Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

LAPAROSCOPY, SURGICAL, WITH VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 G;

Facility

$45,809.96

Service Code	CPT 58553
Hospital Revenue Code	360
Min. Negotiated Rate	$3,536.00
Max. Negotiated Rate	$45,809.96
Rate for Payer: Aetna Commercial	$34,349.57
Rate for Payer: Aetna Medicare Advantage	$40,916.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45,809.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45,809.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,628.52
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	$45,809.96
Rate for Payer: Cigna Commercial	$25,313.84
Rate for Payer: Cigna Medicare Advantage	$12,628.52
Rate for Payer: Clover Medicare Advantage	$11,997.09
Rate for Payer: EmblemHealth Commercial	$37,885.56
Rate for Payer: Humana Medicare Advantage	$13,007.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,628.52
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,628.52
Rate for Payer: Wellcare Medicare Advantage	$12,628.52

LAPAROSCPIC MYOMECTMY =<250 GM

Facility

$34,812.50

Service Code	HCPCS 58545
Hospital Charge Code	16000761
Hospital Revenue Code	360
Min. Negotiated Rate	$988.67
Max. Negotiated Rate	$26,053.61
Rate for Payer: Aetna Commercial	$19,535.72
Rate for Payer: Aetna Medicare Advantage	$23,270.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26,053.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26,053.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,182.25
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	$26,053.61
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: Cigna Medicare Advantage	$7,182.25
Rate for Payer: Clover Medicare Advantage	$6,823.14
Rate for Payer: EmblemHealth Commercial	$21,546.75
Rate for Payer: Humana Medicare Advantage	$7,397.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,182.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,051.25
Rate for Payer: Oxford Commercial	$11,677.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,221.88
Rate for Payer: UnitedHealthcare Commercial	$12,906.00
Rate for Payer: UnitedHealthcare Community & State	$1,100.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,182.25
Rate for Payer: Wellcare Medicare Advantage	$7,182.25
Rate for Payer: Wellpoint Medicaid Managed Care	$988.67

LAPAROSCPIC MYOMECTMY =<250 GM

Facility

$34,812.50

Service Code	HCPCS 58545
Hospital Charge Code	16000761
Hospital Revenue Code	360
Min. Negotiated Rate	$5,221.88
Max. Negotiated Rate	$5,221.88
Rate for Payer: Qualcare PPO/HMO/WC	$5,221.88

LAPARO SLING OPERATION

Facility

$21,530.28

Service Code	HCPCS 51992
Hospital Charge Code	16000997
Hospital Revenue Code	360
Min. Negotiated Rate	$611.46
Max. Negotiated Rate	$26,053.61
Rate for Payer: Aetna Commercial	$19,535.72
Rate for Payer: Aetna Medicare Advantage	$23,270.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26,053.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26,053.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,182.25
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	$26,053.61
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: Cigna Medicare Advantage	$7,182.25
Rate for Payer: Clover Medicare Advantage	$6,823.14
Rate for Payer: EmblemHealth Commercial	$21,546.75
Rate for Payer: Humana Medicare Advantage	$7,397.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,182.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,597.87
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,229.54
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$680.36
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,182.25
Rate for Payer: Wellcare Medicare Advantage	$7,182.25
Rate for Payer: Wellpoint Medicaid Managed Care	$611.46

LAPARO SLING OPERATION

Facility

$21,530.28

Service Code	HCPCS 51992
Hospital Charge Code	16000997
Hospital Revenue Code	360
Min. Negotiated Rate	$3,229.54
Max. Negotiated Rate	$3,229.54
Rate for Payer: Qualcare PPO/HMO/WC	$3,229.54

LAPAROS,W LYSIS OF ADHESIONS

Facility

$43,334.60

Service Code	HCPCS 58660
Hospital Charge Code	160000180
Hospital Revenue Code	360
Min. Negotiated Rate	$6,500.19
Max. Negotiated Rate	$6,500.19
Rate for Payer: Qualcare PPO/HMO/WC	$6,500.19

LAPAROS,W LYSIS OF ADHESIONS

Facility

$43,334.60

Service Code	HCPCS 58660
Hospital Charge Code	160000180
Hospital Revenue Code	360
Min. Negotiated Rate	$1,230.70
Max. Negotiated Rate	$26,053.61
Rate for Payer: Aetna Commercial	$19,535.72
Rate for Payer: Aetna Medicare Advantage	$23,270.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26,053.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26,053.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,182.25
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	$26,053.61
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: Cigna Medicare Advantage	$7,182.25
Rate for Payer: Clover Medicare Advantage	$6,823.14
Rate for Payer: EmblemHealth Commercial	$21,546.75
Rate for Payer: Humana Medicare Advantage	$7,397.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,182.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,267.00
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,500.19
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,369.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,182.25
Rate for Payer: Wellcare Medicare Advantage	$7,182.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1,230.70

LAP BAND AP SYS STD W/LOW PROF

Facility

$17,975.00

Hospital Charge Code	270664441
Hospital Revenue Code	272
Min. Negotiated Rate	$510.49
Max. Negotiated Rate	$8,987.50
Rate for Payer: Aetna Commercial	$6,830.50
Rate for Payer: Aetna Medicare Advantage	$5,392.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,583.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,583.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,583.62
Rate for Payer: Cigna Commercial	$8,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,673.50
Rate for Payer: Oxford Commercial	$3,595.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,696.25
Rate for Payer: UnitedHealthcare Commercial	$3,595.00
Rate for Payer: UnitedHealthcare Community & State	$568.01
Rate for Payer: Wellpoint Medicaid Managed Care	$510.49

LAP BAND AP SYS STD W/LOW PROF

Facility

$17,975.00

Hospital Charge Code	270664441
Hospital Revenue Code	272
Min. Negotiated Rate	$2,696.25
Max. Negotiated Rate	$2,696.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,696.25

LAP-BAND AP SYSTEM STANDARD AP

Facility

$18,875.00

Hospital Charge Code	27064441
Hospital Revenue Code	272
Min. Negotiated Rate	$2,831.25
Max. Negotiated Rate	$2,831.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,831.25

LAP-BAND AP SYSTEM STANDARD AP

Facility

$18,875.00

Hospital Charge Code	27064441
Hospital Revenue Code	272
Min. Negotiated Rate	$536.05
Max. Negotiated Rate	$9,437.50
Rate for Payer: Aetna Commercial	$7,172.50
Rate for Payer: Aetna Medicare Advantage	$5,662.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,813.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,813.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,813.12
Rate for Payer: Cigna Commercial	$9,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,907.50
Rate for Payer: Oxford Commercial	$3,775.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,831.25
Rate for Payer: UnitedHealthcare Commercial	$3,775.00
Rate for Payer: UnitedHealthcare Community & State	$596.45
Rate for Payer: Wellpoint Medicaid Managed Care	$536.05

LAP BAND SYSTEM

Facility

$6,228.00

Hospital Charge Code	270338727
Hospital Revenue Code	272
Min. Negotiated Rate	$176.88
Max. Negotiated Rate	$3,114.00
Rate for Payer: Aetna Commercial	$2,366.64
Rate for Payer: Aetna Medicare Advantage	$1,868.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,588.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,588.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,588.14
Rate for Payer: Cigna Commercial	$3,114.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,619.28
Rate for Payer: Oxford Commercial	$1,245.60
Rate for Payer: Qualcare PPO/HMO/WC	$934.20
Rate for Payer: UnitedHealthcare Commercial	$1,245.60
Rate for Payer: UnitedHealthcare Community & State	$196.80
Rate for Payer: Wellpoint Medicaid Managed Care	$176.88

LAP BAND SYSTEM

Facility

$6,228.00

Hospital Charge Code	270338727
Hospital Revenue Code	272
Min. Negotiated Rate	$934.20
Max. Negotiated Rate	$934.20
Rate for Payer: Qualcare PPO/HMO/WC	$934.20

LAP,CHOLCYSTMY W CHLNGIGR

Facility

$43,334.60

Service Code	HCPCS 47563
Hospital Charge Code	16000644
Hospital Revenue Code	360
Min. Negotiated Rate	$1,230.70
Max. Negotiated Rate	$26,053.61
Rate for Payer: Aetna Commercial	$19,535.72
Rate for Payer: Aetna Medicare Advantage	$23,270.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26,053.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26,053.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,182.25
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	$26,053.61
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: Cigna Medicare Advantage	$7,182.25
Rate for Payer: Clover Medicare Advantage	$6,823.14
Rate for Payer: EmblemHealth Commercial	$21,546.75
Rate for Payer: Humana Medicare Advantage	$7,397.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,182.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,267.00
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,500.19
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,369.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,182.25
Rate for Payer: Wellcare Medicare Advantage	$7,182.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1,230.70

LAP,CHOLCYSTMY W CHLNGIGR

Facility

$43,334.60

Service Code	HCPCS 47563
Hospital Charge Code	16000644
Hospital Revenue Code	360
Min. Negotiated Rate	$6,500.19
Max. Negotiated Rate	$6,500.19
Rate for Payer: Qualcare PPO/HMO/WC	$6,500.19

LAP CLOSE ENTEROSTOMY

Facility

$22,413.00

Service Code	HCPCS 44227
Hospital Charge Code	1600000763
Hospital Revenue Code	360
Min. Negotiated Rate	$3,361.95
Max. Negotiated Rate	$3,361.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,361.95

LAP CLOSE ENTEROSTOMY

Facility

$22,413.00

Service Code	HCPCS 44227
Hospital Charge Code	1600000763
Hospital Revenue Code	360
Min. Negotiated Rate	$636.53
Max. Negotiated Rate	$11,206.50
Rate for Payer: Aetna Commercial	$8,516.94
Rate for Payer: Aetna Medicare Advantage	$6,723.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,715.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,715.31
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	$5,715.31
Rate for Payer: Cigna Commercial	$11,206.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,827.38
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,361.95
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$708.25
Rate for Payer: Wellpoint Medicaid Managed Care	$636.53

LAPCOLECTOMY PART W/ILEUM

Facility

$14,324.36

Service Code	HCPCS 44205
Hospital Charge Code	1600000447
Hospital Revenue Code	360
Min. Negotiated Rate	$406.81
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$5,443.26
Rate for Payer: Aetna Medicare Advantage	$4,297.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,652.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,652.71
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	$3,652.71
Rate for Payer: Cigna Commercial	$7,162.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,724.33
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,148.65
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$452.65
Rate for Payer: Wellpoint Medicaid Managed Care	$406.81

LAPCOLECTOMY PART W/ILEUM

Facility

$14,324.36

Service Code	HCPCS 44205
Hospital Charge Code	1600000447
Hospital Revenue Code	360
Min. Negotiated Rate	$2,148.65
Max. Negotiated Rate	$2,148.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,148.65

LAP COLOSTOMY

Facility

$10,955.74

Service Code	HCPCS 44188
Hospital Charge Code	16000970
Hospital Revenue Code	360
Min. Negotiated Rate	$1,643.36
Max. Negotiated Rate	$1,643.36
Rate for Payer: Qualcare PPO/HMO/WC	$1,643.36

LAP COLOSTOMY

Facility

$10,955.74

Service Code	HCPCS 44188
Hospital Charge Code	16000970
Hospital Revenue Code	360
Min. Negotiated Rate	$311.14
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$4,163.18
Rate for Payer: Aetna Medicare Advantage	$3,286.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,793.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,793.71
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	$2,793.71
Rate for Payer: Cigna Commercial	$5,477.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,848.49
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,643.36
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$346.20
Rate for Payer: Wellpoint Medicaid Managed Care	$311.14

LAP DISC HAND ACC DEVICE LD111

Facility

$2,535.75

Hospital Charge Code	270628294
Hospital Revenue Code	272
Min. Negotiated Rate	$380.36
Max. Negotiated Rate	$380.36
Rate for Payer: Qualcare PPO/HMO/WC	$380.36

LAP DISC HAND ACC DEVICE LD111

Facility

$2,535.75

Hospital Charge Code	270628294
Hospital Revenue Code	272
Min. Negotiated Rate	$72.02
Max. Negotiated Rate	$1,267.88
Rate for Payer: Aetna Commercial	$963.59
Rate for Payer: Aetna Medicare Advantage	$760.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$646.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$646.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$646.62
Rate for Payer: Cigna Commercial	$1,267.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$659.29
Rate for Payer: Oxford Commercial	$507.15
Rate for Payer: Qualcare PPO/HMO/WC	$380.36
Rate for Payer: UnitedHealthcare Commercial	$507.15
Rate for Payer: UnitedHealthcare Community & State	$80.13
Rate for Payer: Wellpoint Medicaid Managed Care	$72.02

LAP ENTERECTOMY

Facility

$8,576.55

Service Code	HCPCS 44202
Hospital Charge Code	1600000632
Hospital Revenue Code	360
Min. Negotiated Rate	$1,286.48
Max. Negotiated Rate	$1,286.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,286.48

LAP ENTERECTOMY

Facility

$8,576.55

Service Code	HCPCS 44202
Hospital Charge Code	1600000632
Hospital Revenue Code	360
Min. Negotiated Rate	$243.57
Max. Negotiated Rate	$12,906.00
Rate for Payer: Aetna Commercial	$3,259.09
Rate for Payer: Aetna Medicare Advantage	$2,572.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,187.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,187.02
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	$2,187.02
Rate for Payer: Cigna Commercial	$4,288.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,229.90
Rate for Payer: Oxford Commercial	$11,677.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,286.48
Rate for Payer: UnitedHealthcare Commercial	$12,906.00
Rate for Payer: UnitedHealthcare Community & State	$271.02
Rate for Payer: Wellpoint Medicaid Managed Care	$243.57

Know your out-of-pocket cost for care.

All Charges