Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

OUTPATIENT ADULT AND CHILD

Facility

$665.20

Service Code	HCPCS 99213
Hospital Charge Code	485099216
Hospital Revenue Code	919
Min. Negotiated Rate	$18.89
Max. Negotiated Rate	$332.60
Rate for Payer: Aetna Commercial	$252.78
Rate for Payer: Aetna Medicare Advantage	$199.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.63
Rate for Payer: Cigna Commercial	$332.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.95
Rate for Payer: Qualcare PPO/HMO/WC	$99.78
Rate for Payer: UnitedHealthcare Community & State	$21.02
Rate for Payer: Wellpoint Medicaid Managed Care	$18.89

OVAAN CYSTECTOMY UL/BL

Facility

$44,316.79

Service Code	HCPCS 59825
Hospital Charge Code	1600000426
Hospital Revenue Code	360
Min. Negotiated Rate	$1,258.60
Max. Negotiated Rate	$22,158.40
Rate for Payer: Aetna Commercial	$16,840.38
Rate for Payer: Aetna Medicare Advantage	$13,295.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,300.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,300.78
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	$11,300.78
Rate for Payer: Cigna Commercial	$22,158.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,522.37
Rate for Payer: Qualcare PPO/HMO/WC	$6,647.52
Rate for Payer: UnitedHealthcare Community & State	$1,400.41
Rate for Payer: Wellpoint Medicaid Managed Care	$1,258.60

OVAAN CYSTECTOMY UL/BL

Facility

$44,316.79

Service Code	HCPCS 59825
Hospital Charge Code	1600000426
Hospital Revenue Code	360
Min. Negotiated Rate	$6,647.52
Max. Negotiated Rate	$6,647.52
Rate for Payer: Qualcare PPO/HMO/WC	$6,647.52

OVA AND PARISITE IDENTIFICATIO

Facility

$60.70

Service Code	HCPCS 87177
Hospital Charge Code	3990161A
Hospital Revenue Code	309
Min. Negotiated Rate	$9.11
Max. Negotiated Rate	$9.11
Rate for Payer: Qualcare PPO/HMO/WC	$9.11

OVA AND PARISITE IDENTIFICATIO

Facility

$122.60

Service Code	HCPCS 87209
Hospital Charge Code	3990161B
Hospital Revenue Code	309
Min. Negotiated Rate	$3.48
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$48.91
Rate for Payer: Aetna Medicare Advantage	$58.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.22
Rate for Payer: Cigna Commercial	$61.30
Rate for Payer: Cigna Medicare Advantage	$17.98
Rate for Payer: Clover Medicare Advantage	$17.08
Rate for Payer: EmblemHealth Commercial	$53.94
Rate for Payer: Humana Medicare Advantage	$18.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.88
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.39
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.98
Rate for Payer: Wellcare Medicare Advantage	$17.98
Rate for Payer: Wellpoint Medicaid Managed Care	$3.48

OVA AND PARISITE IDENTIFICATIO

Facility

$122.60

Service Code	HCPCS 87209
Hospital Charge Code	3990161B
Hospital Revenue Code	309
Min. Negotiated Rate	$18.39
Max. Negotiated Rate	$18.39
Rate for Payer: Qualcare PPO/HMO/WC	$18.39

OVA AND PARISITE IDENTIFICATIO

Facility

$60.70

Service Code	HCPCS 87177
Hospital Charge Code	3990161A
Hospital Revenue Code	309
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$24.21
Rate for Payer: Aetna Medicare Advantage	$28.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.28
Rate for Payer: Cigna Commercial	$30.35
Rate for Payer: Cigna Medicare Advantage	$8.90
Rate for Payer: Clover Medicare Advantage	$8.46
Rate for Payer: EmblemHealth Commercial	$26.70
Rate for Payer: Humana Medicare Advantage	$9.17
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.78
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.11
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$7.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.90
Rate for Payer: Wellcare Medicare Advantage	$8.90
Rate for Payer: Wellpoint Medicaid Managed Care	$1.72

OVAL BURR

Facility

$119.00

Hospital Charge Code	270332555
Hospital Revenue Code	272
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$59.50
Rate for Payer: Aetna Commercial	$45.22
Rate for Payer: Aetna Medicare Advantage	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.34
Rate for Payer: Cigna Commercial	$59.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.94
Rate for Payer: Oxford Commercial	$23.80
Rate for Payer: Qualcare PPO/HMO/WC	$17.85
Rate for Payer: UnitedHealthcare Commercial	$23.80
Rate for Payer: UnitedHealthcare Community & State	$3.76
Rate for Payer: Wellpoint Medicaid Managed Care	$3.38

OVAL BURR

Facility

$119.00

Hospital Charge Code	270332555
Hospital Revenue Code	272
Min. Negotiated Rate	$17.85
Max. Negotiated Rate	$17.85
Rate for Payer: Qualcare PPO/HMO/WC	$17.85

Ova + Parasite Exam

Facility

$667.59

Service Code	HCPCS 87209
Hospital Charge Code	39880003B
Hospital Revenue Code	309
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

Ova + Parasite Exam

Facility

$667.59

Service Code	HCPCS 87209
Hospital Charge Code	39880003B
Hospital Revenue Code	309
Min. Negotiated Rate	$14.38
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$48.91
Rate for Payer: Aetna Medicare Advantage	$58.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.22
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$17.98
Rate for Payer: Clover Medicare Advantage	$17.08
Rate for Payer: EmblemHealth Commercial	$53.94
Rate for Payer: Humana Medicare Advantage	$18.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.57
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.98
Rate for Payer: Wellcare Medicare Advantage	$17.98
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

Ova + Parasite Exam

Facility

$526.67

Service Code	HCPCS 87177
Hospital Charge Code	39880003A
Hospital Revenue Code	309
Min. Negotiated Rate	$79.00
Max. Negotiated Rate	$79.00
Rate for Payer: Qualcare PPO/HMO/WC	$79.00

Ova + Parasite Exam

Facility

$526.67

Service Code	HCPCS 87177
Hospital Charge Code	39880003A
Hospital Revenue Code	309
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$263.33
Rate for Payer: Aetna Commercial	$24.21
Rate for Payer: Aetna Medicare Advantage	$28.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.28
Rate for Payer: Cigna Commercial	$263.33
Rate for Payer: Cigna Medicare Advantage	$8.90
Rate for Payer: Clover Medicare Advantage	$8.46
Rate for Payer: EmblemHealth Commercial	$26.70
Rate for Payer: Humana Medicare Advantage	$9.17
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.93
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$79.00
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$7.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.90
Rate for Payer: Wellcare Medicare Advantage	$8.90
Rate for Payer: Wellpoint Medicaid Managed Care	$14.96

OVA & PARASITES

Facility

$391.00

Service Code	HCPCS 87177
Hospital Charge Code	38475005
Hospital Revenue Code	309
Min. Negotiated Rate	$58.65
Max. Negotiated Rate	$58.65
Rate for Payer: Qualcare PPO/HMO/WC	$58.65

OVA & PARASITES

Facility

$391.00

Service Code	HCPCS 87177
Hospital Charge Code	38475005
Hospital Revenue Code	309
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$195.50
Rate for Payer: Aetna Commercial	$24.21
Rate for Payer: Aetna Medicare Advantage	$28.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.28
Rate for Payer: Cigna Commercial	$195.50
Rate for Payer: Cigna Medicare Advantage	$8.90
Rate for Payer: Clover Medicare Advantage	$8.46
Rate for Payer: EmblemHealth Commercial	$26.70
Rate for Payer: Humana Medicare Advantage	$9.17
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.66
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.65
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$7.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.90
Rate for Payer: Wellcare Medicare Advantage	$8.90
Rate for Payer: Wellpoint Medicaid Managed Care	$11.10

OVARIAN AB SCREEN

Facility

$390.00

Service Code	HCPCS 86255
Hospital Charge Code	38479451A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

OVARIAN AB SCREEN

Facility

$390.00

Service Code	HCPCS 86255
Hospital Charge Code	38479451A
Hospital Revenue Code	302
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.71
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
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	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

OVERDRILL 2.7MM AO CONNECTION

Facility

$1,205.00

Hospital Charge Code	270672587
Hospital Revenue Code	272
Min. Negotiated Rate	$180.75
Max. Negotiated Rate	$180.75
Rate for Payer: Qualcare PPO/HMO/WC	$180.75

OVERDRILL 2.7MM AO CONNECTION

Facility

$1,205.00

Hospital Charge Code	270672587
Hospital Revenue Code	272
Min. Negotiated Rate	$34.22
Max. Negotiated Rate	$602.50
Rate for Payer: Aetna Commercial	$457.90
Rate for Payer: Aetna Medicare Advantage	$361.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.27
Rate for Payer: Cigna Commercial	$602.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.30
Rate for Payer: Oxford Commercial	$241.00
Rate for Payer: Qualcare PPO/HMO/WC	$180.75
Rate for Payer: UnitedHealthcare Commercial	$241.00
Rate for Payer: UnitedHealthcare Community & State	$38.08
Rate for Payer: Wellpoint Medicaid Managed Care	$34.22

OVERDRILL 3.5

Facility

$1,370.00

Hospital Charge Code	270664509
Hospital Revenue Code	270
Min. Negotiated Rate	$38.91
Max. Negotiated Rate	$685.00
Rate for Payer: Aetna Commercial	$520.60
Rate for Payer: Aetna Medicare Advantage	$411.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$349.35
Rate for Payer: Cigna Commercial	$685.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.20
Rate for Payer: Oxford Commercial	$274.00
Rate for Payer: Qualcare PPO/HMO/WC	$205.50
Rate for Payer: UnitedHealthcare Commercial	$274.00
Rate for Payer: UnitedHealthcare Community & State	$43.29
Rate for Payer: Wellpoint Medicaid Managed Care	$38.91

OVERDRILL 3.5

Facility

$1,370.00

Hospital Charge Code	270664509
Hospital Revenue Code	270
Min. Negotiated Rate	$205.50
Max. Negotiated Rate	$205.50
Rate for Payer: Qualcare PPO/HMO/WC	$205.50

OVERDRILL AO DIA 3.5X122MM

Facility

$1,160.70

Hospital Charge Code	270692182
Hospital Revenue Code	272
Min. Negotiated Rate	$32.96
Max. Negotiated Rate	$580.35
Rate for Payer: Aetna Commercial	$441.07
Rate for Payer: Aetna Medicare Advantage	$348.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$295.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$295.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$295.98
Rate for Payer: Cigna Commercial	$580.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.78
Rate for Payer: Oxford Commercial	$232.14
Rate for Payer: Qualcare PPO/HMO/WC	$174.10
Rate for Payer: UnitedHealthcare Commercial	$232.14
Rate for Payer: UnitedHealthcare Community & State	$36.68
Rate for Payer: Wellpoint Medicaid Managed Care	$32.96

OVERDRILL AO DIA 3.5X122MM

Facility

$1,160.70

Hospital Charge Code	270692182
Hospital Revenue Code	272
Min. Negotiated Rate	$174.10
Max. Negotiated Rate	$174.10
Rate for Payer: Qualcare PPO/HMO/WC	$174.10

OVERDRILL AO SHAFT END 2.3mm

Facility

$860.00

Hospital Charge Code	270669953
Hospital Revenue Code	272
Min. Negotiated Rate	$129.00
Max. Negotiated Rate	$129.00
Rate for Payer: Qualcare PPO/HMO/WC	$129.00

OVERDRILL AO SHAFT END 2.3mm

Facility

$860.00

Hospital Charge Code	270669953
Hospital Revenue Code	272
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) PPO	$219.30
Rate for Payer: Cigna Commercial	$430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.60
Rate for Payer: Oxford Commercial	$172.00
Rate for Payer: Qualcare PPO/HMO/WC	$129.00
Rate for Payer: UnitedHealthcare Commercial	$172.00
Rate for Payer: UnitedHealthcare Community & State	$27.18
Rate for Payer: Wellpoint Medicaid Managed Care	$24.42

Know your out-of-pocket cost for care.

All Charges