Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

LAP TIP 2MM X 30CM & TUBESET

Facility

$6,000.00

Hospital Charge Code	270691645
Hospital Revenue Code	272
Min. Negotiated Rate	$170.40
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.00
Rate for Payer: Oxford Commercial	$1,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Commercial	$1,200.00
Rate for Payer: UnitedHealthcare Community & State	$189.60
Rate for Payer: Wellpoint Medicaid Managed Care	$170.40

LAP TX ECT PREG WO SALPIN/OOPH

Facility

$43,334.60

Service Code	HCPCS 59150
Hospital Charge Code	1600000429
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 TX ECT PREG WO SALPIN/OOPH

Facility

$43,334.60

Service Code	HCPCS 59150
Hospital Charge Code	1600000429
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 TX ECT PREG,W SALPIN/OOPHO

Facility

$44,604.40

Service Code	HCPCS 59151
Hospital Charge Code	1600000488
Hospital Revenue Code	360
Min. Negotiated Rate	$1,266.76
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	$11,597.14
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,690.66
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,409.50
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	$1,266.76

LAP TX ECT PREG,W SALPIN/OOPHO

Facility

$44,604.40

Service Code	HCPCS 59151
Hospital Charge Code	1600000488
Hospital Revenue Code	360
Min. Negotiated Rate	$6,690.66
Max. Negotiated Rate	$6,690.66
Rate for Payer: Qualcare PPO/HMO/WC	$6,690.66

LAP TY ABS SUTURE CLIP APPLIER

Facility

$162.70

Hospital Charge Code	270685306
Hospital Revenue Code	272
Min. Negotiated Rate	$4.62
Max. Negotiated Rate	$81.35
Rate for Payer: Aetna Commercial	$61.83
Rate for Payer: Aetna Medicare Advantage	$48.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.49
Rate for Payer: Cigna Commercial	$81.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.30
Rate for Payer: Oxford Commercial	$32.54
Rate for Payer: Qualcare PPO/HMO/WC	$24.41
Rate for Payer: UnitedHealthcare Commercial	$32.54
Rate for Payer: UnitedHealthcare Community & State	$5.14
Rate for Payer: Wellpoint Medicaid Managed Care	$4.62

LAP TY ABS SUTURE CLIP APPLIER

Facility

$162.70

Hospital Charge Code	270685306
Hospital Revenue Code	272
Min. Negotiated Rate	$24.41
Max. Negotiated Rate	$24.41
Rate for Payer: Qualcare PPO/HMO/WC	$24.41

LAP VENT/ABD HERNIA REPAIR

Facility

$66,282.45

Service Code	HCPCS 49652
Hospital Charge Code	16000647
Hospital Revenue Code	360
Min. Negotiated Rate	$1,882.42
Max. Negotiated Rate	$33,141.22
Rate for Payer: Aetna Commercial	$25,187.33
Rate for Payer: Aetna Medicare Advantage	$19,884.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,902.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,902.02
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	$16,902.02
Rate for Payer: Cigna Commercial	$33,141.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17,233.44
Rate for Payer: Qualcare PPO/HMO/WC	$9,942.37
Rate for Payer: UnitedHealthcare Community & State	$2,094.53
Rate for Payer: Wellpoint Medicaid Managed Care	$1,882.42

LAP VENT/ABD HERNIA REPAIR

Facility

$66,282.45

Service Code	HCPCS 49652
Hospital Charge Code	16000647
Hospital Revenue Code	360
Min. Negotiated Rate	$9,942.37
Max. Negotiated Rate	$9,942.37
Rate for Payer: Qualcare PPO/HMO/WC	$9,942.37

LAP W DESTRUCTIONS OF OVIDUCT

Facility

$58,549.97

Service Code	HCPCS 58670
Hospital Charge Code	1600000317
Hospital Revenue Code	360
Min. Negotiated Rate	$8,782.50
Max. Negotiated Rate	$8,782.50
Rate for Payer: Qualcare PPO/HMO/WC	$8,782.50

LAP W DESTRUCTIONS OF OVIDUCT

Facility

$58,549.97

Service Code	HCPCS 58670
Hospital Charge Code	1600000317
Hospital Revenue Code	360
Min. Negotiated Rate	$1,662.82
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	$15,222.99
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,782.50
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,850.18
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	$1,662.82

LAP W/EXC DESTR OVARY PELVIC W

Facility

$58,549.97

Service Code	HCPCS 58662
Hospital Charge Code	16000765
Hospital Revenue Code	360
Min. Negotiated Rate	$1,662.82
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	$15,222.99
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,782.50
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,850.18
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	$1,662.82

LAP W/EXC DESTR OVARY PELVIC W

Facility

$58,549.97

Service Code	HCPCS 58662
Hospital Charge Code	16000765
Hospital Revenue Code	360
Min. Negotiated Rate	$8,782.50
Max. Negotiated Rate	$8,782.50
Rate for Payer: Qualcare PPO/HMO/WC	$8,782.50

LAP,W REM ADNEXAL STRUCTURES

Facility

$44,604.40

Service Code	HCPCS 58661
Hospital Charge Code	16001009
Hospital Revenue Code	360
Min. Negotiated Rate	$6,690.66
Max. Negotiated Rate	$6,690.66
Rate for Payer: Qualcare PPO/HMO/WC	$6,690.66

LAP,W REM ADNEXAL STRUCTURES

Facility

$44,604.40

Service Code	HCPCS 58661
Hospital Charge Code	16001009
Hospital Revenue Code	360
Min. Negotiated Rate	$1,266.76
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	$11,597.14
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,690.66
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,409.50
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	$1,266.76

LARGE CAP BIOPSY ALLIGATOR

Facility

$24.75

Hospital Charge Code	270700337
Hospital Revenue Code	272
Min. Negotiated Rate	$3.71
Max. Negotiated Rate	$3.71
Rate for Payer: Qualcare PPO/HMO/WC	$3.71

LARGE CAP BIOPSY ALLIGATOR

Facility

$24.75

Hospital Charge Code	270700337
Hospital Revenue Code	272
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$12.38
Rate for Payer: Aetna Commercial	$9.40
Rate for Payer: Aetna Medicare Advantage	$7.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.31
Rate for Payer: Cigna Commercial	$12.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.43
Rate for Payer: Oxford Commercial	$4.95
Rate for Payer: Qualcare PPO/HMO/WC	$3.71
Rate for Payer: UnitedHealthcare Commercial	$4.95
Rate for Payer: UnitedHealthcare Community & State	$0.78
Rate for Payer: Wellpoint Medicaid Managed Care	$0.70

LARGE GRAFT JACKET

Facility

$4,906.00

Hospital Charge Code	270334772
Hospital Revenue Code	636
Min. Negotiated Rate	$139.33
Max. Negotiated Rate	$2,453.00
Rate for Payer: Aetna Commercial	$1,864.28
Rate for Payer: Aetna Medicare Advantage	$1,471.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,251.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,251.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,251.03
Rate for Payer: Cigna Commercial	$2,453.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,187.25
Rate for Payer: Qualcare PPO/HMO/WC	$735.90
Rate for Payer: UnitedHealthcare Community & State	$155.03
Rate for Payer: Wellpoint Medicaid Managed Care	$139.33

LARGE GRAFT JACKET

Facility

$4,906.00

Hospital Charge Code	270334772
Hospital Revenue Code	636
Min. Negotiated Rate	$735.90
Max. Negotiated Rate	$1,187.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,187.25
Rate for Payer: Qualcare PPO/HMO/WC	$735.90

LARGE PHASIX PLUG WITH PATCH

Facility

$2,925.00

Service Code	HCPCS C1781
Hospital Charge Code	270683932
Hospital Revenue Code	278
Min. Negotiated Rate	$83.07
Max. Negotiated Rate	$1,462.50
Rate for Payer: Aetna Commercial	$1,111.50
Rate for Payer: Aetna Medicare Advantage	$877.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$745.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$745.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$585.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$745.88
Rate for Payer: Cigna Commercial	$1,462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$707.85
Rate for Payer: Qualcare PPO/HMO/WC	$438.75
Rate for Payer: UnitedHealthcare Community & State	$92.43
Rate for Payer: Wellpoint Medicaid Managed Care	$83.07

LARGE PHASIX PLUG WITH PATCH

Facility

$2,925.00

Service Code	HCPCS C1781
Hospital Charge Code	270683932
Hospital Revenue Code	278
Min. Negotiated Rate	$438.75
Max. Negotiated Rate	$707.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$707.85
Rate for Payer: Qualcare PPO/HMO/WC	$438.75

LARIAT SNARE

Facility

$75.00

Hospital Charge Code	270669843
Hospital Revenue Code	272
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$2.37
Rate for Payer: Wellpoint Medicaid Managed Care	$2.13

LARIAT SNARE

Facility

$75.00

Hospital Charge Code	270669843
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

LARYNGECTOMY TUBE 32.7 FR

Facility

$388.00

Hospital Charge Code	270331691
Hospital Revenue Code	272
Min. Negotiated Rate	$11.02
Max. Negotiated Rate	$194.00
Rate for Payer: Aetna Commercial	$147.44
Rate for Payer: Aetna Medicare Advantage	$116.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.94
Rate for Payer: Cigna Commercial	$194.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.88
Rate for Payer: Oxford Commercial	$77.60
Rate for Payer: Qualcare PPO/HMO/WC	$58.20
Rate for Payer: UnitedHealthcare Commercial	$77.60
Rate for Payer: UnitedHealthcare Community & State	$12.26
Rate for Payer: Wellpoint Medicaid Managed Care	$11.02

LARYNGECTOMY TUBE 32.7 FR

Facility

$388.00

Hospital Charge Code	270331691
Hospital Revenue Code	272
Min. Negotiated Rate	$58.20
Max. Negotiated Rate	$58.20
Rate for Payer: Qualcare PPO/HMO/WC	$58.20

Know your out-of-pocket cost for care.

All Charges