Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

MD HYBRID GLENOID BASE 4MM

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270687429
Hospital Revenue Code	278
Min. Negotiated Rate	$170.40
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$189.60
Rate for Payer: Wellpoint Medicaid Managed Care	$170.40

MDI SIZE 3

Facility

$18,625.00

Hospital Charge Code	270656321
Hospital Revenue Code	278
Min. Negotiated Rate	$528.95
Max. Negotiated Rate	$9,312.50
Rate for Payer: Aetna Commercial	$7,077.50
Rate for Payer: Aetna Medicare Advantage	$5,587.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,749.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,749.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,749.38
Rate for Payer: Cigna Commercial	$9,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,507.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,793.75
Rate for Payer: UnitedHealthcare Community & State	$588.55
Rate for Payer: Wellpoint Medicaid Managed Care	$528.95

MDI SIZE 3

Facility

$18,625.00

Hospital Charge Code	270656321
Hospital Revenue Code	278
Min. Negotiated Rate	$2,793.75
Max. Negotiated Rate	$4,507.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,507.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,793.75

MDLR CP 10 DEG NEU 50/52/54X32

Facility

$4,454.05

Hospital Charge Code	270663144
Hospital Revenue Code	278
Min. Negotiated Rate	$126.50
Max. Negotiated Rate	$2,227.03
Rate for Payer: Aetna Commercial	$1,692.54
Rate for Payer: Aetna Medicare Advantage	$1,336.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,135.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,135.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$890.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,135.78
Rate for Payer: Cigna Commercial	$2,227.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,077.88
Rate for Payer: Qualcare PPO/HMO/WC	$668.11
Rate for Payer: UnitedHealthcare Community & State	$140.75
Rate for Payer: Wellpoint Medicaid Managed Care	$126.50

MDLR CP 10 DEG NEU 50/52/54X32

Facility

$4,454.05

Hospital Charge Code	270663144
Hospital Revenue Code	278
Min. Negotiated Rate	$668.11
Max. Negotiated Rate	$1,077.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$890.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,077.88
Rate for Payer: Qualcare PPO/HMO/WC	$668.11

MD SCREW 2.7MM X 16MM

Facility

$1,190.00

Service Code	HCPCS C1713
Hospital Charge Code	270701903
Hospital Revenue Code	278
Min. Negotiated Rate	$178.50
Max. Negotiated Rate	$287.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$238.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$287.98
Rate for Payer: Qualcare PPO/HMO/WC	$178.50

MD SCREW 2.7MM X 16MM

Facility

$1,190.00

Service Code	HCPCS C1713
Hospital Charge Code	270701903
Hospital Revenue Code	278
Min. Negotiated Rate	$33.80
Max. Negotiated Rate	$595.00
Rate for Payer: Aetna Commercial	$452.20
Rate for Payer: Aetna Medicare Advantage	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$303.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$303.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$238.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$303.45
Rate for Payer: Cigna Commercial	$595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$287.98
Rate for Payer: Qualcare PPO/HMO/WC	$178.50
Rate for Payer: UnitedHealthcare Community & State	$37.60
Rate for Payer: Wellpoint Medicaid Managed Care	$33.80

MD SCREW 2.7MM X 18MM

Facility

$1,190.00

Service Code	HCPCS C1713
Hospital Charge Code	270681159
Hospital Revenue Code	278
Min. Negotiated Rate	$33.80
Max. Negotiated Rate	$595.00
Rate for Payer: Aetna Commercial	$452.20
Rate for Payer: Aetna Medicare Advantage	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$303.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$303.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$238.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$303.45
Rate for Payer: Cigna Commercial	$595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$287.98
Rate for Payer: Qualcare PPO/HMO/WC	$178.50
Rate for Payer: UnitedHealthcare Community & State	$37.60
Rate for Payer: Wellpoint Medicaid Managed Care	$33.80

MD SCREW 2.7MM X 18MM

Facility

$1,190.00

Service Code	HCPCS C1713
Hospital Charge Code	270681159
Hospital Revenue Code	278
Min. Negotiated Rate	$178.50
Max. Negotiated Rate	$287.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$238.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$287.98
Rate for Payer: Qualcare PPO/HMO/WC	$178.50

MD SCREW 2.7MM X 20MM

Facility

$742.50

Service Code	HCPCS C1713
Hospital Charge Code	270688186
Hospital Revenue Code	278
Min. Negotiated Rate	$111.38
Max. Negotiated Rate	$179.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$179.69
Rate for Payer: Qualcare PPO/HMO/WC	$111.38

MD SCREW 2.7MM X 20MM

Facility

$742.50

Service Code	HCPCS C1713
Hospital Charge Code	270688186
Hospital Revenue Code	278
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$371.25
Rate for Payer: Aetna Commercial	$282.15
Rate for Payer: Aetna Medicare Advantage	$222.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.34
Rate for Payer: Cigna Commercial	$371.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$179.69
Rate for Payer: Qualcare PPO/HMO/WC	$111.38
Rate for Payer: UnitedHealthcare Community & State	$23.46
Rate for Payer: Wellpoint Medicaid Managed Care	$21.09

MD SCREW 2.7MM X 22MM

Facility

$742.50

Service Code	HCPCS C1713
Hospital Charge Code	270688187
Hospital Revenue Code	278
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$371.25
Rate for Payer: Aetna Commercial	$282.15
Rate for Payer: Aetna Medicare Advantage	$222.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.34
Rate for Payer: Cigna Commercial	$371.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$179.69
Rate for Payer: Qualcare PPO/HMO/WC	$111.38
Rate for Payer: UnitedHealthcare Community & State	$23.46
Rate for Payer: Wellpoint Medicaid Managed Care	$21.09

MD SCREW 2.7MM X 22MM

Facility

$742.50

Service Code	HCPCS C1713
Hospital Charge Code	270688187
Hospital Revenue Code	278
Min. Negotiated Rate	$111.38
Max. Negotiated Rate	$179.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$179.69
Rate for Payer: Qualcare PPO/HMO/WC	$111.38

MEASLES AB (IGG)

Facility

$390.00

Service Code	HCPCS 86765
Hospital Charge Code	39900386
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

MEASLES AB (IGG)

Facility

$390.00

Service Code	HCPCS 86765
Hospital Charge Code	39900386
Hospital Revenue Code	302
Min. Negotiated Rate	$10.30
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$35.03
Rate for Payer: Aetna Medicare Advantage	$41.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.72
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.88
Rate for Payer: Clover Medicare Advantage	$12.24
Rate for Payer: EmblemHealth Commercial	$38.64
Rate for Payer: Humana Medicare Advantage	$13.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.88
Rate for Payer: Wellcare Medicare Advantage	$12.88
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

MEASLES/MUMPS PANEL I

Facility

$390.00

Service Code	HCPCS 86765
Hospital Charge Code	39990103A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

MEASLES/MUMPS PANEL I

Facility

$390.00

Service Code	HCPCS 86765
Hospital Charge Code	39990103A
Hospital Revenue Code	302
Min. Negotiated Rate	$10.30
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$35.03
Rate for Payer: Aetna Medicare Advantage	$41.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.72
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.88
Rate for Payer: Clover Medicare Advantage	$12.24
Rate for Payer: EmblemHealth Commercial	$38.64
Rate for Payer: Humana Medicare Advantage	$13.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.88
Rate for Payer: Wellcare Medicare Advantage	$12.88
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

MEASLES/MUMPS PANEL II

Facility

$390.00

Service Code	HCPCS 86762
Hospital Charge Code	39990103B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

MEASLES/MUMPS PANEL II

Facility

$390.00

Service Code	HCPCS 86762
Hospital Charge Code	39990103B
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$39.14
Rate for Payer: Aetna Medicare Advantage	$46.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.20
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$14.39
Rate for Payer: Clover Medicare Advantage	$13.67
Rate for Payer: EmblemHealth Commercial	$43.17
Rate for Payer: Humana Medicare Advantage	$14.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$11.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.39
Rate for Payer: Wellcare Medicare Advantage	$14.39
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

MEASLES/MUMPS/RUBELLA VACCINE

Facility

$6.70

Service Code	HCPCS 90707
Hospital Charge Code	60628307
Hospital Revenue Code	636
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$1.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.00

MEASLES/MUMPS/RUBELLA VACCINE

Facility

$6.70

Service Code	HCPCS 90707
Hospital Charge Code	60628307
Hospital Revenue Code	636
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$60.09
Rate for Payer: Aetna Commercial	$2.55
Rate for Payer: Aetna Medicare Advantage	$2.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.71
Rate for Payer: Cigna Commercial	$3.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.00
Rate for Payer: UnitedHealthcare Community & State	$0.21
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

MEAT FIBER, STOOL

Facility

$52.00

Service Code	HCPCS 89160
Hospital Charge Code	38475099
Hospital Revenue Code	300
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

MEAT FIBER, STOOL

Facility

$52.00

Service Code	HCPCS 89160
Hospital Charge Code	38475099
Hospital Revenue Code	300
Min. Negotiated Rate	$1.48
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$13.19
Rate for Payer: Aetna Medicare Advantage	$15.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.59
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: Cigna Medicare Advantage	$4.85
Rate for Payer: Clover Medicare Advantage	$4.61
Rate for Payer: EmblemHealth Commercial	$14.55
Rate for Payer: Humana Medicare Advantage	$5.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.52
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$3.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.85
Rate for Payer: Wellcare Medicare Advantage	$4.85
Rate for Payer: Wellpoint Medicaid Managed Care	$1.48

MEATOTOMY EXCEPT IN NEWBORN

Facility

$18,162.80

Service Code	HCPCS 53020
Hospital Charge Code	1600000546
Hospital Revenue Code	360
Min. Negotiated Rate	$515.82
Max. Negotiated Rate	$9,008.64
Rate for Payer: Aetna Commercial	$6,754.93
Rate for Payer: Aetna Medicare Advantage	$8,046.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,008.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,008.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,483.43
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	$9,008.64
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: Cigna Medicare Advantage	$2,483.43
Rate for Payer: Clover Medicare Advantage	$2,359.26
Rate for Payer: EmblemHealth Commercial	$7,450.29
Rate for Payer: Humana Medicare Advantage	$2,557.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,483.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,722.33
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,724.42
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$573.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,483.43
Rate for Payer: Wellcare Medicare Advantage	$2,483.43
Rate for Payer: Wellpoint Medicaid Managed Care	$515.82

MEATOTOMY EXCEPT IN NEWBORN

Facility

$18,162.80

Service Code	HCPCS 53020
Hospital Charge Code	1600000546
Hospital Revenue Code	360
Min. Negotiated Rate	$2,724.42
Max. Negotiated Rate	$2,724.42
Rate for Payer: Qualcare PPO/HMO/WC	$2,724.42

Know your out-of-pocket cost for care.

All Charges