Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

UGI,DIAGNOSTIC-

Facility

$7,963.40

Service Code	HCPCS 43235
Hospital Charge Code	16000196
Hospital Revenue Code	360
Min. Negotiated Rate	$226.16
Max. Negotiated Rate	$5,347.00
Rate for Payer: Aetna Commercial	$2,930.85
Rate for Payer: Aetna Medicare Advantage	$3,491.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,908.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,908.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,077.52
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	$3,908.70
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: Cigna Medicare Advantage	$1,077.52
Rate for Payer: Clover Medicare Advantage	$1,023.64
Rate for Payer: EmblemHealth Commercial	$3,232.56
Rate for Payer: Humana Medicare Advantage	$1,109.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,077.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,070.48
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,194.51
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$251.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,077.52
Rate for Payer: Wellcare Medicare Advantage	$1,077.52
Rate for Payer: Wellpoint Medicaid Managed Care	$226.16

UGI,DIAGNOSTIC-

Facility

$7,963.40

Service Code	HCPCS 43235
Hospital Charge Code	16000196
Hospital Revenue Code	360
Min. Negotiated Rate	$1,194.51
Max. Negotiated Rate	$1,194.51
Rate for Payer: Qualcare PPO/HMO/WC	$1,194.51

UGI PLACEM GASTROSTOMY TUBE

Facility

$12,032.40

Service Code	HCPCS 43246
Hospital Charge Code	16000962
Hospital Revenue Code	360
Min. Negotiated Rate	$1,804.86
Max. Negotiated Rate	$1,804.86
Rate for Payer: Qualcare PPO/HMO/WC	$1,804.86

UGI PLACEM GASTROSTOMY TUBE

Facility

$12,032.40

Service Code	HCPCS 43246
Hospital Charge Code	16000962
Hospital Revenue Code	360
Min. Negotiated Rate	$380.22
Max. Negotiated Rate	$8,269.65
Rate for Payer: Aetna Commercial	$6,200.81
Rate for Payer: Aetna Medicare Advantage	$7,386.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,269.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,269.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,279.71
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	$8,269.65
Rate for Payer: Cigna Commercial	$4,569.67
Rate for Payer: Cigna Medicare Advantage	$2,279.71
Rate for Payer: Clover Medicare Advantage	$2,165.72
Rate for Payer: EmblemHealth Commercial	$6,839.13
Rate for Payer: Humana Medicare Advantage	$2,348.10
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,279.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,128.42
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,804.86
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$380.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,279.71
Rate for Payer: Wellcare Medicare Advantage	$2,279.71
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,829.61
Rate for Payer: Wellpoint Medicaid Managed Care	$4,734.91

UGI W BX. SGL/MULTIPLE

Facility

$8,280.20

Service Code	HCPCS 27268
Hospital Charge Code	16000874
Hospital Revenue Code	360
Min. Negotiated Rate	$235.16
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$5,196.12
Rate for Payer: Aetna Medicare Advantage	$6,189.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,929.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,929.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,910.34
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	$6,929.76
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: Cigna Medicare Advantage	$1,910.34
Rate for Payer: Clover Medicare Advantage	$1,814.82
Rate for Payer: EmblemHealth Commercial	$5,731.02
Rate for Payer: Humana Medicare Advantage	$1,967.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,910.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,152.85
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,242.03
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$261.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellpoint Medicaid Managed Care	$235.16

UGI W BX. SGL/MULTIPLE

Facility

$8,280.20

Service Code	HCPCS 27268
Hospital Charge Code	16000874
Hospital Revenue Code	360
Min. Negotiated Rate	$1,242.03
Max. Negotiated Rate	$1,242.03
Rate for Payer: Qualcare PPO/HMO/WC	$1,242.03

UGI W BX_SGL/MULTIPLE

Facility

$7,963.40

Service Code	HCPCS 43239
Hospital Charge Code	16000175
Hospital Revenue Code	360
Min. Negotiated Rate	$1,194.51
Max. Negotiated Rate	$1,194.51
Rate for Payer: Qualcare PPO/HMO/WC	$1,194.51

UGI W BX_SGL/MULTIPLE

Facility

$7,963.40

Service Code	HCPCS 43239
Hospital Charge Code	16000175
Hospital Revenue Code	360
Min. Negotiated Rate	$226.16
Max. Negotiated Rate	$5,347.00
Rate for Payer: Aetna Commercial	$2,930.85
Rate for Payer: Aetna Medicare Advantage	$3,491.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,908.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,908.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,077.52
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	$3,908.70
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: Cigna Medicare Advantage	$1,077.52
Rate for Payer: Clover Medicare Advantage	$1,023.64
Rate for Payer: EmblemHealth Commercial	$3,232.56
Rate for Payer: Humana Medicare Advantage	$1,109.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,077.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,070.48
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,194.51
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$251.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,077.52
Rate for Payer: Wellcare Medicare Advantage	$1,077.52
Rate for Payer: Wellpoint Medicaid Managed Care	$226.16

UGI W REMOVAL OF FB

Facility

$7,963.40

Service Code	HCPCS 43247
Hospital Charge Code	16000200
Hospital Revenue Code	360
Min. Negotiated Rate	$1,194.51
Max. Negotiated Rate	$1,194.51
Rate for Payer: Qualcare PPO/HMO/WC	$1,194.51

UGI W REMOVAL OF FB

Facility

$7,963.40

Service Code	HCPCS 43247
Hospital Charge Code	16000200
Hospital Revenue Code	360
Min. Negotiated Rate	$226.16
Max. Negotiated Rate	$5,347.00
Rate for Payer: Aetna Commercial	$2,930.85
Rate for Payer: Aetna Medicare Advantage	$3,491.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,908.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,908.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,077.52
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	$3,908.70
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: Cigna Medicare Advantage	$1,077.52
Rate for Payer: Clover Medicare Advantage	$1,023.64
Rate for Payer: EmblemHealth Commercial	$3,232.56
Rate for Payer: Humana Medicare Advantage	$1,109.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,077.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,070.48
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,194.51
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$251.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,077.52
Rate for Payer: Wellcare Medicare Advantage	$1,077.52
Rate for Payer: Wellpoint Medicaid Managed Care	$226.16

UGI W SUBMUCOS INJ

Facility

$7,963.40

Service Code	HCPCS 43236
Hospital Charge Code	16000961
Hospital Revenue Code	360
Min. Negotiated Rate	$251.64
Max. Negotiated Rate	$5,347.00
Rate for Payer: Aetna Commercial	$2,930.85
Rate for Payer: Aetna Medicare Advantage	$3,491.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,908.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,908.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,077.52
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	$3,908.70
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: Cigna Medicare Advantage	$1,077.52
Rate for Payer: Clover Medicare Advantage	$1,023.64
Rate for Payer: EmblemHealth Commercial	$3,232.56
Rate for Payer: Humana Medicare Advantage	$1,109.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,077.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,070.48
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,194.51
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$251.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,077.52
Rate for Payer: Wellcare Medicare Advantage	$1,077.52
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$2,531.95
Rate for Payer: Wellpoint Medicaid Managed Care	$2,482.30

UGI W SUBMUCOS INJ

Facility

$7,963.40

Service Code	HCPCS 43236
Hospital Charge Code	16000961
Hospital Revenue Code	360
Min. Negotiated Rate	$1,194.51
Max. Negotiated Rate	$1,194.51
Rate for Payer: Qualcare PPO/HMO/WC	$1,194.51

UGT1AI GENE POLYMORPHISM

Facility

$478.88

Service Code	HCPCS 81350
Hospital Charge Code	397080009
Hospital Revenue Code	306
Min. Negotiated Rate	$13.60
Max. Negotiated Rate	$848.84
Rate for Payer: Aetna Commercial	$636.48
Rate for Payer: Aetna Medicare Advantage	$758.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$848.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$848.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$234.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$848.84
Rate for Payer: Cigna Commercial	$239.44
Rate for Payer: Cigna Medicare Advantage	$234.00
Rate for Payer: Clover Medicare Advantage	$222.30
Rate for Payer: EmblemHealth Commercial	$702.00
Rate for Payer: Humana Medicare Advantage	$241.02
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$234.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.51
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$71.83
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$187.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$234.00
Rate for Payer: Wellcare Medicare Advantage	$234.00
Rate for Payer: Wellpoint Medicaid Managed Care	$13.60

UGT1AI GENE POLYMORPHISM

Facility

$478.88

Service Code	HCPCS 81350
Hospital Charge Code	397080009
Hospital Revenue Code	306
Min. Negotiated Rate	$71.83
Max. Negotiated Rate	$71.83
Rate for Payer: Qualcare PPO/HMO/WC	$71.83

UHR UNIV BIPOLAR HEAD OD 53X26

Facility

$3,669.90

Service Code	HCPCS C1776
Hospital Charge Code	270691243
Hospital Revenue Code	278
Min. Negotiated Rate	$104.23
Max. Negotiated Rate	$1,834.95
Rate for Payer: Aetna Commercial	$1,394.56
Rate for Payer: Aetna Medicare Advantage	$1,100.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$935.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$935.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$733.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$935.82
Rate for Payer: Cigna Commercial	$1,834.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$888.12
Rate for Payer: Qualcare PPO/HMO/WC	$550.49
Rate for Payer: UnitedHealthcare Community & State	$115.97
Rate for Payer: Wellpoint Medicaid Managed Care	$104.23

UHR UNIV BIPOLAR HEAD OD 53X26

Facility

$3,669.90

Service Code	HCPCS C1776
Hospital Charge Code	270691243
Hospital Revenue Code	278
Min. Negotiated Rate	$550.49
Max. Negotiated Rate	$888.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$733.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$888.12
Rate for Payer: Qualcare PPO/HMO/WC	$550.49

ULTIVA 2MG VIAL

Facility

$610.64

Service Code	NDC 72078003502
Hospital Charge Code	6063943298
Hospital Revenue Code	250
Min. Negotiated Rate	$91.60
Max. Negotiated Rate	$91.60
Rate for Payer: Qualcare PPO/HMO/WC	$91.60

ULTIVA 2MG VIAL

Facility

$610.64

Service Code	NDC 72078003502
Hospital Charge Code	6063943298
Hospital Revenue Code	250
Min. Negotiated Rate	$17.34
Max. Negotiated Rate	$305.32
Rate for Payer: Aetna Commercial	$232.04
Rate for Payer: Aetna Medicare Advantage	$183.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.71
Rate for Payer: Cigna Commercial	$305.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.77
Rate for Payer: Oxford Commercial	$122.13
Rate for Payer: Qualcare PPO/HMO/WC	$91.60
Rate for Payer: UnitedHealthcare Commercial	$122.13
Rate for Payer: UnitedHealthcare Community & State	$19.30
Rate for Payer: Wellpoint Medicaid Managed Care	$17.34

ULTRABRAID II2 BLUE SUTURE 38

Facility

$102.05

Hospital Charge Code	270681095
Hospital Revenue Code	272
Min. Negotiated Rate	$15.31
Max. Negotiated Rate	$15.31
Rate for Payer: Qualcare PPO/HMO/WC	$15.31

ULTRABRAID II2 BLUE SUTURE 38

Facility

$102.05

Hospital Charge Code	270681095
Hospital Revenue Code	272
Min. Negotiated Rate	$2.90
Max. Negotiated Rate	$51.02
Rate for Payer: Aetna Commercial	$38.78
Rate for Payer: Aetna Medicare Advantage	$30.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.02
Rate for Payer: Cigna Commercial	$51.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.53
Rate for Payer: Oxford Commercial	$20.41
Rate for Payer: Qualcare PPO/HMO/WC	$15.31
Rate for Payer: UnitedHealthcare Commercial	$20.41
Rate for Payer: UnitedHealthcare Community & State	$3.22
Rate for Payer: Wellpoint Medicaid Managed Care	$2.90

ULTRA-COAT KERRISON MEDIUM 40D

Facility

$4,102.95

Hospital Charge Code	270691414
Hospital Revenue Code	272
Min. Negotiated Rate	$116.52
Max. Negotiated Rate	$2,051.47
Rate for Payer: Aetna Commercial	$1,559.12
Rate for Payer: Aetna Medicare Advantage	$1,230.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,046.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,046.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,046.25
Rate for Payer: Cigna Commercial	$2,051.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,066.77
Rate for Payer: Oxford Commercial	$820.59
Rate for Payer: Qualcare PPO/HMO/WC	$615.44
Rate for Payer: UnitedHealthcare Commercial	$820.59
Rate for Payer: UnitedHealthcare Community & State	$129.65
Rate for Payer: Wellpoint Medicaid Managed Care	$116.52

ULTRA-COAT KERRISON MEDIUM 40D

Facility

$4,102.95

Hospital Charge Code	270691414
Hospital Revenue Code	272
Min. Negotiated Rate	$615.44
Max. Negotiated Rate	$615.44
Rate for Payer: Qualcare PPO/HMO/WC	$615.44

ULTRA FAST FIX AB CURVED

Facility

$1,715.00

Hospital Charge Code	270673674
Hospital Revenue Code	272
Min. Negotiated Rate	$257.25
Max. Negotiated Rate	$257.25
Rate for Payer: Qualcare PPO/HMO/WC	$257.25

ULTRA FAST FIX AB CURVED

Facility

$1,715.00

Hospital Charge Code	270673674
Hospital Revenue Code	272
Min. Negotiated Rate	$48.71
Max. Negotiated Rate	$857.50
Rate for Payer: Aetna Commercial	$651.70
Rate for Payer: Aetna Medicare Advantage	$514.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$437.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$437.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$437.32
Rate for Payer: Cigna Commercial	$857.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$445.90
Rate for Payer: Oxford Commercial	$343.00
Rate for Payer: Qualcare PPO/HMO/WC	$257.25
Rate for Payer: UnitedHealthcare Commercial	$343.00
Rate for Payer: UnitedHealthcare Community & State	$54.19
Rate for Payer: Wellpoint Medicaid Managed Care	$48.71

ULTRA FAST FIX AB REVERSE CURV

Facility

$1,765.00

Hospital Charge Code	270673672
Hospital Revenue Code	272
Min. Negotiated Rate	$264.75
Max. Negotiated Rate	$264.75
Rate for Payer: Qualcare PPO/HMO/WC	$264.75

Know your out-of-pocket cost for care.

All Charges