Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

MASTOIDS COMP STUDY

Facility

$5,100.00

Service Code	HCPCS 70130
Hospital Charge Code	94061003
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

MASTOPEXY

Facility

$31,541.30

Service Code	HCPCS 19316
Hospital Charge Code	16000535
Hospital Revenue Code	360
Min. Negotiated Rate	$895.77
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	$8,200.74
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,731.19
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$996.71
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	$895.77

MASTOPEXY

Facility

$31,541.30

Service Code	HCPCS 19316
Hospital Charge Code	16000535
Hospital Revenue Code	360
Min. Negotiated Rate	$4,731.19
Max. Negotiated Rate	$4,731.19
Rate for Payer: Qualcare PPO/HMO/WC	$4,731.19

MASTOTOMY W EXPL DEEP

Facility

$18,641.30

Service Code	HCPCS 19020
Hospital Charge Code	16000371
Hospital Revenue Code	360
Min. Negotiated Rate	$2,796.20
Max. Negotiated Rate	$2,796.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,796.20

MASTOTOMY W EXPL DEEP

Facility

$18,641.30

Service Code	HCPCS 19020
Hospital Charge Code	16000371
Hospital Revenue Code	360
Min. Negotiated Rate	$529.41
Max. Negotiated Rate	$8,192.00
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	$4,846.74
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,796.20
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$589.07
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	$529.41

MAST SIMPLE COMPLETE

Facility

$31,541.30

Service Code	HCPCS 19303
Hospital Charge Code	16000303
Hospital Revenue Code	360
Min. Negotiated Rate	$4,731.19
Max. Negotiated Rate	$4,731.19
Rate for Payer: Qualcare PPO/HMO/WC	$4,731.19

MAST SIMPLE COMPLETE

Facility

$31,541.30

Service Code	HCPCS 19303
Hospital Charge Code	16000303
Hospital Revenue Code	360
Min. Negotiated Rate	$895.77
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	$8,200.74
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,731.19
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$996.71
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	$895.77

MAT CELL CONTAM STDY STR ANLYS

Facility

$1,327.45

Service Code	HCPCS 81265
Hospital Charge Code	401381265
Hospital Revenue Code	310
Min. Negotiated Rate	$199.12
Max. Negotiated Rate	$199.12
Rate for Payer: Qualcare PPO/HMO/WC	$199.12

MAT CELL CONTAM STDY STR ANLYS

Facility

$1,327.45

Service Code	HCPCS 81265
Hospital Charge Code	401381265
Hospital Revenue Code	310
Min. Negotiated Rate	$37.70
Max. Negotiated Rate	$845.46
Rate for Payer: Aetna Commercial	$633.95
Rate for Payer: Aetna Medicare Advantage	$755.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$845.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$845.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$233.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$845.46
Rate for Payer: Cigna Commercial	$663.73
Rate for Payer: Cigna Medicare Advantage	$233.07
Rate for Payer: Clover Medicare Advantage	$221.42
Rate for Payer: EmblemHealth Commercial	$699.21
Rate for Payer: Humana Medicare Advantage	$240.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$233.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$345.14
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$199.12
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$186.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$233.07
Rate for Payer: Wellcare Medicare Advantage	$233.07
Rate for Payer: Wellpoint Medicaid Managed Care	$37.70

MATCH HEAD BUR 3.0MM 23.0M6ST

Facility

$157.00

Hospital Charge Code	270335570
Hospital Revenue Code	272
Min. Negotiated Rate	$23.55
Max. Negotiated Rate	$23.55
Rate for Payer: Qualcare PPO/HMO/WC	$23.55

MATCH HEAD BUR 3.0MM 23.0M6ST

Facility

$157.00

Hospital Charge Code	270335570
Hospital Revenue Code	272
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$78.50
Rate for Payer: Aetna Commercial	$59.66
Rate for Payer: Aetna Medicare Advantage	$47.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.03
Rate for Payer: Cigna Commercial	$78.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.82
Rate for Payer: Oxford Commercial	$31.40
Rate for Payer: Qualcare PPO/HMO/WC	$23.55
Rate for Payer: UnitedHealthcare Commercial	$31.40
Rate for Payer: UnitedHealthcare Community & State	$4.96
Rate for Payer: Wellpoint Medicaid Managed Care	$4.46

MATCH HEAD BUR 9CM 23.0M9ST

Facility

$184.00

Hospital Charge Code	270335571
Hospital Revenue Code	272
Min. Negotiated Rate	$27.60
Max. Negotiated Rate	$27.60
Rate for Payer: Qualcare PPO/HMO/WC	$27.60

MATCH HEAD BUR 9CM 23.0M9ST

Facility

$184.00

Hospital Charge Code	270335571
Hospital Revenue Code	272
Min. Negotiated Rate	$5.23
Max. Negotiated Rate	$92.00
Rate for Payer: Aetna Commercial	$69.92
Rate for Payer: Aetna Medicare Advantage	$55.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.92
Rate for Payer: Cigna Commercial	$92.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.84
Rate for Payer: Oxford Commercial	$36.80
Rate for Payer: Qualcare PPO/HMO/WC	$27.60
Rate for Payer: UnitedHealthcare Commercial	$36.80
Rate for Payer: UnitedHealthcare Community & State	$5.81
Rate for Payer: Wellpoint Medicaid Managed Care	$5.23

MAT ECOSUCTIONER

Facility

$2,760.00

Hospital Charge Code	270675433
Hospital Revenue Code	272
Min. Negotiated Rate	$78.38
Max. Negotiated Rate	$1,380.00
Rate for Payer: Aetna Commercial	$1,048.80
Rate for Payer: Aetna Medicare Advantage	$828.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$703.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$703.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$703.80
Rate for Payer: Cigna Commercial	$1,380.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$717.60
Rate for Payer: Oxford Commercial	$552.00
Rate for Payer: Qualcare PPO/HMO/WC	$414.00
Rate for Payer: UnitedHealthcare Commercial	$552.00
Rate for Payer: UnitedHealthcare Community & State	$87.22
Rate for Payer: Wellpoint Medicaid Managed Care	$78.38

MAT ECOSUCTIONER

Facility

$2,760.00

Hospital Charge Code	270675433
Hospital Revenue Code	272
Min. Negotiated Rate	$414.00
Max. Negotiated Rate	$414.00
Rate for Payer: Qualcare PPO/HMO/WC	$414.00

MATRISTEM MATRIX PLUS 7x10CM

Facility

$9,870.00

Service Code	HCPCS Q4166
Hospital Charge Code	270677281
Hospital Revenue Code	278
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$2,388.54
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,974.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$536.29
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,388.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,480.50
Rate for Payer: UnitedHealthcare Community & State	$311.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$280.31

MATRISTEM MATRIX PLUS 7x10CM

Facility

$9,870.00

Service Code	HCPCS Q4166
Hospital Charge Code	270677281
Hospital Revenue Code	278
Min. Negotiated Rate	$1,480.50
Max. Negotiated Rate	$2,388.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,974.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,388.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,480.50

MATRISTEM SURG MATRIX 10X15CM

Facility

$15,750.00

Service Code	HCPCS C1781
Hospital Charge Code	270651272
Hospital Revenue Code	278
Min. Negotiated Rate	$447.30
Max. Negotiated Rate	$7,875.00
Rate for Payer: Aetna Commercial	$5,985.00
Rate for Payer: Aetna Medicare Advantage	$4,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,016.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,016.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,016.25
Rate for Payer: Cigna Commercial	$7,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,811.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,362.50
Rate for Payer: UnitedHealthcare Community & State	$497.70
Rate for Payer: Wellpoint Medicaid Managed Care	$447.30

MATRISTEM SURG MATRIX 10X15CM

Facility

$15,750.00

Service Code	HCPCS C1781
Hospital Charge Code	270651272
Hospital Revenue Code	278
Min. Negotiated Rate	$2,362.50
Max. Negotiated Rate	$3,811.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,811.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,362.50

MATRISTIM PSM 7X10 CM

Facility

$9,967.50

Service Code	HCPCS Q4166
Hospital Charge Code	270662112
Hospital Revenue Code	278
Min. Negotiated Rate	$1,495.12
Max. Negotiated Rate	$2,412.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,993.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,412.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,495.12

MATRISTIM PSM 7X10 CM

Facility

$9,967.50

Service Code	HCPCS Q4166
Hospital Charge Code	270662112
Hospital Revenue Code	278
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$2,412.14
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,993.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$536.29
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,412.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,495.12
Rate for Payer: UnitedHealthcare Community & State	$314.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$283.08

MATRIX 200mg MM0200

Facility

$3,008.00

Service Code	HCPCS Q4118
Hospital Charge Code	270644124
Hospital Revenue Code	278
Min. Negotiated Rate	$85.43
Max. Negotiated Rate	$1,504.00
Rate for Payer: Aetna Commercial	$1,143.04
Rate for Payer: Aetna Medicare Advantage	$902.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$767.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$767.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$601.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$767.04
Rate for Payer: Cigna Commercial	$1,504.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$727.94
Rate for Payer: Qualcare PPO/HMO/WC	$451.20
Rate for Payer: UnitedHealthcare Community & State	$95.05
Rate for Payer: Wellpoint Medicaid Managed Care	$85.43

MATRIX 200mg MM0200

Facility

$3,008.00

Service Code	HCPCS Q4118
Hospital Charge Code	270644124
Hospital Revenue Code	278
Min. Negotiated Rate	$451.20
Max. Negotiated Rate	$727.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$601.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$727.94
Rate for Payer: Qualcare PPO/HMO/WC	$451.20

MATRIX 200mg MM0200/1MGJW

Facility

$16.00

Hospital Charge Code	270644124W
Hospital Revenue Code	636
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$3.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.87
Rate for Payer: Qualcare PPO/HMO/WC	$2.40

MATRIX 200mg MM0200/1MGJW

Facility

$16.00

Hospital Charge Code	270644124W
Hospital Revenue Code	636
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$8.00
Rate for Payer: Aetna Commercial	$6.08
Rate for Payer: Aetna Medicare Advantage	$4.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.08
Rate for Payer: Cigna Commercial	$8.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.87
Rate for Payer: Qualcare PPO/HMO/WC	$2.40
Rate for Payer: UnitedHealthcare Community & State	$0.51
Rate for Payer: Wellpoint Medicaid Managed Care	$0.45

Know your out-of-pocket cost for care.

All Charges