Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

LAT INTERBODY 18X50X12 12 DEG

Facility

$21,000.00

Hospital Charge Code	270702452
Hospital Revenue Code	278
Min. Negotiated Rate	$596.40
Max. Negotiated Rate	$10,500.00
Rate for Payer: Aetna Commercial	$7,980.00
Rate for Payer: Aetna Medicare Advantage	$6,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,355.00
Rate for Payer: Cigna Commercial	$10,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,082.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,150.00
Rate for Payer: UnitedHealthcare Community & State	$663.60
Rate for Payer: Wellpoint Medicaid Managed Care	$596.40

LAT INTERBODY 18X50X12 12 DEG

Facility

$21,000.00

Hospital Charge Code	270702452
Hospital Revenue Code	278
Min. Negotiated Rate	$3,150.00
Max. Negotiated Rate	$5,082.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,082.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,150.00

LAT THOR/LUMB ADDL SEG

Facility

$9,420.05

Service Code	HCPCS 22534
Hospital Charge Code	1600000881
Hospital Revenue Code	360
Min. Negotiated Rate	$267.53
Max. Negotiated Rate	$4,710.02
Rate for Payer: Aetna Commercial	$3,579.62
Rate for Payer: Aetna Medicare Advantage	$2,826.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,402.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,402.11
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	$2,402.11
Rate for Payer: Cigna Commercial	$4,710.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,449.21
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,413.01
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$297.67
Rate for Payer: Wellpoint Medicaid Managed Care	$267.53

LAT THOR/LUMB ADDL SEG

Facility

$9,420.05

Service Code	HCPCS 22534
Hospital Charge Code	1600000881
Hospital Revenue Code	360
Min. Negotiated Rate	$1,413.01
Max. Negotiated Rate	$1,413.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,413.01

LAYER 1.5 X 10

Facility

$117.50

Hospital Charge Code	270690217
Hospital Revenue Code	272
Min. Negotiated Rate	$3.34
Max. Negotiated Rate	$58.75
Rate for Payer: Aetna Commercial	$44.65
Rate for Payer: Aetna Medicare Advantage	$35.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.96
Rate for Payer: Cigna Commercial	$58.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.55
Rate for Payer: Oxford Commercial	$23.50
Rate for Payer: Qualcare PPO/HMO/WC	$17.62
Rate for Payer: UnitedHealthcare Commercial	$23.50
Rate for Payer: UnitedHealthcare Community & State	$3.71
Rate for Payer: Wellpoint Medicaid Managed Care	$3.34

LAYER 1.5 X 10

Facility

$117.50

Hospital Charge Code	270690217
Hospital Revenue Code	272
Min. Negotiated Rate	$17.62
Max. Negotiated Rate	$17.62
Rate for Payer: Qualcare PPO/HMO/WC	$17.62

LAYER SINGLE CONTACT 4x4

Facility

$125.00

Hospital Charge Code	270676733
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

LAYER SINGLE CONTACT 4x4

Facility

$125.00

Hospital Charge Code	270676733
Hospital Revenue Code	272
Min. Negotiated Rate	$3.55
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$25.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$25.00
Rate for Payer: UnitedHealthcare Community & State	$3.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3.55

LCKNG SCR FOR IM NL 4/18/XL25

Facility

$2,049.20

Service Code	HCPCS C1713
Hospital Charge Code	270705551
Hospital Revenue Code	278
Min. Negotiated Rate	$307.38
Max. Negotiated Rate	$495.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$409.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$495.91
Rate for Payer: Qualcare PPO/HMO/WC	$307.38

LCKNG SCR FOR IM NL 4/18/XL25

Facility

$2,049.20

Service Code	HCPCS C1713
Hospital Charge Code	270705551
Hospital Revenue Code	278
Min. Negotiated Rate	$58.20
Max. Negotiated Rate	$1,024.60
Rate for Payer: Aetna Commercial	$778.70
Rate for Payer: Aetna Medicare Advantage	$614.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$522.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$522.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$409.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$522.55
Rate for Payer: Cigna Commercial	$1,024.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$495.91
Rate for Payer: Qualcare PPO/HMO/WC	$307.38
Rate for Payer: UnitedHealthcare Community & State	$64.75
Rate for Payer: Wellpoint Medicaid Managed Care	$58.20

LCKNG SCR FOR IM NL 4/20/XL25

Facility

$2,049.20

Service Code	HCPCS C1713
Hospital Charge Code	270705552
Hospital Revenue Code	278
Min. Negotiated Rate	$307.38
Max. Negotiated Rate	$495.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$409.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$495.91
Rate for Payer: Qualcare PPO/HMO/WC	$307.38

LCKNG SCR FOR IM NL 4/20/XL25

Facility

$2,049.20

Service Code	HCPCS C1713
Hospital Charge Code	270705552
Hospital Revenue Code	278
Min. Negotiated Rate	$58.20
Max. Negotiated Rate	$1,024.60
Rate for Payer: Aetna Commercial	$778.70
Rate for Payer: Aetna Medicare Advantage	$614.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$522.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$522.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$409.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$522.55
Rate for Payer: Cigna Commercial	$1,024.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$495.91
Rate for Payer: Qualcare PPO/HMO/WC	$307.38
Rate for Payer: UnitedHealthcare Community & State	$64.75
Rate for Payer: Wellpoint Medicaid Managed Care	$58.20

LCL SURG WND/DEH EXTENS

Facility

$16,286.20

Service Code	HCPCS 13160
Hospital Charge Code	16000280
Hospital Revenue Code	360
Min. Negotiated Rate	$514.64
Max. Negotiated Rate	$15,271.92
Rate for Payer: Aetna Commercial	$11,451.31
Rate for Payer: Aetna Medicare Advantage	$13,640.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,271.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,271.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,210.04
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	$15,271.92
Rate for Payer: Cigna Commercial	$8,439.01
Rate for Payer: Cigna Medicare Advantage	$4,210.04
Rate for Payer: Clover Medicare Advantage	$3,999.54
Rate for Payer: EmblemHealth Commercial	$12,630.12
Rate for Payer: Humana Medicare Advantage	$4,336.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,210.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,234.41
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,442.93
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$514.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,210.04
Rate for Payer: Wellcare Medicare Advantage	$4,210.04
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,165.88
Rate for Payer: Wellpoint Medicaid Managed Care	$5,064.59

LCL SURG WND/DEH EXTENS

Facility

$16,286.20

Service Code	HCPCS 13160
Hospital Charge Code	16000280
Hospital Revenue Code	360
Min. Negotiated Rate	$2,442.93
Max. Negotiated Rate	$2,442.93
Rate for Payer: Qualcare PPO/HMO/WC	$2,442.93

l COLECTOMY/COLOPROCTOSTOMY

Facility

$2,998.75

Service Code	HCPCS 44208
Hospital Charge Code	1600000409
Hospital Revenue Code	360
Min. Negotiated Rate	$85.16
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$1,139.53
Rate for Payer: Aetna Medicare Advantage	$899.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$764.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$764.68
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	$764.68
Rate for Payer: Cigna Commercial	$1,499.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$779.67
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$449.81
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$94.76
Rate for Payer: Wellpoint Medicaid Managed Care	$85.16

l COLECTOMY/COLOPROCTOSTOMY

Facility

$2,998.75

Service Code	HCPCS 44208
Hospital Charge Code	1600000409
Hospital Revenue Code	360
Min. Negotiated Rate	$449.81
Max. Negotiated Rate	$449.81
Rate for Payer: Qualcare PPO/HMO/WC	$449.81

L COLECTOMY COLOPROCTOSTOMY

Facility

$29,003.00

Service Code	HCPCS 44207
Hospital Charge Code	1600000788
Hospital Revenue Code	360
Min. Negotiated Rate	$4,350.45
Max. Negotiated Rate	$4,350.45
Rate for Payer: Qualcare PPO/HMO/WC	$4,350.45

L COLECTOMY COLOPROCTOSTOMY

Facility

$29,003.00

Service Code	HCPCS 44207
Hospital Charge Code	1600000788
Hospital Revenue Code	360
Min. Negotiated Rate	$823.69
Max. Negotiated Rate	$14,501.50
Rate for Payer: Aetna Commercial	$11,021.14
Rate for Payer: Aetna Medicare Advantage	$8,700.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,395.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,395.77
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	$7,395.77
Rate for Payer: Cigna Commercial	$14,501.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,540.78
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,350.45
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$916.49
Rate for Payer: Wellpoint Medicaid Managed Care	$823.69

L&D ANESTH: 106-120 MIN

Facility

$4,410.00

Hospital Charge Code	7319029
Hospital Revenue Code	370
Min. Negotiated Rate	$661.50
Max. Negotiated Rate	$661.50
Rate for Payer: Qualcare PPO/HMO/WC	$661.50

L&D ANESTH: 106-120 MIN

Facility

$4,410.00

Hospital Charge Code	7319029
Hospital Revenue Code	370
Min. Negotiated Rate	$125.24
Max. Negotiated Rate	$2,205.00
Rate for Payer: Aetna Commercial	$1,675.80
Rate for Payer: Aetna Medicare Advantage	$1,323.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,124.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,124.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,124.55
Rate for Payer: Cigna Commercial	$2,205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,146.60
Rate for Payer: Oxford Commercial	$882.00
Rate for Payer: Qualcare PPO/HMO/WC	$661.50
Rate for Payer: UnitedHealthcare Commercial	$882.00
Rate for Payer: UnitedHealthcare Community & State	$139.36
Rate for Payer: Wellpoint Medicaid Managed Care	$125.24

L&D ANESTH 1-15 MIN

Facility

$551.00

Hospital Charge Code	73190117
Hospital Revenue Code	370
Min. Negotiated Rate	$15.65
Max. Negotiated Rate	$275.50
Rate for Payer: Aetna Commercial	$209.38
Rate for Payer: Aetna Medicare Advantage	$165.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.50
Rate for Payer: Cigna Commercial	$275.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.26
Rate for Payer: Oxford Commercial	$110.20
Rate for Payer: Qualcare PPO/HMO/WC	$82.65
Rate for Payer: UnitedHealthcare Commercial	$110.20
Rate for Payer: UnitedHealthcare Community & State	$17.41
Rate for Payer: Wellpoint Medicaid Managed Care	$15.65

L&D ANESTH 1-15 MIN

Facility

$551.00

Hospital Charge Code	73190117
Hospital Revenue Code	370
Min. Negotiated Rate	$82.65
Max. Negotiated Rate	$82.65
Rate for Payer: Qualcare PPO/HMO/WC	$82.65

L&D ANESTH: 121-135 MIN

Facility

$4,961.00

Hospital Charge Code	7319031
Hospital Revenue Code	370
Min. Negotiated Rate	$140.89
Max. Negotiated Rate	$2,480.50
Rate for Payer: Aetna Commercial	$1,885.18
Rate for Payer: Aetna Medicare Advantage	$1,488.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,265.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,265.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,265.06
Rate for Payer: Cigna Commercial	$2,480.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,289.86
Rate for Payer: Oxford Commercial	$992.20
Rate for Payer: Qualcare PPO/HMO/WC	$744.15
Rate for Payer: UnitedHealthcare Commercial	$992.20
Rate for Payer: UnitedHealthcare Community & State	$156.77
Rate for Payer: Wellpoint Medicaid Managed Care	$140.89

L&D ANESTH: 121-135 MIN

Facility

$4,961.00

Hospital Charge Code	7319031
Hospital Revenue Code	370
Min. Negotiated Rate	$744.15
Max. Negotiated Rate	$744.15
Rate for Payer: Qualcare PPO/HMO/WC	$744.15

L&D ANESTH: 136-150 MIN

Facility

$5,513.00

Hospital Charge Code	7319033
Hospital Revenue Code	370
Min. Negotiated Rate	$156.57
Max. Negotiated Rate	$2,756.50
Rate for Payer: Aetna Commercial	$2,094.94
Rate for Payer: Aetna Medicare Advantage	$1,653.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,405.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,405.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,405.82
Rate for Payer: Cigna Commercial	$2,756.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,433.38
Rate for Payer: Oxford Commercial	$1,102.60
Rate for Payer: Qualcare PPO/HMO/WC	$826.95
Rate for Payer: UnitedHealthcare Commercial	$1,102.60
Rate for Payer: UnitedHealthcare Community & State	$174.21
Rate for Payer: Wellpoint Medicaid Managed Care	$156.57

Know your out-of-pocket cost for care.

All Charges