Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

NON-HYPOVOLEMIC SODIUM DISORDERS

Facility

$8,388.36

Service Code	APR-DRG 4262
Min. Negotiated Rate	$8,223.88
Max. Negotiated Rate	$8,388.36
Rate for Payer: UnitedHealthcare Community & State	$8,223.88
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,388.36
Rate for Payer: Wellpoint Medicaid Managed Care	$8,223.88

NON-HYPOVOLEMIC SODIUM DISORDERS

Facility

$6,373.07

Service Code	APR-DRG 4261
Min. Negotiated Rate	$6,248.11
Max. Negotiated Rate	$6,373.07
Rate for Payer: UnitedHealthcare Community & State	$6,248.11
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,373.07
Rate for Payer: Wellpoint Medicaid Managed Care	$6,248.11

NON-HYPOVOLEMIC SODIUM DISORDERS

Facility

$22,541.73

Service Code	APR-DRG 4264
Min. Negotiated Rate	$22,099.74
Max. Negotiated Rate	$22,541.73
Rate for Payer: UnitedHealthcare Community & State	$22,099.74
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$22,541.73
Rate for Payer: Wellpoint Medicaid Managed Care	$22,099.74

NON-HYPOVOLEMIC SODIUM DISORDERS

Facility

$12,550.99

Service Code	APR-DRG 4263
Min. Negotiated Rate	$12,304.89
Max. Negotiated Rate	$12,550.99
Rate for Payer: UnitedHealthcare Community & State	$12,304.89
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,550.99
Rate for Payer: Wellpoint Medicaid Managed Care	$12,304.89

NON INV STUDIES LOW EXTREM ART

Facility

$17,200.00

Service Code	HCPCS 93923
Hospital Charge Code	36540009
Hospital Revenue Code	921
Min. Negotiated Rate	$243.69
Max. Negotiated Rate	$7,555.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$301.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$930.53
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
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	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$488.48

NON INV STUDIES LOW EXTREM ART

Facility

$17,200.00

Service Code	HCPCS 93923
Hospital Charge Code	36540009
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

NON LOCKING SCREW 2.9 16MM

Facility

$860.00

Service Code	HCPCS C1713
Hospital Charge Code	270684920
Hospital Revenue Code	278
Min. Negotiated Rate	$24.42
Max. Negotiated Rate	$430.00
Rate for Payer: Aetna Commercial	$326.80
Rate for Payer: Aetna Medicare Advantage	$258.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$172.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.30
Rate for Payer: Cigna Commercial	$430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.12
Rate for Payer: Qualcare PPO/HMO/WC	$129.00
Rate for Payer: UnitedHealthcare Community & State	$27.18
Rate for Payer: Wellpoint Medicaid Managed Care	$24.42

NON LOCKING SCREW 2.9 16MM

Facility

$860.00

Service Code	HCPCS C1713
Hospital Charge Code	270684920
Hospital Revenue Code	278
Min. Negotiated Rate	$129.00
Max. Negotiated Rate	$208.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$172.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.12
Rate for Payer: Qualcare PPO/HMO/WC	$129.00

NON LOCKING SCREW 2.9 8MM

Facility

$1,360.00

Service Code	HCPCS C1713
Hospital Charge Code	270684921
Hospital Revenue Code	278
Min. Negotiated Rate	$38.62
Max. Negotiated Rate	$680.00
Rate for Payer: Aetna Commercial	$516.80
Rate for Payer: Aetna Medicare Advantage	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$346.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$346.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$272.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$346.80
Rate for Payer: Cigna Commercial	$680.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.12
Rate for Payer: Qualcare PPO/HMO/WC	$204.00
Rate for Payer: UnitedHealthcare Community & State	$42.98
Rate for Payer: Wellpoint Medicaid Managed Care	$38.62

NON LOCKING SCREW 2.9 8MM

Facility

$1,360.00

Service Code	HCPCS C1713
Hospital Charge Code	270684921
Hospital Revenue Code	278
Min. Negotiated Rate	$204.00
Max. Negotiated Rate	$329.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$272.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.12
Rate for Payer: Qualcare PPO/HMO/WC	$204.00

NON LOCKING SCREW 3.0X22MM

Facility

$980.00

Service Code	HCPCS C1713
Hospital Charge Code	270661003
Hospital Revenue Code	278
Min. Negotiated Rate	$147.00
Max. Negotiated Rate	$237.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.16
Rate for Payer: Qualcare PPO/HMO/WC	$147.00

NON LOCKING SCREW 3.0X22MM

Facility

$980.00

Service Code	HCPCS C1713
Hospital Charge Code	270661003
Hospital Revenue Code	278
Min. Negotiated Rate	$27.83
Max. Negotiated Rate	$490.00
Rate for Payer: Aetna Commercial	$372.40
Rate for Payer: Aetna Medicare Advantage	$294.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.90
Rate for Payer: Cigna Commercial	$490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.16
Rate for Payer: Qualcare PPO/HMO/WC	$147.00
Rate for Payer: UnitedHealthcare Community & State	$30.97
Rate for Payer: Wellpoint Medicaid Managed Care	$27.83

NON-LOCKING SCREW 3.5X12mm

Facility

$950.00

Hospital Charge Code	270669411
Hospital Revenue Code	278
Min. Negotiated Rate	$26.98
Max. Negotiated Rate	$475.00
Rate for Payer: Aetna Commercial	$361.00
Rate for Payer: Aetna Medicare Advantage	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.25
Rate for Payer: Cigna Commercial	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$142.50
Rate for Payer: UnitedHealthcare Community & State	$30.02
Rate for Payer: Wellpoint Medicaid Managed Care	$26.98

NON-LOCKING SCREW 3.5X12mm

Facility

$950.00

Hospital Charge Code	270669411
Hospital Revenue Code	278
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$229.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$142.50

NON-LOCKING SCREW 3.5 X14MM

Facility

$1,385.00

Hospital Charge Code	270669412
Hospital Revenue Code	278
Min. Negotiated Rate	$39.33
Max. Negotiated Rate	$692.50
Rate for Payer: Aetna Commercial	$526.30
Rate for Payer: Aetna Medicare Advantage	$415.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$353.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$353.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$277.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$353.18
Rate for Payer: Cigna Commercial	$692.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.17
Rate for Payer: Qualcare PPO/HMO/WC	$207.75
Rate for Payer: UnitedHealthcare Community & State	$43.77
Rate for Payer: Wellpoint Medicaid Managed Care	$39.33

NON-LOCKING SCREW 3.5 X14MM

Facility

$1,385.00

Hospital Charge Code	270669412
Hospital Revenue Code	278
Min. Negotiated Rate	$207.75
Max. Negotiated Rate	$335.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$277.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.17
Rate for Payer: Qualcare PPO/HMO/WC	$207.75

NON-LOCKING SCREW 3X14mm

Facility

$950.00

Service Code	HCPCS C1713
Hospital Charge Code	270669410
Hospital Revenue Code	278
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$229.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$142.50

NON-LOCKING SCREW 3X14mm

Facility

$950.00

Service Code	HCPCS C1713
Hospital Charge Code	270669410
Hospital Revenue Code	278
Min. Negotiated Rate	$26.98
Max. Negotiated Rate	$475.00
Rate for Payer: Aetna Commercial	$361.00
Rate for Payer: Aetna Medicare Advantage	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.25
Rate for Payer: Cigna Commercial	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$142.50
Rate for Payer: UnitedHealthcare Community & State	$30.02
Rate for Payer: Wellpoint Medicaid Managed Care	$26.98

NON-MALIGNANT BREAST DISORDERS WITH CC/MCC

Facility

$52,372.48

Service Code	MSDRG 600
Min. Negotiated Rate	$15,946.75
Max. Negotiated Rate	$52,372.48
Rate for Payer: Aetna Commercial	$39,158.78
Rate for Payer: Aetna Medicare Advantage	$52,372.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28,536.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28,536.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16,786.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28,536.15
Rate for Payer: Cigna Commercial	$23,220.39
Rate for Payer: Cigna Medicare Advantage	$16,786.05
Rate for Payer: Clover Medicare Advantage	$15,946.75
Rate for Payer: EmblemHealth Commercial	$50,358.15
Rate for Payer: Humana Medicare Advantage	$17,289.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16,786.05
Rate for Payer: Oxford Commercial	$18,352.99
Rate for Payer: UnitedHealthcare Commercial	$24,566.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$16,786.05
Rate for Payer: Wellcare Medicare Advantage	$16,786.05

NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC

Facility

$38,578.80

Service Code	MSDRG 601
Min. Negotiated Rate	$10,660.10
Max. Negotiated Rate	$38,578.80
Rate for Payer: Aetna Commercial	$29,334.77
Rate for Payer: Aetna Medicare Advantage	$38,578.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17,454.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17,454.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,365.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17,454.15
Rate for Payer: Cigna Commercial	$13,487.26
Rate for Payer: Cigna Medicare Advantage	$12,365.00
Rate for Payer: Clover Medicare Advantage	$11,746.75
Rate for Payer: EmblemHealth Commercial	$37,095.00
Rate for Payer: Humana Medicare Advantage	$12,735.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,365.00
Rate for Payer: Oxford Commercial	$10,660.10
Rate for Payer: UnitedHealthcare Commercial	$14,268.92
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,365.00
Rate for Payer: Wellcare Medicare Advantage	$12,365.00

NONOPASS REACH CRESCENT

Facility

$1,429.70

Hospital Charge Code	270670490
Hospital Revenue Code	272
Min. Negotiated Rate	$214.46
Max. Negotiated Rate	$214.46
Rate for Payer: Qualcare PPO/HMO/WC	$214.46

NONOPASS REACH CRESCENT

Facility

$1,429.70

Hospital Charge Code	270670490
Hospital Revenue Code	272
Min. Negotiated Rate	$40.60
Max. Negotiated Rate	$714.85
Rate for Payer: Aetna Commercial	$543.29
Rate for Payer: Aetna Medicare Advantage	$428.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$364.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$364.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$364.57
Rate for Payer: Cigna Commercial	$714.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$371.72
Rate for Payer: Oxford Commercial	$285.94
Rate for Payer: Qualcare PPO/HMO/WC	$214.46
Rate for Payer: UnitedHealthcare Commercial	$285.94
Rate for Payer: UnitedHealthcare Community & State	$45.18
Rate for Payer: Wellpoint Medicaid Managed Care	$40.60

NON-ROUTINE BL DRAW 3/> YRS

Facility

$40.76

Service Code	HCPCS 36410
Hospital Charge Code	16000342
Hospital Revenue Code	360
Min. Negotiated Rate	$6.11
Max. Negotiated Rate	$6.11
Rate for Payer: Qualcare PPO/HMO/WC	$6.11

NON-ROUTINE BL DRAW 3/> YRS

Facility

$40.76

Service Code	HCPCS 36410
Hospital Charge Code	16000342
Hospital Revenue Code	360
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$15.49
Rate for Payer: Aetna Medicare Advantage	$12.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.39
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	$10.39
Rate for Payer: Cigna Commercial	$20.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.11
Rate for Payer: UnitedHealthcare Community & State	$1.29
Rate for Payer: Wellpoint Medicaid Managed Care	$1.16

NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC

Facility

$51,879.61

Service Code	MSDRG 071
Min. Negotiated Rate	$15,796.68
Max. Negotiated Rate	$51,879.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29,367.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29,367.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29,367.30

Know your out-of-pocket cost for care.

All Charges