Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

MAS PLIF FIXATION ROD, 40MM

Facility

$2,980.00

Hospital Charge Code	270667571
Hospital Revenue Code	278
Min. Negotiated Rate	$447.00
Max. Negotiated Rate	$721.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$596.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$721.16
Rate for Payer: Qualcare PPO/HMO/WC	$447.00

MAS PLIF FIXATION ROD, 40MM

Facility

$2,980.00

Hospital Charge Code	270667571
Hospital Revenue Code	278
Min. Negotiated Rate	$84.63
Max. Negotiated Rate	$1,490.00
Rate for Payer: Aetna Commercial	$1,132.40
Rate for Payer: Aetna Medicare Advantage	$894.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$759.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$759.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$596.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$759.90
Rate for Payer: Cigna Commercial	$1,490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$721.16
Rate for Payer: Qualcare PPO/HMO/WC	$447.00
Rate for Payer: UnitedHealthcare Community & State	$94.17
Rate for Payer: Wellpoint Medicaid Managed Care	$84.63

MAS PLIF MODULE

Facility

$15,495.00

Service Code	HCPCS C1713
Hospital Charge Code	270667569
Hospital Revenue Code	278
Min. Negotiated Rate	$2,324.25
Max. Negotiated Rate	$3,749.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,099.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,749.79
Rate for Payer: Qualcare PPO/HMO/WC	$2,324.25

MAS PLIF MODULE

Facility

$15,495.00

Service Code	HCPCS C1713
Hospital Charge Code	270667569
Hospital Revenue Code	278
Min. Negotiated Rate	$440.06
Max. Negotiated Rate	$7,747.50
Rate for Payer: Aetna Commercial	$5,888.10
Rate for Payer: Aetna Medicare Advantage	$4,648.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,951.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,951.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,099.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,951.22
Rate for Payer: Cigna Commercial	$7,747.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,749.79
Rate for Payer: Qualcare PPO/HMO/WC	$2,324.25
Rate for Payer: UnitedHealthcare Community & State	$489.64
Rate for Payer: Wellpoint Medicaid Managed Care	$440.06

MASSAGE EA 15 MIN CQ

Facility

$116.85

Service Code	HCPCS 97124GP
Hospital Charge Code	409197124Q
Hospital Revenue Code	420
Min. Negotiated Rate	$3.32
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$44.40
Rate for Payer: Aetna Medicare Advantage	$35.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.80
Rate for Payer: Cigna Commercial	$58.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.38
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.53
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$3.69
Rate for Payer: Wellpoint Medicaid Managed Care	$3.32

MASSAGE EA 15 MIN CQ

Facility

$116.85

Service Code	HCPCS 97124GP
Hospital Charge Code	409197124Q
Hospital Revenue Code	420
Min. Negotiated Rate	$17.53
Max. Negotiated Rate	$17.53
Rate for Payer: Qualcare PPO/HMO/WC	$17.53

MASTECTOMY FOR MALIGNANCY WITH CC/MCC

Facility

$80,332.82

Service Code	MSDRG 582
Min. Negotiated Rate	$24,460.31
Max. Negotiated Rate	$80,332.82
Rate for Payer: Aetna Commercial	$59,072.48
Rate for Payer: Aetna Medicare Advantage	$80,332.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48,206.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48,206.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25,747.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48,206.70
Rate for Payer: Cigna Commercial	$42,949.69
Rate for Payer: Cigna Medicare Advantage	$25,747.70
Rate for Payer: Clover Medicare Advantage	$24,460.31
Rate for Payer: EmblemHealth Commercial	$77,243.10
Rate for Payer: Humana Medicare Advantage	$26,520.13
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$25,747.70
Rate for Payer: Oxford Commercial	$33,946.69
Rate for Payer: UnitedHealthcare Commercial	$45,438.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$25,747.70
Rate for Payer: Wellcare Medicare Advantage	$25,747.70

MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC

Facility

$73,944.59

Service Code	MSDRG 583
Min. Negotiated Rate	$22,515.18
Max. Negotiated Rate	$73,944.59
Rate for Payer: Aetna Commercial	$54,522.69
Rate for Payer: Aetna Medicare Advantage	$73,944.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42,111.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42,111.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23,700.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42,111.60
Rate for Payer: Cigna Commercial	$38,442.05
Rate for Payer: Cigna Medicare Advantage	$23,700.19
Rate for Payer: Clover Medicare Advantage	$22,515.18
Rate for Payer: EmblemHealth Commercial	$71,100.57
Rate for Payer: Humana Medicare Advantage	$24,411.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$23,700.19
Rate for Payer: Oxford Commercial	$30,383.93
Rate for Payer: UnitedHealthcare Commercial	$40,669.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$23,700.19
Rate for Payer: Wellcare Medicare Advantage	$23,700.19

MASTECTOMY PROCEDURES

Facility

$48,786.81

Service Code	APR-DRG 3624
Min. Negotiated Rate	$47,830.21
Max. Negotiated Rate	$48,786.81
Rate for Payer: UnitedHealthcare Community & State	$47,830.21
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$48,786.81
Rate for Payer: Wellpoint Medicaid Managed Care	$47,830.21

MASTECTOMY PROCEDURES

Facility

$29,695.62

Service Code	APR-DRG 3623
Min. Negotiated Rate	$29,113.35
Max. Negotiated Rate	$29,695.62
Rate for Payer: UnitedHealthcare Community & State	$29,113.35
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$29,695.62
Rate for Payer: Wellpoint Medicaid Managed Care	$29,113.35

MASTECTOMY PROCEDURES

Facility

$17,348.31

Service Code	APR-DRG 3621
Min. Negotiated Rate	$17,008.15
Max. Negotiated Rate	$17,348.31
Rate for Payer: UnitedHealthcare Community & State	$17,008.15
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,348.31
Rate for Payer: Wellpoint Medicaid Managed Care	$17,008.15

MASTECTOMY PROCEDURES

Facility

$26,333.53

Service Code	APR-DRG 3622
Min. Negotiated Rate	$25,817.19
Max. Negotiated Rate	$26,333.53
Rate for Payer: UnitedHealthcare Community & State	$25,817.19
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$26,333.53
Rate for Payer: Wellpoint Medicaid Managed Care	$25,817.19

MA STEREOTACTIC LOC BILAT

Facility

$1,872.50

Service Code	HCPCS 19083
Hospital Charge Code	2700013
Hospital Revenue Code	361
Min. Negotiated Rate	$280.88
Max. Negotiated Rate	$280.88
Rate for Payer: Qualcare PPO/HMO/WC	$280.88

MA STEREOTACTIC LOC BILAT

Facility

$1,872.50

Service Code	HCPCS 19083
Hospital Charge Code	2700013
Hospital Revenue Code	361
Min. Negotiated Rate	$53.18
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	$486.85
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$280.88
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$59.17
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	$53.18

MA STEREOTACTIC LOC LEFT

Facility

$1,872.50

Service Code	HCPCS 19083
Hospital Charge Code	2700014
Hospital Revenue Code	361
Min. Negotiated Rate	$53.18
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	$486.85
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$280.88
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$59.17
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	$53.18

MA STEREOTACTIC LOC LEFT

Facility

$1,872.50

Service Code	HCPCS 19083
Hospital Charge Code	2700014
Hospital Revenue Code	361
Min. Negotiated Rate	$280.88
Max. Negotiated Rate	$280.88
Rate for Payer: Qualcare PPO/HMO/WC	$280.88

MA STEREOTACTIC LOC RIGHT

Facility

$1,872.50

Service Code	HCPCS 19083
Hospital Charge Code	2700015
Hospital Revenue Code	361
Min. Negotiated Rate	$280.88
Max. Negotiated Rate	$280.88
Rate for Payer: Qualcare PPO/HMO/WC	$280.88

MA STEREOTACTIC LOC RIGHT

Facility

$1,872.50

Service Code	HCPCS 19083
Hospital Charge Code	2700015
Hospital Revenue Code	361
Min. Negotiated Rate	$53.18
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	$486.85
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$280.88
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$59.17
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	$53.18

MASTISOL ADHESIVE 3CC

Facility

$7.89

Hospital Charge Code	270650820
Hospital Revenue Code	270
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$3.94
Rate for Payer: Aetna Commercial	$3.00
Rate for Payer: Aetna Medicare Advantage	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.01
Rate for Payer: Cigna Commercial	$3.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.05
Rate for Payer: Oxford Commercial	$1.58
Rate for Payer: Qualcare PPO/HMO/WC	$1.18
Rate for Payer: UnitedHealthcare Commercial	$1.58
Rate for Payer: UnitedHealthcare Community & State	$0.25
Rate for Payer: Wellpoint Medicaid Managed Care	$0.22

MASTISOL ADHESIVE 3CC

Facility

$7.89

Hospital Charge Code	270650820
Hospital Revenue Code	270
Min. Negotiated Rate	$1.18
Max. Negotiated Rate	$1.18
Rate for Payer: Qualcare PPO/HMO/WC	$1.18

MAS TLIF KIT

Facility

$12,810.00

Hospital Charge Code	270691370
Hospital Revenue Code	272
Min. Negotiated Rate	$363.80
Max. Negotiated Rate	$6,405.00
Rate for Payer: Aetna Commercial	$4,867.80
Rate for Payer: Aetna Medicare Advantage	$3,843.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,266.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,266.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,266.55
Rate for Payer: Cigna Commercial	$6,405.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,330.60
Rate for Payer: Oxford Commercial	$2,562.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,921.50
Rate for Payer: UnitedHealthcare Commercial	$2,562.00
Rate for Payer: UnitedHealthcare Community & State	$404.80
Rate for Payer: Wellpoint Medicaid Managed Care	$363.80

MAS TLIF KIT

Facility

$12,810.00

Hospital Charge Code	270691370
Hospital Revenue Code	272
Min. Negotiated Rate	$1,921.50
Max. Negotiated Rate	$1,921.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,921.50

MAST MOD RAD

Facility

$42,601.70

Service Code	HCPCS 19307
Hospital Charge Code	16000298
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

MAST MOD RAD

Facility

$42,601.70

Service Code	HCPCS 19307
Hospital Charge Code	16000298
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

MASTOIDS COMP STUDY

Facility

$5,100.00

Service Code	HCPCS 70130
Hospital Charge Code	94061003
Hospital Revenue Code	320
Min. Negotiated Rate	$40.54
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	$40.54
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	$407.88
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

Know your out-of-pocket cost for care.

All Charges