Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SURG TX INCOMPL ABORTION_

Facility

$24,422.22

Service Code	HCPCS 59812
Hospital Charge Code	16001013
Hospital Revenue Code	360
Min. Negotiated Rate	$693.59
Max. Negotiated Rate	$13,950.60
Rate for Payer: Aetna Commercial	$10,460.55
Rate for Payer: Aetna Medicare Advantage	$12,460.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,950.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,950.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,845.79
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	$13,950.60
Rate for Payer: Cigna Commercial	$7,708.87
Rate for Payer: Cigna Medicare Advantage	$3,845.79
Rate for Payer: Clover Medicare Advantage	$3,653.50
Rate for Payer: EmblemHealth Commercial	$11,537.37
Rate for Payer: Humana Medicare Advantage	$3,961.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,845.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,349.78
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,663.33
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$771.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,845.79
Rate for Payer: Wellcare Medicare Advantage	$3,845.79
Rate for Payer: Wellpoint Medicaid Managed Care	$693.59

SURG TX INCOMPL ABORTION_

Facility

$24,422.22

Service Code	HCPCS 59812
Hospital Charge Code	16001013
Hospital Revenue Code	360
Min. Negotiated Rate	$3,663.33
Max. Negotiated Rate	$3,663.33
Rate for Payer: Qualcare PPO/HMO/WC	$3,663.33

SURG TX MISSED ABRT,1ST TMEST

Facility

$24,422.22

Service Code	HCPCS 59820
Hospital Charge Code	16001014
Hospital Revenue Code	360
Min. Negotiated Rate	$3,663.33
Max. Negotiated Rate	$3,663.33
Rate for Payer: Qualcare PPO/HMO/WC	$3,663.33

SURG TX MISSED ABRT,1ST TMEST

Facility

$24,422.22

Service Code	HCPCS 59820
Hospital Charge Code	16001014
Hospital Revenue Code	360
Min. Negotiated Rate	$693.59
Max. Negotiated Rate	$13,950.60
Rate for Payer: Aetna Commercial	$10,460.55
Rate for Payer: Aetna Medicare Advantage	$12,460.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,950.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,950.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,845.79
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	$13,950.60
Rate for Payer: Cigna Commercial	$7,708.87
Rate for Payer: Cigna Medicare Advantage	$3,845.79
Rate for Payer: Clover Medicare Advantage	$3,653.50
Rate for Payer: EmblemHealth Commercial	$11,537.37
Rate for Payer: Humana Medicare Advantage	$3,961.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,845.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,349.78
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,663.33
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$771.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,845.79
Rate for Payer: Wellcare Medicare Advantage	$3,845.79
Rate for Payer: Wellpoint Medicaid Managed Care	$693.59

SUSCEPTIBILITY STUDIES ENZIME

Facility

$33.00

Service Code	HCPCS 87085
Hospital Charge Code	38477038
Hospital Revenue Code	306
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$4.95
Rate for Payer: Qualcare PPO/HMO/WC	$4.95

SUSCEPTIBILITY STUDIES ENZIME

Facility

$33.00

Service Code	HCPCS 87085
Hospital Charge Code	38477038
Hospital Revenue Code	306
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$12.54
Rate for Payer: Aetna Medicare Advantage	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.41
Rate for Payer: Cigna Commercial	$16.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.58
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.95
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$0.94

SUSCEPTIBILITY STUDIES MLC

Facility

$73.00

Service Code	HCPCS 87187
Hospital Charge Code	38477071
Hospital Revenue Code	309
Min. Negotiated Rate	$10.95
Max. Negotiated Rate	$10.95
Rate for Payer: Qualcare PPO/HMO/WC	$10.95

SUSCEPTIBILITY STUDIES MLC

Facility

$73.00

Service Code	HCPCS 87187
Hospital Charge Code	38477071
Hospital Revenue Code	309
Min. Negotiated Rate	$2.07
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$109.26
Rate for Payer: Aetna Medicare Advantage	$130.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$40.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.72
Rate for Payer: Cigna Commercial	$36.50
Rate for Payer: Cigna Medicare Advantage	$40.17
Rate for Payer: Clover Medicare Advantage	$38.16
Rate for Payer: EmblemHealth Commercial	$120.51
Rate for Payer: Humana Medicare Advantage	$41.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$40.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.98
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.95
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$32.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$40.17
Rate for Payer: Wellcare Medicare Advantage	$40.17
Rate for Payer: Wellpoint Medicaid Managed Care	$2.07

SUSCEPTIBILITY STUD MACROBROTH

Facility

$47.00

Service Code	HCPCS 87188
Hospital Charge Code	38477049
Hospital Revenue Code	309
Min. Negotiated Rate	$1.33
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$18.06
Rate for Payer: Aetna Medicare Advantage	$21.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.09
Rate for Payer: Cigna Commercial	$23.50
Rate for Payer: Cigna Medicare Advantage	$6.64
Rate for Payer: Clover Medicare Advantage	$6.31
Rate for Payer: EmblemHealth Commercial	$19.92
Rate for Payer: Humana Medicare Advantage	$6.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.22
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.05
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$5.31
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.64
Rate for Payer: Wellcare Medicare Advantage	$6.64
Rate for Payer: Wellpoint Medicaid Managed Care	$1.33

SUSCEPTIBILITY STUD MACROBROTH

Facility

$47.00

Service Code	HCPCS 87188
Hospital Charge Code	38477049
Hospital Revenue Code	309
Min. Negotiated Rate	$7.05
Max. Negotiated Rate	$7.05
Rate for Payer: Qualcare PPO/HMO/WC	$7.05

SUSCEPTIBILTY AGAR DILUTION

Facility

$390.00

Service Code	HCPCS 87181
Hospital Charge Code	38477037
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SUSCEPTIBILTY AGAR DILUTION

Facility

$390.00

Service Code	HCPCS 87181
Hospital Charge Code	38477037
Hospital Revenue Code	309
Min. Negotiated Rate	$3.80
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$12.92
Rate for Payer: Aetna Medicare Advantage	$15.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.23
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$4.75
Rate for Payer: Clover Medicare Advantage	$4.51
Rate for Payer: EmblemHealth Commercial	$14.25
Rate for Payer: Humana Medicare Advantage	$4.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.75
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	$3.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.75
Rate for Payer: Wellcare Medicare Advantage	$4.75
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

SUSCEPTYEASTCOMPPNL(BRONFLUID)

Facility

$623.18

Service Code	HCPCS 87186
Hospital Charge Code	401387186
Hospital Revenue Code	306
Min. Negotiated Rate	$93.48
Max. Negotiated Rate	$93.48
Rate for Payer: Qualcare PPO/HMO/WC	$93.48

SUSCEPTYEASTCOMPPNL(BRONFLUID)

Facility

$623.18

Service Code	HCPCS 87186
Hospital Charge Code	401387186
Hospital Revenue Code	306
Min. Negotiated Rate	$6.92
Max. Negotiated Rate	$311.59
Rate for Payer: Aetna Commercial	$23.53
Rate for Payer: Aetna Medicare Advantage	$28.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.38
Rate for Payer: Cigna Commercial	$311.59
Rate for Payer: Cigna Medicare Advantage	$8.65
Rate for Payer: Clover Medicare Advantage	$8.22
Rate for Payer: EmblemHealth Commercial	$25.95
Rate for Payer: Humana Medicare Advantage	$8.91
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.03
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.48
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$6.92
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.65
Rate for Payer: Wellcare Medicare Advantage	$8.65
Rate for Payer: Wellpoint Medicaid Managed Care	$17.70

SUSPEND BOWEL W/PROSTHESIS

Facility

$21,202.60

Service Code	HCPCS 44700
Hospital Charge Code	1600000651
Hospital Revenue Code	360
Min. Negotiated Rate	$602.15
Max. Negotiated Rate	$10,601.30
Rate for Payer: Aetna Commercial	$8,056.99
Rate for Payer: Aetna Medicare Advantage	$6,360.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,406.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,406.66
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	$5,406.66
Rate for Payer: Cigna Commercial	$10,601.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,512.68
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,180.39
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$670.00
Rate for Payer: Wellpoint Medicaid Managed Care	$602.15

SUSPEND BOWEL W/PROSTHESIS

Facility

$21,202.60

Service Code	HCPCS 44700
Hospital Charge Code	1600000651
Hospital Revenue Code	360
Min. Negotiated Rate	$3,180.39
Max. Negotiated Rate	$3,180.39
Rate for Payer: Qualcare PPO/HMO/WC	$3,180.39

SUSPENSORY 0-2 W/STRAP LARGE

Facility

$43.40

Hospital Charge Code	270651066
Hospital Revenue Code	270
Min. Negotiated Rate	$1.23
Max. Negotiated Rate	$21.70
Rate for Payer: Aetna Commercial	$16.49
Rate for Payer: Aetna Medicare Advantage	$13.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.07
Rate for Payer: Cigna Commercial	$21.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.28
Rate for Payer: Oxford Commercial	$8.68
Rate for Payer: Qualcare PPO/HMO/WC	$6.51
Rate for Payer: UnitedHealthcare Commercial	$8.68
Rate for Payer: UnitedHealthcare Community & State	$1.37
Rate for Payer: Wellpoint Medicaid Managed Care	$1.23

SUSPENSORY 0-2 W/STRAP LARGE

Facility

$43.40

Hospital Charge Code	270651066
Hospital Revenue Code	270
Min. Negotiated Rate	$6.51
Max. Negotiated Rate	$6.51
Rate for Payer: Qualcare PPO/HMO/WC	$6.51

SUSPENSORY W/STRAP XL

Facility

$49.55

Hospital Charge Code	270650254
Hospital Revenue Code	272
Min. Negotiated Rate	$7.43
Max. Negotiated Rate	$7.43
Rate for Payer: Qualcare PPO/HMO/WC	$7.43

SUSPENSORY W/STRAP XL

Facility

$49.55

Hospital Charge Code	270650254
Hospital Revenue Code	272
Min. Negotiated Rate	$1.41
Max. Negotiated Rate	$24.77
Rate for Payer: Aetna Commercial	$18.83
Rate for Payer: Aetna Medicare Advantage	$14.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.64
Rate for Payer: Cigna Commercial	$24.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.88
Rate for Payer: Oxford Commercial	$9.91
Rate for Payer: Qualcare PPO/HMO/WC	$7.43
Rate for Payer: UnitedHealthcare Commercial	$9.91
Rate for Payer: UnitedHealthcare Community & State	$1.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1.41

SUT ANCHR OSSIOFIB 4.75 BB TP2

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270700793
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$961.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

SUT ANCHR OSSIOFIB 4.75 BB TP2

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270700793
Hospital Revenue Code	278
Min. Negotiated Rate	$112.89
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,510.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25
Rate for Payer: UnitedHealthcare Community & State	$125.61
Rate for Payer: Wellpoint Medicaid Managed Care	$112.89

SUT ANCHR OSSIOFIB 4.75BLK TP2

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270700792
Hospital Revenue Code	278
Min. Negotiated Rate	$112.89
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,510.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25
Rate for Payer: UnitedHealthcare Community & State	$125.61
Rate for Payer: Wellpoint Medicaid Managed Care	$112.89

SUT ANCHR OSSIOFIB 4.75BLK TP2

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270700792
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$961.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

SUT ANCHR OSSIOFIB 4.75 SNARE

Facility

$3,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270700794
Hospital Revenue Code	278
Min. Negotiated Rate	$521.25
Max. Negotiated Rate	$840.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.95
Rate for Payer: Qualcare PPO/HMO/WC	$521.25

Know your out-of-pocket cost for care.

All Charges