Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ONLAY TIB INSRT SZ7 8MM THICK

Facility

$5,435.00

Hospital Charge Code	270668839
Hospital Revenue Code	278
Min. Negotiated Rate	$815.25
Max. Negotiated Rate	$1,315.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,087.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,315.27
Rate for Payer: Qualcare PPO/HMO/WC	$815.25

ONLAY TIB INSRT SZ8 10MM THICK

Facility

$5,435.00

Hospital Charge Code	270668845
Hospital Revenue Code	278
Min. Negotiated Rate	$815.25
Max. Negotiated Rate	$1,315.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,087.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,315.27
Rate for Payer: Qualcare PPO/HMO/WC	$815.25

ONLAY TIB INSRT SZ8 10MM THICK

Facility

$5,435.00

Hospital Charge Code	270668845
Hospital Revenue Code	278
Min. Negotiated Rate	$154.35
Max. Negotiated Rate	$2,717.50
Rate for Payer: Aetna Commercial	$2,065.30
Rate for Payer: Aetna Medicare Advantage	$1,630.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,385.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,385.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,087.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,385.92
Rate for Payer: Cigna Commercial	$2,717.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,315.27
Rate for Payer: Qualcare PPO/HMO/WC	$815.25
Rate for Payer: UnitedHealthcare Community & State	$171.75
Rate for Payer: Wellpoint Medicaid Managed Care	$154.35

ONLAY TIB INSRT SZ8 12MM THICK

Facility

$5,435.00

Hospital Charge Code	270668846
Hospital Revenue Code	278
Min. Negotiated Rate	$154.35
Max. Negotiated Rate	$2,717.50
Rate for Payer: Aetna Commercial	$2,065.30
Rate for Payer: Aetna Medicare Advantage	$1,630.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,385.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,385.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,087.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,385.92
Rate for Payer: Cigna Commercial	$2,717.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,315.27
Rate for Payer: Qualcare PPO/HMO/WC	$815.25
Rate for Payer: UnitedHealthcare Community & State	$171.75
Rate for Payer: Wellpoint Medicaid Managed Care	$154.35

ONLAY TIB INSRT SZ8 12MM THICK

Facility

$5,435.00

Hospital Charge Code	270668846
Hospital Revenue Code	278
Min. Negotiated Rate	$815.25
Max. Negotiated Rate	$1,315.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,087.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,315.27
Rate for Payer: Qualcare PPO/HMO/WC	$815.25

ONLAY TIB INSRT SZ8 9MM THICK

Facility

$5,435.00

Hospital Charge Code	270668844
Hospital Revenue Code	278
Min. Negotiated Rate	$815.25
Max. Negotiated Rate	$1,315.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,087.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,315.27
Rate for Payer: Qualcare PPO/HMO/WC	$815.25

ONLAY TIB INSRT SZ8 9MM THICK

Facility

$5,435.00

Hospital Charge Code	270668844
Hospital Revenue Code	278
Min. Negotiated Rate	$154.35
Max. Negotiated Rate	$2,717.50
Rate for Payer: Aetna Commercial	$2,065.30
Rate for Payer: Aetna Medicare Advantage	$1,630.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,385.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,385.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,087.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,385.92
Rate for Payer: Cigna Commercial	$2,717.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,315.27
Rate for Payer: Qualcare PPO/HMO/WC	$815.25
Rate for Payer: UnitedHealthcare Community & State	$171.75
Rate for Payer: Wellpoint Medicaid Managed Care	$154.35

ON-Q PAIN PUMP W/ BUPIVACAINE

Facility

$4,281.30

Service Code	NDC 61553032160
Hospital Charge Code	606390094
Hospital Revenue Code	250
Min. Negotiated Rate	$642.20
Max. Negotiated Rate	$642.20
Rate for Payer: Qualcare PPO/HMO/WC	$642.20

ON-Q PAIN PUMP W/ BUPIVACAINE

Facility

$4,281.30

Service Code	NDC 61553032160
Hospital Charge Code	606390094
Hospital Revenue Code	250
Min. Negotiated Rate	$121.59
Max. Negotiated Rate	$2,140.65
Rate for Payer: Aetna Commercial	$1,626.89
Rate for Payer: Aetna Medicare Advantage	$1,284.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,091.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,091.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,091.73
Rate for Payer: Cigna Commercial	$2,140.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,113.14
Rate for Payer: Oxford Commercial	$856.26
Rate for Payer: Qualcare PPO/HMO/WC	$642.20
Rate for Payer: UnitedHealthcare Commercial	$856.26
Rate for Payer: UnitedHealthcare Community & State	$135.29
Rate for Payer: Wellpoint Medicaid Managed Care	$121.59

ON-Q SOAKER 6.5

Facility

$280.00

Hospital Charge Code	270335662
Hospital Revenue Code	272
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00

ON-Q SOAKER 6.5

Facility

$280.00

Hospital Charge Code	270335662
Hospital Revenue Code	272
Min. Negotiated Rate	$7.95
Max. Negotiated Rate	$140.00
Rate for Payer: Aetna Commercial	$106.40
Rate for Payer: Aetna Medicare Advantage	$84.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.40
Rate for Payer: Cigna Commercial	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.80
Rate for Payer: Oxford Commercial	$56.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00
Rate for Payer: UnitedHealthcare Commercial	$56.00
Rate for Payer: UnitedHealthcare Community & State	$8.85
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

OOPHORECTMY PARTIAL OR TTAL UL

Facility

$6,544.55

Service Code	HCPCS 58940
Hospital Charge Code	1600000827
Hospital Revenue Code	360
Min. Negotiated Rate	$981.68
Max. Negotiated Rate	$981.68
Rate for Payer: Qualcare PPO/HMO/WC	$981.68

OOPHORECTMY PARTIAL OR TTAL UL

Facility

$6,544.55

Service Code	HCPCS 58940
Hospital Charge Code	1600000827
Hospital Revenue Code	360
Min. Negotiated Rate	$185.87
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$2,486.93
Rate for Payer: Aetna Medicare Advantage	$1,963.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,668.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,668.86
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	$1,668.86
Rate for Payer: Cigna Commercial	$3,272.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,701.58
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$981.68
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$206.81
Rate for Payer: Wellpoint Medicaid Managed Care	$185.87

OP AV FUSE UPPR ARM CEPHALIC

Facility

$38,857.60

Service Code	HCPCS 36818
Hospital Charge Code	1600000639
Hospital Revenue Code	360
Min. Negotiated Rate	$1,227.90
Max. Negotiated Rate	$43,244.40
Rate for Payer: Aetna Commercial	$17,981.27
Rate for Payer: Aetna Medicare Advantage	$21,418.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,610.76
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	$23,980.53
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: Cigna Medicare Advantage	$6,610.76
Rate for Payer: Clover Medicare Advantage	$6,280.22
Rate for Payer: EmblemHealth Commercial	$19,832.28
Rate for Payer: Humana Medicare Advantage	$6,809.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,610.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,102.98
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,828.64
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,227.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,610.76
Rate for Payer: Wellcare Medicare Advantage	$6,610.76
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$43,244.40
Rate for Payer: Wellpoint Medicaid Managed Care	$42,396.47

OP AV FUSE UPPR ARM CEPHALIC

Facility

$38,857.60

Service Code	HCPCS 36818
Hospital Charge Code	1600000639
Hospital Revenue Code	360
Min. Negotiated Rate	$5,828.64
Max. Negotiated Rate	$5,828.64
Rate for Payer: Qualcare PPO/HMO/WC	$5,828.64

OP BREAST CAPSULOTOMY

Facility

$31,541.30

Service Code	HCPCS 19370
Hospital Charge Code	16000789
Hospital Revenue Code	360
Min. Negotiated Rate	$895.77
Max. Negotiated Rate	$16,873.82
Rate for Payer: Aetna Commercial	$12,652.46
Rate for Payer: Aetna Medicare Advantage	$15,071.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,873.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,873.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,651.64
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	$16,873.82
Rate for Payer: Cigna Commercial	$9,324.19
Rate for Payer: Cigna Medicare Advantage	$4,651.64
Rate for Payer: Clover Medicare Advantage	$4,419.06
Rate for Payer: EmblemHealth Commercial	$13,954.92
Rate for Payer: Humana Medicare Advantage	$4,791.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,651.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,200.74
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,731.19
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$996.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,651.64
Rate for Payer: Wellcare Medicare Advantage	$4,651.64
Rate for Payer: Wellpoint Medicaid Managed Care	$895.77

OP BREAST CAPSULOTOMY

Facility

$31,541.30

Service Code	HCPCS 19370
Hospital Charge Code	16000789
Hospital Revenue Code	360
Min. Negotiated Rate	$4,731.19
Max. Negotiated Rate	$4,731.19
Rate for Payer: Qualcare PPO/HMO/WC	$4,731.19

OPD INDIVID NON MD 20-30 MIN

Facility

$275.00

Service Code	HCPCS 90832
Hospital Charge Code	87504015
Hospital Revenue Code	914
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

OPD INDIVID NON MD 20-30 MIN

Facility

$275.00

Service Code	HCPCS 90832
Hospital Charge Code	87504015
Hospital Revenue Code	914
Min. Negotiated Rate	$7.81
Max. Negotiated Rate	$764.93
Rate for Payer: Aetna Commercial	$573.57
Rate for Payer: Aetna Medicare Advantage	$683.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$764.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$764.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$210.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$764.93
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: Cigna Medicare Advantage	$210.87
Rate for Payer: Clover Medicare Advantage	$200.33
Rate for Payer: EmblemHealth Commercial	$632.61
Rate for Payer: Humana Medicare Advantage	$217.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$210.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Community & State	$8.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$210.87
Rate for Payer: Wellcare Medicare Advantage	$210.87
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$71.39
Rate for Payer: Wellpoint Medicaid Managed Care	$7.81

OPD INDIVID NON MD 20-30 MIN

Facility

$1,296.00

Service Code	HCPCS 90832
Hospital Charge Code	84310060
Hospital Revenue Code	914
Min. Negotiated Rate	$194.40
Max. Negotiated Rate	$194.40
Rate for Payer: Qualcare PPO/HMO/WC	$194.40

OPD INDIVID NON MD 20-30 MIN

Facility

$1,296.00

Service Code	HCPCS 90832
Hospital Charge Code	84310060
Hospital Revenue Code	914
Min. Negotiated Rate	$36.81
Max. Negotiated Rate	$764.93
Rate for Payer: Aetna Commercial	$573.57
Rate for Payer: Aetna Medicare Advantage	$683.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$764.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$764.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$210.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$764.93
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: Cigna Medicare Advantage	$210.87
Rate for Payer: Clover Medicare Advantage	$200.33
Rate for Payer: EmblemHealth Commercial	$632.61
Rate for Payer: Humana Medicare Advantage	$217.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$210.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$336.96
Rate for Payer: Qualcare PPO/HMO/WC	$194.40
Rate for Payer: UnitedHealthcare Community & State	$40.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$210.87
Rate for Payer: Wellcare Medicare Advantage	$210.87
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$71.39
Rate for Payer: Wellpoint Medicaid Managed Care	$36.81

OPD INDIVID NON MD 45-50 MIN

Facility

$425.00

Service Code	HCPCS 90834
Hospital Charge Code	87504025
Hospital Revenue Code	914
Min. Negotiated Rate	$12.07
Max. Negotiated Rate	$764.93
Rate for Payer: Aetna Commercial	$573.57
Rate for Payer: Aetna Medicare Advantage	$683.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$764.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$764.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$210.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$764.93
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: Cigna Medicare Advantage	$210.87
Rate for Payer: Clover Medicare Advantage	$200.33
Rate for Payer: EmblemHealth Commercial	$632.61
Rate for Payer: Humana Medicare Advantage	$217.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$210.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Community & State	$13.43
Rate for Payer: UnitedHealthcare Medicare Advantage	$210.87
Rate for Payer: Wellcare Medicare Advantage	$210.87
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$94.46
Rate for Payer: Wellpoint Medicaid Managed Care	$12.07

OPD INDIVID NON MD 45-50 MIN

Facility

$1,423.80

Service Code	HCPCS 90834
Hospital Charge Code	84310070
Hospital Revenue Code	914
Min. Negotiated Rate	$213.57
Max. Negotiated Rate	$213.57
Rate for Payer: Qualcare PPO/HMO/WC	$213.57

OPD INDIVID NON MD 45-50 MIN

Facility

$1,423.80

Service Code	HCPCS 90834
Hospital Charge Code	84310070
Hospital Revenue Code	914
Min. Negotiated Rate	$40.44
Max. Negotiated Rate	$764.93
Rate for Payer: Aetna Commercial	$573.57
Rate for Payer: Aetna Medicare Advantage	$683.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$764.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$764.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$210.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$764.93
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: Cigna Medicare Advantage	$210.87
Rate for Payer: Clover Medicare Advantage	$200.33
Rate for Payer: EmblemHealth Commercial	$632.61
Rate for Payer: Humana Medicare Advantage	$217.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$210.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$370.19
Rate for Payer: Qualcare PPO/HMO/WC	$213.57
Rate for Payer: UnitedHealthcare Community & State	$44.99
Rate for Payer: UnitedHealthcare Medicare Advantage	$210.87
Rate for Payer: Wellcare Medicare Advantage	$210.87
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$94.46
Rate for Payer: Wellpoint Medicaid Managed Care	$40.44

OPD INDIVID NON MD 45-50 MIN

Facility

$425.00

Service Code	HCPCS 90834
Hospital Charge Code	87504025
Hospital Revenue Code	914
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

Know your out-of-pocket cost for care.

All Charges