Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PERQ VERTEBRAL AUGMENTATION

Facility

$15,443.85

Service Code	HCPCS 22515
Hospital Charge Code	321022515
Hospital Revenue Code	320
Min. Negotiated Rate	$438.61
Max. Negotiated Rate	$7,721.93
Rate for Payer: Aetna Commercial	$5,868.66
Rate for Payer: Aetna Medicare Advantage	$4,633.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,938.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,938.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,913.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,938.18
Rate for Payer: Cigna Commercial	$7,721.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,015.40
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,316.58
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$488.03
Rate for Payer: Wellpoint Medicaid Managed Care	$438.61

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22513
Hospital Charge Code	321022513
Hospital Revenue Code	320
Min. Negotiated Rate	$5,630.17
Max. Negotiated Rate	$5,630.17
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22513
Hospital Charge Code	7411355
Hospital Revenue Code	320
Min. Negotiated Rate	$1,065.98
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	$4,820.87
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	$6,034.40
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	$9,758.96
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$1,186.09
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	$1,065.98

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22514
Hospital Charge Code	321022514
Hospital Revenue Code	320
Min. Negotiated Rate	$1,065.98
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	$4,797.40
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	$6,034.40
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	$9,758.96
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$1,186.09
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	$1,065.98

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22514
Hospital Charge Code	411022514
Hospital Revenue Code	320
Min. Negotiated Rate	$5,630.17
Max. Negotiated Rate	$5,630.17
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17

PERQ VERTEBRAL AUGMENTATION

Facility

$15,443.85

Service Code	HCPCS 22515
Hospital Charge Code	7411357
Hospital Revenue Code	320
Min. Negotiated Rate	$438.61
Max. Negotiated Rate	$7,721.93
Rate for Payer: Aetna Commercial	$5,868.66
Rate for Payer: Aetna Medicare Advantage	$4,633.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,938.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,938.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,913.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,938.18
Rate for Payer: Cigna Commercial	$7,721.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,015.40
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,316.58
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$488.03
Rate for Payer: Wellpoint Medicaid Managed Care	$438.61

PERQ VERTERBRAL AUGMENTATION

Facility

$33,092.48

Service Code	HCPCS 22513
Hospital Charge Code	16000605
Hospital Revenue Code	360
Min. Negotiated Rate	$939.83
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	$8,604.04
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,963.87
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,045.72
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	$939.83

PERQ VERTERBRAL AUGMENTATION

Facility

$33,092.48

Service Code	HCPCS 22513
Hospital Charge Code	16000605
Hospital Revenue Code	360
Min. Negotiated Rate	$4,963.87
Max. Negotiated Rate	$4,963.87
Rate for Payer: Qualcare PPO/HMO/WC	$4,963.87

PERSONA EXT TAPERD CEM 14X30MM

Facility

$6,042.00

Service Code	HCPCS C1776
Hospital Charge Code	270686934
Hospital Revenue Code	278
Min. Negotiated Rate	$906.30
Max. Negotiated Rate	$1,462.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,208.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,462.16
Rate for Payer: Qualcare PPO/HMO/WC	$906.30

PERSONA EXT TAPERD CEM 14X30MM

Facility

$6,042.00

Service Code	HCPCS C1776
Hospital Charge Code	270686934
Hospital Revenue Code	278
Min. Negotiated Rate	$171.59
Max. Negotiated Rate	$3,021.00
Rate for Payer: Aetna Commercial	$2,295.96
Rate for Payer: Aetna Medicare Advantage	$1,812.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,540.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,540.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,208.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,540.71
Rate for Payer: Cigna Commercial	$3,021.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,462.16
Rate for Payer: Qualcare PPO/HMO/WC	$906.30
Rate for Payer: UnitedHealthcare Community & State	$190.93
Rate for Payer: Wellpoint Medicaid Managed Care	$171.59

PERSONA LEFT ARTICULAR SURFACE

Facility

$13,181.25

Service Code	HCPCS C1776
Hospital Charge Code	270703896
Hospital Revenue Code	278
Min. Negotiated Rate	$1,977.19
Max. Negotiated Rate	$3,189.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,636.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,189.86
Rate for Payer: Qualcare PPO/HMO/WC	$1,977.19

PERSONA LEFT ARTICULAR SURFACE

Facility

$13,181.25

Service Code	HCPCS C1776
Hospital Charge Code	270703896
Hospital Revenue Code	278
Min. Negotiated Rate	$374.35
Max. Negotiated Rate	$6,590.62
Rate for Payer: Aetna Commercial	$5,008.88
Rate for Payer: Aetna Medicare Advantage	$3,954.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,361.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,361.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,636.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,361.22
Rate for Payer: Cigna Commercial	$6,590.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,189.86
Rate for Payer: Qualcare PPO/HMO/WC	$1,977.19
Rate for Payer: UnitedHealthcare Community & State	$416.53
Rate for Payer: Wellpoint Medicaid Managed Care	$374.35

PERSONALITY DISORDERS

Facility

$3,862.05

Service Code	APR-DRG 7521
Min. Negotiated Rate	$3,786.32
Max. Negotiated Rate	$3,862.05
Rate for Payer: UnitedHealthcare Community & State	$3,786.32
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$3,862.05
Rate for Payer: Wellpoint Medicaid Managed Care	$3,786.32

PERSONALITY DISORDERS

Facility

$49,685.63

Service Code	APR-DRG 7524
Min. Negotiated Rate	$48,711.40
Max. Negotiated Rate	$49,685.63
Rate for Payer: UnitedHealthcare Community & State	$48,711.40
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$49,685.63
Rate for Payer: Wellpoint Medicaid Managed Care	$48,711.40

PERSONALITY DISORDERS

Facility

$5,475.72

Service Code	APR-DRG 7522
Min. Negotiated Rate	$5,368.35
Max. Negotiated Rate	$5,475.72
Rate for Payer: UnitedHealthcare Community & State	$5,368.35
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,475.72
Rate for Payer: Wellpoint Medicaid Managed Care	$5,368.35

PERSONALITY DISORDERS

Facility

$13,614.10

Service Code	APR-DRG 7523
Min. Negotiated Rate	$13,347.16
Max. Negotiated Rate	$13,614.10
Rate for Payer: UnitedHealthcare Community & State	$13,347.16
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,614.10
Rate for Payer: Wellpoint Medicaid Managed Care	$13,347.16

PERS ONSITE <24 HRS

Facility

$4,104.00

Service Code	HCPCS S9480
Hospital Charge Code	7500131
Hospital Revenue Code	911
Min. Negotiated Rate	$116.55
Max. Negotiated Rate	$2,052.00
Rate for Payer: Aetna Commercial	$1,559.52
Rate for Payer: Aetna Medicare Advantage	$1,231.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,046.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,046.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,046.52
Rate for Payer: Cigna Commercial	$2,052.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,067.04
Rate for Payer: Qualcare PPO/HMO/WC	$615.60
Rate for Payer: UnitedHealthcare Community & State	$129.69
Rate for Payer: Wellpoint Medicaid Managed Care	$116.55

PERS ONSITE <24 HRS

Facility

$4,104.00

Service Code	HCPCS S9480
Hospital Charge Code	7500131
Hospital Revenue Code	911
Min. Negotiated Rate	$615.60
Max. Negotiated Rate	$615.60
Rate for Payer: Qualcare PPO/HMO/WC	$615.60

PERS ONSITE <24 HRS

Facility

$4,104.00

Service Code	HCPCS S9480
Hospital Charge Code	4512631
Hospital Revenue Code	911
Min. Negotiated Rate	$116.55
Max. Negotiated Rate	$2,052.00
Rate for Payer: Aetna Commercial	$1,559.52
Rate for Payer: Aetna Medicare Advantage	$1,231.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,046.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,046.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,046.52
Rate for Payer: Cigna Commercial	$2,052.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,067.04
Rate for Payer: Qualcare PPO/HMO/WC	$615.60
Rate for Payer: UnitedHealthcare Community & State	$129.69
Rate for Payer: Wellpoint Medicaid Managed Care	$116.55

PERS ONSITE <24 HRS

Facility

$4,104.00

Service Code	HCPCS S9480
Hospital Charge Code	4512631
Hospital Revenue Code	911
Min. Negotiated Rate	$615.60
Max. Negotiated Rate	$615.60
Rate for Payer: Qualcare PPO/HMO/WC	$615.60

PERS ONSITE EA ADD HR >24

Facility

$136.15

Hospital Charge Code	7500132
Hospital Revenue Code	911
Min. Negotiated Rate	$20.42
Max. Negotiated Rate	$20.42
Rate for Payer: Qualcare PPO/HMO/WC	$20.42

PERS ONSITE EA ADD HR >24

Facility

$136.15

Hospital Charge Code	7500132
Hospital Revenue Code	911
Min. Negotiated Rate	$3.87
Max. Negotiated Rate	$68.08
Rate for Payer: Aetna Commercial	$51.74
Rate for Payer: Aetna Medicare Advantage	$40.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.72
Rate for Payer: Cigna Commercial	$68.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.40
Rate for Payer: Qualcare PPO/HMO/WC	$20.42
Rate for Payer: UnitedHealthcare Community & State	$4.30
Rate for Payer: Wellpoint Medicaid Managed Care	$3.87

PERTUZUMAB PER 10MG INJ

Facility

$510.45

Hospital Charge Code	60639600
Hospital Revenue Code	636
Min. Negotiated Rate	$14.50
Max. Negotiated Rate	$255.22
Rate for Payer: Aetna Commercial	$193.97
Rate for Payer: Aetna Medicare Advantage	$153.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.16
Rate for Payer: Cigna Commercial	$255.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.53
Rate for Payer: Qualcare PPO/HMO/WC	$76.57
Rate for Payer: UnitedHealthcare Community & State	$16.13
Rate for Payer: Wellpoint Medicaid Managed Care	$14.50

PERTUZUMAB PER 10MG INJ

Facility

$510.45

Hospital Charge Code	60639600
Hospital Revenue Code	636
Min. Negotiated Rate	$76.57
Max. Negotiated Rate	$123.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.53
Rate for Payer: Qualcare PPO/HMO/WC	$76.57

PET BRAIN IMAG METAB EVAL - PI

Facility

$40,000.00

Service Code	HCPCS 78608PI
Hospital Charge Code	80000050PI
Hospital Revenue Code	404
Min. Negotiated Rate	$6,000.00
Max. Negotiated Rate	$6,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,000.00

Know your out-of-pocket cost for care.

All Charges