Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

REDUCTION EXT RELINE

Facility

$3,300.00

Service Code	HCPCS C1713
Hospital Charge Code	270691363
Hospital Revenue Code	278
Min. Negotiated Rate	$93.72
Max. Negotiated Rate	$1,650.00
Rate for Payer: Aetna Commercial	$1,254.00
Rate for Payer: Aetna Medicare Advantage	$990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$841.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$841.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$841.50
Rate for Payer: Cigna Commercial	$1,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$798.60
Rate for Payer: Qualcare PPO/HMO/WC	$495.00
Rate for Payer: UnitedHealthcare Community & State	$104.28
Rate for Payer: Wellpoint Medicaid Managed Care	$93.72

REDUCTION FORCEP

Facility

$2,916.95

Hospital Charge Code	270655155
Hospital Revenue Code	272
Min. Negotiated Rate	$437.54
Max. Negotiated Rate	$437.54
Rate for Payer: Qualcare PPO/HMO/WC	$437.54

REDUCTION FORCEP

Facility

$2,685.20

Hospital Charge Code	270655150
Hospital Revenue Code	272
Min. Negotiated Rate	$76.26
Max. Negotiated Rate	$1,342.60
Rate for Payer: Aetna Commercial	$1,020.38
Rate for Payer: Aetna Medicare Advantage	$805.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$684.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$684.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$684.73
Rate for Payer: Cigna Commercial	$1,342.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$698.15
Rate for Payer: Oxford Commercial	$537.04
Rate for Payer: Qualcare PPO/HMO/WC	$402.78
Rate for Payer: UnitedHealthcare Commercial	$537.04
Rate for Payer: UnitedHealthcare Community & State	$84.85
Rate for Payer: Wellpoint Medicaid Managed Care	$76.26

REDUCTION FORCEP

Facility

$2,685.20

Hospital Charge Code	270655150
Hospital Revenue Code	272
Min. Negotiated Rate	$402.78
Max. Negotiated Rate	$402.78
Rate for Payer: Qualcare PPO/HMO/WC	$402.78

REDUCTION FORCEP

Facility

$2,916.95

Hospital Charge Code	270655155
Hospital Revenue Code	272
Min. Negotiated Rate	$82.84
Max. Negotiated Rate	$1,458.47
Rate for Payer: Aetna Commercial	$1,108.44
Rate for Payer: Aetna Medicare Advantage	$875.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$743.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$743.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$743.82
Rate for Payer: Cigna Commercial	$1,458.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$758.41
Rate for Payer: Oxford Commercial	$583.39
Rate for Payer: Qualcare PPO/HMO/WC	$437.54
Rate for Payer: UnitedHealthcare Commercial	$583.39
Rate for Payer: UnitedHealthcare Community & State	$92.18
Rate for Payer: Wellpoint Medicaid Managed Care	$82.84

REDUCTION FORCEP WITH NARROW

Facility

$2,870.60

Hospital Charge Code	270655153
Hospital Revenue Code	272
Min. Negotiated Rate	$81.53
Max. Negotiated Rate	$1,435.30
Rate for Payer: Aetna Commercial	$1,090.83
Rate for Payer: Aetna Medicare Advantage	$861.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$732.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$732.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$732.00
Rate for Payer: Cigna Commercial	$1,435.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$746.36
Rate for Payer: Oxford Commercial	$574.12
Rate for Payer: Qualcare PPO/HMO/WC	$430.59
Rate for Payer: UnitedHealthcare Commercial	$574.12
Rate for Payer: UnitedHealthcare Community & State	$90.71
Rate for Payer: Wellpoint Medicaid Managed Care	$81.53

REDUCTION FORCEP WITH NARROW

Facility

$2,870.60

Hospital Charge Code	270655153
Hospital Revenue Code	272
Min. Negotiated Rate	$430.59
Max. Negotiated Rate	$430.59
Rate for Payer: Qualcare PPO/HMO/WC	$430.59

REDUCTION PIN CANCELL THD 5.0M

Facility

$3,335.00

Hospital Charge Code	270701156
Hospital Revenue Code	279
Min. Negotiated Rate	$94.71
Max. Negotiated Rate	$1,667.50
Rate for Payer: Aetna Commercial	$1,267.30
Rate for Payer: Aetna Medicare Advantage	$1,000.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$850.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$850.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$850.42
Rate for Payer: Cigna Commercial	$1,667.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$867.10
Rate for Payer: Oxford Commercial	$667.00
Rate for Payer: Qualcare PPO/HMO/WC	$500.25
Rate for Payer: UnitedHealthcare Commercial	$667.00
Rate for Payer: UnitedHealthcare Community & State	$105.39
Rate for Payer: Wellpoint Medicaid Managed Care	$94.71

REDUCTION PIN CANCELL THD 5.0M

Facility

$3,335.00

Hospital Charge Code	270701156
Hospital Revenue Code	279
Min. Negotiated Rate	$500.25
Max. Negotiated Rate	$500.25
Rate for Payer: Qualcare PPO/HMO/WC	$500.25

REDUCTION TALOTARSAL JOINT

Facility

$713.00

Service Code	HCPCS 28570
Hospital Charge Code	5780115
Hospital Revenue Code	450
Min. Negotiated Rate	$106.95
Max. Negotiated Rate	$106.95
Rate for Payer: Qualcare PPO/HMO/WC	$106.95

REDUCTION TALOTARSAL JOINT

Facility

$713.00

Service Code	HCPCS 28570
Hospital Charge Code	5780115
Hospital Revenue Code	450
Min. Negotiated Rate	$20.25
Max. Negotiated Rate	$1,063.04
Rate for Payer: Aetna Commercial	$797.10
Rate for Payer: Aetna Medicare Advantage	$949.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,063.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,063.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$293.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,063.04
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: Cigna Medicare Advantage	$293.05
Rate for Payer: Clover Medicare Advantage	$278.40
Rate for Payer: EmblemHealth Commercial	$879.15
Rate for Payer: Humana Medicare Advantage	$301.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$293.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.38
Rate for Payer: Qualcare PPO/HMO/WC	$106.95
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$293.05
Rate for Payer: Wellcare Medicare Advantage	$293.05
Rate for Payer: Wellpoint Medicaid Managed Care	$20.25

REDUCTN OF TORSION TESTIS SURG

Facility

$20,610.70

Service Code	HCPCS 54600
Hospital Charge Code	1600000816
Hospital Revenue Code	360
Min. Negotiated Rate	$585.34
Max. Negotiated Rate	$15,191.14
Rate for Payer: Aetna Commercial	$11,390.73
Rate for Payer: Aetna Medicare Advantage	$13,568.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,191.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,191.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,187.77
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	$15,191.14
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: Cigna Medicare Advantage	$4,187.77
Rate for Payer: Clover Medicare Advantage	$3,978.38
Rate for Payer: EmblemHealth Commercial	$12,563.31
Rate for Payer: Humana Medicare Advantage	$4,313.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,187.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,358.78
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,091.61
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$651.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,187.77
Rate for Payer: Wellcare Medicare Advantage	$4,187.77
Rate for Payer: Wellpoint Medicaid Managed Care	$585.34

REDUCTN OF TORSION TESTIS SURG

Facility

$20,610.70

Service Code	HCPCS 54600
Hospital Charge Code	1600000816
Hospital Revenue Code	360
Min. Negotiated Rate	$3,091.61
Max. Negotiated Rate	$3,091.61
Rate for Payer: Qualcare PPO/HMO/WC	$3,091.61

REDUCTN TARSOMETATARSAL JOINT

Facility

$645.00

Service Code	HCPCS 28600
Hospital Charge Code	5780120
Hospital Revenue Code	450
Min. Negotiated Rate	$18.32
Max. Negotiated Rate	$1,063.04
Rate for Payer: Aetna Commercial	$797.10
Rate for Payer: Aetna Medicare Advantage	$949.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,063.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,063.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$293.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,063.04
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: Cigna Medicare Advantage	$293.05
Rate for Payer: Clover Medicare Advantage	$278.40
Rate for Payer: EmblemHealth Commercial	$879.15
Rate for Payer: Humana Medicare Advantage	$301.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$293.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.70
Rate for Payer: Qualcare PPO/HMO/WC	$96.75
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$293.05
Rate for Payer: Wellcare Medicare Advantage	$293.05
Rate for Payer: Wellpoint Medicaid Managed Care	$18.32

REDUCTN TARSOMETATARSAL JOINT

Facility

$645.00

Service Code	HCPCS 28600
Hospital Charge Code	5780120
Hospital Revenue Code	450
Min. Negotiated Rate	$96.75
Max. Negotiated Rate	$96.75
Rate for Payer: Qualcare PPO/HMO/WC	$96.75

RE-EVALUATION OT

Facility

$286.00

Service Code	HCPCS 97004GO
Hospital Charge Code	74203023
Hospital Revenue Code	434
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$108.68
Rate for Payer: Aetna Medicare Advantage	$85.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.93
Rate for Payer: Cigna Commercial	$143.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.36
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.90
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellpoint Medicaid Managed Care	$65.00

RE-EVALUATION OT

Facility

$286.00

Service Code	HCPCS 97004GO
Hospital Charge Code	74203023
Hospital Revenue Code	434
Min. Negotiated Rate	$42.90
Max. Negotiated Rate	$42.90
Rate for Payer: Qualcare PPO/HMO/WC	$42.90

RE EVALUATION PT

Facility

$394.00

Service Code	HCPCS 97164
Hospital Charge Code	409297164
Hospital Revenue Code	424
Min. Negotiated Rate	$59.10
Max. Negotiated Rate	$59.10
Rate for Payer: Qualcare PPO/HMO/WC	$59.10

RE EVALUATION PT

Facility

$394.00

Service Code	HCPCS 97164
Hospital Charge Code	409297164
Hospital Revenue Code	424
Min. Negotiated Rate	$12.45
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$149.72
Rate for Payer: Aetna Medicare Advantage	$118.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.47
Rate for Payer: Cigna Commercial	$197.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.44
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$59.10
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$12.45
Rate for Payer: Wellpoint Medicaid Managed Care	$65.00

REFERRED AB ID, COMPLEX

Facility

$149.00

Service Code	HCPCS 86870
Hospital Charge Code	38471152
Hospital Revenue Code	302
Min. Negotiated Rate	$4.23
Max. Negotiated Rate	$1,544.73
Rate for Payer: Aetna Commercial	$1,158.28
Rate for Payer: Aetna Medicare Advantage	$1,379.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,544.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,544.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$425.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,544.73
Rate for Payer: Cigna Commercial	$853.60
Rate for Payer: Cigna Medicare Advantage	$425.84
Rate for Payer: Clover Medicare Advantage	$404.55
Rate for Payer: EmblemHealth Commercial	$1,277.52
Rate for Payer: Humana Medicare Advantage	$438.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$425.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.74
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.35
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$425.84
Rate for Payer: Wellcare Medicare Advantage	$425.84
Rate for Payer: Wellpoint Medicaid Managed Care	$4.23

REFERRED AB ID, COMPLEX

Facility

$149.00

Service Code	HCPCS 86870
Hospital Charge Code	38471152
Hospital Revenue Code	302
Min. Negotiated Rate	$22.35
Max. Negotiated Rate	$22.35
Rate for Payer: Qualcare PPO/HMO/WC	$22.35

REFILL/MAINT PORTABLE PUMP

Facility

$762.00

Service Code	HCPCS 96521
Hospital Charge Code	3401151
Hospital Revenue Code	335
Min. Negotiated Rate	$21.64
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$687.34
Rate for Payer: Aetna Medicare Advantage	$818.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$916.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$916.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$252.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$916.67
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: Cigna Medicare Advantage	$176.89
Rate for Payer: Clover Medicare Advantage	$240.06
Rate for Payer: EmblemHealth Commercial	$758.10
Rate for Payer: Humana Medicare Advantage	$260.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$252.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.12
Rate for Payer: Oxford Commercial	$2,441.00
Rate for Payer: Qualcare PPO/HMO/WC	$114.30
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$24.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$252.70
Rate for Payer: Wellcare Medicare Advantage	$252.70
Rate for Payer: Wellpoint Medicaid Managed Care	$21.64

REFILL/MAINT PORTABLE PUMP

Facility

$762.00

Service Code	HCPCS 96521
Hospital Charge Code	3401151
Hospital Revenue Code	335
Min. Negotiated Rate	$114.30
Max. Negotiated Rate	$114.30
Rate for Payer: Qualcare PPO/HMO/WC	$114.30

REFLEX OVARIAN AB TITER

Facility

$390.00

Service Code	HCPCS 86256
Hospital Charge Code	38479451B
Hospital Revenue Code	302
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.71
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
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	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

REFLEX OVARIAN AB TITER

Facility

$390.00

Service Code	HCPCS 86256
Hospital Charge Code	38479451B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Know your out-of-pocket cost for care.

All Charges