Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PERM PACEMAKER DUAL

Facility

$39,837.00

Service Code	HCPCS 33208
Hospital Charge Code	366833208
Hospital Revenue Code	480
Min. Negotiated Rate	$321.54
Max. Negotiated Rate	$45,043.57
Rate for Payer: Aetna Commercial	$33,774.92
Rate for Payer: Aetna Medicare Advantage	$40,231.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45,043.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45,043.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,417.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$321.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45,043.57
Rate for Payer: Cigna Commercial	$24,890.32
Rate for Payer: Cigna Medicare Advantage	$12,417.25
Rate for Payer: Clover Medicare Advantage	$11,796.39
Rate for Payer: EmblemHealth Commercial	$37,251.75
Rate for Payer: Humana Medicare Advantage	$12,789.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,417.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,357.62
Rate for Payer: Oxford Commercial	$2,441.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,975.55
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$1,258.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,417.25
Rate for Payer: Wellcare Medicare Advantage	$12,417.25
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,126.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1,131.37

PERM PACEMAKER DUAL

Facility

$39,837.00

Service Code	HCPCS 33208
Hospital Charge Code	366833208
Hospital Revenue Code	480
Min. Negotiated Rate	$5,975.55
Max. Negotiated Rate	$5,975.55
Rate for Payer: Qualcare PPO/HMO/WC	$5,975.55

PERM PACEMAKER VENT

Facility

$32,811.00

Service Code	HCPCS 33207
Hospital Charge Code	366833207
Hospital Revenue Code	480
Min. Negotiated Rate	$451.00
Max. Negotiated Rate	$45,043.57
Rate for Payer: Aetna Commercial	$33,774.92
Rate for Payer: Aetna Medicare Advantage	$40,231.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45,043.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45,043.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,417.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45,043.57
Rate for Payer: Cigna Commercial	$24,890.32
Rate for Payer: Cigna Medicare Advantage	$12,417.25
Rate for Payer: Clover Medicare Advantage	$11,796.39
Rate for Payer: EmblemHealth Commercial	$37,251.75
Rate for Payer: Humana Medicare Advantage	$12,789.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,417.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,530.86
Rate for Payer: Oxford Commercial	$2,441.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,921.65
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$1,036.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,417.25
Rate for Payer: Wellcare Medicare Advantage	$12,417.25
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,126.04
Rate for Payer: Wellpoint Medicaid Managed Care	$931.83

PERM PACEMAKER VENT

Facility

$32,811.00

Service Code	HCPCS 33207
Hospital Charge Code	366833207
Hospital Revenue Code	480
Min. Negotiated Rate	$4,921.65
Max. Negotiated Rate	$4,921.65
Rate for Payer: Qualcare PPO/HMO/WC	$4,921.65

PERPHENAZINE 2 MG TAB

Facility

$13.13

Service Code	HCPCS Q0175
Hospital Charge Code	60627814
Hospital Revenue Code	636
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$6.57
Rate for Payer: Aetna Commercial	$4.99
Rate for Payer: Aetna Medicare Advantage	$3.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.35
Rate for Payer: Cigna Commercial	$6.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.18
Rate for Payer: Qualcare PPO/HMO/WC	$1.97
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

PERPHENAZINE 2 MG TAB

Facility

$13.13

Service Code	HCPCS Q0175
Hospital Charge Code	60627814
Hospital Revenue Code	636
Min. Negotiated Rate	$1.97
Max. Negotiated Rate	$3.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.18
Rate for Payer: Qualcare PPO/HMO/WC	$1.97

PERPHENAZINE 4 MG TAB

Facility

$18.02

Service Code	HCPCS Q0175
Hospital Charge Code	60627815
Hospital Revenue Code	636
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$9.01
Rate for Payer: Aetna Commercial	$6.85
Rate for Payer: Aetna Medicare Advantage	$5.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.60
Rate for Payer: Cigna Commercial	$9.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.36
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Community & State	$0.57
Rate for Payer: Wellpoint Medicaid Managed Care	$0.51

PERPHENAZINE 4 MG TAB

Facility

$18.02

Service Code	HCPCS Q0175
Hospital Charge Code	60627815
Hospital Revenue Code	636
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$4.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.36
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

PERPHENAZINE 8 MG TAB

Facility

$21.84

Service Code	HCPCS Q0175
Hospital Charge Code	60627816
Hospital Revenue Code	636
Min. Negotiated Rate	$3.28
Max. Negotiated Rate	$5.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.29
Rate for Payer: Qualcare PPO/HMO/WC	$3.28

PERPHENAZINE 8 MG TAB

Facility

$21.84

Service Code	HCPCS Q0175
Hospital Charge Code	60627816
Hospital Revenue Code	636
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$10.92
Rate for Payer: Aetna Commercial	$8.30
Rate for Payer: Aetna Medicare Advantage	$6.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.57
Rate for Payer: Cigna Commercial	$10.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.29
Rate for Payer: Qualcare PPO/HMO/WC	$3.28
Rate for Payer: UnitedHealthcare Community & State	$0.69
Rate for Payer: Wellpoint Medicaid Managed Care	$0.62

PERQ ACCESS & CLSR FEM ART

Facility

$6,785.00

Service Code	HCPCS 34713
Hospital Charge Code	321034713
Hospital Revenue Code	361
Min. Negotiated Rate	$192.69
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,578.30
Rate for Payer: Aetna Medicare Advantage	$2,035.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,730.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,730.17
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	$1,730.17
Rate for Payer: Cigna Commercial	$3,392.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,764.10
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,017.75
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$214.41
Rate for Payer: Wellpoint Medicaid Managed Care	$192.69

PERQ ACCESS & CLSR FEM ART

Facility

$6,785.00

Service Code	HCPCS 34713
Hospital Charge Code	321034713
Hospital Revenue Code	361
Min. Negotiated Rate	$1,017.75
Max. Negotiated Rate	$1,017.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,017.75

PERQ ACCESS & CLSR FEM ART

Facility

$6,785.00

Service Code	HCPCS 34713
Hospital Charge Code	404634713
Hospital Revenue Code	361
Min. Negotiated Rate	$1,017.75
Max. Negotiated Rate	$1,017.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,017.75

PERQ ACCESS & CLSR FEM ART

Facility

$6,785.00

Service Code	HCPCS 34713
Hospital Charge Code	404634713
Hospital Revenue Code	361
Min. Negotiated Rate	$192.69
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,578.30
Rate for Payer: Aetna Medicare Advantage	$2,035.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,730.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,730.17
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	$1,730.17
Rate for Payer: Cigna Commercial	$3,392.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,764.10
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,017.75
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$214.41
Rate for Payer: Wellpoint Medicaid Managed Care	$192.69

PERQ ART M-THROMBECT &/NFS

Facility

$61,616.39

Service Code	HCPCS 61645
Hospital Charge Code	411061645
Hospital Revenue Code	361
Min. Negotiated Rate	$1,749.91
Max. Negotiated Rate	$30,808.19
Rate for Payer: Aetna Commercial	$23,414.23
Rate for Payer: Aetna Medicare Advantage	$18,484.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,712.18
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	$15,712.18
Rate for Payer: Cigna Commercial	$30,808.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,020.26
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$1,947.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1,749.91

PERQ ART M-THROMBECT &/NFS

Facility

$61,616.39

Service Code	HCPCS 61645
Hospital Charge Code	411061645
Hospital Revenue Code	361
Min. Negotiated Rate	$9,242.46
Max. Negotiated Rate	$9,242.46
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

PERQ ART M-THROMBECT &/NFS

Facility

$61,616.39

Service Code	HCPCS 61645
Hospital Charge Code	366861645
Hospital Revenue Code	361
Min. Negotiated Rate	$1,749.91
Max. Negotiated Rate	$30,808.19
Rate for Payer: Aetna Commercial	$23,414.23
Rate for Payer: Aetna Medicare Advantage	$18,484.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,712.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,712.18
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	$15,712.18
Rate for Payer: Cigna Commercial	$30,808.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,020.26
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$1,947.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1,749.91

PERQ ART M-THROMBECT &/NFS

Facility

$61,616.39

Service Code	HCPCS 61645
Hospital Charge Code	366861645
Hospital Revenue Code	361
Min. Negotiated Rate	$9,242.46
Max. Negotiated Rate	$9,242.46
Rate for Payer: Qualcare PPO/HMO/WC	$9,242.46

PERQ CERVICOTHORACIC INJECT

Facility

$15,447.21

Service Code	HCPCS 22510
Hospital Charge Code	5701103
Hospital Revenue Code	320
Min. Negotiated Rate	$2,317.08
Max. Negotiated Rate	$2,317.08
Rate for Payer: Qualcare PPO/HMO/WC	$2,317.08

PERQ CERVICOTHORACIC INJECT

Facility

$15,447.21

Service Code	HCPCS 22510
Hospital Charge Code	5701103
Hospital Revenue Code	320
Min. Negotiated Rate	$438.70
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	$1,140.11
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	$2,721.05
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	$4,016.27
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,317.08
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$488.13
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	$438.70

PERQ CERVICOTHORACIC INJECT

Facility

$15,447.21

Service Code	HCPCS 22510
Hospital Charge Code	7411352
Hospital Revenue Code	320
Min. Negotiated Rate	$438.70
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	$1,140.11
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	$2,721.05
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	$4,016.27
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,317.08
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$488.13
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	$438.70

PERQ CERVICOTHORACIC INJECT

Facility

$15,447.21

Service Code	HCPCS 22510
Hospital Charge Code	7411352
Hospital Revenue Code	320
Min. Negotiated Rate	$2,317.08
Max. Negotiated Rate	$2,317.08
Rate for Payer: Qualcare PPO/HMO/WC	$2,317.08

PERQ DEV BREAST 1ST STRTCTC

Facility

$1,167.00

Service Code	HCPCS 19283
Hospital Charge Code	16000534
Hospital Revenue Code	360
Min. Negotiated Rate	$175.05
Max. Negotiated Rate	$175.05
Rate for Payer: Qualcare PPO/HMO/WC	$175.05

PERQ DEV BREAST 1ST STRTCTC

Facility

$1,167.00

Service Code	HCPCS 19283
Hospital Charge Code	16000534
Hospital Revenue Code	360
Min. Negotiated Rate	$33.14
Max. Negotiated Rate	$3,629.00
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
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	$3,051.74
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.42
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$175.05
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$36.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$33.14

PERQ DEV BREAST 1ST US IMAG

Facility

$1,167.00

Service Code	HCPCS 19285
Hospital Charge Code	16000195
Hospital Revenue Code	360
Min. Negotiated Rate	$33.14
Max. Negotiated Rate	$3,629.00
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
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	$3,051.74
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.42
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$175.05
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$36.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$33.14

Know your out-of-pocket cost for care.

All Charges