Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

RENAL ANG-SUPSEL W/AOR-LT

Facility

$25,628.45

Service Code	HCPCS 36253LT
Hospital Charge Code	366836253L
Hospital Revenue Code	361
Min. Negotiated Rate	$727.85
Max. Negotiated Rate	$12,814.23
Rate for Payer: Aetna Commercial	$9,738.81
Rate for Payer: Aetna Medicare Advantage	$7,688.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,535.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,535.25
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	$6,535.25
Rate for Payer: Cigna Commercial	$12,814.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,663.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27
Rate for Payer: UnitedHealthcare Community & State	$809.86
Rate for Payer: Wellpoint Medicaid Managed Care	$727.85

RENAL ANG-SUPSEL W/AOR-LT

Facility

$25,628.45

Service Code	HCPCS 36253LT
Hospital Charge Code	7411914
Hospital Revenue Code	361
Min. Negotiated Rate	$3,844.27
Max. Negotiated Rate	$3,844.27
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

RENAL ANG-SUPSEL W/AOR-LT

Facility

$25,628.45

Service Code	HCPCS 36253LT
Hospital Charge Code	321036253L
Hospital Revenue Code	361
Min. Negotiated Rate	$3,844.27
Max. Negotiated Rate	$3,844.27
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

RENAL ANG-SUPSEL W/AOR-LT

Facility

$25,628.45

Service Code	HCPCS 36253LT
Hospital Charge Code	7411914
Hospital Revenue Code	361
Min. Negotiated Rate	$727.85
Max. Negotiated Rate	$12,814.23
Rate for Payer: Aetna Commercial	$9,738.81
Rate for Payer: Aetna Medicare Advantage	$7,688.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,535.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,535.25
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	$6,535.25
Rate for Payer: Cigna Commercial	$12,814.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,663.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27
Rate for Payer: UnitedHealthcare Community & State	$809.86
Rate for Payer: Wellpoint Medicaid Managed Care	$727.85

RENAL ANG-SUPSEL W/AOR-RT

Facility

$25,628.45

Service Code	HCPCS 36253RT
Hospital Charge Code	7411915
Hospital Revenue Code	361
Min. Negotiated Rate	$3,844.27
Max. Negotiated Rate	$3,844.27
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

RENAL ANG-SUPSEL W/AOR-RT

Facility

$25,628.45

Service Code	HCPCS 25628RT
Hospital Charge Code	321036253R
Hospital Revenue Code	361
Min. Negotiated Rate	$727.85
Max. Negotiated Rate	$12,814.23
Rate for Payer: Aetna Commercial	$9,738.81
Rate for Payer: Aetna Medicare Advantage	$7,688.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,535.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,535.25
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	$6,535.25
Rate for Payer: Cigna Commercial	$12,814.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,663.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27
Rate for Payer: UnitedHealthcare Community & State	$809.86
Rate for Payer: Wellpoint Medicaid Managed Care	$727.85

RENAL ANG-SUPSEL W/AOR-RT

Facility

$25,628.45

Service Code	HCPCS 25628RT
Hospital Charge Code	321036253R
Hospital Revenue Code	361
Min. Negotiated Rate	$3,844.27
Max. Negotiated Rate	$3,844.27
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

RENAL ANG-SUPSEL W/AOR-RT

Facility

$25,628.45

Service Code	HCPCS 36253RT
Hospital Charge Code	2691295
Hospital Revenue Code	361
Min. Negotiated Rate	$3,844.27
Max. Negotiated Rate	$3,844.27
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

RENAL ANG-SUPSEL W/AOR-RT

Facility

$25,628.45

Service Code	HCPCS 36253RT
Hospital Charge Code	2691295
Hospital Revenue Code	361
Min. Negotiated Rate	$727.85
Max. Negotiated Rate	$12,814.23
Rate for Payer: Aetna Commercial	$9,738.81
Rate for Payer: Aetna Medicare Advantage	$7,688.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,535.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,535.25
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	$6,535.25
Rate for Payer: Cigna Commercial	$12,814.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,663.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27
Rate for Payer: UnitedHealthcare Community & State	$809.86
Rate for Payer: Wellpoint Medicaid Managed Care	$727.85

RENAL ANG-SUPSEL W/AOR-RT

Facility

$25,628.45

Service Code	HCPCS 36253RT
Hospital Charge Code	7411915
Hospital Revenue Code	361
Min. Negotiated Rate	$727.85
Max. Negotiated Rate	$12,814.23
Rate for Payer: Aetna Commercial	$9,738.81
Rate for Payer: Aetna Medicare Advantage	$7,688.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,535.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,535.25
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	$6,535.25
Rate for Payer: Cigna Commercial	$12,814.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,663.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27
Rate for Payer: UnitedHealthcare Community & State	$809.86
Rate for Payer: Wellpoint Medicaid Managed Care	$727.85

RENAL ARTERY DUPLEX SCAN

Facility

$17,200.00

Service Code	HCPCS 93975
Hospital Charge Code	2101111
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

RENAL ARTERY DUPLEX SCAN

Facility

$17,200.00

Service Code	HCPCS 93975
Hospital Charge Code	74116050
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

RENAL ARTERY DUPLEX SCAN

Facility

$17,200.00

Service Code	HCPCS 93975
Hospital Charge Code	74117050
Hospital Revenue Code	921
Min. Negotiated Rate	$269.30
Max. Negotiated Rate	$7,555.00
Rate for Payer: Aetna Commercial	$771.04
Rate for Payer: Aetna Medicare Advantage	$918.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,028.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,028.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$283.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$356.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,028.29
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: Cigna Medicare Advantage	$283.47
Rate for Payer: Clover Medicare Advantage	$269.30
Rate for Payer: EmblemHealth Commercial	$850.41
Rate for Payer: Humana Medicare Advantage	$291.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$283.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,472.00
Rate for Payer: Oxford Commercial	$6,888.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$7,555.00
Rate for Payer: UnitedHealthcare Community & State	$543.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$488.48

RENAL ARTERY DUPLEX SCAN

Facility

$17,200.00

Service Code	HCPCS 93975
Hospital Charge Code	74117050
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

RENAL ARTERY DUPLEX SCAN

Facility

$17,200.00

Service Code	HCPCS 93975
Hospital Charge Code	2692165
Hospital Revenue Code	921
Min. Negotiated Rate	$269.30
Max. Negotiated Rate	$7,555.00
Rate for Payer: Aetna Commercial	$771.04
Rate for Payer: Aetna Medicare Advantage	$918.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,028.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,028.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$283.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$356.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,028.29
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: Cigna Medicare Advantage	$283.47
Rate for Payer: Clover Medicare Advantage	$269.30
Rate for Payer: EmblemHealth Commercial	$850.41
Rate for Payer: Humana Medicare Advantage	$291.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$283.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,472.00
Rate for Payer: Oxford Commercial	$6,888.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$7,555.00
Rate for Payer: UnitedHealthcare Community & State	$543.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$488.48

RENAL ARTERY DUPLEX SCAN

Facility

$17,200.00

Service Code	HCPCS 93975
Hospital Charge Code	2101111
Hospital Revenue Code	921
Min. Negotiated Rate	$269.30
Max. Negotiated Rate	$7,555.00
Rate for Payer: Aetna Commercial	$771.04
Rate for Payer: Aetna Medicare Advantage	$918.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,028.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,028.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$283.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$356.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,028.29
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: Cigna Medicare Advantage	$283.47
Rate for Payer: Clover Medicare Advantage	$269.30
Rate for Payer: EmblemHealth Commercial	$850.41
Rate for Payer: Humana Medicare Advantage	$291.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$283.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,472.00
Rate for Payer: Oxford Commercial	$6,888.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$7,555.00
Rate for Payer: UnitedHealthcare Community & State	$543.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$488.48

RENAL ARTERY DUPLEX SCAN

Facility

$17,200.00

Service Code	HCPCS 93975
Hospital Charge Code	74115050
Hospital Revenue Code	921
Min. Negotiated Rate	$269.30
Max. Negotiated Rate	$7,555.00
Rate for Payer: Aetna Commercial	$771.04
Rate for Payer: Aetna Medicare Advantage	$918.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,028.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,028.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$283.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$356.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,028.29
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: Cigna Medicare Advantage	$283.47
Rate for Payer: Clover Medicare Advantage	$269.30
Rate for Payer: EmblemHealth Commercial	$850.41
Rate for Payer: Humana Medicare Advantage	$291.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$283.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,472.00
Rate for Payer: Oxford Commercial	$6,888.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$7,555.00
Rate for Payer: UnitedHealthcare Community & State	$543.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$488.48

RENAL ARTERY DUPLEX SCAN

Facility

$17,200.00

Service Code	HCPCS 93975
Hospital Charge Code	74115050
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

RENAL ARTERY DUPLEX SCAN

Facility

$17,200.00

Service Code	HCPCS 93975
Hospital Charge Code	2692165
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

RENAL ARTERY DUPLEX SCAN

Facility

$17,200.00

Service Code	HCPCS 93975
Hospital Charge Code	74116050
Hospital Revenue Code	921
Min. Negotiated Rate	$269.30
Max. Negotiated Rate	$7,555.00
Rate for Payer: Aetna Commercial	$771.04
Rate for Payer: Aetna Medicare Advantage	$918.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,028.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,028.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$283.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$356.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,028.29
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: Cigna Medicare Advantage	$283.47
Rate for Payer: Clover Medicare Advantage	$269.30
Rate for Payer: EmblemHealth Commercial	$850.41
Rate for Payer: Humana Medicare Advantage	$291.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$283.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,472.00
Rate for Payer: Oxford Commercial	$6,888.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$7,555.00
Rate for Payer: UnitedHealthcare Community & State	$543.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$488.48

RENAL ARTERY DUPLEX SCAN LTD

Facility

$17,200.00

Service Code	HCPCS 93976
Hospital Charge Code	2692170
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

RENAL ARTERY DUPLEX SCAN LTD

Facility

$17,200.00

Service Code	HCPCS 93976
Hospital Charge Code	2101113
Hospital Revenue Code	921
Min. Negotiated Rate	$117.99
Max. Negotiated Rate	$7,555.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$313.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$450.54
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$124.20
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,472.00
Rate for Payer: Oxford Commercial	$6,888.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$7,555.00
Rate for Payer: UnitedHealthcare Community & State	$543.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$488.48

RENAL ARTERY DUPLEX SCAN LTD

Facility

$17,200.00

Service Code	HCPCS 93976
Hospital Charge Code	2101113
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

RENAL ARTERY DUPLEX SCAN LTD

Facility

$17,200.00

Service Code	HCPCS 93976
Hospital Charge Code	74115051
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

RENAL ARTERY DUPLEX SCAN LTD

Facility

$17,200.00

Service Code	HCPCS 93976
Hospital Charge Code	421593976
Hospital Revenue Code	921
Min. Negotiated Rate	$117.99
Max. Negotiated Rate	$7,555.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$313.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$450.54
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$124.20
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,472.00
Rate for Payer: Oxford Commercial	$6,888.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$7,555.00
Rate for Payer: UnitedHealthcare Community & State	$543.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$488.48

Know your out-of-pocket cost for care.

All Charges