigna Commercial	$6,064.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,153.54
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,819.35
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$383.28
Rate for Payer: Wellpoint Medicaid Managed Care	$344.46

IR PRIMPERC TRAN MEC THROMB SG

Facility

$12,129.00

Service Code	HCPCS 37185
Hospital Charge Code	2001358
Hospital Revenue Code	361
Min. Negotiated Rate	$1,819.35
Max. Negotiated Rate	$1,819.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,819.35

IR PRIMPERC TRAN MEC THROMB SG

Facility

$12,129.00

Service Code	HCPCS 37185
Hospital Charge Code	2001358
Hospital Revenue Code	361
Min. Negotiated Rate	$344.46
Max. Negotiated Rate	$6,064.50
Rate for Payer: Aetna Commercial	$4,609.02
Rate for Payer: Aetna Medicare Advantage	$3,638.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,092.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,092.89
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	$3,092.89
Rate for Payer: Cigna Commercial	$6,064.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,153.54
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,819.35
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$383.28
Rate for Payer: Wellpoint Medicaid Managed Care	$344.46

IR-PSEUDOAN INJ-RT

Facility

$3,630.70

Service Code	HCPCS 36002RT
Hospital Charge Code	2691140
Hospital Revenue Code	361
Min. Negotiated Rate	$103.11
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,379.67
Rate for Payer: Aetna Medicare Advantage	$1,089.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$925.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$925.83
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	$925.83
Rate for Payer: Cigna Commercial	$1,815.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$943.98
Rate for Payer: Qualcare PPO/HMO/WC	$544.61
Rate for Payer: UnitedHealthcare Community & State	$114.73
Rate for Payer: Wellpoint Medicaid Managed Care	$103.11

IR-PSEUDOAN INJ-RT

Facility

$3,630.70

Service Code	HCPCS 36002RT
Hospital Charge Code	321036002R
Hospital Revenue Code	361
Min. Negotiated Rate	$103.11
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,379.67
Rate for Payer: Aetna Medicare Advantage	$1,089.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$925.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$925.83
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	$925.83
Rate for Payer: Cigna Commercial	$1,815.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$943.98
Rate for Payer: Qualcare PPO/HMO/WC	$544.61
Rate for Payer: UnitedHealthcare Community & State	$114.73
Rate for Payer: Wellpoint Medicaid Managed Care	$103.11

IR-PSEUDOAN INJ-RT

Facility

$3,630.70

Service Code	HCPCS 36002RT
Hospital Charge Code	321036002R
Hospital Revenue Code	361
Min. Negotiated Rate	$544.61
Max. Negotiated Rate	$544.61
Rate for Payer: Qualcare PPO/HMO/WC	$544.61

IR-PSEUDOAN INJ-RT

Facility

$3,630.70

Service Code	HCPCS 36002RT
Hospital Charge Code	2691140
Hospital Revenue Code	361
Min. Negotiated Rate	$544.61
Max. Negotiated Rate	$544.61
Rate for Payer: Qualcare PPO/HMO/WC	$544.61

IR PTA BALLOON AORTIC

Facility

$22,441.00

Service Code	HCPCS 35472
Hospital Charge Code	2000844
Hospital Revenue Code	361
Min. Negotiated Rate	$637.32
Max. Negotiated Rate	$11,220.50
Rate for Payer: Aetna Commercial	$8,527.58
Rate for Payer: Aetna Medicare Advantage	$6,732.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,722.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,722.45
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	$5,722.45
Rate for Payer: Cigna Commercial	$11,220.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,834.66
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.15
Rate for Payer: UnitedHealthcare Community & State	$709.14
Rate for Payer: Wellpoint Medicaid Managed Care	$637.32

IR PTA BALLOON AORTIC

Facility

$22,441.00

Service Code	HCPCS 35472
Hospital Charge Code	2000844
Hospital Revenue Code	361
Min. Negotiated Rate	$3,366.15
Max. Negotiated Rate	$3,366.15
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.15

IR PTA BALLOON BRACH TRUNK

Facility

$22,441.00

Service Code	HCPCS 35475
Hospital Charge Code	2000846
Hospital Revenue Code	361
Min. Negotiated Rate	$3,366.15
Max. Negotiated Rate	$3,366.15
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.15

IR PTA BALLOON BRACH TRUNK

Facility

$22,441.00

Service Code	HCPCS 35475
Hospital Charge Code	2000846
Hospital Revenue Code	361
Min. Negotiated Rate	$637.32
Max. Negotiated Rate	$11,220.50
Rate for Payer: Aetna Commercial	$8,527.58
Rate for Payer: Aetna Medicare Advantage	$6,732.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,722.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,722.45
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	$5,722.45
Rate for Payer: Cigna Commercial	$11,220.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,834.66
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.15
Rate for Payer: UnitedHealthcare Community & State	$709.14
Rate for Payer: Wellpoint Medicaid Managed Care	$637.32

IR PTA BALLOON BRACH TRUNK

Facility

$22,441.00

Service Code	HCPCS 35475
Hospital Charge Code	7411408
Hospital Revenue Code	361
Min. Negotiated Rate	$637.32
Max. Negotiated Rate	$11,220.50
Rate for Payer: Aetna Commercial	$8,527.58
Rate for Payer: Aetna Medicare Advantage	$6,732.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,722.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,722.45
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	$5,722.45
Rate for Payer: Cigna Commercial	$11,220.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,834.66
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.15
Rate for Payer: UnitedHealthcare Community & State	$709.14
Rate for Payer: Wellpoint Medicaid Managed Care	$637.32

IR PTA BALLOON BRACH TRUNK

Facility

$22,441.00

Service Code	HCPCS 35475
Hospital Charge Code	7411408
Hospital Revenue Code	361
Min. Negotiated Rate	$3,366.15
Max. Negotiated Rate	$3,366.15
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.15

IR PTA BALLOON RENAL OR VIS EA

Facility

$22,441.00

Service Code	HCPCS 35471
Hospital Charge Code	7411406
Hospital Revenue Code	361
Min. Negotiated Rate	$637.32
Max. Negotiated Rate	$11,220.50
Rate for Payer: Aetna Commercial	$8,527.58
Rate for Payer: Aetna Medicare Advantage	$6,732.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,722.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,722.45
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	$5,722.45
Rate for Payer: Cigna Commercial	$11,220.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,834.66
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.15
Rate for Payer: UnitedHealthcare Community & State	$709.14
Rate for Payer: Wellpoint Medicaid Managed Care	$637.32

IR PTA BALLOON RENAL OR VIS EA

Facility

$22,441.00

Service Code	HCPCS 35471
Hospital Charge Code	2000845
Hospital Revenue Code	361
Min. Negotiated Rate	$3,366.15
Max. Negotiated Rate	$3,366.15
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.15

IR PTA BALLOON RENAL OR VIS EA

Facility

$22,441.00

Service Code	HCPCS 35471
Hospital Charge Code	2000845
Hospital Revenue Code	361
Min. Negotiated Rate	$637.32
Max. Negotiated Rate	$11,220.50
Rate for Payer: Aetna Commercial	$8,527.58
Rate for Payer: Aetna Medicare Advantage	$6,732.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,722.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,722.45
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	$5,722.45
Rate for Payer: Cigna Commercial	$11,220.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,834.66
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.15
Rate for Payer: UnitedHealthcare Community & State	$709.14
Rate for Payer: Wellpoint Medicaid Managed Care	$637.32

IR PTA BALLOON RENAL OR VIS EA

Facility

$22,441.00

Service Code	HCPCS 35471
Hospital Charge Code	7411406
Hospital Revenue Code	361
Min. Negotiated Rate	$3,366.15
Max. Negotiated Rate	$3,366.15
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.15

IR-PTA ILIAC ARTERY

Facility

$21,962.00

Service Code	HCPCS 35473
Hospital Charge Code	2680155
Hospital Revenue Code	361
Min. Negotiated Rate	$3,294.30
Max. Negotiated Rate	$3,294.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.30

IR-PTA ILIAC ARTERY

Facility

$21,962.00

Service Code	HCPCS 35473
Hospital Charge Code	2680155
Hospital Revenue Code	361
Min. Negotiated Rate	$623.72
Max. Negotiated Rate	$10,981.00
Rate for Payer: Aetna Commercial	$8,345.56
Rate for Payer: Aetna Medicare Advantage	$6,588.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,600.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,600.31
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	$5,600.31
Rate for Payer: Cigna Commercial	$10,981.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,710.12
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.30
Rate for Payer: UnitedHealthcare Community & State	$694.00
Rate for Payer: Wellpoint Medicaid Managed Care	$623.72

IR PTA PERPHRAL ARTRY OTHER S&

Facility

$22,441.00

Service Code	HCPCS 75962
Hospital Charge Code	7411736
Hospital Revenue Code	320
Min. Negotiated Rate	$637.32
Max. Negotiated Rate	$11,220.50
Rate for Payer: Aetna Commercial	$8,527.58
Rate for Payer: Aetna Medicare Advantage	$6,732.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,722.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,722.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,722.45
Rate for Payer: Cigna Commercial	$11,220.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,834.66
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.15
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$709.14
Rate for Payer: Wellpoint Medicaid Managed Care	$637.32

IR PTA PERPHRAL ARTRY OTHER S&

Facility

$22,441.00

Service Code	HCPCS 75962
Hospital Charge Code	7411736
Hospital Revenue Code	320
Min. Negotiated Rate	$3,366.15
Max. Negotiated Rate	$3,366.15
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.15

IR PTA PERPHRAL ARTRY OTHER S&

Facility

$22,441.00

Service Code	HCPCS 75962
Hospital Charge Code	2011180
Hospital Revenue Code	320
Min. Negotiated Rate	$637.32
Max. Negotiated Rate	$11,220.50
Rate for Payer: Aetna Commercial	$8,527.58
Rate for Payer: Aetna Medicare Advantage	$6,732.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,722.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,722.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,722.45
Rate for Payer: Cigna Commercial	$11,220.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,834.66
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.15
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$709.14
Rate for Payer: Wellpoint Medicaid Managed Care	$637.32

Know your out-of-pocket cost for care.

All Charges