Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BALLON NCRS PTA AB14W020120150

Facility

$1,538.60

Service Code	HCPCS C1725
Hospital Charge Code	270644365C
Hospital Revenue Code	278
Min. Negotiated Rate	$230.79
Max. Negotiated Rate	$372.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$307.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.34
Rate for Payer: Qualcare PPO/HMO/WC	$230.79

BALLON NCRS PTA AB14W020150150

Facility

$1,852.20

Service Code	HCPCS C1725
Hospital Charge Code	270644445C
Hospital Revenue Code	278
Min. Negotiated Rate	$52.60
Max. Negotiated Rate	$926.10
Rate for Payer: Aetna Commercial	$703.84
Rate for Payer: Aetna Medicare Advantage	$555.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$472.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$472.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$472.31
Rate for Payer: Cigna Commercial	$926.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.23
Rate for Payer: Qualcare PPO/HMO/WC	$277.83
Rate for Payer: UnitedHealthcare Community & State	$58.53
Rate for Payer: Wellpoint Medicaid Managed Care	$52.60

BALLON NCRS PTA AB14W020150150

Facility

$1,852.20

Service Code	HCPCS C1725
Hospital Charge Code	270644445C
Hospital Revenue Code	278
Min. Negotiated Rate	$277.83
Max. Negotiated Rate	$448.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.23
Rate for Payer: Qualcare PPO/HMO/WC	$277.83

BALLON NCRS PTA AB14W020210150

Facility

$1,852.20

Service Code	HCPCS C1725
Hospital Charge Code	270644444A
Hospital Revenue Code	278
Min. Negotiated Rate	$277.83
Max. Negotiated Rate	$448.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.23
Rate for Payer: Qualcare PPO/HMO/WC	$277.83

BALLON NCRS PTA AB14W020210150

Facility

$1,852.20

Service Code	HCPCS C1725
Hospital Charge Code	270644444A
Hospital Revenue Code	278
Min. Negotiated Rate	$52.60
Max. Negotiated Rate	$926.10
Rate for Payer: Aetna Commercial	$703.84
Rate for Payer: Aetna Medicare Advantage	$555.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$472.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$472.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$472.31
Rate for Payer: Cigna Commercial	$926.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.23
Rate for Payer: Qualcare PPO/HMO/WC	$277.83
Rate for Payer: UnitedHealthcare Community & State	$58.53
Rate for Payer: Wellpoint Medicaid Managed Care	$52.60

BALLON NCRS PTA AB14W020210150

Facility

$1,852.20

Service Code	HCPCS C1725
Hospital Charge Code	270644444C
Hospital Revenue Code	278
Min. Negotiated Rate	$277.83
Max. Negotiated Rate	$448.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.23
Rate for Payer: Qualcare PPO/HMO/WC	$277.83

BALLON NCRS PTA AB14W020210150

Facility

$1,852.20

Service Code	HCPCS C1725
Hospital Charge Code	270644444C
Hospital Revenue Code	278
Min. Negotiated Rate	$52.60
Max. Negotiated Rate	$926.10
Rate for Payer: Aetna Commercial	$703.84
Rate for Payer: Aetna Medicare Advantage	$555.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$472.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$472.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$472.31
Rate for Payer: Cigna Commercial	$926.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.23
Rate for Payer: Qualcare PPO/HMO/WC	$277.83
Rate for Payer: UnitedHealthcare Community & State	$58.53
Rate for Payer: Wellpoint Medicaid Managed Care	$52.60

BALLON NCRS PTA AB14W025020150

Facility

$1,734.60

Service Code	HCPCS C1725
Hospital Charge Code	270644446C
Hospital Revenue Code	278
Min. Negotiated Rate	$260.19
Max. Negotiated Rate	$419.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$346.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$419.77
Rate for Payer: Qualcare PPO/HMO/WC	$260.19

BALLON NCRS PTA AB14W025020150

Facility

$1,734.60

Service Code	HCPCS C1725
Hospital Charge Code	270644446C
Hospital Revenue Code	278
Min. Negotiated Rate	$49.26
Max. Negotiated Rate	$867.30
Rate for Payer: Aetna Commercial	$659.15
Rate for Payer: Aetna Medicare Advantage	$520.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$442.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$442.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$346.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$442.32
Rate for Payer: Cigna Commercial	$867.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$419.77
Rate for Payer: Qualcare PPO/HMO/WC	$260.19
Rate for Payer: UnitedHealthcare Community & State	$54.81
Rate for Payer: Wellpoint Medicaid Managed Care	$49.26

BALLON NCRS PTA AB14W025020150

Facility

$1,734.60

Service Code	HCPCS C1725
Hospital Charge Code	270644446A
Hospital Revenue Code	278
Min. Negotiated Rate	$260.19
Max. Negotiated Rate	$419.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$346.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$419.77
Rate for Payer: Qualcare PPO/HMO/WC	$260.19

BALLON NCRS PTA AB14W025020150

Facility

$1,734.60

Service Code	HCPCS C1725
Hospital Charge Code	270644446A
Hospital Revenue Code	278
Min. Negotiated Rate	$49.26
Max. Negotiated Rate	$867.30
Rate for Payer: Aetna Commercial	$659.15
Rate for Payer: Aetna Medicare Advantage	$520.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$442.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$442.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$346.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$442.32
Rate for Payer: Cigna Commercial	$867.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$419.77
Rate for Payer: Qualcare PPO/HMO/WC	$260.19
Rate for Payer: UnitedHealthcare Community & State	$54.81
Rate for Payer: Wellpoint Medicaid Managed Care	$49.26

BALLON NCRS PTA AB14W025040150

Facility

$1,538.60

Service Code	HCPCS C1725
Hospital Charge Code	270643677A
Hospital Revenue Code	278
Min. Negotiated Rate	$43.70
Max. Negotiated Rate	$769.30
Rate for Payer: Aetna Commercial	$584.67
Rate for Payer: Aetna Medicare Advantage	$461.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$392.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$392.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$307.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$392.34
Rate for Payer: Cigna Commercial	$769.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.34
Rate for Payer: Qualcare PPO/HMO/WC	$230.79
Rate for Payer: UnitedHealthcare Community & State	$48.62
Rate for Payer: Wellpoint Medicaid Managed Care	$43.70

BALLON NCRS PTA AB14W025040150

Facility

$1,538.60

Service Code	HCPCS C1725
Hospital Charge Code	270643677A
Hospital Revenue Code	278
Min. Negotiated Rate	$230.79
Max. Negotiated Rate	$372.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$307.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.34
Rate for Payer: Qualcare PPO/HMO/WC	$230.79

BALLON NCRS PTA AB14W025040150

Facility

$1,538.60

Service Code	HCPCS C1725
Hospital Charge Code	270643677C
Hospital Revenue Code	278
Min. Negotiated Rate	$43.70
Max. Negotiated Rate	$769.30
Rate for Payer: Aetna Commercial	$584.67
Rate for Payer: Aetna Medicare Advantage	$461.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$392.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$392.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$307.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$392.34
Rate for Payer: Cigna Commercial	$769.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.34
Rate for Payer: Qualcare PPO/HMO/WC	$230.79
Rate for Payer: UnitedHealthcare Community & State	$48.62
Rate for Payer: Wellpoint Medicaid Managed Care	$43.70

BALLON NCRS PTA AB14W025040150

Facility

$1,538.60

Service Code	HCPCS C1725
Hospital Charge Code	270643677C
Hospital Revenue Code	278
Min. Negotiated Rate	$230.79
Max. Negotiated Rate	$372.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$307.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.34
Rate for Payer: Qualcare PPO/HMO/WC	$230.79

BALLON NCRS PTA AB14W025150150

Facility

$1,852.20

Service Code	HCPCS C1725
Hospital Charge Code	270644447C
Hospital Revenue Code	278
Min. Negotiated Rate	$277.83
Max. Negotiated Rate	$448.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.23
Rate for Payer: Qualcare PPO/HMO/WC	$277.83

BALLON NCRS PTA AB14W025150150

Facility

$1,852.20

Service Code	HCPCS C1725
Hospital Charge Code	270644447A
Hospital Revenue Code	278
Min. Negotiated Rate	$277.83
Max. Negotiated Rate	$448.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.23
Rate for Payer: Qualcare PPO/HMO/WC	$277.83

BALLON NCRS PTA AB14W025150150

Facility

$1,852.20

Service Code	HCPCS C1725
Hospital Charge Code	270644447A
Hospital Revenue Code	278
Min. Negotiated Rate	$52.60
Max. Negotiated Rate	$926.10
Rate for Payer: Aetna Commercial	$703.84
Rate for Payer: Aetna Medicare Advantage	$555.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$472.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$472.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$472.31
Rate for Payer: Cigna Commercial	$926.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.23
Rate for Payer: Qualcare PPO/HMO/WC	$277.83
Rate for Payer: UnitedHealthcare Community & State	$58.53
Rate for Payer: Wellpoint Medicaid Managed Care	$52.60

BALLON NCRS PTA AB14W025150150

Facility

$1,852.20

Service Code	HCPCS C1725
Hospital Charge Code	270644447C
Hospital Revenue Code	278
Min. Negotiated Rate	$52.60
Max. Negotiated Rate	$926.10
Rate for Payer: Aetna Commercial	$703.84
Rate for Payer: Aetna Medicare Advantage	$555.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$472.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$472.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$472.31
Rate for Payer: Cigna Commercial	$926.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.23
Rate for Payer: Qualcare PPO/HMO/WC	$277.83
Rate for Payer: UnitedHealthcare Community & State	$58.53
Rate for Payer: Wellpoint Medicaid Managed Care	$52.60

BALLON NCRS PTA AB14W025210150

Facility

$1,852.20

Service Code	HCPCS C1725
Hospital Charge Code	270644366C
Hospital Revenue Code	278
Min. Negotiated Rate	$277.83
Max. Negotiated Rate	$448.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.23
Rate for Payer: Qualcare PPO/HMO/WC	$277.83

BALLON NCRS PTA AB14W025210150

Facility

$1,852.20

Service Code	HCPCS C1725
Hospital Charge Code	270644366A
Hospital Revenue Code	278
Min. Negotiated Rate	$277.83
Max. Negotiated Rate	$448.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.23
Rate for Payer: Qualcare PPO/HMO/WC	$277.83

BALLON NCRS PTA AB14W025210150

Facility

$1,852.20

Service Code	HCPCS C1725
Hospital Charge Code	270644366A
Hospital Revenue Code	278
Min. Negotiated Rate	$52.60
Max. Negotiated Rate	$926.10
Rate for Payer: Aetna Commercial	$703.84
Rate for Payer: Aetna Medicare Advantage	$555.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$472.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$472.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$472.31
Rate for Payer: Cigna Commercial	$926.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.23
Rate for Payer: Qualcare PPO/HMO/WC	$277.83
Rate for Payer: UnitedHealthcare Community & State	$58.53
Rate for Payer: Wellpoint Medicaid Managed Care	$52.60

BALLON NCRS PTA AB14W025210150

Facility

$1,852.20

Service Code	HCPCS C1725
Hospital Charge Code	270644366C
Hospital Revenue Code	278
Min. Negotiated Rate	$52.60
Max. Negotiated Rate	$926.10
Rate for Payer: Aetna Commercial	$703.84
Rate for Payer: Aetna Medicare Advantage	$555.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$472.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$472.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$472.31
Rate for Payer: Cigna Commercial	$926.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.23
Rate for Payer: Qualcare PPO/HMO/WC	$277.83
Rate for Payer: UnitedHealthcare Community & State	$58.53
Rate for Payer: Wellpoint Medicaid Managed Care	$52.60

BALLON NCRS PTA AB14W030020150

Facility

$1,538.60

Service Code	HCPCS C1725
Hospital Charge Code	270644410C
Hospital Revenue Code	278
Min. Negotiated Rate	$43.70
Max. Negotiated Rate	$769.30
Rate for Payer: Aetna Commercial	$584.67
Rate for Payer: Aetna Medicare Advantage	$461.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$392.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$392.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$307.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$392.34
Rate for Payer: Cigna Commercial	$769.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.34
Rate for Payer: Qualcare PPO/HMO/WC	$230.79
Rate for Payer: UnitedHealthcare Community & State	$48.62
Rate for Payer: Wellpoint Medicaid Managed Care	$43.70

BALLON NCRS PTA AB14W030020150

Facility

$1,538.60

Service Code	HCPCS C1725
Hospital Charge Code	270644410C
Hospital Revenue Code	278
Min. Negotiated Rate	$230.79
Max. Negotiated Rate	$372.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$307.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.34
Rate for Payer: Qualcare PPO/HMO/WC	$230.79

Know your out-of-pocket cost for care.

All Charges