Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

IR THROMBO DECLOT VASC ACCESS

Facility

$18,441.00

Service Code	HCPCS 36870
Hospital Charge Code	7411490
Hospital Revenue Code	361
Min. Negotiated Rate	$2,766.15
Max. Negotiated Rate	$2,766.15
Rate for Payer: Qualcare PPO/HMO/WC	$2,766.15

IR THROMBO DECLOT VASC ACCESS

Facility

$18,441.00

Service Code	HCPCS 36870
Hospital Charge Code	2011171
Hospital Revenue Code	361
Min. Negotiated Rate	$523.72
Max. Negotiated Rate	$9,220.50
Rate for Payer: Aetna Commercial	$7,007.58
Rate for Payer: Aetna Medicare Advantage	$5,532.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,702.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,702.45
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	$4,702.45
Rate for Payer: Cigna Commercial	$9,220.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,794.66
Rate for Payer: Qualcare PPO/HMO/WC	$2,766.15
Rate for Payer: UnitedHealthcare Community & State	$582.74
Rate for Payer: Wellpoint Medicaid Managed Care	$523.72

IR THROMBO DECLOT VASC ACCESS

Facility

$18,441.00

Service Code	HCPCS 36870
Hospital Charge Code	7411490
Hospital Revenue Code	361
Min. Negotiated Rate	$523.72
Max. Negotiated Rate	$9,220.50
Rate for Payer: Aetna Commercial	$7,007.58
Rate for Payer: Aetna Medicare Advantage	$5,532.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,702.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,702.45
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	$4,702.45
Rate for Payer: Cigna Commercial	$9,220.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,794.66
Rate for Payer: Qualcare PPO/HMO/WC	$2,766.15
Rate for Payer: UnitedHealthcare Community & State	$582.74
Rate for Payer: Wellpoint Medicaid Managed Care	$523.72

IR THROMBOLYTIC VENOUS TX

Facility

$15,468.50

Service Code	HCPCS 37212
Hospital Charge Code	2011166
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 THROMBOLYTIC VENOUS TX

Facility

$15,468.50

Service Code	HCPCS 37212
Hospital Charge Code	2011166
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 THROMBOLYTIC VENOUS TX

Facility

$15,468.50

Service Code	HCPCS 37212
Hospital Charge Code	321037212
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 THROMBOLYTIC VENOUS TX

Facility

$15,468.50

Service Code	HCPCS 37212
Hospital Charge Code	321037212
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 TIB/PER REVASC ADD-ON

Facility

$47,642.70

Service Code	HCPCS 37232
Hospital Charge Code	321037232
Hospital Revenue Code	361
Min. Negotiated Rate	$7,146.40
Max. Negotiated Rate	$7,146.40
Rate for Payer: Qualcare PPO/HMO/WC	$7,146.40

IR TIB/PER REVASC ADD-ON

Facility

$47,642.70

Service Code	HCPCS 37232
Hospital Charge Code	5600213
Hospital Revenue Code	361
Min. Negotiated Rate	$7,146.40
Max. Negotiated Rate	$7,146.40
Rate for Payer: Qualcare PPO/HMO/WC	$7,146.40

IR TIB/PER REVASC ADD-ON

Facility

$15,877.00

Service Code	HCPCS 37232
Hospital Charge Code	366837232
Hospital Revenue Code	361
Min. Negotiated Rate	$450.91
Max. Negotiated Rate	$14,869.00
Rate for Payer: Aetna Commercial	$6,033.26
Rate for Payer: Aetna Medicare Advantage	$4,763.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,048.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,048.64
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	$4,048.64
Rate for Payer: Cigna Commercial	$7,938.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,128.02
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$501.71
Rate for Payer: Wellpoint Medicaid Managed Care	$450.91

IR TIB/PER REVASC ADD-ON

Facility

$15,877.00

Service Code	HCPCS 37281
Hospital Charge Code	411037232
Hospital Revenue Code	361
Min. Negotiated Rate	$450.91
Max. Negotiated Rate	$7,938.50
Rate for Payer: Aetna Commercial	$6,033.26
Rate for Payer: Aetna Medicare Advantage	$4,763.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,048.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,048.64
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	$4,048.64
Rate for Payer: Cigna Commercial	$7,938.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,128.02
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55
Rate for Payer: UnitedHealthcare Community & State	$501.71
Rate for Payer: Wellpoint Medicaid Managed Care	$450.91

IR TIB/PER REVASC ADD-ON

Facility

$47,642.70

Service Code	HCPCS 37232
Hospital Charge Code	5600213
Hospital Revenue Code	361
Min. Negotiated Rate	$1,353.05
Max. Negotiated Rate	$23,821.35
Rate for Payer: Aetna Commercial	$18,104.23
Rate for Payer: Aetna Medicare Advantage	$14,292.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,148.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,148.89
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	$12,148.89
Rate for Payer: Cigna Commercial	$23,821.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,387.10
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,146.40
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,505.51
Rate for Payer: Wellpoint Medicaid Managed Care	$1,353.05

IR TIB/PER REVASC ADD-ON

Facility

$15,877.00

Service Code	HCPCS 37281
Hospital Charge Code	411037232
Hospital Revenue Code	361
Min. Negotiated Rate	$2,381.55
Max. Negotiated Rate	$2,381.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

IR TIB/PER REVASC ADD-ON

Facility

$47,642.70

Service Code	HCPCS 37232
Hospital Charge Code	321037232
Hospital Revenue Code	361
Min. Negotiated Rate	$1,353.05
Max. Negotiated Rate	$23,821.35
Rate for Payer: Aetna Commercial	$18,104.23
Rate for Payer: Aetna Medicare Advantage	$14,292.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,148.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,148.89
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	$12,148.89
Rate for Payer: Cigna Commercial	$23,821.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,387.10
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,146.40
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,505.51
Rate for Payer: Wellpoint Medicaid Managed Care	$1,353.05

IR TIB/PER REVASC ADD-ON

Facility

$15,877.00

Service Code	HCPCS 37232
Hospital Charge Code	366837232
Hospital Revenue Code	361
Min. Negotiated Rate	$2,381.55
Max. Negotiated Rate	$2,381.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

IR TIB/PER REVASC STNT & ATHER

Facility

$22,441.40

Service Code	HCPCS 37235
Hospital Charge Code	7411525A
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 TIB/PER REVASC STNT & ATHER

Facility

$22,441.40

Service Code	HCPCS 37235
Hospital Charge Code	7411525A
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 TIB/PER REVASC W/ATHER

Facility

$80,096.45

Service Code	HCPCS 37288
Hospital Charge Code	411037229
Hospital Revenue Code	361
Min. Negotiated Rate	$2,274.74
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	$20,825.08
Rate for Payer: Qualcare PPO/HMO/WC	$12,014.47
Rate for Payer: UnitedHealthcare Community & State	$2,531.05
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	$2,274.74

IR TIB/PER REVASC W/ATHER

Facility

$80,096.45

Service Code	HCPCS 37288
Hospital Charge Code	411037229
Hospital Revenue Code	361
Min. Negotiated Rate	$12,014.47
Max. Negotiated Rate	$12,014.47
Rate for Payer: Qualcare PPO/HMO/WC	$12,014.47

IR TIB/PER REVASC W/ATHER

Facility

$89,914.40

Service Code	HCPCS 37229
Hospital Charge Code	5600210
Hospital Revenue Code	361
Min. Negotiated Rate	$13,487.16
Max. Negotiated Rate	$13,487.16
Rate for Payer: Qualcare PPO/HMO/WC	$13,487.16

IR TIB/PER REVASC W/ATHER

Facility

$89,914.00

Service Code	HCPCS 37229
Hospital Charge Code	1600000746
Hospital Revenue Code	360
Min. Negotiated Rate	$13,487.10
Max. Negotiated Rate	$13,487.10
Rate for Payer: Qualcare PPO/HMO/WC	$13,487.10

IR TIB/PER REVASC W/ATHER

Facility

$89,914.40

Service Code	HCPCS 37229
Hospital Charge Code	5600210
Hospital Revenue Code	361
Min. Negotiated Rate	$2,553.57
Max. Negotiated Rate	$44,957.20
Rate for Payer: Aetna Commercial	$34,167.47
Rate for Payer: Aetna Medicare Advantage	$26,974.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,928.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,928.17
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	$22,928.17
Rate for Payer: Cigna Commercial	$44,957.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23,377.74
Rate for Payer: Oxford Commercial	$14,968.00
Rate for Payer: Qualcare PPO/HMO/WC	$13,487.16
Rate for Payer: UnitedHealthcare Commercial	$16,639.00
Rate for Payer: UnitedHealthcare Community & State	$2,841.30
Rate for Payer: Wellpoint Medicaid Managed Care	$2,553.57

IR TIB/PER REVASC W/ATHER

Facility

$80,096.45

Service Code	HCPCS 37229
Hospital Charge Code	366837229
Hospital Revenue Code	361
Min. Negotiated Rate	$2,274.74
Max. Negotiated Rate	$40,048.22
Rate for Payer: Aetna Commercial	$30,436.65
Rate for Payer: Aetna Medicare Advantage	$24,028.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20,424.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20,424.59
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	$20,424.59
Rate for Payer: Cigna Commercial	$40,048.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20,825.08
Rate for Payer: Oxford Commercial	$14,968.00
Rate for Payer: Qualcare PPO/HMO/WC	$12,014.47
Rate for Payer: UnitedHealthcare Commercial	$16,639.00
Rate for Payer: UnitedHealthcare Community & State	$2,531.05
Rate for Payer: Wellpoint Medicaid Managed Care	$2,274.74

IR TIB/PER REVASC W/ATHER

Facility

$89,914.00

Service Code	HCPCS 37229
Hospital Charge Code	1600000746
Hospital Revenue Code	360
Min. Negotiated Rate	$2,553.56
Max. Negotiated Rate	$44,957.00
Rate for Payer: Aetna Commercial	$34,167.32
Rate for Payer: Aetna Medicare Advantage	$26,974.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,928.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,928.07
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	$22,928.07
Rate for Payer: Cigna Commercial	$44,957.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23,377.64
Rate for Payer: Oxford Commercial	$14,968.00
Rate for Payer: Qualcare PPO/HMO/WC	$13,487.10
Rate for Payer: UnitedHealthcare Commercial	$16,639.00
Rate for Payer: UnitedHealthcare Community & State	$2,841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$2,553.56

IR TIB/PER REVASC W/ATHER

Facility

$89,914.40

Service Code	HCPCS 37229
Hospital Charge Code	321037229
Hospital Revenue Code	361
Min. Negotiated Rate	$2,553.57
Max. Negotiated Rate	$44,957.20
Rate for Payer: Aetna Commercial	$34,167.47
Rate for Payer: Aetna Medicare Advantage	$26,974.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,928.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,928.17
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	$22,928.17
Rate for Payer: Cigna Commercial	$44,957.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23,377.74
Rate for Payer: Oxford Commercial	$14,968.00
Rate for Payer: Qualcare PPO/HMO/WC	$13,487.16
Rate for Payer: UnitedHealthcare Commercial	$16,639.00
Rate for Payer: UnitedHealthcare Community & State	$2,841.30
Rate for Payer: Wellpoint Medicaid Managed Care	$2,553.57

Know your out-of-pocket cost for care.

All Charges