Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATELET PHERESIS IRRADIATED

Facility

$2,688.00

Hospital Charge Code	38471097
Hospital Revenue Code	390
Min. Negotiated Rate	$76.34
Max. Negotiated Rate	$1,344.00
Rate for Payer: Aetna Commercial	$1,021.44
Rate for Payer: Aetna Medicare Advantage	$806.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$685.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$685.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$685.44
Rate for Payer: Cigna Commercial	$1,344.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$698.88
Rate for Payer: Oxford Commercial	$1,028.00
Rate for Payer: Qualcare PPO/HMO/WC	$403.20
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$84.94
Rate for Payer: Wellpoint Medicaid Managed Care	$76.34

PLATELET PHERESIS LEUKOREDUCED

Facility

$5,626.57

Service Code	HCPCS P9035
Hospital Charge Code	3101513
Hospital Revenue Code	390
Min. Negotiated Rate	$843.99
Max. Negotiated Rate	$843.99
Rate for Payer: Qualcare PPO/HMO/WC	$843.99

PLATELET PHERESIS LEUKOREDUCED

Facility

$5,626.57

Service Code	HCPCS P9035
Hospital Charge Code	3101513
Hospital Revenue Code	390
Min. Negotiated Rate	$159.79
Max. Negotiated Rate	$2,158.00
Rate for Payer: Aetna Commercial	$1,618.13
Rate for Payer: Aetna Medicare Advantage	$1,927.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,158.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,158.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$594.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,158.00
Rate for Payer: Cigna Commercial	$1,192.48
Rate for Payer: Cigna Medicare Advantage	$594.90
Rate for Payer: Clover Medicare Advantage	$565.15
Rate for Payer: EmblemHealth Commercial	$1,784.70
Rate for Payer: Humana Medicare Advantage	$612.75
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$594.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,462.91
Rate for Payer: Oxford Commercial	$1,028.00
Rate for Payer: Qualcare PPO/HMO/WC	$843.99
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$177.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$594.90
Rate for Payer: Wellcare Medicare Advantage	$594.90
Rate for Payer: Wellpoint Medicaid Managed Care	$159.79

PLATELET PHER LEUK CMV NEG IRR

Facility

$3,706.00

Hospital Charge Code	38471210
Hospital Revenue Code	390
Min. Negotiated Rate	$105.25
Max. Negotiated Rate	$1,853.00
Rate for Payer: Aetna Commercial	$1,408.28
Rate for Payer: Aetna Medicare Advantage	$1,111.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$945.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$945.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$945.03
Rate for Payer: Cigna Commercial	$1,853.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$963.56
Rate for Payer: Oxford Commercial	$1,028.00
Rate for Payer: Qualcare PPO/HMO/WC	$555.90
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$117.11
Rate for Payer: Wellpoint Medicaid Managed Care	$105.25

PLATELET PHER LEUK CMV NEG IRR

Facility

$3,706.00

Hospital Charge Code	38471210
Hospital Revenue Code	390
Min. Negotiated Rate	$555.90
Max. Negotiated Rate	$555.90
Rate for Payer: Qualcare PPO/HMO/WC	$555.90

PLATELETS, IRRADIATED EA UNIT

Facility

$488.00

Hospital Charge Code	38471096
Hospital Revenue Code	384
Min. Negotiated Rate	$73.20
Max. Negotiated Rate	$73.20
Rate for Payer: Qualcare PPO/HMO/WC	$73.20

PLATELETS, IRRADIATED EA UNIT

Facility

$488.00

Hospital Charge Code	38471096
Hospital Revenue Code	384
Min. Negotiated Rate	$13.86
Max. Negotiated Rate	$1,167.00
Rate for Payer: Aetna Commercial	$185.44
Rate for Payer: Aetna Medicare Advantage	$146.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.44
Rate for Payer: Cigna Commercial	$244.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.88
Rate for Payer: Oxford Commercial	$1,028.00
Rate for Payer: Qualcare PPO/HMO/WC	$73.20
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$15.42
Rate for Payer: Wellpoint Medicaid Managed Care	$13.86

PLATELETS PHERESIS LEUKORED

Facility

$3,197.00

Hospital Charge Code	38471204
Hospital Revenue Code	390
Min. Negotiated Rate	$90.79
Max. Negotiated Rate	$1,598.50
Rate for Payer: Aetna Commercial	$1,214.86
Rate for Payer: Aetna Medicare Advantage	$959.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$815.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$815.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$815.24
Rate for Payer: Cigna Commercial	$1,598.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$831.22
Rate for Payer: Oxford Commercial	$1,028.00
Rate for Payer: Qualcare PPO/HMO/WC	$479.55
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$101.03
Rate for Payer: Wellpoint Medicaid Managed Care	$90.79

PLATELETS PHERESIS LEUKORED

Facility

$3,197.00

Hospital Charge Code	38471204
Hospital Revenue Code	390
Min. Negotiated Rate	$479.55
Max. Negotiated Rate	$479.55
Rate for Payer: Qualcare PPO/HMO/WC	$479.55

PLATELETS PHER IRRAD LEUKORED

Facility

$3,890.00

Hospital Charge Code	38471205
Hospital Revenue Code	390
Min. Negotiated Rate	$583.50
Max. Negotiated Rate	$583.50
Rate for Payer: Qualcare PPO/HMO/WC	$583.50

PLATELETS PHER IRRAD LEUKORED

Facility

$3,890.00

Hospital Charge Code	38471205
Hospital Revenue Code	390
Min. Negotiated Rate	$110.48
Max. Negotiated Rate	$1,945.00
Rate for Payer: Aetna Commercial	$1,478.20
Rate for Payer: Aetna Medicare Advantage	$1,167.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$991.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$991.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$991.95
Rate for Payer: Cigna Commercial	$1,945.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,011.40
Rate for Payer: Oxford Commercial	$1,028.00
Rate for Payer: Qualcare PPO/HMO/WC	$583.50
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$122.92
Rate for Payer: Wellpoint Medicaid Managed Care	$110.48

PLATELETS PHER LEUKO CMV NEG

Facility

$2,638.00

Hospital Charge Code	38471212
Hospital Revenue Code	390
Min. Negotiated Rate	$74.92
Max. Negotiated Rate	$1,319.00
Rate for Payer: Aetna Commercial	$1,002.44
Rate for Payer: Aetna Medicare Advantage	$791.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$672.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$672.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$672.69
Rate for Payer: Cigna Commercial	$1,319.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$685.88
Rate for Payer: Oxford Commercial	$1,028.00
Rate for Payer: Qualcare PPO/HMO/WC	$395.70
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$83.36
Rate for Payer: Wellpoint Medicaid Managed Care	$74.92

PLATELETS PHER LEUKO CMV NEG

Facility

$2,638.00

Hospital Charge Code	38471212
Hospital Revenue Code	390
Min. Negotiated Rate	$395.70
Max. Negotiated Rate	$395.70
Rate for Payer: Qualcare PPO/HMO/WC	$395.70

PLATE LEVEL 1 26 MM PYRENEES

Facility

$6,520.00

Service Code	HCPCS C1713
Hospital Charge Code	270689798
Hospital Revenue Code	278
Min. Negotiated Rate	$185.17
Max. Negotiated Rate	$3,260.00
Rate for Payer: Aetna Commercial	$2,477.60
Rate for Payer: Aetna Medicare Advantage	$1,956.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,662.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,662.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,304.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,662.60
Rate for Payer: Cigna Commercial	$3,260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,577.84
Rate for Payer: Qualcare PPO/HMO/WC	$978.00
Rate for Payer: UnitedHealthcare Community & State	$206.03
Rate for Payer: Wellpoint Medicaid Managed Care	$185.17

PLATE LEVEL 1 26 MM PYRENEES

Facility

$6,520.00

Service Code	HCPCS C1713
Hospital Charge Code	270689798
Hospital Revenue Code	278
Min. Negotiated Rate	$978.00
Max. Negotiated Rate	$1,577.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,304.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,577.84
Rate for Payer: Qualcare PPO/HMO/WC	$978.00

PLATE LEVEL 1 32MM

Facility

$6,520.00

Service Code	HCPCS C1713
Hospital Charge Code	270692337
Hospital Revenue Code	278
Min. Negotiated Rate	$185.17
Max. Negotiated Rate	$3,260.00
Rate for Payer: Aetna Commercial	$2,477.60
Rate for Payer: Aetna Medicare Advantage	$1,956.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,662.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,662.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,304.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,662.60
Rate for Payer: Cigna Commercial	$3,260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,577.84
Rate for Payer: Qualcare PPO/HMO/WC	$978.00
Rate for Payer: UnitedHealthcare Community & State	$206.03
Rate for Payer: Wellpoint Medicaid Managed Care	$185.17

PLATE LEVEL 1 32MM

Facility

$6,520.00

Service Code	HCPCS C1713
Hospital Charge Code	270692337
Hospital Revenue Code	278
Min. Negotiated Rate	$978.00
Max. Negotiated Rate	$1,577.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,304.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,577.84
Rate for Payer: Qualcare PPO/HMO/WC	$978.00

PLATE L-FUSION 2.4/2.7MM SH RT

Facility

$3,828.00

Service Code	HCPCS C1713
Hospital Charge Code	270675598
Hospital Revenue Code	278
Min. Negotiated Rate	$108.72
Max. Negotiated Rate	$1,914.00
Rate for Payer: Aetna Commercial	$1,454.64
Rate for Payer: Aetna Medicare Advantage	$1,148.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$976.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$976.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$765.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$976.14
Rate for Payer: Cigna Commercial	$1,914.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$926.38
Rate for Payer: Qualcare PPO/HMO/WC	$574.20
Rate for Payer: UnitedHealthcare Community & State	$120.96
Rate for Payer: Wellpoint Medicaid Managed Care	$108.72

PLATE L-FUSION 2.4/2.7MM SH RT

Facility

$3,828.00

Service Code	HCPCS C1713
Hospital Charge Code	270675598
Hospital Revenue Code	278
Min. Negotiated Rate	$574.20
Max. Negotiated Rate	$926.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$765.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$926.38
Rate for Payer: Qualcare PPO/HMO/WC	$574.20

PLATE LG ANTER TIBIA 2DI SYS

Facility

$5,611.50

Service Code	HCPCS C1713
Hospital Charge Code	270704105
Hospital Revenue Code	278
Min. Negotiated Rate	$159.37
Max. Negotiated Rate	$2,805.75
Rate for Payer: Aetna Commercial	$2,132.37
Rate for Payer: Aetna Medicare Advantage	$1,683.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,430.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,430.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,122.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,430.93
Rate for Payer: Cigna Commercial	$2,805.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,357.98
Rate for Payer: Qualcare PPO/HMO/WC	$841.73
Rate for Payer: UnitedHealthcare Community & State	$177.32
Rate for Payer: Wellpoint Medicaid Managed Care	$159.37

PLATE LG ANTER TIBIA 2DI SYS

Facility

$5,611.50

Service Code	HCPCS C1713
Hospital Charge Code	270704105
Hospital Revenue Code	278
Min. Negotiated Rate	$841.73
Max. Negotiated Rate	$1,357.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,122.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,357.98
Rate for Payer: Qualcare PPO/HMO/WC	$841.73

PLATE LISFRANC MEDIUM

Facility

$10,015.00

Hospital Charge Code	270669553
Hospital Revenue Code	278
Min. Negotiated Rate	$284.43
Max. Negotiated Rate	$5,007.50
Rate for Payer: Aetna Commercial	$3,805.70
Rate for Payer: Aetna Medicare Advantage	$3,004.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,553.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,553.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,003.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,553.82
Rate for Payer: Cigna Commercial	$5,007.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,423.63
Rate for Payer: Qualcare PPO/HMO/WC	$1,502.25
Rate for Payer: UnitedHealthcare Community & State	$316.47
Rate for Payer: Wellpoint Medicaid Managed Care	$284.43

PLATE LISFRANC MEDIUM

Facility

$10,015.00

Hospital Charge Code	270669553
Hospital Revenue Code	278
Min. Negotiated Rate	$1,502.25
Max. Negotiated Rate	$2,423.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,003.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,423.63
Rate for Payer: Qualcare PPO/HMO/WC	$1,502.25

PLATE LISS RIGHT 13 HOLE FEMUR

Facility

$6,804.00

Hospital Charge Code	270669725
Hospital Revenue Code	278
Min. Negotiated Rate	$193.23
Max. Negotiated Rate	$3,402.00
Rate for Payer: Aetna Commercial	$2,585.52
Rate for Payer: Aetna Medicare Advantage	$2,041.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,735.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,735.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,360.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,735.02
Rate for Payer: Cigna Commercial	$3,402.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,646.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.60
Rate for Payer: UnitedHealthcare Community & State	$215.01
Rate for Payer: Wellpoint Medicaid Managed Care	$193.23

PLATE LISS RIGHT 13 HOLE FEMUR

Facility

$6,804.00

Hospital Charge Code	270669725
Hospital Revenue Code	278
Min. Negotiated Rate	$1,020.60
Max. Negotiated Rate	$1,646.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,360.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,646.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.60

Know your out-of-pocket cost for care.

All Charges