Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BILRY DUCT TRNSHPTIC DLATON

Facility

$5,100.00

Service Code	HCPCS 74363
Hospital Charge Code	5100832
Hospital Revenue Code	320
Min. Negotiated Rate	$144.84
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$294.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.00
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$161.16
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

BILRY DUCT TRNSHPTIC DLATON

Facility

$5,100.00

Service Code	HCPCS 74363
Hospital Charge Code	5100832
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

BI-MENTUM ALTRX LINER 53/28

Facility

$28,860.00

Service Code	HCPCS C1776
Hospital Charge Code	270700358
Hospital Revenue Code	278
Min. Negotiated Rate	$819.62
Max. Negotiated Rate	$14,430.00
Rate for Payer: Aetna Commercial	$10,966.80
Rate for Payer: Aetna Medicare Advantage	$8,658.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,359.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,359.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,772.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,359.30
Rate for Payer: Cigna Commercial	$14,430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,984.12
Rate for Payer: Qualcare PPO/HMO/WC	$4,329.00
Rate for Payer: UnitedHealthcare Community & State	$911.98
Rate for Payer: Wellpoint Medicaid Managed Care	$819.62

BI-MENTUM ALTRX LINER 53/28

Facility

$28,860.00

Service Code	HCPCS C1776
Hospital Charge Code	270700358
Hospital Revenue Code	278
Min. Negotiated Rate	$4,329.00
Max. Negotiated Rate	$6,984.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,772.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,984.12
Rate for Payer: Qualcare PPO/HMO/WC	$4,329.00

BI-METRIC POR FMRL 9.0X250MMR

Facility

$42,630.00

Service Code	HCPCS C1776
Hospital Charge Code	270688751
Hospital Revenue Code	278
Min. Negotiated Rate	$1,210.69
Max. Negotiated Rate	$21,315.00
Rate for Payer: Aetna Commercial	$16,199.40
Rate for Payer: Aetna Medicare Advantage	$12,789.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,870.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,870.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,526.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,870.65
Rate for Payer: Cigna Commercial	$21,315.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,316.46
Rate for Payer: Qualcare PPO/HMO/WC	$6,394.50
Rate for Payer: UnitedHealthcare Community & State	$1,347.11
Rate for Payer: Wellpoint Medicaid Managed Care	$1,210.69

BI-METRIC POR FMRL 9.0X250MMR

Facility

$42,630.00

Service Code	HCPCS C1776
Hospital Charge Code	270688751
Hospital Revenue Code	278
Min. Negotiated Rate	$6,394.50
Max. Negotiated Rate	$10,316.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,526.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,316.46
Rate for Payer: Qualcare PPO/HMO/WC	$6,394.50

BINAXNOW COVID19 ANTIGEN POC

Facility

$206.90

Service Code	HCPCS 87811
Hospital Charge Code	401187811
Hospital Revenue Code	306
Min. Negotiated Rate	$5.88
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$112.55
Rate for Payer: Aetna Medicare Advantage	$134.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$150.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$150.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$41.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$150.11
Rate for Payer: Cigna Commercial	$103.45
Rate for Payer: Cigna Medicare Advantage	$41.38
Rate for Payer: Clover Medicare Advantage	$39.31
Rate for Payer: EmblemHealth Commercial	$124.14
Rate for Payer: Humana Medicare Advantage	$42.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$41.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.79
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.04
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$33.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$41.38
Rate for Payer: Wellcare Medicare Advantage	$41.38
Rate for Payer: Wellpoint Medicaid Managed Care	$5.88

BINAXNOW COVID19 ANTIGEN POC

Facility

$206.90

Service Code	HCPCS 87811
Hospital Charge Code	401187811
Hospital Revenue Code	306
Min. Negotiated Rate	$31.04
Max. Negotiated Rate	$31.04
Rate for Payer: Qualcare PPO/HMO/WC	$31.04

BIN BREA LIN 2XL 45-49 S-XL/L

Facility

$110.00

Hospital Charge Code	270637535
Hospital Revenue Code	272
Min. Negotiated Rate	$3.12
Max. Negotiated Rate	$55.00
Rate for Payer: Aetna Commercial	$41.80
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.60
Rate for Payer: Oxford Commercial	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$22.00
Rate for Payer: UnitedHealthcare Community & State	$3.48
Rate for Payer: Wellpoint Medicaid Managed Care	$3.12

BIN BREA LIN 2XL 45-49 S-XL/L

Facility

$110.00

Hospital Charge Code	270637535
Hospital Revenue Code	272
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

BIN BR LIN LG 36-40 L/L-BBIND

Facility

$232.20

Hospital Charge Code	270637533
Hospital Revenue Code	272
Min. Negotiated Rate	$6.59
Max. Negotiated Rate	$116.10
Rate for Payer: Aetna Commercial	$88.24
Rate for Payer: Aetna Medicare Advantage	$69.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.21
Rate for Payer: Cigna Commercial	$116.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.37
Rate for Payer: Oxford Commercial	$46.44
Rate for Payer: Qualcare PPO/HMO/WC	$34.83
Rate for Payer: UnitedHealthcare Commercial	$46.44
Rate for Payer: UnitedHealthcare Community & State	$7.34
Rate for Payer: Wellpoint Medicaid Managed Care	$6.59

BIN BR LIN LG 36-40 L/L-BBIND

Facility

$232.20

Hospital Charge Code	270637533
Hospital Revenue Code	272
Min. Negotiated Rate	$34.83
Max. Negotiated Rate	$34.83
Rate for Payer: Qualcare PPO/HMO/WC	$34.83

BIN BR LIN MED 34-36 M/L-BBIND

Facility

$110.00

Hospital Charge Code	270637532
Hospital Revenue Code	272
Min. Negotiated Rate	$3.12
Max. Negotiated Rate	$55.00
Rate for Payer: Aetna Commercial	$41.80
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.60
Rate for Payer: Oxford Commercial	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$22.00
Rate for Payer: UnitedHealthcare Community & State	$3.48
Rate for Payer: Wellpoint Medicaid Managed Care	$3.12

BIN BR LIN MED 34-36 M/L-BBIND

Facility

$110.00

Hospital Charge Code	270637532
Hospital Revenue Code	272
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

BIN BR LIN XLG 42-46XL/L-BBIND

Facility

$233.25

Hospital Charge Code	270637534
Hospital Revenue Code	272
Min. Negotiated Rate	$34.99
Max. Negotiated Rate	$34.99
Rate for Payer: Qualcare PPO/HMO/WC	$34.99

BIN BR LIN XLG 42-46XL/L-BBIND

Facility

$233.25

Hospital Charge Code	270637534
Hospital Revenue Code	272
Min. Negotiated Rate	$6.62
Max. Negotiated Rate	$116.62
Rate for Payer: Aetna Commercial	$88.64
Rate for Payer: Aetna Medicare Advantage	$69.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.48
Rate for Payer: Cigna Commercial	$116.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.65
Rate for Payer: Oxford Commercial	$46.65
Rate for Payer: Qualcare PPO/HMO/WC	$34.99
Rate for Payer: UnitedHealthcare Commercial	$46.65
Rate for Payer: UnitedHealthcare Community & State	$7.37
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

BIN BR LI SM 32-34in S/L-BBIND

Facility

$110.00

Hospital Charge Code	270637531
Hospital Revenue Code	272
Min. Negotiated Rate	$3.12
Max. Negotiated Rate	$55.00
Rate for Payer: Aetna Commercial	$41.80
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.60
Rate for Payer: Oxford Commercial	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$22.00
Rate for Payer: UnitedHealthcare Community & State	$3.48
Rate for Payer: Wellpoint Medicaid Managed Care	$3.12

BIN BR LI SM 32-34in S/L-BBIND

Facility

$110.00

Hospital Charge Code	270637531
Hospital Revenue Code	272
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

BINDER ABDOMINAL

Facility

$31.70

Hospital Charge Code	270303090
Hospital Revenue Code	270
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$15.85
Rate for Payer: Aetna Commercial	$12.05
Rate for Payer: Aetna Medicare Advantage	$9.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.08
Rate for Payer: Cigna Commercial	$15.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.24
Rate for Payer: Oxford Commercial	$6.34
Rate for Payer: Qualcare PPO/HMO/WC	$4.75
Rate for Payer: UnitedHealthcare Commercial	$6.34
Rate for Payer: UnitedHealthcare Community & State	$1.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.90

BINDER ABDOMINAL

Facility

$31.70

Hospital Charge Code	270303090
Hospital Revenue Code	270
Min. Negotiated Rate	$4.75
Max. Negotiated Rate	$4.75
Rate for Payer: Qualcare PPO/HMO/WC	$4.75

BINDER ABDOMINAL 3 PANEL 26-49

Facility

$38.95

Hospital Charge Code	270650460
Hospital Revenue Code	272
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$19.48
Rate for Payer: Aetna Commercial	$14.80
Rate for Payer: Aetna Medicare Advantage	$11.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.93
Rate for Payer: Cigna Commercial	$19.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.13
Rate for Payer: Oxford Commercial	$7.79
Rate for Payer: Qualcare PPO/HMO/WC	$5.84
Rate for Payer: UnitedHealthcare Commercial	$7.79
Rate for Payer: UnitedHealthcare Community & State	$1.23
Rate for Payer: Wellpoint Medicaid Managed Care	$1.11

BINDER ABDOMINAL 3 PANEL 26-49

Facility

$38.95

Hospital Charge Code	270650460
Hospital Revenue Code	272
Min. Negotiated Rate	$5.84
Max. Negotiated Rate	$5.84
Rate for Payer: Qualcare PPO/HMO/WC	$5.84

BINDER ABDOMINAL 3 PANEL 46-62

Facility

$39.45

Hospital Charge Code	270650463
Hospital Revenue Code	272
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$19.73
Rate for Payer: Aetna Commercial	$14.99
Rate for Payer: Aetna Medicare Advantage	$11.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.06
Rate for Payer: Cigna Commercial	$19.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.26
Rate for Payer: Oxford Commercial	$7.89
Rate for Payer: Qualcare PPO/HMO/WC	$5.92
Rate for Payer: UnitedHealthcare Commercial	$7.89
Rate for Payer: UnitedHealthcare Community & State	$1.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1.12

BINDER ABDOMINAL 3 PANEL 46-62

Facility

$39.45

Hospital Charge Code	270650463
Hospital Revenue Code	272
Min. Negotiated Rate	$5.92
Max. Negotiated Rate	$5.92
Rate for Payer: Qualcare PPO/HMO/WC	$5.92

BINDER ABDOMINAL 46-62

Facility

$24.00

Hospital Charge Code	270650243
Hospital Revenue Code	272
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$12.00
Rate for Payer: Aetna Commercial	$9.12
Rate for Payer: Aetna Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.12
Rate for Payer: Cigna Commercial	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.24
Rate for Payer: Oxford Commercial	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$3.60
Rate for Payer: UnitedHealthcare Commercial	$4.80
Rate for Payer: UnitedHealthcare Community & State	$0.76
Rate for Payer: Wellpoint Medicaid Managed Care	$0.68

Know your out-of-pocket cost for care.

All Charges