Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

MAMMAPL,W PROSTHETIC LT

Facility

$89,485.25

Service Code	HCPCS 19325
Hospital Charge Code	16000496
Hospital Revenue Code	360
Min. Negotiated Rate	$13,422.79
Max. Negotiated Rate	$13,422.79
Rate for Payer: Qualcare PPO/HMO/WC	$13,422.79

MAMMO NDLE/WIRE LOC BRST RT

Facility

$996.00

Service Code	HCPCS 19281
Hospital Charge Code	2008040
Hospital Revenue Code	361
Min. Negotiated Rate	$149.40
Max. Negotiated Rate	$149.40
Rate for Payer: Qualcare PPO/HMO/WC	$149.40

MAMMO NDLE/WIRE LOC BRST RT

Facility

$996.00

Service Code	HCPCS 19281
Hospital Charge Code	2008040
Hospital Revenue Code	361
Min. Negotiated Rate	$28.29
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.96
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$149.40
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$31.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$28.29

MAMMOPLASTY,REDUCTION

Facility

$42,601.70

Service Code	HCPCS 19318
Hospital Charge Code	16000335
Hospital Revenue Code	360
Min. Negotiated Rate	$1,209.89
Max. Negotiated Rate	$28,616.22
Rate for Payer: Aetna Commercial	$21,457.24
Rate for Payer: Aetna Medicare Advantage	$25,559.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28,616.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28,616.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,888.69
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	$28,616.22
Rate for Payer: Cigna Commercial	$15,812.86
Rate for Payer: Cigna Medicare Advantage	$7,888.69
Rate for Payer: Clover Medicare Advantage	$7,494.26
Rate for Payer: EmblemHealth Commercial	$23,666.07
Rate for Payer: Humana Medicare Advantage	$8,125.35
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,888.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,076.44
Rate for Payer: Oxford Commercial	$11,677.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,390.26
Rate for Payer: UnitedHealthcare Commercial	$12,906.00
Rate for Payer: UnitedHealthcare Community & State	$1,346.21
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,888.69
Rate for Payer: Wellcare Medicare Advantage	$7,888.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1,209.89

MAMMOPLASTY,REDUCTION

Facility

$42,601.70

Service Code	HCPCS 19318
Hospital Charge Code	16000335
Hospital Revenue Code	360
Min. Negotiated Rate	$6,390.26
Max. Negotiated Rate	$6,390.26
Rate for Payer: Qualcare PPO/HMO/WC	$6,390.26

MAMMOTOME BIOPSY SITE IDENTIFI

Facility

$492.00

Hospital Charge Code	26702050
Hospital Revenue Code	272
Min. Negotiated Rate	$13.97
Max. Negotiated Rate	$246.00
Rate for Payer: Aetna Commercial	$186.96
Rate for Payer: Aetna Medicare Advantage	$147.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.46
Rate for Payer: Cigna Commercial	$246.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.92
Rate for Payer: Oxford Commercial	$98.40
Rate for Payer: Qualcare PPO/HMO/WC	$73.80
Rate for Payer: UnitedHealthcare Commercial	$98.40
Rate for Payer: UnitedHealthcare Community & State	$15.55
Rate for Payer: Wellpoint Medicaid Managed Care	$13.97

MAMMOTOME BIOPSY SITE IDENTIFI

Facility

$492.00

Hospital Charge Code	26702050
Hospital Revenue Code	272
Min. Negotiated Rate	$73.80
Max. Negotiated Rate	$73.80
Rate for Payer: Qualcare PPO/HMO/WC	$73.80

MAMMOTOME PROBE

Facility

$1,475.00

Hospital Charge Code	26702052
Hospital Revenue Code	272
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$221.25
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

MAMMOTOME PROBE

Facility

$1,475.00

Hospital Charge Code	26702052
Hospital Revenue Code	272
Min. Negotiated Rate	$41.89
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$383.50
Rate for Payer: Oxford Commercial	$295.00
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Commercial	$295.00
Rate for Payer: UnitedHealthcare Community & State	$46.61
Rate for Payer: Wellpoint Medicaid Managed Care	$41.89

MAMMOTOME STANDARD BREAST MARK

Facility

$1,968.00

Hospital Charge Code	270663458
Hospital Revenue Code	272
Min. Negotiated Rate	$55.89
Max. Negotiated Rate	$984.00
Rate for Payer: Aetna Commercial	$747.84
Rate for Payer: Aetna Medicare Advantage	$590.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$501.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$501.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$501.84
Rate for Payer: Cigna Commercial	$984.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$511.68
Rate for Payer: Oxford Commercial	$393.60
Rate for Payer: Qualcare PPO/HMO/WC	$295.20
Rate for Payer: UnitedHealthcare Commercial	$393.60
Rate for Payer: UnitedHealthcare Community & State	$62.19
Rate for Payer: Wellpoint Medicaid Managed Care	$55.89

MAMMOTOME STANDARD BREAST MARK

Facility

$1,968.00

Hospital Charge Code	270663458
Hospital Revenue Code	272
Min. Negotiated Rate	$295.20
Max. Negotiated Rate	$295.20
Rate for Payer: Qualcare PPO/HMO/WC	$295.20

MAMMOTOME STAR MARKER

Facility

$492.00

Hospital Charge Code	26702048
Hospital Revenue Code	272
Min. Negotiated Rate	$13.97
Max. Negotiated Rate	$246.00
Rate for Payer: Aetna Commercial	$186.96
Rate for Payer: Aetna Medicare Advantage	$147.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.46
Rate for Payer: Cigna Commercial	$246.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.92
Rate for Payer: Oxford Commercial	$98.40
Rate for Payer: Qualcare PPO/HMO/WC	$73.80
Rate for Payer: UnitedHealthcare Commercial	$98.40
Rate for Payer: UnitedHealthcare Community & State	$15.55
Rate for Payer: Wellpoint Medicaid Managed Care	$13.97

MAMMOTOME STAR MARKER

Facility

$492.00

Hospital Charge Code	26702048
Hospital Revenue Code	272
Min. Negotiated Rate	$73.80
Max. Negotiated Rate	$73.80
Rate for Payer: Qualcare PPO/HMO/WC	$73.80

MANDIBLE COMP 4 VIEW

Facility

$5,100.00

Service Code	HCPCS 70110
Hospital Charge Code	94061001
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

MANDIBLE COMP 4 VIEW

Facility

$5,100.00

Service Code	HCPCS 70110
Hospital Charge Code	94061001
Hospital Revenue Code	320
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$450.54
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$86.94
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.00
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$161.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,627.00
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

MANGANESE

Facility

$173.00

Service Code	HCPCS 83785
Hospital Charge Code	38477175
Hospital Revenue Code	301
Min. Negotiated Rate	$4.91
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$72.49
Rate for Payer: Aetna Medicare Advantage	$86.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.67
Rate for Payer: Cigna Commercial	$86.50
Rate for Payer: Cigna Medicare Advantage	$26.65
Rate for Payer: Clover Medicare Advantage	$25.32
Rate for Payer: EmblemHealth Commercial	$79.95
Rate for Payer: Humana Medicare Advantage	$27.45
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.98
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.95
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$21.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.65
Rate for Payer: Wellcare Medicare Advantage	$26.65
Rate for Payer: Wellpoint Medicaid Managed Care	$4.91

MANGANESE

Facility

$173.00

Service Code	HCPCS 83785
Hospital Charge Code	38477175
Hospital Revenue Code	301
Min. Negotiated Rate	$25.95
Max. Negotiated Rate	$25.95
Rate for Payer: Qualcare PPO/HMO/WC	$25.95

MANIFOLD 3 PORT

Facility

$20.25

Hospital Charge Code	270663920
Hospital Revenue Code	272
Min. Negotiated Rate	$3.04
Max. Negotiated Rate	$3.04
Rate for Payer: Qualcare PPO/HMO/WC	$3.04

MANIFOLD 3 PORT

Facility

$20.25

Hospital Charge Code	270663920
Hospital Revenue Code	272
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$10.12
Rate for Payer: Aetna Commercial	$7.70
Rate for Payer: Aetna Medicare Advantage	$6.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.16
Rate for Payer: Cigna Commercial	$10.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.26
Rate for Payer: Oxford Commercial	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$3.04
Rate for Payer: UnitedHealthcare Commercial	$4.05
Rate for Payer: UnitedHealthcare Community & State	$0.64
Rate for Payer: Wellpoint Medicaid Managed Care	$0.58

MANIFOLD UNIV.SET-UP 39TUBING

Facility

$28.00

Hospital Charge Code	270331479
Hospital Revenue Code	272
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$14.00
Rate for Payer: Aetna Commercial	$10.64
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.28
Rate for Payer: Oxford Commercial	$5.60
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$5.60
Rate for Payer: UnitedHealthcare Community & State	$0.88
Rate for Payer: Wellpoint Medicaid Managed Care	$0.80

MANIFOLD UNIV.SET-UP 39TUBING

Facility

$28.00

Hospital Charge Code	270331479
Hospital Revenue Code	272
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

MANIFOLD W/COLLECTION SOCK

Facility

$34.30

Hospital Charge Code	270676801
Hospital Revenue Code	272
Min. Negotiated Rate	$5.14
Max. Negotiated Rate	$5.14
Rate for Payer: Qualcare PPO/HMO/WC	$5.14

MANIFOLD W/COLLECTION SOCK

Facility

$34.30

Hospital Charge Code	270676801
Hospital Revenue Code	272
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$17.15
Rate for Payer: Aetna Commercial	$13.03
Rate for Payer: Aetna Medicare Advantage	$10.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.75
Rate for Payer: Cigna Commercial	$17.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.92
Rate for Payer: Oxford Commercial	$6.86
Rate for Payer: Qualcare PPO/HMO/WC	$5.14
Rate for Payer: UnitedHealthcare Commercial	$6.86
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$0.97

MANIP ELBOW W ANESTH

Facility

$13,711.90

Service Code	HCPCS 24300
Hospital Charge Code	16000682
Hospital Revenue Code	360
Min. Negotiated Rate	$389.42
Max. Negotiated Rate	$6,929.76
Rate for Payer: Aetna Commercial	$5,196.12
Rate for Payer: Aetna Medicare Advantage	$6,189.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,929.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,929.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,910.34
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	$6,929.76
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: Cigna Medicare Advantage	$1,910.34
Rate for Payer: Clover Medicare Advantage	$1,814.82
Rate for Payer: EmblemHealth Commercial	$5,731.02
Rate for Payer: Humana Medicare Advantage	$1,967.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,910.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,565.09
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,056.78
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$433.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellpoint Medicaid Managed Care	$389.42

MANIP ELBOW W ANESTH

Facility

$13,711.90

Service Code	HCPCS 24300
Hospital Charge Code	16000682
Hospital Revenue Code	360
Min. Negotiated Rate	$2,056.78
Max. Negotiated Rate	$2,056.78
Rate for Payer: Qualcare PPO/HMO/WC	$2,056.78

Know your out-of-pocket cost for care.

All Charges