Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PROSTATE NEEDLE PUNCH BX

Facility

$5,698.20

Service Code	HCPCS 55705
Hospital Charge Code	1600000829
Hospital Revenue Code	360
Min. Negotiated Rate	$854.73
Max. Negotiated Rate	$854.73
Rate for Payer: Qualcare PPO/HMO/WC	$854.73

PROSTATE NEEDLE PUNCH BX

Facility

$5,698.20

Service Code	HCPCS 57714
Hospital Charge Code	404155714
Hospital Revenue Code	361
Min. Negotiated Rate	$161.83
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,165.32
Rate for Payer: Aetna Medicare Advantage	$1,709.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,453.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,453.04
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	$1,453.04
Rate for Payer: Cigna Commercial	$2,849.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,481.53
Rate for Payer: Qualcare PPO/HMO/WC	$854.73
Rate for Payer: UnitedHealthcare Community & State	$180.06
Rate for Payer: Wellpoint Medicaid Managed Care	$161.83

PROSTATE NEEDLE PUNCH BX

Facility

$5,698.20

Service Code	HCPCS 55705
Hospital Charge Code	1600000829
Hospital Revenue Code	360
Min. Negotiated Rate	$161.83
Max. Negotiated Rate	$15,191.14
Rate for Payer: Aetna Commercial	$11,390.73
Rate for Payer: Aetna Medicare Advantage	$13,568.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,191.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,191.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,187.77
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	$15,191.14
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: Cigna Medicare Advantage	$4,187.77
Rate for Payer: Clover Medicare Advantage	$3,978.38
Rate for Payer: EmblemHealth Commercial	$12,563.31
Rate for Payer: Humana Medicare Advantage	$4,313.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,187.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,481.53
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$854.73
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$180.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,187.77
Rate for Payer: Wellcare Medicare Advantage	$4,187.77
Rate for Payer: Wellpoint Medicaid Managed Care	$161.83

PROSTATE NEEDLE PUNCH BX

Facility

$5,698.20

Service Code	HCPCS 55711
Hospital Charge Code	1600000844
Hospital Revenue Code	360
Min. Negotiated Rate	$854.73
Max. Negotiated Rate	$854.73
Rate for Payer: Qualcare PPO/HMO/WC	$854.73

PROSTATE SPECIF ANTIGEN

Facility

$390.00

Service Code	HCPCS 84153
Hospital Charge Code	3007671
Hospital Revenue Code	309
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$50.02
Rate for Payer: Aetna Medicare Advantage	$59.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.71
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$18.39
Rate for Payer: Clover Medicare Advantage	$17.47
Rate for Payer: EmblemHealth Commercial	$55.17
Rate for Payer: Humana Medicare Advantage	$18.94
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.39
Rate for Payer: Wellcare Medicare Advantage	$18.39
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

PROSTATE SPECIF ANTIGEN

Facility

$390.00

Service Code	HCPCS 84153
Hospital Charge Code	3007671
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PROSTATE-SPECIFIC ANTIGEN,TOTA

Facility

$281.00

Service Code	HCPCS 84153
Hospital Charge Code	38472572
Hospital Revenue Code	301
Min. Negotiated Rate	$7.98
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$50.02
Rate for Payer: Aetna Medicare Advantage	$59.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.71
Rate for Payer: Cigna Commercial	$140.50
Rate for Payer: Cigna Medicare Advantage	$18.39
Rate for Payer: Clover Medicare Advantage	$17.47
Rate for Payer: EmblemHealth Commercial	$55.17
Rate for Payer: Humana Medicare Advantage	$18.94
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.06
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.15
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.39
Rate for Payer: Wellcare Medicare Advantage	$18.39
Rate for Payer: Wellpoint Medicaid Managed Care	$7.98

PROSTATE-SPECIFIC ANTIGEN,TOTA

Facility

$281.00

Service Code	HCPCS 84153
Hospital Charge Code	38472572
Hospital Revenue Code	301
Min. Negotiated Rate	$42.15
Max. Negotiated Rate	$42.15
Rate for Payer: Qualcare PPO/HMO/WC	$42.15

PROSTATE SPECIFIC FREE

Facility

$390.00

Service Code	HCPCS 84154
Hospital Charge Code	3007673A
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$50.02
Rate for Payer: Aetna Medicare Advantage	$59.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.71
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$18.39
Rate for Payer: Clover Medicare Advantage	$17.47
Rate for Payer: EmblemHealth Commercial	$55.17
Rate for Payer: Humana Medicare Advantage	$18.94
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.39
Rate for Payer: Wellcare Medicare Advantage	$18.39
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

PROSTATE SPECIFIC FREE

Facility

$390.00

Service Code	HCPCS 84154
Hospital Charge Code	3007673A
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PROSTATE SPECIFIC TOTAL

Facility

$667.59

Service Code	HCPCS 84153
Hospital Charge Code	3007673B
Hospital Revenue Code	301
Min. Negotiated Rate	$14.71
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$50.02
Rate for Payer: Aetna Medicare Advantage	$59.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.71
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$18.39
Rate for Payer: Clover Medicare Advantage	$17.47
Rate for Payer: EmblemHealth Commercial	$55.17
Rate for Payer: Humana Medicare Advantage	$18.94
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.57
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.39
Rate for Payer: Wellcare Medicare Advantage	$18.39
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

PROSTATE SPECIFIC TOTAL

Facility

$667.59

Service Code	HCPCS 84153
Hospital Charge Code	3007673B
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

PROSTECTOMY SUBTOTAL

Facility

$39,911.00

Service Code	HCPCS 55821
Hospital Charge Code	1600000882
Hospital Revenue Code	360
Min. Negotiated Rate	$1,133.47
Max. Negotiated Rate	$19,955.50
Rate for Payer: Aetna Commercial	$15,166.18
Rate for Payer: Aetna Medicare Advantage	$11,973.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,177.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,177.31
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	$10,177.31
Rate for Payer: Cigna Commercial	$19,955.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,376.86
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,986.65
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$1,261.19
Rate for Payer: Wellpoint Medicaid Managed Care	$1,133.47

PROSTECTOMY SUBTOTAL

Facility

$39,911.00

Service Code	HCPCS 55821
Hospital Charge Code	1600000882
Hospital Revenue Code	360
Min. Negotiated Rate	$5,986.65
Max. Negotiated Rate	$5,986.65
Rate for Payer: Qualcare PPO/HMO/WC	$5,986.65

PROSTEP MICA DEPTH GAUGE 150MM

Facility

$660.00

Hospital Charge Code	270703496
Hospital Revenue Code	279
Min. Negotiated Rate	$99.00
Max. Negotiated Rate	$99.00
Rate for Payer: Qualcare PPO/HMO/WC	$99.00

PROSTEP MICA DEPTH GAUGE 150MM

Facility

$660.00

Hospital Charge Code	270703496
Hospital Revenue Code	279
Min. Negotiated Rate	$18.74
Max. Negotiated Rate	$330.00
Rate for Payer: Aetna Commercial	$250.80
Rate for Payer: Aetna Medicare Advantage	$198.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.30
Rate for Payer: Cigna Commercial	$330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.60
Rate for Payer: Oxford Commercial	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$99.00
Rate for Payer: UnitedHealthcare Commercial	$132.00
Rate for Payer: UnitedHealthcare Community & State	$20.86
Rate for Payer: Wellpoint Medicaid Managed Care	$18.74

PROSTEP MICA SCR 4.0X38MM STRL

Facility

$2,845.25

Service Code	HCPCS C1713
Hospital Charge Code	270702656
Hospital Revenue Code	278
Min. Negotiated Rate	$80.81
Max. Negotiated Rate	$1,422.62
Rate for Payer: Aetna Commercial	$1,081.19
Rate for Payer: Aetna Medicare Advantage	$853.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$725.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$725.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$725.54
Rate for Payer: Cigna Commercial	$1,422.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$688.55
Rate for Payer: Qualcare PPO/HMO/WC	$426.79
Rate for Payer: UnitedHealthcare Community & State	$89.91
Rate for Payer: Wellpoint Medicaid Managed Care	$80.81

PROSTEP MICA SCR 4.0X38MM STRL

Facility

$2,845.25

Service Code	HCPCS C1713
Hospital Charge Code	270702656
Hospital Revenue Code	278
Min. Negotiated Rate	$426.79
Max. Negotiated Rate	$688.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$688.55
Rate for Payer: Qualcare PPO/HMO/WC	$426.79

PROSTEP MICA SCR 4.0X40MM STRL

Facility

$2,845.25

Hospital Charge Code	270702755
Hospital Revenue Code	278
Min. Negotiated Rate	$80.81
Max. Negotiated Rate	$1,422.62
Rate for Payer: Aetna Commercial	$1,081.19
Rate for Payer: Aetna Medicare Advantage	$853.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$725.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$725.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$725.54
Rate for Payer: Cigna Commercial	$1,422.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$688.55
Rate for Payer: Qualcare PPO/HMO/WC	$426.79
Rate for Payer: UnitedHealthcare Community & State	$89.91
Rate for Payer: Wellpoint Medicaid Managed Care	$80.81

PROSTEP MICA SCR 4.0X40MM STRL

Facility

$2,845.25

Hospital Charge Code	270702755
Hospital Revenue Code	278
Min. Negotiated Rate	$426.79
Max. Negotiated Rate	$688.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$688.55
Rate for Payer: Qualcare PPO/HMO/WC	$426.79

PROSTEP MICA SCR 4.0X52MM STRL

Facility

$2,845.25

Hospital Charge Code	270702756
Hospital Revenue Code	278
Min. Negotiated Rate	$80.81
Max. Negotiated Rate	$1,422.62
Rate for Payer: Aetna Commercial	$1,081.19
Rate for Payer: Aetna Medicare Advantage	$853.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$725.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$725.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$725.54
Rate for Payer: Cigna Commercial	$1,422.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$688.55
Rate for Payer: Qualcare PPO/HMO/WC	$426.79
Rate for Payer: UnitedHealthcare Community & State	$89.91
Rate for Payer: Wellpoint Medicaid Managed Care	$80.81

PROSTEP MICA SCR 4.0X52MM STRL

Facility

$2,845.25

Hospital Charge Code	270702756
Hospital Revenue Code	278
Min. Negotiated Rate	$426.79
Max. Negotiated Rate	$688.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$688.55
Rate for Payer: Qualcare PPO/HMO/WC	$426.79

PROSTEP MICA SCREW

Facility

$2,845.25

Hospital Charge Code	270703025
Hospital Revenue Code	278
Min. Negotiated Rate	$426.79
Max. Negotiated Rate	$688.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$688.55
Rate for Payer: Qualcare PPO/HMO/WC	$426.79

PROSTEP MICA SCREW

Facility

$2,845.25

Hospital Charge Code	270703026
Hospital Revenue Code	278
Min. Negotiated Rate	$80.81
Max. Negotiated Rate	$1,422.62
Rate for Payer: Aetna Commercial	$1,081.19
Rate for Payer: Aetna Medicare Advantage	$853.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$725.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$725.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$725.54
Rate for Payer: Cigna Commercial	$1,422.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$688.55
Rate for Payer: Qualcare PPO/HMO/WC	$426.79
Rate for Payer: UnitedHealthcare Community & State	$89.91
Rate for Payer: Wellpoint Medicaid Managed Care	$80.81

PROSTEP MICA SCREW

Facility

$2,845.25

Hospital Charge Code	270703025
Hospital Revenue Code	278
Min. Negotiated Rate	$80.81
Max. Negotiated Rate	$1,422.62
Rate for Payer: Aetna Commercial	$1,081.19
Rate for Payer: Aetna Medicare Advantage	$853.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$725.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$725.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$725.54
Rate for Payer: Cigna Commercial	$1,422.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$688.55
Rate for Payer: Qualcare PPO/HMO/WC	$426.79
Rate for Payer: UnitedHealthcare Community & State	$89.91
Rate for Payer: Wellpoint Medicaid Managed Care	$80.81

Know your out-of-pocket cost for care.

All Charges