Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

LEAD ISTIME PNE TEST STIMN

Facility

$300.00

Service Code	HCPCS C1778
Hospital Charge Code	270691915
Hospital Revenue Code	278
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

LEAD ISTIME PNE TEST STIMN

Facility

$300.00

Service Code	HCPCS C1778
Hospital Charge Code	270691915
Hospital Revenue Code	278
Min. Negotiated Rate	$8.52
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Community & State	$9.48
Rate for Payer: Wellpoint Medicaid Managed Care	$8.52

LEAD ISTIME TEST KIT

Facility

$500.00

Service Code	HCPCS C1897
Hospital Charge Code	270691914
Hospital Revenue Code	272
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$100.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

LEAD ISTIME TEST KIT

Facility

$500.00

Service Code	HCPCS C1897
Hospital Charge Code	270691914
Hospital Revenue Code	272
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

LEAD KIT CONTRACT INFINION 16

Facility

$3,750.00

Hospital Charge Code	270702403
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

LEAD KIT CONTRACT INFINION 16

Facility

$3,750.00

Hospital Charge Code	270701876
Hospital Revenue Code	278
Min. Negotiated Rate	$106.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$118.50
Rate for Payer: Wellpoint Medicaid Managed Care	$106.50

LEAD KIT CONTRACT INFINION 16

Facility

$3,750.00

Hospital Charge Code	270701876
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

LEAD KIT CONTRACT INFINION 16

Facility

$3,750.00

Hospital Charge Code	270702403
Hospital Revenue Code	278
Min. Negotiated Rate	$106.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$118.50
Rate for Payer: Wellpoint Medicaid Managed Care	$106.50

LEAD KIT NEUROSTIM 5X50 BLUE

Facility

$2,500.00

Service Code	HCPCS C1778
Hospital Charge Code	270693283
Hospital Revenue Code	278
Min. Negotiated Rate	$71.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Community & State	$79.00
Rate for Payer: Wellpoint Medicaid Managed Care	$71.00

LEAD KIT NEUROSTIM 5X50 BLUE

Facility

$2,500.00

Service Code	HCPCS C1778
Hospital Charge Code	270693283
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

LEAD KIT TINED

Facility

$2,000.00

Hospital Charge Code	270684097
Hospital Revenue Code	272
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

LEAD KIT TINED

Facility

$2,000.00

Hospital Charge Code	270684097
Hospital Revenue Code	272
Min. Negotiated Rate	$56.80
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$520.00
Rate for Payer: Oxford Commercial	$400.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Commercial	$400.00
Rate for Payer: UnitedHealthcare Community & State	$63.20
Rate for Payer: Wellpoint Medicaid Managed Care	$56.80

LEAD KIT TINED 28CM

Facility

$17,425.00

Service Code	HCPCS C1778
Hospital Charge Code	270671676
Hospital Revenue Code	278
Min. Negotiated Rate	$494.87
Max. Negotiated Rate	$8,712.50
Rate for Payer: Aetna Commercial	$6,621.50
Rate for Payer: Aetna Medicare Advantage	$5,227.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,443.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,443.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,485.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,443.38
Rate for Payer: Cigna Commercial	$8,712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,216.85
Rate for Payer: Qualcare PPO/HMO/WC	$2,613.75
Rate for Payer: UnitedHealthcare Community & State	$550.63
Rate for Payer: Wellpoint Medicaid Managed Care	$494.87

LEAD KIT TINED 28CM

Facility

$17,425.00

Service Code	HCPCS C1778
Hospital Charge Code	270671676
Hospital Revenue Code	278
Min. Negotiated Rate	$2,613.75
Max. Negotiated Rate	$4,216.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,216.85
Rate for Payer: Qualcare PPO/HMO/WC	$2,613.75

LEAD MEDT PCEMKER 5092-52CM

Facility

$2,420.00

Service Code	HCPCS C1779
Hospital Charge Code	270626470
Hospital Revenue Code	275
Min. Negotiated Rate	$68.73
Max. Negotiated Rate	$1,210.00
Rate for Payer: Aetna Commercial	$919.60
Rate for Payer: Aetna Medicare Advantage	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$617.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$617.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$617.10
Rate for Payer: Cigna Commercial	$1,210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.64
Rate for Payer: Qualcare PPO/HMO/WC	$363.00
Rate for Payer: UnitedHealthcare Community & State	$76.47
Rate for Payer: Wellpoint Medicaid Managed Care	$68.73

LEAD MEDT PCEMKER 5092-52CM

Facility

$2,420.00

Service Code	HCPCS C1779
Hospital Charge Code	270626470
Hospital Revenue Code	275
Min. Negotiated Rate	$363.00
Max. Negotiated Rate	$585.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$484.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.64
Rate for Payer: Qualcare PPO/HMO/WC	$363.00

LEAD MEDT PCEMKR 5076-52

Facility

$2,795.00

Service Code	HCPCS C1779
Hospital Charge Code	270623124
Hospital Revenue Code	275
Min. Negotiated Rate	$419.25
Max. Negotiated Rate	$676.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$559.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$676.39
Rate for Payer: Qualcare PPO/HMO/WC	$419.25

LEAD MEDT PCEMKR 5076-52

Facility

$2,795.00

Service Code	HCPCS C1779
Hospital Charge Code	270623124
Hospital Revenue Code	275
Min. Negotiated Rate	$79.38
Max. Negotiated Rate	$1,397.50
Rate for Payer: Aetna Commercial	$1,062.10
Rate for Payer: Aetna Medicare Advantage	$838.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$712.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$712.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$559.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$712.73
Rate for Payer: Cigna Commercial	$1,397.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$676.39
Rate for Payer: Qualcare PPO/HMO/WC	$419.25
Rate for Payer: UnitedHealthcare Community & State	$88.32
Rate for Payer: Wellpoint Medicaid Managed Care	$79.38

LEAD MEDT PCEMKR 5092-58

Facility

$2,420.00

Service Code	HCPCS C1779
Hospital Charge Code	270611035
Hospital Revenue Code	275
Min. Negotiated Rate	$68.73
Max. Negotiated Rate	$1,210.00
Rate for Payer: Aetna Commercial	$919.60
Rate for Payer: Aetna Medicare Advantage	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$617.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$617.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$617.10
Rate for Payer: Cigna Commercial	$1,210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.64
Rate for Payer: Qualcare PPO/HMO/WC	$363.00
Rate for Payer: UnitedHealthcare Community & State	$76.47
Rate for Payer: Wellpoint Medicaid Managed Care	$68.73

LEAD MEDT PCEMKR 5092-58

Facility

$2,420.00

Service Code	HCPCS C1779
Hospital Charge Code	270611035
Hospital Revenue Code	275
Min. Negotiated Rate	$363.00
Max. Negotiated Rate	$585.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$484.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.64
Rate for Payer: Qualcare PPO/HMO/WC	$363.00

LEAD MEDT PCEMKR 5568

Facility

$3,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270609354
Hospital Revenue Code	275
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

LEAD MEDT PCEMKR 5568

Facility

$3,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270609354
Hospital Revenue Code	275
Min. Negotiated Rate	$85.20
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$94.80
Rate for Payer: Wellpoint Medicaid Managed Care	$85.20

LEAD MEDT PCEMKR FIX 4068-58

Facility

$3,625.00

Service Code	HCPCS C1779
Hospital Charge Code	270602750
Hospital Revenue Code	275
Min. Negotiated Rate	$543.75
Max. Negotiated Rate	$877.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.25
Rate for Payer: Qualcare PPO/HMO/WC	$543.75

LEAD MEDT PCEMKR FIX 4068-58

Facility

$3,625.00

Service Code	HCPCS C1779
Hospital Charge Code	270602750
Hospital Revenue Code	275
Min. Negotiated Rate	$102.95
Max. Negotiated Rate	$1,812.50
Rate for Payer: Aetna Commercial	$1,377.50
Rate for Payer: Aetna Medicare Advantage	$1,087.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$924.38
Rate for Payer: Cigna Commercial	$1,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.25
Rate for Payer: Qualcare PPO/HMO/WC	$543.75
Rate for Payer: UnitedHealthcare Community & State	$114.55
Rate for Payer: Wellpoint Medicaid Managed Care	$102.95

LEADNEUROINTERSTIMSURESCAN28CM

Facility

$22,770.00

Service Code	HCPCS C1778
Hospital Charge Code	270692608
Hospital Revenue Code	278
Min. Negotiated Rate	$3,415.50
Max. Negotiated Rate	$5,510.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,554.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,510.34
Rate for Payer: Qualcare PPO/HMO/WC	$3,415.50

Know your out-of-pocket cost for care.

All Charges