Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PULSAVAC WOUND DEBRIDEMENT SYS

Facility

$90.00

Hospital Charge Code	270638990
Hospital Revenue Code	272
Min. Negotiated Rate	$2.56
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$34.20
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.40
Rate for Payer: Oxford Commercial	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$18.00
Rate for Payer: UnitedHealthcare Community & State	$2.84
Rate for Payer: Wellpoint Medicaid Managed Care	$2.56

PULSAVAC WOUND DEBRIDEMENT SYS

Facility

$90.00

Hospital Charge Code	270638990
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

PULSE GENERATOR KIT SPECTRA

Facility

$102,500.00

Service Code	HCPCS C1767
Hospital Charge Code	270696217
Hospital Revenue Code	278
Min. Negotiated Rate	$15,375.00
Max. Negotiated Rate	$24,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24,805.00
Rate for Payer: Qualcare PPO/HMO/WC	$15,375.00

PULSE GENERATOR KIT SPECTRA

Facility

$102,500.00

Service Code	HCPCS C1767
Hospital Charge Code	270696217
Hospital Revenue Code	278
Min. Negotiated Rate	$2,911.00
Max. Negotiated Rate	$51,250.00
Rate for Payer: Aetna Commercial	$38,950.00
Rate for Payer: Aetna Medicare Advantage	$30,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26,137.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26,137.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26,137.50
Rate for Payer: Cigna Commercial	$51,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24,805.00
Rate for Payer: Qualcare PPO/HMO/WC	$15,375.00
Rate for Payer: UnitedHealthcare Community & State	$3,239.00
Rate for Payer: Wellpoint Medicaid Managed Care	$2,911.00

PULSE OXIMETRY NON INV CONT MO

Facility

$393.00

Service Code	HCPCS 94762
Hospital Charge Code	9500614
Hospital Revenue Code	460
Min. Negotiated Rate	$11.16
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$415.81
Rate for Payer: Aetna Medicare Advantage	$495.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$554.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$554.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$152.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$554.54
Rate for Payer: Cigna Commercial	$306.43
Rate for Payer: Cigna Medicare Advantage	$152.87
Rate for Payer: Clover Medicare Advantage	$145.23
Rate for Payer: EmblemHealth Commercial	$458.61
Rate for Payer: Humana Medicare Advantage	$157.46
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$152.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.18
Rate for Payer: Oxford Commercial	$2,184.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.95
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$12.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$152.87
Rate for Payer: Wellcare Medicare Advantage	$152.87
Rate for Payer: Wellpoint Medicaid Managed Care	$11.16

PULSE OXIMETRY NON INV CONT MO

Facility

$393.00

Service Code	HCPCS 94762
Hospital Charge Code	9500614
Hospital Revenue Code	460
Min. Negotiated Rate	$58.95
Max. Negotiated Rate	$58.95
Rate for Payer: Qualcare PPO/HMO/WC	$58.95

PULSE OXIMETRY SINGLE

Facility

$503.00

Hospital Charge Code	83091022
Hospital Revenue Code	460
Min. Negotiated Rate	$75.45
Max. Negotiated Rate	$75.45
Rate for Payer: Qualcare PPO/HMO/WC	$75.45

PULSE OXIMETRY SINGLE

Facility

$503.00

Hospital Charge Code	83091022
Hospital Revenue Code	460
Min. Negotiated Rate	$14.29
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$191.14
Rate for Payer: Aetna Medicare Advantage	$150.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.26
Rate for Payer: Cigna Commercial	$251.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.78
Rate for Payer: Oxford Commercial	$2,184.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.45
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$15.89
Rate for Payer: Wellpoint Medicaid Managed Care	$14.29

PULSE OXIMETRY SINGLE

Facility

$503.00

Hospital Charge Code	83092032
Hospital Revenue Code	460
Min. Negotiated Rate	$14.29
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$191.14
Rate for Payer: Aetna Medicare Advantage	$150.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.26
Rate for Payer: Cigna Commercial	$251.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.78
Rate for Payer: Oxford Commercial	$2,184.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.45
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$15.89
Rate for Payer: Wellpoint Medicaid Managed Care	$14.29

PULSE OXIMETRY SINGLE

Facility

$503.00

Hospital Charge Code	83092032
Hospital Revenue Code	460
Min. Negotiated Rate	$75.45
Max. Negotiated Rate	$75.45
Rate for Payer: Qualcare PPO/HMO/WC	$75.45

PULSE OXIMETRY SPOT CHECK

Facility

$10,110.97

Service Code	HCPCS 94760
Hospital Charge Code	9500612
Hospital Revenue Code	460
Min. Negotiated Rate	$1,516.65
Max. Negotiated Rate	$1,516.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,516.65

PULSE OXIMETRY SPOT CHECK

Facility

$10,110.97

Service Code	HCPCS 94760
Hospital Charge Code	9500612
Hospital Revenue Code	460
Min. Negotiated Rate	$55.00
Max. Negotiated Rate	$5,055.48
Rate for Payer: Aetna Commercial	$3,842.17
Rate for Payer: Aetna Medicare Advantage	$3,033.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,578.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,578.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,578.30
Rate for Payer: Cigna Commercial	$5,055.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,628.85
Rate for Payer: Oxford Commercial	$2,184.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,516.65
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$319.51
Rate for Payer: Wellpoint Medicaid Managed Care	$287.15

PULSE OX MULTI DETERMINATION

Facility

$10,222.71

Service Code	HCPCS 94761
Hospital Charge Code	9500615
Hospital Revenue Code	460
Min. Negotiated Rate	$30.80
Max. Negotiated Rate	$5,111.35
Rate for Payer: Aetna Commercial	$3,884.63
Rate for Payer: Aetna Medicare Advantage	$3,066.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,606.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,606.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,606.79
Rate for Payer: Cigna Commercial	$5,111.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,657.90
Rate for Payer: Oxford Commercial	$2,184.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,533.41
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$323.04
Rate for Payer: Wellpoint Medicaid Managed Care	$290.32

PULSE OX MULTI DETERMINATION

Facility

$10,222.71

Service Code	HCPCS 94761
Hospital Charge Code	9500615
Hospital Revenue Code	460
Min. Negotiated Rate	$1,533.41
Max. Negotiated Rate	$1,533.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,533.41

PULSE SPRAY INFUSION SYS 5FR 4

Facility

$2,260.00

Hospital Charge Code	270665488
Hospital Revenue Code	270
Min. Negotiated Rate	$339.00
Max. Negotiated Rate	$339.00
Rate for Payer: Qualcare PPO/HMO/WC	$339.00

PULSE SPRAY INFUSION SYS 5FR 4

Facility

$2,260.00

Hospital Charge Code	270665488
Hospital Revenue Code	270
Min. Negotiated Rate	$64.18
Max. Negotiated Rate	$1,130.00
Rate for Payer: Aetna Commercial	$858.80
Rate for Payer: Aetna Medicare Advantage	$678.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$576.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$576.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$576.30
Rate for Payer: Cigna Commercial	$1,130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$587.60
Rate for Payer: Oxford Commercial	$452.00
Rate for Payer: Qualcare PPO/HMO/WC	$339.00
Rate for Payer: UnitedHealthcare Commercial	$452.00
Rate for Payer: UnitedHealthcare Community & State	$71.42
Rate for Payer: Wellpoint Medicaid Managed Care	$64.18

PULSE SPRAY INFUSION SYS 5FR 9

Facility

$2,260.00

Hospital Charge Code	270663789
Hospital Revenue Code	270
Min. Negotiated Rate	$339.00
Max. Negotiated Rate	$339.00
Rate for Payer: Qualcare PPO/HMO/WC	$339.00

PULSE SPRAY INFUSION SYS 5FR 9

Facility

$2,260.00

Hospital Charge Code	270663789
Hospital Revenue Code	270
Min. Negotiated Rate	$64.18
Max. Negotiated Rate	$1,130.00
Rate for Payer: Aetna Commercial	$858.80
Rate for Payer: Aetna Medicare Advantage	$678.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$576.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$576.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$576.30
Rate for Payer: Cigna Commercial	$1,130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$587.60
Rate for Payer: Oxford Commercial	$452.00
Rate for Payer: Qualcare PPO/HMO/WC	$339.00
Rate for Payer: UnitedHealthcare Commercial	$452.00
Rate for Payer: UnitedHealthcare Community & State	$71.42
Rate for Payer: Wellpoint Medicaid Managed Care	$64.18

PUMP FLO STEADY ARTHROSCOPY

Facility

$313.95

Hospital Charge Code	270654828
Hospital Revenue Code	272
Min. Negotiated Rate	$8.92
Max. Negotiated Rate	$156.97
Rate for Payer: Aetna Commercial	$119.30
Rate for Payer: Aetna Medicare Advantage	$94.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.06
Rate for Payer: Cigna Commercial	$156.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.63
Rate for Payer: Oxford Commercial	$62.79
Rate for Payer: Qualcare PPO/HMO/WC	$47.09
Rate for Payer: UnitedHealthcare Commercial	$62.79
Rate for Payer: UnitedHealthcare Community & State	$9.92
Rate for Payer: Wellpoint Medicaid Managed Care	$8.92

PUMP FLO STEADY ARTHROSCOPY

Facility

$313.95

Hospital Charge Code	270654828
Hospital Revenue Code	272
Min. Negotiated Rate	$47.09
Max. Negotiated Rate	$47.09
Rate for Payer: Qualcare PPO/HMO/WC	$47.09

PUMP GX 18 CM

Facility

$50,465.00

Service Code	HCPCS C1813
Hospital Charge Code	270684782
Hospital Revenue Code	278
Min. Negotiated Rate	$1,433.21
Max. Negotiated Rate	$25,232.50
Rate for Payer: Aetna Commercial	$19,176.70
Rate for Payer: Aetna Medicare Advantage	$15,139.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,868.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,868.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,093.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,868.58
Rate for Payer: Cigna Commercial	$25,232.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,212.53
Rate for Payer: Qualcare PPO/HMO/WC	$7,569.75
Rate for Payer: UnitedHealthcare Community & State	$1,594.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1,433.21

PUMP GX 18 CM

Facility

$50,465.00

Service Code	HCPCS C1813
Hospital Charge Code	270684782
Hospital Revenue Code	278
Min. Negotiated Rate	$7,569.75
Max. Negotiated Rate	$12,212.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,093.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,212.53
Rate for Payer: Qualcare PPO/HMO/WC	$7,569.75

PUMPING SYS SINGLE ACTION

Facility

$368.11

Hospital Charge Code	270601211
Hospital Revenue Code	272
Min. Negotiated Rate	$10.45
Max. Negotiated Rate	$184.06
Rate for Payer: Aetna Commercial	$139.88
Rate for Payer: Aetna Medicare Advantage	$110.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.87
Rate for Payer: Cigna Commercial	$184.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.71
Rate for Payer: Oxford Commercial	$73.62
Rate for Payer: Qualcare PPO/HMO/WC	$55.22
Rate for Payer: UnitedHealthcare Commercial	$73.62
Rate for Payer: UnitedHealthcare Community & State	$11.63
Rate for Payer: Wellpoint Medicaid Managed Care	$10.45

PUMPING SYS SINGLE ACTION

Facility

$368.11

Hospital Charge Code	270601211
Hospital Revenue Code	272
Min. Negotiated Rate	$55.22
Max. Negotiated Rate	$55.22
Rate for Payer: Qualcare PPO/HMO/WC	$55.22

PUMP INTRATHECAL AP03000H

Facility

$69,750.00

Service Code	HCPCS C1772
Hospital Charge Code	270699219
Hospital Revenue Code	278
Min. Negotiated Rate	$1,980.90
Max. Negotiated Rate	$34,875.00
Rate for Payer: Aetna Commercial	$26,505.00
Rate for Payer: Aetna Medicare Advantage	$20,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17,786.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17,786.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17,786.25
Rate for Payer: Cigna Commercial	$34,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,879.50
Rate for Payer: Qualcare PPO/HMO/WC	$10,462.50
Rate for Payer: UnitedHealthcare Community & State	$2,204.10
Rate for Payer: Wellpoint Medicaid Managed Care	$1,980.90

Know your out-of-pocket cost for care.

All Charges