Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

NEEDLE LOC US GD ADD LES BIL

Facility

$4,642.30

Service Code	HCPCS 1928650
Hospital Charge Code	94064019
Hospital Revenue Code	361
Min. Negotiated Rate	$131.84
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,764.07
Rate for Payer: Aetna Medicare Advantage	$1,392.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,183.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,183.79
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	$1,183.79
Rate for Payer: Cigna Commercial	$2,321.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,207.00
Rate for Payer: Qualcare PPO/HMO/WC	$696.35
Rate for Payer: UnitedHealthcare Community & State	$146.70
Rate for Payer: Wellpoint Medicaid Managed Care	$131.84

NEEDLE LOC US GD ADD LES BIL

Facility

$4,642.30

Service Code	HCPCS 1928650
Hospital Charge Code	94064019
Hospital Revenue Code	361
Min. Negotiated Rate	$696.35
Max. Negotiated Rate	$696.35
Rate for Payer: Qualcare PPO/HMO/WC	$696.35

NEEDLE LOC US GUIDE 1ST LES BI

Facility

$5,497.10

Service Code	HCPCS 1928550
Hospital Charge Code	94064017
Hospital Revenue Code	361
Min. Negotiated Rate	$156.12
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,088.90
Rate for Payer: Aetna Medicare Advantage	$1,649.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,401.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,401.76
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	$1,401.76
Rate for Payer: Cigna Commercial	$2,748.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,429.25
Rate for Payer: Qualcare PPO/HMO/WC	$824.57
Rate for Payer: UnitedHealthcare Community & State	$173.71
Rate for Payer: Wellpoint Medicaid Managed Care	$156.12

NEEDLE LOC US GUIDE 1ST LES BI

Facility

$5,497.10

Service Code	HCPCS 1928550
Hospital Charge Code	94064017
Hospital Revenue Code	361
Min. Negotiated Rate	$824.57
Max. Negotiated Rate	$824.57
Rate for Payer: Qualcare PPO/HMO/WC	$824.57

NEEDLE LOC US GUIDE 1ST LESION

Facility

$2,748.55

Service Code	HCPCS 19285RT
Hospital Charge Code	94064017R
Hospital Revenue Code	361
Min. Negotiated Rate	$412.28
Max. Negotiated Rate	$412.28
Rate for Payer: Qualcare PPO/HMO/WC	$412.28

NEEDLE LOC US GUIDE 1ST LESION

Facility

$2,748.55

Service Code	HCPCS 19285LT
Hospital Charge Code	94064017L
Hospital Revenue Code	361
Min. Negotiated Rate	$78.06
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,044.45
Rate for Payer: Aetna Medicare Advantage	$824.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$700.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$700.88
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	$700.88
Rate for Payer: Cigna Commercial	$1,374.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$714.62
Rate for Payer: Qualcare PPO/HMO/WC	$412.28
Rate for Payer: UnitedHealthcare Community & State	$86.85
Rate for Payer: Wellpoint Medicaid Managed Care	$78.06

NEEDLE LOC US GUIDE 1ST LESION

Facility

$2,748.55

Service Code	HCPCS 19285RT
Hospital Charge Code	94064017R
Hospital Revenue Code	361
Min. Negotiated Rate	$78.06
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,044.45
Rate for Payer: Aetna Medicare Advantage	$824.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$700.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$700.88
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	$700.88
Rate for Payer: Cigna Commercial	$1,374.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$714.62
Rate for Payer: Qualcare PPO/HMO/WC	$412.28
Rate for Payer: UnitedHealthcare Community & State	$86.85
Rate for Payer: Wellpoint Medicaid Managed Care	$78.06

NEEDLE LOC US GUIDE 1ST LESION

Facility

$2,748.55

Service Code	HCPCS 19285
Hospital Charge Code	87502813
Hospital Revenue Code	361
Min. Negotiated Rate	$78.06
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	$714.62
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.28
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$86.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$78.06

NEEDLE LOC US GUIDE 1ST LESION

Facility

$2,748.55

Service Code	HCPCS 19285
Hospital Charge Code	87502813
Hospital Revenue Code	361
Min. Negotiated Rate	$412.28
Max. Negotiated Rate	$412.28
Rate for Payer: Qualcare PPO/HMO/WC	$412.28

NEEDLE LOC US GUIDE 1ST LESION

Facility

$2,748.55

Service Code	HCPCS 19285LT
Hospital Charge Code	94064017L
Hospital Revenue Code	361
Min. Negotiated Rate	$412.28
Max. Negotiated Rate	$412.28
Rate for Payer: Qualcare PPO/HMO/WC	$412.28

NEEDLE LOC US GUIDE ADDLESION

Facility

$2,321.15

Service Code	HCPCS 19286LT
Hospital Charge Code	94064019L
Hospital Revenue Code	361
Min. Negotiated Rate	$65.92
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$882.04
Rate for Payer: Aetna Medicare Advantage	$696.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$591.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$591.89
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	$591.89
Rate for Payer: Cigna Commercial	$1,160.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$603.50
Rate for Payer: Qualcare PPO/HMO/WC	$348.17
Rate for Payer: UnitedHealthcare Community & State	$73.35
Rate for Payer: Wellpoint Medicaid Managed Care	$65.92

NEEDLE LOC US GUIDE ADDLESION

Facility

$2,321.15

Service Code	HCPCS 19286RT
Hospital Charge Code	94064019R
Hospital Revenue Code	361
Min. Negotiated Rate	$65.92
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$882.04
Rate for Payer: Aetna Medicare Advantage	$696.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$591.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$591.89
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	$591.89
Rate for Payer: Cigna Commercial	$1,160.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$603.50
Rate for Payer: Qualcare PPO/HMO/WC	$348.17
Rate for Payer: UnitedHealthcare Community & State	$73.35
Rate for Payer: Wellpoint Medicaid Managed Care	$65.92

NEEDLE LOC US GUIDE ADDLESION

Facility

$2,321.15

Service Code	HCPCS 19286LT
Hospital Charge Code	94064019L
Hospital Revenue Code	361
Min. Negotiated Rate	$348.17
Max. Negotiated Rate	$348.17
Rate for Payer: Qualcare PPO/HMO/WC	$348.17

NEEDLE LOC US GUIDE ADDLESION

Facility

$2,321.15

Service Code	HCPCS 19286
Hospital Charge Code	87502814
Hospital Revenue Code	361
Min. Negotiated Rate	$65.92
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$882.04
Rate for Payer: Aetna Medicare Advantage	$696.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$591.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$591.89
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	$591.89
Rate for Payer: Cigna Commercial	$1,160.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$603.50
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$348.17
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$73.35
Rate for Payer: Wellpoint Medicaid Managed Care	$65.92

NEEDLE LOC US GUIDE ADDLESION

Facility

$2,321.15

Service Code	HCPCS 19286
Hospital Charge Code	87502814
Hospital Revenue Code	361
Min. Negotiated Rate	$348.17
Max. Negotiated Rate	$348.17
Rate for Payer: Qualcare PPO/HMO/WC	$348.17

NEEDLE LOC US GUIDE ADDLESION

Facility

$2,321.15

Service Code	HCPCS 19286RT
Hospital Charge Code	94064019R
Hospital Revenue Code	361
Min. Negotiated Rate	$348.17
Max. Negotiated Rate	$348.17
Rate for Payer: Qualcare PPO/HMO/WC	$348.17

NEEDLE MAYO 1/2 #5 CIRC

Facility

$15.12

Hospital Charge Code	270669513
Hospital Revenue Code	272
Min. Negotiated Rate	$2.27
Max. Negotiated Rate	$2.27
Rate for Payer: Qualcare PPO/HMO/WC	$2.27

NEEDLE MAYO 1/2 #5 CIRC

Facility

$15.12

Hospital Charge Code	270669513
Hospital Revenue Code	272
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$7.56
Rate for Payer: Aetna Commercial	$5.75
Rate for Payer: Aetna Medicare Advantage	$4.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.86
Rate for Payer: Cigna Commercial	$7.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.93
Rate for Payer: Oxford Commercial	$3.02
Rate for Payer: Qualcare PPO/HMO/WC	$2.27
Rate for Payer: UnitedHealthcare Commercial	$3.02
Rate for Payer: UnitedHealthcare Community & State	$0.48
Rate for Payer: Wellpoint Medicaid Managed Care	$0.43

NEEDLE MAYO 1/2 CIRC CATGUT #4

Facility

$23.60

Hospital Charge Code	270663269
Hospital Revenue Code	272
Min. Negotiated Rate	$3.54
Max. Negotiated Rate	$3.54
Rate for Payer: Qualcare PPO/HMO/WC	$3.54

NEEDLE MAYO 1/2 CIRC CATGUT #4

Facility

$23.60

Hospital Charge Code	270663269
Hospital Revenue Code	272
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$11.80
Rate for Payer: Aetna Commercial	$8.97
Rate for Payer: Aetna Medicare Advantage	$7.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.02
Rate for Payer: Cigna Commercial	$11.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.14
Rate for Payer: Oxford Commercial	$4.72
Rate for Payer: Qualcare PPO/HMO/WC	$3.54
Rate for Payer: UnitedHealthcare Commercial	$4.72
Rate for Payer: UnitedHealthcare Community & State	$0.75
Rate for Payer: Wellpoint Medicaid Managed Care	$0.67

NEEDLE MAYO CATGUT 1/2 CIRCLE

Facility

$2.85

Hospital Charge Code	270629952
Hospital Revenue Code	272
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$1.43
Rate for Payer: Aetna Commercial	$1.08
Rate for Payer: Aetna Medicare Advantage	$0.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.73
Rate for Payer: Cigna Commercial	$1.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.74
Rate for Payer: Oxford Commercial	$0.57
Rate for Payer: Qualcare PPO/HMO/WC	$0.43
Rate for Payer: UnitedHealthcare Commercial	$0.57
Rate for Payer: UnitedHealthcare Community & State	$0.09
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

NEEDLE MAYO CATGUT 1/2 CIRCLE

Facility

$2.85

Hospital Charge Code	270629952
Hospital Revenue Code	272
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$0.43
Rate for Payer: Qualcare PPO/HMO/WC	$0.43

NEEDLE MENISCAL 2-0

Facility

$360.00

Hospital Charge Code	270652729
Hospital Revenue Code	272
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00

NEEDLE MENISCAL 2-0

Facility

$360.00

Hospital Charge Code	270652729
Hospital Revenue Code	272
Min. Negotiated Rate	$10.22
Max. Negotiated Rate	$180.00
Rate for Payer: Aetna Commercial	$136.80
Rate for Payer: Aetna Medicare Advantage	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.80
Rate for Payer: Cigna Commercial	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.60
Rate for Payer: Oxford Commercial	$72.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00
Rate for Payer: UnitedHealthcare Commercial	$72.00
Rate for Payer: UnitedHealthcare Community & State	$11.38
Rate for Payer: Wellpoint Medicaid Managed Care	$10.22

NEEDLE MULTIFIRE SCORPIAN

Facility

$850.00

Hospital Charge Code	270664265
Hospital Revenue Code	272
Min. Negotiated Rate	$24.14
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$323.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$221.00
Rate for Payer: Oxford Commercial	$170.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Commercial	$170.00
Rate for Payer: UnitedHealthcare Community & State	$26.86
Rate for Payer: Wellpoint Medicaid Managed Care	$24.14

Know your out-of-pocket cost for care.

All Charges