Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PRTL REM FT BONE,MTRSL HD1-5EA

Facility

$9,331.45

Service Code	HCPCS 28288
Hospital Charge Code	16000327
Hospital Revenue Code	360
Min. Negotiated Rate	$265.01
Max. Negotiated Rate	$14,100.89
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
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	$14,100.89
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,426.18
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,399.72
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$294.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$265.01

PRTL REM FT BONE,MTRSL HD1-5EA

Facility

$9,331.45

Service Code	HCPCS 28288
Hospital Charge Code	16000327
Hospital Revenue Code	360
Min. Negotiated Rate	$1,399.72
Max. Negotiated Rate	$1,399.72
Rate for Payer: Qualcare PPO/HMO/WC	$1,399.72

PRX HUM LO PLT 2H 73MM

Facility

$6,957.50

Service Code	HCPCS C1776
Hospital Charge Code	270680682
Hospital Revenue Code	278
Min. Negotiated Rate	$197.59
Max. Negotiated Rate	$3,478.75
Rate for Payer: Aetna Commercial	$2,643.85
Rate for Payer: Aetna Medicare Advantage	$2,087.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,774.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,774.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,391.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,774.16
Rate for Payer: Cigna Commercial	$3,478.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,683.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,043.62
Rate for Payer: UnitedHealthcare Community & State	$219.86
Rate for Payer: Wellpoint Medicaid Managed Care	$197.59

PRX HUM LO PLT 2H 73MM

Facility

$6,957.50

Service Code	HCPCS C1776
Hospital Charge Code	270680682
Hospital Revenue Code	278
Min. Negotiated Rate	$1,043.62
Max. Negotiated Rate	$1,683.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,391.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,683.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,043.62

PRX HUM LO PLT LT 11H 190MM

Facility

$8,580.00

Service Code	HCPCS C1713
Hospital Charge Code	270680847
Hospital Revenue Code	278
Min. Negotiated Rate	$243.67
Max. Negotiated Rate	$4,290.00
Rate for Payer: Aetna Commercial	$3,260.40
Rate for Payer: Aetna Medicare Advantage	$2,574.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,187.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,187.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,716.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,187.90
Rate for Payer: Cigna Commercial	$4,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,076.36
Rate for Payer: Qualcare PPO/HMO/WC	$1,287.00
Rate for Payer: UnitedHealthcare Community & State	$271.13
Rate for Payer: Wellpoint Medicaid Managed Care	$243.67

PRX HUM LO PLT LT 11H 190MM

Facility

$8,580.00

Service Code	HCPCS C1713
Hospital Charge Code	270680847
Hospital Revenue Code	278
Min. Negotiated Rate	$1,287.00
Max. Negotiated Rate	$2,076.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,716.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,076.36
Rate for Payer: Qualcare PPO/HMO/WC	$1,287.00

PRXMALHUMERLNAILT2LONGRT240MM

Facility

$13,990.00

Service Code	HCPCS C1713
Hospital Charge Code	270663838
Hospital Revenue Code	278
Min. Negotiated Rate	$2,098.50
Max. Negotiated Rate	$3,385.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,798.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,385.58
Rate for Payer: Qualcare PPO/HMO/WC	$2,098.50

PRXMALHUMERLNAILT2LONGRT240MM

Facility

$13,990.00

Service Code	HCPCS C1713
Hospital Charge Code	270663838
Hospital Revenue Code	278
Min. Negotiated Rate	$397.32
Max. Negotiated Rate	$6,995.00
Rate for Payer: Aetna Commercial	$5,316.20
Rate for Payer: Aetna Medicare Advantage	$4,197.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,567.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,567.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,798.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,567.45
Rate for Payer: Cigna Commercial	$6,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,385.58
Rate for Payer: Qualcare PPO/HMO/WC	$2,098.50
Rate for Payer: UnitedHealthcare Community & State	$442.08
Rate for Payer: Wellpoint Medicaid Managed Care	$397.32

PR Z1 ST/OSS LH CP/XL AA DM LN

Facility

$32,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704914
Hospital Revenue Code	278
Min. Negotiated Rate	$923.00
Max. Negotiated Rate	$16,250.00
Rate for Payer: Aetna Commercial	$12,350.00
Rate for Payer: Aetna Medicare Advantage	$9,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,287.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,287.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,287.50
Rate for Payer: Cigna Commercial	$16,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,865.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,875.00
Rate for Payer: UnitedHealthcare Community & State	$1,027.00
Rate for Payer: Wellpoint Medicaid Managed Care	$923.00

PR Z1 ST/OSS LH CP/XL AA DM LN

Facility

$32,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704914
Hospital Revenue Code	278
Min. Negotiated Rate	$4,875.00
Max. Negotiated Rate	$7,865.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,865.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,875.00

PSA DISPOSABLE CABLE

Facility

$303.75

Hospital Charge Code	270666011
Hospital Revenue Code	272
Min. Negotiated Rate	$45.56
Max. Negotiated Rate	$45.56
Rate for Payer: Qualcare PPO/HMO/WC	$45.56

PSA DISPOSABLE CABLE

Facility

$303.75

Hospital Charge Code	270666011
Hospital Revenue Code	272
Min. Negotiated Rate	$8.63
Max. Negotiated Rate	$151.88
Rate for Payer: Aetna Commercial	$115.42
Rate for Payer: Aetna Medicare Advantage	$91.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.46
Rate for Payer: Cigna Commercial	$151.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.97
Rate for Payer: Oxford Commercial	$60.75
Rate for Payer: Qualcare PPO/HMO/WC	$45.56
Rate for Payer: UnitedHealthcare Commercial	$60.75
Rate for Payer: UnitedHealthcare Community & State	$9.60
Rate for Payer: Wellpoint Medicaid Managed Care	$8.63

PSA Disposible Cable

Facility

$303.75

Hospital Charge Code	270666011S
Hospital Revenue Code	272
Min. Negotiated Rate	$45.56
Max. Negotiated Rate	$45.56
Rate for Payer: Qualcare PPO/HMO/WC	$45.56

PSA Disposible Cable

Facility

$303.75

Hospital Charge Code	270666011N
Hospital Revenue Code	272
Min. Negotiated Rate	$45.56
Max. Negotiated Rate	$45.56
Rate for Payer: Qualcare PPO/HMO/WC	$45.56

PSA Disposible Cable

Facility

$303.75

Hospital Charge Code	270666011S
Hospital Revenue Code	272
Min. Negotiated Rate	$8.63
Max. Negotiated Rate	$151.88
Rate for Payer: Aetna Commercial	$115.42
Rate for Payer: Aetna Medicare Advantage	$91.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.46
Rate for Payer: Cigna Commercial	$151.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.97
Rate for Payer: Oxford Commercial	$60.75
Rate for Payer: Qualcare PPO/HMO/WC	$45.56
Rate for Payer: UnitedHealthcare Commercial	$60.75
Rate for Payer: UnitedHealthcare Community & State	$9.60
Rate for Payer: Wellpoint Medicaid Managed Care	$8.63

PSA Disposible Cable

Facility

$303.75

Hospital Charge Code	270666011N
Hospital Revenue Code	272
Min. Negotiated Rate	$8.63
Max. Negotiated Rate	$151.88
Rate for Payer: Aetna Commercial	$115.42
Rate for Payer: Aetna Medicare Advantage	$91.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.46
Rate for Payer: Cigna Commercial	$151.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.97
Rate for Payer: Oxford Commercial	$60.75
Rate for Payer: Qualcare PPO/HMO/WC	$45.56
Rate for Payer: UnitedHealthcare Commercial	$60.75
Rate for Payer: UnitedHealthcare Community & State	$9.60
Rate for Payer: Wellpoint Medicaid Managed Care	$8.63

PSA FREE

Facility

$281.00

Service Code	HCPCS 84154
Hospital Charge Code	38472582
Hospital Revenue Code	301
Min. Negotiated Rate	$42.15
Max. Negotiated Rate	$42.15
Rate for Payer: Qualcare PPO/HMO/WC	$42.15

PSA FREE

Facility

$281.00

Service Code	HCPCS 84154
Hospital Charge Code	38472582
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	$17.19
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

PSA FREE AND TOTAL I

Facility

$390.00

Service Code	HCPCS 84153
Hospital Charge Code	39990074A
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PSA FREE AND TOTAL I

Facility

$390.00

Service Code	HCPCS 84153
Hospital Charge Code	39990074A
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	$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

PSA FREE AND TOTAL II

Facility

$390.00

Service Code	HCPCS 84154
Hospital Charge Code	39990074B
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PSA FREE AND TOTAL II

Facility

$390.00

Service Code	HCPCS 84154
Hospital Charge Code	39990074B
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

PSA POST PROSTATECTOMY W HAMA

Facility

$390.00

Service Code	HCPCS 84153
Hospital Charge Code	366884153
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	$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

PSA POST PROSTATECTOMY W HAMA

Facility

$390.00

Service Code	HCPCS 84153
Hospital Charge Code	366884153
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PSA POST PROSTATECTOMY W HAMA

Facility

$390.00

Service Code	HCPCS 84153
Hospital Charge Code	39708029
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	$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

Know your out-of-pocket cost for care.

All Charges