Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

LAPIPLASTY SYSTEM 3R SK23

Facility

$37,470.00

Service Code	HCPCS C1713
Hospital Charge Code	270697749
Hospital Revenue Code	278
Min. Negotiated Rate	$5,620.50
Max. Negotiated Rate	$9,067.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,494.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,067.74
Rate for Payer: Qualcare PPO/HMO/WC	$5,620.50

LAPIPLASTY SYSTEM 3R SK23

Facility

$37,470.00

Service Code	HCPCS C1713
Hospital Charge Code	270697749
Hospital Revenue Code	278
Min. Negotiated Rate	$1,064.15
Max. Negotiated Rate	$18,735.00
Rate for Payer: Aetna Commercial	$14,238.60
Rate for Payer: Aetna Medicare Advantage	$11,241.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,554.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,554.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,494.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,554.85
Rate for Payer: Cigna Commercial	$18,735.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,067.74
Rate for Payer: Qualcare PPO/HMO/WC	$5,620.50
Rate for Payer: UnitedHealthcare Community & State	$1,184.05
Rate for Payer: Wellpoint Medicaid Managed Care	$1,064.15

LAPIPLASTY SYSTEM S4A

Facility

$25,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270696718
Hospital Revenue Code	278
Min. Negotiated Rate	$3,896.25
Max. Negotiated Rate	$6,285.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,285.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,896.25

LAPIPLASTY SYSTEM S4A

Facility

$25,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270696718
Hospital Revenue Code	278
Min. Negotiated Rate	$737.69
Max. Negotiated Rate	$12,987.50
Rate for Payer: Aetna Commercial	$9,870.50
Rate for Payer: Aetna Medicare Advantage	$7,792.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,623.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,623.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,623.62
Rate for Payer: Cigna Commercial	$12,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,285.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,896.25
Rate for Payer: UnitedHealthcare Community & State	$820.81
Rate for Payer: Wellpoint Medicaid Managed Care	$737.69

LAPI SPEEDPLATE MIC QUAD 14MM

Facility

$19,370.00

Hospital Charge Code	270702793
Hospital Revenue Code	278
Min. Negotiated Rate	$550.11
Max. Negotiated Rate	$9,685.00
Rate for Payer: Aetna Commercial	$7,360.60
Rate for Payer: Aetna Medicare Advantage	$5,811.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,939.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,939.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,874.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,939.35
Rate for Payer: Cigna Commercial	$9,685.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,687.54
Rate for Payer: Qualcare PPO/HMO/WC	$2,905.50
Rate for Payer: UnitedHealthcare Community & State	$612.09
Rate for Payer: Wellpoint Medicaid Managed Care	$550.11

LAPI SPEEDPLATE MIC QUAD 14MM

Facility

$19,370.00

Hospital Charge Code	270702793
Hospital Revenue Code	278
Min. Negotiated Rate	$2,905.50
Max. Negotiated Rate	$4,687.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,874.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,687.54
Rate for Payer: Qualcare PPO/HMO/WC	$2,905.50

LAPI SPEEDPLATE MIC QUAD 17MM

Facility

$19,370.00

Hospital Charge Code	270703012
Hospital Revenue Code	278
Min. Negotiated Rate	$2,905.50
Max. Negotiated Rate	$4,687.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,874.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,687.54
Rate for Payer: Qualcare PPO/HMO/WC	$2,905.50

LAPI SPEEDPLATE MIC QUAD 17MM

Facility

$19,370.00

Hospital Charge Code	270703012
Hospital Revenue Code	278
Min. Negotiated Rate	$550.11
Max. Negotiated Rate	$9,685.00
Rate for Payer: Aetna Commercial	$7,360.60
Rate for Payer: Aetna Medicare Advantage	$5,811.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,939.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,939.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,874.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,939.35
Rate for Payer: Cigna Commercial	$9,685.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,687.54
Rate for Payer: Qualcare PPO/HMO/WC	$2,905.50
Rate for Payer: UnitedHealthcare Community & State	$612.09
Rate for Payer: Wellpoint Medicaid Managed Care	$550.11

LAP MOBIL SPLENIC FL ADD-ON

Facility

$33,620.30

Service Code	HCPCS 44213
Hospital Charge Code	16000746
Hospital Revenue Code	360
Min. Negotiated Rate	$954.82
Max. Negotiated Rate	$16,810.15
Rate for Payer: Aetna Commercial	$12,775.71
Rate for Payer: Aetna Medicare Advantage	$10,086.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,573.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,573.18
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	$8,573.18
Rate for Payer: Cigna Commercial	$16,810.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,741.28
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,043.05
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$1,062.40
Rate for Payer: Wellpoint Medicaid Managed Care	$954.82

LAP MOBIL SPLENIC FL ADD-ON

Facility

$33,620.30

Service Code	HCPCS 44213
Hospital Charge Code	16000746
Hospital Revenue Code	360
Min. Negotiated Rate	$5,043.05
Max. Negotiated Rate	$5,043.05
Rate for Payer: Qualcare PPO/HMO/WC	$5,043.05

LAP MVL GASTR ADJ ALL PARTS

Facility

$10,973.76

Service Code	HCPCS 43774
Hospital Charge Code	1600000580
Hospital Revenue Code	360
Min. Negotiated Rate	$311.65
Max. Negotiated Rate	$16,639.00
Rate for Payer: Aetna Commercial	$12,458.69
Rate for Payer: Aetna Medicare Advantage	$14,840.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,580.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,304.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,120.00
Rate for Payer: Cigna Commercial	$9,181.40
Rate for Payer: Cigna Medicare Advantage	$4,580.40
Rate for Payer: Clover Medicare Advantage	$4,351.38
Rate for Payer: EmblemHealth Commercial	$13,741.20
Rate for Payer: Humana Medicare Advantage	$4,717.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,580.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,853.18
Rate for Payer: Oxford Commercial	$14,968.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,646.06
Rate for Payer: UnitedHealthcare Commercial	$16,639.00
Rate for Payer: UnitedHealthcare Community & State	$346.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,580.40
Rate for Payer: Wellcare Medicare Advantage	$4,580.40
Rate for Payer: Wellpoint Medicaid Managed Care	$311.65

LAP MVL GASTR ADJ ALL PARTS

Facility

$10,973.76

Service Code	HCPCS 43774
Hospital Charge Code	1600000580
Hospital Revenue Code	360
Min. Negotiated Rate	$1,646.06
Max. Negotiated Rate	$1,646.06
Rate for Payer: Qualcare PPO/HMO/WC	$1,646.06

LAP PARTIAL COLECTOMY

Facility

$17,148.70

Service Code	HCPCS 44204
Hospital Charge Code	16000745
Hospital Revenue Code	360
Min. Negotiated Rate	$2,572.30
Max. Negotiated Rate	$2,572.30
Rate for Payer: Qualcare PPO/HMO/WC	$2,572.30

LAP PARTIAL COLECTOMY

Facility

$17,148.70

Service Code	HCPCS 44204
Hospital Charge Code	16000745
Hospital Revenue Code	360
Min. Negotiated Rate	$487.02
Max. Negotiated Rate	$12,906.00
Rate for Payer: Aetna Commercial	$6,516.51
Rate for Payer: Aetna Medicare Advantage	$5,144.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,372.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,372.92
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	$4,372.92
Rate for Payer: Cigna Commercial	$8,574.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,458.66
Rate for Payer: Oxford Commercial	$11,677.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,572.30
Rate for Payer: UnitedHealthcare Commercial	$12,906.00
Rate for Payer: UnitedHealthcare Community & State	$541.90
Rate for Payer: Wellpoint Medicaid Managed Care	$487.02

LAP PROBE 10 MM

Facility

$664.00

Hospital Charge Code	270335112
Hospital Revenue Code	272
Min. Negotiated Rate	$99.60
Max. Negotiated Rate	$99.60
Rate for Payer: Qualcare PPO/HMO/WC	$99.60

LAP PROBE 10 MM

Facility

$664.00

Hospital Charge Code	270335112
Hospital Revenue Code	272
Min. Negotiated Rate	$18.86
Max. Negotiated Rate	$332.00
Rate for Payer: Aetna Commercial	$252.32
Rate for Payer: Aetna Medicare Advantage	$199.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.32
Rate for Payer: Cigna Commercial	$332.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.64
Rate for Payer: Oxford Commercial	$132.80
Rate for Payer: Qualcare PPO/HMO/WC	$99.60
Rate for Payer: UnitedHealthcare Commercial	$132.80
Rate for Payer: UnitedHealthcare Community & State	$20.98
Rate for Payer: Wellpoint Medicaid Managed Care	$18.86

LAP RADICAL HYST

Facility

$48,210.00

Service Code	HCPCS 58548
Hospital Charge Code	1600000258
Hospital Revenue Code	360
Min. Negotiated Rate	$7,231.50
Max. Negotiated Rate	$7,231.50
Rate for Payer: Qualcare PPO/HMO/WC	$7,231.50

LAP RADICAL HYST

Facility

$48,210.00

Service Code	HCPCS 58548
Hospital Charge Code	1600000258
Hospital Revenue Code	360
Min. Negotiated Rate	$1,369.16
Max. Negotiated Rate	$24,105.00
Rate for Payer: Aetna Commercial	$18,319.80
Rate for Payer: Aetna Medicare Advantage	$14,463.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,293.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,293.55
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	$12,293.55
Rate for Payer: Cigna Commercial	$24,105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,534.60
Rate for Payer: Oxford Commercial	$11,677.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,231.50
Rate for Payer: UnitedHealthcare Commercial	$12,906.00
Rate for Payer: UnitedHealthcare Community & State	$1,523.44
Rate for Payer: Wellpoint Medicaid Managed Care	$1,369.16

LAP RMVL GASTR ADJ DEVICE

Facility

$12,867.57

Service Code	HCPCS 43772
Hospital Charge Code	1600000419
Hospital Revenue Code	360
Min. Negotiated Rate	$365.44
Max. Negotiated Rate	$14,840.50
Rate for Payer: Aetna Commercial	$12,458.69
Rate for Payer: Aetna Medicare Advantage	$14,840.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,580.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,304.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,120.00
Rate for Payer: Cigna Commercial	$9,181.40
Rate for Payer: Cigna Medicare Advantage	$4,580.40
Rate for Payer: Clover Medicare Advantage	$4,351.38
Rate for Payer: EmblemHealth Commercial	$13,741.20
Rate for Payer: Humana Medicare Advantage	$4,717.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,580.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,345.57
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,930.14
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$406.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,580.40
Rate for Payer: Wellcare Medicare Advantage	$4,580.40
Rate for Payer: Wellpoint Medicaid Managed Care	$365.44

LAP RMVL GASTR ADJ DEVICE

Facility

$12,867.57

Service Code	HCPCS 43772
Hospital Charge Code	1600000419
Hospital Revenue Code	360
Min. Negotiated Rate	$1,930.14
Max. Negotiated Rate	$1,930.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,930.14

LAPRO PRO SPERMATIC CORD

Facility

$17,954.72

Service Code	HCPCS 55559
Hospital Charge Code	1600000329
Hospital Revenue Code	360
Min. Negotiated Rate	$2,693.21
Max. Negotiated Rate	$2,693.21
Rate for Payer: Qualcare PPO/HMO/WC	$2,693.21

LAPRO PRO SPERMATIC CORD

Facility

$17,954.72

Service Code	HCPCS 55559
Hospital Charge Code	1600000329
Hospital Revenue Code	360
Min. Negotiated Rate	$509.91
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	$4,668.23
Rate for Payer: Oxford Commercial	$11,677.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,693.21
Rate for Payer: UnitedHealthcare Commercial	$12,906.00
Rate for Payer: UnitedHealthcare Community & State	$567.37
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	$509.91

LAP SLEEVE GASTRECTOMY

Facility

$10,973.76

Service Code	HCPCS 43775
Hospital Charge Code	16000273
Hospital Revenue Code	360
Min. Negotiated Rate	$311.65
Max. Negotiated Rate	$14,869.00
Rate for Payer: Aetna Commercial	$4,170.03
Rate for Payer: Aetna Medicare Advantage	$3,292.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,304.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,120.00
Rate for Payer: Cigna Commercial	$5,486.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,853.18
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,646.06
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$346.77
Rate for Payer: Wellpoint Medicaid Managed Care	$311.65

LAP SLEEVE GASTRECTOMY

Facility

$10,973.76

Service Code	HCPCS 43775
Hospital Charge Code	16000273
Hospital Revenue Code	360
Min. Negotiated Rate	$1,646.06
Max. Negotiated Rate	$1,646.06
Rate for Payer: Qualcare PPO/HMO/WC	$1,646.06

LAP TIP 2MM X 30CM & TUBESET

Facility

$6,000.00

Hospital Charge Code	270691645
Hospital Revenue Code	272
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$900.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

Know your out-of-pocket cost for care.

All Charges