Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

IR-TRANS ARTHERE ILIAC-BI

Facility

$93,917.89

Service Code	HCPCS 0238T50
Hospital Charge Code	41100238TB
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-LT

Facility

$93,917.89

Service Code	HCPCS 0238TLT
Hospital Charge Code	2690850
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-LT

Facility

$93,917.89

Service Code	HCPCS 0238TLT
Hospital Charge Code	2690850
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-LT

Facility

$93,917.89

Service Code	HCPCS 0238TLT
Hospital Charge Code	32100238TL
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-LT

Facility

$93,917.89

Service Code	HCPCS 0238TLT
Hospital Charge Code	32100238TL
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-RT

Facility

$93,917.89

Service Code	HCPCS 0238TRT
Hospital Charge Code	32100238TR
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-RT

Facility

$93,917.89

Service Code	HCPCS 0238TRT
Hospital Charge Code	32100238TR
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-RT

Facility

$93,917.89

Service Code	HCPCS 0238TRT
Hospital Charge Code	2690855
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-RT

Facility

$93,917.89

Service Code	HCPCS 0238TRT
Hospital Charge Code	2690855
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 RENAL-BI

Facility

$86,028.15

Service Code	HCPCS 3722550
Hospital Charge Code	2690525
Hospital Revenue Code	361
Min. Negotiated Rate	$12,904.22
Max. Negotiated Rate	$12,904.22
Rate for Payer: Qualcare PPO/HMO/WC	$12,904.22

IR-TRANS ARTHERE RENAL-BI

Facility

$75,737.34

Service Code	HCPCS 3722550
Hospital Charge Code	7411515
Hospital Revenue Code	361
Min. Negotiated Rate	$2,150.94
Max. Negotiated Rate	$37,868.67
Rate for Payer: Aetna Commercial	$28,780.19
Rate for Payer: Aetna Medicare Advantage	$22,721.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19,313.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19,313.02
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	$19,313.02
Rate for Payer: Cigna Commercial	$37,868.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19,691.71
Rate for Payer: Qualcare PPO/HMO/WC	$11,360.60
Rate for Payer: UnitedHealthcare Community & State	$2,393.30
Rate for Payer: Wellpoint Medicaid Managed Care	$2,150.94

IR-TRANS ARTHERE RENAL-BI

Facility

$86,028.15

Service Code	HCPCS 3722550
Hospital Charge Code	2690525
Hospital Revenue Code	361
Min. Negotiated Rate	$2,443.20
Max. Negotiated Rate	$43,014.07
Rate for Payer: Aetna Commercial	$32,690.70
Rate for Payer: Aetna Medicare Advantage	$25,808.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21,937.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21,937.18
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	$21,937.18
Rate for Payer: Cigna Commercial	$43,014.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22,367.32
Rate for Payer: Qualcare PPO/HMO/WC	$12,904.22
Rate for Payer: UnitedHealthcare Community & State	$2,718.49
Rate for Payer: Wellpoint Medicaid Managed Care	$2,443.20

IR-TRANS ARTHERE RENAL-BI

Facility

$75,737.34

Service Code	HCPCS 3722550
Hospital Charge Code	7411515
Hospital Revenue Code	361
Min. Negotiated Rate	$11,360.60
Max. Negotiated Rate	$11,360.60
Rate for Payer: Qualcare PPO/HMO/WC	$11,360.60

IR-TRANS ARTHERE RENAL-LT

Facility

$47,711.75

Service Code	HCPCS 37225LT
Hospital Charge Code	2691375
Hospital Revenue Code	361
Min. Negotiated Rate	$1,355.01
Max. Negotiated Rate	$23,855.88
Rate for Payer: Aetna Commercial	$18,130.47
Rate for Payer: Aetna Medicare Advantage	$14,313.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,166.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,166.50
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	$12,166.50
Rate for Payer: Cigna Commercial	$23,855.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,405.06
Rate for Payer: Qualcare PPO/HMO/WC	$7,156.76
Rate for Payer: UnitedHealthcare Community & State	$1,507.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1,355.01

IR-TRANS ARTHERE RENAL-LT

Facility

$47,711.75

Service Code	HCPCS 37225LT
Hospital Charge Code	2691375
Hospital Revenue Code	361
Min. Negotiated Rate	$7,156.76
Max. Negotiated Rate	$7,156.76
Rate for Payer: Qualcare PPO/HMO/WC	$7,156.76

IR-TRANS ARTHERE RENAL-LT

Facility

$47,711.75

Service Code	HCPCS 37225LT
Hospital Charge Code	7412043
Hospital Revenue Code	361
Min. Negotiated Rate	$1,355.01
Max. Negotiated Rate	$23,855.88
Rate for Payer: Aetna Commercial	$18,130.47
Rate for Payer: Aetna Medicare Advantage	$14,313.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,166.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,166.50
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	$12,166.50
Rate for Payer: Cigna Commercial	$23,855.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,405.06
Rate for Payer: Qualcare PPO/HMO/WC	$7,156.76
Rate for Payer: UnitedHealthcare Community & State	$1,507.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1,355.01

IR-TRANS ARTHERE RENAL-LT

Facility

$47,711.75

Service Code	HCPCS 37225LT
Hospital Charge Code	7412043
Hospital Revenue Code	361
Min. Negotiated Rate	$7,156.76
Max. Negotiated Rate	$7,156.76
Rate for Payer: Qualcare PPO/HMO/WC	$7,156.76

IR-TRANS ARTHERE RENAL-RT

Facility

$47,711.75

Service Code	HCPCS 37225RT
Hospital Charge Code	2691385
Hospital Revenue Code	361
Min. Negotiated Rate	$7,156.76
Max. Negotiated Rate	$7,156.76
Rate for Payer: Qualcare PPO/HMO/WC	$7,156.76

IR-TRANS ARTHERE RENAL-RT

Facility

$47,711.75

Service Code	HCPCS 37225RT
Hospital Charge Code	2691385
Hospital Revenue Code	361
Min. Negotiated Rate	$1,355.01
Max. Negotiated Rate	$23,855.88
Rate for Payer: Aetna Commercial	$18,130.47
Rate for Payer: Aetna Medicare Advantage	$14,313.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,166.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,166.50
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	$12,166.50
Rate for Payer: Cigna Commercial	$23,855.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,405.06
Rate for Payer: Qualcare PPO/HMO/WC	$7,156.76
Rate for Payer: UnitedHealthcare Community & State	$1,507.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1,355.01

IR-TRANS ARTHERE RENAL-RT

Facility

$47,711.75

Service Code	HCPCS 37225RT
Hospital Charge Code	7412045
Hospital Revenue Code	361
Min. Negotiated Rate	$1,355.01
Max. Negotiated Rate	$23,855.88
Rate for Payer: Aetna Commercial	$18,130.47
Rate for Payer: Aetna Medicare Advantage	$14,313.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,166.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,166.50
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	$12,166.50
Rate for Payer: Cigna Commercial	$23,855.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,405.06
Rate for Payer: Qualcare PPO/HMO/WC	$7,156.76
Rate for Payer: UnitedHealthcare Community & State	$1,507.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1,355.01

IR-TRANS ARTHERE RENAL-RT

Facility

$47,711.75

Service Code	HCPCS 37225RT
Hospital Charge Code	7412045
Hospital Revenue Code	361
Min. Negotiated Rate	$7,156.76
Max. Negotiated Rate	$7,156.76
Rate for Payer: Qualcare PPO/HMO/WC	$7,156.76

IR-TRANS BALLN ANG F/P-BI

Facility

$44,000.00

Service Code	HCPCS 3722450
Hospital Charge Code	7411802
Hospital Revenue Code	361
Min. Negotiated Rate	$6,600.00
Max. Negotiated Rate	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,600.00

IR-TRANS BALLN ANG F/P-BI

Facility

$44,000.00

Service Code	HCPCS 3722450
Hospital Charge Code	7411802
Hospital Revenue Code	361
Min. Negotiated Rate	$1,249.60
Max. Negotiated Rate	$22,000.00
Rate for Payer: Aetna Commercial	$16,720.00
Rate for Payer: Aetna Medicare Advantage	$13,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,220.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,220.00
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	$11,220.00
Rate for Payer: Cigna Commercial	$22,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,440.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,600.00
Rate for Payer: UnitedHealthcare Community & State	$1,390.40
Rate for Payer: Wellpoint Medicaid Managed Care	$1,249.60

IR-TRANS BALLN ANG F/P-LT

Facility

$27,397.00

Service Code	HCPCS 37224LT
Hospital Charge Code	2691360
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-TRANS BALLN ANG F/P-LT

Facility

$27,397.00

Service Code	HCPCS 37224LT
Hospital Charge Code	366837224L
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

Know your out-of-pocket cost for care.

All Charges