Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

OBV INP HSP LOW SEVERITY

Facility

$412.93

Service Code	HCPCS 99234
Hospital Charge Code	87502345
Hospital Revenue Code	510
Min. Negotiated Rate	$11.73
Max. Negotiated Rate	$206.47
Rate for Payer: Aetna Commercial	$156.91
Rate for Payer: Aetna Medicare Advantage	$123.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.30
Rate for Payer: Cigna Commercial	$206.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.36
Rate for Payer: Qualcare PPO/HMO/WC	$61.94
Rate for Payer: UnitedHealthcare Community & State	$13.05
Rate for Payer: Wellpoint Medicaid Managed Care	$11.73

OCA 125

Facility

$143.05

Service Code	HCPCS 86304
Hospital Charge Code	39900468
Hospital Revenue Code	302
Min. Negotiated Rate	$21.46
Max. Negotiated Rate	$21.46
Rate for Payer: Qualcare PPO/HMO/WC	$21.46

OCA 125

Facility

$143.05

Service Code	HCPCS 86304
Hospital Charge Code	39900468
Hospital Revenue Code	302
Min. Negotiated Rate	$4.06
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$56.60
Rate for Payer: Aetna Medicare Advantage	$67.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.49
Rate for Payer: Cigna Commercial	$71.53
Rate for Payer: Cigna Medicare Advantage	$20.81
Rate for Payer: Clover Medicare Advantage	$19.77
Rate for Payer: EmblemHealth Commercial	$62.43
Rate for Payer: Humana Medicare Advantage	$21.43
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.19
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.46
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$16.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.81
Rate for Payer: Wellcare Medicare Advantage	$20.81
Rate for Payer: Wellpoint Medicaid Managed Care	$4.06

OCCLUDER DOME HOLE

Facility

$385.00

Hospital Charge Code	270669170
Hospital Revenue Code	278
Min. Negotiated Rate	$10.93
Max. Negotiated Rate	$192.50
Rate for Payer: Aetna Commercial	$146.30
Rate for Payer: Aetna Medicare Advantage	$115.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.17
Rate for Payer: Cigna Commercial	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.17
Rate for Payer: Qualcare PPO/HMO/WC	$57.75
Rate for Payer: UnitedHealthcare Community & State	$12.17
Rate for Payer: Wellpoint Medicaid Managed Care	$10.93

OCCLUDER DOME HOLE

Facility

$385.00

Hospital Charge Code	270669170
Hospital Revenue Code	278
Min. Negotiated Rate	$57.75
Max. Negotiated Rate	$93.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.17
Rate for Payer: Qualcare PPO/HMO/WC	$57.75

OCCLUSION BALLOON CATHETER

Facility

$681.00

Hospital Charge Code	270331704
Hospital Revenue Code	278
Min. Negotiated Rate	$19.34
Max. Negotiated Rate	$340.50
Rate for Payer: Aetna Commercial	$258.78
Rate for Payer: Aetna Medicare Advantage	$204.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$173.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$173.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$173.66
Rate for Payer: Cigna Commercial	$340.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.80
Rate for Payer: Qualcare PPO/HMO/WC	$102.15
Rate for Payer: UnitedHealthcare Community & State	$21.52
Rate for Payer: Wellpoint Medicaid Managed Care	$19.34

OCCLUSION BALLOON CATHETER

Facility

$774.00

Hospital Charge Code	270332337
Hospital Revenue Code	278
Min. Negotiated Rate	$21.98
Max. Negotiated Rate	$387.00
Rate for Payer: Aetna Commercial	$294.12
Rate for Payer: Aetna Medicare Advantage	$232.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.37
Rate for Payer: Cigna Commercial	$387.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.31
Rate for Payer: Qualcare PPO/HMO/WC	$116.10
Rate for Payer: UnitedHealthcare Community & State	$24.46
Rate for Payer: Wellpoint Medicaid Managed Care	$21.98

OCCLUSION BALLOON CATHETER

Facility

$774.00

Hospital Charge Code	270332337
Hospital Revenue Code	278
Min. Negotiated Rate	$116.10
Max. Negotiated Rate	$187.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.31
Rate for Payer: Qualcare PPO/HMO/WC	$116.10

OCCLUSION BALLOON CATHETER

Facility

$681.00

Hospital Charge Code	270331704
Hospital Revenue Code	278
Min. Negotiated Rate	$102.15
Max. Negotiated Rate	$164.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.80
Rate for Payer: Qualcare PPO/HMO/WC	$102.15

OCCLUSIVE DEVICE IN VEIN ART

Facility

$1,564.00

Service Code	HCPCS G0269
Hospital Charge Code	4110G0269
Hospital Revenue Code	481
Min. Negotiated Rate	$234.60
Max. Negotiated Rate	$234.60
Rate for Payer: Qualcare PPO/HMO/WC	$234.60

OCCLUSIVE DEVICE IN VEIN ART

Facility

$1,564.00

Service Code	HCPCS G0269
Hospital Charge Code	4110G0269
Hospital Revenue Code	481
Min. Negotiated Rate	$44.42
Max. Negotiated Rate	$4,213.00
Rate for Payer: Aetna Commercial	$594.32
Rate for Payer: Aetna Medicare Advantage	$469.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$398.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$398.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$398.82
Rate for Payer: Cigna Commercial	$782.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$406.64
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$234.60
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$49.42
Rate for Payer: Wellpoint Medicaid Managed Care	$44.42

OCCLUSIVE DEVICE IN VEIN/ART

Facility

$1,564.00

Service Code	HCPCS G0269
Hospital Charge Code	3210G0279
Hospital Revenue Code	361
Min. Negotiated Rate	$234.60
Max. Negotiated Rate	$234.60
Rate for Payer: Qualcare PPO/HMO/WC	$234.60

OCCLUSIVE DEVICE IN VEIN/ART

Facility

$1,564.00

Service Code	HCPCS G0269
Hospital Charge Code	3210G0279
Hospital Revenue Code	361
Min. Negotiated Rate	$44.42
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$594.32
Rate for Payer: Aetna Medicare Advantage	$469.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$398.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$398.82
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	$398.82
Rate for Payer: Cigna Commercial	$782.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$406.64
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$234.60
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$49.42
Rate for Payer: Wellpoint Medicaid Managed Care	$44.42

OCCULAR OCCLUDERS

Facility

$44.00

Hospital Charge Code	270335277
Hospital Revenue Code	272
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

OCCULAR OCCLUDERS

Facility

$44.00

Hospital Charge Code	270335277
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$22.00
Rate for Payer: Aetna Commercial	$16.72
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.44
Rate for Payer: Oxford Commercial	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$8.80
Rate for Payer: UnitedHealthcare Community & State	$1.39
Rate for Payer: Wellpoint Medicaid Managed Care	$1.25

OCCULT BLOOD

Facility

$121.00

Service Code	HCPCS 82270
Hospital Charge Code	38475023
Hospital Revenue Code	301
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$18.15

OCCULT BLOOD

Facility

$121.00

Service Code	HCPCS 82270
Hospital Charge Code	38475023
Hospital Revenue Code	301
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$11.91
Rate for Payer: Aetna Medicare Advantage	$14.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.89
Rate for Payer: Cigna Commercial	$60.50
Rate for Payer: Cigna Medicare Advantage	$4.38
Rate for Payer: Clover Medicare Advantage	$4.16
Rate for Payer: EmblemHealth Commercial	$13.14
Rate for Payer: Humana Medicare Advantage	$4.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.46
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.15
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$3.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.38
Rate for Payer: Wellcare Medicare Advantage	$4.38
Rate for Payer: Wellpoint Medicaid Managed Care	$3.44

OCCULT BLOOD, STOOL SCREENING

Facility

$269.60

Service Code	HCPCS G0328
Hospital Charge Code	3002988
Hospital Revenue Code	305
Min. Negotiated Rate	$40.44
Max. Negotiated Rate	$40.44
Rate for Payer: Qualcare PPO/HMO/WC	$40.44

OCCULT BLOOD, STOOL SCREENING

Facility

$269.60

Service Code	HCPCS G0328
Hospital Charge Code	3002988
Hospital Revenue Code	305
Min. Negotiated Rate	$7.66
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$49.10
Rate for Payer: Aetna Medicare Advantage	$58.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.48
Rate for Payer: Cigna Commercial	$134.80
Rate for Payer: Cigna Medicare Advantage	$18.05
Rate for Payer: Clover Medicare Advantage	$17.15
Rate for Payer: EmblemHealth Commercial	$54.15
Rate for Payer: Humana Medicare Advantage	$18.59
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.10
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.44
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.05
Rate for Payer: Wellcare Medicare Advantage	$18.05
Rate for Payer: Wellpoint Medicaid Managed Care	$7.66

OCCULT BLOOD VOMITUS

Facility

$390.00

Service Code	HCPCS 82270
Hospital Charge Code	3002989
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

OCCULT BLOOD VOMITUS

Facility

$390.00

Service Code	HCPCS 82270
Hospital Charge Code	3002989
Hospital Revenue Code	301
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$11.91
Rate for Payer: Aetna Medicare Advantage	$14.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.89
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$4.38
Rate for Payer: Clover Medicare Advantage	$4.16
Rate for Payer: EmblemHealth Commercial	$13.14
Rate for Payer: Humana Medicare Advantage	$4.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$3.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.38
Rate for Payer: Wellcare Medicare Advantage	$4.38
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

OC DRILL

Facility

$2,375.00

Hospital Charge Code	270663781
Hospital Revenue Code	272
Min. Negotiated Rate	$356.25
Max. Negotiated Rate	$356.25
Rate for Payer: Qualcare PPO/HMO/WC	$356.25

OC DRILL

Facility

$2,375.00

Hospital Charge Code	270663781
Hospital Revenue Code	272
Min. Negotiated Rate	$67.45
Max. Negotiated Rate	$1,187.50
Rate for Payer: Aetna Commercial	$902.50
Rate for Payer: Aetna Medicare Advantage	$712.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$605.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$605.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$605.62
Rate for Payer: Cigna Commercial	$1,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$617.50
Rate for Payer: Oxford Commercial	$475.00
Rate for Payer: Qualcare PPO/HMO/WC	$356.25
Rate for Payer: UnitedHealthcare Commercial	$475.00
Rate for Payer: UnitedHealthcare Community & State	$75.05
Rate for Payer: Wellpoint Medicaid Managed Care	$67.45

OC SET SCREWS

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270687818
Hospital Revenue Code	278
Min. Negotiated Rate	$99.75
Max. Negotiated Rate	$160.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: Qualcare PPO/HMO/WC	$99.75

OC SET SCREWS

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270687818
Hospital Revenue Code	278
Min. Negotiated Rate	$18.89
Max. Negotiated Rate	$332.50
Rate for Payer: Aetna Commercial	$252.70
Rate for Payer: Aetna Medicare Advantage	$199.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.57
Rate for Payer: Cigna Commercial	$332.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: Qualcare PPO/HMO/WC	$99.75
Rate for Payer: UnitedHealthcare Community & State	$21.01
Rate for Payer: Wellpoint Medicaid Managed Care	$18.89

Know your out-of-pocket cost for care.

All Charges