Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

NEEDLE LOC MRI GUIDE 1STLESION

Facility

$13,500.00

Service Code	HCPCS 19287RT
Hospital Charge Code	94064021R
Hospital Revenue Code	610
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$2,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

NEEDLE LOC MRI GUIDE 1STLESION

Facility

$13,500.00

Service Code	HCPCS 19287LT
Hospital Charge Code	94064021L
Hospital Revenue Code	610
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$2,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

NEEDLE LOC MRI GUIDE 1STLESION

Facility

$13,500.00

Service Code	HCPCS 1928750
Hospital Charge Code	94064021
Hospital Revenue Code	610
Min. Negotiated Rate	$383.40
Max. Negotiated Rate	$6,750.00
Rate for Payer: Aetna Commercial	$5,130.00
Rate for Payer: Aetna Medicare Advantage	$4,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,442.50
Rate for Payer: Cigna Commercial	$6,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,510.00
Rate for Payer: Oxford Commercial	$5,427.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00
Rate for Payer: UnitedHealthcare Commercial	$6,130.00
Rate for Payer: UnitedHealthcare Community & State	$426.60
Rate for Payer: Wellpoint Medicaid Managed Care	$383.40

NEEDLE LOC MRI GUIDE ADDLESION

Facility

$13,500.00

Service Code	HCPCS 19288
Hospital Charge Code	94064023
Hospital Revenue Code	610
Min. Negotiated Rate	$383.40
Max. Negotiated Rate	$6,750.00
Rate for Payer: Aetna Commercial	$5,130.00
Rate for Payer: Aetna Medicare Advantage	$4,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,442.50
Rate for Payer: Cigna Commercial	$6,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,510.00
Rate for Payer: Oxford Commercial	$5,427.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00
Rate for Payer: UnitedHealthcare Commercial	$6,130.00
Rate for Payer: UnitedHealthcare Community & State	$426.60
Rate for Payer: Wellpoint Medicaid Managed Care	$383.40

NEEDLE LOC MRI GUIDE ADDLESION

Facility

$13,500.00

Service Code	HCPCS 19288
Hospital Charge Code	94064023
Hospital Revenue Code	610
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$2,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

NEEDLE LOC MRI GUIDE ADDLESION

Facility

$983.40

Service Code	HCPCS 19288
Hospital Charge Code	94064023L
Hospital Revenue Code	610
Min. Negotiated Rate	$147.51
Max. Negotiated Rate	$147.51
Rate for Payer: Qualcare PPO/HMO/WC	$147.51

NEEDLE LOC MRI GUIDE ADDLESION

Facility

$983.40

Service Code	HCPCS 19288
Hospital Charge Code	94064023R
Hospital Revenue Code	610
Min. Negotiated Rate	$147.51
Max. Negotiated Rate	$147.51
Rate for Payer: Qualcare PPO/HMO/WC	$147.51

NEEDLE LOC MRI GUIDE ADDLESION

Facility

$983.40

Service Code	HCPCS 19288
Hospital Charge Code	94064023L
Hospital Revenue Code	610
Min. Negotiated Rate	$27.93
Max. Negotiated Rate	$6,130.00
Rate for Payer: Aetna Commercial	$373.69
Rate for Payer: Aetna Medicare Advantage	$295.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$250.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$250.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$250.77
Rate for Payer: Cigna Commercial	$491.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.68
Rate for Payer: Oxford Commercial	$5,427.00
Rate for Payer: Qualcare PPO/HMO/WC	$147.51
Rate for Payer: UnitedHealthcare Commercial	$6,130.00
Rate for Payer: UnitedHealthcare Community & State	$31.08
Rate for Payer: Wellpoint Medicaid Managed Care	$27.93

NEEDLE LOC MRI GUIDE ADDLESION

Facility

$983.40

Service Code	HCPCS 19288
Hospital Charge Code	94064023R
Hospital Revenue Code	610
Min. Negotiated Rate	$27.93
Max. Negotiated Rate	$6,130.00
Rate for Payer: Aetna Commercial	$373.69
Rate for Payer: Aetna Medicare Advantage	$295.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$250.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$250.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$250.77
Rate for Payer: Cigna Commercial	$491.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.68
Rate for Payer: Oxford Commercial	$5,427.00
Rate for Payer: Qualcare PPO/HMO/WC	$147.51
Rate for Payer: UnitedHealthcare Commercial	$6,130.00
Rate for Payer: UnitedHealthcare Community & State	$31.08
Rate for Payer: Wellpoint Medicaid Managed Care	$27.93

NEEDLE LOC STEREO GUIDE 1ST LE

Facility

$1,597.20

Service Code	HCPCS 19283RT
Hospital Charge Code	94064013R
Hospital Revenue Code	361
Min. Negotiated Rate	$45.36
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$606.94
Rate for Payer: Aetna Medicare Advantage	$479.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$407.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$407.29
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	$407.29
Rate for Payer: Cigna Commercial	$798.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$415.27
Rate for Payer: Qualcare PPO/HMO/WC	$239.58
Rate for Payer: UnitedHealthcare Community & State	$50.47
Rate for Payer: Wellpoint Medicaid Managed Care	$45.36

NEEDLE LOC STEREO GUIDE 1ST LE

Facility

$1,597.20

Service Code	HCPCS 19283LT
Hospital Charge Code	94064013L
Hospital Revenue Code	361
Min. Negotiated Rate	$239.58
Max. Negotiated Rate	$239.58
Rate for Payer: Qualcare PPO/HMO/WC	$239.58

NEEDLE LOC STEREO GUIDE 1ST LE

Facility

$3,194.40

Service Code	HCPCS 1928350
Hospital Charge Code	94064013
Hospital Revenue Code	361
Min. Negotiated Rate	$90.72
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,213.87
Rate for Payer: Aetna Medicare Advantage	$958.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$814.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$814.57
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	$814.57
Rate for Payer: Cigna Commercial	$1,597.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$830.54
Rate for Payer: Qualcare PPO/HMO/WC	$479.16
Rate for Payer: UnitedHealthcare Community & State	$100.94
Rate for Payer: Wellpoint Medicaid Managed Care	$90.72

NEEDLE LOC STEREO GUIDE 1ST LE

Facility

$1,597.20

Service Code	HCPCS 19283
Hospital Charge Code	87502811
Hospital Revenue Code	361
Min. Negotiated Rate	$45.36
Max. Negotiated Rate	$3,629.00
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
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	$3,051.74
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$415.27
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$239.58
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$50.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$45.36

NEEDLE LOC STEREO GUIDE 1ST LE

Facility

$1,597.20

Service Code	HCPCS 19283
Hospital Charge Code	87502811
Hospital Revenue Code	361
Min. Negotiated Rate	$239.58
Max. Negotiated Rate	$239.58
Rate for Payer: Qualcare PPO/HMO/WC	$239.58

NEEDLE LOC STEREO GUIDE 1ST LE

Facility

$1,597.20

Service Code	HCPCS 19283LT
Hospital Charge Code	94064013L
Hospital Revenue Code	361
Min. Negotiated Rate	$45.36
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$606.94
Rate for Payer: Aetna Medicare Advantage	$479.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$407.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$407.29
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	$407.29
Rate for Payer: Cigna Commercial	$798.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$415.27
Rate for Payer: Qualcare PPO/HMO/WC	$239.58
Rate for Payer: UnitedHealthcare Community & State	$50.47
Rate for Payer: Wellpoint Medicaid Managed Care	$45.36

NEEDLE LOC STEREO GUIDE 1ST LE

Facility

$3,194.40

Service Code	HCPCS 1928350
Hospital Charge Code	94064013
Hospital Revenue Code	361
Min. Negotiated Rate	$479.16
Max. Negotiated Rate	$479.16
Rate for Payer: Qualcare PPO/HMO/WC	$479.16

NEEDLE LOC STEREO GUIDE 1ST LE

Facility

$1,597.20

Service Code	HCPCS 19283RT
Hospital Charge Code	94064013R
Hospital Revenue Code	361
Min. Negotiated Rate	$239.58
Max. Negotiated Rate	$239.58
Rate for Payer: Qualcare PPO/HMO/WC	$239.58

NEEDLE LOC STEREO GUIDE ADD LE

Facility

$1,184.85

Service Code	HCPCS 19284
Hospital Charge Code	87502812
Hospital Revenue Code	361
Min. Negotiated Rate	$33.65
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$450.24
Rate for Payer: Aetna Medicare Advantage	$355.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$302.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$302.14
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	$302.14
Rate for Payer: Cigna Commercial	$592.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.06
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$177.73
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$37.44
Rate for Payer: Wellpoint Medicaid Managed Care	$33.65

NEEDLE LOC STEREO GUIDE ADD LE

Facility

$1,184.85

Service Code	HCPCS 19284
Hospital Charge Code	87502812
Hospital Revenue Code	361
Min. Negotiated Rate	$177.73
Max. Negotiated Rate	$177.73
Rate for Payer: Qualcare PPO/HMO/WC	$177.73

NEEDLE LOC STEREO GUIDE ADD LE

Facility

$1,184.85

Service Code	HCPCS 19284
Hospital Charge Code	94064015R
Hospital Revenue Code	361
Min. Negotiated Rate	$33.65
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$450.24
Rate for Payer: Aetna Medicare Advantage	$355.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$302.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$302.14
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	$302.14
Rate for Payer: Cigna Commercial	$592.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.06
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$177.73
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$37.44
Rate for Payer: Wellpoint Medicaid Managed Care	$33.65

NEEDLE LOC STEREO GUIDE ADD LE

Facility

$2,369.70

Service Code	HCPCS 19284
Hospital Charge Code	94064015
Hospital Revenue Code	361
Min. Negotiated Rate	$67.30
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$900.49
Rate for Payer: Aetna Medicare Advantage	$710.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$604.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$604.27
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	$604.27
Rate for Payer: Cigna Commercial	$1,184.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$616.12
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$355.45
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$74.88
Rate for Payer: Wellpoint Medicaid Managed Care	$67.30

NEEDLE LOC STEREO GUIDE ADD LE

Facility

$1,184.85

Service Code	HCPCS 19284
Hospital Charge Code	94064015R
Hospital Revenue Code	361
Min. Negotiated Rate	$177.73
Max. Negotiated Rate	$177.73
Rate for Payer: Qualcare PPO/HMO/WC	$177.73

NEEDLE LOC STEREO GUIDE ADD LE

Facility

$1,184.85

Service Code	HCPCS 19284LT
Hospital Charge Code	94064015L
Hospital Revenue Code	361
Min. Negotiated Rate	$177.73
Max. Negotiated Rate	$177.73
Rate for Payer: Qualcare PPO/HMO/WC	$177.73

NEEDLE LOC STEREO GUIDE ADD LE

Facility

$2,369.70

Service Code	HCPCS 19284
Hospital Charge Code	94064015
Hospital Revenue Code	361
Min. Negotiated Rate	$355.45
Max. Negotiated Rate	$355.45
Rate for Payer: Qualcare PPO/HMO/WC	$355.45

NEEDLE LOC STEREO GUIDE ADD LE

Facility

$1,184.85

Service Code	HCPCS 19284LT
Hospital Charge Code	94064015L
Hospital Revenue Code	361
Min. Negotiated Rate	$33.65
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$450.24
Rate for Payer: Aetna Medicare Advantage	$355.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$302.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$302.14
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	$302.14
Rate for Payer: Cigna Commercial	$592.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.06
Rate for Payer: Qualcare PPO/HMO/WC	$177.73
Rate for Payer: UnitedHealthcare Community & State	$37.44
Rate for Payer: Wellpoint Medicaid Managed Care	$33.65

Know your out-of-pocket cost for care.

All Charges