Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SIMPLIFY DISC SZ 3 HT 5

Facility

$26,991.25

Service Code	HCPCS C1713
Hospital Charge Code	270703756
Hospital Revenue Code	278
Min. Negotiated Rate	$766.55
Max. Negotiated Rate	$13,495.62
Rate for Payer: Aetna Commercial	$10,256.67
Rate for Payer: Aetna Medicare Advantage	$8,097.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,882.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,882.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,398.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,882.77
Rate for Payer: Cigna Commercial	$13,495.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,531.88
Rate for Payer: Qualcare PPO/HMO/WC	$4,048.69
Rate for Payer: UnitedHealthcare Community & State	$852.92
Rate for Payer: Wellpoint Medicaid Managed Care	$766.55

SIMPLIFY DISC SZ 3 HT 5

Facility

$26,991.25

Service Code	HCPCS C1713
Hospital Charge Code	270703756
Hospital Revenue Code	278
Min. Negotiated Rate	$4,048.69
Max. Negotiated Rate	$6,531.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,398.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,531.88
Rate for Payer: Qualcare PPO/HMO/WC	$4,048.69

SIMPL SOLO SYST W/SHOW 0067700

Facility

$247.98

Hospital Charge Code	270640026
Hospital Revenue Code	272
Min. Negotiated Rate	$7.04
Max. Negotiated Rate	$123.99
Rate for Payer: Aetna Commercial	$94.23
Rate for Payer: Aetna Medicare Advantage	$74.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.23
Rate for Payer: Cigna Commercial	$123.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.47
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

SIMPL SOLO SYST W/SHOW 0067700

Facility

$247.98

Hospital Charge Code	270640026
Hospital Revenue Code	272
Min. Negotiated Rate	$37.20
Max. Negotiated Rate	$37.20
Rate for Payer: Qualcare PPO/HMO/WC	$37.20

SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT

Facility

$196,533.92

Service Code	MSDRG 008
Min. Negotiated Rate	$59,842.06
Max. Negotiated Rate	$196,533.92
Rate for Payer: Aetna Medicare Advantage	$196,533.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145,728.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145,728.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$62,991.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145,728.30
Rate for Payer: Cigna Commercial	$124,943.35
Rate for Payer: Cigna Medicare Advantage	$62,991.64
Rate for Payer: Clover Medicare Advantage	$59,842.06
Rate for Payer: EmblemHealth Commercial	$188,974.92
Rate for Payer: Humana Medicare Advantage	$64,881.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$62,991.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$62,991.64
Rate for Payer: Wellcare Medicare Advantage	$62,991.64

SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS

Facility

$244,872.05

Service Code	MSDRG 019
Min. Negotiated Rate	$74,560.40
Max. Negotiated Rate	$244,872.05
Rate for Payer: Aetna Medicare Advantage	$244,872.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$221,362.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$221,362.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$78,484.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$221,362.95
Rate for Payer: Cigna Commercial	$147,740.17
Rate for Payer: Cigna Medicare Advantage	$78,484.63
Rate for Payer: Clover Medicare Advantage	$74,560.40
Rate for Payer: EmblemHealth Commercial	$235,453.89
Rate for Payer: Humana Medicare Advantage	$80,839.17
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$78,484.63
Rate for Payer: Oxford Commercial	$116,771.26
Rate for Payer: UnitedHealthcare Commercial	$156,302.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$78,484.63
Rate for Payer: Wellcare Medicare Advantage	$78,484.63

SINCALIDE 5 MCG VIAL

Facility

$579.35

Service Code	HCPCS J2805
Hospital Charge Code	6063943241
Hospital Revenue Code	636
Min. Negotiated Rate	$16.45
Max. Negotiated Rate	$289.68
Rate for Payer: Aetna Commercial	$220.15
Rate for Payer: Aetna Medicare Advantage	$173.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.73
Rate for Payer: Cigna Commercial	$289.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.20
Rate for Payer: Qualcare PPO/HMO/WC	$86.90
Rate for Payer: UnitedHealthcare Community & State	$18.31
Rate for Payer: Wellpoint Medicaid Managed Care	$16.45

SINCALIDE 5 MCG VIAL

Facility

$579.35

Service Code	HCPCS J2805
Hospital Charge Code	6063943241
Hospital Revenue Code	636
Min. Negotiated Rate	$86.90
Max. Negotiated Rate	$140.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.20
Rate for Payer: Qualcare PPO/HMO/WC	$86.90

Sincalide for Injection-Vial (

Facility

$430.04

Hospital Charge Code	4509087
Hospital Revenue Code	636
Min. Negotiated Rate	$64.51
Max. Negotiated Rate	$104.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.07
Rate for Payer: Qualcare PPO/HMO/WC	$64.51

Sincalide for Injection-Vial (

Facility

$430.04

Hospital Charge Code	4509087
Hospital Revenue Code	636
Min. Negotiated Rate	$12.21
Max. Negotiated Rate	$215.02
Rate for Payer: Aetna Commercial	$163.42
Rate for Payer: Aetna Medicare Advantage	$129.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.66
Rate for Payer: Cigna Commercial	$215.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.07
Rate for Payer: Qualcare PPO/HMO/WC	$64.51
Rate for Payer: UnitedHealthcare Community & State	$13.59
Rate for Payer: Wellpoint Medicaid Managed Care	$12.21

SINEMET

Facility

$324.00

Service Code	HCPCS 80299
Hospital Charge Code	38472754
Hospital Revenue Code	301
Min. Negotiated Rate	$9.20
Max. Negotiated Rate	$162.00
Rate for Payer: Aetna Commercial	$50.70
Rate for Payer: Aetna Medicare Advantage	$60.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.62
Rate for Payer: Cigna Commercial	$162.00
Rate for Payer: Cigna Medicare Advantage	$18.64
Rate for Payer: Clover Medicare Advantage	$17.71
Rate for Payer: EmblemHealth Commercial	$55.92
Rate for Payer: Humana Medicare Advantage	$19.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.24
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.60
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Medicare Advantage	$18.64
Rate for Payer: Wellpoint Medicaid Managed Care	$9.20

SINEMET

Facility

$324.00

Service Code	HCPCS 80299
Hospital Charge Code	38472754
Hospital Revenue Code	301
Min. Negotiated Rate	$48.60
Max. Negotiated Rate	$48.60
Rate for Payer: Qualcare PPO/HMO/WC	$48.60

SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL

Facility

$146,486.59

Service Code	MSDRG 402
Min. Negotiated Rate	$44,603.29
Max. Negotiated Rate	$146,486.59
Rate for Payer: Aetna Commercial	$106,187.94
Rate for Payer: Aetna Medicare Advantage	$146,486.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$46,950.83
Rate for Payer: Cigna Commercial	$89,629.01
Rate for Payer: Cigna Medicare Advantage	$46,950.83
Rate for Payer: Clover Medicare Advantage	$44,603.29
Rate for Payer: EmblemHealth Commercial	$140,852.49
Rate for Payer: Humana Medicare Advantage	$48,359.35
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$46,950.83
Rate for Payer: Oxford Commercial	$70,841.21
Rate for Payer: UnitedHealthcare Commercial	$94,823.49
Rate for Payer: UnitedHealthcare Medicare Advantage	$46,950.83
Rate for Payer: Wellcare Medicare Advantage	$46,950.83

SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE

Facility

$187,845.65

Service Code	MSDRG 450
Min. Negotiated Rate	$57,196.59
Max. Negotiated Rate	$187,845.65
Rate for Payer: Aetna Commercial	$135,644.34
Rate for Payer: Aetna Medicare Advantage	$187,845.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$60,206.94
Rate for Payer: Cigna Commercial	$118,812.77
Rate for Payer: Cigna Medicare Advantage	$60,206.94
Rate for Payer: Clover Medicare Advantage	$57,196.59
Rate for Payer: EmblemHealth Commercial	$180,620.82
Rate for Payer: Humana Medicare Advantage	$62,013.15
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$60,206.94
Rate for Payer: Oxford Commercial	$93,907.55
Rate for Payer: UnitedHealthcare Commercial	$125,698.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$60,206.94
Rate for Payer: Wellcare Medicare Advantage	$60,206.94

SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC

Facility

$121,524.53

Service Code	MSDRG 451
Min. Negotiated Rate	$37,002.66
Max. Negotiated Rate	$121,524.53
Rate for Payer: Aetna Commercial	$88,409.69
Rate for Payer: Aetna Medicare Advantage	$121,524.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$38,950.17
Rate for Payer: Cigna Commercial	$72,015.31
Rate for Payer: Cigna Medicare Advantage	$38,950.17
Rate for Payer: Clover Medicare Advantage	$37,002.66
Rate for Payer: EmblemHealth Commercial	$116,850.51
Rate for Payer: Humana Medicare Advantage	$40,118.68
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$38,950.17
Rate for Payer: Oxford Commercial	$56,919.65
Rate for Payer: UnitedHealthcare Commercial	$76,188.98
Rate for Payer: UnitedHealthcare Medicare Advantage	$38,950.17
Rate for Payer: Wellcare Medicare Advantage	$38,950.17

SINGLE USE ADULT BP CUFF

Facility

$29.20

Hospital Charge Code	270654010
Hospital Revenue Code	272
Min. Negotiated Rate	$4.38
Max. Negotiated Rate	$4.38
Rate for Payer: Qualcare PPO/HMO/WC	$4.38

SINGLE USE ADULT BP CUFF

Facility

$29.20

Hospital Charge Code	270654010
Hospital Revenue Code	272
Min. Negotiated Rate	$0.83
Max. Negotiated Rate	$14.60
Rate for Payer: Aetna Commercial	$11.10
Rate for Payer: Aetna Medicare Advantage	$8.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.45
Rate for Payer: Cigna Commercial	$14.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.59
Rate for Payer: Oxford Commercial	$5.84
Rate for Payer: Qualcare PPO/HMO/WC	$4.38
Rate for Payer: UnitedHealthcare Commercial	$5.84
Rate for Payer: UnitedHealthcare Community & State	$0.92
Rate for Payer: Wellpoint Medicaid Managed Care	$0.83

SINGLE USE HUMIDIFYING CHAMBER

Facility

$98.00

Hospital Charge Code	270332051
Hospital Revenue Code	272
Min. Negotiated Rate	$2.78
Max. Negotiated Rate	$49.00
Rate for Payer: Aetna Commercial	$37.24
Rate for Payer: Aetna Medicare Advantage	$29.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.99
Rate for Payer: Cigna Commercial	$49.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.48
Rate for Payer: Oxford Commercial	$19.60
Rate for Payer: Qualcare PPO/HMO/WC	$14.70
Rate for Payer: UnitedHealthcare Commercial	$19.60
Rate for Payer: UnitedHealthcare Community & State	$3.10
Rate for Payer: Wellpoint Medicaid Managed Care	$2.78

SINGLE USE HUMIDIFYING CHAMBER

Facility

$98.00

Hospital Charge Code	270332051
Hospital Revenue Code	272
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$14.70
Rate for Payer: Qualcare PPO/HMO/WC	$14.70

SINGLE USE LIGATING DEVICE

Facility

$867.00

Hospital Charge Code	270325383
Hospital Revenue Code	272
Min. Negotiated Rate	$24.62
Max. Negotiated Rate	$433.50
Rate for Payer: Aetna Commercial	$329.46
Rate for Payer: Aetna Medicare Advantage	$260.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$221.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$221.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$221.09
Rate for Payer: Cigna Commercial	$433.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.42
Rate for Payer: Oxford Commercial	$173.40
Rate for Payer: Qualcare PPO/HMO/WC	$130.05
Rate for Payer: UnitedHealthcare Commercial	$173.40
Rate for Payer: UnitedHealthcare Community & State	$27.40
Rate for Payer: Wellpoint Medicaid Managed Care	$24.62

SINGLE USE LIGATING DEVICE

Facility

$174.00

Hospital Charge Code	270325685
Hospital Revenue Code	272
Min. Negotiated Rate	$26.10
Max. Negotiated Rate	$26.10
Rate for Payer: Qualcare PPO/HMO/WC	$26.10

SINGLE USE LIGATING DEVICE

Facility

$867.00

Hospital Charge Code	270325383
Hospital Revenue Code	272
Min. Negotiated Rate	$130.05
Max. Negotiated Rate	$130.05
Rate for Payer: Qualcare PPO/HMO/WC	$130.05

SINGLE USE LIGATING DEVICE

Facility

$174.00

Hospital Charge Code	270325685
Hospital Revenue Code	272
Min. Negotiated Rate	$4.94
Max. Negotiated Rate	$87.00
Rate for Payer: Aetna Commercial	$66.12
Rate for Payer: Aetna Medicare Advantage	$52.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.37
Rate for Payer: Cigna Commercial	$87.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.24
Rate for Payer: Oxford Commercial	$34.80
Rate for Payer: Qualcare PPO/HMO/WC	$26.10
Rate for Payer: UnitedHealthcare Commercial	$34.80
Rate for Payer: UnitedHealthcare Community & State	$5.50
Rate for Payer: Wellpoint Medicaid Managed Care	$4.94

SING/MULT TRIGGER PTS INJ 3 OR

Facility

$1,091.00

Service Code	HCPCS 20553
Hospital Charge Code	5780025
Hospital Revenue Code	450
Min. Negotiated Rate	$29.78
Max. Negotiated Rate	$1,322.84
Rate for Payer: Aetna Commercial	$991.90
Rate for Payer: Aetna Medicare Advantage	$1,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,322.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,322.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$364.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,322.84
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: Cigna Medicare Advantage	$364.67
Rate for Payer: Clover Medicare Advantage	$346.44
Rate for Payer: EmblemHealth Commercial	$1,094.01
Rate for Payer: Humana Medicare Advantage	$375.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$364.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$283.66
Rate for Payer: Qualcare PPO/HMO/WC	$163.65
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$364.67
Rate for Payer: Wellcare Medicare Advantage	$364.67
Rate for Payer: Wellpoint Medicaid Managed Care	$30.98

SING/MULT TRIGGER PTS INJ 3 OR

Facility

$1,091.00

Service Code	HCPCS 20553
Hospital Charge Code	5780025
Hospital Revenue Code	450
Min. Negotiated Rate	$163.65
Max. Negotiated Rate	$163.65
Rate for Payer: Qualcare PPO/HMO/WC	$163.65

Know your out-of-pocket cost for care.

All Charges