Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCL-70 AB,ID

Facility

$390.00

Service Code	HCPCS 86235
Hospital Charge Code	39900202
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SCL-70 AB,ID

Facility

$390.00

Service Code	HCPCS 86235
Hospital Charge Code	39900202
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$48.77
Rate for Payer: Aetna Medicare Advantage	$58.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.04
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$17.93
Rate for Payer: Clover Medicare Advantage	$17.03
Rate for Payer: EmblemHealth Commercial	$53.79
Rate for Payer: Humana Medicare Advantage	$18.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.93
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	$14.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.93
Rate for Payer: Wellcare Medicare Advantage	$17.93
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

SCLERODERMA AB

Facility

$489.00

Service Code	HCPCS 86235
Hospital Charge Code	38476043
Hospital Revenue Code	302
Min. Negotiated Rate	$73.35
Max. Negotiated Rate	$73.35
Rate for Payer: Qualcare PPO/HMO/WC	$73.35

SCLERODERMA AB

Facility

$489.00

Service Code	HCPCS 86235
Hospital Charge Code	38476043
Hospital Revenue Code	302
Min. Negotiated Rate	$13.89
Max. Negotiated Rate	$244.50
Rate for Payer: Aetna Commercial	$48.77
Rate for Payer: Aetna Medicare Advantage	$58.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.04
Rate for Payer: Cigna Commercial	$244.50
Rate for Payer: Cigna Medicare Advantage	$17.93
Rate for Payer: Clover Medicare Advantage	$17.03
Rate for Payer: EmblemHealth Commercial	$53.79
Rate for Payer: Humana Medicare Advantage	$18.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.14
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$73.35
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.93
Rate for Payer: Wellcare Medicare Advantage	$17.93
Rate for Payer: Wellpoint Medicaid Managed Care	$13.89

SCLEROTHERAPY NEEDLE 23GA 4MN

Facility

$294.00

Hospital Charge Code	270330649
Hospital Revenue Code	272
Min. Negotiated Rate	$8.35
Max. Negotiated Rate	$147.00
Rate for Payer: Aetna Commercial	$111.72
Rate for Payer: Aetna Medicare Advantage	$88.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.97
Rate for Payer: Cigna Commercial	$147.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.44
Rate for Payer: Oxford Commercial	$58.80
Rate for Payer: Qualcare PPO/HMO/WC	$44.10
Rate for Payer: UnitedHealthcare Commercial	$58.80
Rate for Payer: UnitedHealthcare Community & State	$9.29
Rate for Payer: Wellpoint Medicaid Managed Care	$8.35

SCLEROTHERAPY NEEDLE 23GA 4MN

Facility

$294.00

Hospital Charge Code	270330649
Hospital Revenue Code	272
Min. Negotiated Rate	$44.10
Max. Negotiated Rate	$44.10
Rate for Payer: Qualcare PPO/HMO/WC	$44.10

SCLEROTX FLUID COLLECTION

Facility

$2,714.04

Service Code	HCPCS 49185
Hospital Charge Code	16000751
Hospital Revenue Code	360
Min. Negotiated Rate	$77.08
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$705.65
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$407.11
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$85.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$77.08

SCLEROTX FLUID COLLECTION

Facility

$2,714.04

Service Code	HCPCS 49185
Hospital Charge Code	16000751
Hospital Revenue Code	360
Min. Negotiated Rate	$407.11
Max. Negotiated Rate	$407.11
Rate for Payer: Qualcare PPO/HMO/WC	$407.11

SCLEROTX FLUID COLLECT PRQ W/I

Facility

$3,574.55

Service Code	HCPCS 49185
Hospital Charge Code	404649185
Hospital Revenue Code	361
Min. Negotiated Rate	$536.18
Max. Negotiated Rate	$536.18
Rate for Payer: Qualcare PPO/HMO/WC	$536.18

SCLEROTX FLUID COLLECT PRQ W/I

Facility

$3,574.55

Service Code	HCPCS 49185
Hospital Charge Code	404649185
Hospital Revenue Code	361
Min. Negotiated Rate	$101.52
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$929.38
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$536.18
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$112.96
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$101.52

SCLRSL INTRPLRL AERSL TAL PWDR

Facility

$6,710.00

Hospital Charge Code	270643368
Hospital Revenue Code	270
Min. Negotiated Rate	$1,006.50
Max. Negotiated Rate	$1,006.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,006.50

SCLRSL INTRPLRL AERSL TAL PWDR

Facility

$6,710.00

Hospital Charge Code	270643368
Hospital Revenue Code	270
Min. Negotiated Rate	$190.56
Max. Negotiated Rate	$3,355.00
Rate for Payer: Aetna Commercial	$2,549.80
Rate for Payer: Aetna Medicare Advantage	$2,013.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,711.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,711.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,711.05
Rate for Payer: Cigna Commercial	$3,355.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,744.60
Rate for Payer: Oxford Commercial	$1,342.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,006.50
Rate for Payer: UnitedHealthcare Commercial	$1,342.00
Rate for Payer: UnitedHealthcare Community & State	$212.04
Rate for Payer: Wellpoint Medicaid Managed Care	$190.56

SCNDRY REPR RUPT ACHILLES TNDN

Facility

$44,916.00

Service Code	HCPCS 27654
Hospital Charge Code	16000893
Hospital Revenue Code	360
Min. Negotiated Rate	$1,275.61
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	$11,678.16
Rate for Payer: Oxford Commercial	$11,677.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,737.40
Rate for Payer: UnitedHealthcare Commercial	$12,906.00
Rate for Payer: UnitedHealthcare Community & State	$1,419.35
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	$1,275.61

SCNDRY REPR RUPT ACHILLES TNDN

Facility

$44,916.00

Service Code	HCPCS 27654
Hospital Charge Code	16000893
Hospital Revenue Code	360
Min. Negotiated Rate	$6,737.40
Max. Negotiated Rate	$6,737.40
Rate for Payer: Qualcare PPO/HMO/WC	$6,737.40

SCOOP GALLSTONE DESJARDINS 6MM

Facility

$784.20

Hospital Charge Code	270689562
Hospital Revenue Code	272
Min. Negotiated Rate	$22.27
Max. Negotiated Rate	$392.10
Rate for Payer: Aetna Commercial	$298.00
Rate for Payer: Aetna Medicare Advantage	$235.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$199.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$199.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$199.97
Rate for Payer: Cigna Commercial	$392.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$203.89
Rate for Payer: Oxford Commercial	$156.84
Rate for Payer: Qualcare PPO/HMO/WC	$117.63
Rate for Payer: UnitedHealthcare Commercial	$156.84
Rate for Payer: UnitedHealthcare Community & State	$24.78
Rate for Payer: Wellpoint Medicaid Managed Care	$22.27

SCOOP GALLSTONE DESJARDINS 6MM

Facility

$784.20

Hospital Charge Code	270689562
Hospital Revenue Code	272
Min. Negotiated Rate	$117.63
Max. Negotiated Rate	$117.63
Rate for Payer: Qualcare PPO/HMO/WC	$117.63

SCOOP GALLSTONE DESJARDINS 7MM

Facility

$784.20

Hospital Charge Code	270689563
Hospital Revenue Code	272
Min. Negotiated Rate	$117.63
Max. Negotiated Rate	$117.63
Rate for Payer: Qualcare PPO/HMO/WC	$117.63

SCOOP GALLSTONE DESJARDINS 7MM

Facility

$784.20

Hospital Charge Code	270689563
Hospital Revenue Code	272
Min. Negotiated Rate	$22.27
Max. Negotiated Rate	$392.10
Rate for Payer: Aetna Commercial	$298.00
Rate for Payer: Aetna Medicare Advantage	$235.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$199.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$199.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$199.97
Rate for Payer: Cigna Commercial	$392.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$203.89
Rate for Payer: Oxford Commercial	$156.84
Rate for Payer: Qualcare PPO/HMO/WC	$117.63
Rate for Payer: UnitedHealthcare Commercial	$156.84
Rate for Payer: UnitedHealthcare Community & State	$24.78
Rate for Payer: Wellpoint Medicaid Managed Care	$22.27

SCOOP GALLSTONE DESJARDINS 8MM

Facility

$784.20

Hospital Charge Code	270689564
Hospital Revenue Code	272
Min. Negotiated Rate	$22.27
Max. Negotiated Rate	$392.10
Rate for Payer: Aetna Commercial	$298.00
Rate for Payer: Aetna Medicare Advantage	$235.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$199.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$199.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$199.97
Rate for Payer: Cigna Commercial	$392.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$203.89
Rate for Payer: Oxford Commercial	$156.84
Rate for Payer: Qualcare PPO/HMO/WC	$117.63
Rate for Payer: UnitedHealthcare Commercial	$156.84
Rate for Payer: UnitedHealthcare Community & State	$24.78
Rate for Payer: Wellpoint Medicaid Managed Care	$22.27

SCOOP GALLSTONE DESJARDINS 8MM

Facility

$784.20

Hospital Charge Code	270689564
Hospital Revenue Code	272
Min. Negotiated Rate	$117.63
Max. Negotiated Rate	$117.63
Rate for Payer: Qualcare PPO/HMO/WC	$117.63

SCOOP GALLSTONE DESJARDINS 9MM

Facility

$784.20

Hospital Charge Code	270689565
Hospital Revenue Code	272
Min. Negotiated Rate	$117.63
Max. Negotiated Rate	$117.63
Rate for Payer: Qualcare PPO/HMO/WC	$117.63

SCOOP GALLSTONE DESJARDINS 9MM

Facility

$784.20

Hospital Charge Code	270689565
Hospital Revenue Code	272
Min. Negotiated Rate	$22.27
Max. Negotiated Rate	$392.10
Rate for Payer: Aetna Commercial	$298.00
Rate for Payer: Aetna Medicare Advantage	$235.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$199.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$199.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$199.97
Rate for Payer: Cigna Commercial	$392.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$203.89
Rate for Payer: Oxford Commercial	$156.84
Rate for Payer: Qualcare PPO/HMO/WC	$117.63
Rate for Payer: UnitedHealthcare Commercial	$156.84
Rate for Payer: UnitedHealthcare Community & State	$24.78
Rate for Payer: Wellpoint Medicaid Managed Care	$22.27

SCOPE 4 RHINOLARYNGO SLIM

Facility

$850.00

Hospital Charge Code	270688726
Hospital Revenue Code	272
Min. Negotiated Rate	$24.14
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$323.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$221.00
Rate for Payer: Oxford Commercial	$170.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Commercial	$170.00
Rate for Payer: UnitedHealthcare Community & State	$26.86
Rate for Payer: Wellpoint Medicaid Managed Care	$24.14

SCOPE 4 RHINOLARYNGO SLIM

Facility

$850.00

Hospital Charge Code	270688726
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

SCOPE NANONEEDLE 125MM

Facility

$2,625.00

Service Code	HCPCS A4649
Hospital Charge Code	270699064
Hospital Revenue Code	272
Min. Negotiated Rate	$393.75
Max. Negotiated Rate	$393.75
Rate for Payer: Qualcare PPO/HMO/WC	$393.75

Know your out-of-pocket cost for care.

All Charges