Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SICKLE CELL ANEMIA CRISIS

Facility

$13,616.87

Service Code	APR-DRG 6623
Min. Negotiated Rate	$13,349.87
Max. Negotiated Rate	$13,616.87
Rate for Payer: UnitedHealthcare Community & State	$13,349.87
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,616.87
Rate for Payer: Wellpoint Medicaid Managed Care	$13,349.87

SICKLE CELL ANEMIA CRISIS

Facility

$6,910.97

Service Code	APR-DRG 6621
Min. Negotiated Rate	$6,775.46
Max. Negotiated Rate	$6,910.97
Rate for Payer: UnitedHealthcare Community & State	$6,775.46
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,910.97
Rate for Payer: Wellpoint Medicaid Managed Care	$6,775.46

SICKLE CELL ANEMIA CRISIS

Facility

$9,441.65

Service Code	APR-DRG 6622
Min. Negotiated Rate	$9,256.52
Max. Negotiated Rate	$9,441.65
Rate for Payer: UnitedHealthcare Community & State	$9,256.52
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,441.65
Rate for Payer: Wellpoint Medicaid Managed Care	$9,256.52

SICKLE CELL ANEMIA CRISIS

Facility

$28,417.68

Service Code	APR-DRG 6624
Min. Negotiated Rate	$27,860.47
Max. Negotiated Rate	$28,417.68
Rate for Payer: UnitedHealthcare Community & State	$27,860.47
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$28,417.68
Rate for Payer: Wellpoint Medicaid Managed Care	$27,860.47

SICKLE CELL SCREEN

Facility

$390.00

Service Code	HCPCS 85660
Hospital Charge Code	39900182
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SICKLE CELL SCREEN

Facility

$390.00

Service Code	HCPCS 85660
Hospital Charge Code	39900182
Hospital Revenue Code	305
Min. Negotiated Rate	$4.41
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$14.99
Rate for Payer: Aetna Medicare Advantage	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.51
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	$19.99
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.51
Rate for Payer: Clover Medicare Advantage	$5.23
Rate for Payer: EmblemHealth Commercial	$16.53
Rate for Payer: Humana Medicare Advantage	$5.68
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.51
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	$4.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.51
Rate for Payer: Wellcare Medicare Advantage	$5.51
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

SIDE CUTTER (ADULT)

Facility

$191.00

Hospital Charge Code	270335569
Hospital Revenue Code	272
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$95.50
Rate for Payer: Aetna Commercial	$72.58
Rate for Payer: Aetna Medicare Advantage	$57.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.70
Rate for Payer: Cigna Commercial	$95.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.66
Rate for Payer: Oxford Commercial	$38.20
Rate for Payer: Qualcare PPO/HMO/WC	$28.65
Rate for Payer: UnitedHealthcare Commercial	$38.20
Rate for Payer: UnitedHealthcare Community & State	$6.04
Rate for Payer: Wellpoint Medicaid Managed Care	$5.42

SIDE CUTTER (ADULT)

Facility

$191.00

Hospital Charge Code	270335569
Hospital Revenue Code	272
Min. Negotiated Rate	$28.65
Max. Negotiated Rate	$28.65
Rate for Payer: Qualcare PPO/HMO/WC	$28.65

SIDE CUTTER BUR AM-10

Facility

$310.00

Hospital Charge Code	270335564
Hospital Revenue Code	272
Min. Negotiated Rate	$8.80
Max. Negotiated Rate	$155.00
Rate for Payer: Aetna Commercial	$117.80
Rate for Payer: Aetna Medicare Advantage	$93.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.05
Rate for Payer: Cigna Commercial	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.60
Rate for Payer: Oxford Commercial	$62.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.50
Rate for Payer: UnitedHealthcare Commercial	$62.00
Rate for Payer: UnitedHealthcare Community & State	$9.80
Rate for Payer: Wellpoint Medicaid Managed Care	$8.80

SIDE CUTTER BUR AM-10

Facility

$310.00

Hospital Charge Code	270335564
Hospital Revenue Code	272
Min. Negotiated Rate	$46.50
Max. Negotiated Rate	$46.50
Rate for Payer: Qualcare PPO/HMO/WC	$46.50

SIDE CUTTER BUR TU-10

Facility

$321.00

Hospital Charge Code	270335563
Hospital Revenue Code	272
Min. Negotiated Rate	$9.12
Max. Negotiated Rate	$160.50
Rate for Payer: Aetna Commercial	$121.98
Rate for Payer: Aetna Medicare Advantage	$96.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.86
Rate for Payer: Cigna Commercial	$160.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.46
Rate for Payer: Oxford Commercial	$64.20
Rate for Payer: Qualcare PPO/HMO/WC	$48.15
Rate for Payer: UnitedHealthcare Commercial	$64.20
Rate for Payer: UnitedHealthcare Community & State	$10.14
Rate for Payer: Wellpoint Medicaid Managed Care	$9.12

SIDE CUTTER BUR TU-10

Facility

$321.00

Hospital Charge Code	270335563
Hospital Revenue Code	272
Min. Negotiated Rate	$48.15
Max. Negotiated Rate	$48.15
Rate for Payer: Qualcare PPO/HMO/WC	$48.15

SIDE CUTTER CRANIOTOME

Facility

$186.00

Hospital Charge Code	270335568
Hospital Revenue Code	272
Min. Negotiated Rate	$27.90
Max. Negotiated Rate	$27.90
Rate for Payer: Qualcare PPO/HMO/WC	$27.90

SIDE CUTTER CRANIOTOME

Facility

$186.00

Hospital Charge Code	270335568
Hospital Revenue Code	272
Min. Negotiated Rate	$5.28
Max. Negotiated Rate	$93.00
Rate for Payer: Aetna Commercial	$70.68
Rate for Payer: Aetna Medicare Advantage	$55.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.43
Rate for Payer: Cigna Commercial	$93.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.36
Rate for Payer: Oxford Commercial	$37.20
Rate for Payer: Qualcare PPO/HMO/WC	$27.90
Rate for Payer: UnitedHealthcare Commercial	$37.20
Rate for Payer: UnitedHealthcare Community & State	$5.88
Rate for Payer: Wellpoint Medicaid Managed Care	$5.28

SIDE CUTTING BUR 1.5 X7.5

Facility

$208.00

Hospital Charge Code	270332569
Hospital Revenue Code	272
Min. Negotiated Rate	$31.20
Max. Negotiated Rate	$31.20
Rate for Payer: Qualcare PPO/HMO/WC	$31.20

SIDE CUTTING BUR 1.5 X7.5

Facility

$208.00

Hospital Charge Code	270332569
Hospital Revenue Code	272
Min. Negotiated Rate	$5.91
Max. Negotiated Rate	$104.00
Rate for Payer: Aetna Commercial	$79.04
Rate for Payer: Aetna Medicare Advantage	$62.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.04
Rate for Payer: Cigna Commercial	$104.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.08
Rate for Payer: Oxford Commercial	$41.60
Rate for Payer: Qualcare PPO/HMO/WC	$31.20
Rate for Payer: UnitedHealthcare Commercial	$41.60
Rate for Payer: UnitedHealthcare Community & State	$6.57
Rate for Payer: Wellpoint Medicaid Managed Care	$5.91

SIDE CUTTING BUR 2 X 19

Facility

$248.00

Hospital Charge Code	270332570
Hospital Revenue Code	272
Min. Negotiated Rate	$7.04
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$94.24
Rate for Payer: Aetna Medicare Advantage	$74.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.24
Rate for Payer: Cigna Commercial	$124.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.48
Rate for Payer: Oxford Commercial	$49.60
Rate for Payer: Qualcare PPO/HMO/WC	$37.20
Rate for Payer: UnitedHealthcare Commercial	$49.60
Rate for Payer: UnitedHealthcare Community & State	$7.84
Rate for Payer: Wellpoint Medicaid Managed Care	$7.04

SIDE CUTTING BUR 2 X 19

Facility

$248.00

Hospital Charge Code	270332570
Hospital Revenue Code	272
Min. Negotiated Rate	$37.20
Max. Negotiated Rate	$37.20
Rate for Payer: Qualcare PPO/HMO/WC	$37.20

SIGMA SHIM

Facility

$2,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270703545
Hospital Revenue Code	278
Min. Negotiated Rate	$442.50
Max. Negotiated Rate	$713.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$590.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$713.90
Rate for Payer: Qualcare PPO/HMO/WC	$442.50

SIGMA SHIM

Facility

$2,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270703545
Hospital Revenue Code	278
Min. Negotiated Rate	$83.78
Max. Negotiated Rate	$1,475.00
Rate for Payer: Aetna Commercial	$1,121.00
Rate for Payer: Aetna Medicare Advantage	$885.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$752.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$752.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$590.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$752.25
Rate for Payer: Cigna Commercial	$1,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$713.90
Rate for Payer: Qualcare PPO/HMO/WC	$442.50
Rate for Payer: UnitedHealthcare Community & State	$93.22
Rate for Payer: Wellpoint Medicaid Managed Care	$83.78

SIGMA TLIF MIS

Facility

$6,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270703775
Hospital Revenue Code	278
Min. Negotiated Rate	$177.50
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Community & State	$197.50
Rate for Payer: Wellpoint Medicaid Managed Care	$177.50

SIGMA TLIF MIS

Facility

$6,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270703775
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

SIGMOIDOSCOPE DISP

Facility

$10.15

Hospital Charge Code	270649352
Hospital Revenue Code	270
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$1.52
Rate for Payer: Qualcare PPO/HMO/WC	$1.52

SIGMOIDOSCOPE DISP

Facility

$10.15

Hospital Charge Code	270649352
Hospital Revenue Code	270
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$5.08
Rate for Payer: Aetna Commercial	$3.86
Rate for Payer: Aetna Medicare Advantage	$3.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.59
Rate for Payer: Cigna Commercial	$5.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.64
Rate for Payer: Oxford Commercial	$2.03
Rate for Payer: Qualcare PPO/HMO/WC	$1.52
Rate for Payer: UnitedHealthcare Commercial	$2.03
Rate for Payer: UnitedHealthcare Community & State	$0.32
Rate for Payer: Wellpoint Medicaid Managed Care	$0.29

SIGMOIDOSCOPE W/SUBMUC INJ

Facility

$3,720.52

Service Code	HCPCS 45335
Hospital Charge Code	16000981
Hospital Revenue Code	360
Min. Negotiated Rate	$558.08
Max. Negotiated Rate	$558.08
Rate for Payer: Qualcare PPO/HMO/WC	$558.08

Know your out-of-pocket cost for care.

All Charges