Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

RECORDER LOOP

Facility

$21,500.00

Service Code	HCPCS C1764
Hospital Charge Code	270696573S
Hospital Revenue Code	278
Min. Negotiated Rate	$610.60
Max. Negotiated Rate	$10,750.00
Rate for Payer: Aetna Commercial	$8,170.00
Rate for Payer: Aetna Medicare Advantage	$6,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,482.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,482.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,482.50
Rate for Payer: Cigna Commercial	$10,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,203.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,225.00
Rate for Payer: UnitedHealthcare Community & State	$679.40
Rate for Payer: Wellpoint Medicaid Managed Care	$610.60

RECORDER LOOP

Facility

$21,500.00

Service Code	HCPCS C1764
Hospital Charge Code	270696573S
Hospital Revenue Code	278
Min. Negotiated Rate	$3,225.00
Max. Negotiated Rate	$5,203.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,203.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,225.00

RECORDER LOOP DM5300 ASSERT

Facility

$19,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270704451
Hospital Revenue Code	278
Min. Negotiated Rate	$553.80
Max. Negotiated Rate	$9,750.00
Rate for Payer: Aetna Commercial	$7,410.00
Rate for Payer: Aetna Medicare Advantage	$5,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,972.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,972.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,972.50
Rate for Payer: Cigna Commercial	$9,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,719.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,925.00
Rate for Payer: UnitedHealthcare Community & State	$616.20
Rate for Payer: Wellpoint Medicaid Managed Care	$553.80

RECORDER LOOP DM5300 ASSERT

Facility

$19,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270704451
Hospital Revenue Code	278
Min. Negotiated Rate	$2,925.00
Max. Negotiated Rate	$4,719.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,719.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,925.00

RECORDER LP REVEAL MEDT 9526

Facility

$19,024.00

Service Code	HCPCS C1764
Hospital Charge Code	270625754
Hospital Revenue Code	278
Min. Negotiated Rate	$540.28
Max. Negotiated Rate	$9,512.00
Rate for Payer: Aetna Commercial	$7,229.12
Rate for Payer: Aetna Medicare Advantage	$5,707.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,851.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,851.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,804.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,851.12
Rate for Payer: Cigna Commercial	$9,512.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,603.81
Rate for Payer: Qualcare PPO/HMO/WC	$2,853.60
Rate for Payer: UnitedHealthcare Community & State	$601.16
Rate for Payer: Wellpoint Medicaid Managed Care	$540.28

RECORDER LP REVEAL MEDT 9526

Facility

$19,024.00

Service Code	HCPCS C1764
Hospital Charge Code	270625754
Hospital Revenue Code	278
Min. Negotiated Rate	$2,853.60
Max. Negotiated Rate	$4,603.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,804.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,603.81
Rate for Payer: Qualcare PPO/HMO/WC	$2,853.60

RECORDER REVEAL LNQ LOOP

Facility

$24,975.00

Service Code	HCPCS C1764
Hospital Charge Code	270669999
Hospital Revenue Code	278
Min. Negotiated Rate	$709.29
Max. Negotiated Rate	$12,487.50
Rate for Payer: Aetna Commercial	$9,490.50
Rate for Payer: Aetna Medicare Advantage	$7,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,368.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,368.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,368.62
Rate for Payer: Cigna Commercial	$12,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,043.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,746.25
Rate for Payer: UnitedHealthcare Community & State	$789.21
Rate for Payer: Wellpoint Medicaid Managed Care	$709.29

RECORDER REVEAL LNQ LOOP

Facility

$24,975.00

Service Code	HCPCS C1764
Hospital Charge Code	270669999
Hospital Revenue Code	278
Min. Negotiated Rate	$3,746.25
Max. Negotiated Rate	$6,043.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,043.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,746.25

RECORDER REVEAL LNQ LOOP

Facility

$24,975.00

Service Code	HCPCS C1764
Hospital Charge Code	270669999S
Hospital Revenue Code	278
Min. Negotiated Rate	$709.29
Max. Negotiated Rate	$12,487.50
Rate for Payer: Aetna Commercial	$9,490.50
Rate for Payer: Aetna Medicare Advantage	$7,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,368.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,368.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,368.62
Rate for Payer: Cigna Commercial	$12,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,043.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,746.25
Rate for Payer: UnitedHealthcare Community & State	$789.21
Rate for Payer: Wellpoint Medicaid Managed Care	$709.29

RECORDER REVEAL LNQ LOOP

Facility

$26,475.00

Service Code	HCPCS C1764
Hospital Charge Code	270669999N
Hospital Revenue Code	278
Min. Negotiated Rate	$751.89
Max. Negotiated Rate	$13,237.50
Rate for Payer: Aetna Commercial	$10,060.50
Rate for Payer: Aetna Medicare Advantage	$7,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,751.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,751.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,751.12
Rate for Payer: Cigna Commercial	$13,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,406.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,971.25
Rate for Payer: UnitedHealthcare Community & State	$836.61
Rate for Payer: Wellpoint Medicaid Managed Care	$751.89

RECORDER REVEAL LNQ LOOP

Facility

$24,975.00

Service Code	HCPCS C1764
Hospital Charge Code	270669999S
Hospital Revenue Code	278
Min. Negotiated Rate	$3,746.25
Max. Negotiated Rate	$6,043.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,043.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,746.25

RECORDER REVEAL LNQ LOOP

Facility

$26,475.00

Service Code	HCPCS C1764
Hospital Charge Code	270669999N
Hospital Revenue Code	278
Min. Negotiated Rate	$3,971.25
Max. Negotiated Rate	$6,406.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,406.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,971.25

RECORDER REVEAL LOOP XL 9529

Facility

$21,500.00

Service Code	HCPCS C1764
Hospital Charge Code	270662230
Hospital Revenue Code	278
Min. Negotiated Rate	$3,225.00
Max. Negotiated Rate	$5,203.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,203.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,225.00

RECORDER REVEAL LOOP XL 9529

Facility

$21,500.00

Service Code	HCPCS C1764
Hospital Charge Code	270662230
Hospital Revenue Code	278
Min. Negotiated Rate	$610.60
Max. Negotiated Rate	$10,750.00
Rate for Payer: Aetna Commercial	$8,170.00
Rate for Payer: Aetna Medicare Advantage	$6,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,482.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,482.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,482.50
Rate for Payer: Cigna Commercial	$10,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,203.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,225.00
Rate for Payer: UnitedHealthcare Community & State	$679.40
Rate for Payer: Wellpoint Medicaid Managed Care	$610.60

RECORDER REVEAL LOOP XL 9529

Facility

$24,975.00

Service Code	HCPCS C1764
Hospital Charge Code	270662230N
Hospital Revenue Code	278
Min. Negotiated Rate	$709.29
Max. Negotiated Rate	$12,487.50
Rate for Payer: Aetna Commercial	$9,490.50
Rate for Payer: Aetna Medicare Advantage	$7,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,368.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,368.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,368.62
Rate for Payer: Cigna Commercial	$12,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,043.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,746.25
Rate for Payer: UnitedHealthcare Community & State	$789.21
Rate for Payer: Wellpoint Medicaid Managed Care	$709.29

RECORDER REVEAL LOOP XL 9529

Facility

$24,975.00

Service Code	HCPCS C1764
Hospital Charge Code	270662230N
Hospital Revenue Code	278
Min. Negotiated Rate	$3,746.25
Max. Negotiated Rate	$6,043.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,043.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,746.25

RECOV EA ADD 30 MIN (NON-PACU)

Facility

$400.00

Hospital Charge Code	1001189
Hospital Revenue Code	710
Min. Negotiated Rate	$11.36
Max. Negotiated Rate	$200.00
Rate for Payer: Aetna Commercial	$152.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.00
Rate for Payer: Oxford Commercial	$80.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Commercial	$80.00
Rate for Payer: UnitedHealthcare Community & State	$12.64
Rate for Payer: Wellpoint Medicaid Managed Care	$11.36

RECOV EA ADD 30 MIN (NON-PACU)

Facility

$400.00

Hospital Charge Code	1001189
Hospital Revenue Code	710
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

RECOV EA ADD 30 MIN (NON-PACU)

Facility

$400.00

Hospital Charge Code	41101005
Hospital Revenue Code	710
Min. Negotiated Rate	$11.36
Max. Negotiated Rate	$200.00
Rate for Payer: Aetna Commercial	$152.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.00
Rate for Payer: Oxford Commercial	$80.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Commercial	$80.00
Rate for Payer: UnitedHealthcare Community & State	$12.64
Rate for Payer: Wellpoint Medicaid Managed Care	$11.36

RECOV EA ADD 30 MIN (NON-PACU)

Facility

$400.00

Hospital Charge Code	41101005
Hospital Revenue Code	710
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

RECOVERY ADDITIONAL 1/2 HOUR

Facility

$551.50

Hospital Charge Code	93500176
Hospital Revenue Code	710
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$275.75
Rate for Payer: Aetna Commercial	$209.57
Rate for Payer: Aetna Medicare Advantage	$165.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.63
Rate for Payer: Cigna Commercial	$275.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.39
Rate for Payer: Oxford Commercial	$110.30
Rate for Payer: Qualcare PPO/HMO/WC	$82.72
Rate for Payer: UnitedHealthcare Commercial	$110.30
Rate for Payer: UnitedHealthcare Community & State	$17.43
Rate for Payer: Wellpoint Medicaid Managed Care	$15.66

RECOVERY ADDITIONAL 1/2 HOUR

Facility

$551.50

Hospital Charge Code	93500176
Hospital Revenue Code	710
Min. Negotiated Rate	$82.72
Max. Negotiated Rate	$82.72
Rate for Payer: Qualcare PPO/HMO/WC	$82.72

RECOVERY ADDITIONAL 1 HR

Facility

$1,103.00

Hospital Charge Code	93500174
Hospital Revenue Code	710
Min. Negotiated Rate	$31.33
Max. Negotiated Rate	$551.50
Rate for Payer: Aetna Commercial	$419.14
Rate for Payer: Aetna Medicare Advantage	$330.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$281.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$281.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$281.26
Rate for Payer: Cigna Commercial	$551.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$286.78
Rate for Payer: Oxford Commercial	$220.60
Rate for Payer: Qualcare PPO/HMO/WC	$165.45
Rate for Payer: UnitedHealthcare Commercial	$220.60
Rate for Payer: UnitedHealthcare Community & State	$34.85
Rate for Payer: Wellpoint Medicaid Managed Care	$31.33

RECOVERY ADDITIONAL 1 HR

Facility

$1,103.00

Hospital Charge Code	93500174
Hospital Revenue Code	710
Min. Negotiated Rate	$165.45
Max. Negotiated Rate	$165.45
Rate for Payer: Qualcare PPO/HMO/WC	$165.45

RECOVERY EXTEND/HR AFTER 3

Facility

$664.00

Hospital Charge Code	73190156
Hospital Revenue Code	710
Min. Negotiated Rate	$18.86
Max. Negotiated Rate	$332.00
Rate for Payer: Aetna Commercial	$252.32
Rate for Payer: Aetna Medicare Advantage	$199.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.32
Rate for Payer: Cigna Commercial	$332.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.64
Rate for Payer: Oxford Commercial	$132.80
Rate for Payer: Qualcare PPO/HMO/WC	$99.60
Rate for Payer: UnitedHealthcare Commercial	$132.80
Rate for Payer: UnitedHealthcare Community & State	$20.98
Rate for Payer: Wellpoint Medicaid Managed Care	$18.86

Know your out-of-pocket cost for care.

All Charges