Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

STRESS TEST

Facility

$11,000.00

Service Code	HCPCS 93017
Hospital Charge Code	94053035
Hospital Revenue Code	482
Min. Negotiated Rate	$243.69
Max. Negotiated Rate	$4,554.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$336.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$930.53
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,860.00
Rate for Payer: Oxford Commercial	$4,336.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00
Rate for Payer: UnitedHealthcare Commercial	$4,554.00
Rate for Payer: UnitedHealthcare Community & State	$347.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$312.40

STRESS TEST

Facility

$11,000.00

Service Code	HCPCS 93017
Hospital Charge Code	74116009
Hospital Revenue Code	482
Min. Negotiated Rate	$243.69
Max. Negotiated Rate	$4,554.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$336.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$930.53
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,860.00
Rate for Payer: Oxford Commercial	$4,336.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00
Rate for Payer: UnitedHealthcare Commercial	$4,554.00
Rate for Payer: UnitedHealthcare Community & State	$347.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$312.40

STRESS TEST

Facility

$11,000.00

Service Code	HCPCS 93017
Hospital Charge Code	74117009
Hospital Revenue Code	482
Min. Negotiated Rate	$1,650.00
Max. Negotiated Rate	$1,650.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00

STRESS TEST

Facility

$3,249.40

Service Code	HCPCS 93017
Hospital Charge Code	36540019
Hospital Revenue Code	482
Min. Negotiated Rate	$92.28
Max. Negotiated Rate	$4,554.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$336.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$930.53
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$844.84
Rate for Payer: Oxford Commercial	$4,336.00
Rate for Payer: Qualcare PPO/HMO/WC	$487.41
Rate for Payer: UnitedHealthcare Commercial	$4,554.00
Rate for Payer: UnitedHealthcare Community & State	$102.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$92.28

STRESS TEST

Facility

$11,000.00

Service Code	HCPCS 93017
Hospital Charge Code	94053035
Hospital Revenue Code	482
Min. Negotiated Rate	$1,650.00
Max. Negotiated Rate	$1,650.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00

STRESS TEST

Facility

$11,000.00

Service Code	HCPCS 93017
Hospital Charge Code	74117009
Hospital Revenue Code	482
Min. Negotiated Rate	$243.69
Max. Negotiated Rate	$4,554.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$336.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$930.53
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,860.00
Rate for Payer: Oxford Commercial	$4,336.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00
Rate for Payer: UnitedHealthcare Commercial	$4,554.00
Rate for Payer: UnitedHealthcare Community & State	$347.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$312.40

STRESS TEST

Facility

$3,249.40

Service Code	HCPCS 93017
Hospital Charge Code	36540019
Hospital Revenue Code	482
Min. Negotiated Rate	$487.41
Max. Negotiated Rate	$487.41
Rate for Payer: Qualcare PPO/HMO/WC	$487.41

STRESS TEST

Facility

$11,000.00

Service Code	HCPCS 93017
Hospital Charge Code	5300058
Hospital Revenue Code	482
Min. Negotiated Rate	$1,650.00
Max. Negotiated Rate	$1,650.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00

STRIATED MUSCLE AB W/RFX

Facility

$390.00

Service Code	HCPCS 86255
Hospital Charge Code	39900206
Hospital Revenue Code	302
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.71
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
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	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

STRIATED MUSCLE AB W/RFX

Facility

$390.00

Service Code	HCPCS 86255
Hospital Charge Code	39900206
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

STRIATED MUSCLE ANTIBODY

Facility

$407.00

Service Code	HCPCS 86255
Hospital Charge Code	38472925
Hospital Revenue Code	302
Min. Negotiated Rate	$61.05
Max. Negotiated Rate	$61.05
Rate for Payer: Qualcare PPO/HMO/WC	$61.05

STRIATED MUSCLE ANTIBODY

Facility

$407.00

Service Code	HCPCS 86255
Hospital Charge Code	38472925
Hospital Revenue Code	302
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$203.50
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.71
Rate for Payer: Cigna Commercial	$203.50
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.82
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$61.05
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$11.56

STRIP CODMAN SURGICAL 1/4X

Facility

$1,290.00

Hospital Charge Code	270660810
Hospital Revenue Code	272
Min. Negotiated Rate	$36.64
Max. Negotiated Rate	$645.00
Rate for Payer: Aetna Commercial	$490.20
Rate for Payer: Aetna Medicare Advantage	$387.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$328.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$328.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$328.95
Rate for Payer: Cigna Commercial	$645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.40
Rate for Payer: Oxford Commercial	$258.00
Rate for Payer: Qualcare PPO/HMO/WC	$193.50
Rate for Payer: UnitedHealthcare Commercial	$258.00
Rate for Payer: UnitedHealthcare Community & State	$40.76
Rate for Payer: Wellpoint Medicaid Managed Care	$36.64

STRIP CODMAN SURGICAL 1/4X

Facility

$1,290.00

Hospital Charge Code	270660810
Hospital Revenue Code	272
Min. Negotiated Rate	$193.50
Max. Negotiated Rate	$193.50
Rate for Payer: Qualcare PPO/HMO/WC	$193.50

STRIP FIBER FUSE 1X10CM

Facility

$10,318.75

Service Code	HCPCS C1713
Hospital Charge Code	270694063
Hospital Revenue Code	278
Min. Negotiated Rate	$1,547.81
Max. Negotiated Rate	$2,497.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,063.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,497.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,547.81

STRIP FIBER FUSE 1X10CM

Facility

$10,318.75

Service Code	HCPCS C1713
Hospital Charge Code	270694063
Hospital Revenue Code	278
Min. Negotiated Rate	$293.05
Max. Negotiated Rate	$5,159.38
Rate for Payer: Aetna Commercial	$3,921.12
Rate for Payer: Aetna Medicare Advantage	$3,095.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,631.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,631.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,063.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,631.28
Rate for Payer: Cigna Commercial	$5,159.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,497.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,547.81
Rate for Payer: UnitedHealthcare Community & State	$326.07
Rate for Payer: Wellpoint Medicaid Managed Care	$293.05

STRIP OSTEO SPONGE 50x20x7MM

Facility

$11,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270664105
Hospital Revenue Code	278
Min. Negotiated Rate	$325.89
Max. Negotiated Rate	$5,737.50
Rate for Payer: Aetna Commercial	$4,360.50
Rate for Payer: Aetna Medicare Advantage	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,926.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,926.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,926.12
Rate for Payer: Cigna Commercial	$5,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,776.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,721.25
Rate for Payer: UnitedHealthcare Community & State	$362.61
Rate for Payer: Wellpoint Medicaid Managed Care	$325.89

STRIP OSTEO SPONGE 50x20x7MM

Facility

$11,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270664105
Hospital Revenue Code	278
Min. Negotiated Rate	$1,721.25
Max. Negotiated Rate	$2,776.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,776.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,721.25

STRIPPER VEIN DISP

Facility

$26.40

Hospital Charge Code	270600422
Hospital Revenue Code	272
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$13.20
Rate for Payer: Aetna Commercial	$10.03
Rate for Payer: Aetna Medicare Advantage	$7.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.73
Rate for Payer: Cigna Commercial	$13.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.86
Rate for Payer: Oxford Commercial	$5.28
Rate for Payer: Qualcare PPO/HMO/WC	$3.96
Rate for Payer: UnitedHealthcare Commercial	$5.28
Rate for Payer: UnitedHealthcare Community & State	$0.83
Rate for Payer: Wellpoint Medicaid Managed Care	$0.75

STRIPPER VEIN DISP

Facility

$26.40

Hospital Charge Code	270600422
Hospital Revenue Code	272
Min. Negotiated Rate	$3.96
Max. Negotiated Rate	$3.96
Rate for Payer: Qualcare PPO/HMO/WC	$3.96

STRIPS SURGICAL 3/4x6

Facility

$6.45

Hospital Charge Code	270608223
Hospital Revenue Code	272
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$0.97
Rate for Payer: Qualcare PPO/HMO/WC	$0.97

STRIPS SURGICAL 3/4x6

Facility

$6.45

Hospital Charge Code	270608223
Hospital Revenue Code	272
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.23
Rate for Payer: Aetna Commercial	$2.45
Rate for Payer: Aetna Medicare Advantage	$1.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.64
Rate for Payer: Cigna Commercial	$3.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.68
Rate for Payer: Oxford Commercial	$1.29
Rate for Payer: Qualcare PPO/HMO/WC	$0.97
Rate for Payer: UnitedHealthcare Commercial	$1.29
Rate for Payer: UnitedHealthcare Community & State	$0.20
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

STRIP SURGICAL 1/2 X 6

Facility

$11.23

Hospital Charge Code	270607227
Hospital Revenue Code	272
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$4.27
Rate for Payer: Aetna Medicare Advantage	$3.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.86
Rate for Payer: Cigna Commercial	$5.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.92
Rate for Payer: Oxford Commercial	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.68
Rate for Payer: UnitedHealthcare Commercial	$2.25
Rate for Payer: UnitedHealthcare Community & State	$0.35
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

STRIP SURGICAL 1/2 X 6

Facility

$11.23

Hospital Charge Code	270607227
Hospital Revenue Code	272
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$1.68
Rate for Payer: Qualcare PPO/HMO/WC	$1.68

STRM MDS SCREW 3.5X12MM

Facility

$1,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270694005
Hospital Revenue Code	278
Min. Negotiated Rate	$180.00
Max. Negotiated Rate	$290.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.40
Rate for Payer: Qualcare PPO/HMO/WC	$180.00

Know your out-of-pocket cost for care.

All Charges