Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PUL ART BALLOON REPR PERCUT

Facility

$35,998.44

Service Code	HCPCS 92998
Hospital Charge Code	411092998
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

PUL ART BALLOON REPR PERCUT

Facility

$35,998.44

Service Code	HCPCS 92997
Hospital Charge Code	411092997
Hospital Revenue Code	481
Min. Negotiated Rate	$1,022.36
Max. Negotiated Rate	$49,750.44
Rate for Payer: Aetna Commercial	$37,304.26
Rate for Payer: Aetna Medicare Advantage	$44,435.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,750.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,750.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,714.80
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	$49,750.44
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: Cigna Medicare Advantage	$13,714.80
Rate for Payer: Clover Medicare Advantage	$13,029.06
Rate for Payer: EmblemHealth Commercial	$41,144.40
Rate for Payer: Humana Medicare Advantage	$14,126.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,714.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,359.59
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,137.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare Medicare Advantage	$13,714.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1,022.36

PUL ART BALLOON REPR PERCUT

Facility

$35,998.44

Service Code	HCPCS 92997
Hospital Charge Code	411092997
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

PUL ART BALLOON REPR PERCUT

Facility

$35,998.44

Service Code	HCPCS 92998
Hospital Charge Code	411092998
Hospital Revenue Code	481
Min. Negotiated Rate	$1,022.36
Max. Negotiated Rate	$17,999.22
Rate for Payer: Aetna Commercial	$13,679.41
Rate for Payer: Aetna Medicare Advantage	$10,799.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,179.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,179.60
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	$9,179.60
Rate for Payer: Cigna Commercial	$17,999.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,359.59
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,137.55
Rate for Payer: Wellpoint Medicaid Managed Care	$1,022.36

PULM FUNC PRE/POST BRONCHDL

Facility

$6,100.00

Service Code	HCPCS 94060
Hospital Charge Code	9500034
Hospital Revenue Code	460
Min. Negotiated Rate	$915.00
Max. Negotiated Rate	$915.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00

PULM FUNC PRE/POST BRONCHDL

Facility

$6,100.00

Service Code	HCPCS 94060
Hospital Charge Code	9500034
Hospital Revenue Code	460
Min. Negotiated Rate	$173.24
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$1,205.83
Rate for Payer: Aetna Medicare Advantage	$1,436.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,608.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,608.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$443.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$238.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,608.14
Rate for Payer: Cigna Commercial	$888.63
Rate for Payer: Cigna Medicare Advantage	$443.32
Rate for Payer: Clover Medicare Advantage	$421.15
Rate for Payer: EmblemHealth Commercial	$1,329.96
Rate for Payer: Humana Medicare Advantage	$456.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$443.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,586.00
Rate for Payer: Oxford Commercial	$2,184.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$192.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$443.32
Rate for Payer: Wellcare Medicare Advantage	$443.32
Rate for Payer: Wellpoint Medicaid Managed Care	$173.24

PULMONARY EDEMA AND RESPIRATORY FAILURE

Facility

$58,495.29

Service Code	MSDRG 189
Min. Negotiated Rate	$17,811.07
Max. Negotiated Rate	$58,495.29
Rate for Payer: Aetna Commercial	$43,519.52
Rate for Payer: Aetna Medicare Advantage	$58,495.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34,077.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34,077.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18,748.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34,077.15
Rate for Payer: Cigna Commercial	$27,540.77
Rate for Payer: Cigna Medicare Advantage	$18,748.49
Rate for Payer: Clover Medicare Advantage	$17,811.07
Rate for Payer: EmblemHealth Commercial	$56,245.47
Rate for Payer: Humana Medicare Advantage	$19,310.94
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18,748.49
Rate for Payer: Oxford Commercial	$21,767.75
Rate for Payer: UnitedHealthcare Commercial	$29,136.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$18,748.49
Rate for Payer: Wellcare Medicare Advantage	$18,748.49

PULMONARY EMBOLISM

Facility

$7,832.19

Service Code	APR-DRG 1341
Min. Negotiated Rate	$7,678.62
Max. Negotiated Rate	$7,832.19
Rate for Payer: UnitedHealthcare Community & State	$7,678.62
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,832.19
Rate for Payer: Wellpoint Medicaid Managed Care	$7,678.62

PULMONARY EMBOLISM

Facility

$24,478.40

Service Code	APR-DRG 1344
Min. Negotiated Rate	$23,998.43
Max. Negotiated Rate	$24,478.40
Rate for Payer: UnitedHealthcare Community & State	$23,998.43
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,478.40
Rate for Payer: Wellpoint Medicaid Managed Care	$23,998.43

PULMONARY EMBOLISM

Facility

$14,802.20

Service Code	APR-DRG 1343
Min. Negotiated Rate	$14,511.96
Max. Negotiated Rate	$14,802.20
Rate for Payer: UnitedHealthcare Community & State	$14,511.96
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$14,802.20
Rate for Payer: Wellpoint Medicaid Managed Care	$14,511.96

PULMONARY EMBOLISM

Facility

$9,999.19

Service Code	APR-DRG 1342
Min. Negotiated Rate	$9,803.13
Max. Negotiated Rate	$9,999.19
Rate for Payer: UnitedHealthcare Community & State	$9,803.13
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,999.19
Rate for Payer: Wellpoint Medicaid Managed Care	$9,803.13

PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE

Facility

$62,861.57

Service Code	MSDRG 175
Min. Negotiated Rate	$19,140.54
Max. Negotiated Rate	$62,861.57
Rate for Payer: Aetna Commercial	$46,629.22
Rate for Payer: Aetna Medicare Advantage	$62,861.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38,787.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38,787.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,147.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38,787.00
Rate for Payer: Cigna Commercial	$30,621.66
Rate for Payer: Cigna Medicare Advantage	$20,147.94
Rate for Payer: Clover Medicare Advantage	$19,140.54
Rate for Payer: EmblemHealth Commercial	$60,443.82
Rate for Payer: Humana Medicare Advantage	$20,752.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20,147.94
Rate for Payer: Oxford Commercial	$24,202.83
Rate for Payer: UnitedHealthcare Commercial	$32,396.36
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,147.94
Rate for Payer: Wellcare Medicare Advantage	$20,147.94

PULMONARY EMBOLISM WITHOUT MCC

Facility

$44,897.49

Service Code	MSDRG 176
Min. Negotiated Rate	$13,670.71
Max. Negotiated Rate	$44,897.49
Rate for Payer: Aetna Commercial	$33,835.01
Rate for Payer: Aetna Medicare Advantage	$44,897.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,718.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,718.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14,390.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,718.10
Rate for Payer: Cigna Commercial	$17,945.87
Rate for Payer: Cigna Medicare Advantage	$14,390.22
Rate for Payer: Clover Medicare Advantage	$13,670.71
Rate for Payer: EmblemHealth Commercial	$43,170.66
Rate for Payer: Humana Medicare Advantage	$14,821.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14,390.22
Rate for Payer: Oxford Commercial	$14,184.10
Rate for Payer: UnitedHealthcare Commercial	$18,985.92
Rate for Payer: UnitedHealthcare Medicare Advantage	$14,390.22
Rate for Payer: Wellcare Medicare Advantage	$14,390.22

PULMONARY FUNC DIFFUSION

Facility

$6,100.00

Service Code	HCPCS 94729
Hospital Charge Code	9500042
Hospital Revenue Code	460
Min. Negotiated Rate	$915.00
Max. Negotiated Rate	$915.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00

PULMONARY FUNC DIFFUSION

Facility

$6,100.00

Service Code	HCPCS 94729
Hospital Charge Code	9500042
Hospital Revenue Code	460
Min. Negotiated Rate	$34.35
Max. Negotiated Rate	$3,050.00
Rate for Payer: Aetna Commercial	$2,318.00
Rate for Payer: Aetna Medicare Advantage	$1,830.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,555.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,555.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,555.50
Rate for Payer: Cigna Commercial	$3,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,586.00
Rate for Payer: Oxford Commercial	$2,184.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$192.76
Rate for Payer: Wellpoint Medicaid Managed Care	$173.24

PULMONARY FUNC LUNG VOLUME

Facility

$6,100.00

Service Code	HCPCS 94727
Hospital Charge Code	9500043
Hospital Revenue Code	460
Min. Negotiated Rate	$26.79
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$930.53
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,586.00
Rate for Payer: Oxford Commercial	$2,184.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$192.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$173.24

PULMONARY FUNC LUNG VOLUME

Facility

$6,100.00

Service Code	HCPCS 94727
Hospital Charge Code	9500043
Hospital Revenue Code	460
Min. Negotiated Rate	$915.00
Max. Negotiated Rate	$915.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00

PULMONARY FUNCTION SCREENING

Facility

$6,100.00

Service Code	HCPCS 94010
Hospital Charge Code	9500026
Hospital Revenue Code	460
Min. Negotiated Rate	$173.24
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$174.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$930.53
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,586.00
Rate for Payer: Oxford Commercial	$2,184.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$192.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$173.24

PULMONARY FUNCTION SCREENING

Facility

$6,100.00

Service Code	HCPCS 94010
Hospital Charge Code	9500026
Hospital Revenue Code	460
Min. Negotiated Rate	$915.00
Max. Negotiated Rate	$915.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00

PULM STRESS TEST 6 MIN WALK

Facility

$6,100.00

Service Code	HCPCS 94618
Hospital Charge Code	95090389
Hospital Revenue Code	460
Min. Negotiated Rate	$915.00
Max. Negotiated Rate	$915.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00

PULM STRESS TEST 6 MIN WALK

Facility

$6,100.00

Service Code	HCPCS 94618
Hospital Charge Code	95090389
Hospital Revenue Code	460
Min. Negotiated Rate	$17.57
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.36
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,586.00
Rate for Payer: Oxford Commercial	$2,184.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$192.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$173.24

PULM VENT IMAGING

Facility

$1,169.00

Service Code	HCPCS 78579
Hospital Charge Code	4508020
Hospital Revenue Code	341
Min. Negotiated Rate	$175.35
Max. Negotiated Rate	$175.35
Rate for Payer: Qualcare PPO/HMO/WC	$175.35

PULM VENT IMAGING

Facility

$1,169.00

Service Code	HCPCS 78579
Hospital Charge Code	4508020
Hospital Revenue Code	341
Min. Negotiated Rate	$33.20
Max. Negotiated Rate	$4,820.00
Rate for Payer: Aetna Commercial	$1,291.84
Rate for Payer: Aetna Medicare Advantage	$1,538.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,722.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,722.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$474.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,722.84
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: Cigna Medicare Advantage	$332.46
Rate for Payer: Clover Medicare Advantage	$451.19
Rate for Payer: EmblemHealth Commercial	$1,424.82
Rate for Payer: Humana Medicare Advantage	$489.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$474.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.94
Rate for Payer: Oxford Commercial	$4,820.00
Rate for Payer: Qualcare PPO/HMO/WC	$175.35
Rate for Payer: UnitedHealthcare Commercial	$4,748.00
Rate for Payer: UnitedHealthcare Community & State	$36.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$474.94
Rate for Payer: Wellcare Medicare Advantage	$474.94
Rate for Payer: Wellpoint Medicaid Managed Care	$33.20

PULSA VAC

Facility

$433.20

Hospital Charge Code	270656072
Hospital Revenue Code	271
Min. Negotiated Rate	$64.98
Max. Negotiated Rate	$64.98
Rate for Payer: Qualcare PPO/HMO/WC	$64.98

PULSA VAC

Facility

$433.20

Hospital Charge Code	270656072
Hospital Revenue Code	271
Min. Negotiated Rate	$12.30
Max. Negotiated Rate	$216.60
Rate for Payer: Aetna Commercial	$164.62
Rate for Payer: Aetna Medicare Advantage	$129.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.47
Rate for Payer: Cigna Commercial	$216.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.63
Rate for Payer: Oxford Commercial	$86.64
Rate for Payer: Qualcare PPO/HMO/WC	$64.98
Rate for Payer: UnitedHealthcare Commercial	$86.64
Rate for Payer: UnitedHealthcare Community & State	$13.69
Rate for Payer: Wellpoint Medicaid Managed Care	$12.30

Know your out-of-pocket cost for care.

All Charges