Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

NEUROTHERM ELECTRODE

Facility

$525.00

Hospital Charge Code	270339098
Hospital Revenue Code	272
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$78.75
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

NEUROTHERM ELECTRODE

Facility

$525.00

Hospital Charge Code	270339098
Hospital Revenue Code	272
Min. Negotiated Rate	$14.91
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.50
Rate for Payer: Oxford Commercial	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Commercial	$105.00
Rate for Payer: UnitedHealthcare Community & State	$16.59
Rate for Payer: Wellpoint Medicaid Managed Care	$14.91

NEUROTHERM INTRODUCER

Facility

$225.00

Hospital Charge Code	270339465
Hospital Revenue Code	272
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

NEUROTHERM INTRODUCER

Facility

$225.00

Hospital Charge Code	270339465
Hospital Revenue Code	272
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.50
Rate for Payer: Oxford Commercial	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$45.00
Rate for Payer: UnitedHealthcare Community & State	$7.11
Rate for Payer: Wellpoint Medicaid Managed Care	$6.39

NEUROVISION NEEDLE MODULE

Facility

$2,245.00

Hospital Charge Code	270332625
Hospital Revenue Code	272
Min. Negotiated Rate	$63.76
Max. Negotiated Rate	$1,122.50
Rate for Payer: Aetna Commercial	$853.10
Rate for Payer: Aetna Medicare Advantage	$673.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$572.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$572.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$572.48
Rate for Payer: Cigna Commercial	$1,122.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$583.70
Rate for Payer: Oxford Commercial	$449.00
Rate for Payer: Qualcare PPO/HMO/WC	$336.75
Rate for Payer: UnitedHealthcare Commercial	$449.00
Rate for Payer: UnitedHealthcare Community & State	$70.94
Rate for Payer: Wellpoint Medicaid Managed Care	$63.76

NEUROVISION NEEDLE MODULE

Facility

$2,245.00

Hospital Charge Code	270332625
Hospital Revenue Code	272
Min. Negotiated Rate	$336.75
Max. Negotiated Rate	$336.75
Rate for Payer: Qualcare PPO/HMO/WC	$336.75

NEUROVISION XLIF KIT

Facility

$1,600.00

Hospital Charge Code	270332626
Hospital Revenue Code	272
Min. Negotiated Rate	$45.44
Max. Negotiated Rate	$800.00
Rate for Payer: Aetna Commercial	$608.00
Rate for Payer: Aetna Medicare Advantage	$480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$408.00
Rate for Payer: Cigna Commercial	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$416.00
Rate for Payer: Oxford Commercial	$320.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00
Rate for Payer: UnitedHealthcare Commercial	$320.00
Rate for Payer: UnitedHealthcare Community & State	$50.56
Rate for Payer: Wellpoint Medicaid Managed Care	$45.44

NEUROVISION XLIF KIT

Facility

$1,600.00

Hospital Charge Code	270332626
Hospital Revenue Code	272
Min. Negotiated Rate	$240.00
Max. Negotiated Rate	$240.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00

NEUROWRAP 7mmX4 cm

Facility

$6,540.00

Service Code	HCPCS C9353
Hospital Charge Code	270682015
Hospital Revenue Code	278
Min. Negotiated Rate	$185.74
Max. Negotiated Rate	$3,270.00
Rate for Payer: Aetna Commercial	$2,485.20
Rate for Payer: Aetna Medicare Advantage	$1,962.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,667.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,667.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,308.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,667.70
Rate for Payer: Cigna Commercial	$3,270.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,582.68
Rate for Payer: Qualcare PPO/HMO/WC	$981.00
Rate for Payer: UnitedHealthcare Community & State	$206.66
Rate for Payer: Wellpoint Medicaid Managed Care	$185.74

NEUROWRAP 7mmX4 cm

Facility

$6,540.00

Service Code	HCPCS C9353
Hospital Charge Code	270682015
Hospital Revenue Code	278
Min. Negotiated Rate	$981.00
Max. Negotiated Rate	$1,582.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,308.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,582.68
Rate for Payer: Qualcare PPO/HMO/WC	$981.00

NEURPLASTY,MEDN NRV AT CRP TNL

Facility

$16,437.00

Service Code	HCPCS 64721
Hospital Charge Code	16000267
Hospital Revenue Code	360
Min. Negotiated Rate	$2,465.55
Max. Negotiated Rate	$2,465.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,465.55

NEURPLASTY,MEDN NRV AT CRP TNL

Facility

$16,437.00

Service Code	HCPCS 64721
Hospital Charge Code	16000267
Hospital Revenue Code	360
Min. Negotiated Rate	$466.81
Max. Negotiated Rate	$8,415.40
Rate for Payer: Aetna Commercial	$6,310.10
Rate for Payer: Aetna Medicare Advantage	$7,516.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,415.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,415.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,319.89
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	$8,415.40
Rate for Payer: Cigna Commercial	$4,650.22
Rate for Payer: Cigna Medicare Advantage	$2,319.89
Rate for Payer: Clover Medicare Advantage	$2,203.90
Rate for Payer: EmblemHealth Commercial	$6,959.67
Rate for Payer: Humana Medicare Advantage	$2,389.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,319.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,273.62
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,465.55
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$519.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,319.89
Rate for Payer: Wellcare Medicare Advantage	$2,319.89
Rate for Payer: Wellpoint Medicaid Managed Care	$466.81

NEUT INJ

Facility

$50.65

Service Code	NDC 409660902
Hospital Charge Code	60635046
Hospital Revenue Code	250
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$25.32
Rate for Payer: Aetna Commercial	$19.25
Rate for Payer: Aetna Medicare Advantage	$15.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.92
Rate for Payer: Cigna Commercial	$25.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.17
Rate for Payer: Oxford Commercial	$10.13
Rate for Payer: Qualcare PPO/HMO/WC	$7.60
Rate for Payer: UnitedHealthcare Commercial	$10.13
Rate for Payer: UnitedHealthcare Community & State	$1.60
Rate for Payer: Wellpoint Medicaid Managed Care	$1.44

NEUT INJ

Facility

$50.65

Service Code	NDC 409660902
Hospital Charge Code	60635046
Hospital Revenue Code	250
Min. Negotiated Rate	$7.60
Max. Negotiated Rate	$7.60
Rate for Payer: Qualcare PPO/HMO/WC	$7.60

NEVIRAPINE 200 MG TAB

Facility

$72.63

Service Code	NDC 51991033106
Hospital Charge Code	6063943219
Hospital Revenue Code	250
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$36.31
Rate for Payer: Aetna Commercial	$27.60
Rate for Payer: Aetna Medicare Advantage	$21.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.52
Rate for Payer: Cigna Commercial	$36.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.88
Rate for Payer: Oxford Commercial	$14.53
Rate for Payer: Qualcare PPO/HMO/WC	$10.89
Rate for Payer: UnitedHealthcare Commercial	$14.53
Rate for Payer: UnitedHealthcare Community & State	$2.30
Rate for Payer: Wellpoint Medicaid Managed Care	$2.06

NEVIRAPINE 200 MG TAB

Facility

$72.63

Service Code	NDC 51991033106
Hospital Charge Code	6063943219
Hospital Revenue Code	250
Min. Negotiated Rate	$10.89
Max. Negotiated Rate	$10.89
Rate for Payer: Qualcare PPO/HMO/WC	$10.89

NEVIRAPINE 200MG TAB

Facility

$4.00

Hospital Charge Code	6063943147
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

NEVIRAPINE 200MG TAB

Facility

$4.00

Hospital Charge Code	6063943147
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

NEVIRAPINE 50MG/5ML

Facility

$5.29

Service Code	NDC 65862005724
Hospital Charge Code	606390249
Hospital Revenue Code	250
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$0.79
Rate for Payer: Qualcare PPO/HMO/WC	$0.79

NEVIRAPINE 50MG/5ML

Facility

$5.29

Service Code	NDC 65862005724
Hospital Charge Code	606390249
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$2.65
Rate for Payer: Aetna Commercial	$2.01
Rate for Payer: Aetna Medicare Advantage	$1.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.35
Rate for Payer: Cigna Commercial	$2.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.38
Rate for Payer: Oxford Commercial	$1.06
Rate for Payer: Qualcare PPO/HMO/WC	$0.79
Rate for Payer: UnitedHealthcare Commercial	$1.06
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

NEVOS SPONGE 50X20X7MM DBM

Facility

$13,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270692542
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$3,327.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

NEVOS SPONGE 50X20X7MM DBM

Facility

$13,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270692542
Hospital Revenue Code	278
Min. Negotiated Rate	$390.50
Max. Negotiated Rate	$6,875.00
Rate for Payer: Aetna Commercial	$5,225.00
Rate for Payer: Aetna Medicare Advantage	$4,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,506.25
Rate for Payer: Cigna Commercial	$6,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50
Rate for Payer: UnitedHealthcare Community & State	$434.50
Rate for Payer: Wellpoint Medicaid Managed Care	$390.50

NEW I/P CONSULT LEVEL 4

Facility

$628.83

Service Code	HCPCS 99222
Hospital Charge Code	85000870
Hospital Revenue Code	510
Min. Negotiated Rate	$94.32
Max. Negotiated Rate	$94.32
Rate for Payer: Qualcare PPO/HMO/WC	$94.32

NEW I/P CONSULT LEVEL 4

Facility

$628.83

Service Code	HCPCS 99222
Hospital Charge Code	85000870
Hospital Revenue Code	510
Min. Negotiated Rate	$17.86
Max. Negotiated Rate	$314.42
Rate for Payer: Aetna Commercial	$238.96
Rate for Payer: Aetna Medicare Advantage	$188.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.35
Rate for Payer: Cigna Commercial	$314.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.50
Rate for Payer: Qualcare PPO/HMO/WC	$94.32
Rate for Payer: UnitedHealthcare Community & State	$19.87
Rate for Payer: Wellpoint Medicaid Managed Care	$17.86

NEW PATIENT LEV 2 >=15 MINS

Facility

$402.00

Service Code	HCPCS 99202
Hospital Charge Code	87502205
Hospital Revenue Code	510
Min. Negotiated Rate	$11.42
Max. Negotiated Rate	$201.00
Rate for Payer: Aetna Commercial	$152.76
Rate for Payer: Aetna Medicare Advantage	$120.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.51
Rate for Payer: Cigna Commercial	$201.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.52
Rate for Payer: Qualcare PPO/HMO/WC	$60.30
Rate for Payer: UnitedHealthcare Community & State	$12.70
Rate for Payer: Wellpoint Medicaid Managed Care	$11.42

Know your out-of-pocket cost for care.

All Charges