Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

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	$1,560.60
Max. Negotiated Rate	$27,464.85
Rate for Payer: Aetna Commercial	$20,593.91
Rate for Payer: Aetna Medicare Advantage	$24,530.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27,464.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27,464.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,571.29
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	$27,464.85
Rate for Payer: Cigna Commercial	$15,176.62
Rate for Payer: Cigna Medicare Advantage	$7,571.29
Rate for Payer: Clover Medicare Advantage	$7,192.73
Rate for Payer: EmblemHealth Commercial	$22,713.87
Rate for Payer: Humana Medicare Advantage	$7,798.43
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,571.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,287.21
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,242.62
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,736.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,571.29
Rate for Payer: Wellcare Medicare Advantage	$7,571.29
Rate for Payer: Wellpoint Medicaid Managed Care	$1,560.60

PERC INC ADDUCTOR/HAMSTRING T

Facility

$12,831.20

Service Code	HCPCS 27306
Hospital Charge Code	16000877
Hospital Revenue Code	360
Min. Negotiated Rate	$364.41
Max. Negotiated Rate	$14,100.89
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
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	$14,100.89
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,336.11
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,924.68
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$405.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$364.41

PERC INC ADDUCTOR/HAMSTRING T

Facility

$12,831.20

Service Code	HCPCS 27306
Hospital Charge Code	16000877
Hospital Revenue Code	360
Min. Negotiated Rate	$1,924.68
Max. Negotiated Rate	$1,924.68
Rate for Payer: Qualcare PPO/HMO/WC	$1,924.68

PERC INC HIP ADDUCTOR

Facility

$6,353.84

Service Code	HCPCS 27000
Hospital Charge Code	1600000333
Hospital Revenue Code	360
Min. Negotiated Rate	$953.08
Max. Negotiated Rate	$953.08
Rate for Payer: Qualcare PPO/HMO/WC	$953.08

PERC INC HIP ADDUCTOR

Facility

$6,353.84

Service Code	HCPCS 27000
Hospital Charge Code	1600000333
Hospital Revenue Code	360
Min. Negotiated Rate	$180.45
Max. Negotiated Rate	$8,192.00
Rate for Payer: Aetna Commercial	$5,196.12
Rate for Payer: Aetna Medicare Advantage	$6,189.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,929.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,929.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,910.34
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	$6,929.76
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: Cigna Medicare Advantage	$1,910.34
Rate for Payer: Clover Medicare Advantage	$1,814.82
Rate for Payer: EmblemHealth Commercial	$5,731.02
Rate for Payer: Humana Medicare Advantage	$1,967.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,910.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,652.00
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$953.08
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$200.78
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellpoint Medicaid Managed Care	$180.45

PERC INJ RENAL CYST-BI

Facility

$7,064.85

Service Code	HCPCS 5039050
Hospital Charge Code	2101196
Hospital Revenue Code	361
Min. Negotiated Rate	$200.64
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,684.64
Rate for Payer: Aetna Medicare Advantage	$2,119.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,801.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,801.54
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	$1,801.54
Rate for Payer: Cigna Commercial	$3,532.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,836.86
Rate for Payer: Qualcare PPO/HMO/WC	$1,059.73
Rate for Payer: UnitedHealthcare Community & State	$223.25
Rate for Payer: Wellpoint Medicaid Managed Care	$200.64

PERC INJ RENAL CYST-BI

Facility

$7,064.85

Service Code	HCPCS 5039050
Hospital Charge Code	2101196
Hospital Revenue Code	361
Min. Negotiated Rate	$1,059.73
Max. Negotiated Rate	$1,059.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,059.73

PERC INJ RENAL CYST-LT

Facility

$4,709.90

Service Code	HCPCS 50390LT
Hospital Charge Code	2101198
Hospital Revenue Code	361
Min. Negotiated Rate	$133.76
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,789.76
Rate for Payer: Aetna Medicare Advantage	$1,412.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,201.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,201.02
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	$1,201.02
Rate for Payer: Cigna Commercial	$2,354.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,224.57
Rate for Payer: Qualcare PPO/HMO/WC	$706.49
Rate for Payer: UnitedHealthcare Community & State	$148.83
Rate for Payer: Wellpoint Medicaid Managed Care	$133.76

PERC INJ RENAL CYST-LT

Facility

$4,709.90

Service Code	HCPCS 50390LT
Hospital Charge Code	2101198
Hospital Revenue Code	361
Min. Negotiated Rate	$706.49
Max. Negotiated Rate	$706.49
Rate for Payer: Qualcare PPO/HMO/WC	$706.49

PERC INSERT IABP

Facility

$4,727.00

Service Code	HCPCS 33967
Hospital Charge Code	366833967
Hospital Revenue Code	361
Min. Negotiated Rate	$709.05
Max. Negotiated Rate	$709.05
Rate for Payer: Qualcare PPO/HMO/WC	$709.05

PERC INSERT IABP

Facility

$4,727.00

Service Code	HCPCS 33967
Hospital Charge Code	366833967
Hospital Revenue Code	361
Min. Negotiated Rate	$134.25
Max. Negotiated Rate	$20,109.00
Rate for Payer: Aetna Commercial	$1,796.26
Rate for Payer: Aetna Medicare Advantage	$1,418.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,205.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,205.38
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	$1,205.38
Rate for Payer: Cigna Commercial	$2,363.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,229.02
Rate for Payer: Oxford Commercial	$18,024.00
Rate for Payer: Qualcare PPO/HMO/WC	$709.05
Rate for Payer: UnitedHealthcare Commercial	$20,109.00
Rate for Payer: UnitedHealthcare Community & State	$149.37
Rate for Payer: Wellpoint Medicaid Managed Care	$134.25

PERC INSERT IABP

Facility

$4,727.00

Service Code	HCPCS 33967
Hospital Charge Code	7411037
Hospital Revenue Code	361
Min. Negotiated Rate	$709.05
Max. Negotiated Rate	$709.05
Rate for Payer: Qualcare PPO/HMO/WC	$709.05

PERC INSERT IABP

Facility

$4,727.00

Service Code	HCPCS 33967
Hospital Charge Code	7411037
Hospital Revenue Code	361
Min. Negotiated Rate	$134.25
Max. Negotiated Rate	$20,109.00
Rate for Payer: Aetna Commercial	$1,796.26
Rate for Payer: Aetna Medicare Advantage	$1,418.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,205.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,205.38
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	$1,205.38
Rate for Payer: Cigna Commercial	$2,363.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,229.02
Rate for Payer: Oxford Commercial	$18,024.00
Rate for Payer: Qualcare PPO/HMO/WC	$709.05
Rate for Payer: UnitedHealthcare Commercial	$20,109.00
Rate for Payer: UnitedHealthcare Community & State	$149.37
Rate for Payer: Wellpoint Medicaid Managed Care	$134.25

PERC INSERTION KIT FOR 2.9 PUS

Facility

$1,100.00

Hospital Charge Code	270672023
Hospital Revenue Code	272
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00

PERC INSERTION KIT FOR 2.9 PUS

Facility

$1,100.00

Hospital Charge Code	270672023
Hospital Revenue Code	272
Min. Negotiated Rate	$31.24
Max. Negotiated Rate	$550.00
Rate for Payer: Aetna Commercial	$418.00
Rate for Payer: Aetna Medicare Advantage	$330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$280.50
Rate for Payer: Cigna Commercial	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$286.00
Rate for Payer: Oxford Commercial	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00
Rate for Payer: UnitedHealthcare Commercial	$220.00
Rate for Payer: UnitedHealthcare Community & State	$34.76
Rate for Payer: Wellpoint Medicaid Managed Care	$31.24

PERCLOSE PROSTYLE 12773-03

Facility

$1,200.00

Service Code	HCPCS C1760
Hospital Charge Code	270694951S
Hospital Revenue Code	278
Min. Negotiated Rate	$180.00
Max. Negotiated Rate	$290.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.40
Rate for Payer: Qualcare PPO/HMO/WC	$180.00

PERCLOSE PROSTYLE 12773-03

Facility

$1,200.00

Service Code	HCPCS C1760
Hospital Charge Code	270694951S
Hospital Revenue Code	278
Min. Negotiated Rate	$34.08
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$456.00
Rate for Payer: Aetna Medicare Advantage	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$306.00
Rate for Payer: Cigna Commercial	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.40
Rate for Payer: Qualcare PPO/HMO/WC	$180.00
Rate for Payer: UnitedHealthcare Community & State	$37.92
Rate for Payer: Wellpoint Medicaid Managed Care	$34.08

PERC N BX ABD /RETROPERITNL M

Facility

$8,404.60

Service Code	HCPCS 49180
Hospital Charge Code	160000198
Hospital Revenue Code	360
Min. Negotiated Rate	$1,260.69
Max. Negotiated Rate	$1,260.69
Rate for Payer: Qualcare PPO/HMO/WC	$1,260.69

PERC N BX ABD /RETROPERITNL M

Facility

$8,404.60

Service Code	HCPCS 49180
Hospital Charge Code	160000198
Hospital Revenue Code	360
Min. Negotiated Rate	$238.69
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,185.20
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,260.69
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$265.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$238.69

PERC NDL CORE BRST BX WO GUID

Facility

$4,884.50

Service Code	HCPCS 19100
Hospital Charge Code	16000788
Hospital Revenue Code	360
Min. Negotiated Rate	$732.67
Max. Negotiated Rate	$732.67
Rate for Payer: Qualcare PPO/HMO/WC	$732.67

PERC NDL CORE BRST BX WO GUID

Facility

$4,884.50

Service Code	HCPCS 19100
Hospital Charge Code	16000788
Hospital Revenue Code	360
Min. Negotiated Rate	$138.72
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,269.97
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$732.67
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$154.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$138.72

PERC NEPHROSTOLITHOTOMY,TO 2CM

Facility

$39,246.40

Service Code	HCPCS 50080
Hospital Charge Code	1600000679
Hospital Revenue Code	360
Min. Negotiated Rate	$5,886.96
Max. Negotiated Rate	$5,886.96
Rate for Payer: Qualcare PPO/HMO/WC	$5,886.96

PERC NEPHROSTOLITHOTOMY,TO 2CM

Facility

$39,246.40

Service Code	HCPCS 50080
Hospital Charge Code	1600000679
Hospital Revenue Code	360
Min. Negotiated Rate	$1,114.60
Max. Negotiated Rate	$40,796.35
Rate for Payer: Aetna Commercial	$30,590.24
Rate for Payer: Aetna Medicare Advantage	$36,438.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40,796.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40,796.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11,246.41
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	$40,796.35
Rate for Payer: Cigna Commercial	$22,543.37
Rate for Payer: Cigna Medicare Advantage	$11,246.41
Rate for Payer: Clover Medicare Advantage	$10,684.09
Rate for Payer: EmblemHealth Commercial	$33,739.23
Rate for Payer: Humana Medicare Advantage	$11,583.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11,246.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,204.06
Rate for Payer: Oxford Commercial	$11,677.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,886.96
Rate for Payer: UnitedHealthcare Commercial	$12,906.00
Rate for Payer: UnitedHealthcare Community & State	$1,240.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$11,246.41
Rate for Payer: Wellcare Medicare Advantage	$11,246.41
Rate for Payer: Wellpoint Medicaid Managed Care	$1,114.60

PERC PLACMNT OF ENTEROCLYSIS T

Facility

$766.60

Service Code	HCPCS 44015
Hospital Charge Code	1600000345
Hospital Revenue Code	360
Min. Negotiated Rate	$114.99
Max. Negotiated Rate	$114.99
Rate for Payer: Qualcare PPO/HMO/WC	$114.99

PERC PLACMNT OF ENTEROCLYSIS T

Facility

$766.60

Service Code	HCPCS 44015
Hospital Charge Code	1600000345
Hospital Revenue Code	360
Min. Negotiated Rate	$21.77
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$291.31
Rate for Payer: Aetna Medicare Advantage	$229.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$195.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$195.48
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	$195.48
Rate for Payer: Cigna Commercial	$383.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.32
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$114.99
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$24.22
Rate for Payer: Wellpoint Medicaid Managed Care	$21.77

Know your out-of-pocket cost for care.

All Charges