Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

IR-TRANS BALLN ANG F/P-LT

Facility

$27,397.00

Service Code	HCPCS 37224LT
Hospital Charge Code	7411924
Hospital Revenue Code	361
Min. Negotiated Rate	$778.07
Max. Negotiated Rate	$13,698.50
Rate for Payer: Aetna Commercial	$10,410.86
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,123.22
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Community & State	$865.75
Rate for Payer: Wellpoint Medicaid Managed Care	$778.07

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	$778.07
Max. Negotiated Rate	$13,698.50
Rate for Payer: Aetna Commercial	$10,410.86
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,123.22
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Community & State	$865.75
Rate for Payer: Wellpoint Medicaid Managed Care	$778.07

IR-TRANS BALLN ANG F/P-LT

Facility

$27,397.00

Service Code	HCPCS 37224LT
Hospital Charge Code	321037224L
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	321037224L
Hospital Revenue Code	361
Min. Negotiated Rate	$778.07
Max. Negotiated Rate	$13,698.50
Rate for Payer: Aetna Commercial	$10,410.86
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,123.22
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Community & State	$865.75
Rate for Payer: Wellpoint Medicaid Managed Care	$778.07

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	$778.07
Max. Negotiated Rate	$13,698.50
Rate for Payer: Aetna Commercial	$10,410.86
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,123.22
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Community & State	$865.75
Rate for Payer: Wellpoint Medicaid Managed Care	$778.07

IR-TRANS BALLN ANG F/P-LT

Facility

$27,397.00

Service Code	HCPCS 37224LT
Hospital Charge Code	7411924
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-RT

Facility

$27,397.00

Service Code	HCPCS 37224RT
Hospital Charge Code	2691365
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-RT

Facility

$27,397.00

Service Code	HCPCS 37224RT
Hospital Charge Code	366837224R
Hospital Revenue Code	361
Min. Negotiated Rate	$778.07
Max. Negotiated Rate	$13,698.50
Rate for Payer: Aetna Commercial	$10,410.86
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,123.22
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Community & State	$865.75
Rate for Payer: Wellpoint Medicaid Managed Care	$778.07

IR-TRANS BALLN ANG F/P-RT

Facility

$27,397.00

Service Code	HCPCS 37224RT
Hospital Charge Code	2691365
Hospital Revenue Code	361
Min. Negotiated Rate	$778.07
Max. Negotiated Rate	$13,698.50
Rate for Payer: Aetna Commercial	$10,410.86
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,123.22
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Community & State	$865.75
Rate for Payer: Wellpoint Medicaid Managed Care	$778.07

IR-TRANS BALLN ANG F/P-RT

Facility

$27,397.00

Service Code	HCPCS 37224RT
Hospital Charge Code	7411925
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-RT

Facility

$27,397.00

Service Code	HCPCS 37224RT
Hospital Charge Code	7411925
Hospital Revenue Code	361
Min. Negotiated Rate	$778.07
Max. Negotiated Rate	$13,698.50
Rate for Payer: Aetna Commercial	$10,410.86
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,123.22
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Community & State	$865.75
Rate for Payer: Wellpoint Medicaid Managed Care	$778.07

IR-TRANS BALLN ANG F/P-RT

Facility

$27,397.00

Service Code	HCPCS 37224RT
Hospital Charge Code	366837224R
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-RT

Facility

$27,397.00

Service Code	HCPCS 37224RT
Hospital Charge Code	321037224R
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-RT

Facility

$27,397.00

Service Code	HCPCS 37224RT
Hospital Charge Code	321037224R
Hospital Revenue Code	361
Min. Negotiated Rate	$778.07
Max. Negotiated Rate	$13,698.50
Rate for Payer: Aetna Commercial	$10,410.86
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,123.22
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Community & State	$865.75
Rate for Payer: Wellpoint Medicaid Managed Care	$778.07

IR-TRANS BALLN ANG ILI-BI

Facility

$27,397.00

Service Code	HCPCS 3722050
Hospital Charge Code	2690495
Hospital Revenue Code	361
Min. Negotiated Rate	$778.07
Max. Negotiated Rate	$13,698.50
Rate for Payer: Aetna Commercial	$10,410.86
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,123.22
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Community & State	$865.75
Rate for Payer: Wellpoint Medicaid Managed Care	$778.07

IR-TRANS BALLN ANG ILI-BI

Facility

$27,397.00

Service Code	HCPCS 3722050
Hospital Charge Code	3668372205
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 ILI-BI

Facility

$27,397.00

Service Code	HCPCS 3722050
Hospital Charge Code	2690495
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 ILI-BI

Facility

$27,397.00

Service Code	HCPCS 3722050
Hospital Charge Code	321037220B
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 ILI-BI

Facility

$27,397.00

Service Code	HCPCS 3722050
Hospital Charge Code	411037220B
Hospital Revenue Code	361
Min. Negotiated Rate	$778.07
Max. Negotiated Rate	$13,698.50
Rate for Payer: Aetna Commercial	$10,410.86
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,123.22
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Community & State	$865.75
Rate for Payer: Wellpoint Medicaid Managed Care	$778.07

IR-TRANS BALLN ANG ILI-BI

Facility

$27,397.00

Service Code	HCPCS 3722050
Hospital Charge Code	321037220B
Hospital Revenue Code	361
Min. Negotiated Rate	$778.07
Max. Negotiated Rate	$13,698.50
Rate for Payer: Aetna Commercial	$10,410.86
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,123.22
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Community & State	$865.75
Rate for Payer: Wellpoint Medicaid Managed Care	$778.07

IR-TRANS BALLN ANG ILI-BI

Facility

$27,397.00

Service Code	HCPCS 3722050
Hospital Charge Code	411037220B
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 ILI-BI

Facility

$27,397.00

Service Code	HCPCS 3722050
Hospital Charge Code	3668372205
Hospital Revenue Code	361
Min. Negotiated Rate	$778.07
Max. Negotiated Rate	$13,698.50
Rate for Payer: Aetna Commercial	$10,410.86
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,123.22
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Community & State	$865.75
Rate for Payer: Wellpoint Medicaid Managed Care	$778.07

IR-TRANS BALLN ANG ILI-LT

Facility

$27,397.00

Service Code	HCPCS 37220LT
Hospital Charge Code	366837220L
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 ILI-LT

Facility

$27,397.00

Service Code	HCPCS 37220LT
Hospital Charge Code	2691320
Hospital Revenue Code	361
Min. Negotiated Rate	$778.07
Max. Negotiated Rate	$13,698.50
Rate for Payer: Aetna Commercial	$10,410.86
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,123.22
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Community & State	$865.75
Rate for Payer: Wellpoint Medicaid Managed Care	$778.07

IR-TRANS BALLN ANG ILI-LT

Facility

$27,397.00

Service Code	HCPCS 37220LT
Hospital Charge Code	2691320
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