Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TOTAL IRON BINDING CAPACITY

Facility

$667.59

Service Code	HCPCS 83550
Hospital Charge Code	3009289
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

TOTAL IRON BINDING CAPACITY

Facility

$667.59

Service Code	HCPCS 83550
Hospital Charge Code	3009289
Hospital Revenue Code	301
Min. Negotiated Rate	$6.99
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$23.77
Rate for Payer: Aetna Medicare Advantage	$28.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.70
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$8.74
Rate for Payer: Clover Medicare Advantage	$8.30
Rate for Payer: EmblemHealth Commercial	$26.22
Rate for Payer: Humana Medicare Advantage	$9.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.57
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$6.99
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.74
Rate for Payer: Wellcare Medicare Advantage	$8.74
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

TOTAL KNEE KIT

Facility

$1,296.00

Hospital Charge Code	270338757
Hospital Revenue Code	272
Min. Negotiated Rate	$194.40
Max. Negotiated Rate	$194.40
Rate for Payer: Qualcare PPO/HMO/WC	$194.40

TOTAL KNEE KIT

Facility

$1,296.00

Hospital Charge Code	270338757
Hospital Revenue Code	272
Min. Negotiated Rate	$36.81
Max. Negotiated Rate	$648.00
Rate for Payer: Aetna Commercial	$492.48
Rate for Payer: Aetna Medicare Advantage	$388.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.48
Rate for Payer: Cigna Commercial	$648.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$336.96
Rate for Payer: Oxford Commercial	$259.20
Rate for Payer: Qualcare PPO/HMO/WC	$194.40
Rate for Payer: UnitedHealthcare Commercial	$259.20
Rate for Payer: UnitedHealthcare Community & State	$40.95
Rate for Payer: Wellpoint Medicaid Managed Care	$36.81

TOTAL KNEE REPLCMNT(HOWMEDICA)

Facility

$10,817.00

Hospital Charge Code	270335459
Hospital Revenue Code	278
Min. Negotiated Rate	$1,622.55
Max. Negotiated Rate	$2,617.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,163.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,617.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,622.55

TOTAL KNEE REPLCMNT(HOWMEDICA)

Facility

$10,817.00

Hospital Charge Code	270335459
Hospital Revenue Code	278
Min. Negotiated Rate	$307.20
Max. Negotiated Rate	$5,408.50
Rate for Payer: Aetna Commercial	$4,110.46
Rate for Payer: Aetna Medicare Advantage	$3,245.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,758.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,758.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,163.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,758.34
Rate for Payer: Cigna Commercial	$5,408.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,617.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,622.55
Rate for Payer: UnitedHealthcare Community & State	$341.82
Rate for Payer: Wellpoint Medicaid Managed Care	$307.20

TOTAL PLUS INFUSION SET

Facility

$996.00

Hospital Charge Code	270332585
Hospital Revenue Code	272
Min. Negotiated Rate	$28.29
Max. Negotiated Rate	$498.00
Rate for Payer: Aetna Commercial	$378.48
Rate for Payer: Aetna Medicare Advantage	$298.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.98
Rate for Payer: Cigna Commercial	$498.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.96
Rate for Payer: Oxford Commercial	$199.20
Rate for Payer: Qualcare PPO/HMO/WC	$149.40
Rate for Payer: UnitedHealthcare Commercial	$199.20
Rate for Payer: UnitedHealthcare Community & State	$31.47
Rate for Payer: Wellpoint Medicaid Managed Care	$28.29

TOTAL PLUS INFUSION SET

Facility

$996.00

Hospital Charge Code	270332585
Hospital Revenue Code	272
Min. Negotiated Rate	$149.40
Max. Negotiated Rate	$149.40
Rate for Payer: Qualcare PPO/HMO/WC	$149.40

TOTAL PROTEIN

Facility

$116.00

Service Code	HCPCS 84157
Hospital Charge Code	38479402
Hospital Revenue Code	301
Min. Negotiated Rate	$17.40
Max. Negotiated Rate	$17.40
Rate for Payer: Qualcare PPO/HMO/WC	$17.40

TOTAL PROTEIN

Facility

$116.00

Service Code	HCPCS 84157
Hospital Charge Code	38479402
Hospital Revenue Code	301
Min. Negotiated Rate	$3.20
Max. Negotiated Rate	$15,880.57
Rate for Payer: Aetna Commercial	$10.88
Rate for Payer: Aetna Medicare Advantage	$12.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.51
Rate for Payer: Cigna Commercial	$58.00
Rate for Payer: Cigna Medicare Advantage	$4.00
Rate for Payer: Clover Medicare Advantage	$3.80
Rate for Payer: EmblemHealth Commercial	$12.00
Rate for Payer: Humana Medicare Advantage	$4.12
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.16
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.40
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$3.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.00
Rate for Payer: Wellcare Medicare Advantage	$4.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$15,880.57
Rate for Payer: Wellpoint Medicaid Managed Care	$3.29

TOTAL PROTEIN, 24 HOUR URINE

Facility

$105.62

Service Code	HCPCS 84156
Hospital Charge Code	3000371
Hospital Revenue Code	301
Min. Negotiated Rate	$2.94
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$9.98
Rate for Payer: Aetna Medicare Advantage	$11.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.31
Rate for Payer: Cigna Commercial	$52.81
Rate for Payer: Cigna Medicare Advantage	$3.67
Rate for Payer: Clover Medicare Advantage	$3.49
Rate for Payer: EmblemHealth Commercial	$11.01
Rate for Payer: Humana Medicare Advantage	$3.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.46
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.84
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$2.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.67
Rate for Payer: Wellcare Medicare Advantage	$3.67
Rate for Payer: Wellpoint Medicaid Managed Care	$3.00

TOTAL PROTEIN, 24 HOUR URINE

Facility

$105.62

Service Code	HCPCS 84156
Hospital Charge Code	3000371
Hospital Revenue Code	301
Min. Negotiated Rate	$15.84
Max. Negotiated Rate	$15.84
Rate for Payer: Qualcare PPO/HMO/WC	$15.84

TOTAL PROTEIN, CSF

Facility

$116.00

Service Code	HCPCS 84157
Hospital Charge Code	38472590
Hospital Revenue Code	301
Min. Negotiated Rate	$3.20
Max. Negotiated Rate	$15,880.57
Rate for Payer: Aetna Commercial	$10.88
Rate for Payer: Aetna Medicare Advantage	$12.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.51
Rate for Payer: Cigna Commercial	$58.00
Rate for Payer: Cigna Medicare Advantage	$4.00
Rate for Payer: Clover Medicare Advantage	$3.80
Rate for Payer: EmblemHealth Commercial	$12.00
Rate for Payer: Humana Medicare Advantage	$4.12
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.16
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.40
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$3.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.00
Rate for Payer: Wellcare Medicare Advantage	$4.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$15,880.57
Rate for Payer: Wellpoint Medicaid Managed Care	$3.29

TOTAL PROTEIN, CSF

Facility

$116.00

Service Code	HCPCS 84157
Hospital Charge Code	38472590
Hospital Revenue Code	301
Min. Negotiated Rate	$17.40
Max. Negotiated Rate	$17.40
Rate for Payer: Qualcare PPO/HMO/WC	$17.40

TOTAL PROTEIN,SERUM

Facility

$116.00

Service Code	HCPCS 84155
Hospital Charge Code	38472584
Hospital Revenue Code	301
Min. Negotiated Rate	$2.94
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$9.98
Rate for Payer: Aetna Medicare Advantage	$11.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.31
Rate for Payer: Cigna Commercial	$58.00
Rate for Payer: Cigna Medicare Advantage	$3.67
Rate for Payer: Clover Medicare Advantage	$3.49
Rate for Payer: EmblemHealth Commercial	$11.01
Rate for Payer: Humana Medicare Advantage	$3.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.16
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.40
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$2.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.67
Rate for Payer: Wellcare Medicare Advantage	$3.67
Rate for Payer: Wellpoint Medicaid Managed Care	$3.29

TOTAL PROTEIN,SERUM

Facility

$116.00

Service Code	HCPCS 84155
Hospital Charge Code	38472584
Hospital Revenue Code	301
Min. Negotiated Rate	$17.40
Max. Negotiated Rate	$17.40
Rate for Payer: Qualcare PPO/HMO/WC	$17.40

TOTAL PROTEIN, SYNOVIAL FLUID

Facility

$390.00

Service Code	HCPCS 84157
Hospital Charge Code	3000375
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TOTAL PROTEIN, SYNOVIAL FLUID

Facility

$390.00

Service Code	HCPCS 84157
Hospital Charge Code	3000375
Hospital Revenue Code	301
Min. Negotiated Rate	$3.20
Max. Negotiated Rate	$15,880.57
Rate for Payer: Aetna Commercial	$10.88
Rate for Payer: Aetna Medicare Advantage	$12.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.51
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$4.00
Rate for Payer: Clover Medicare Advantage	$3.80
Rate for Payer: EmblemHealth Commercial	$12.00
Rate for Payer: Humana Medicare Advantage	$4.12
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.00
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	$3.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.00
Rate for Payer: Wellcare Medicare Advantage	$4.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$15,880.57
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

TOTAL PROTEIN, URINE

Facility

$390.00

Service Code	HCPCS 84156
Hospital Charge Code	38472587
Hospital Revenue Code	301
Min. Negotiated Rate	$2.94
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$9.98
Rate for Payer: Aetna Medicare Advantage	$11.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.31
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$3.67
Rate for Payer: Clover Medicare Advantage	$3.49
Rate for Payer: EmblemHealth Commercial	$11.01
Rate for Payer: Humana Medicare Advantage	$3.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.67
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	$2.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.67
Rate for Payer: Wellcare Medicare Advantage	$3.67
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

TOTAL PROTEIN, URINE

Facility

$390.00

Service Code	HCPCS 84156
Hospital Charge Code	38472587
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TOTAL PROT.RDM UR

Facility

$116.00

Service Code	HCPCS 84156
Hospital Charge Code	38479042
Hospital Revenue Code	301
Min. Negotiated Rate	$17.40
Max. Negotiated Rate	$17.40
Rate for Payer: Qualcare PPO/HMO/WC	$17.40

TOTAL PROT.RDM UR

Facility

$116.00

Service Code	HCPCS 84156
Hospital Charge Code	38479042
Hospital Revenue Code	301
Min. Negotiated Rate	$2.94
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$9.98
Rate for Payer: Aetna Medicare Advantage	$11.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.31
Rate for Payer: Cigna Commercial	$58.00
Rate for Payer: Cigna Medicare Advantage	$3.67
Rate for Payer: Clover Medicare Advantage	$3.49
Rate for Payer: EmblemHealth Commercial	$11.01
Rate for Payer: Humana Medicare Advantage	$3.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.16
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.40
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$2.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.67
Rate for Payer: Wellcare Medicare Advantage	$3.67
Rate for Payer: Wellpoint Medicaid Managed Care	$3.29

TOTAL STABILIZER + TIBIAL INSE

Facility

$29,468.25

Service Code	HCPCS C1713
Hospital Charge Code	270704574
Hospital Revenue Code	278
Min. Negotiated Rate	$4,420.24
Max. Negotiated Rate	$7,131.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,893.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,131.32
Rate for Payer: Qualcare PPO/HMO/WC	$4,420.24

TOTAL STABILIZER + TIBIAL INSE

Facility

$29,468.25

Service Code	HCPCS C1713
Hospital Charge Code	270704574
Hospital Revenue Code	278
Min. Negotiated Rate	$836.90
Max. Negotiated Rate	$14,734.12
Rate for Payer: Aetna Commercial	$11,197.93
Rate for Payer: Aetna Medicare Advantage	$8,840.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,514.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,514.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,893.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,514.40
Rate for Payer: Cigna Commercial	$14,734.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,131.32
Rate for Payer: Qualcare PPO/HMO/WC	$4,420.24
Rate for Payer: UnitedHealthcare Community & State	$931.20
Rate for Payer: Wellpoint Medicaid Managed Care	$836.90

TOT KNEE ARTHROPLASTY

Facility

$24,330.17

Service Code	HCPCS 27447
Hospital Charge Code	1600000372
Hospital Revenue Code	360
Min. Negotiated Rate	$3,649.53
Max. Negotiated Rate	$3,649.53
Rate for Payer: Qualcare PPO/HMO/WC	$3,649.53

Know your out-of-pocket cost for care.

All Charges