Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

LEAD BLOOD

Facility

$325.00

Service Code	HCPCS 83655
Hospital Charge Code	38472446
Hospital Revenue Code	301
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

LEAD BLOOD

Facility

$325.00

Service Code	HCPCS 83655
Hospital Charge Code	38472446
Hospital Revenue Code	301
Min. Negotiated Rate	$9.23
Max. Negotiated Rate	$162.50
Rate for Payer: Aetna Commercial	$32.94
Rate for Payer: Aetna Medicare Advantage	$39.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.93
Rate for Payer: Cigna Commercial	$162.50
Rate for Payer: Cigna Medicare Advantage	$12.11
Rate for Payer: Clover Medicare Advantage	$11.50
Rate for Payer: EmblemHealth Commercial	$36.33
Rate for Payer: Humana Medicare Advantage	$12.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.50
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.75
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.11
Rate for Payer: Wellcare Medicare Advantage	$12.11
Rate for Payer: Wellpoint Medicaid Managed Care	$9.23

LEAD,BLOOD

Facility

$667.59

Service Code	HCPCS 83655
Hospital Charge Code	39900102
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

LEAD,BLOOD

Facility

$667.59

Service Code	HCPCS 83655
Hospital Charge Code	39900102
Hospital Revenue Code	301
Min. Negotiated Rate	$9.69
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$32.94
Rate for Payer: Aetna Medicare Advantage	$39.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.93
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$12.11
Rate for Payer: Clover Medicare Advantage	$11.50
Rate for Payer: EmblemHealth Commercial	$36.33
Rate for Payer: Humana Medicare Advantage	$12.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.57
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.11
Rate for Payer: Wellcare Medicare Advantage	$12.11
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

LEAD CAPSUREFIX MRI

Facility

$4,230.00

Service Code	HCPCS C1898
Hospital Charge Code	270673835
Hospital Revenue Code	278
Min. Negotiated Rate	$634.50
Max. Negotiated Rate	$1,023.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$846.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,023.66
Rate for Payer: Qualcare PPO/HMO/WC	$634.50

LEAD CAPSUREFIX MRI

Facility

$4,230.00

Service Code	HCPCS C1898
Hospital Charge Code	270673835
Hospital Revenue Code	278
Min. Negotiated Rate	$120.13
Max. Negotiated Rate	$2,115.00
Rate for Payer: Aetna Commercial	$1,607.40
Rate for Payer: Aetna Medicare Advantage	$1,269.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,078.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,078.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$846.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,078.65
Rate for Payer: Cigna Commercial	$2,115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,023.66
Rate for Payer: Qualcare PPO/HMO/WC	$634.50
Rate for Payer: UnitedHealthcare Community & State	$133.67
Rate for Payer: Wellpoint Medicaid Managed Care	$120.13

LEAD CAPSUREZ NOVUS

Facility

$3,276.00

Hospital Charge Code	270640301
Hospital Revenue Code	275
Min. Negotiated Rate	$93.04
Max. Negotiated Rate	$1,638.00
Rate for Payer: Aetna Commercial	$1,244.88
Rate for Payer: Aetna Medicare Advantage	$982.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$835.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$835.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$655.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$835.38
Rate for Payer: Cigna Commercial	$1,638.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$792.79
Rate for Payer: Qualcare PPO/HMO/WC	$491.40
Rate for Payer: UnitedHealthcare Community & State	$103.52
Rate for Payer: Wellpoint Medicaid Managed Care	$93.04

LEAD CAPSUREZ NOVUS

Facility

$3,276.00

Hospital Charge Code	270640301
Hospital Revenue Code	275
Min. Negotiated Rate	$491.40
Max. Negotiated Rate	$792.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$655.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$792.79
Rate for Payer: Qualcare PPO/HMO/WC	$491.40

LEAD CORO VENTR QUARTET 86MM

Facility

$16,475.00

Service Code	HCPCS C1900
Hospital Charge Code	270699083S
Hospital Revenue Code	275
Min. Negotiated Rate	$2,471.25
Max. Negotiated Rate	$3,986.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25

LEAD CORO VENTR QUARTET 86MM

Facility

$16,475.00

Service Code	HCPCS C1900
Hospital Charge Code	270699083S
Hospital Revenue Code	275
Min. Negotiated Rate	$467.89
Max. Negotiated Rate	$8,237.50
Rate for Payer: Aetna Commercial	$6,260.50
Rate for Payer: Aetna Medicare Advantage	$4,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,201.12
Rate for Payer: Cigna Commercial	$8,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25
Rate for Payer: UnitedHealthcare Community & State	$520.61
Rate for Payer: Wellpoint Medicaid Managed Care	$467.89

LEAD EON 60cm

Facility

$16,075.00

Service Code	HCPCS C1778
Hospital Charge Code	270642323
Hospital Revenue Code	278
Min. Negotiated Rate	$2,411.25
Max. Negotiated Rate	$3,890.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,890.15
Rate for Payer: Qualcare PPO/HMO/WC	$2,411.25

LEAD EON 60cm

Facility

$16,075.00

Service Code	HCPCS C1778
Hospital Charge Code	270642323
Hospital Revenue Code	278
Min. Negotiated Rate	$456.53
Max. Negotiated Rate	$8,037.50
Rate for Payer: Aetna Commercial	$6,108.50
Rate for Payer: Aetna Medicare Advantage	$4,822.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,099.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,099.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,099.12
Rate for Payer: Cigna Commercial	$8,037.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,890.15
Rate for Payer: Qualcare PPO/HMO/WC	$2,411.25
Rate for Payer: UnitedHealthcare Community & State	$507.97
Rate for Payer: Wellpoint Medicaid Managed Care	$456.53

LEAD FINELINE EZ ST PACEMKR

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270696940S
Hospital Revenue Code	278
Min. Negotiated Rate	$113.60
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$126.40
Rate for Payer: Wellpoint Medicaid Managed Care	$113.60

LEAD FINELINE EZ ST PACEMKR

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270696940S
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

LEAD FINELINE II PASSIVE 53

Facility

$5,325.00

Hospital Charge Code	270666558
Hospital Revenue Code	275
Min. Negotiated Rate	$798.75
Max. Negotiated Rate	$1,288.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,065.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,288.65
Rate for Payer: Qualcare PPO/HMO/WC	$798.75

LEAD FINELINE II PASSIVE 53

Facility

$5,325.00

Hospital Charge Code	270666558
Hospital Revenue Code	275
Min. Negotiated Rate	$151.23
Max. Negotiated Rate	$2,662.50
Rate for Payer: Aetna Commercial	$2,023.50
Rate for Payer: Aetna Medicare Advantage	$1,597.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,357.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,357.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,065.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,357.88
Rate for Payer: Cigna Commercial	$2,662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,288.65
Rate for Payer: Qualcare PPO/HMO/WC	$798.75
Rate for Payer: UnitedHealthcare Community & State	$168.27
Rate for Payer: Wellpoint Medicaid Managed Care	$151.23

Lead Ingebity MRI 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270679666S
Hospital Revenue Code	278
Min. Negotiated Rate	$113.60
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$126.40
Rate for Payer: Wellpoint Medicaid Managed Care	$113.60

Lead Ingebity MRI 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270679666N
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

Lead Ingebity MRI 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270679666N
Hospital Revenue Code	278
Min. Negotiated Rate	$113.60
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$126.40
Rate for Payer: Wellpoint Medicaid Managed Care	$113.60

Lead Ingebity MRI 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270679666S
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

Lead Ingevity Cm

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270678803N
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

Lead Ingevity Cm

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270678803S
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

Lead Ingevity Cm

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270678803S
Hospital Revenue Code	278
Min. Negotiated Rate	$113.60
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$126.40
Rate for Payer: Wellpoint Medicaid Managed Care	$113.60

Lead Ingevity Cm

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270678803N
Hospital Revenue Code	278
Min. Negotiated Rate	$113.60
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$126.40
Rate for Payer: Wellpoint Medicaid Managed Care	$113.60

LEAD INGEVITY MRI 7741 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270677540
Hospital Revenue Code	278
Min. Negotiated Rate	$113.60
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$126.40
Rate for Payer: Wellpoint Medicaid Managed Care	$113.60

Know your out-of-pocket cost for care.

All Charges