Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

IR-REM INT URET STENT-LT

Facility

$10,187.80

Service Code	HCPCS 50384LT
Hospital Charge Code	2691560
Hospital Revenue Code	361
Min. Negotiated Rate	$1,528.17
Max. Negotiated Rate	$1,528.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

IR-REM INT URET STENT-LT

Facility

$10,187.80

Service Code	HCPCS 50384LT
Hospital Charge Code	321050384L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,528.17
Max. Negotiated Rate	$1,528.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

IR-REM INT URET STENT-LT

Facility

$10,187.80

Service Code	HCPCS 50384LT
Hospital Charge Code	321050384L
Hospital Revenue Code	361
Min. Negotiated Rate	$289.33
Max. Negotiated Rate	$5,093.90
Rate for Payer: Aetna Commercial	$3,871.36
Rate for Payer: Aetna Medicare Advantage	$3,056.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,597.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,597.89
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	$2,597.89
Rate for Payer: Cigna Commercial	$5,093.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,648.83
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17
Rate for Payer: UnitedHealthcare Community & State	$321.93
Rate for Payer: Wellpoint Medicaid Managed Care	$289.33

IR-REM INT URET STENT-RT

Facility

$10,187.80

Service Code	HCPCS 50384RT
Hospital Charge Code	2691565
Hospital Revenue Code	361
Min. Negotiated Rate	$1,528.17
Max. Negotiated Rate	$1,528.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

IR-REM INT URET STENT-RT

Facility

$10,187.80

Service Code	HCPCS 50384RT
Hospital Charge Code	321050384R
Hospital Revenue Code	361
Min. Negotiated Rate	$1,528.17
Max. Negotiated Rate	$1,528.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

IR-REM INT URET STENT-RT

Facility

$10,187.80

Service Code	HCPCS 50384RT
Hospital Charge Code	321050384R
Hospital Revenue Code	361
Min. Negotiated Rate	$289.33
Max. Negotiated Rate	$5,093.90
Rate for Payer: Aetna Commercial	$3,871.36
Rate for Payer: Aetna Medicare Advantage	$3,056.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,597.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,597.89
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	$2,597.89
Rate for Payer: Cigna Commercial	$5,093.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,648.83
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17
Rate for Payer: UnitedHealthcare Community & State	$321.93
Rate for Payer: Wellpoint Medicaid Managed Care	$289.33

IR-REM INT URET STENT-RT

Facility

$10,187.80

Service Code	HCPCS 50384RT
Hospital Charge Code	2691565
Hospital Revenue Code	361
Min. Negotiated Rate	$289.33
Max. Negotiated Rate	$5,093.90
Rate for Payer: Aetna Commercial	$3,871.36
Rate for Payer: Aetna Medicare Advantage	$3,056.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,597.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,597.89
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	$2,597.89
Rate for Payer: Cigna Commercial	$5,093.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,648.83
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17
Rate for Payer: UnitedHealthcare Community & State	$321.93
Rate for Payer: Wellpoint Medicaid Managed Care	$289.33

IR-REM NEPHROSTOM TUBE-LT

Facility

$3,292.50

Service Code	HCPCS 50389LT
Hospital Charge Code	321050389L
Hospital Revenue Code	361
Min. Negotiated Rate	$93.51
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,251.15
Rate for Payer: Aetna Medicare Advantage	$987.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$839.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$839.59
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	$839.59
Rate for Payer: Cigna Commercial	$1,646.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$856.05
Rate for Payer: Qualcare PPO/HMO/WC	$493.88
Rate for Payer: UnitedHealthcare Community & State	$104.04
Rate for Payer: Wellpoint Medicaid Managed Care	$93.51

IR-REM NEPHROSTOM TUBE-LT

Facility

$3,292.50

Service Code	HCPCS 50389LT
Hospital Charge Code	366850389L
Hospital Revenue Code	361
Min. Negotiated Rate	$493.88
Max. Negotiated Rate	$493.88
Rate for Payer: Qualcare PPO/HMO/WC	$493.88

IR-REM NEPHROSTOM TUBE-LT

Facility

$3,292.50

Service Code	HCPCS 50389LT
Hospital Charge Code	321050389L
Hospital Revenue Code	361
Min. Negotiated Rate	$493.88
Max. Negotiated Rate	$493.88
Rate for Payer: Qualcare PPO/HMO/WC	$493.88

IR-REM NEPHROSTOM TUBE-LT

Facility

$3,292.50

Service Code	HCPCS 50389LT
Hospital Charge Code	366850389L
Hospital Revenue Code	361
Min. Negotiated Rate	$93.51
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,251.15
Rate for Payer: Aetna Medicare Advantage	$987.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$839.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$839.59
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	$839.59
Rate for Payer: Cigna Commercial	$1,646.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$856.05
Rate for Payer: Qualcare PPO/HMO/WC	$493.88
Rate for Payer: UnitedHealthcare Community & State	$104.04
Rate for Payer: Wellpoint Medicaid Managed Care	$93.51

IR-REM NEPHROSTOM TUBE-LT

Facility

$3,292.50

Service Code	HCPCS 50389LT
Hospital Charge Code	411050389L
Hospital Revenue Code	361
Min. Negotiated Rate	$493.88
Max. Negotiated Rate	$493.88
Rate for Payer: Qualcare PPO/HMO/WC	$493.88

IR-REM NEPHROSTOM TUBE-LT

Facility

$3,292.50

Service Code	HCPCS 50389LT
Hospital Charge Code	411050389L
Hospital Revenue Code	361
Min. Negotiated Rate	$93.51
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,251.15
Rate for Payer: Aetna Medicare Advantage	$987.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$839.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$839.59
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	$839.59
Rate for Payer: Cigna Commercial	$1,646.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$856.05
Rate for Payer: Qualcare PPO/HMO/WC	$493.88
Rate for Payer: UnitedHealthcare Community & State	$104.04
Rate for Payer: Wellpoint Medicaid Managed Care	$93.51

IR-REM NEPHROSTOM TUBE-LT

Facility

$3,292.50

Service Code	HCPCS 50389LT
Hospital Charge Code	2691580
Hospital Revenue Code	361
Min. Negotiated Rate	$493.88
Max. Negotiated Rate	$493.88
Rate for Payer: Qualcare PPO/HMO/WC	$493.88

IR-REM NEPHROSTOM TUBE-LT

Facility

$3,292.50

Service Code	HCPCS 50389LT
Hospital Charge Code	2691580
Hospital Revenue Code	361
Min. Negotiated Rate	$93.51
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,251.15
Rate for Payer: Aetna Medicare Advantage	$987.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$839.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$839.59
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	$839.59
Rate for Payer: Cigna Commercial	$1,646.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$856.05
Rate for Payer: Qualcare PPO/HMO/WC	$493.88
Rate for Payer: UnitedHealthcare Community & State	$104.04
Rate for Payer: Wellpoint Medicaid Managed Care	$93.51

IR-REM NEPHROSTOM TUBE-RT

Facility

$3,292.50

Service Code	HCPCS 50389RT
Hospital Charge Code	2691585
Hospital Revenue Code	361
Min. Negotiated Rate	$93.51
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,251.15
Rate for Payer: Aetna Medicare Advantage	$987.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$839.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$839.59
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	$839.59
Rate for Payer: Cigna Commercial	$1,646.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$856.05
Rate for Payer: Qualcare PPO/HMO/WC	$493.88
Rate for Payer: UnitedHealthcare Community & State	$104.04
Rate for Payer: Wellpoint Medicaid Managed Care	$93.51

IR-REM NEPHROSTOM TUBE-RT

Facility

$3,292.50

Service Code	HCPCS 50389RT
Hospital Charge Code	2691585
Hospital Revenue Code	361
Min. Negotiated Rate	$493.88
Max. Negotiated Rate	$493.88
Rate for Payer: Qualcare PPO/HMO/WC	$493.88

IR-REM NEPHROSTOM TUBE-RT

Facility

$3,292.50

Service Code	HCPCS 50389RT
Hospital Charge Code	366850389R
Hospital Revenue Code	361
Min. Negotiated Rate	$93.51
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,251.15
Rate for Payer: Aetna Medicare Advantage	$987.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$839.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$839.59
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	$839.59
Rate for Payer: Cigna Commercial	$1,646.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$856.05
Rate for Payer: Qualcare PPO/HMO/WC	$493.88
Rate for Payer: UnitedHealthcare Community & State	$104.04
Rate for Payer: Wellpoint Medicaid Managed Care	$93.51

IR-REM NEPHROSTOM TUBE-RT

Facility

$3,292.50

Service Code	HCPCS 50389RT
Hospital Charge Code	366850389R
Hospital Revenue Code	361
Min. Negotiated Rate	$493.88
Max. Negotiated Rate	$493.88
Rate for Payer: Qualcare PPO/HMO/WC	$493.88

IR-REM NEPHROSTOM TUBE-RT

Facility

$3,292.50

Service Code	HCPCS 50389RT
Hospital Charge Code	411050389R
Hospital Revenue Code	361
Min. Negotiated Rate	$93.51
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,251.15
Rate for Payer: Aetna Medicare Advantage	$987.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$839.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$839.59
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	$839.59
Rate for Payer: Cigna Commercial	$1,646.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$856.05
Rate for Payer: Qualcare PPO/HMO/WC	$493.88
Rate for Payer: UnitedHealthcare Community & State	$104.04
Rate for Payer: Wellpoint Medicaid Managed Care	$93.51

IR-REM NEPHROSTOM TUBE-RT

Facility

$3,292.50

Service Code	HCPCS 50389RT
Hospital Charge Code	411050389R
Hospital Revenue Code	361
Min. Negotiated Rate	$493.88
Max. Negotiated Rate	$493.88
Rate for Payer: Qualcare PPO/HMO/WC	$493.88

IR-REM NEPHROSTOM TUBE-RT

Facility

$3,292.50

Service Code	HCPCS 50389RT
Hospital Charge Code	321050389R
Hospital Revenue Code	361
Min. Negotiated Rate	$93.51
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,251.15
Rate for Payer: Aetna Medicare Advantage	$987.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$839.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$839.59
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	$839.59
Rate for Payer: Cigna Commercial	$1,646.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$856.05
Rate for Payer: Qualcare PPO/HMO/WC	$493.88
Rate for Payer: UnitedHealthcare Community & State	$104.04
Rate for Payer: Wellpoint Medicaid Managed Care	$93.51

IR-REM NEPHROSTOM TUBE-RT

Facility

$3,292.50

Service Code	HCPCS 50389RT
Hospital Charge Code	321050389R
Hospital Revenue Code	361
Min. Negotiated Rate	$493.88
Max. Negotiated Rate	$493.88
Rate for Payer: Qualcare PPO/HMO/WC	$493.88

IR-REM OBS G/G-J/COLO TUB

Facility

$3,717.20

Service Code	HCPCS 49460
Hospital Charge Code	411049460
Hospital Revenue Code	361
Min. Negotiated Rate	$105.57
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	$966.47
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$557.58
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$117.46
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	$105.57

IR-REM OBS G/G-J/COLO TUB

Facility

$3,717.20

Service Code	HCPCS 49460
Hospital Charge Code	411049460
Hospital Revenue Code	361
Min. Negotiated Rate	$557.58
Max. Negotiated Rate	$557.58
Rate for Payer: Qualcare PPO/HMO/WC	$557.58

Know your out-of-pocket cost for care.

All Charges