Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SPHINCTEROTOME 5MM 20MM

Facility

$980.00

Hospital Charge Code	270701540
Hospital Revenue Code	278
Min. Negotiated Rate	$27.83
Max. Negotiated Rate	$490.00
Rate for Payer: Aetna Commercial	$372.40
Rate for Payer: Aetna Medicare Advantage	$294.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.90
Rate for Payer: Cigna Commercial	$490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.16
Rate for Payer: Qualcare PPO/HMO/WC	$147.00
Rate for Payer: UnitedHealthcare Community & State	$30.97
Rate for Payer: Wellpoint Medicaid Managed Care	$27.83

SPHINCTEROTOME 5MM 20MM

Facility

$980.00

Hospital Charge Code	270701541
Hospital Revenue Code	278
Min. Negotiated Rate	$27.83
Max. Negotiated Rate	$490.00
Rate for Payer: Aetna Commercial	$372.40
Rate for Payer: Aetna Medicare Advantage	$294.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.90
Rate for Payer: Cigna Commercial	$490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.16
Rate for Payer: Qualcare PPO/HMO/WC	$147.00
Rate for Payer: UnitedHealthcare Community & State	$30.97
Rate for Payer: Wellpoint Medicaid Managed Care	$27.83

SPHINCTEROTOME-BILLROTH DOUBLE

Facility

$1,130.00

Service Code	HCPCS C1729
Hospital Charge Code	270679383
Hospital Revenue Code	278
Min. Negotiated Rate	$32.09
Max. Negotiated Rate	$565.00
Rate for Payer: Aetna Commercial	$429.40
Rate for Payer: Aetna Medicare Advantage	$339.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$288.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$288.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$226.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$288.15
Rate for Payer: Cigna Commercial	$565.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$273.46
Rate for Payer: Qualcare PPO/HMO/WC	$169.50
Rate for Payer: UnitedHealthcare Community & State	$35.71
Rate for Payer: Wellpoint Medicaid Managed Care	$32.09

SPHINCTEROTOME-BILLROTH DOUBLE

Facility

$1,130.00

Service Code	HCPCS C1729
Hospital Charge Code	270679383
Hospital Revenue Code	278
Min. Negotiated Rate	$169.50
Max. Negotiated Rate	$273.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$226.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$273.46
Rate for Payer: Qualcare PPO/HMO/WC	$169.50

SPHINCTEROTOME CELVER CUT 3 V

Facility

$1,925.00

Hospital Charge Code	270684735
Hospital Revenue Code	272
Min. Negotiated Rate	$288.75
Max. Negotiated Rate	$288.75
Rate for Payer: Qualcare PPO/HMO/WC	$288.75

SPHINCTEROTOME CELVER CUT 3 V

Facility

$1,925.00

Hospital Charge Code	270684735
Hospital Revenue Code	272
Min. Negotiated Rate	$54.67
Max. Negotiated Rate	$962.50
Rate for Payer: Aetna Commercial	$731.50
Rate for Payer: Aetna Medicare Advantage	$577.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$490.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$490.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$490.88
Rate for Payer: Cigna Commercial	$962.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$500.50
Rate for Payer: Oxford Commercial	$385.00
Rate for Payer: Qualcare PPO/HMO/WC	$288.75
Rate for Payer: UnitedHealthcare Commercial	$385.00
Rate for Payer: UnitedHealthcare Community & State	$60.83
Rate for Payer: Wellpoint Medicaid Managed Care	$54.67

SPHINCTEROTOME MCV 20MM 4517

Facility

$1,097.25

Hospital Charge Code	270630651
Hospital Revenue Code	272
Min. Negotiated Rate	$31.16
Max. Negotiated Rate	$548.62
Rate for Payer: Aetna Commercial	$416.95
Rate for Payer: Aetna Medicare Advantage	$329.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$279.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$279.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$279.80
Rate for Payer: Cigna Commercial	$548.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$285.29
Rate for Payer: Oxford Commercial	$219.45
Rate for Payer: Qualcare PPO/HMO/WC	$164.59
Rate for Payer: UnitedHealthcare Commercial	$219.45
Rate for Payer: UnitedHealthcare Community & State	$34.67
Rate for Payer: Wellpoint Medicaid Managed Care	$31.16

SPHINCTEROTOME MCV 20MM 4517

Facility

$1,097.25

Hospital Charge Code	270630651
Hospital Revenue Code	272
Min. Negotiated Rate	$164.59
Max. Negotiated Rate	$164.59
Rate for Payer: Qualcare PPO/HMO/WC	$164.59

SPHINCTERTMY ANL DIV OF SPH

Facility

$16,685.10

Service Code	HCPCS 46080
Hospital Charge Code	1600000381
Hospital Revenue Code	360
Min. Negotiated Rate	$2,502.76
Max. Negotiated Rate	$2,502.76
Rate for Payer: Qualcare PPO/HMO/WC	$2,502.76

SPHINCTERTMY ANL DIV OF SPH

Facility

$16,685.10

Service Code	HCPCS 46080
Hospital Charge Code	1600000381
Hospital Revenue Code	360
Min. Negotiated Rate	$473.86
Max. Negotiated Rate	$11,961.90
Rate for Payer: Aetna Commercial	$8,969.36
Rate for Payer: Aetna Medicare Advantage	$10,684.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,961.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,961.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,297.56
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	$11,961.90
Rate for Payer: Cigna Commercial	$6,609.93
Rate for Payer: Cigna Medicare Advantage	$3,297.56
Rate for Payer: Clover Medicare Advantage	$3,132.68
Rate for Payer: EmblemHealth Commercial	$9,892.68
Rate for Payer: Humana Medicare Advantage	$3,396.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,297.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,338.13
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,502.76
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$527.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,297.56
Rate for Payer: Wellcare Medicare Advantage	$3,297.56
Rate for Payer: Wellpoint Medicaid Managed Care	$473.86

SPHINCTER URINARY AMS800

Facility

$39,500.00

Service Code	HCPCS C1813
Hospital Charge Code	270700789
Hospital Revenue Code	278
Min. Negotiated Rate	$1,121.80
Max. Negotiated Rate	$19,750.00
Rate for Payer: Aetna Commercial	$15,010.00
Rate for Payer: Aetna Medicare Advantage	$11,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,072.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,072.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,072.50
Rate for Payer: Cigna Commercial	$19,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,925.00
Rate for Payer: UnitedHealthcare Community & State	$1,248.20
Rate for Payer: Wellpoint Medicaid Managed Care	$1,121.80

SPHINCTER URINARY AMS800

Facility

$39,500.00

Service Code	HCPCS C1813
Hospital Charge Code	270700789
Hospital Revenue Code	278
Min. Negotiated Rate	$5,925.00
Max. Negotiated Rate	$9,559.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,925.00

SPICA THUMB MEDIUM LEFT

Facility

$71.55

Hospital Charge Code	270653979
Hospital Revenue Code	272
Min. Negotiated Rate	$10.73
Max. Negotiated Rate	$10.73
Rate for Payer: Qualcare PPO/HMO/WC	$10.73

SPICA THUMB MEDIUM LEFT

Facility

$71.55

Hospital Charge Code	270653979
Hospital Revenue Code	272
Min. Negotiated Rate	$2.03
Max. Negotiated Rate	$35.77
Rate for Payer: Aetna Commercial	$27.19
Rate for Payer: Aetna Medicare Advantage	$21.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.25
Rate for Payer: Cigna Commercial	$35.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.60
Rate for Payer: Oxford Commercial	$14.31
Rate for Payer: Qualcare PPO/HMO/WC	$10.73
Rate for Payer: UnitedHealthcare Commercial	$14.31
Rate for Payer: UnitedHealthcare Community & State	$2.26
Rate for Payer: Wellpoint Medicaid Managed Care	$2.03

SPICA THUMB SMALL LEFT

Facility

$73.65

Hospital Charge Code	270653980
Hospital Revenue Code	272
Min. Negotiated Rate	$2.09
Max. Negotiated Rate	$36.83
Rate for Payer: Aetna Commercial	$27.99
Rate for Payer: Aetna Medicare Advantage	$22.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.78
Rate for Payer: Cigna Commercial	$36.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.15
Rate for Payer: Oxford Commercial	$14.73
Rate for Payer: Qualcare PPO/HMO/WC	$11.05
Rate for Payer: UnitedHealthcare Commercial	$14.73
Rate for Payer: UnitedHealthcare Community & State	$2.33
Rate for Payer: Wellpoint Medicaid Managed Care	$2.09

SPICA THUMB SMALL LEFT

Facility

$73.65

Hospital Charge Code	270653980
Hospital Revenue Code	272
Min. Negotiated Rate	$11.05
Max. Negotiated Rate	$11.05
Rate for Payer: Qualcare PPO/HMO/WC	$11.05

SPICA THUM MED RIGHT

Facility

$73.65

Hospital Charge Code	270653973
Hospital Revenue Code	272
Min. Negotiated Rate	$11.05
Max. Negotiated Rate	$11.05
Rate for Payer: Qualcare PPO/HMO/WC	$11.05

SPICA THUM MED RIGHT

Facility

$73.65

Hospital Charge Code	270653973
Hospital Revenue Code	272
Min. Negotiated Rate	$2.09
Max. Negotiated Rate	$36.83
Rate for Payer: Aetna Commercial	$27.99
Rate for Payer: Aetna Medicare Advantage	$22.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.78
Rate for Payer: Cigna Commercial	$36.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.15
Rate for Payer: Oxford Commercial	$14.73
Rate for Payer: Qualcare PPO/HMO/WC	$11.05
Rate for Payer: UnitedHealthcare Commercial	$14.73
Rate for Payer: UnitedHealthcare Community & State	$2.33
Rate for Payer: Wellpoint Medicaid Managed Care	$2.09

SPICA THUM SMALL RIGHT

Facility

$73.65

Hospital Charge Code	270653974
Hospital Revenue Code	272
Min. Negotiated Rate	$2.09
Max. Negotiated Rate	$36.83
Rate for Payer: Aetna Commercial	$27.99
Rate for Payer: Aetna Medicare Advantage	$22.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.78
Rate for Payer: Cigna Commercial	$36.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.15
Rate for Payer: Oxford Commercial	$14.73
Rate for Payer: Qualcare PPO/HMO/WC	$11.05
Rate for Payer: UnitedHealthcare Commercial	$14.73
Rate for Payer: UnitedHealthcare Community & State	$2.33
Rate for Payer: Wellpoint Medicaid Managed Care	$2.09

SPICA THUM SMALL RIGHT

Facility

$73.65

Hospital Charge Code	270653974
Hospital Revenue Code	272
Min. Negotiated Rate	$11.05
Max. Negotiated Rate	$11.05
Rate for Payer: Qualcare PPO/HMO/WC	$11.05

SPIDER VEINS LEG-30 MINUTES

Facility

$372.00

Service Code	HCPCS 36468
Hospital Charge Code	75190130
Hospital Revenue Code	510
Min. Negotiated Rate	$10.56
Max. Negotiated Rate	$1,751.90
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,751.90
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.72
Rate for Payer: Qualcare PPO/HMO/WC	$55.80
Rate for Payer: UnitedHealthcare Community & State	$11.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$10.56

SPIDER VEINS LEG-30 MINUTES

Facility

$372.00

Service Code	HCPCS 36468
Hospital Charge Code	75190130
Hospital Revenue Code	510
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

SPIDER WRIST ACCESSORY

Facility

$3,865.00

Hospital Charge Code	270688366
Hospital Revenue Code	272
Min. Negotiated Rate	$579.75
Max. Negotiated Rate	$579.75
Rate for Payer: Qualcare PPO/HMO/WC	$579.75

SPIDER WRIST ACCESSORY

Facility

$3,865.00

Hospital Charge Code	270688366
Hospital Revenue Code	272
Min. Negotiated Rate	$109.77
Max. Negotiated Rate	$1,932.50
Rate for Payer: Aetna Commercial	$1,468.70
Rate for Payer: Aetna Medicare Advantage	$1,159.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$985.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$985.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$985.58
Rate for Payer: Cigna Commercial	$1,932.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,004.90
Rate for Payer: Oxford Commercial	$773.00
Rate for Payer: Qualcare PPO/HMO/WC	$579.75
Rate for Payer: UnitedHealthcare Commercial	$773.00
Rate for Payer: UnitedHealthcare Community & State	$122.13
Rate for Payer: Wellpoint Medicaid Managed Care	$109.77

SPI FIL WIRE 6.0M SPD2US060320

Facility

$6,000.00

Hospital Charge Code	270638657
Hospital Revenue Code	272
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$900.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

Know your out-of-pocket cost for care.

All Charges