Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PERC CHOLECYSTOSTOMY

Facility

$17,067.55

Service Code	HCPCS 47490
Hospital Charge Code	2250452
Hospital Revenue Code	361
Min. Negotiated Rate	$2,560.13
Max. Negotiated Rate	$2,560.13
Rate for Payer: Qualcare PPO/HMO/WC	$2,560.13

PERC CHOLECYSTOSTOMY

Facility

$17,067.55

Service Code	HCPCS 47490
Hospital Charge Code	2250452
Hospital Revenue Code	361
Min. Negotiated Rate	$484.72
Max. Negotiated Rate	$15,429.97
Rate for Payer: Aetna Commercial	$11,569.82
Rate for Payer: Aetna Medicare Advantage	$13,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,429.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,429.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,253.61
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	$15,429.97
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: Cigna Medicare Advantage	$4,253.61
Rate for Payer: Clover Medicare Advantage	$4,040.93
Rate for Payer: EmblemHealth Commercial	$12,760.83
Rate for Payer: Humana Medicare Advantage	$4,381.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,253.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,437.56
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,560.13
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$539.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,253.61
Rate for Payer: Wellcare Medicare Advantage	$4,253.61
Rate for Payer: Wellpoint Medicaid Managed Care	$484.72

PERC FIX FEM PROX NK FX

Facility

$30,595.00

Service Code	HCPCS 27235
Hospital Charge Code	1600000365
Hospital Revenue Code	360
Min. Negotiated Rate	$4,589.25
Max. Negotiated Rate	$4,589.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25

PERC FIX FEM PROX NK FX

Facility

$30,595.00

Service Code	HCPCS 27235
Hospital Charge Code	1600000365
Hospital Revenue Code	360
Min. Negotiated Rate	$868.90
Max. Negotiated Rate	$31,271.12
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,271.12
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,954.70
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$966.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$868.90

PERC FIX SC/TC HUMERUS FX

Facility

$23,899.60

Service Code	HCPCS 24538
Hospital Charge Code	16000825
Hospital Revenue Code	360
Min. Negotiated Rate	$3,584.94
Max. Negotiated Rate	$3,584.94
Rate for Payer: Qualcare PPO/HMO/WC	$3,584.94

PERC FIX SC/TC HUMERUS FX

Facility

$23,899.60

Service Code	HCPCS 24538
Hospital Charge Code	16000825
Hospital Revenue Code	360
Min. Negotiated Rate	$678.75
Max. Negotiated Rate	$31,271.12
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,271.12
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,213.90
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,584.94
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$755.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$678.75

PERC FNA PLEURA-BIL

Facility

$3,604.80

Service Code	HCPCS 1002250
Hospital Charge Code	7412050
Hospital Revenue Code	361
Min. Negotiated Rate	$540.72
Max. Negotiated Rate	$540.72
Rate for Payer: Qualcare PPO/HMO/WC	$540.72

PERC FNA PLEURA-BIL

Facility

$3,604.80

Service Code	HCPCS 1002250
Hospital Charge Code	2250445
Hospital Revenue Code	361
Min. Negotiated Rate	$102.38
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,369.82
Rate for Payer: Aetna Medicare Advantage	$1,081.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$919.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$919.22
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	$919.22
Rate for Payer: Cigna Commercial	$1,802.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.25
Rate for Payer: Qualcare PPO/HMO/WC	$540.72
Rate for Payer: UnitedHealthcare Community & State	$113.91
Rate for Payer: Wellpoint Medicaid Managed Care	$102.38

PERC FNA PLEURA-BIL

Facility

$3,604.80

Service Code	HCPCS 1002250
Hospital Charge Code	7412050
Hospital Revenue Code	361
Min. Negotiated Rate	$102.38
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,369.82
Rate for Payer: Aetna Medicare Advantage	$1,081.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$919.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$919.22
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	$919.22
Rate for Payer: Cigna Commercial	$1,802.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.25
Rate for Payer: Qualcare PPO/HMO/WC	$540.72
Rate for Payer: UnitedHealthcare Community & State	$113.91
Rate for Payer: Wellpoint Medicaid Managed Care	$102.38

PERC FNA PLEURA-BIL

Facility

$3,604.80

Service Code	HCPCS 1002250
Hospital Charge Code	2250445
Hospital Revenue Code	361
Min. Negotiated Rate	$540.72
Max. Negotiated Rate	$540.72
Rate for Payer: Qualcare PPO/HMO/WC	$540.72

PERC FNA PLEURA=BIL

Facility

$3,604.80

Service Code	HCPCS 1002250
Hospital Charge Code	2101195
Hospital Revenue Code	361
Min. Negotiated Rate	$102.38
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,369.82
Rate for Payer: Aetna Medicare Advantage	$1,081.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$919.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$919.22
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	$919.22
Rate for Payer: Cigna Commercial	$1,802.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.25
Rate for Payer: Qualcare PPO/HMO/WC	$540.72
Rate for Payer: UnitedHealthcare Community & State	$113.91
Rate for Payer: Wellpoint Medicaid Managed Care	$102.38

PERC FNA PLEURA=BIL

Facility

$3,604.80

Service Code	HCPCS 1002250
Hospital Charge Code	2101195
Hospital Revenue Code	361
Min. Negotiated Rate	$540.72
Max. Negotiated Rate	$540.72
Rate for Payer: Qualcare PPO/HMO/WC	$540.72

PERC FNA PLEURA-LT

Facility

$2,403.20

Service Code	HCPCS 10022LT
Hospital Charge Code	2101200
Hospital Revenue Code	361
Min. Negotiated Rate	$360.48
Max. Negotiated Rate	$360.48
Rate for Payer: Qualcare PPO/HMO/WC	$360.48

PERC FNA PLEURA-LT

Facility

$2,403.20

Service Code	HCPCS 10022LT
Hospital Charge Code	2101200
Hospital Revenue Code	361
Min. Negotiated Rate	$68.25
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$913.22
Rate for Payer: Aetna Medicare Advantage	$720.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.82
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	$612.82
Rate for Payer: Cigna Commercial	$1,201.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.83
Rate for Payer: Qualcare PPO/HMO/WC	$360.48
Rate for Payer: UnitedHealthcare Community & State	$75.94
Rate for Payer: Wellpoint Medicaid Managed Care	$68.25

PERC FNA PLEURA-LT

Facility

$2,403.20

Service Code	HCPCS 10022LT
Hospital Charge Code	7412051
Hospital Revenue Code	361
Min. Negotiated Rate	$360.48
Max. Negotiated Rate	$360.48
Rate for Payer: Qualcare PPO/HMO/WC	$360.48

PERC FNA PLEURA-LT

Facility

$2,403.20

Service Code	HCPCS 10022LT
Hospital Charge Code	2250446
Hospital Revenue Code	361
Min. Negotiated Rate	$360.48
Max. Negotiated Rate	$360.48
Rate for Payer: Qualcare PPO/HMO/WC	$360.48

PERC FNA PLEURA-LT

Facility

$2,403.20

Service Code	HCPCS 10022LT
Hospital Charge Code	2250446
Hospital Revenue Code	361
Min. Negotiated Rate	$68.25
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$913.22
Rate for Payer: Aetna Medicare Advantage	$720.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.82
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	$612.82
Rate for Payer: Cigna Commercial	$1,201.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.83
Rate for Payer: Qualcare PPO/HMO/WC	$360.48
Rate for Payer: UnitedHealthcare Community & State	$75.94
Rate for Payer: Wellpoint Medicaid Managed Care	$68.25

PERC FNA PLEURA-LT

Facility

$2,403.20

Service Code	HCPCS 10022LT
Hospital Charge Code	7412051
Hospital Revenue Code	361
Min. Negotiated Rate	$68.25
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$913.22
Rate for Payer: Aetna Medicare Advantage	$720.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.82
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	$612.82
Rate for Payer: Cigna Commercial	$1,201.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.83
Rate for Payer: Qualcare PPO/HMO/WC	$360.48
Rate for Payer: UnitedHealthcare Community & State	$75.94
Rate for Payer: Wellpoint Medicaid Managed Care	$68.25

PERC FNA PLEURA-RT

Facility

$2,403.20

Service Code	HCPCS 10022RT
Hospital Charge Code	7412052
Hospital Revenue Code	361
Min. Negotiated Rate	$360.48
Max. Negotiated Rate	$360.48
Rate for Payer: Qualcare PPO/HMO/WC	$360.48

PERC FNA PLEURA-RT

Facility

$2,403.20

Service Code	HCPCS 10022RT
Hospital Charge Code	2101201
Hospital Revenue Code	361
Min. Negotiated Rate	$68.25
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$913.22
Rate for Payer: Aetna Medicare Advantage	$720.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.82
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	$612.82
Rate for Payer: Cigna Commercial	$1,201.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.83
Rate for Payer: Qualcare PPO/HMO/WC	$360.48
Rate for Payer: UnitedHealthcare Community & State	$75.94
Rate for Payer: Wellpoint Medicaid Managed Care	$68.25

PERC FNA PLEURA-RT

Facility

$2,403.20

Service Code	HCPCS 10022RT
Hospital Charge Code	2101201
Hospital Revenue Code	361
Min. Negotiated Rate	$360.48
Max. Negotiated Rate	$360.48
Rate for Payer: Qualcare PPO/HMO/WC	$360.48

PERC FNA PLEURA-RT

Facility

$2,403.20

Service Code	HCPCS 10022RT
Hospital Charge Code	2250447
Hospital Revenue Code	361
Min. Negotiated Rate	$360.48
Max. Negotiated Rate	$360.48
Rate for Payer: Qualcare PPO/HMO/WC	$360.48

PERC FNA PLEURA-RT

Facility

$2,403.20

Service Code	HCPCS 10022RT
Hospital Charge Code	2250447
Hospital Revenue Code	361
Min. Negotiated Rate	$68.25
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$913.22
Rate for Payer: Aetna Medicare Advantage	$720.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.82
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	$612.82
Rate for Payer: Cigna Commercial	$1,201.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.83
Rate for Payer: Qualcare PPO/HMO/WC	$360.48
Rate for Payer: UnitedHealthcare Community & State	$75.94
Rate for Payer: Wellpoint Medicaid Managed Care	$68.25

PERC FNA PLEURA-RT

Facility

$2,403.20

Service Code	HCPCS 10022RT
Hospital Charge Code	7412052
Hospital Revenue Code	361
Min. Negotiated Rate	$68.25
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$913.22
Rate for Payer: Aetna Medicare Advantage	$720.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.82
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	$612.82
Rate for Payer: Cigna Commercial	$1,201.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.83
Rate for Payer: Qualcare PPO/HMO/WC	$360.48
Rate for Payer: UnitedHealthcare Community & State	$75.94
Rate for Payer: Wellpoint Medicaid Managed Care	$68.25

PERC IMPL NS ELCTRD ARY,EPIDRL

Facility

$54,950.80

Service Code	HCPCS 63650
Hospital Charge Code	160000193
Hospital Revenue Code	360
Min. Negotiated Rate	$8,242.62
Max. Negotiated Rate	$8,242.62
Rate for Payer: Qualcare PPO/HMO/WC	$8,242.62

Know your out-of-pocket cost for care.

All Charges