Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

RADIAL HEAD POLYMER 24MM

Facility

$12,045.00

Service Code	HCPCS C1776
Hospital Charge Code	270695661
Hospital Revenue Code	278
Min. Negotiated Rate	$1,806.75
Max. Negotiated Rate	$2,914.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,409.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,914.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,806.75

RADIAL HEAD PROSTHESIS

Facility

$20,750.00

Hospital Charge Code	270663135
Hospital Revenue Code	278
Min. Negotiated Rate	$3,112.50
Max. Negotiated Rate	$5,021.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,021.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,112.50

RADIAL HEAD PROSTHESIS

Facility

$20,750.00

Hospital Charge Code	270663135
Hospital Revenue Code	278
Min. Negotiated Rate	$589.30
Max. Negotiated Rate	$10,375.00
Rate for Payer: Aetna Commercial	$7,885.00
Rate for Payer: Aetna Medicare Advantage	$6,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,291.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,291.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,291.25
Rate for Payer: Cigna Commercial	$10,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,021.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,112.50
Rate for Payer: UnitedHealthcare Community & State	$655.70
Rate for Payer: Wellpoint Medicaid Managed Care	$589.30

RADIAL JAW 160CM FORCEP

Facility

$46.25

Hospital Charge Code	270653857
Hospital Revenue Code	272
Min. Negotiated Rate	$6.94
Max. Negotiated Rate	$6.94
Rate for Payer: Qualcare PPO/HMO/WC	$6.94

RADIAL JAW 160CM FORCEP

Facility

$46.25

Hospital Charge Code	270653857
Hospital Revenue Code	272
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$23.12
Rate for Payer: Aetna Commercial	$17.57
Rate for Payer: Aetna Medicare Advantage	$13.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.79
Rate for Payer: Cigna Commercial	$23.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.03
Rate for Payer: Oxford Commercial	$9.25
Rate for Payer: Qualcare PPO/HMO/WC	$6.94
Rate for Payer: UnitedHealthcare Commercial	$9.25
Rate for Payer: UnitedHealthcare Community & State	$1.46
Rate for Payer: Wellpoint Medicaid Managed Care	$1.31

RADIAL JAW HOT BIOPSY

Facility

$140.00

Hospital Charge Code	270654280
Hospital Revenue Code	270
Min. Negotiated Rate	$3.98
Max. Negotiated Rate	$70.00
Rate for Payer: Aetna Commercial	$53.20
Rate for Payer: Aetna Medicare Advantage	$42.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.70
Rate for Payer: Cigna Commercial	$70.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.40
Rate for Payer: Oxford Commercial	$28.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.00
Rate for Payer: UnitedHealthcare Commercial	$28.00
Rate for Payer: UnitedHealthcare Community & State	$4.42
Rate for Payer: Wellpoint Medicaid Managed Care	$3.98

RADIAL JAW HOT BIOPSY

Facility

$140.00

Hospital Charge Code	270654280
Hospital Revenue Code	270
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$21.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.00

RADIAL STYLOID PLT SID RAD 5H

Facility

$4,605.00

Hospital Charge Code	270702937
Hospital Revenue Code	278
Min. Negotiated Rate	$690.75
Max. Negotiated Rate	$1,114.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$921.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,114.41
Rate for Payer: Qualcare PPO/HMO/WC	$690.75

RADIAL STYLOID PLT SID RAD 5H

Facility

$4,605.00

Hospital Charge Code	270702937
Hospital Revenue Code	278
Min. Negotiated Rate	$130.78
Max. Negotiated Rate	$2,302.50
Rate for Payer: Aetna Commercial	$1,749.90
Rate for Payer: Aetna Medicare Advantage	$1,381.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,174.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,174.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$921.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,174.28
Rate for Payer: Cigna Commercial	$2,302.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,114.41
Rate for Payer: Qualcare PPO/HMO/WC	$690.75
Rate for Payer: UnitedHealthcare Community & State	$145.52
Rate for Payer: Wellpoint Medicaid Managed Care	$130.78

RADIALUCENT DILATOR ABBOT SPN

Facility

$295.00

Hospital Charge Code	270339026
Hospital Revenue Code	272
Min. Negotiated Rate	$8.38
Max. Negotiated Rate	$147.50
Rate for Payer: Aetna Commercial	$112.10
Rate for Payer: Aetna Medicare Advantage	$88.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.22
Rate for Payer: Cigna Commercial	$147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.70
Rate for Payer: Oxford Commercial	$59.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.25
Rate for Payer: UnitedHealthcare Commercial	$59.00
Rate for Payer: UnitedHealthcare Community & State	$9.32
Rate for Payer: Wellpoint Medicaid Managed Care	$8.38

RADIALUCENT DILATOR ABBOT SPN

Facility

$295.00

Hospital Charge Code	270339026
Hospital Revenue Code	272
Min. Negotiated Rate	$44.25
Max. Negotiated Rate	$44.25
Rate for Payer: Qualcare PPO/HMO/WC	$44.25

RADIATION PHYSICS CONSULT

Facility

$620.00

Service Code	HCPCS 77336
Hospital Charge Code	85000640
Hospital Revenue Code	333
Min. Negotiated Rate	$93.00
Max. Negotiated Rate	$93.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.00

RADIATION PHYSICS CONSULT

Facility

$620.00

Service Code	HCPCS 77336
Hospital Charge Code	85000640
Hospital Revenue Code	333
Min. Negotiated Rate	$17.61
Max. Negotiated Rate	$6,851.00
Rate for Payer: Aetna Commercial	$434.33
Rate for Payer: Aetna Medicare Advantage	$517.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$579.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$579.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$159.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$579.24
Rate for Payer: Cigna Commercial	$320.09
Rate for Payer: Cigna Medicare Advantage	$111.78
Rate for Payer: Clover Medicare Advantage	$151.70
Rate for Payer: EmblemHealth Commercial	$479.04
Rate for Payer: Humana Medicare Advantage	$164.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$159.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.20
Rate for Payer: Oxford Commercial	$6,034.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.00
Rate for Payer: UnitedHealthcare Commercial	$6,851.00
Rate for Payer: UnitedHealthcare Community & State	$19.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$159.68
Rate for Payer: Wellcare Medicare Advantage	$159.68
Rate for Payer: Wellpoint Medicaid Managed Care	$17.61

RADIATION TX AID/S-GL

Facility

$1,663.00

Service Code	HCPCS 77334
Hospital Charge Code	85000625
Hospital Revenue Code	333
Min. Negotiated Rate	$249.45
Max. Negotiated Rate	$249.45
Rate for Payer: Qualcare PPO/HMO/WC	$249.45

RADIATION TX AID/S-GL

Facility

$1,186.00

Service Code	HCPCS 77333
Hospital Charge Code	85000610
Hospital Revenue Code	333
Min. Negotiated Rate	$33.68
Max. Negotiated Rate	$6,851.00
Rate for Payer: Aetna Commercial	$434.33
Rate for Payer: Aetna Medicare Advantage	$517.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$579.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$579.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$159.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$579.24
Rate for Payer: Cigna Commercial	$320.09
Rate for Payer: Cigna Medicare Advantage	$111.78
Rate for Payer: Clover Medicare Advantage	$151.70
Rate for Payer: EmblemHealth Commercial	$479.04
Rate for Payer: Humana Medicare Advantage	$164.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$159.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.36
Rate for Payer: Oxford Commercial	$6,034.00
Rate for Payer: Qualcare PPO/HMO/WC	$177.90
Rate for Payer: UnitedHealthcare Commercial	$6,851.00
Rate for Payer: UnitedHealthcare Community & State	$37.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$159.68
Rate for Payer: Wellcare Medicare Advantage	$159.68
Rate for Payer: Wellpoint Medicaid Managed Care	$33.68

RADIATION TX AID/S-GL

Facility

$1,663.00

Service Code	HCPCS 77334
Hospital Charge Code	85000625
Hospital Revenue Code	333
Min. Negotiated Rate	$47.23
Max. Negotiated Rate	$6,851.00
Rate for Payer: Aetna Commercial	$1,209.94
Rate for Payer: Aetna Medicare Advantage	$1,441.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,613.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,613.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$444.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,613.62
Rate for Payer: Cigna Commercial	$891.65
Rate for Payer: Cigna Medicare Advantage	$311.38
Rate for Payer: Clover Medicare Advantage	$422.59
Rate for Payer: EmblemHealth Commercial	$1,334.49
Rate for Payer: Humana Medicare Advantage	$458.17
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$444.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$432.38
Rate for Payer: Oxford Commercial	$6,034.00
Rate for Payer: Qualcare PPO/HMO/WC	$249.45
Rate for Payer: UnitedHealthcare Commercial	$6,851.00
Rate for Payer: UnitedHealthcare Community & State	$52.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$444.83
Rate for Payer: Wellcare Medicare Advantage	$444.83
Rate for Payer: Wellpoint Medicaid Managed Care	$47.23

RADIATION TX AID/S-GL

Facility

$1,186.00

Service Code	HCPCS 77332
Hospital Charge Code	85000595
Hospital Revenue Code	333
Min. Negotiated Rate	$177.90
Max. Negotiated Rate	$177.90
Rate for Payer: Qualcare PPO/HMO/WC	$177.90

RADIATION TX AID/S-GL

Facility

$1,186.00

Service Code	HCPCS 77333
Hospital Charge Code	85000610
Hospital Revenue Code	333
Min. Negotiated Rate	$177.90
Max. Negotiated Rate	$177.90
Rate for Payer: Qualcare PPO/HMO/WC	$177.90

RADIATION TX AID/S-GL

Facility

$1,186.00

Service Code	HCPCS 77332
Hospital Charge Code	85000595
Hospital Revenue Code	333
Min. Negotiated Rate	$33.68
Max. Negotiated Rate	$6,851.00
Rate for Payer: Aetna Commercial	$434.33
Rate for Payer: Aetna Medicare Advantage	$517.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$579.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$579.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$159.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$579.24
Rate for Payer: Cigna Commercial	$320.09
Rate for Payer: Cigna Medicare Advantage	$111.78
Rate for Payer: Clover Medicare Advantage	$151.70
Rate for Payer: EmblemHealth Commercial	$479.04
Rate for Payer: Humana Medicare Advantage	$164.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$159.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.36
Rate for Payer: Oxford Commercial	$6,034.00
Rate for Payer: Qualcare PPO/HMO/WC	$177.90
Rate for Payer: UnitedHealthcare Commercial	$6,851.00
Rate for Payer: UnitedHealthcare Community & State	$37.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$159.68
Rate for Payer: Wellcare Medicare Advantage	$159.68
Rate for Payer: Wellpoint Medicaid Managed Care	$33.68

RADIATION TX COMPLEX

Facility

$887.30

Service Code	HCPCS 77263
Hospital Charge Code	85000372
Hospital Revenue Code	333
Min. Negotiated Rate	$25.20
Max. Negotiated Rate	$6,851.00
Rate for Payer: Aetna Commercial	$337.17
Rate for Payer: Aetna Medicare Advantage	$266.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$226.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$226.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$226.26
Rate for Payer: Cigna Commercial	$443.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.70
Rate for Payer: Oxford Commercial	$6,034.00
Rate for Payer: Qualcare PPO/HMO/WC	$133.09
Rate for Payer: UnitedHealthcare Commercial	$6,851.00
Rate for Payer: UnitedHealthcare Community & State	$28.04
Rate for Payer: Wellpoint Medicaid Managed Care	$25.20

RADIATION TX COMPLEX

Facility

$887.30

Service Code	HCPCS 77263
Hospital Charge Code	85000372
Hospital Revenue Code	333
Min. Negotiated Rate	$133.09
Max. Negotiated Rate	$133.09
Rate for Payer: Qualcare PPO/HMO/WC	$133.09

RADIATION TX DELIVERY

Facility

$922.00

Service Code	HCPCS 77407
Hospital Charge Code	85000710
Hospital Revenue Code	333
Min. Negotiated Rate	$26.18
Max. Negotiated Rate	$6,851.00
Rate for Payer: Aetna Commercial	$1,246.36
Rate for Payer: Aetna Medicare Advantage	$1,484.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,662.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,662.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$458.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,662.19
Rate for Payer: Cigna Commercial	$918.50
Rate for Payer: Cigna Medicare Advantage	$320.75
Rate for Payer: Clover Medicare Advantage	$435.31
Rate for Payer: EmblemHealth Commercial	$1,374.66
Rate for Payer: Humana Medicare Advantage	$471.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$458.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$239.72
Rate for Payer: Oxford Commercial	$6,034.00
Rate for Payer: Qualcare PPO/HMO/WC	$138.30
Rate for Payer: UnitedHealthcare Commercial	$6,851.00
Rate for Payer: UnitedHealthcare Community & State	$29.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$458.22
Rate for Payer: Wellcare Medicare Advantage	$458.22
Rate for Payer: Wellpoint Medicaid Managed Care	$26.18

RADIATION TX DELIVERY

Facility

$712.00

Service Code	HCPCS 77402
Hospital Charge Code	85000695
Hospital Revenue Code	333
Min. Negotiated Rate	$106.80
Max. Negotiated Rate	$106.80
Rate for Payer: Qualcare PPO/HMO/WC	$106.80

RADIATION TX DELIVERY

Facility

$712.00

Service Code	HCPCS 77402
Hospital Charge Code	85000695
Hospital Revenue Code	333
Min. Negotiated Rate	$20.22
Max. Negotiated Rate	$6,851.00
Rate for Payer: Aetna Commercial	$329.69
Rate for Payer: Aetna Medicare Advantage	$392.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$121.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.69
Rate for Payer: Cigna Commercial	$242.98
Rate for Payer: Cigna Medicare Advantage	$84.85
Rate for Payer: Clover Medicare Advantage	$115.15
Rate for Payer: EmblemHealth Commercial	$363.63
Rate for Payer: Humana Medicare Advantage	$124.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$121.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.12
Rate for Payer: Oxford Commercial	$6,034.00
Rate for Payer: Qualcare PPO/HMO/WC	$106.80
Rate for Payer: UnitedHealthcare Commercial	$6,851.00
Rate for Payer: UnitedHealthcare Community & State	$22.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$121.21
Rate for Payer: Wellcare Medicare Advantage	$121.21
Rate for Payer: Wellpoint Medicaid Managed Care	$20.22

RADIATION TX DELIVERY

Facility

$1,161.00

Service Code	HCPCS 77412
Hospital Charge Code	85000735
Hospital Revenue Code	333
Min. Negotiated Rate	$174.15
Max. Negotiated Rate	$174.15
Rate for Payer: Qualcare PPO/HMO/WC	$174.15

Know your out-of-pocket cost for care.

All Charges