Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TEICHOIC ACID AB

Facility

$82.35

Service Code	HCPCS 86331
Hospital Charge Code	39900213
Hospital Revenue Code	302
Min. Negotiated Rate	$12.35
Max. Negotiated Rate	$12.35
Rate for Payer: Qualcare PPO/HMO/WC	$12.35

TEICHOIC ACID ANTIBODIES

Facility

$293.00

Service Code	HCPCS 86331
Hospital Charge Code	38472613
Hospital Revenue Code	302
Min. Negotiated Rate	$7.42
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$32.59
Rate for Payer: Aetna Medicare Advantage	$38.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.46
Rate for Payer: Cigna Commercial	$146.50
Rate for Payer: Cigna Medicare Advantage	$11.98
Rate for Payer: Clover Medicare Advantage	$11.38
Rate for Payer: EmblemHealth Commercial	$35.94
Rate for Payer: Humana Medicare Advantage	$12.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.18
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.95
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.98
Rate for Payer: Wellcare Medicare Advantage	$11.98
Rate for Payer: Wellpoint Medicaid Managed Care	$8.32

TEICHOIC ACID ANTIBODIES

Facility

$293.00

Service Code	HCPCS 86331
Hospital Charge Code	38472613
Hospital Revenue Code	302
Min. Negotiated Rate	$43.95
Max. Negotiated Rate	$43.95
Rate for Payer: Qualcare PPO/HMO/WC	$43.95

TEICHOIC ACID TITER

Facility

$96.50

Service Code	HCPCS 86329
Hospital Charge Code	39900212
Hospital Revenue Code	302
Min. Negotiated Rate	$2.74
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$38.22
Rate for Payer: Aetna Medicare Advantage	$45.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.97
Rate for Payer: Cigna Commercial	$48.25
Rate for Payer: Cigna Medicare Advantage	$14.05
Rate for Payer: Clover Medicare Advantage	$13.35
Rate for Payer: EmblemHealth Commercial	$42.15
Rate for Payer: Humana Medicare Advantage	$14.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.09
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.47
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$11.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.05
Rate for Payer: Wellcare Medicare Advantage	$14.05
Rate for Payer: Wellpoint Medicaid Managed Care	$2.74

TEICHOIC ACID TITER

Facility

$96.50

Service Code	HCPCS 86329
Hospital Charge Code	39900212
Hospital Revenue Code	302
Min. Negotiated Rate	$14.47
Max. Negotiated Rate	$14.47
Rate for Payer: Qualcare PPO/HMO/WC	$14.47

TEICHOIC ACID W/TITER RFX

Facility

$390.00

Service Code	HCPCS 86331
Hospital Charge Code	39900410
Hospital Revenue Code	302
Min. Negotiated Rate	$7.42
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$32.59
Rate for Payer: Aetna Medicare Advantage	$38.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.46
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$11.98
Rate for Payer: Clover Medicare Advantage	$11.38
Rate for Payer: EmblemHealth Commercial	$35.94
Rate for Payer: Humana Medicare Advantage	$12.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.98
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	$9.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.98
Rate for Payer: Wellcare Medicare Advantage	$11.98
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

TEICHOIC ACID W/TITER RFX

Facility

$390.00

Service Code	HCPCS 86331
Hospital Charge Code	39900410
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TELEHEALTH FACILITY FEE

Facility

$133.25

Service Code	HCPCS Q3014
Hospital Charge Code	4850Q3014
Hospital Revenue Code	780
Min. Negotiated Rate	$3.78
Max. Negotiated Rate	$66.62
Rate for Payer: Aetna Commercial	$50.63
Rate for Payer: Aetna Medicare Advantage	$39.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.98
Rate for Payer: Cigna Commercial	$66.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.65
Rate for Payer: Oxford Commercial	$26.65
Rate for Payer: Qualcare PPO/HMO/WC	$19.99
Rate for Payer: UnitedHealthcare Commercial	$26.65
Rate for Payer: UnitedHealthcare Community & State	$4.21
Rate for Payer: Wellpoint Medicaid Managed Care	$3.78

TELEHEALTH FACILITY FEE

Facility

$133.25

Service Code	HCPCS Q3014
Hospital Charge Code	4855Q3014
Hospital Revenue Code	780
Min. Negotiated Rate	$19.99
Max. Negotiated Rate	$19.99
Rate for Payer: Qualcare PPO/HMO/WC	$19.99

TELEHEALTH FACILITY FEE

Facility

$133.25

Service Code	HCPCS Q3014
Hospital Charge Code	4850Q3014
Hospital Revenue Code	780
Min. Negotiated Rate	$19.99
Max. Negotiated Rate	$19.99
Rate for Payer: Qualcare PPO/HMO/WC	$19.99

TELEHEALTH FACILITY FEE

Facility

$133.25

Service Code	HCPCS Q3014
Hospital Charge Code	4855Q3014
Hospital Revenue Code	780
Min. Negotiated Rate	$3.78
Max. Negotiated Rate	$66.62
Rate for Payer: Aetna Commercial	$50.63
Rate for Payer: Aetna Medicare Advantage	$39.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.98
Rate for Payer: Cigna Commercial	$66.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.65
Rate for Payer: Oxford Commercial	$26.65
Rate for Payer: Qualcare PPO/HMO/WC	$19.99
Rate for Payer: UnitedHealthcare Commercial	$26.65
Rate for Payer: UnitedHealthcare Community & State	$4.21
Rate for Payer: Wellpoint Medicaid Managed Care	$3.78

TELEPORT 2.1F 150CM

Facility

$3,500.00

Hospital Charge Code	270686315
Hospital Revenue Code	272
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$525.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

TELEPORT 2.1F 150CM

Facility

$3,500.00

Hospital Charge Code	270686315N
Hospital Revenue Code	272
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$525.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

TELEPORT 2.1F 150CM

Facility

$3,500.00

Hospital Charge Code	270686315N
Hospital Revenue Code	272
Min. Negotiated Rate	$99.40
Max. Negotiated Rate	$1,750.00
Rate for Payer: Aetna Commercial	$1,330.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$910.00
Rate for Payer: Oxford Commercial	$700.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00
Rate for Payer: UnitedHealthcare Commercial	$700.00
Rate for Payer: UnitedHealthcare Community & State	$110.60
Rate for Payer: Wellpoint Medicaid Managed Care	$99.40

TELEPORT 2.1F 150CM

Facility

$3,500.00

Hospital Charge Code	270686315
Hospital Revenue Code	272
Min. Negotiated Rate	$99.40
Max. Negotiated Rate	$1,750.00
Rate for Payer: Aetna Commercial	$1,330.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$910.00
Rate for Payer: Oxford Commercial	$700.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00
Rate for Payer: UnitedHealthcare Commercial	$700.00
Rate for Payer: UnitedHealthcare Community & State	$110.60
Rate for Payer: Wellpoint Medicaid Managed Care	$99.40

TELEPORT MICRO CATH 135CM 21FR

Facility

$3,500.00

Service Code	HCPCS C1887
Hospital Charge Code	270692099
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$847.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

TELEPORT MICRO CATH 135CM 21FR

Facility

$3,500.00

Service Code	HCPCS C1887
Hospital Charge Code	270692099
Hospital Revenue Code	278
Min. Negotiated Rate	$99.40
Max. Negotiated Rate	$1,750.00
Rate for Payer: Aetna Commercial	$1,330.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00
Rate for Payer: UnitedHealthcare Community & State	$110.60
Rate for Payer: Wellpoint Medicaid Managed Care	$99.40

TELESCOPIC STRUT GOLD

Facility

$6,644.50

Hospital Charge Code	270702657
Hospital Revenue Code	278
Min. Negotiated Rate	$188.70
Max. Negotiated Rate	$3,322.25
Rate for Payer: Aetna Commercial	$2,524.91
Rate for Payer: Aetna Medicare Advantage	$1,993.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,694.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,694.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,328.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,694.35
Rate for Payer: Cigna Commercial	$3,322.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,607.97
Rate for Payer: Qualcare PPO/HMO/WC	$996.67
Rate for Payer: UnitedHealthcare Community & State	$209.97
Rate for Payer: Wellpoint Medicaid Managed Care	$188.70

TELESCOPIC STRUT GOLD

Facility

$6,644.50

Hospital Charge Code	270702657
Hospital Revenue Code	278
Min. Negotiated Rate	$996.67
Max. Negotiated Rate	$1,607.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,328.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,607.97
Rate for Payer: Qualcare PPO/HMO/WC	$996.67

TELES.STRUT LONG 177-277MM RED

Facility

$6,479.60

Hospital Charge Code	270702827
Hospital Revenue Code	278
Min. Negotiated Rate	$184.02
Max. Negotiated Rate	$3,239.80
Rate for Payer: Aetna Commercial	$2,462.25
Rate for Payer: Aetna Medicare Advantage	$1,943.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,652.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,652.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,652.30
Rate for Payer: Cigna Commercial	$3,239.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,568.06
Rate for Payer: Qualcare PPO/HMO/WC	$971.94
Rate for Payer: UnitedHealthcare Community & State	$204.76
Rate for Payer: Wellpoint Medicaid Managed Care	$184.02

TELES.STRUT LONG 177-277MM RED

Facility

$6,479.60

Hospital Charge Code	270702827
Hospital Revenue Code	278
Min. Negotiated Rate	$971.94
Max. Negotiated Rate	$1,568.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,568.06
Rate for Payer: Qualcare PPO/HMO/WC	$971.94

TELES.STRUT SHRT 119-161MM BLU

Facility

$6,479.60

Hospital Charge Code	270702826
Hospital Revenue Code	278
Min. Negotiated Rate	$184.02
Max. Negotiated Rate	$3,239.80
Rate for Payer: Aetna Commercial	$2,462.25
Rate for Payer: Aetna Medicare Advantage	$1,943.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,652.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,652.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,652.30
Rate for Payer: Cigna Commercial	$3,239.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,568.06
Rate for Payer: Qualcare PPO/HMO/WC	$971.94
Rate for Payer: UnitedHealthcare Community & State	$204.76
Rate for Payer: Wellpoint Medicaid Managed Care	$184.02

TELES.STRUT SHRT 119-161MM BLU

Facility

$6,479.60

Hospital Charge Code	270702826
Hospital Revenue Code	278
Min. Negotiated Rate	$971.94
Max. Negotiated Rate	$1,568.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,568.06
Rate for Payer: Qualcare PPO/HMO/WC	$971.94

TELETHX ISODOSE PLAN CPLX

Facility

$671.79

Service Code	HCPCS 77307
Hospital Charge Code	85000892
Hospital Revenue Code	333
Min. Negotiated Rate	$19.08
Max. Negotiated Rate	$6,851.00
Rate for Payer: Aetna Commercial	$1,209.94
Rate for Payer: Aetna Medicare Advantage	$1,441.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,613.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,613.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$444.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,613.62
Rate for Payer: Cigna Commercial	$891.65
Rate for Payer: Cigna Medicare Advantage	$311.38
Rate for Payer: Clover Medicare Advantage	$422.59
Rate for Payer: EmblemHealth Commercial	$1,334.49
Rate for Payer: Humana Medicare Advantage	$458.17
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$444.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.67
Rate for Payer: Oxford Commercial	$6,034.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.77
Rate for Payer: UnitedHealthcare Commercial	$6,851.00
Rate for Payer: UnitedHealthcare Community & State	$21.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$444.83
Rate for Payer: Wellcare Medicare Advantage	$444.83
Rate for Payer: Wellpoint Medicaid Managed Care	$19.08

TELETHX ISODOSE PLAN CPLX

Facility

$671.79

Service Code	HCPCS 77307
Hospital Charge Code	85000892
Hospital Revenue Code	333
Min. Negotiated Rate	$100.77
Max. Negotiated Rate	$100.77
Rate for Payer: Qualcare PPO/HMO/WC	$100.77

Know your out-of-pocket cost for care.

All Charges