Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

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	$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

$80,096.45

Service Code	HCPCS 37229
Hospital Charge Code	366837229
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/STENT

Facility

$89,914.40

Service Code	HCPCS 37230
Hospital Charge Code	321037230
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/STENT

Facility

$80,096.45

Service Code	HCPCS 37230
Hospital Charge Code	366837230
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/STENT

Facility

$89,914.40

Service Code	HCPCS 37230
Hospital Charge Code	321037230
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/STENT

Facility

$80,096.45

Service Code	HCPCS 37230
Hospital Charge Code	366837230
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/STENT

Facility

$80,096.45

Service Code	HCPCS 37284
Hospital Charge Code	411037230
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/STENT

Facility

$80,096.45

Service Code	HCPCS 37284
Hospital Charge Code	411037230
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/STENT

Facility

$89,914.40

Service Code	HCPCS 37230
Hospital Charge Code	5600211
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/STENT

Facility

$89,914.40

Service Code	HCPCS 37230
Hospital Charge Code	5600211
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/TLA

Facility

$52,548.60

Service Code	HCPCS 37228
Hospital Charge Code	366837228
Hospital Revenue Code	361
Min. Negotiated Rate	$1,492.38
Max. Negotiated Rate	$26,274.30
Rate for Payer: Aetna Commercial	$19,968.47
Rate for Payer: Aetna Medicare Advantage	$15,764.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,399.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,399.89
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	$13,399.89
Rate for Payer: Cigna Commercial	$26,274.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,662.64
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,882.29
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,660.54
Rate for Payer: Wellpoint Medicaid Managed Care	$1,492.38

IR TIB/PER REVASC W/TLA

Facility

$52,548.60

Service Code	HCPCS 37228
Hospital Charge Code	366837228
Hospital Revenue Code	361
Min. Negotiated Rate	$7,882.29
Max. Negotiated Rate	$7,882.29
Rate for Payer: Qualcare PPO/HMO/WC	$7,882.29

IR TIB/PER REVASC W/TLA

Facility

$52,548.60

Service Code	HCPCS 37280
Hospital Charge Code	411037228
Hospital Revenue Code	361
Min. Negotiated Rate	$1,492.38
Max. Negotiated Rate	$49,750.44
Rate for Payer: Aetna Commercial	$37,304.26
Rate for Payer: Aetna Medicare Advantage	$44,435.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,750.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,750.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,714.80
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	$49,750.44
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: Cigna Medicare Advantage	$13,714.80
Rate for Payer: Clover Medicare Advantage	$13,029.06
Rate for Payer: EmblemHealth Commercial	$41,144.40
Rate for Payer: Humana Medicare Advantage	$14,126.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,714.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,662.64
Rate for Payer: Qualcare PPO/HMO/WC	$7,882.29
Rate for Payer: UnitedHealthcare Community & State	$1,660.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare Medicare Advantage	$13,714.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1,492.38

IR TIB/PER REVASC W/TLA

Facility

$56,620.95

Service Code	HCPCS 37228
Hospital Charge Code	321037228
Hospital Revenue Code	361
Min. Negotiated Rate	$1,608.03
Max. Negotiated Rate	$28,310.47
Rate for Payer: Aetna Commercial	$21,515.96
Rate for Payer: Aetna Medicare Advantage	$16,986.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,438.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,438.34
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	$14,438.34
Rate for Payer: Cigna Commercial	$28,310.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,721.45
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,789.22
Rate for Payer: Wellpoint Medicaid Managed Care	$1,608.03

IR TIB/PER REVASC W/TLA

Facility

$52,548.60

Service Code	HCPCS 37280
Hospital Charge Code	411037228
Hospital Revenue Code	361
Min. Negotiated Rate	$7,882.29
Max. Negotiated Rate	$7,882.29
Rate for Payer: Qualcare PPO/HMO/WC	$7,882.29

IR TIB/PER REVASC W/TLA

Facility

$56,620.95

Service Code	HCPCS 37228
Hospital Charge Code	321037228
Hospital Revenue Code	361
Min. Negotiated Rate	$8,493.14
Max. Negotiated Rate	$8,493.14
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14

IR TIB/PER REVASC W/TLA

Facility

$56,620.95

Service Code	HCPCS 37228
Hospital Charge Code	5600209
Hospital Revenue Code	361
Min. Negotiated Rate	$8,493.14
Max. Negotiated Rate	$8,493.14
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14

IR TIB/PER REVASC W/TLA

Facility

$56,620.95

Service Code	HCPCS 37228
Hospital Charge Code	5600209
Hospital Revenue Code	361
Min. Negotiated Rate	$1,608.03
Max. Negotiated Rate	$28,310.47
Rate for Payer: Aetna Commercial	$21,515.96
Rate for Payer: Aetna Medicare Advantage	$16,986.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,438.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,438.34
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	$14,438.34
Rate for Payer: Cigna Commercial	$28,310.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,721.45
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,789.22
Rate for Payer: Wellpoint Medicaid Managed Care	$1,608.03

IR-TRANS ARTHERE ILIAC-BI

Facility

$93,917.89

Service Code	HCPCS 0238T50
Hospital Charge Code	32100238TB
Hospital Revenue Code	361
Min. Negotiated Rate	$14,087.68
Max. Negotiated Rate	$14,087.68
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68

IR-TRANS ARTHERE ILIAC-BI

Facility

$93,917.89

Service Code	HCPCS 0238T50
Hospital Charge Code	32100238TB
Hospital Revenue Code	361
Min. Negotiated Rate	$2,667.27
Max. Negotiated Rate	$46,958.94
Rate for Payer: Aetna Commercial	$35,688.80
Rate for Payer: Aetna Medicare Advantage	$28,175.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,949.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,949.06
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	$23,949.06
Rate for Payer: Cigna Commercial	$46,958.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24,418.65
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68
Rate for Payer: UnitedHealthcare Community & State	$2,967.81
Rate for Payer: Wellpoint Medicaid Managed Care	$2,667.27

IR-TRANS ARTHERE ILIAC-BI

Facility

$93,917.89

Service Code	HCPCS 0238T50
Hospital Charge Code	36680238T5
Hospital Revenue Code	361
Min. Negotiated Rate	$2,667.27
Max. Negotiated Rate	$46,958.94
Rate for Payer: Aetna Commercial	$35,688.80
Rate for Payer: Aetna Medicare Advantage	$28,175.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,949.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,949.06
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	$23,949.06
Rate for Payer: Cigna Commercial	$46,958.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24,418.65
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68
Rate for Payer: UnitedHealthcare Community & State	$2,967.81
Rate for Payer: Wellpoint Medicaid Managed Care	$2,667.27

IR-TRANS ARTHERE ILIAC-BI

Facility

$93,917.89

Service Code	HCPCS 0238T50
Hospital Charge Code	36680238T5
Hospital Revenue Code	361
Min. Negotiated Rate	$14,087.68
Max. Negotiated Rate	$14,087.68
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68

IR-TRANS ARTHERE ILIAC-BI

Facility

$93,917.89

Service Code	HCPCS 0238T50
Hospital Charge Code	2690845
Hospital Revenue Code	361
Min. Negotiated Rate	$14,087.68
Max. Negotiated Rate	$14,087.68
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68

IR-TRANS ARTHERE ILIAC-BI

Facility

$93,917.89

Service Code	HCPCS 0238T50
Hospital Charge Code	41100238TB
Hospital Revenue Code	361
Min. Negotiated Rate	$2,667.27
Max. Negotiated Rate	$46,958.94
Rate for Payer: Aetna Commercial	$35,688.80
Rate for Payer: Aetna Medicare Advantage	$28,175.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,949.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,949.06
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	$23,949.06
Rate for Payer: Cigna Commercial	$46,958.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24,418.65
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68
Rate for Payer: UnitedHealthcare Community & State	$2,967.81
Rate for Payer: Wellpoint Medicaid Managed Care	$2,667.27

IR-TRANS ARTHERE ILIAC-BI

Facility

$93,917.89

Service Code	HCPCS 0238T50
Hospital Charge Code	2690845
Hospital Revenue Code	361
Min. Negotiated Rate	$2,667.27
Max. Negotiated Rate	$46,958.94
Rate for Payer: Aetna Commercial	$35,688.80
Rate for Payer: Aetna Medicare Advantage	$28,175.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,949.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,949.06
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	$23,949.06
Rate for Payer: Cigna Commercial	$46,958.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24,418.65
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68
Rate for Payer: UnitedHealthcare Community & State	$2,967.81
Rate for Payer: Wellpoint Medicaid Managed Care	$2,667.27

Know your out-of-pocket cost for care.

All Charges