Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

STOCKINETTE TUBULAR 4X25

Facility

$82.55

Hospital Charge Code	270653377
Hospital Revenue Code	272
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$41.27
Rate for Payer: Aetna Commercial	$31.37
Rate for Payer: Aetna Medicare Advantage	$24.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.05
Rate for Payer: Cigna Commercial	$41.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.46
Rate for Payer: Oxford Commercial	$16.51
Rate for Payer: Qualcare PPO/HMO/WC	$12.38
Rate for Payer: UnitedHealthcare Commercial	$16.51
Rate for Payer: UnitedHealthcare Community & State	$2.61
Rate for Payer: Wellpoint Medicaid Managed Care	$2.34

STOCKING ANTI EMBOLISM KNEE XL

Facility

$11.77

Hospital Charge Code	270649867
Hospital Revenue Code	270
Min. Negotiated Rate	$1.77
Max. Negotiated Rate	$1.77
Rate for Payer: Qualcare PPO/HMO/WC	$1.77

STOCKING ANTI EMBOLISM KNEE XL

Facility

$11.77

Hospital Charge Code	270649867
Hospital Revenue Code	270
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$5.88
Rate for Payer: Aetna Commercial	$4.47
Rate for Payer: Aetna Medicare Advantage	$3.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.00
Rate for Payer: Cigna Commercial	$5.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.06
Rate for Payer: Oxford Commercial	$2.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.77
Rate for Payer: UnitedHealthcare Commercial	$2.35
Rate for Payer: UnitedHealthcare Community & State	$0.37
Rate for Payer: Wellpoint Medicaid Managed Care	$0.33

STOCKING ANTI-EM KNEE LG REG

Facility

$11.77

Hospital Charge Code	270648980
Hospital Revenue Code	270
Min. Negotiated Rate	$1.77
Max. Negotiated Rate	$1.77
Rate for Payer: Qualcare PPO/HMO/WC	$1.77

STOCKING ANTI-EM KNEE LG REG

Facility

$11.77

Hospital Charge Code	270648980
Hospital Revenue Code	270
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$5.88
Rate for Payer: Aetna Commercial	$4.47
Rate for Payer: Aetna Medicare Advantage	$3.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.00
Rate for Payer: Cigna Commercial	$5.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.06
Rate for Payer: Oxford Commercial	$2.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.77
Rate for Payer: UnitedHealthcare Commercial	$2.35
Rate for Payer: UnitedHealthcare Community & State	$0.37
Rate for Payer: Wellpoint Medicaid Managed Care	$0.33

STOCKING ANTI EM KNEE MED

Facility

$11.77

Hospital Charge Code	270649863
Hospital Revenue Code	270
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$5.88
Rate for Payer: Aetna Commercial	$4.47
Rate for Payer: Aetna Medicare Advantage	$3.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.00
Rate for Payer: Cigna Commercial	$5.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.06
Rate for Payer: Oxford Commercial	$2.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.77
Rate for Payer: UnitedHealthcare Commercial	$2.35
Rate for Payer: UnitedHealthcare Community & State	$0.37
Rate for Payer: Wellpoint Medicaid Managed Care	$0.33

STOCKING ANTI EM KNEE MED

Facility

$11.77

Hospital Charge Code	270649863
Hospital Revenue Code	270
Min. Negotiated Rate	$1.77
Max. Negotiated Rate	$1.77
Rate for Payer: Qualcare PPO/HMO/WC	$1.77

STOCKING ANTI EM THIGH LG

Facility

$35.14

Hospital Charge Code	270649862
Hospital Revenue Code	270
Min. Negotiated Rate	$5.27
Max. Negotiated Rate	$5.27
Rate for Payer: Qualcare PPO/HMO/WC	$5.27

STOCKING ANTI EM THIGH LG

Facility

$35.14

Hospital Charge Code	270649862
Hospital Revenue Code	270
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$17.57
Rate for Payer: Aetna Commercial	$13.35
Rate for Payer: Aetna Medicare Advantage	$10.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.96
Rate for Payer: Cigna Commercial	$17.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.14
Rate for Payer: Oxford Commercial	$7.03
Rate for Payer: Qualcare PPO/HMO/WC	$5.27
Rate for Payer: UnitedHealthcare Commercial	$7.03
Rate for Payer: UnitedHealthcare Community & State	$1.11
Rate for Payer: Wellpoint Medicaid Managed Care	$1.00

STOCKING ANTI-EM THIGH LG

Facility

$23.10

Hospital Charge Code	270648982
Hospital Revenue Code	272
Min. Negotiated Rate	$0.66
Max. Negotiated Rate	$11.55
Rate for Payer: Aetna Commercial	$8.78
Rate for Payer: Aetna Medicare Advantage	$6.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.89
Rate for Payer: Cigna Commercial	$11.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.01
Rate for Payer: Oxford Commercial	$4.62
Rate for Payer: Qualcare PPO/HMO/WC	$3.46
Rate for Payer: UnitedHealthcare Commercial	$4.62
Rate for Payer: UnitedHealthcare Community & State	$0.73
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

STOCKING ANTI-EM THIGH LG

Facility

$23.10

Hospital Charge Code	270648982
Hospital Revenue Code	272
Min. Negotiated Rate	$3.46
Max. Negotiated Rate	$3.46
Rate for Payer: Qualcare PPO/HMO/WC	$3.46

STOCKING ANTI EM THIGH MED

Facility

$49.05

Hospital Charge Code	270649861
Hospital Revenue Code	271
Min. Negotiated Rate	$7.36
Max. Negotiated Rate	$7.36
Rate for Payer: Qualcare PPO/HMO/WC	$7.36

STOCKING ANTI EM THIGH MED

Facility

$49.05

Hospital Charge Code	270649861
Hospital Revenue Code	271
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$24.52
Rate for Payer: Aetna Commercial	$18.64
Rate for Payer: Aetna Medicare Advantage	$14.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.51
Rate for Payer: Cigna Commercial	$24.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.75
Rate for Payer: Oxford Commercial	$9.81
Rate for Payer: Qualcare PPO/HMO/WC	$7.36
Rate for Payer: UnitedHealthcare Commercial	$9.81
Rate for Payer: UnitedHealthcare Community & State	$1.55
Rate for Payer: Wellpoint Medicaid Managed Care	$1.39

STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC

Facility

$96,685.68

Service Code	MSDRG 327
Min. Negotiated Rate	$29,439.55
Max. Negotiated Rate	$96,685.68
Rate for Payer: Aetna Commercial	$70,719.16
Rate for Payer: Aetna Medicare Advantage	$96,685.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69,262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69,262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$30,989.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69,262.50
Rate for Payer: Cigna Commercial	$54,488.55
Rate for Payer: Cigna Medicare Advantage	$30,989.00
Rate for Payer: Clover Medicare Advantage	$29,439.55
Rate for Payer: EmblemHealth Commercial	$92,967.00
Rate for Payer: Humana Medicare Advantage	$31,918.67
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$30,989.00
Rate for Payer: Oxford Commercial	$43,066.80
Rate for Payer: UnitedHealthcare Commercial	$57,646.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$30,989.00
Rate for Payer: Wellcare Medicare Advantage	$30,989.00

STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC

Facility

$177,034.35

Service Code	MSDRG 326
Min. Negotiated Rate	$53,904.69
Max. Negotiated Rate	$177,034.35
Rate for Payer: Aetna Commercial	$127,944.43
Rate for Payer: Aetna Medicare Advantage	$177,034.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140,741.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140,741.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$56,741.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140,741.40
Rate for Payer: Cigna Commercial	$111,184.11
Rate for Payer: Cigna Medicare Advantage	$56,741.78
Rate for Payer: Clover Medicare Advantage	$53,904.69
Rate for Payer: EmblemHealth Commercial	$170,225.34
Rate for Payer: Humana Medicare Advantage	$58,444.03
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$56,741.78
Rate for Payer: Oxford Commercial	$87,877.99
Rate for Payer: UnitedHealthcare Commercial	$117,627.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$56,741.78
Rate for Payer: Wellcare Medicare Advantage	$56,741.78

STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC

Facility

$70,086.99

Service Code	MSDRG 328
Min. Negotiated Rate	$21,340.59
Max. Negotiated Rate	$70,086.99
Rate for Payer: Aetna Commercial	$51,775.29
Rate for Payer: Aetna Medicare Advantage	$70,086.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44,328.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44,328.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22,463.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44,328.00
Rate for Payer: Cigna Commercial	$35,720.07
Rate for Payer: Cigna Medicare Advantage	$22,463.78
Rate for Payer: Clover Medicare Advantage	$21,340.59
Rate for Payer: EmblemHealth Commercial	$67,391.34
Rate for Payer: Humana Medicare Advantage	$23,137.69
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22,463.78
Rate for Payer: Oxford Commercial	$28,232.53
Rate for Payer: UnitedHealthcare Commercial	$37,790.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$22,463.78
Rate for Payer: Wellcare Medicare Advantage	$22,463.78

STOMA FLEX WAFER 2 3/4

Facility

$29.65

Hospital Charge Code	270303150
Hospital Revenue Code	272
Min. Negotiated Rate	$4.45
Max. Negotiated Rate	$4.45
Rate for Payer: Qualcare PPO/HMO/WC	$4.45

STOMA FLEX WAFER 2 3/4

Facility

$29.65

Hospital Charge Code	270303150
Hospital Revenue Code	272
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$14.82
Rate for Payer: Aetna Commercial	$11.27
Rate for Payer: Aetna Medicare Advantage	$8.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.56
Rate for Payer: Cigna Commercial	$14.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.71
Rate for Payer: Oxford Commercial	$5.93
Rate for Payer: Qualcare PPO/HMO/WC	$4.45
Rate for Payer: UnitedHealthcare Commercial	$5.93
Rate for Payer: UnitedHealthcare Community & State	$0.94
Rate for Payer: Wellpoint Medicaid Managed Care	$0.84

STOMAHESIVE POWDER 1OZ

Facility

$18.00

Hospital Charge Code	270649016
Hospital Revenue Code	270
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$9.00
Rate for Payer: Aetna Commercial	$6.84
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.68
Rate for Payer: Oxford Commercial	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$3.60
Rate for Payer: UnitedHealthcare Community & State	$0.57
Rate for Payer: Wellpoint Medicaid Managed Care	$0.51

STOMAHESIVE POWDER 1OZ

Facility

$18.00

Hospital Charge Code	270649016
Hospital Revenue Code	270
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

STONE ANALYSIS

Facility

$658.00

Service Code	HCPCS 82365
Hospital Charge Code	38474158
Hospital Revenue Code	301
Min. Negotiated Rate	$98.70
Max. Negotiated Rate	$98.70
Rate for Payer: Qualcare PPO/HMO/WC	$98.70

STONE ANALYSIS

Facility

$658.00

Service Code	HCPCS 82365
Hospital Charge Code	38474158
Hospital Revenue Code	301
Min. Negotiated Rate	$10.32
Max. Negotiated Rate	$329.00
Rate for Payer: Aetna Commercial	$35.09
Rate for Payer: Aetna Medicare Advantage	$41.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.79
Rate for Payer: Cigna Commercial	$329.00
Rate for Payer: Cigna Medicare Advantage	$12.90
Rate for Payer: Clover Medicare Advantage	$12.26
Rate for Payer: EmblemHealth Commercial	$38.70
Rate for Payer: Humana Medicare Advantage	$13.29
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.08
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$98.70
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.90
Rate for Payer: Wellcare Medicare Advantage	$12.90
Rate for Payer: Wellpoint Medicaid Managed Care	$18.69

STONE ANALYSIS

Facility

$390.00

Service Code	HCPCS 82365
Hospital Charge Code	39900514
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

STONE ANALYSIS

Facility

$390.00

Service Code	HCPCS 82365
Hospital Charge Code	39900514
Hospital Revenue Code	301
Min. Negotiated Rate	$10.32
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$35.09
Rate for Payer: Aetna Medicare Advantage	$41.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.79
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.90
Rate for Payer: Clover Medicare Advantage	$12.26
Rate for Payer: EmblemHealth Commercial	$38.70
Rate for Payer: Humana Medicare Advantage	$13.29
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.90
Rate for Payer: Wellcare Medicare Advantage	$12.90
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

STONE ANALYSIS, QUAL

Facility

$390.00

Service Code	HCPCS 82355
Hospital Charge Code	3005295
Hospital Revenue Code	301
Min. Negotiated Rate	$9.26
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$31.50
Rate for Payer: Aetna Medicare Advantage	$37.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.01
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$11.58
Rate for Payer: Clover Medicare Advantage	$11.00
Rate for Payer: EmblemHealth Commercial	$34.74
Rate for Payer: Humana Medicare Advantage	$11.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.58
Rate for Payer: Wellcare Medicare Advantage	$11.58
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

Know your out-of-pocket cost for care.

All Charges