Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

JC POLYOMA VIRUS DAN URINE

Facility

$390.00

Service Code	HCPCS 87799
Hospital Charge Code	39708011
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

JC POLYOMA VIRUS DAN URINE

Facility

$390.00

Service Code	HCPCS 87799
Hospital Charge Code	39708011
Hospital Revenue Code	306
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$116.52
Rate for Payer: Aetna Medicare Advantage	$138.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.40
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$42.84
Rate for Payer: Clover Medicare Advantage	$40.70
Rate for Payer: EmblemHealth Commercial	$128.52
Rate for Payer: Humana Medicare Advantage	$44.13
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$42.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$34.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$42.84
Rate for Payer: Wellcare Medicare Advantage	$42.84
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

JC POLYOMA VIRUS DNA RT PCR CF

Facility

$390.00

Service Code	HCPCS 87799
Hospital Charge Code	401387799
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$116.52
Rate for Payer: Aetna Medicare Advantage	$138.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.40
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$42.84
Rate for Payer: Clover Medicare Advantage	$40.70
Rate for Payer: EmblemHealth Commercial	$128.52
Rate for Payer: Humana Medicare Advantage	$44.13
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$42.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$34.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$42.84
Rate for Payer: Wellcare Medicare Advantage	$42.84
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

JC POLYOMA VIRUS DNA RT PCR CF

Facility

$390.00

Service Code	HCPCS 87799
Hospital Charge Code	401387799
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

JET 7 Kit

Facility

$13,975.00

Hospital Charge Code	270685060N
Hospital Revenue Code	272
Min. Negotiated Rate	$396.89
Max. Negotiated Rate	$6,987.50
Rate for Payer: Aetna Commercial	$5,310.50
Rate for Payer: Aetna Medicare Advantage	$4,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,563.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,563.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,563.62
Rate for Payer: Cigna Commercial	$6,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,633.50
Rate for Payer: Oxford Commercial	$2,795.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,096.25
Rate for Payer: UnitedHealthcare Commercial	$2,795.00
Rate for Payer: UnitedHealthcare Community & State	$441.61
Rate for Payer: Wellpoint Medicaid Managed Care	$396.89

JET 7 Kit

Facility

$13,975.00

Hospital Charge Code	270685060N
Hospital Revenue Code	272
Min. Negotiated Rate	$2,096.25
Max. Negotiated Rate	$2,096.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,096.25

JETWIRE JETSTREAM

Facility

$500.00

Hospital Charge Code	270675788
Hospital Revenue Code	272
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

JETWIRE JETSTREAM

Facility

$500.00

Hospital Charge Code	270675788
Hospital Revenue Code	272
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$100.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

JGRKNT2.9MM #2 BLUE MB

Facility

$2,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270681524
Hospital Revenue Code	278
Min. Negotiated Rate	$427.50
Max. Negotiated Rate	$689.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$570.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$689.70
Rate for Payer: Qualcare PPO/HMO/WC	$427.50

JGRKNT2.9MM #2 BLUE MB

Facility

$2,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270681524
Hospital Revenue Code	278
Min. Negotiated Rate	$80.94
Max. Negotiated Rate	$1,425.00
Rate for Payer: Aetna Commercial	$1,083.00
Rate for Payer: Aetna Medicare Advantage	$855.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$726.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$726.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$726.75
Rate for Payer: Cigna Commercial	$1,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$689.70
Rate for Payer: Qualcare PPO/HMO/WC	$427.50
Rate for Payer: UnitedHealthcare Community & State	$90.06
Rate for Payer: Wellpoint Medicaid Managed Care	$80.94

JO-1 AB

Facility

$390.00

Service Code	HCPCS 86235
Hospital Charge Code	39900363
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

JO-1 AB

Facility

$390.00

Service Code	HCPCS 86235
Hospital Charge Code	39900363
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$48.77
Rate for Payer: Aetna Medicare Advantage	$58.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.04
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$17.93
Rate for Payer: Clover Medicare Advantage	$17.03
Rate for Payer: EmblemHealth Commercial	$53.79
Rate for Payer: Humana Medicare Advantage	$18.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.93
Rate for Payer: Wellcare Medicare Advantage	$17.93
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

JO-1-ANTIBODY

Facility

$476.00

Service Code	HCPCS 86235
Hospital Charge Code	38476207
Hospital Revenue Code	302
Min. Negotiated Rate	$13.52
Max. Negotiated Rate	$238.00
Rate for Payer: Aetna Commercial	$48.77
Rate for Payer: Aetna Medicare Advantage	$58.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.04
Rate for Payer: Cigna Commercial	$238.00
Rate for Payer: Cigna Medicare Advantage	$17.93
Rate for Payer: Clover Medicare Advantage	$17.03
Rate for Payer: EmblemHealth Commercial	$53.79
Rate for Payer: Humana Medicare Advantage	$18.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.76
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$71.40
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.93
Rate for Payer: Wellcare Medicare Advantage	$17.93
Rate for Payer: Wellpoint Medicaid Managed Care	$13.52

JO-1-ANTIBODY

Facility

$476.00

Service Code	HCPCS 86235
Hospital Charge Code	38476207
Hospital Revenue Code	302
Min. Negotiated Rate	$71.40
Max. Negotiated Rate	$71.40
Rate for Payer: Qualcare PPO/HMO/WC	$71.40

JOINT SMALL 3.5mm

Facility

$238.76

Service Code	HCPCS C1776
Hospital Charge Code	270665087
Hospital Revenue Code	278
Min. Negotiated Rate	$35.81
Max. Negotiated Rate	$57.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.78
Rate for Payer: Qualcare PPO/HMO/WC	$35.81

JOINT SMALL 3.5mm

Facility

$238.76

Service Code	HCPCS C1776
Hospital Charge Code	270665087
Hospital Revenue Code	278
Min. Negotiated Rate	$6.78
Max. Negotiated Rate	$119.38
Rate for Payer: Aetna Commercial	$90.73
Rate for Payer: Aetna Medicare Advantage	$71.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.88
Rate for Payer: Cigna Commercial	$119.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.78
Rate for Payer: Qualcare PPO/HMO/WC	$35.81
Rate for Payer: UnitedHealthcare Community & State	$7.54
Rate for Payer: Wellpoint Medicaid Managed Care	$6.78

JOINT UNIVERSAL FOR TWO TUBES

Facility

$3,380.45

Service Code	HCPCS C1776
Hospital Charge Code	270639891
Hospital Revenue Code	278
Min. Negotiated Rate	$96.00
Max. Negotiated Rate	$1,690.22
Rate for Payer: Aetna Commercial	$1,284.57
Rate for Payer: Aetna Medicare Advantage	$1,014.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$862.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$862.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$676.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$862.01
Rate for Payer: Cigna Commercial	$1,690.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$818.07
Rate for Payer: Qualcare PPO/HMO/WC	$507.07
Rate for Payer: UnitedHealthcare Community & State	$106.82
Rate for Payer: Wellpoint Medicaid Managed Care	$96.00

JOINT UNIVERSAL FOR TWO TUBES

Facility

$3,380.45

Service Code	HCPCS C1776
Hospital Charge Code	270639891
Hospital Revenue Code	278
Min. Negotiated Rate	$507.07
Max. Negotiated Rate	$818.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$676.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$818.07
Rate for Payer: Qualcare PPO/HMO/WC	$507.07

JOYSTICK REDUCTION 2.8MM

Facility

$318.25

Hospital Charge Code	270678309
Hospital Revenue Code	272
Min. Negotiated Rate	$47.74
Max. Negotiated Rate	$47.74
Rate for Payer: Qualcare PPO/HMO/WC	$47.74

JOYSTICK REDUCTION 2.8MM

Facility

$318.25

Hospital Charge Code	270678309
Hospital Revenue Code	272
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$159.12
Rate for Payer: Aetna Commercial	$120.94
Rate for Payer: Aetna Medicare Advantage	$95.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.15
Rate for Payer: Cigna Commercial	$159.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.75
Rate for Payer: Oxford Commercial	$63.65
Rate for Payer: Qualcare PPO/HMO/WC	$47.74
Rate for Payer: UnitedHealthcare Commercial	$63.65
Rate for Payer: UnitedHealthcare Community & State	$10.06
Rate for Payer: Wellpoint Medicaid Managed Care	$9.04

JOYSTICK REDUCTION 5.0 MM

Facility

$1,591.35

Service Code	HCPCS C1713
Hospital Charge Code	270680137
Hospital Revenue Code	278
Min. Negotiated Rate	$45.19
Max. Negotiated Rate	$795.67
Rate for Payer: Aetna Commercial	$604.71
Rate for Payer: Aetna Medicare Advantage	$477.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$405.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$405.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$318.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$405.79
Rate for Payer: Cigna Commercial	$795.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$385.11
Rate for Payer: Qualcare PPO/HMO/WC	$238.70
Rate for Payer: UnitedHealthcare Community & State	$50.29
Rate for Payer: Wellpoint Medicaid Managed Care	$45.19

JOYSTICK REDUCTION 5.0 MM

Facility

$1,591.35

Service Code	HCPCS C1713
Hospital Charge Code	270680137
Hospital Revenue Code	278
Min. Negotiated Rate	$238.70
Max. Negotiated Rate	$385.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$318.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$385.11
Rate for Payer: Qualcare PPO/HMO/WC	$238.70

JOYSTICK REDUCTION 6.5MM

Facility

$1,545.55

Hospital Charge Code	270677510
Hospital Revenue Code	272
Min. Negotiated Rate	$231.83
Max. Negotiated Rate	$231.83
Rate for Payer: Qualcare PPO/HMO/WC	$231.83

JOYSTICK REDUCTION 6.5MM

Facility

$1,545.55

Hospital Charge Code	270677510
Hospital Revenue Code	272
Min. Negotiated Rate	$43.89
Max. Negotiated Rate	$772.77
Rate for Payer: Aetna Commercial	$587.31
Rate for Payer: Aetna Medicare Advantage	$463.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.12
Rate for Payer: Cigna Commercial	$772.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$401.84
Rate for Payer: Oxford Commercial	$309.11
Rate for Payer: Qualcare PPO/HMO/WC	$231.83
Rate for Payer: UnitedHealthcare Commercial	$309.11
Rate for Payer: UnitedHealthcare Community & State	$48.84
Rate for Payer: Wellpoint Medicaid Managed Care	$43.89

JUGGERKNOT 2.0 DISP KIT

Facility

$2,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270681525
Hospital Revenue Code	278
Min. Negotiated Rate	$397.50
Max. Negotiated Rate	$641.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$530.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$641.30
Rate for Payer: Qualcare PPO/HMO/WC	$397.50

Know your out-of-pocket cost for care.

All Charges