Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PROXIMATE LINEAR STAPLER 30MM

Facility

$548.00

Hospital Charge Code	270334720
Hospital Revenue Code	272
Min. Negotiated Rate	$82.20
Max. Negotiated Rate	$82.20
Rate for Payer: Qualcare PPO/HMO/WC	$82.20

PROXIMATE LINEAR STAPLER 30MM

Facility

$548.00

Hospital Charge Code	270334720
Hospital Revenue Code	272
Min. Negotiated Rate	$15.56
Max. Negotiated Rate	$274.00
Rate for Payer: Aetna Commercial	$208.24
Rate for Payer: Aetna Medicare Advantage	$164.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$139.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$139.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$139.74
Rate for Payer: Cigna Commercial	$274.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.48
Rate for Payer: Oxford Commercial	$109.60
Rate for Payer: Qualcare PPO/HMO/WC	$82.20
Rate for Payer: UnitedHealthcare Commercial	$109.60
Rate for Payer: UnitedHealthcare Community & State	$17.32
Rate for Payer: Wellpoint Medicaid Managed Care	$15.56

PROXMALHUMERALPLATETS3HOLELEFT

Facility

$10,240.00

Service Code	HCPCS C1713
Hospital Charge Code	270663874
Hospital Revenue Code	278
Min. Negotiated Rate	$1,536.00
Max. Negotiated Rate	$2,478.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,048.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,478.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,536.00

PROXMALHUMERALPLATETS3HOLELEFT

Facility

$10,240.00

Service Code	HCPCS C1713
Hospital Charge Code	270663874
Hospital Revenue Code	278
Min. Negotiated Rate	$290.82
Max. Negotiated Rate	$5,120.00
Rate for Payer: Aetna Commercial	$3,891.20
Rate for Payer: Aetna Medicare Advantage	$3,072.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,611.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,611.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,048.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,611.20
Rate for Payer: Cigna Commercial	$5,120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,478.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,536.00
Rate for Payer: UnitedHealthcare Community & State	$323.58
Rate for Payer: Wellpoint Medicaid Managed Care	$290.82

PROX TIB LOCK PLATE LT 3H STD

Facility

$5,112.00

Service Code	HCPCS C1713
Hospital Charge Code	270683103
Hospital Revenue Code	278
Min. Negotiated Rate	$145.18
Max. Negotiated Rate	$2,556.00
Rate for Payer: Aetna Commercial	$1,942.56
Rate for Payer: Aetna Medicare Advantage	$1,533.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,303.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,303.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,022.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,303.56
Rate for Payer: Cigna Commercial	$2,556.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,237.10
Rate for Payer: Qualcare PPO/HMO/WC	$766.80
Rate for Payer: UnitedHealthcare Community & State	$161.54
Rate for Payer: Wellpoint Medicaid Managed Care	$145.18

PROX TIB LOCK PLATE LT 3H STD

Facility

$5,112.00

Service Code	HCPCS C1713
Hospital Charge Code	270683103
Hospital Revenue Code	278
Min. Negotiated Rate	$766.80
Max. Negotiated Rate	$1,237.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,022.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,237.10
Rate for Payer: Qualcare PPO/HMO/WC	$766.80

PRP I/HERN INIT BLOCK 5+YR BL

Facility

$54,380.28

Service Code	HCPCS 49507
Hospital Charge Code	160000247
Hospital Revenue Code	360
Min. Negotiated Rate	$1,544.40
Max. Negotiated Rate	$15,429.97
Rate for Payer: Aetna Commercial	$11,569.82
Rate for Payer: Aetna Medicare Advantage	$13,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,429.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,429.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,253.61
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	$15,429.97
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: Cigna Medicare Advantage	$4,253.61
Rate for Payer: Clover Medicare Advantage	$4,040.93
Rate for Payer: EmblemHealth Commercial	$12,760.83
Rate for Payer: Humana Medicare Advantage	$4,381.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,253.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,138.87
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,157.04
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$1,718.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,253.61
Rate for Payer: Wellcare Medicare Advantage	$4,253.61
Rate for Payer: Wellpoint Medicaid Managed Care	$1,544.40

PRP I/HERN INIT BLOCK 5+YR BL

Facility

$54,380.28

Service Code	HCPCS 49507
Hospital Charge Code	160000247
Hospital Revenue Code	360
Min. Negotiated Rate	$8,157.04
Max. Negotiated Rate	$8,157.04
Rate for Payer: Qualcare PPO/HMO/WC	$8,157.04

PRPI/HERN INIT REDUC >5YR

Facility

$30,877.00

Service Code	HCPCS 49505
Hospital Charge Code	16000753
Hospital Revenue Code	360
Min. Negotiated Rate	$876.91
Max. Negotiated Rate	$15,429.97
Rate for Payer: Aetna Commercial	$11,569.82
Rate for Payer: Aetna Medicare Advantage	$13,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,429.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,429.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,253.61
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	$15,429.97
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: Cigna Medicare Advantage	$4,253.61
Rate for Payer: Clover Medicare Advantage	$4,040.93
Rate for Payer: EmblemHealth Commercial	$12,760.83
Rate for Payer: Humana Medicare Advantage	$4,381.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,253.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,028.02
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,631.55
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$975.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,253.61
Rate for Payer: Wellcare Medicare Advantage	$4,253.61
Rate for Payer: Wellpoint Medicaid Managed Care	$876.91

PRPI/HERN INIT REDUC >5YR

Facility

$30,877.00

Service Code	HCPCS 49505
Hospital Charge Code	16000753
Hospital Revenue Code	360
Min. Negotiated Rate	$4,631.55
Max. Negotiated Rate	$4,631.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,631.55

PRP PREP BIOLOGICAL

Facility

$6,975.00

Hospital Charge Code	270691769
Hospital Revenue Code	272
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$1,046.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

PRP PREP BIOLOGICAL

Facility

$6,975.00

Hospital Charge Code	270691769
Hospital Revenue Code	272
Min. Negotiated Rate	$198.09
Max. Negotiated Rate	$3,487.50
Rate for Payer: Aetna Commercial	$2,650.50
Rate for Payer: Aetna Medicare Advantage	$2,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,778.62
Rate for Payer: Cigna Commercial	$3,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,813.50
Rate for Payer: Oxford Commercial	$1,395.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25
Rate for Payer: UnitedHealthcare Commercial	$1,395.00
Rate for Payer: UnitedHealthcare Community & State	$220.41
Rate for Payer: Wellpoint Medicaid Managed Care	$198.09

PR PRM ST/0S CP/VE AA DM LN/C

Facility

$35,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270703908
Hospital Revenue Code	278
Min. Negotiated Rate	$994.00
Max. Negotiated Rate	$17,500.00
Rate for Payer: Aetna Commercial	$13,300.00
Rate for Payer: Aetna Medicare Advantage	$10,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,925.00
Rate for Payer: Cigna Commercial	$17,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,470.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,250.00
Rate for Payer: UnitedHealthcare Community & State	$1,106.00
Rate for Payer: Wellpoint Medicaid Managed Care	$994.00

PR PRM ST/0S CP/VE AA DM LN/C

Facility

$35,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270703908
Hospital Revenue Code	278
Min. Negotiated Rate	$5,250.00
Max. Negotiated Rate	$8,470.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,470.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,250.00

PR PRM ST/OSS LH CP/XL AA

Facility

$30,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270704093
Hospital Revenue Code	278
Min. Negotiated Rate	$852.00
Max. Negotiated Rate	$15,000.00
Rate for Payer: Aetna Commercial	$11,400.00
Rate for Payer: Aetna Medicare Advantage	$9,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,650.00
Rate for Payer: Cigna Commercial	$15,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,260.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,500.00
Rate for Payer: UnitedHealthcare Community & State	$948.00
Rate for Payer: Wellpoint Medicaid Managed Care	$852.00

PR PRM ST/OSS LH CP/XL AA

Facility

$30,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270704093
Hospital Revenue Code	278
Min. Negotiated Rate	$4,500.00
Max. Negotiated Rate	$7,260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,260.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,500.00

PRQ CARDIAC ANGIO ADDL ART

Facility

$23,700.99

Service Code	HCPCS 92920
Hospital Charge Code	5100787
Hospital Revenue Code	481
Min. Negotiated Rate	$3,555.15
Max. Negotiated Rate	$3,555.15
Rate for Payer: Qualcare PPO/HMO/WC	$3,555.15

PRQ CARDIAC ANGIO ADDL ART

Facility

$23,700.99

Service Code	HCPCS 92920
Hospital Charge Code	5100787
Hospital Revenue Code	481
Min. Negotiated Rate	$673.11
Max. Negotiated Rate	$24,528.18
Rate for Payer: Aetna Commercial	$18,391.91
Rate for Payer: Aetna Medicare Advantage	$21,908.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24,528.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24,528.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,761.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24,528.18
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: Cigna Medicare Advantage	$6,761.73
Rate for Payer: Clover Medicare Advantage	$6,423.64
Rate for Payer: EmblemHealth Commercial	$20,285.19
Rate for Payer: Humana Medicare Advantage	$6,964.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,761.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,162.26
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,555.15
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$748.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,761.73
Rate for Payer: Wellcare Medicare Advantage	$6,761.73
Rate for Payer: Wellpoint Medicaid Managed Care	$673.11

PRQ CARDIAC ANGIOPLAT 1 ART

Facility

$23,700.99

Service Code	HCPCS 92920
Hospital Charge Code	366892920
Hospital Revenue Code	481
Min. Negotiated Rate	$3,555.15
Max. Negotiated Rate	$3,555.15
Rate for Payer: Qualcare PPO/HMO/WC	$3,555.15

PRQ CARDIAC ANGIOPLAT 1 ART

Facility

$23,700.99

Service Code	HCPCS 92920
Hospital Charge Code	366892920
Hospital Revenue Code	481
Min. Negotiated Rate	$673.11
Max. Negotiated Rate	$24,528.18
Rate for Payer: Aetna Commercial	$18,391.91
Rate for Payer: Aetna Medicare Advantage	$21,908.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24,528.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24,528.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,761.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24,528.18
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: Cigna Medicare Advantage	$6,761.73
Rate for Payer: Clover Medicare Advantage	$6,423.64
Rate for Payer: EmblemHealth Commercial	$20,285.19
Rate for Payer: Humana Medicare Advantage	$6,964.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,761.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,162.26
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,555.15
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$748.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,761.73
Rate for Payer: Wellcare Medicare Advantage	$6,761.73
Rate for Payer: Wellpoint Medicaid Managed Care	$673.11

PRQ CARDIAC ANGIOPLAT 1 ART

Facility

$23,700.99

Service Code	HCPCS 92920
Hospital Charge Code	5100786
Hospital Revenue Code	481
Min. Negotiated Rate	$3,555.15
Max. Negotiated Rate	$3,555.15
Rate for Payer: Qualcare PPO/HMO/WC	$3,555.15

PRQ CARDIAC ANGIOPLAT 1 ART

Facility

$23,700.99

Service Code	HCPCS 92920
Hospital Charge Code	74110079
Hospital Revenue Code	481
Min. Negotiated Rate	$673.11
Max. Negotiated Rate	$24,528.18
Rate for Payer: Aetna Commercial	$18,391.91
Rate for Payer: Aetna Medicare Advantage	$21,908.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24,528.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24,528.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,761.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24,528.18
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: Cigna Medicare Advantage	$6,761.73
Rate for Payer: Clover Medicare Advantage	$6,423.64
Rate for Payer: EmblemHealth Commercial	$20,285.19
Rate for Payer: Humana Medicare Advantage	$6,964.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,761.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,162.26
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,555.15
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$748.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,761.73
Rate for Payer: Wellcare Medicare Advantage	$6,761.73
Rate for Payer: Wellpoint Medicaid Managed Care	$673.11

PRQ CARDIAC ANGIOPLAT 1 ART

Facility

$23,700.99

Service Code	HCPCS 92920
Hospital Charge Code	5100786
Hospital Revenue Code	481
Min. Negotiated Rate	$673.11
Max. Negotiated Rate	$24,528.18
Rate for Payer: Aetna Commercial	$18,391.91
Rate for Payer: Aetna Medicare Advantage	$21,908.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24,528.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24,528.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,761.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24,528.18
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: Cigna Medicare Advantage	$6,761.73
Rate for Payer: Clover Medicare Advantage	$6,423.64
Rate for Payer: EmblemHealth Commercial	$20,285.19
Rate for Payer: Humana Medicare Advantage	$6,964.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,761.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,162.26
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,555.15
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$748.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,761.73
Rate for Payer: Wellcare Medicare Advantage	$6,761.73
Rate for Payer: Wellpoint Medicaid Managed Care	$673.11

PRQ CARDIAC ANGIOPLAT 1 ART

Facility

$23,700.99

Service Code	HCPCS 92920
Hospital Charge Code	74110079
Hospital Revenue Code	481
Min. Negotiated Rate	$3,555.15
Max. Negotiated Rate	$3,555.15
Rate for Payer: Qualcare PPO/HMO/WC	$3,555.15

PRQ CARDI STENT W/ANGIO ADDL

Facility

$35,998.44

Service Code	HCPCS 92928
Hospital Charge Code	5100791
Hospital Revenue Code	481
Min. Negotiated Rate	$5,399.77
Max. Negotiated Rate	$5,399.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77

Know your out-of-pocket cost for care.

All Charges