Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ART BMC PLUS KIT

Facility

$8,500.00

Hospital Charge Code	270691940
Hospital Revenue Code	272
Min. Negotiated Rate	$241.40
Max. Negotiated Rate	$4,250.00
Rate for Payer: Aetna Commercial	$3,230.00
Rate for Payer: Aetna Medicare Advantage	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,167.50
Rate for Payer: Cigna Commercial	$4,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,210.00
Rate for Payer: Oxford Commercial	$1,700.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00
Rate for Payer: UnitedHealthcare Commercial	$1,700.00
Rate for Payer: UnitedHealthcare Community & State	$268.60
Rate for Payer: Wellpoint Medicaid Managed Care	$241.40

ART BYP FEM-ANT-POST-TIB/PRL

Facility

$32,300.40

Service Code	HCPCS 35566
Hospital Charge Code	1600000873
Hospital Revenue Code	360
Min. Negotiated Rate	$4,845.06
Max. Negotiated Rate	$4,845.06
Rate for Payer: Qualcare PPO/HMO/WC	$4,845.06

ART BYP FEM-ANT-POST-TIB/PRL

Facility

$32,300.40

Service Code	HCPCS 35566
Hospital Charge Code	1600000873
Hospital Revenue Code	360
Min. Negotiated Rate	$917.33
Max. Negotiated Rate	$16,150.20
Rate for Payer: Aetna Commercial	$12,274.15
Rate for Payer: Aetna Medicare Advantage	$9,690.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,236.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,236.60
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	$8,236.60
Rate for Payer: Cigna Commercial	$16,150.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,398.10
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,845.06
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$1,020.69
Rate for Payer: Wellpoint Medicaid Managed Care	$917.33

ART BYP FEMORAL- FEMORAL

Facility

$16,108.00

Service Code	HCPCS 35661
Hospital Charge Code	1600000680
Hospital Revenue Code	360
Min. Negotiated Rate	$2,416.20
Max. Negotiated Rate	$2,416.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,416.20

ART BYP FEMORAL- FEMORAL

Facility

$16,108.00

Service Code	HCPCS 35661
Hospital Charge Code	1600000680
Hospital Revenue Code	360
Min. Negotiated Rate	$457.47
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$6,121.04
Rate for Payer: Aetna Medicare Advantage	$4,832.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,107.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,107.54
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	$4,107.54
Rate for Payer: Cigna Commercial	$8,054.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,188.08
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,416.20
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$509.01
Rate for Payer: Wellpoint Medicaid Managed Care	$457.47

ART BYP FEMORAL- POPLITEAL

Facility

$40,828.00

Service Code	HCPCS 35656
Hospital Charge Code	1600000371
Hospital Revenue Code	360
Min. Negotiated Rate	$1,159.52
Max. Negotiated Rate	$20,414.00
Rate for Payer: Aetna Commercial	$15,514.64
Rate for Payer: Aetna Medicare Advantage	$12,248.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,411.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,411.14
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	$10,411.14
Rate for Payer: Cigna Commercial	$20,414.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,615.28
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,124.20
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$1,290.16
Rate for Payer: Wellpoint Medicaid Managed Care	$1,159.52

ART BYP FEMORAL- POPLITEAL

Facility

$40,828.00

Service Code	HCPCS 35656
Hospital Charge Code	1600000371
Hospital Revenue Code	360
Min. Negotiated Rate	$6,124.20
Max. Negotiated Rate	$6,124.20
Rate for Payer: Qualcare PPO/HMO/WC	$6,124.20

ART.COMP,OVOMOTION 46X42MM

Facility

$33,130.00

Service Code	HCPCS C1776
Hospital Charge Code	270687341
Hospital Revenue Code	278
Min. Negotiated Rate	$4,969.50
Max. Negotiated Rate	$8,017.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,626.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,017.46
Rate for Payer: Qualcare PPO/HMO/WC	$4,969.50

ART.COMP,OVOMOTION 46X42MM

Facility

$33,130.00

Service Code	HCPCS C1776
Hospital Charge Code	270687341
Hospital Revenue Code	278
Min. Negotiated Rate	$940.89
Max. Negotiated Rate	$16,565.00
Rate for Payer: Aetna Commercial	$12,589.40
Rate for Payer: Aetna Medicare Advantage	$9,939.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,448.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,448.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,448.15
Rate for Payer: Cigna Commercial	$16,565.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,017.46
Rate for Payer: Qualcare PPO/HMO/WC	$4,969.50
Rate for Payer: UnitedHealthcare Community & State	$1,046.91
Rate for Payer: Wellpoint Medicaid Managed Care	$940.89

ARTEGRAFT 6MM 34C M

Facility

$8,845.00

Service Code	HCPCS C1768
Hospital Charge Code	270686955
Hospital Revenue Code	278
Min. Negotiated Rate	$251.20
Max. Negotiated Rate	$4,422.50
Rate for Payer: Aetna Commercial	$3,361.10
Rate for Payer: Aetna Medicare Advantage	$2,653.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,255.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,255.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,769.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,255.47
Rate for Payer: Cigna Commercial	$4,422.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,140.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,326.75
Rate for Payer: UnitedHealthcare Community & State	$279.50
Rate for Payer: Wellpoint Medicaid Managed Care	$251.20

ARTEGRAFT 6MM 34C M

Facility

$8,845.00

Service Code	HCPCS C1768
Hospital Charge Code	270686955
Hospital Revenue Code	278
Min. Negotiated Rate	$1,326.75
Max. Negotiated Rate	$2,140.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,769.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,140.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,326.75

ARTEGRAFT 7MM 42CM

Facility

$6,095.00

Service Code	HCPCS C1768
Hospital Charge Code	270638164
Hospital Revenue Code	278
Min. Negotiated Rate	$914.25
Max. Negotiated Rate	$1,474.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,219.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,474.99
Rate for Payer: Qualcare PPO/HMO/WC	$914.25

ARTEGRAFT 7MM 42CM

Facility

$6,095.00

Service Code	HCPCS C1768
Hospital Charge Code	270638164
Hospital Revenue Code	278
Min. Negotiated Rate	$173.10
Max. Negotiated Rate	$3,047.50
Rate for Payer: Aetna Commercial	$2,316.10
Rate for Payer: Aetna Medicare Advantage	$1,828.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,554.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,554.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,219.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,554.22
Rate for Payer: Cigna Commercial	$3,047.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,474.99
Rate for Payer: Qualcare PPO/HMO/WC	$914.25
Rate for Payer: UnitedHealthcare Community & State	$192.60
Rate for Payer: Wellpoint Medicaid Managed Care	$173.10

ARTERIAL BLOOD GAS

Facility

$733.49

Service Code	HCPCS 82803
Hospital Charge Code	397361012
Hospital Revenue Code	300
Min. Negotiated Rate	$20.83
Max. Negotiated Rate	$366.75
Rate for Payer: Aetna Commercial	$70.91
Rate for Payer: Aetna Medicare Advantage	$84.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.57
Rate for Payer: Cigna Commercial	$366.75
Rate for Payer: Cigna Medicare Advantage	$26.07
Rate for Payer: Clover Medicare Advantage	$24.77
Rate for Payer: EmblemHealth Commercial	$78.21
Rate for Payer: Humana Medicare Advantage	$26.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$190.71
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$110.02
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$20.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.07
Rate for Payer: Wellcare Medicare Advantage	$26.07
Rate for Payer: Wellpoint Medicaid Managed Care	$20.83

ARTERIAL BLOOD GAS

Facility

$733.49

Service Code	HCPCS 82803
Hospital Charge Code	397361012
Hospital Revenue Code	300
Min. Negotiated Rate	$110.02
Max. Negotiated Rate	$110.02
Rate for Payer: Qualcare PPO/HMO/WC	$110.02

ARTERIAL CANNULATION SUPPORT

Facility

$27.00

Hospital Charge Code	270331605
Hospital Revenue Code	272
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$13.50
Rate for Payer: Aetna Commercial	$10.26
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.88
Rate for Payer: Cigna Commercial	$13.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.02
Rate for Payer: Oxford Commercial	$5.40
Rate for Payer: Qualcare PPO/HMO/WC	$4.05
Rate for Payer: UnitedHealthcare Commercial	$5.40
Rate for Payer: UnitedHealthcare Community & State	$0.85
Rate for Payer: Wellpoint Medicaid Managed Care	$0.77

ARTERIAL CANNULATION SUPPORT

Facility

$27.00

Hospital Charge Code	270331605
Hospital Revenue Code	272
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.05

ARTERIAL DOPPLER-LOWER LTD

Facility

$17,200.00

Service Code	HCPCS 93922
Hospital Charge Code	74115031
Hospital Revenue Code	921
Min. Negotiated Rate	$150.16
Max. Negotiated Rate	$7,555.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.36
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,472.00
Rate for Payer: Oxford Commercial	$6,888.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$7,555.00
Rate for Payer: UnitedHealthcare Community & State	$543.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$488.48

ARTERIAL DOPPLER-LOWER LTD

Facility

$17,200.00

Service Code	HCPCS 93922
Hospital Charge Code	94053175
Hospital Revenue Code	921
Min. Negotiated Rate	$150.16
Max. Negotiated Rate	$7,555.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.36
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,472.00
Rate for Payer: Oxford Commercial	$6,888.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$7,555.00
Rate for Payer: UnitedHealthcare Community & State	$543.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$488.48

ARTERIAL DOPPLER-LOWER LTD

Facility

$17,200.00

Service Code	HCPCS 93922
Hospital Charge Code	94053175
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

ARTERIAL DOPPLER-LOWER LTD

Facility

$17,200.00

Service Code	HCPCS 93922
Hospital Charge Code	74115031
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

ARTERIAL DOPPLER UPP LOW EXTR

Facility

$17,200.00

Service Code	HCPCS 93922
Hospital Charge Code	2692035
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

ARTERIAL DOPPLER UPP LOW EXTR

Facility

$17,200.00

Service Code	HCPCS 93922
Hospital Charge Code	2692035
Hospital Revenue Code	921
Min. Negotiated Rate	$150.16
Max. Negotiated Rate	$7,555.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.36
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,472.00
Rate for Payer: Oxford Commercial	$6,888.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$7,555.00
Rate for Payer: UnitedHealthcare Community & State	$543.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$488.48

ARTERIAL DOPPLER UPP LOW LTD

Facility

$17,200.00

Service Code	HCPCS 93922
Hospital Charge Code	421593922
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

ARTERIAL DOPPLER UPP LOW LTD

Facility

$17,200.00

Service Code	HCPCS 93922
Hospital Charge Code	421593922
Hospital Revenue Code	921
Min. Negotiated Rate	$150.16
Max. Negotiated Rate	$7,555.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.36
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,472.00
Rate for Payer: Oxford Commercial	$6,888.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$7,555.00
Rate for Payer: UnitedHealthcare Community & State	$543.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$488.48

Know your out-of-pocket cost for care.

All Charges