Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

STEREOTACGUIDEBRSTBIOP1STLESLT

Facility

$4,169.44

Service Code	HCPCS 19081
Hospital Charge Code	94064001L
Hospital Revenue Code	361
Min. Negotiated Rate	$625.42
Max. Negotiated Rate	$625.42
Rate for Payer: Qualcare PPO/HMO/WC	$625.42

STEREOTACGUIDEBRSTBIOP1STLESRT

Facility

$4,169.44

Service Code	HCPCS 19081
Hospital Charge Code	94064001R
Hospital Revenue Code	361
Min. Negotiated Rate	$118.41
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,084.05
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$625.42
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$131.75
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$118.41

STEREOTACGUIDEBRSTBIOP1STLESRT

Facility

$4,169.44

Service Code	HCPCS 19081
Hospital Charge Code	94064001R
Hospital Revenue Code	361
Min. Negotiated Rate	$625.42
Max. Negotiated Rate	$625.42
Rate for Payer: Qualcare PPO/HMO/WC	$625.42

STEREOTACGUIDEBRSTBIOPADDLESLT

Facility

$3,214.70

Service Code	HCPCS 19082
Hospital Charge Code	94064003L
Hospital Revenue Code	361
Min. Negotiated Rate	$482.20
Max. Negotiated Rate	$482.20
Rate for Payer: Qualcare PPO/HMO/WC	$482.20

STEREOTACGUIDEBRSTBIOPADDLESLT

Facility

$3,214.70

Service Code	HCPCS 19082
Hospital Charge Code	94064003L
Hospital Revenue Code	361
Min. Negotiated Rate	$91.30
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,221.59
Rate for Payer: Aetna Medicare Advantage	$964.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$819.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$819.75
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	$819.75
Rate for Payer: Cigna Commercial	$1,607.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$835.82
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$482.20
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$101.58
Rate for Payer: Wellpoint Medicaid Managed Care	$91.30

STEREOTACGUIDEBRSTBIOPADDLESRT

Facility

$3,214.70

Service Code	HCPCS 19082
Hospital Charge Code	94064003R
Hospital Revenue Code	361
Min. Negotiated Rate	$482.20
Max. Negotiated Rate	$482.20
Rate for Payer: Qualcare PPO/HMO/WC	$482.20

STEREOTACGUIDEBRSTBIOPADDLESRT

Facility

$3,214.70

Service Code	HCPCS 19082
Hospital Charge Code	94064003R
Hospital Revenue Code	361
Min. Negotiated Rate	$91.30
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,221.59
Rate for Payer: Aetna Medicare Advantage	$964.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$819.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$819.75
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	$819.75
Rate for Payer: Cigna Commercial	$1,607.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$835.82
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$482.20
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$101.58
Rate for Payer: Wellpoint Medicaid Managed Care	$91.30

STEREOTACGUIDEBRSTBIOPSY1STLES

Facility

$8,338.88

Service Code	HCPCS 19081
Hospital Charge Code	94064001
Hospital Revenue Code	361
Min. Negotiated Rate	$236.82
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,168.11
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,250.83
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$263.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$236.82

STEREOTACGUIDEBRSTBIOPSY1STLES

Facility

$8,338.88

Service Code	HCPCS 19081
Hospital Charge Code	94064001
Hospital Revenue Code	361
Min. Negotiated Rate	$1,250.83
Max. Negotiated Rate	$1,250.83
Rate for Payer: Qualcare PPO/HMO/WC	$1,250.83

STEREOTACGUIDEBRSTBIOPSYADDLES

Facility

$6,429.40

Service Code	HCPCS 19082
Hospital Charge Code	94064003
Hospital Revenue Code	361
Min. Negotiated Rate	$964.41
Max. Negotiated Rate	$964.41
Rate for Payer: Qualcare PPO/HMO/WC	$964.41

STEREOTACGUIDEBRSTBIOPSYADDLES

Facility

$6,429.40

Service Code	HCPCS 19082
Hospital Charge Code	94064003
Hospital Revenue Code	361
Min. Negotiated Rate	$182.59
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,443.17
Rate for Payer: Aetna Medicare Advantage	$1,928.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,639.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,639.50
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	$1,639.50
Rate for Payer: Cigna Commercial	$3,214.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,671.64
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$964.41
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$203.17
Rate for Payer: Wellpoint Medicaid Managed Care	$182.59

STEREOTACTIC BREAST BIOPSY

Facility

$2,669.00

Service Code	HCPCS 19081
Hospital Charge Code	87502806
Hospital Revenue Code	361
Min. Negotiated Rate	$400.35
Max. Negotiated Rate	$400.35
Rate for Payer: Qualcare PPO/HMO/WC	$400.35

STEREOTACTIC BREAST BIOPSY

Facility

$2,669.00

Service Code	HCPCS 19081
Hospital Charge Code	87502806
Hospital Revenue Code	361
Min. Negotiated Rate	$75.80
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$693.94
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$400.35
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$84.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$75.80

STEREOTACTIC BREAST BIOPSY

Facility

$2,669.00

Service Code	HCPCS 19081
Hospital Charge Code	2008035
Hospital Revenue Code	361
Min. Negotiated Rate	$75.80
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$693.94
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$400.35
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$84.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$75.80

STEREOTACTIC BREAST BIOPSY

Facility

$2,669.00

Service Code	HCPCS 19081
Hospital Charge Code	2008035
Hospital Revenue Code	361
Min. Negotiated Rate	$400.35
Max. Negotiated Rate	$400.35
Rate for Payer: Qualcare PPO/HMO/WC	$400.35

STEREOTACTIC BREAST LOCALIZATI

Facility

$1,597.20

Service Code	HCPCS 19283
Hospital Charge Code	2700026
Hospital Revenue Code	361
Min. Negotiated Rate	$45.36
Max. Negotiated Rate	$3,629.00
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
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	$3,051.74
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$415.27
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$239.58
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$50.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$45.36

STEREOTACTIC BREAST LOCALIZATI

Facility

$1,597.20

Service Code	HCPCS 19283
Hospital Charge Code	2700026
Hospital Revenue Code	361
Min. Negotiated Rate	$239.58
Max. Negotiated Rate	$239.58
Rate for Payer: Qualcare PPO/HMO/WC	$239.58

STERILE BARIUM SULFATE 50ML

Facility

$157.00

Hospital Charge Code	270335722
Hospital Revenue Code	272
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$78.50
Rate for Payer: Aetna Commercial	$59.66
Rate for Payer: Aetna Medicare Advantage	$47.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.03
Rate for Payer: Cigna Commercial	$78.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.82
Rate for Payer: Oxford Commercial	$31.40
Rate for Payer: Qualcare PPO/HMO/WC	$23.55
Rate for Payer: UnitedHealthcare Commercial	$31.40
Rate for Payer: UnitedHealthcare Community & State	$4.96
Rate for Payer: Wellpoint Medicaid Managed Care	$4.46

STERILE BARIUM SULFATE 50ML

Facility

$157.00

Hospital Charge Code	270335722
Hospital Revenue Code	272
Min. Negotiated Rate	$23.55
Max. Negotiated Rate	$23.55
Rate for Payer: Qualcare PPO/HMO/WC	$23.55

STERILE DISPOSABLE DRAIN BAG

Facility

$95.00

Hospital Charge Code	270330543
Hospital Revenue Code	272
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$47.50
Rate for Payer: Aetna Commercial	$36.10
Rate for Payer: Aetna Medicare Advantage	$28.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.23
Rate for Payer: Cigna Commercial	$47.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.70
Rate for Payer: Oxford Commercial	$19.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.25
Rate for Payer: UnitedHealthcare Commercial	$19.00
Rate for Payer: UnitedHealthcare Community & State	$3.00
Rate for Payer: Wellpoint Medicaid Managed Care	$2.70

STERILE DISPOSABLE DRAIN BAG

Facility

$95.00

Hospital Charge Code	270330543
Hospital Revenue Code	272
Min. Negotiated Rate	$14.25
Max. Negotiated Rate	$14.25
Rate for Payer: Qualcare PPO/HMO/WC	$14.25

STERILE O.R. TOWELS

Facility

$280.55

Hospital Charge Code	270653367
Hospital Revenue Code	272
Min. Negotiated Rate	$7.97
Max. Negotiated Rate	$140.28
Rate for Payer: Aetna Commercial	$106.61
Rate for Payer: Aetna Medicare Advantage	$84.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.54
Rate for Payer: Cigna Commercial	$140.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.94
Rate for Payer: Oxford Commercial	$56.11
Rate for Payer: Qualcare PPO/HMO/WC	$42.08
Rate for Payer: UnitedHealthcare Commercial	$56.11
Rate for Payer: UnitedHealthcare Community & State	$8.87
Rate for Payer: Wellpoint Medicaid Managed Care	$7.97

STERILE O.R. TOWELS

Facility

$280.55

Hospital Charge Code	270653367
Hospital Revenue Code	272
Min. Negotiated Rate	$42.08
Max. Negotiated Rate	$42.08
Rate for Payer: Qualcare PPO/HMO/WC	$42.08

STERILE TALC 4 GM AEROSOL

Facility

$112.56

Service Code	NDC 63256010030
Hospital Charge Code	6063943270
Hospital Revenue Code	250
Min. Negotiated Rate	$16.88
Max. Negotiated Rate	$16.88
Rate for Payer: Qualcare PPO/HMO/WC	$16.88

STERILE TALC 4 GM AEROSOL

Facility

$112.56

Service Code	NDC 63256010030
Hospital Charge Code	6063943270
Hospital Revenue Code	250
Min. Negotiated Rate	$3.20
Max. Negotiated Rate	$56.28
Rate for Payer: Aetna Commercial	$42.77
Rate for Payer: Aetna Medicare Advantage	$33.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.70
Rate for Payer: Cigna Commercial	$56.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.27
Rate for Payer: Oxford Commercial	$22.51
Rate for Payer: Qualcare PPO/HMO/WC	$16.88
Rate for Payer: UnitedHealthcare Commercial	$22.51
Rate for Payer: UnitedHealthcare Community & State	$3.56
Rate for Payer: Wellpoint Medicaid Managed Care	$3.20

Know your out-of-pocket cost for care.

All Charges