Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SPECULUM VAGINAL LARGE DISP.

Facility

$8.64

Hospital Charge Code	270658820
Hospital Revenue Code	270
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$1.30
Rate for Payer: Qualcare PPO/HMO/WC	$1.30

SPECULUM VAGINAL SMALL DISP

Facility

$6.90

Hospital Charge Code	270652828
Hospital Revenue Code	270
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$3.45
Rate for Payer: Aetna Commercial	$2.62
Rate for Payer: Aetna Medicare Advantage	$2.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.76
Rate for Payer: Cigna Commercial	$3.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.79
Rate for Payer: Oxford Commercial	$1.38
Rate for Payer: Qualcare PPO/HMO/WC	$1.03
Rate for Payer: UnitedHealthcare Commercial	$1.38
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

SPECULUM VAGINAL SMALL DISP

Facility

$6.90

Hospital Charge Code	270652828
Hospital Revenue Code	270
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$1.03
Rate for Payer: Qualcare PPO/HMO/WC	$1.03

SPECULUUM VAG AUVARD WEIGHTED

Facility

$2,469.30

Hospital Charge Code	270611251
Hospital Revenue Code	270
Min. Negotiated Rate	$70.13
Max. Negotiated Rate	$1,234.65
Rate for Payer: Aetna Commercial	$938.33
Rate for Payer: Aetna Medicare Advantage	$740.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$629.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$629.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$629.67
Rate for Payer: Cigna Commercial	$1,234.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$642.02
Rate for Payer: Oxford Commercial	$493.86
Rate for Payer: Qualcare PPO/HMO/WC	$370.39
Rate for Payer: UnitedHealthcare Commercial	$493.86
Rate for Payer: UnitedHealthcare Community & State	$78.03
Rate for Payer: Wellpoint Medicaid Managed Care	$70.13

SPECULUUM VAG AUVARD WEIGHTED

Facility

$2,469.30

Hospital Charge Code	270611251
Hospital Revenue Code	270
Min. Negotiated Rate	$370.39
Max. Negotiated Rate	$370.39
Rate for Payer: Qualcare PPO/HMO/WC	$370.39

SPEECH LANG CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G9174GN
Hospital Charge Code	84201095
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

SPEECH LANG CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G9174GN
Hospital Charge Code	84201095
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

SPEECH LANG CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G9174GN
Hospital Charge Code	84201177
Hospital Revenue Code	449
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

SPEECH LANG CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G9174GN
Hospital Charge Code	84201177
Hospital Revenue Code	449
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

SPEECH LANG D/C STATUS

Facility

$0.01

Service Code	HCPCS G9178GN
Hospital Charge Code	84201179
Hospital Revenue Code	449
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

SPEECH LANG D/C STATUS

Facility

$0.01

Service Code	HCPCS G9178GN
Hospital Charge Code	84201179
Hospital Revenue Code	449
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

SPEECH LANG D/C STATUS

Facility

$0.01

Service Code	HCPCS G9176GN
Hospital Charge Code	84201105
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

SPEECH LANG D/C STATUS

Facility

$0.01

Service Code	HCPCS G9176GN
Hospital Charge Code	84201105
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

SPEECH LANG GOAL STATUS

Facility

$0.01

Service Code	HCPCS G9175GN
Hospital Charge Code	84201178
Hospital Revenue Code	449
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

SPEECH LANG GOAL STATUS

Facility

$0.01

Service Code	HCPCS G9175GN
Hospital Charge Code	84201178
Hospital Revenue Code	449
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

SPEECH LANG GOAL STATUS

Facility

$0.01

Service Code	HCPCS G9175GN
Hospital Charge Code	84201100
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

SPEECH LANG GOAL STATUS

Facility

$0.01

Service Code	HCPCS G9175GN
Hospital Charge Code	84201100
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

SPEEDAKIN RAP COMP IMP 9MMX9MM

Facility

$9,370.00

Hospital Charge Code	270702792
Hospital Revenue Code	278
Min. Negotiated Rate	$1,405.50
Max. Negotiated Rate	$2,267.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,874.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,267.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,405.50

SPEEDAKIN RAP COMP IMP 9MMX9MM

Facility

$9,370.00

Hospital Charge Code	270702792
Hospital Revenue Code	278
Min. Negotiated Rate	$266.11
Max. Negotiated Rate	$4,685.00
Rate for Payer: Aetna Commercial	$3,560.60
Rate for Payer: Aetna Medicare Advantage	$2,811.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,389.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,389.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,874.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,389.35
Rate for Payer: Cigna Commercial	$4,685.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,267.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,405.50
Rate for Payer: UnitedHealthcare Community & State	$296.09
Rate for Payer: Wellpoint Medicaid Managed Care	$266.11

SPEEDBRG IMP SYS W/BIO

Facility

$1,910.00

Hospital Charge Code	270687030
Hospital Revenue Code	272
Min. Negotiated Rate	$286.50
Max. Negotiated Rate	$286.50
Rate for Payer: Qualcare PPO/HMO/WC	$286.50

SPEEDBRG IMP SYS W/BIO

Facility

$1,910.00

Hospital Charge Code	270687030
Hospital Revenue Code	272
Min. Negotiated Rate	$54.24
Max. Negotiated Rate	$955.00
Rate for Payer: Aetna Commercial	$725.80
Rate for Payer: Aetna Medicare Advantage	$573.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$487.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$487.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$487.05
Rate for Payer: Cigna Commercial	$955.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$496.60
Rate for Payer: Oxford Commercial	$382.00
Rate for Payer: Qualcare PPO/HMO/WC	$286.50
Rate for Payer: UnitedHealthcare Commercial	$382.00
Rate for Payer: UnitedHealthcare Community & State	$60.36
Rate for Payer: Wellpoint Medicaid Managed Care	$54.24

SPEEDBRIDGE, ACHILLES

Facility

$14,160.00

Hospital Charge Code	270701993
Hospital Revenue Code	278
Min. Negotiated Rate	$2,124.00
Max. Negotiated Rate	$3,426.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,832.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,426.72
Rate for Payer: Qualcare PPO/HMO/WC	$2,124.00

SPEEDBRIDGE, ACHILLES

Facility

$14,160.00

Hospital Charge Code	270701993
Hospital Revenue Code	278
Min. Negotiated Rate	$402.14
Max. Negotiated Rate	$7,080.00
Rate for Payer: Aetna Commercial	$5,380.80
Rate for Payer: Aetna Medicare Advantage	$4,248.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,610.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,610.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,832.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,610.80
Rate for Payer: Cigna Commercial	$7,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,426.72
Rate for Payer: Qualcare PPO/HMO/WC	$2,124.00
Rate for Payer: UnitedHealthcare Community & State	$447.46
Rate for Payer: Wellpoint Medicaid Managed Care	$402.14

SPEEDBRIDGE IMP SYS 4.75/5.5MM

Facility

$9,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270699520
Hospital Revenue Code	278
Min. Negotiated Rate	$1,432.50
Max. Negotiated Rate	$2,311.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,910.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,311.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,432.50

SPEEDBRIDGE IMP SYS 4.75/5.5MM

Facility

$9,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270699520
Hospital Revenue Code	278
Min. Negotiated Rate	$271.22
Max. Negotiated Rate	$4,775.00
Rate for Payer: Aetna Commercial	$3,629.00
Rate for Payer: Aetna Medicare Advantage	$2,865.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,435.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,435.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,910.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,435.25
Rate for Payer: Cigna Commercial	$4,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,311.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,432.50
Rate for Payer: UnitedHealthcare Community & State	$301.78
Rate for Payer: Wellpoint Medicaid Managed Care	$271.22

Know your out-of-pocket cost for care.

All Charges