Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SUPPORT TUBE

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270703248
Hospital Revenue Code	278
Min. Negotiated Rate	$42.60
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Community & State	$47.40
Rate for Payer: Wellpoint Medicaid Managed Care	$42.60

SUPPORT WRIST COMFORT MED LEFT

Facility

$27.65

Hospital Charge Code	270653967
Hospital Revenue Code	270
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$13.82
Rate for Payer: Aetna Commercial	$10.51
Rate for Payer: Aetna Medicare Advantage	$8.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.05
Rate for Payer: Cigna Commercial	$13.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.19
Rate for Payer: Oxford Commercial	$5.53
Rate for Payer: Qualcare PPO/HMO/WC	$4.15
Rate for Payer: UnitedHealthcare Commercial	$5.53
Rate for Payer: UnitedHealthcare Community & State	$0.87
Rate for Payer: Wellpoint Medicaid Managed Care	$0.79

SUPPORT WRIST COMFORT MED LEFT

Facility

$27.65

Hospital Charge Code	270653967
Hospital Revenue Code	270
Min. Negotiated Rate	$4.15
Max. Negotiated Rate	$4.15
Rate for Payer: Qualcare PPO/HMO/WC	$4.15

SUPRA CONDYLAR COMP. PLATE

Facility

$1,688.00

Hospital Charge Code	270335020
Hospital Revenue Code	278
Min. Negotiated Rate	$47.94
Max. Negotiated Rate	$844.00
Rate for Payer: Aetna Commercial	$641.44
Rate for Payer: Aetna Medicare Advantage	$506.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$430.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$430.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$337.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$430.44
Rate for Payer: Cigna Commercial	$844.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$408.50
Rate for Payer: Qualcare PPO/HMO/WC	$253.20
Rate for Payer: UnitedHealthcare Community & State	$53.34
Rate for Payer: Wellpoint Medicaid Managed Care	$47.94

SUPRA CONDYLAR COMP. PLATE

Facility

$1,688.00

Hospital Charge Code	270335020
Hospital Revenue Code	278
Min. Negotiated Rate	$253.20
Max. Negotiated Rate	$408.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$337.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$408.50
Rate for Payer: Qualcare PPO/HMO/WC	$253.20

SUPRA ENTRY GUIDEWIRE 3.0MM

Facility

$687.50

Hospital Charge Code	270703325
Hospital Revenue Code	272
Min. Negotiated Rate	$19.52
Max. Negotiated Rate	$343.75
Rate for Payer: Aetna Commercial	$261.25
Rate for Payer: Aetna Medicare Advantage	$206.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$175.31
Rate for Payer: Cigna Commercial	$343.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$178.75
Rate for Payer: Oxford Commercial	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$103.12
Rate for Payer: UnitedHealthcare Commercial	$137.50
Rate for Payer: UnitedHealthcare Community & State	$21.73
Rate for Payer: Wellpoint Medicaid Managed Care	$19.52

SUPRA ENTRY GUIDEWIRE 3.0MM

Facility

$687.50

Hospital Charge Code	270703325
Hospital Revenue Code	272
Min. Negotiated Rate	$103.12
Max. Negotiated Rate	$103.12
Rate for Payer: Qualcare PPO/HMO/WC	$103.12

SUREPATH-FP AND HPV

Facility

$241.20

Hospital Charge Code	39900409
Hospital Revenue Code	306
Min. Negotiated Rate	$36.18
Max. Negotiated Rate	$36.18
Rate for Payer: Qualcare PPO/HMO/WC	$36.18

SUREPATH-FP AND HPV

Facility

$241.20

Hospital Charge Code	39900409
Hospital Revenue Code	306
Min. Negotiated Rate	$6.85
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$91.66
Rate for Payer: Aetna Medicare Advantage	$72.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.51
Rate for Payer: Cigna Commercial	$120.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.71
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.18
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$7.62
Rate for Payer: Wellpoint Medicaid Managed Care	$6.85

SUREPATH-FPGS/HPV RFX GENOTYPE

Facility

$241.20

Service Code	HCPCS 87624
Hospital Charge Code	39900408
Hospital Revenue Code	306
Min. Negotiated Rate	$36.18
Max. Negotiated Rate	$36.18
Rate for Payer: Qualcare PPO/HMO/WC	$36.18

SUREPATH-FPGS/HPV RFX GENOTYPE

Facility

$241.20

Service Code	HCPCS 87624
Hospital Charge Code	39900408
Hospital Revenue Code	306
Min. Negotiated Rate	$6.85
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$95.44
Rate for Payer: Aetna Medicare Advantage	$113.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.29
Rate for Payer: Cigna Commercial	$120.60
Rate for Payer: Cigna Medicare Advantage	$35.09
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.71
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.18
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$28.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Medicare Advantage	$35.09
Rate for Payer: Wellpoint Medicaid Managed Care	$6.85

SUREPATH W/FOCAL POINT RE

Facility

$176.15

Service Code	HCPCS 88175
Hospital Charge Code	39900312
Hospital Revenue Code	311
Min. Negotiated Rate	$26.42
Max. Negotiated Rate	$26.42
Rate for Payer: Qualcare PPO/HMO/WC	$26.42

SUREPATH W/FOCAL POINT RE

Facility

$176.15

Service Code	HCPCS 88175
Hospital Charge Code	39900312
Hospital Revenue Code	311
Min. Negotiated Rate	$5.00
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$72.38
Rate for Payer: Aetna Medicare Advantage	$86.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.53
Rate for Payer: Cigna Commercial	$88.08
Rate for Payer: Cigna Medicare Advantage	$26.61
Rate for Payer: Clover Medicare Advantage	$25.28
Rate for Payer: EmblemHealth Commercial	$79.83
Rate for Payer: Humana Medicare Advantage	$27.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.80
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.42
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$21.29
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.61
Rate for Payer: Wellcare Medicare Advantage	$26.61
Rate for Payer: Wellpoint Medicaid Managed Care	$5.00

SURE SWAB I

Facility

$390.00

Service Code	HCPCS 8748191
Hospital Charge Code	39990113A
Hospital Revenue Code	306
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

SURE SWAB I

Facility

$390.00

Service Code	HCPCS 8748191
Hospital Charge Code	39990113A
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SURE SWAB II

Facility

$390.00

Service Code	HCPCS 8748191
Hospital Charge Code	39990113B
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SURE SWAB II

Facility

$390.00

Service Code	HCPCS 8748191
Hospital Charge Code	39990113B
Hospital Revenue Code	306
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

SURE SWAB III

Facility

$390.00

Service Code	HCPCS 8748191
Hospital Charge Code	39990113C
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SURE SWAB III

Facility

$390.00

Service Code	HCPCS 8748191
Hospital Charge Code	39990113C
Hospital Revenue Code	306
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

SURE SWAB IV

Facility

$390.00

Service Code	HCPCS 8748191
Hospital Charge Code	39990113D
Hospital Revenue Code	306
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

SURE SWAB IV

Facility

$390.00

Service Code	HCPCS 8748191
Hospital Charge Code	39990113D
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SURE SWAB IX

Facility

$390.00

Service Code	HCPCS 8779991
Hospital Charge Code	39990113I
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SURE SWAB IX

Facility

$390.00

Service Code	HCPCS 8779991
Hospital Charge Code	39990113I
Hospital Revenue Code	306
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

SURE SWAB V

Facility

$390.00

Service Code	HCPCS 87491
Hospital Charge Code	39990113E
Hospital Revenue Code	306
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$95.44
Rate for Payer: Aetna Medicare Advantage	$113.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.29
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$35.09
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35.09
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	$28.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Medicare Advantage	$35.09
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

SURE SWAB V

Facility

$390.00

Service Code	HCPCS 87491
Hospital Charge Code	39990113E
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Know your out-of-pocket cost for care.

All Charges