Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TBA EA ADD ARTERY (NOT LE)

Facility

$974.90

Service Code	HCPCS 37247
Hospital Charge Code	2709032
Hospital Revenue Code	361
Min. Negotiated Rate	$27.69
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$370.46
Rate for Payer: Aetna Medicare Advantage	$292.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.60
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	$248.60
Rate for Payer: Cigna Commercial	$487.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$253.47
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.24
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$30.81
Rate for Payer: Wellpoint Medicaid Managed Care	$27.69

TBA EA ADD ARTERY (NOT LE)

Facility

$974.90

Service Code	HCPCS 37247
Hospital Charge Code	2692137
Hospital Revenue Code	361
Min. Negotiated Rate	$27.69
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$370.46
Rate for Payer: Aetna Medicare Advantage	$292.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.60
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	$248.60
Rate for Payer: Cigna Commercial	$487.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$253.47
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.24
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$30.81
Rate for Payer: Wellpoint Medicaid Managed Care	$27.69

TBA EA ADD ARTERY (NOT LE)

Facility

$974.90

Service Code	HCPCS 37247
Hospital Charge Code	366837247
Hospital Revenue Code	361
Min. Negotiated Rate	$27.69
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$370.46
Rate for Payer: Aetna Medicare Advantage	$292.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.60
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	$248.60
Rate for Payer: Cigna Commercial	$487.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$253.47
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.24
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$30.81
Rate for Payer: Wellpoint Medicaid Managed Care	$27.69

TBA EA ADD ARTERY (NOT LE)

Facility

$974.90

Service Code	HCPCS 37247
Hospital Charge Code	7412066
Hospital Revenue Code	361
Min. Negotiated Rate	$146.24
Max. Negotiated Rate	$146.24
Rate for Payer: Qualcare PPO/HMO/WC	$146.24

TBA EA ADD ARTERY (NOT LE)

Facility

$974.90

Service Code	HCPCS 37247
Hospital Charge Code	2692137
Hospital Revenue Code	361
Min. Negotiated Rate	$146.24
Max. Negotiated Rate	$146.24
Rate for Payer: Qualcare PPO/HMO/WC	$146.24

TBA EA ADD ARTERY (NOT LE)

Facility

$974.90

Service Code	HCPCS 37247
Hospital Charge Code	366837247
Hospital Revenue Code	361
Min. Negotiated Rate	$146.24
Max. Negotiated Rate	$146.24
Rate for Payer: Qualcare PPO/HMO/WC	$146.24

TBA EA ADD ARTERY (NOT LE)

Facility

$974.90

Service Code	HCPCS 37247
Hospital Charge Code	321037247
Hospital Revenue Code	361
Min. Negotiated Rate	$27.69
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$370.46
Rate for Payer: Aetna Medicare Advantage	$292.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.60
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	$248.60
Rate for Payer: Cigna Commercial	$487.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$253.47
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.24
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$30.81
Rate for Payer: Wellpoint Medicaid Managed Care	$27.69

TBA EA ADD ARTERY (NOT LE)

Facility

$974.90

Service Code	HCPCS 37247
Hospital Charge Code	2709032
Hospital Revenue Code	361
Min. Negotiated Rate	$146.24
Max. Negotiated Rate	$146.24
Rate for Payer: Qualcare PPO/HMO/WC	$146.24

TBA EA ADD ARTERY (NOT LE)

Facility

$974.90

Service Code	HCPCS 37247
Hospital Charge Code	7412066
Hospital Revenue Code	361
Min. Negotiated Rate	$27.69
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$370.46
Rate for Payer: Aetna Medicare Advantage	$292.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.60
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	$248.60
Rate for Payer: Cigna Commercial	$487.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$253.47
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.24
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$30.81
Rate for Payer: Wellpoint Medicaid Managed Care	$27.69

TBA EA ADD ARTERY (NOT LE)

Facility

$974.90

Service Code	HCPCS 37247
Hospital Charge Code	5100845
Hospital Revenue Code	361
Min. Negotiated Rate	$146.24
Max. Negotiated Rate	$146.24
Rate for Payer: Qualcare PPO/HMO/WC	$146.24

TBA EA ADD ART (NOT DIALYSIS)

Facility

$829.85

Service Code	HCPCS 37249
Hospital Charge Code	5100847
Hospital Revenue Code	361
Min. Negotiated Rate	$23.57
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$315.34
Rate for Payer: Aetna Medicare Advantage	$248.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.61
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	$211.61
Rate for Payer: Cigna Commercial	$414.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.76
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$124.48
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$26.22
Rate for Payer: Wellpoint Medicaid Managed Care	$23.57

TBA EA ADD ART (NOT DIALYSIS)

Facility

$829.85

Service Code	HCPCS 37249
Hospital Charge Code	7412068
Hospital Revenue Code	361
Min. Negotiated Rate	$124.48
Max. Negotiated Rate	$124.48
Rate for Payer: Qualcare PPO/HMO/WC	$124.48

TBA EA ADD ART (NOT DIALYSIS)

Facility

$829.85

Service Code	HCPCS 37249
Hospital Charge Code	2692139
Hospital Revenue Code	361
Min. Negotiated Rate	$23.57
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$315.34
Rate for Payer: Aetna Medicare Advantage	$248.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.61
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	$211.61
Rate for Payer: Cigna Commercial	$414.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.76
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$124.48
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$26.22
Rate for Payer: Wellpoint Medicaid Managed Care	$23.57

TBA EA ADD ART (NOT DIALYSIS)

Facility

$829.85

Service Code	HCPCS 37249
Hospital Charge Code	366837249
Hospital Revenue Code	361
Min. Negotiated Rate	$23.57
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$315.34
Rate for Payer: Aetna Medicare Advantage	$248.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.61
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	$211.61
Rate for Payer: Cigna Commercial	$414.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.76
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$124.48
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$26.22
Rate for Payer: Wellpoint Medicaid Managed Care	$23.57

TBA EA ADD ART (NOT DIALYSIS)

Facility

$829.85

Service Code	HCPCS 37249
Hospital Charge Code	321037249
Hospital Revenue Code	361
Min. Negotiated Rate	$23.57
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$315.34
Rate for Payer: Aetna Medicare Advantage	$248.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.61
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	$211.61
Rate for Payer: Cigna Commercial	$414.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.76
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$124.48
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$26.22
Rate for Payer: Wellpoint Medicaid Managed Care	$23.57

TBA EA ADD ART (NOT DIALYSIS)

Facility

$829.85

Service Code	HCPCS 37249
Hospital Charge Code	2692139
Hospital Revenue Code	361
Min. Negotiated Rate	$124.48
Max. Negotiated Rate	$124.48
Rate for Payer: Qualcare PPO/HMO/WC	$124.48

TBA EA ADD ART (NOT DIALYSIS)

Facility

$829.85

Service Code	HCPCS 37249
Hospital Charge Code	7412068
Hospital Revenue Code	361
Min. Negotiated Rate	$23.57
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$315.34
Rate for Payer: Aetna Medicare Advantage	$248.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.61
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	$211.61
Rate for Payer: Cigna Commercial	$414.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.76
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$124.48
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$26.22
Rate for Payer: Wellpoint Medicaid Managed Care	$23.57

TBA EA ADD ART (NOT DIALYSIS)

Facility

$829.85

Service Code	HCPCS 37249
Hospital Charge Code	2709034
Hospital Revenue Code	361
Min. Negotiated Rate	$23.57
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$315.34
Rate for Payer: Aetna Medicare Advantage	$248.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.61
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	$211.61
Rate for Payer: Cigna Commercial	$414.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.76
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$124.48
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$26.22
Rate for Payer: Wellpoint Medicaid Managed Care	$23.57

TBA EA ADD ART (NOT DIALYSIS)

Facility

$829.85

Service Code	HCPCS 37249
Hospital Charge Code	321037249
Hospital Revenue Code	361
Min. Negotiated Rate	$124.48
Max. Negotiated Rate	$124.48
Rate for Payer: Qualcare PPO/HMO/WC	$124.48

TBA EA ADD ART (NOT DIALYSIS)

Facility

$829.85

Service Code	HCPCS 37249
Hospital Charge Code	366837249
Hospital Revenue Code	361
Min. Negotiated Rate	$124.48
Max. Negotiated Rate	$124.48
Rate for Payer: Qualcare PPO/HMO/WC	$124.48

TBA EA ADD ART (NOT DIALYSIS)

Facility

$829.85

Service Code	HCPCS 37249
Hospital Charge Code	5100847
Hospital Revenue Code	361
Min. Negotiated Rate	$124.48
Max. Negotiated Rate	$124.48
Rate for Payer: Qualcare PPO/HMO/WC	$124.48

TBA EA ADD ART (NOT DIALYSIS)

Facility

$829.85

Service Code	HCPCS 37249
Hospital Charge Code	2709034
Hospital Revenue Code	361
Min. Negotiated Rate	$124.48
Max. Negotiated Rate	$124.48
Rate for Payer: Qualcare PPO/HMO/WC	$124.48

TBA PERIPH DIALYSIS SEGMENT

Facility

$27,397.00

Service Code	HCPCS 36902
Hospital Charge Code	2692128
Hospital Revenue Code	361
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

TBA PERIPH DIALYSIS SEGMENT

Facility

$24,115.80

Service Code	HCPCS 36902
Hospital Charge Code	5100836
Hospital Revenue Code	361
Min. Negotiated Rate	$3,617.37
Max. Negotiated Rate	$3,617.37
Rate for Payer: Qualcare PPO/HMO/WC	$3,617.37

TBA PERIPH DIALYSIS SEGMENT

Facility

$24,115.80

Service Code	HCPCS 36902
Hospital Charge Code	5100836
Hospital Revenue Code	361
Min. Negotiated Rate	$684.89
Max. Negotiated Rate	$24,528.18
Rate for Payer: Aetna Commercial	$18,391.91
Rate for Payer: Aetna Medicare Advantage	$21,908.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24,528.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24,528.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,761.73
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	$24,528.18
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: Cigna Medicare Advantage	$6,761.73
Rate for Payer: Clover Medicare Advantage	$6,423.64
Rate for Payer: EmblemHealth Commercial	$20,285.19
Rate for Payer: Humana Medicare Advantage	$6,964.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,761.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,270.11
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,617.37
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$762.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,761.73
Rate for Payer: Wellcare Medicare Advantage	$6,761.73
Rate for Payer: Wellpoint Medicaid Managed Care	$684.89

Know your out-of-pocket cost for care.

All Charges