Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

STONE ANALYSIS, QUAL

Facility

$390.00

Service Code	HCPCS 82355
Hospital Charge Code	3005295
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

STONE BASKET EXPAND 212 3 FR 9

Facility

$831.95

Hospital Charge Code	270682472
Hospital Revenue Code	272
Min. Negotiated Rate	$124.79
Max. Negotiated Rate	$124.79
Rate for Payer: Qualcare PPO/HMO/WC	$124.79

STONE BASKET EXPAND 212 3 FR 9

Facility

$831.95

Hospital Charge Code	270682472
Hospital Revenue Code	272
Min. Negotiated Rate	$23.63
Max. Negotiated Rate	$415.98
Rate for Payer: Aetna Commercial	$316.14
Rate for Payer: Aetna Medicare Advantage	$249.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.15
Rate for Payer: Cigna Commercial	$415.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.31
Rate for Payer: Oxford Commercial	$166.39
Rate for Payer: Qualcare PPO/HMO/WC	$124.79
Rate for Payer: UnitedHealthcare Commercial	$166.39
Rate for Payer: UnitedHealthcare Community & State	$26.29
Rate for Payer: Wellpoint Medicaid Managed Care	$23.63

STONEBASKET G07313

Facility

$2,389.35

Hospital Charge Code	270635185
Hospital Revenue Code	272
Min. Negotiated Rate	$358.40
Max. Negotiated Rate	$358.40
Rate for Payer: Qualcare PPO/HMO/WC	$358.40

STONEBASKET G07313

Facility

$2,389.35

Hospital Charge Code	270635185
Hospital Revenue Code	272
Min. Negotiated Rate	$67.86
Max. Negotiated Rate	$1,194.67
Rate for Payer: Aetna Commercial	$907.95
Rate for Payer: Aetna Medicare Advantage	$716.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$609.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$609.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$609.28
Rate for Payer: Cigna Commercial	$1,194.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$621.23
Rate for Payer: Oxford Commercial	$477.87
Rate for Payer: Qualcare PPO/HMO/WC	$358.40
Rate for Payer: UnitedHealthcare Commercial	$477.87
Rate for Payer: UnitedHealthcare Community & State	$75.50
Rate for Payer: Wellpoint Medicaid Managed Care	$67.86

STOOL CULTURE

Facility

$508.00

Service Code	HCPCS 87045
Hospital Charge Code	38475062
Hospital Revenue Code	309
Min. Negotiated Rate	$76.20
Max. Negotiated Rate	$76.20
Rate for Payer: Qualcare PPO/HMO/WC	$76.20

STOOL CULTURE

Facility

$508.00

Service Code	HCPCS 87045
Hospital Charge Code	38475062
Hospital Revenue Code	309
Min. Negotiated Rate	$7.55
Max. Negotiated Rate	$254.00
Rate for Payer: Aetna Commercial	$25.68
Rate for Payer: Aetna Medicare Advantage	$30.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.44
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	$34.24
Rate for Payer: Cigna Commercial	$254.00
Rate for Payer: Cigna Medicare Advantage	$9.44
Rate for Payer: Clover Medicare Advantage	$8.97
Rate for Payer: EmblemHealth Commercial	$28.32
Rate for Payer: Humana Medicare Advantage	$9.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.08
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$76.20
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$7.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.44
Rate for Payer: Wellcare Medicare Advantage	$9.44
Rate for Payer: Wellpoint Medicaid Managed Care	$14.43

STOOL MNGT SYSTEM DIGNICARE

Facility

$866.13

Hospital Charge Code	270650193
Hospital Revenue Code	272
Min. Negotiated Rate	$24.60
Max. Negotiated Rate	$433.06
Rate for Payer: Aetna Commercial	$329.13
Rate for Payer: Aetna Medicare Advantage	$259.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$220.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$220.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$220.86
Rate for Payer: Cigna Commercial	$433.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.19
Rate for Payer: Oxford Commercial	$173.23
Rate for Payer: Qualcare PPO/HMO/WC	$129.92
Rate for Payer: UnitedHealthcare Commercial	$173.23
Rate for Payer: UnitedHealthcare Community & State	$27.37
Rate for Payer: Wellpoint Medicaid Managed Care	$24.60

STOOL MNGT SYSTEM DIGNICARE

Facility

$866.13

Hospital Charge Code	270650193
Hospital Revenue Code	272
Min. Negotiated Rate	$129.92
Max. Negotiated Rate	$129.92
Rate for Payer: Qualcare PPO/HMO/WC	$129.92

Stool Reducing substance

Facility

$390.00

Service Code	HCPCS 84376
Hospital Charge Code	39708020
Hospital Revenue Code	301
Min. Negotiated Rate	$4.40
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$14.96
Rate for Payer: Aetna Medicare Advantage	$17.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.95
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.50
Rate for Payer: Clover Medicare Advantage	$5.22
Rate for Payer: EmblemHealth Commercial	$16.50
Rate for Payer: Humana Medicare Advantage	$5.67
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.50
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	$4.40
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.50
Rate for Payer: Wellcare Medicare Advantage	$5.50
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

Stool Reducing substance

Facility

$390.00

Service Code	HCPCS 84376
Hospital Charge Code	39708020
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

STOPCOCK

Facility

$584.80

Hospital Charge Code	270665008
Hospital Revenue Code	270
Min. Negotiated Rate	$16.61
Max. Negotiated Rate	$292.40
Rate for Payer: Aetna Commercial	$222.22
Rate for Payer: Aetna Medicare Advantage	$175.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.12
Rate for Payer: Cigna Commercial	$292.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.05
Rate for Payer: Oxford Commercial	$116.96
Rate for Payer: Qualcare PPO/HMO/WC	$87.72
Rate for Payer: UnitedHealthcare Commercial	$116.96
Rate for Payer: UnitedHealthcare Community & State	$18.48
Rate for Payer: Wellpoint Medicaid Managed Care	$16.61

STOPCOCK

Facility

$584.80

Hospital Charge Code	270665008
Hospital Revenue Code	270
Min. Negotiated Rate	$87.72
Max. Negotiated Rate	$87.72
Rate for Payer: Qualcare PPO/HMO/WC	$87.72

STOPCOCK 3 WAY ANES W/33 EXT

Facility

$4.07

Hospital Charge Code	270649017
Hospital Revenue Code	272
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$0.61
Rate for Payer: Qualcare PPO/HMO/WC	$0.61

STOPCOCK 3 WAY ANES W/33 EXT

Facility

$4.07

Hospital Charge Code	270649017
Hospital Revenue Code	272
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.04
Rate for Payer: Aetna Commercial	$1.55
Rate for Payer: Aetna Medicare Advantage	$1.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.04
Rate for Payer: Cigna Commercial	$2.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.06
Rate for Payer: Oxford Commercial	$0.81
Rate for Payer: Qualcare PPO/HMO/WC	$0.61
Rate for Payer: UnitedHealthcare Commercial	$0.81
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.12

STOPCOCK 3-WAY DISP M3SNC

Facility

$4.80

Hospital Charge Code	270624050
Hospital Revenue Code	272
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$0.72
Rate for Payer: Qualcare PPO/HMO/WC	$0.72

STOPCOCK 3-WAY DISP M3SNC

Facility

$4.80

Hospital Charge Code	270624050
Hospital Revenue Code	272
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.40
Rate for Payer: Aetna Commercial	$1.82
Rate for Payer: Aetna Medicare Advantage	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.22
Rate for Payer: Cigna Commercial	$2.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.25
Rate for Payer: Oxford Commercial	$0.96
Rate for Payer: Qualcare PPO/HMO/WC	$0.72
Rate for Payer: UnitedHealthcare Commercial	$0.96
Rate for Payer: UnitedHealthcare Community & State	$0.15
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

STOPCOCK 3-WAY PLASTIC

Facility

$23.65

Hospital Charge Code	270601461
Hospital Revenue Code	272
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$11.82
Rate for Payer: Aetna Commercial	$8.99
Rate for Payer: Aetna Medicare Advantage	$7.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.03
Rate for Payer: Cigna Commercial	$11.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.15
Rate for Payer: Oxford Commercial	$4.73
Rate for Payer: Qualcare PPO/HMO/WC	$3.55
Rate for Payer: UnitedHealthcare Commercial	$4.73
Rate for Payer: UnitedHealthcare Community & State	$0.75
Rate for Payer: Wellpoint Medicaid Managed Care	$0.67

STOPCOCK 3-WAY PLASTIC

Facility

$23.65

Hospital Charge Code	270601461
Hospital Revenue Code	272
Min. Negotiated Rate	$3.55
Max. Negotiated Rate	$3.55
Rate for Payer: Qualcare PPO/HMO/WC	$3.55

STOPCOCK ADAPTOR PHD

Facility

$625.00

Hospital Charge Code	270695076S
Hospital Revenue Code	272
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

STOPCOCK ADAPTOR PHD

Facility

$625.00

Hospital Charge Code	270695076S
Hospital Revenue Code	272
Min. Negotiated Rate	$17.75
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.50
Rate for Payer: Oxford Commercial	$125.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Commercial	$125.00
Rate for Payer: UnitedHealthcare Community & State	$19.75
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

STOPCOCK HIGH PRESSURE H3RRC

Facility

$12.00

Hospital Charge Code	270658301
Hospital Revenue Code	272
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$4.56
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.12
Rate for Payer: Oxford Commercial	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$2.40
Rate for Payer: UnitedHealthcare Community & State	$0.38
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

STOPCOCK HIGH PRESSURE H3RRC

Facility

$12.00

Hospital Charge Code	270658301S
Hospital Revenue Code	272
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

STOPCOCK HIGH PRESSURE H3RRC

Facility

$12.00

Hospital Charge Code	270658301S
Hospital Revenue Code	272
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$4.56
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.12
Rate for Payer: Oxford Commercial	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$2.40
Rate for Payer: UnitedHealthcare Community & State	$0.38
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

STOPCOCK HIGH PRESSURE H3RRC

Facility

$12.00

Hospital Charge Code	270658301
Hospital Revenue Code	272
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

Know your out-of-pocket cost for care.

All Charges