Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TAP BLOCK BI INJECTION

Facility

$1,147.71

Service Code	HCPCS 64488
Hospital Charge Code	16000333
Hospital Revenue Code	360
Min. Negotiated Rate	$32.59
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$436.13
Rate for Payer: Aetna Medicare Advantage	$344.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$292.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$292.67
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	$292.67
Rate for Payer: Cigna Commercial	$573.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$298.40
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.16
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$36.27
Rate for Payer: Wellpoint Medicaid Managed Care	$32.59

TAP BLOCK BI INJECTION

Facility

$1,147.71

Service Code	HCPCS 64488
Hospital Charge Code	16000333
Hospital Revenue Code	360
Min. Negotiated Rate	$172.16
Max. Negotiated Rate	$172.16
Rate for Payer: Qualcare PPO/HMO/WC	$172.16

TAP BLOCK BILATERAL

Facility

$2,296.25

Service Code	HCPCS 64488
Hospital Charge Code	1650119
Hospital Revenue Code	361
Min. Negotiated Rate	$65.21
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$872.58
Rate for Payer: Aetna Medicare Advantage	$688.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$585.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$585.54
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	$585.54
Rate for Payer: Cigna Commercial	$1,148.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$597.02
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$344.44
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$72.56
Rate for Payer: Wellpoint Medicaid Managed Care	$65.21

TAP BLOCK BILATERAL

Facility

$2,296.25

Service Code	HCPCS 64488
Hospital Charge Code	1650119
Hospital Revenue Code	361
Min. Negotiated Rate	$344.44
Max. Negotiated Rate	$344.44
Rate for Payer: Qualcare PPO/HMO/WC	$344.44

TAP BLOCK BY INFUSION

Facility

$6,663.00

Service Code	HCPCS 64489
Hospital Charge Code	1600000859
Hospital Revenue Code	360
Min. Negotiated Rate	$999.45
Max. Negotiated Rate	$999.45
Rate for Payer: Qualcare PPO/HMO/WC	$999.45

TAP BLOCK BY INFUSION

Facility

$6,663.00

Service Code	HCPCS 64489
Hospital Charge Code	1600000859
Hospital Revenue Code	360
Min. Negotiated Rate	$189.23
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,531.94
Rate for Payer: Aetna Medicare Advantage	$1,998.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,699.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,699.07
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	$1,699.07
Rate for Payer: Cigna Commercial	$3,331.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,732.38
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$999.45
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$210.55
Rate for Payer: Wellpoint Medicaid Managed Care	$189.23

TAP BLOCK UNILATERAL

Facility

$2,296.25

Service Code	HCPCS 64486
Hospital Charge Code	1650118
Hospital Revenue Code	361
Min. Negotiated Rate	$65.21
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$872.58
Rate for Payer: Aetna Medicare Advantage	$688.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$585.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$585.54
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	$585.54
Rate for Payer: Cigna Commercial	$1,148.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$597.02
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$344.44
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$72.56
Rate for Payer: Wellpoint Medicaid Managed Care	$65.21

TAP BLOCK UNILATERAL

Facility

$2,296.25

Service Code	HCPCS 64486
Hospital Charge Code	1650118
Hospital Revenue Code	361
Min. Negotiated Rate	$344.44
Max. Negotiated Rate	$344.44
Rate for Payer: Qualcare PPO/HMO/WC	$344.44

TAP BLOCK UNIL BY INJ

Facility

$1,147.71

Service Code	HCPCS 64486
Hospital Charge Code	16000461
Hospital Revenue Code	360
Min. Negotiated Rate	$32.59
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$436.13
Rate for Payer: Aetna Medicare Advantage	$344.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$292.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$292.67
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	$292.67
Rate for Payer: Cigna Commercial	$573.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$298.40
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.16
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$36.27
Rate for Payer: Wellpoint Medicaid Managed Care	$32.59

TAP BLOCK UNIL BY INJ

Facility

$1,147.71

Service Code	HCPCS 64486
Hospital Charge Code	16000461
Hospital Revenue Code	360
Min. Negotiated Rate	$172.16
Max. Negotiated Rate	$172.16
Rate for Payer: Qualcare PPO/HMO/WC	$172.16

TAP BX 2.7MM BT2703

Facility

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	270620188
Hospital Revenue Code	278
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$11.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.65

TAP BX 2.7MM BT2703

Facility

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	270620188
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

TAP CANN CREO MIS 6.5MM

Facility

$2,055.00

Hospital Charge Code	270698075
Hospital Revenue Code	272
Min. Negotiated Rate	$58.36
Max. Negotiated Rate	$1,027.50
Rate for Payer: Aetna Commercial	$780.90
Rate for Payer: Aetna Medicare Advantage	$616.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$524.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$524.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$524.02
Rate for Payer: Cigna Commercial	$1,027.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$534.30
Rate for Payer: Oxford Commercial	$411.00
Rate for Payer: Qualcare PPO/HMO/WC	$308.25
Rate for Payer: UnitedHealthcare Commercial	$411.00
Rate for Payer: UnitedHealthcare Community & State	$64.94
Rate for Payer: Wellpoint Medicaid Managed Care	$58.36

TAP CANN CREO MIS 6.5MM

Facility

$2,055.00

Hospital Charge Code	270698075
Hospital Revenue Code	272
Min. Negotiated Rate	$308.25
Max. Negotiated Rate	$308.25
Rate for Payer: Qualcare PPO/HMO/WC	$308.25

TAP CANNULATED 4.5MM

Facility

$875.00

Hospital Charge Code	270673452
Hospital Revenue Code	272
Min. Negotiated Rate	$24.85
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$27.65
Rate for Payer: Wellpoint Medicaid Managed Care	$24.85

TAP CANNULATED 4.5MM

Facility

$875.00

Hospital Charge Code	270673452
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

TAPE CASTING 2

Facility

$10.21

Hospital Charge Code	270300825
Hospital Revenue Code	270
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$5.11
Rate for Payer: Aetna Commercial	$3.88
Rate for Payer: Aetna Medicare Advantage	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.60
Rate for Payer: Cigna Commercial	$5.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.65
Rate for Payer: Oxford Commercial	$2.04
Rate for Payer: Qualcare PPO/HMO/WC	$1.53
Rate for Payer: UnitedHealthcare Commercial	$2.04
Rate for Payer: UnitedHealthcare Community & State	$0.32
Rate for Payer: Wellpoint Medicaid Managed Care	$0.29

TAPE CASTING 2

Facility

$10.21

Hospital Charge Code	270300825
Hospital Revenue Code	270
Min. Negotiated Rate	$1.53
Max. Negotiated Rate	$1.53
Rate for Payer: Qualcare PPO/HMO/WC	$1.53

TAPE CASTING 3

Facility

$11.85

Hospital Charge Code	270300830
Hospital Revenue Code	270
Min. Negotiated Rate	$1.78
Max. Negotiated Rate	$1.78
Rate for Payer: Qualcare PPO/HMO/WC	$1.78

TAPE CASTING 3

Facility

$11.85

Hospital Charge Code	270300830W
Hospital Revenue Code	270
Min. Negotiated Rate	$1.78
Max. Negotiated Rate	$1.78
Rate for Payer: Qualcare PPO/HMO/WC	$1.78

TAPE CASTING 3

Facility

$11.85

Hospital Charge Code	270300830
Hospital Revenue Code	270
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$5.92
Rate for Payer: Aetna Commercial	$4.50
Rate for Payer: Aetna Medicare Advantage	$3.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.02
Rate for Payer: Cigna Commercial	$5.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.08
Rate for Payer: Oxford Commercial	$2.37
Rate for Payer: Qualcare PPO/HMO/WC	$1.78
Rate for Payer: UnitedHealthcare Commercial	$2.37
Rate for Payer: UnitedHealthcare Community & State	$0.37
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

TAPE CASTING 3

Facility

$11.85

Hospital Charge Code	270300830W
Hospital Revenue Code	270
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$5.92
Rate for Payer: Aetna Commercial	$4.50
Rate for Payer: Aetna Medicare Advantage	$3.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.02
Rate for Payer: Cigna Commercial	$5.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.08
Rate for Payer: Oxford Commercial	$2.37
Rate for Payer: Qualcare PPO/HMO/WC	$1.78
Rate for Payer: UnitedHealthcare Commercial	$2.37
Rate for Payer: UnitedHealthcare Community & State	$0.37
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

TAPE CASTING 4

Facility

$16.15

Hospital Charge Code	270300835W
Hospital Revenue Code	270
Min. Negotiated Rate	$2.42
Max. Negotiated Rate	$2.42
Rate for Payer: Qualcare PPO/HMO/WC	$2.42

TAPE CASTING 4

Facility

$16.15

Hospital Charge Code	270300835W
Hospital Revenue Code	270
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$8.07
Rate for Payer: Aetna Commercial	$6.14
Rate for Payer: Aetna Medicare Advantage	$4.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.12
Rate for Payer: Cigna Commercial	$8.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.20
Rate for Payer: Oxford Commercial	$3.23
Rate for Payer: Qualcare PPO/HMO/WC	$2.42
Rate for Payer: UnitedHealthcare Commercial	$3.23
Rate for Payer: UnitedHealthcare Community & State	$0.51
Rate for Payer: Wellpoint Medicaid Managed Care	$0.46

TAPE CASTING 4 IN

Facility

$16.15

Hospital Charge Code	270300835
Hospital Revenue Code	270
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$8.07
Rate for Payer: Aetna Commercial	$6.14
Rate for Payer: Aetna Medicare Advantage	$4.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.12
Rate for Payer: Cigna Commercial	$8.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.20
Rate for Payer: Oxford Commercial	$3.23
Rate for Payer: Qualcare PPO/HMO/WC	$2.42
Rate for Payer: UnitedHealthcare Commercial	$3.23
Rate for Payer: UnitedHealthcare Community & State	$0.51
Rate for Payer: Wellpoint Medicaid Managed Care	$0.46

Know your out-of-pocket cost for care.

All Charges