Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PERICARDIAL DRAINAGE, > 6Y0

Facility

$6,404.20

Service Code	HCPCS 33017
Hospital Charge Code	321033017
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

PERICARDIAL DRAINAGE, > 6Y0

Facility

$6,404.20

Service Code	HCPCS 33017
Hospital Charge Code	404633017
Hospital Revenue Code	361
Min. Negotiated Rate	$181.88
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$2,433.60
Rate for Payer: Aetna Medicare Advantage	$1,921.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.07
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	$1,633.07
Rate for Payer: Cigna Commercial	$3,202.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,665.09
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$960.63
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$202.37
Rate for Payer: Wellpoint Medicaid Managed Care	$181.88

PERICARDIAL DRAINAGE, > 6Y0

Facility

$6,404.20

Service Code	HCPCS 33017
Hospital Charge Code	321033017
Hospital Revenue Code	361
Min. Negotiated Rate	$181.88
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$2,433.60
Rate for Payer: Aetna Medicare Advantage	$1,921.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.07
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	$1,633.07
Rate for Payer: Cigna Commercial	$3,202.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,665.09
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$960.63
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$202.37
Rate for Payer: Wellpoint Medicaid Managed Care	$181.88

PERICARDIAL DRAINAGE, > 6Y0

Facility

$6,404.20

Service Code	HCPCS 33017
Hospital Charge Code	411033017
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

PERICARDIAL DRAINAGE, > 6Y0

Facility

$6,404.20

Service Code	HCPCS 33017
Hospital Charge Code	404633017
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

PERICARDIAL DRAINAGE, > 6Y0

Facility

$6,404.20

Service Code	HCPCS 33017
Hospital Charge Code	411033017
Hospital Revenue Code	361
Min. Negotiated Rate	$181.88
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$2,433.60
Rate for Payer: Aetna Medicare Advantage	$1,921.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.07
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	$1,633.07
Rate for Payer: Cigna Commercial	$3,202.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,665.09
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$960.63
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$202.37
Rate for Payer: Wellpoint Medicaid Managed Care	$181.88

PERICARDIAL DRAINAGE, > 6Y0

Facility

$6,404.20

Service Code	HCPCS 33017
Hospital Charge Code	404133017
Hospital Revenue Code	361
Min. Negotiated Rate	$181.88
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$2,433.60
Rate for Payer: Aetna Medicare Advantage	$1,921.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.07
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	$1,633.07
Rate for Payer: Cigna Commercial	$3,202.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,665.09
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$960.63
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$202.37
Rate for Payer: Wellpoint Medicaid Managed Care	$181.88

PERICARDIAL DRAINAGE, > 6Y0

Facility

$6,404.20

Service Code	HCPCS 33017
Hospital Charge Code	404133017
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

PERICARDIAL DRAINAGE W CT

Facility

$6,404.20

Service Code	HCPCS 33019
Hospital Charge Code	404633019
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

PERICARDIAL DRAINAGE W CT

Facility

$6,404.20

Service Code	HCPCS 33019
Hospital Charge Code	411033019
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

PERICARDIAL DRAINAGE W CT

Facility

$6,404.20

Service Code	HCPCS 33019
Hospital Charge Code	411033019
Hospital Revenue Code	361
Min. Negotiated Rate	$181.88
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$2,433.60
Rate for Payer: Aetna Medicare Advantage	$1,921.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.07
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	$1,633.07
Rate for Payer: Cigna Commercial	$3,202.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,665.09
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$960.63
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$202.37
Rate for Payer: Wellpoint Medicaid Managed Care	$181.88

PERICARDIAL DRAINAGE W CT

Facility

$6,404.20

Service Code	HCPCS 33019
Hospital Charge Code	321033019
Hospital Revenue Code	361
Min. Negotiated Rate	$181.88
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$2,433.60
Rate for Payer: Aetna Medicare Advantage	$1,921.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.07
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	$1,633.07
Rate for Payer: Cigna Commercial	$3,202.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,665.09
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$960.63
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$202.37
Rate for Payer: Wellpoint Medicaid Managed Care	$181.88

PERICARDIAL DRAINAGE W CT

Facility

$6,404.20

Service Code	HCPCS 33019
Hospital Charge Code	404133019
Hospital Revenue Code	361
Min. Negotiated Rate	$181.88
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$2,433.60
Rate for Payer: Aetna Medicare Advantage	$1,921.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.07
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	$1,633.07
Rate for Payer: Cigna Commercial	$3,202.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,665.09
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$960.63
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$202.37
Rate for Payer: Wellpoint Medicaid Managed Care	$181.88

PERICARDIAL DRAINAGE W CT

Facility

$6,404.20

Service Code	HCPCS 33019
Hospital Charge Code	321033019
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

PERICARDIAL DRAINAGE W CT

Facility

$6,404.20

Service Code	HCPCS 33019
Hospital Charge Code	404133019
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

PERICARDIAL DRAINAGE W CT

Facility

$6,404.20

Service Code	HCPCS 33019
Hospital Charge Code	404633019
Hospital Revenue Code	361
Min. Negotiated Rate	$181.88
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$2,433.60
Rate for Payer: Aetna Medicare Advantage	$1,921.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.07
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	$1,633.07
Rate for Payer: Cigna Commercial	$3,202.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,665.09
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$960.63
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$202.37
Rate for Payer: Wellpoint Medicaid Managed Care	$181.88

PERICARDIOCENTESIS I

Facility

$1,613.00

Service Code	HCPCS 33010
Hospital Charge Code	366833010
Hospital Revenue Code	361
Min. Negotiated Rate	$241.95
Max. Negotiated Rate	$241.95
Rate for Payer: Qualcare PPO/HMO/WC	$241.95

PERICARDIOCENTESIS I

Facility

$1,613.00

Service Code	HCPCS 33010
Hospital Charge Code	366833010
Hospital Revenue Code	361
Min. Negotiated Rate	$45.81
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$612.94
Rate for Payer: Aetna Medicare Advantage	$483.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$411.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$411.31
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	$411.31
Rate for Payer: Cigna Commercial	$806.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$419.38
Rate for Payer: Qualcare PPO/HMO/WC	$241.95
Rate for Payer: UnitedHealthcare Community & State	$50.97
Rate for Payer: Wellpoint Medicaid Managed Care	$45.81

PERICARDIOCENTESIS W IMAGING

Facility

$9,550.68

Service Code	HCPCS 33016
Hospital Charge Code	411033016
Hospital Revenue Code	361
Min. Negotiated Rate	$1,432.60
Max. Negotiated Rate	$1,432.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,432.60

PERICARDIOCENTESIS W IMAGING

Facility

$9,550.68

Service Code	HCPCS 33016
Hospital Charge Code	323033016
Hospital Revenue Code	450
Min. Negotiated Rate	$1,432.60
Max. Negotiated Rate	$1,432.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,432.60

PERICARDIOCENTESIS W IMAGING

Facility

$9,550.68

Service Code	HCPCS 33016
Hospital Charge Code	411033016
Hospital Revenue Code	361
Min. Negotiated Rate	$271.24
Max. Negotiated Rate	$6,783.93
Rate for Payer: Aetna Commercial	$5,086.78
Rate for Payer: Aetna Medicare Advantage	$6,059.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,783.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,783.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,870.14
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	$6,783.93
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: Cigna Medicare Advantage	$1,870.14
Rate for Payer: Clover Medicare Advantage	$1,776.63
Rate for Payer: EmblemHealth Commercial	$5,610.42
Rate for Payer: Humana Medicare Advantage	$1,926.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,870.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,483.18
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,432.60
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$301.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,870.14
Rate for Payer: Wellcare Medicare Advantage	$1,870.14
Rate for Payer: Wellpoint Medicaid Managed Care	$271.24

PERICARDIOCENTESIS W IMAGING

Facility

$9,550.68

Service Code	HCPCS 33016
Hospital Charge Code	321033016
Hospital Revenue Code	361
Min. Negotiated Rate	$271.24
Max. Negotiated Rate	$6,783.93
Rate for Payer: Aetna Commercial	$5,086.78
Rate for Payer: Aetna Medicare Advantage	$6,059.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,783.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,783.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,870.14
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	$6,783.93
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: Cigna Medicare Advantage	$1,870.14
Rate for Payer: Clover Medicare Advantage	$1,776.63
Rate for Payer: EmblemHealth Commercial	$5,610.42
Rate for Payer: Humana Medicare Advantage	$1,926.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,870.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,483.18
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,432.60
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$301.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,870.14
Rate for Payer: Wellcare Medicare Advantage	$1,870.14
Rate for Payer: Wellpoint Medicaid Managed Care	$271.24

PERICARDIOCENTESIS W IMAGING

Facility

$9,550.68

Service Code	HCPCS 33016
Hospital Charge Code	323033016
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$6,783.93
Rate for Payer: Aetna Commercial	$5,086.78
Rate for Payer: Aetna Medicare Advantage	$6,059.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,783.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,783.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,870.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,783.93
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: Cigna Medicare Advantage	$1,870.14
Rate for Payer: Clover Medicare Advantage	$1,776.63
Rate for Payer: EmblemHealth Commercial	$5,610.42
Rate for Payer: Humana Medicare Advantage	$1,926.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,870.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,483.18
Rate for Payer: Qualcare PPO/HMO/WC	$1,432.60
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,870.14
Rate for Payer: Wellcare Medicare Advantage	$1,870.14
Rate for Payer: Wellpoint Medicaid Managed Care	$271.24

PERICARDIOCENTESIS W IMAGING

Facility

$9,550.68

Service Code	HCPCS 33016
Hospital Charge Code	404633016
Hospital Revenue Code	361
Min. Negotiated Rate	$1,432.60
Max. Negotiated Rate	$1,432.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,432.60

PERICARDIOCENTESIS W IMAGING

Facility

$9,550.68

Service Code	HCPCS 33016
Hospital Charge Code	404133016
Hospital Revenue Code	361
Min. Negotiated Rate	$1,432.60
Max. Negotiated Rate	$1,432.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,432.60

Know your out-of-pocket cost for care.

All Charges