Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SEPARATOR 8 150CM

Facility

$9,400.00

Hospital Charge Code	270683397
Hospital Revenue Code	272
Min. Negotiated Rate	$1,410.00
Max. Negotiated Rate	$1,410.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,410.00

SEPRA FILM

Facility

$1,345.00

Hospital Charge Code	270627662
Hospital Revenue Code	272
Min. Negotiated Rate	$201.75
Max. Negotiated Rate	$201.75
Rate for Payer: Qualcare PPO/HMO/WC	$201.75

SEPRA FILM

Facility

$1,345.00

Hospital Charge Code	270627662
Hospital Revenue Code	272
Min. Negotiated Rate	$38.20
Max. Negotiated Rate	$672.50
Rate for Payer: Aetna Commercial	$511.10
Rate for Payer: Aetna Medicare Advantage	$403.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$342.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$342.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$342.98
Rate for Payer: Cigna Commercial	$672.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$349.70
Rate for Payer: Oxford Commercial	$269.00
Rate for Payer: Qualcare PPO/HMO/WC	$201.75
Rate for Payer: UnitedHealthcare Commercial	$269.00
Rate for Payer: UnitedHealthcare Community & State	$42.50
Rate for Payer: Wellpoint Medicaid Managed Care	$38.20

SEPTIC ARTHRITIS WITH CC

Facility

$57,604.37

Service Code	MSDRG 549
Min. Negotiated Rate	$17,539.79
Max. Negotiated Rate	$57,604.37
Rate for Payer: Aetna Commercial	$42,884.98
Rate for Payer: Aetna Medicare Advantage	$57,604.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33,523.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33,523.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18,462.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33,523.05
Rate for Payer: Cigna Commercial	$26,912.11
Rate for Payer: Cigna Medicare Advantage	$18,462.94
Rate for Payer: Clover Medicare Advantage	$17,539.79
Rate for Payer: EmblemHealth Commercial	$55,388.82
Rate for Payer: Humana Medicare Advantage	$19,016.83
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18,462.94
Rate for Payer: Oxford Commercial	$21,270.86
Rate for Payer: UnitedHealthcare Commercial	$28,471.81
Rate for Payer: UnitedHealthcare Medicare Advantage	$18,462.94
Rate for Payer: Wellcare Medicare Advantage	$18,462.94

SEPTIC ARTHRITIS WITH MCC

Facility

$80,468.67

Service Code	MSDRG 548
Min. Negotiated Rate	$24,501.68
Max. Negotiated Rate	$80,468.67
Rate for Payer: Aetna Commercial	$59,169.20
Rate for Payer: Aetna Medicare Advantage	$80,468.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54,024.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54,024.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25,791.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54,024.75
Rate for Payer: Cigna Commercial	$43,045.55
Rate for Payer: Cigna Medicare Advantage	$25,791.24
Rate for Payer: Clover Medicare Advantage	$24,501.68
Rate for Payer: EmblemHealth Commercial	$77,373.72
Rate for Payer: Humana Medicare Advantage	$26,564.98
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$25,791.24
Rate for Payer: Oxford Commercial	$34,022.46
Rate for Payer: UnitedHealthcare Commercial	$45,540.28
Rate for Payer: UnitedHealthcare Medicare Advantage	$25,791.24
Rate for Payer: Wellcare Medicare Advantage	$25,791.24

SEPTIC ARTHRITIS WITHOUT CC/MCC

Facility

$47,080.61

Service Code	MSDRG 550
Min. Negotiated Rate	$14,335.44
Max. Negotiated Rate	$47,080.61
Rate for Payer: Aetna Commercial	$35,389.85
Rate for Payer: Aetna Medicare Advantage	$47,080.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26,042.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26,042.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,089.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26,042.70
Rate for Payer: Cigna Commercial	$19,486.31
Rate for Payer: Cigna Medicare Advantage	$15,089.94
Rate for Payer: Clover Medicare Advantage	$14,335.44
Rate for Payer: EmblemHealth Commercial	$45,269.82
Rate for Payer: Humana Medicare Advantage	$15,542.64
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,089.94
Rate for Payer: Oxford Commercial	$15,401.64
Rate for Payer: UnitedHealthcare Commercial	$20,615.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,089.94
Rate for Payer: Wellcare Medicare Advantage	$15,089.94

SEPTICEMIA AND DISSEMINATED INFECTIONS

Facility

$10,038.50

Service Code	APR-DRG 7202
Min. Negotiated Rate	$9,841.67
Max. Negotiated Rate	$10,038.50
Rate for Payer: UnitedHealthcare Community & State	$9,841.67
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,038.50
Rate for Payer: Wellpoint Medicaid Managed Care	$9,841.67

SEPTICEMIA AND DISSEMINATED INFECTIONS

Facility

$27,473.88

Service Code	APR-DRG 7204
Min. Negotiated Rate	$26,935.18
Max. Negotiated Rate	$27,473.88
Rate for Payer: UnitedHealthcare Community & State	$26,935.18
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27,473.88
Rate for Payer: Wellpoint Medicaid Managed Care	$26,935.18

SEPTICEMIA AND DISSEMINATED INFECTIONS

Facility

$7,840.64

Service Code	APR-DRG 7201
Min. Negotiated Rate	$7,686.90
Max. Negotiated Rate	$7,840.64
Rate for Payer: UnitedHealthcare Community & State	$7,686.90
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,840.64
Rate for Payer: Wellpoint Medicaid Managed Care	$7,686.90

SEPTICEMIA AND DISSEMINATED INFECTIONS

Facility

$14,997.37

Service Code	APR-DRG 7203
Min. Negotiated Rate	$14,703.30
Max. Negotiated Rate	$14,997.37
Rate for Payer: UnitedHealthcare Community & State	$14,703.30
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$14,997.37
Rate for Payer: Wellpoint Medicaid Managed Care	$14,703.30

SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS

Facility

$237,833.08

Service Code	MSDRG 870
Min. Negotiated Rate	$72,417.12
Max. Negotiated Rate	$237,833.08
Rate for Payer: Aetna Commercial	$171,245.97
Rate for Payer: Aetna Medicare Advantage	$237,833.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192,826.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192,826.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$76,228.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192,826.80
Rate for Payer: Cigna Commercial	$154,084.76
Rate for Payer: Cigna Medicare Advantage	$76,228.55
Rate for Payer: Clover Medicare Advantage	$72,417.12
Rate for Payer: EmblemHealth Commercial	$228,685.65
Rate for Payer: Humana Medicare Advantage	$78,515.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$76,228.55
Rate for Payer: Oxford Commercial	$121,785.92
Rate for Payer: UnitedHealthcare Commercial	$163,014.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$76,228.55
Rate for Payer: Wellcare Medicare Advantage	$76,228.55

SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC

Facility

$80,835.14

Service Code	MSDRG 871
Min. Negotiated Rate	$24,613.26
Max. Negotiated Rate	$80,835.14
Rate for Payer: Aetna Commercial	$59,430.22
Rate for Payer: Aetna Medicare Advantage	$80,835.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54,855.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54,855.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25,908.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54,855.90
Rate for Payer: Cigna Commercial	$43,304.15
Rate for Payer: Cigna Medicare Advantage	$25,908.70
Rate for Payer: Clover Medicare Advantage	$24,613.26
Rate for Payer: EmblemHealth Commercial	$77,726.10
Rate for Payer: Humana Medicare Advantage	$26,685.96
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$25,908.70
Rate for Payer: Oxford Commercial	$34,226.85
Rate for Payer: UnitedHealthcare Commercial	$45,813.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$25,908.70
Rate for Payer: Wellcare Medicare Advantage	$25,908.70

SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC

Facility

$51,794.34

Service Code	MSDRG 872
Min. Negotiated Rate	$15,770.71
Max. Negotiated Rate	$51,794.34
Rate for Payer: Aetna Commercial	$38,747.04
Rate for Payer: Aetna Medicare Advantage	$51,794.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28,536.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28,536.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16,600.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28,536.15
Rate for Payer: Cigna Commercial	$22,812.43
Rate for Payer: Cigna Medicare Advantage	$16,600.75
Rate for Payer: Clover Medicare Advantage	$15,770.71
Rate for Payer: EmblemHealth Commercial	$49,802.25
Rate for Payer: Humana Medicare Advantage	$17,098.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16,600.75
Rate for Payer: Oxford Commercial	$18,030.55
Rate for Payer: UnitedHealthcare Commercial	$24,134.53
Rate for Payer: UnitedHealthcare Medicare Advantage	$16,600.75
Rate for Payer: Wellcare Medicare Advantage	$16,600.75

SEPTOPLASTY/SMR

Facility

$22,083.40

Service Code	HCPCS 30520
Hospital Charge Code	1600000330
Hospital Revenue Code	360
Min. Negotiated Rate	$627.17
Max. Negotiated Rate	$14,288.18
Rate for Payer: Aetna Commercial	$10,713.67
Rate for Payer: Aetna Medicare Advantage	$12,761.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,288.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,288.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,938.85
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	$14,288.18
Rate for Payer: Cigna Commercial	$7,895.42
Rate for Payer: Cigna Medicare Advantage	$3,938.85
Rate for Payer: Clover Medicare Advantage	$3,741.91
Rate for Payer: EmblemHealth Commercial	$11,816.55
Rate for Payer: Humana Medicare Advantage	$4,057.02
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,938.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,741.68
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,312.51
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$697.84
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,938.85
Rate for Payer: Wellcare Medicare Advantage	$3,938.85
Rate for Payer: Wellpoint Medicaid Managed Care	$627.17

SEPTOPLASTY/SMR

Facility

$22,083.40

Service Code	HCPCS 30520
Hospital Charge Code	1600000330
Hospital Revenue Code	360
Min. Negotiated Rate	$3,312.51
Max. Negotiated Rate	$3,312.51
Rate for Payer: Qualcare PPO/HMO/WC	$3,312.51

SERFAS ENERGY 90S CRUISE

Facility

$750.00

Hospital Charge Code	270678967
Hospital Revenue Code	272
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.00
Rate for Payer: Oxford Commercial	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Commercial	$150.00
Rate for Payer: UnitedHealthcare Community & State	$23.70
Rate for Payer: Wellpoint Medicaid Managed Care	$21.30

SERFAS ENERGY 90S CRUISE

Facility

$750.00

Hospital Charge Code	270678967
Hospital Revenue Code	272
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

SER.FLUID DIFFERENTIAL

Facility

$183.00

Service Code	HCPCS 89051
Hospital Charge Code	38479053
Hospital Revenue Code	309
Min. Negotiated Rate	$27.45
Max. Negotiated Rate	$27.45
Rate for Payer: Qualcare PPO/HMO/WC	$27.45

SER.FLUID DIFFERENTIAL

Facility

$183.00

Service Code	HCPCS 89051
Hospital Charge Code	38479053
Hospital Revenue Code	309
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$15.23
Rate for Payer: Aetna Medicare Advantage	$18.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.31
Rate for Payer: Cigna Commercial	$91.50
Rate for Payer: Cigna Medicare Advantage	$5.60
Rate for Payer: Clover Medicare Advantage	$5.32
Rate for Payer: EmblemHealth Commercial	$16.80
Rate for Payer: Humana Medicare Advantage	$5.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.58
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.45
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$4.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.60
Rate for Payer: Wellcare Medicare Advantage	$5.60
Rate for Payer: Wellpoint Medicaid Managed Care	$5.20

SERIES A PAT WR 37 MM 1 PEG

Facility

$1,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690277
Hospital Revenue Code	278
Min. Negotiated Rate	$42.60
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Community & State	$47.40
Rate for Payer: Wellpoint Medicaid Managed Care	$42.60

SERIES A PAT WR 37 MM 1 PEG

Facility

$1,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690277
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

SEROLOGY

Facility

$133.00

Service Code	HCPCS 86696
Hospital Charge Code	39900242
Hospital Revenue Code	302
Min. Negotiated Rate	$19.95
Max. Negotiated Rate	$19.95
Rate for Payer: Qualcare PPO/HMO/WC	$19.95

SEROLOGY

Facility

$133.00

Service Code	HCPCS 86696
Hospital Charge Code	39900242
Hospital Revenue Code	302
Min. Negotiated Rate	$3.78
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$52.63
Rate for Payer: Aetna Medicare Advantage	$62.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.19
Rate for Payer: Cigna Commercial	$66.50
Rate for Payer: Cigna Medicare Advantage	$19.35
Rate for Payer: Clover Medicare Advantage	$18.38
Rate for Payer: EmblemHealth Commercial	$58.05
Rate for Payer: Humana Medicare Advantage	$19.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.58
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.95
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$15.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.35
Rate for Payer: Wellcare Medicare Advantage	$19.35
Rate for Payer: Wellpoint Medicaid Managed Care	$3.78

SEROLOGY WB

Facility

$133.00

Service Code	HCPCS 86689
Hospital Charge Code	39900239
Hospital Revenue Code	302
Min. Negotiated Rate	$19.95
Max. Negotiated Rate	$19.95
Rate for Payer: Qualcare PPO/HMO/WC	$19.95

SEROLOGY WB

Facility

$133.00

Service Code	HCPCS 86689
Hospital Charge Code	39900239
Hospital Revenue Code	302
Min. Negotiated Rate	$3.78
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$52.63
Rate for Payer: Aetna Medicare Advantage	$62.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.19
Rate for Payer: Cigna Commercial	$66.50
Rate for Payer: Cigna Medicare Advantage	$19.35
Rate for Payer: Clover Medicare Advantage	$18.38
Rate for Payer: EmblemHealth Commercial	$58.05
Rate for Payer: Humana Medicare Advantage	$19.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.58
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.95
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$15.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.35
Rate for Payer: Wellcare Medicare Advantage	$19.35
Rate for Payer: Wellpoint Medicaid Managed Care	$3.78

Know your out-of-pocket cost for care.

All Charges