Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

STATLOCK FOR INTRA AORTIC BALL

Facility

$89.50

Hospital Charge Code	270657663
Hospital Revenue Code	270
Min. Negotiated Rate	$2.54
Max. Negotiated Rate	$44.75
Rate for Payer: Aetna Commercial	$34.01
Rate for Payer: Aetna Medicare Advantage	$26.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.82
Rate for Payer: Cigna Commercial	$44.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.27
Rate for Payer: Oxford Commercial	$17.90
Rate for Payer: Qualcare PPO/HMO/WC	$13.43
Rate for Payer: UnitedHealthcare Commercial	$17.90
Rate for Payer: UnitedHealthcare Community & State	$2.83
Rate for Payer: Wellpoint Medicaid Managed Care	$2.54

STATLOCK FOR INTRA AORTIC BALL

Facility

$89.50

Hospital Charge Code	270657663S
Hospital Revenue Code	270
Min. Negotiated Rate	$2.54
Max. Negotiated Rate	$44.75
Rate for Payer: Aetna Commercial	$34.01
Rate for Payer: Aetna Medicare Advantage	$26.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.82
Rate for Payer: Cigna Commercial	$44.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.27
Rate for Payer: Oxford Commercial	$17.90
Rate for Payer: Qualcare PPO/HMO/WC	$13.43
Rate for Payer: UnitedHealthcare Commercial	$17.90
Rate for Payer: UnitedHealthcare Community & State	$2.83
Rate for Payer: Wellpoint Medicaid Managed Care	$2.54

STAT TACK FIZATION 5MM

Facility

$828.65

Hospital Charge Code	270619730
Hospital Revenue Code	272
Min. Negotiated Rate	$23.53
Max. Negotiated Rate	$414.32
Rate for Payer: Aetna Commercial	$314.89
Rate for Payer: Aetna Medicare Advantage	$248.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.31
Rate for Payer: Cigna Commercial	$414.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.45
Rate for Payer: Oxford Commercial	$165.73
Rate for Payer: Qualcare PPO/HMO/WC	$124.30
Rate for Payer: UnitedHealthcare Commercial	$165.73
Rate for Payer: UnitedHealthcare Community & State	$26.19
Rate for Payer: Wellpoint Medicaid Managed Care	$23.53

STAT TACK FIZATION 5MM

Facility

$828.65

Hospital Charge Code	270619730
Hospital Revenue Code	272
Min. Negotiated Rate	$124.30
Max. Negotiated Rate	$124.30
Rate for Payer: Qualcare PPO/HMO/WC	$124.30

ST AUDIOMETRIC SCREENING

Facility

$66.00

Service Code	HCPCS 92551GN
Hospital Charge Code	74204001
Hospital Revenue Code	440
Min. Negotiated Rate	$9.90
Max. Negotiated Rate	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$9.90

ST AUDIOMETRIC SCREENING

Facility

$66.00

Service Code	HCPCS 92551GN
Hospital Charge Code	74204001
Hospital Revenue Code	440
Min. Negotiated Rate	$1.87
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$25.08
Rate for Payer: Aetna Medicare Advantage	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.83
Rate for Payer: Cigna Commercial	$33.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.16
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.90
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$2.09
Rate for Payer: Wellpoint Medicaid Managed Care	$1.87

ST AUG DEVICE EVALUATION

Facility

$646.00

Service Code	HCPCS 92597GN
Hospital Charge Code	74204019
Hospital Revenue Code	440
Min. Negotiated Rate	$96.90
Max. Negotiated Rate	$96.90
Rate for Payer: Qualcare PPO/HMO/WC	$96.90

ST AUG DEVICE EVALUATION

Facility

$646.00

Service Code	HCPCS 92597GN
Hospital Charge Code	74204019
Hospital Revenue Code	440
Min. Negotiated Rate	$18.35
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$245.48
Rate for Payer: Aetna Medicare Advantage	$193.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$164.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$164.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$164.73
Rate for Payer: Cigna Commercial	$323.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.96
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$96.90
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$20.41
Rate for Payer: Wellpoint Medicaid Managed Care	$18.35

ST AURAL REHABILITATION

Facility

$959.00

Service Code	HCPCS 92506GN
Hospital Charge Code	74204009
Hospital Revenue Code	444
Min. Negotiated Rate	$30.30
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$364.42
Rate for Payer: Aetna Medicare Advantage	$287.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$244.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$244.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$244.54
Rate for Payer: Cigna Commercial	$479.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.34
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$143.85
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$30.30
Rate for Payer: Wellpoint Medicaid Managed Care	$65.00

ST AURAL REHABILITATION

Facility

$959.00

Service Code	HCPCS 92506GN
Hospital Charge Code	74204009
Hospital Revenue Code	444
Min. Negotiated Rate	$143.85
Max. Negotiated Rate	$143.85
Rate for Payer: Qualcare PPO/HMO/WC	$143.85

STAVUDINE 20MG CAPSULE

Facility

$57.08

Service Code	NDC 3196501
Hospital Charge Code	60632297
Hospital Revenue Code	250
Min. Negotiated Rate	$8.56
Max. Negotiated Rate	$8.56
Rate for Payer: Qualcare PPO/HMO/WC	$8.56

STAVUDINE 20MG CAPSULE

Facility

$57.08

Service Code	NDC 3196501
Hospital Charge Code	60632297
Hospital Revenue Code	250
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$28.54
Rate for Payer: Aetna Commercial	$21.69
Rate for Payer: Aetna Medicare Advantage	$17.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.56
Rate for Payer: Cigna Commercial	$28.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.84
Rate for Payer: Oxford Commercial	$11.42
Rate for Payer: Qualcare PPO/HMO/WC	$8.56
Rate for Payer: UnitedHealthcare Commercial	$11.42
Rate for Payer: UnitedHealthcare Community & State	$1.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1.62

STAVUDINE 30MG CAPSULE

Facility

$60.64

Service Code	NDC 3196601
Hospital Charge Code	60632296
Hospital Revenue Code	250
Min. Negotiated Rate	$9.10
Max. Negotiated Rate	$9.10
Rate for Payer: Qualcare PPO/HMO/WC	$9.10

STAVUDINE 30MG CAPSULE

Facility

$60.64

Service Code	NDC 3196601
Hospital Charge Code	60632296
Hospital Revenue Code	250
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$30.32
Rate for Payer: Aetna Commercial	$23.04
Rate for Payer: Aetna Medicare Advantage	$18.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.46
Rate for Payer: Cigna Commercial	$30.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.77
Rate for Payer: Oxford Commercial	$12.13
Rate for Payer: Qualcare PPO/HMO/WC	$9.10
Rate for Payer: UnitedHealthcare Commercial	$12.13
Rate for Payer: UnitedHealthcare Community & State	$1.92
Rate for Payer: Wellpoint Medicaid Managed Care	$1.72

STAVUDINE 40MG CAPSULE

Facility

$61.77

Service Code	NDC 3196701
Hospital Charge Code	60632295
Hospital Revenue Code	250
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$30.89
Rate for Payer: Aetna Commercial	$23.47
Rate for Payer: Aetna Medicare Advantage	$18.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.75
Rate for Payer: Cigna Commercial	$30.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.06
Rate for Payer: Oxford Commercial	$12.35
Rate for Payer: Qualcare PPO/HMO/WC	$9.27
Rate for Payer: UnitedHealthcare Commercial	$12.35
Rate for Payer: UnitedHealthcare Community & State	$1.95
Rate for Payer: Wellpoint Medicaid Managed Care	$1.75

STAVUDINE 40MG CAPSULE

Facility

$61.77

Service Code	NDC 3196701
Hospital Charge Code	60632295
Hospital Revenue Code	250
Min. Negotiated Rate	$9.27
Max. Negotiated Rate	$9.27
Rate for Payer: Qualcare PPO/HMO/WC	$9.27

STAYS 5MM 3311-8G

Facility

$41.46

Hospital Charge Code	270608601
Hospital Revenue Code	272
Min. Negotiated Rate	$1.18
Max. Negotiated Rate	$20.73
Rate for Payer: Aetna Commercial	$15.75
Rate for Payer: Aetna Medicare Advantage	$12.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.57
Rate for Payer: Cigna Commercial	$20.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.78
Rate for Payer: Oxford Commercial	$8.29
Rate for Payer: Qualcare PPO/HMO/WC	$6.22
Rate for Payer: UnitedHealthcare Commercial	$8.29
Rate for Payer: UnitedHealthcare Community & State	$1.31
Rate for Payer: Wellpoint Medicaid Managed Care	$1.18

STAYS 5MM 3311-8G

Facility

$41.46

Hospital Charge Code	270608601
Hospital Revenue Code	272
Min. Negotiated Rate	$6.22
Max. Negotiated Rate	$6.22
Rate for Payer: Qualcare PPO/HMO/WC	$6.22

ST BEH QUAL ANALY VOICE & RESO

Facility

$2,400.00

Service Code	HCPCS 92524GN
Hospital Charge Code	74204045
Hospital Revenue Code	444
Min. Negotiated Rate	$360.00
Max. Negotiated Rate	$360.00
Rate for Payer: Qualcare PPO/HMO/WC	$360.00

ST BEH QUAL ANALY VOICE & RESO

Facility

$2,400.00

Service Code	HCPCS 92524GN
Hospital Charge Code	74204045
Hospital Revenue Code	444
Min. Negotiated Rate	$65.00
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$912.00
Rate for Payer: Aetna Medicare Advantage	$720.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$612.00
Rate for Payer: Cigna Commercial	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.00
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$360.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$75.84
Rate for Payer: Wellpoint Medicaid Managed Care	$65.00

STD1 COLLARED

Facility

$8,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686976
Hospital Revenue Code	278
Min. Negotiated Rate	$227.20
Max. Negotiated Rate	$4,000.00
Rate for Payer: Aetna Commercial	$3,040.00
Rate for Payer: Aetna Medicare Advantage	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,040.00
Rate for Payer: Cigna Commercial	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00
Rate for Payer: UnitedHealthcare Community & State	$252.80
Rate for Payer: Wellpoint Medicaid Managed Care	$227.20

STD1 COLLARED

Facility

$8,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686976
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

STD FEMORAL HEAD

Facility

$11,480.00

Service Code	HCPCS C1776
Hospital Charge Code	270667471
Hospital Revenue Code	278
Min. Negotiated Rate	$326.03
Max. Negotiated Rate	$5,740.00
Rate for Payer: Aetna Commercial	$4,362.40
Rate for Payer: Aetna Medicare Advantage	$3,444.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,927.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,927.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,296.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,927.40
Rate for Payer: Cigna Commercial	$5,740.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,778.16
Rate for Payer: Qualcare PPO/HMO/WC	$1,722.00
Rate for Payer: UnitedHealthcare Community & State	$362.77
Rate for Payer: Wellpoint Medicaid Managed Care	$326.03

STD FEMORAL HEAD

Facility

$11,480.00

Service Code	HCPCS C1776
Hospital Charge Code	270667471
Hospital Revenue Code	278
Min. Negotiated Rate	$1,722.00
Max. Negotiated Rate	$2,778.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,296.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,778.16
Rate for Payer: Qualcare PPO/HMO/WC	$1,722.00

STD FEM STEM ECHO SZ 10

Facility

$15,000.00

Hospital Charge Code	270702516
Hospital Revenue Code	278
Min. Negotiated Rate	$426.00
Max. Negotiated Rate	$7,500.00
Rate for Payer: Aetna Commercial	$5,700.00
Rate for Payer: Aetna Medicare Advantage	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,825.00
Rate for Payer: Cigna Commercial	$7,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00
Rate for Payer: UnitedHealthcare Community & State	$474.00
Rate for Payer: Wellpoint Medicaid Managed Care	$426.00

Know your out-of-pocket cost for care.

All Charges