Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

REPLACE SAGITTAL SAW KEY

Facility

$1,311.00

Hospital Charge Code	270683665
Hospital Revenue Code	272
Min. Negotiated Rate	$196.65
Max. Negotiated Rate	$196.65
Rate for Payer: Qualcare PPO/HMO/WC	$196.65

REPLACE SAGITTAL SAW KEY

Facility

$1,311.00

Hospital Charge Code	270683665
Hospital Revenue Code	272
Min. Negotiated Rate	$37.23
Max. Negotiated Rate	$655.50
Rate for Payer: Aetna Commercial	$498.18
Rate for Payer: Aetna Medicare Advantage	$393.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$334.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$334.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$334.31
Rate for Payer: Cigna Commercial	$655.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$340.86
Rate for Payer: Oxford Commercial	$262.20
Rate for Payer: Qualcare PPO/HMO/WC	$196.65
Rate for Payer: UnitedHealthcare Commercial	$262.20
Rate for Payer: UnitedHealthcare Community & State	$41.43
Rate for Payer: Wellpoint Medicaid Managed Care	$37.23

REPLACE TUNNELED CV CATH

Facility

$18,530.00

Service Code	HCPCS 36578
Hospital Charge Code	411093601
Hospital Revenue Code	481
Min. Negotiated Rate	$2,779.50
Max. Negotiated Rate	$2,779.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,779.50

REPLACE TUNNELED CV CATH

Facility

$9,970.96

Service Code	HCPCS 36500
Hospital Charge Code	16000946
Hospital Revenue Code	360
Min. Negotiated Rate	$283.18
Max. Negotiated Rate	$4,985.48
Rate for Payer: Aetna Commercial	$3,788.96
Rate for Payer: Aetna Medicare Advantage	$2,991.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,542.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,542.59
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	$2,542.59
Rate for Payer: Cigna Commercial	$4,985.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,592.45
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,495.64
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$315.08
Rate for Payer: Wellpoint Medicaid Managed Care	$283.18

REPLACE TUNNELED CV CATH

Facility

$9,970.96

Service Code	HCPCS 36500
Hospital Charge Code	16000946
Hospital Revenue Code	360
Min. Negotiated Rate	$1,495.64
Max. Negotiated Rate	$1,495.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,495.64

REPLACE TUNNELED CV CATH

Facility

$22,851.90

Service Code	HCPCS 36581
Hospital Charge Code	16000581
Hospital Revenue Code	360
Min. Negotiated Rate	$3,427.78
Max. Negotiated Rate	$3,427.78
Rate for Payer: Qualcare PPO/HMO/WC	$3,427.78

REPLACE TUNNELED CV CATH

Facility

$22,851.90

Service Code	HCPCS 36581
Hospital Charge Code	16000581
Hospital Revenue Code	360
Min. Negotiated Rate	$648.99
Max. Negotiated Rate	$13,607.37
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
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	$13,607.37
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,941.49
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,427.78
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$722.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$648.99

REPLACE TUNNELED CV CATH

Facility

$18,530.00

Service Code	HCPCS 36578
Hospital Charge Code	411093601
Hospital Revenue Code	481
Min. Negotiated Rate	$526.25
Max. Negotiated Rate	$13,607.37
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,607.37
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,817.80
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,779.50
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$585.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$526.25

REPLAC TUBE D/J PERC FLUR/CONT

Facility

$2,087.20

Service Code	HCPCS 49451
Hospital Charge Code	5700495
Hospital Revenue Code	450
Min. Negotiated Rate	$313.08
Max. Negotiated Rate	$313.08
Rate for Payer: Qualcare PPO/HMO/WC	$313.08

REPLAC TUBE D/J PERC FLUR/CONT

Facility

$2,087.20

Service Code	HCPCS 49451
Hospital Charge Code	5700495
Hospital Revenue Code	450
Min. Negotiated Rate	$59.28
Max. Negotiated Rate	$3,908.70
Rate for Payer: Aetna Commercial	$2,930.85
Rate for Payer: Aetna Medicare Advantage	$3,491.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,908.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,908.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,077.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,908.70
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: Cigna Medicare Advantage	$1,077.52
Rate for Payer: Clover Medicare Advantage	$1,023.64
Rate for Payer: EmblemHealth Commercial	$3,232.56
Rate for Payer: Humana Medicare Advantage	$1,109.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,077.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$542.67
Rate for Payer: Qualcare PPO/HMO/WC	$313.08
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,077.52
Rate for Payer: Wellcare Medicare Advantage	$1,077.52
Rate for Payer: Wellpoint Medicaid Managed Care	$59.28

REPL EXT URET STENT-BI

Facility

$10,187.80

Service Code	HCPCS 5038750
Hospital Charge Code	2011505
Hospital Revenue Code	361
Min. Negotiated Rate	$289.33
Max. Negotiated Rate	$5,093.90
Rate for Payer: Aetna Commercial	$3,871.36
Rate for Payer: Aetna Medicare Advantage	$3,056.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,597.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,597.89
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	$2,597.89
Rate for Payer: Cigna Commercial	$5,093.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,648.83
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17
Rate for Payer: UnitedHealthcare Community & State	$321.93
Rate for Payer: Wellpoint Medicaid Managed Care	$289.33

REPL EXT URET STENT-BI

Facility

$10,187.80

Service Code	HCPCS 5038750
Hospital Charge Code	2011505
Hospital Revenue Code	361
Min. Negotiated Rate	$1,528.17
Max. Negotiated Rate	$1,528.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

REPL EXT URET STENT-BI

Facility

$6,757.27

Service Code	HCPCS 5038750
Hospital Charge Code	7412032
Hospital Revenue Code	361
Min. Negotiated Rate	$191.91
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,567.76
Rate for Payer: Aetna Medicare Advantage	$2,027.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,723.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,723.10
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	$1,723.10
Rate for Payer: Cigna Commercial	$3,378.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,756.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,013.59
Rate for Payer: UnitedHealthcare Community & State	$213.53
Rate for Payer: Wellpoint Medicaid Managed Care	$191.91

REPL EXT URET STENT-BI

Facility

$6,757.27

Service Code	HCPCS 5038750
Hospital Charge Code	7412032
Hospital Revenue Code	361
Min. Negotiated Rate	$1,013.59
Max. Negotiated Rate	$1,013.59
Rate for Payer: Qualcare PPO/HMO/WC	$1,013.59

REPL EXT URET STENT-LT

Facility

$6,757.27

Service Code	HCPCS 50387LT
Hospital Charge Code	7412033
Hospital Revenue Code	361
Min. Negotiated Rate	$191.91
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,567.76
Rate for Payer: Aetna Medicare Advantage	$2,027.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,723.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,723.10
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	$1,723.10
Rate for Payer: Cigna Commercial	$3,378.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,756.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,013.59
Rate for Payer: UnitedHealthcare Community & State	$213.53
Rate for Payer: Wellpoint Medicaid Managed Care	$191.91

REPL EXT URET STENT-LT

Facility

$6,757.27

Service Code	HCPCS 50387LT
Hospital Charge Code	2011506
Hospital Revenue Code	361
Min. Negotiated Rate	$1,013.59
Max. Negotiated Rate	$1,013.59
Rate for Payer: Qualcare PPO/HMO/WC	$1,013.59

REPL EXT URET STENT-LT

Facility

$6,757.27

Service Code	HCPCS 50387LT
Hospital Charge Code	2011506
Hospital Revenue Code	361
Min. Negotiated Rate	$191.91
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,567.76
Rate for Payer: Aetna Medicare Advantage	$2,027.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,723.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,723.10
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	$1,723.10
Rate for Payer: Cigna Commercial	$3,378.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,756.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,013.59
Rate for Payer: UnitedHealthcare Community & State	$213.53
Rate for Payer: Wellpoint Medicaid Managed Care	$191.91

REPL EXT URET STENT-LT

Facility

$6,757.27

Service Code	HCPCS 50387LT
Hospital Charge Code	7412033
Hospital Revenue Code	361
Min. Negotiated Rate	$1,013.59
Max. Negotiated Rate	$1,013.59
Rate for Payer: Qualcare PPO/HMO/WC	$1,013.59

REPL EXT URET STENT-RT

Facility

$6,757.27

Service Code	HCPCS 50387RT
Hospital Charge Code	2011507
Hospital Revenue Code	361
Min. Negotiated Rate	$1,013.59
Max. Negotiated Rate	$1,013.59
Rate for Payer: Qualcare PPO/HMO/WC	$1,013.59

REPL EXT URET STENT-RT

Facility

$6,757.27

Service Code	HCPCS 50387RT
Hospital Charge Code	2011507
Hospital Revenue Code	361
Min. Negotiated Rate	$191.91
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,567.76
Rate for Payer: Aetna Medicare Advantage	$2,027.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,723.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,723.10
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	$1,723.10
Rate for Payer: Cigna Commercial	$3,378.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,756.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,013.59
Rate for Payer: UnitedHealthcare Community & State	$213.53
Rate for Payer: Wellpoint Medicaid Managed Care	$191.91

REPL EXT URET STENT-RT

Facility

$6,757.27

Service Code	HCPCS 50387RT
Hospital Charge Code	7412034
Hospital Revenue Code	361
Min. Negotiated Rate	$1,013.59
Max. Negotiated Rate	$1,013.59
Rate for Payer: Qualcare PPO/HMO/WC	$1,013.59

REPL EXT URET STENT-RT

Facility

$6,757.27

Service Code	HCPCS 50387RT
Hospital Charge Code	7412034
Hospital Revenue Code	361
Min. Negotiated Rate	$191.91
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,567.76
Rate for Payer: Aetna Medicare Advantage	$2,027.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,723.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,723.10
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	$1,723.10
Rate for Payer: Cigna Commercial	$3,378.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,756.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,013.59
Rate for Payer: UnitedHealthcare Community & State	$213.53
Rate for Payer: Wellpoint Medicaid Managed Care	$191.91

REPLIFORM 4X7

Facility

$3,912.00

Hospital Charge Code	270650889
Hospital Revenue Code	272
Min. Negotiated Rate	$586.80
Max. Negotiated Rate	$586.80
Rate for Payer: Qualcare PPO/HMO/WC	$586.80

REPLIFORM 4X7

Facility

$3,912.00

Hospital Charge Code	270650889
Hospital Revenue Code	272
Min. Negotiated Rate	$111.10
Max. Negotiated Rate	$1,956.00
Rate for Payer: Aetna Commercial	$1,486.56
Rate for Payer: Aetna Medicare Advantage	$1,173.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$997.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$997.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$997.56
Rate for Payer: Cigna Commercial	$1,956.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,017.12
Rate for Payer: Oxford Commercial	$782.40
Rate for Payer: Qualcare PPO/HMO/WC	$586.80
Rate for Payer: UnitedHealthcare Commercial	$782.40
Rate for Payer: UnitedHealthcare Community & State	$123.62
Rate for Payer: Wellpoint Medicaid Managed Care	$111.10

REPLIFORM MESH

Facility

$1,003.00

Hospital Charge Code	270335612
Hospital Revenue Code	278
Min. Negotiated Rate	$150.45
Max. Negotiated Rate	$242.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.73
Rate for Payer: Qualcare PPO/HMO/WC	$150.45

Know your out-of-pocket cost for care.

All Charges