Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

RPR PARASTOMAL HERNIA RDC

Facility

$58,232.00

Service Code	HCPCS 49621
Hospital Charge Code	1600000766
Hospital Revenue Code	360
Min. Negotiated Rate	$8,734.80
Max. Negotiated Rate	$8,734.80
Rate for Payer: Qualcare PPO/HMO/WC	$8,734.80

RPR, QUAL

Facility

$63.00

Service Code	HCPCS 86592
Hospital Charge Code	38476035
Hospital Revenue Code	302
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$11.61
Rate for Payer: Aetna Medicare Advantage	$13.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.49
Rate for Payer: Cigna Commercial	$31.50
Rate for Payer: Cigna Medicare Advantage	$4.27
Rate for Payer: Clover Medicare Advantage	$4.06
Rate for Payer: EmblemHealth Commercial	$12.81
Rate for Payer: Humana Medicare Advantage	$4.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.38
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.45
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$3.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.27
Rate for Payer: Wellcare Medicare Advantage	$4.27
Rate for Payer: Wellpoint Medicaid Managed Care	$1.79

RPR, QUAL

Facility

$63.00

Service Code	HCPCS 86592
Hospital Charge Code	38476035
Hospital Revenue Code	302
Min. Negotiated Rate	$9.45
Max. Negotiated Rate	$9.45
Rate for Payer: Qualcare PPO/HMO/WC	$9.45

RPR TARSOMETATARSAL JNT DISLCT

Facility

$48,992.10

Service Code	HCPCS 28615
Hospital Charge Code	16000576
Hospital Revenue Code	360
Min. Negotiated Rate	$1,391.38
Max. Negotiated Rate	$31,271.12
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,271.12
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,737.95
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,348.81
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,548.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1,391.38

RPR TARSOMETATARSAL JNT DISLCT

Facility

$48,992.10

Service Code	HCPCS 28615
Hospital Charge Code	16000576
Hospital Revenue Code	360
Min. Negotiated Rate	$7,348.81
Max. Negotiated Rate	$7,348.81
Rate for Payer: Qualcare PPO/HMO/WC	$7,348.81

RPR TITER

Facility

$390.00

Service Code	HCPCS 86593
Hospital Charge Code	39900225
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

RPR TITER

Facility

$390.00

Service Code	HCPCS 86593
Hospital Charge Code	39900225
Hospital Revenue Code	302
Min. Negotiated Rate	$3.52
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$11.97
Rate for Payer: Aetna Medicare Advantage	$14.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.96
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$4.40
Rate for Payer: Clover Medicare Advantage	$4.18
Rate for Payer: EmblemHealth Commercial	$13.20
Rate for Payer: Humana Medicare Advantage	$4.53
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.40
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	$3.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.40
Rate for Payer: Wellcare Medicare Advantage	$4.40
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

RPR, Treponema pallidum IA

Facility

$42.06

Service Code	HCPCS 36126
Hospital Charge Code	3000078
Hospital Revenue Code	306
Min. Negotiated Rate	$6.31
Max. Negotiated Rate	$6.31
Rate for Payer: Qualcare PPO/HMO/WC	$6.31

RPR, Treponema pallidum IA

Facility

$42.06

Service Code	HCPCS 36126
Hospital Charge Code	3000078
Hospital Revenue Code	306
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$15.98
Rate for Payer: Aetna Medicare Advantage	$12.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.73
Rate for Payer: Cigna Commercial	$21.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.94
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.31
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$1.33
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

RPR UMBIL HERN REDUC 5+YR

Facility

$30,877.00

Service Code	HCPCS 49585
Hospital Charge Code	16000991
Hospital Revenue Code	360
Min. Negotiated Rate	$4,631.55
Max. Negotiated Rate	$4,631.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,631.55

RPR UMBIL HERN REDUC 5+YR

Facility

$30,877.00

Service Code	HCPCS 49585
Hospital Charge Code	16000991
Hospital Revenue Code	360
Min. Negotiated Rate	$876.91
Max. Negotiated Rate	$15,438.50
Rate for Payer: Aetna Commercial	$11,733.26
Rate for Payer: Aetna Medicare Advantage	$9,263.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,873.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,873.64
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	$7,873.64
Rate for Payer: Cigna Commercial	$15,438.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,028.02
Rate for Payer: Qualcare PPO/HMO/WC	$4,631.55
Rate for Payer: UnitedHealthcare Community & State	$975.71
Rate for Payer: Wellpoint Medicaid Managed Care	$876.91

RSS BODY SCREW

Facility

$984.75

Service Code	HCPCS C1713
Hospital Charge Code	270688882
Hospital Revenue Code	278
Min. Negotiated Rate	$147.71
Max. Negotiated Rate	$238.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.31
Rate for Payer: Qualcare PPO/HMO/WC	$147.71

RSS BODY SCREW

Facility

$984.75

Service Code	HCPCS C1713
Hospital Charge Code	270688882
Hospital Revenue Code	278
Min. Negotiated Rate	$27.97
Max. Negotiated Rate	$492.38
Rate for Payer: Aetna Commercial	$374.20
Rate for Payer: Aetna Medicare Advantage	$295.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$251.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$251.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$251.11
Rate for Payer: Cigna Commercial	$492.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.31
Rate for Payer: Qualcare PPO/HMO/WC	$147.71
Rate for Payer: UnitedHealthcare Community & State	$31.12
Rate for Payer: Wellpoint Medicaid Managed Care	$27.97

RSS GLENOID BASEPLATE-S

Facility

$12,057.50

Service Code	HCPCS C1713
Hospital Charge Code	270688776
Hospital Revenue Code	278
Min. Negotiated Rate	$1,808.62
Max. Negotiated Rate	$2,917.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,411.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,917.91
Rate for Payer: Qualcare PPO/HMO/WC	$1,808.62

RSS GLENOID BASEPLATE-S

Facility

$12,057.50

Service Code	HCPCS C1713
Hospital Charge Code	270688776
Hospital Revenue Code	278
Min. Negotiated Rate	$342.43
Max. Negotiated Rate	$6,028.75
Rate for Payer: Aetna Commercial	$4,581.85
Rate for Payer: Aetna Medicare Advantage	$3,617.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,074.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,074.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,411.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,074.66
Rate for Payer: Cigna Commercial	$6,028.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,917.91
Rate for Payer: Qualcare PPO/HMO/WC	$1,808.62
Rate for Payer: UnitedHealthcare Community & State	$381.02
Rate for Payer: Wellpoint Medicaid Managed Care	$342.43

RSS GLENOSPHERE ECCENTRI-S 2MM

Facility

$12,509.25

Service Code	HCPCS C1776
Hospital Charge Code	270688778
Hospital Revenue Code	278
Min. Negotiated Rate	$355.26
Max. Negotiated Rate	$6,254.62
Rate for Payer: Aetna Commercial	$4,753.52
Rate for Payer: Aetna Medicare Advantage	$3,752.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,189.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,189.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,501.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,189.86
Rate for Payer: Cigna Commercial	$6,254.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,027.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,876.39
Rate for Payer: UnitedHealthcare Community & State	$395.29
Rate for Payer: Wellpoint Medicaid Managed Care	$355.26

RSS GLENOSPHERE ECCENTRI-S 2MM

Facility

$12,509.25

Service Code	HCPCS C1776
Hospital Charge Code	270688778
Hospital Revenue Code	278
Min. Negotiated Rate	$1,876.39
Max. Negotiated Rate	$3,027.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,501.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,027.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,876.39

RSS HXL LINER STD 0S

Facility

$6,428.70

Service Code	HCPCS C1776
Hospital Charge Code	270691335
Hospital Revenue Code	278
Min. Negotiated Rate	$964.30
Max. Negotiated Rate	$1,555.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,285.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,555.75
Rate for Payer: Qualcare PPO/HMO/WC	$964.30

RSS HXL LINER STD 0S

Facility

$6,428.70

Service Code	HCPCS C1776
Hospital Charge Code	270691335
Hospital Revenue Code	278
Min. Negotiated Rate	$182.58
Max. Negotiated Rate	$3,214.35
Rate for Payer: Aetna Commercial	$2,442.91
Rate for Payer: Aetna Medicare Advantage	$1,928.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,639.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,639.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,285.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,639.32
Rate for Payer: Cigna Commercial	$3,214.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,555.75
Rate for Payer: Qualcare PPO/HMO/WC	$964.30
Rate for Payer: UnitedHealthcare Community & State	$203.15
Rate for Payer: Wellpoint Medicaid Managed Care	$182.58

RSV VIRUS IMMUNE GLOBULIN

Facility

$462.30

Service Code	NDC 49281057515
Hospital Charge Code	6064943022
Hospital Revenue Code	250
Min. Negotiated Rate	$13.13
Max. Negotiated Rate	$231.15
Rate for Payer: Aetna Commercial	$175.67
Rate for Payer: Aetna Medicare Advantage	$138.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$117.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$117.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$117.89
Rate for Payer: Cigna Commercial	$231.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.20
Rate for Payer: Oxford Commercial	$92.46
Rate for Payer: Qualcare PPO/HMO/WC	$69.34
Rate for Payer: UnitedHealthcare Commercial	$92.46
Rate for Payer: UnitedHealthcare Community & State	$14.61
Rate for Payer: Wellpoint Medicaid Managed Care	$13.13

RSV VIRUS IMMUNE GLOBULIN

Facility

$462.30

Service Code	NDC 49281057515
Hospital Charge Code	6064943022
Hospital Revenue Code	250
Min. Negotiated Rate	$69.34
Max. Negotiated Rate	$69.34
Rate for Payer: Qualcare PPO/HMO/WC	$69.34

RT IB TR W FLIPCUTTER III DRIL

Facility

$5,275.00

Service Code	HCPCS C1713
Hospital Charge Code	270693992
Hospital Revenue Code	278
Min. Negotiated Rate	$149.81
Max. Negotiated Rate	$2,637.50
Rate for Payer: Aetna Commercial	$2,004.50
Rate for Payer: Aetna Medicare Advantage	$1,582.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,345.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,345.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,055.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,345.12
Rate for Payer: Cigna Commercial	$2,637.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,276.55
Rate for Payer: Qualcare PPO/HMO/WC	$791.25
Rate for Payer: UnitedHealthcare Community & State	$166.69
Rate for Payer: Wellpoint Medicaid Managed Care	$149.81

RT IB TR W FLIPCUTTER III DRIL

Facility

$5,275.00

Service Code	HCPCS C1713
Hospital Charge Code	270693992
Hospital Revenue Code	278
Min. Negotiated Rate	$791.25
Max. Negotiated Rate	$1,276.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,055.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,276.55
Rate for Payer: Qualcare PPO/HMO/WC	$791.25

RT MTP PLATE MED 5

Facility

$7,680.00

Service Code	HCPCS C1713
Hospital Charge Code	270684669
Hospital Revenue Code	278
Min. Negotiated Rate	$1,152.00
Max. Negotiated Rate	$1,858.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,536.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,858.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,152.00

RT MTP PLATE MED 5

Facility

$7,680.00

Service Code	HCPCS C1713
Hospital Charge Code	270684669
Hospital Revenue Code	278
Min. Negotiated Rate	$218.11
Max. Negotiated Rate	$3,840.00
Rate for Payer: Aetna Commercial	$2,918.40
Rate for Payer: Aetna Medicare Advantage	$2,304.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,958.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,958.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,958.40
Rate for Payer: Cigna Commercial	$3,840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,858.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,152.00
Rate for Payer: UnitedHealthcare Community & State	$242.69
Rate for Payer: Wellpoint Medicaid Managed Care	$218.11

Know your out-of-pocket cost for care.

All Charges