Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

IR RETRIV INTRAVASC VENA CAVA

Facility

$15,468.50

Service Code	HCPCS 37193
Hospital Charge Code	2670100
Hospital Revenue Code	361
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

IR RETRIV INTRAVASC VENA CAVA

Facility

$10,625.00

Service Code	HCPCS 37193
Hospital Charge Code	7411499
Hospital Revenue Code	361
Min. Negotiated Rate	$301.75
Max. Negotiated Rate	$13,607.37
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
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	$13,607.37
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,762.50
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,593.75
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$335.75
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$301.75

IR RETRIV INTRAVASC VENA CAVA

Facility

$10,625.00

Service Code	HCPCS 37193
Hospital Charge Code	7411499
Hospital Revenue Code	361
Min. Negotiated Rate	$1,593.75
Max. Negotiated Rate	$1,593.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,593.75

IR RETRIV INTRAVASC VENA CAVA

Facility

$15,468.50

Service Code	HCPCS 37193
Hospital Charge Code	321037193
Hospital Revenue Code	361
Min. Negotiated Rate	$439.31
Max. Negotiated Rate	$13,607.37
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
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	$13,607.37
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,021.81
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$488.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$439.31

IR RETRIV INTRAVASC VENA CAVA

Facility

$15,468.50

Service Code	HCPCS 37193
Hospital Charge Code	2670100
Hospital Revenue Code	361
Min. Negotiated Rate	$439.31
Max. Negotiated Rate	$13,607.37
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
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	$13,607.37
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,021.81
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$488.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$439.31

IR RETRIV INTRAVASC VENA CAVA

Facility

$15,468.50

Service Code	HCPCS 37193
Hospital Charge Code	321037193
Hospital Revenue Code	361
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

IR RETRIV INTRAVASC VENA CAVA

Facility

$12,618.93

Service Code	HCPCS 37193
Hospital Charge Code	411037193
Hospital Revenue Code	361
Min. Negotiated Rate	$358.38
Max. Negotiated Rate	$13,607.37
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
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	$13,607.37
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,280.92
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,892.84
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$398.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$358.38

IR REVASC OPN/PRQ TIB/PER STN

Facility

$22,441.40

Service Code	HCPCS 37285
Hospital Charge Code	411037234
Hospital Revenue Code	361
Min. Negotiated Rate	$637.34
Max. Negotiated Rate	$11,220.70
Rate for Payer: Aetna Commercial	$8,527.73
Rate for Payer: Aetna Medicare Advantage	$6,732.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,722.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,722.56
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	$5,722.56
Rate for Payer: Cigna Commercial	$11,220.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,834.76
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21
Rate for Payer: UnitedHealthcare Community & State	$709.15
Rate for Payer: Wellpoint Medicaid Managed Care	$637.34

IR REVASC OPN/PRQ TIB/PER STN

Facility

$22,441.40

Service Code	HCPCS 37234
Hospital Charge Code	366837234
Hospital Revenue Code	361
Min. Negotiated Rate	$3,366.21
Max. Negotiated Rate	$3,366.21
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21

IR REVASC OPN/PRQ TIB/PER STN

Facility

$22,441.40

Service Code	HCPCS 37234
Hospital Charge Code	366837234
Hospital Revenue Code	361
Min. Negotiated Rate	$637.34
Max. Negotiated Rate	$14,869.00
Rate for Payer: Aetna Commercial	$8,527.73
Rate for Payer: Aetna Medicare Advantage	$6,732.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,722.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,722.56
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	$5,722.56
Rate for Payer: Cigna Commercial	$11,220.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,834.76
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$709.15
Rate for Payer: Wellpoint Medicaid Managed Care	$637.34

IR REVASC OPN/PRQ TIB/PER STN

Facility

$22,441.40

Service Code	HCPCS 37285
Hospital Charge Code	411037234
Hospital Revenue Code	361
Min. Negotiated Rate	$3,366.21
Max. Negotiated Rate	$3,366.21
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21

IR-REVIS/REINSERTION TRANS TUB

Facility

$6,672.00

Hospital Charge Code	2670165
Hospital Revenue Code	361
Min. Negotiated Rate	$189.48
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,535.36
Rate for Payer: Aetna Medicare Advantage	$2,001.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,701.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,701.36
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	$1,701.36
Rate for Payer: Cigna Commercial	$3,336.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,734.72
Rate for Payer: Qualcare PPO/HMO/WC	$1,000.80
Rate for Payer: UnitedHealthcare Community & State	$210.84
Rate for Payer: Wellpoint Medicaid Managed Care	$189.48

IR-REVIS/REINSERTION TRANS TUB

Facility

$6,672.00

Hospital Charge Code	2670165
Hospital Revenue Code	361
Min. Negotiated Rate	$1,000.80
Max. Negotiated Rate	$1,000.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,000.80

IR REVSC OPN/PRQ TIB/PERO STEN

Facility

$22,441.40

Service Code	HCPCS 37234
Hospital Charge Code	321037234
Hospital Revenue Code	361
Min. Negotiated Rate	$3,366.21
Max. Negotiated Rate	$3,366.21
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21

IR REVSC OPN/PRQ TIB/PERO STEN

Facility

$22,441.40

Service Code	HCPCS 37234
Hospital Charge Code	5600215
Hospital Revenue Code	361
Min. Negotiated Rate	$3,366.21
Max. Negotiated Rate	$3,366.21
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21

IR REVSC OPN/PRQ TIB/PERO STEN

Facility

$22,441.40

Service Code	HCPCS 37234
Hospital Charge Code	321037234
Hospital Revenue Code	361
Min. Negotiated Rate	$637.34
Max. Negotiated Rate	$14,869.00
Rate for Payer: Aetna Commercial	$8,527.73
Rate for Payer: Aetna Medicare Advantage	$6,732.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,722.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,722.56
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	$5,722.56
Rate for Payer: Cigna Commercial	$11,220.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,834.76
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$709.15
Rate for Payer: Wellpoint Medicaid Managed Care	$637.34

IR REVSC OPN/PRQ TIB/PERO STEN

Facility

$22,441.40

Service Code	HCPCS 37234
Hospital Charge Code	5600215
Hospital Revenue Code	361
Min. Negotiated Rate	$637.34
Max. Negotiated Rate	$14,869.00
Rate for Payer: Aetna Commercial	$8,527.73
Rate for Payer: Aetna Medicare Advantage	$6,732.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,722.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,722.56
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	$5,722.56
Rate for Payer: Cigna Commercial	$11,220.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,834.76
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.21
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$709.15
Rate for Payer: Wellpoint Medicaid Managed Care	$637.34

IR-RFA KIDNEY-BI

Facility

$26,912.85

Service Code	HCPCS 5059250
Hospital Charge Code	2690665
Hospital Revenue Code	361
Min. Negotiated Rate	$764.32
Max. Negotiated Rate	$13,456.42
Rate for Payer: Aetna Commercial	$10,226.88
Rate for Payer: Aetna Medicare Advantage	$8,073.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,862.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,862.78
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	$6,862.78
Rate for Payer: Cigna Commercial	$13,456.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,997.34
Rate for Payer: Qualcare PPO/HMO/WC	$4,036.93
Rate for Payer: UnitedHealthcare Community & State	$850.45
Rate for Payer: Wellpoint Medicaid Managed Care	$764.32

IR-RFA KIDNEY-BI

Facility

$26,912.85

Service Code	HCPCS 5059250
Hospital Charge Code	2690665
Hospital Revenue Code	361
Min. Negotiated Rate	$4,036.93
Max. Negotiated Rate	$4,036.93
Rate for Payer: Qualcare PPO/HMO/WC	$4,036.93

IR-RFA KIDNEY-BI

Facility

$26,912.85

Service Code	HCPCS 5059250
Hospital Charge Code	321050592B
Hospital Revenue Code	361
Min. Negotiated Rate	$4,036.93
Max. Negotiated Rate	$4,036.93
Rate for Payer: Qualcare PPO/HMO/WC	$4,036.93

IR-RFA KIDNEY-BI

Facility

$26,912.85

Service Code	HCPCS 5059250
Hospital Charge Code	321050592B
Hospital Revenue Code	361
Min. Negotiated Rate	$764.32
Max. Negotiated Rate	$13,456.42
Rate for Payer: Aetna Commercial	$10,226.88
Rate for Payer: Aetna Medicare Advantage	$8,073.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,862.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,862.78
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	$6,862.78
Rate for Payer: Cigna Commercial	$13,456.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,997.34
Rate for Payer: Qualcare PPO/HMO/WC	$4,036.93
Rate for Payer: UnitedHealthcare Community & State	$850.45
Rate for Payer: Wellpoint Medicaid Managed Care	$764.32

IRRIGANT GU 0.9% NACL 1000ML

Facility

$22.50

Hospital Charge Code	270040040
Hospital Revenue Code	270
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$3.38
Rate for Payer: Qualcare PPO/HMO/WC	$3.38

IRRIGANT GU 0.9% NACL 1000ML

Facility

$22.50

Hospital Charge Code	270040040
Hospital Revenue Code	270
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$11.25
Rate for Payer: Aetna Commercial	$8.55
Rate for Payer: Aetna Medicare Advantage	$6.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.74
Rate for Payer: Cigna Commercial	$11.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.85
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.38
Rate for Payer: UnitedHealthcare Commercial	$4.50
Rate for Payer: UnitedHealthcare Community & State	$0.71
Rate for Payer: Wellpoint Medicaid Managed Care	$0.64

IRRIGANT GU 0.9% NACL 3000ML

Facility

$35.00

Hospital Charge Code	270061485
Hospital Revenue Code	272
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$17.50
Rate for Payer: Aetna Commercial	$13.30
Rate for Payer: Aetna Medicare Advantage	$10.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.93
Rate for Payer: Cigna Commercial	$17.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.10
Rate for Payer: Oxford Commercial	$7.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.25
Rate for Payer: UnitedHealthcare Commercial	$7.00
Rate for Payer: UnitedHealthcare Community & State	$1.11
Rate for Payer: Wellpoint Medicaid Managed Care	$0.99

IRRIGANT GU 0.9% NACL 3000ML

Facility

$35.00

Hospital Charge Code	270061485
Hospital Revenue Code	272
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$5.25
Rate for Payer: Qualcare PPO/HMO/WC	$5.25

Know your out-of-pocket cost for care.

All Charges