Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ULTRA FAST FIX AB REVERSE CURV

Facility

$1,765.00

Hospital Charge Code	270673672
Hospital Revenue Code	272
Min. Negotiated Rate	$50.13
Max. Negotiated Rate	$882.50
Rate for Payer: Aetna Commercial	$670.70
Rate for Payer: Aetna Medicare Advantage	$529.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$450.07
Rate for Payer: Cigna Commercial	$882.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$458.90
Rate for Payer: Oxford Commercial	$353.00
Rate for Payer: Qualcare PPO/HMO/WC	$264.75
Rate for Payer: UnitedHealthcare Commercial	$353.00
Rate for Payer: UnitedHealthcare Community & State	$55.77
Rate for Payer: Wellpoint Medicaid Managed Care	$50.13

ULTRA FAST FIX AB STRAIGHT

Facility

$1,765.00

Hospital Charge Code	270673676
Hospital Revenue Code	272
Min. Negotiated Rate	$50.13
Max. Negotiated Rate	$882.50
Rate for Payer: Aetna Commercial	$670.70
Rate for Payer: Aetna Medicare Advantage	$529.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$450.07
Rate for Payer: Cigna Commercial	$882.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$458.90
Rate for Payer: Oxford Commercial	$353.00
Rate for Payer: Qualcare PPO/HMO/WC	$264.75
Rate for Payer: UnitedHealthcare Commercial	$353.00
Rate for Payer: UnitedHealthcare Community & State	$55.77
Rate for Payer: Wellpoint Medicaid Managed Care	$50.13

ULTRA FAST FIX AB STRAIGHT

Facility

$1,765.00

Hospital Charge Code	270673676
Hospital Revenue Code	272
Min. Negotiated Rate	$264.75
Max. Negotiated Rate	$264.75
Rate for Payer: Qualcare PPO/HMO/WC	$264.75

ULTRASLING EXTRA LARGE

Facility

$256.40

Hospital Charge Code	270666409
Hospital Revenue Code	270
Min. Negotiated Rate	$38.46
Max. Negotiated Rate	$38.46
Rate for Payer: Qualcare PPO/HMO/WC	$38.46

ULTRASLING EXTRA LARGE

Facility

$256.40

Hospital Charge Code	270666409
Hospital Revenue Code	270
Min. Negotiated Rate	$7.28
Max. Negotiated Rate	$128.20
Rate for Payer: Aetna Commercial	$97.43
Rate for Payer: Aetna Medicare Advantage	$76.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.38
Rate for Payer: Cigna Commercial	$128.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.66
Rate for Payer: Oxford Commercial	$51.28
Rate for Payer: Qualcare PPO/HMO/WC	$38.46
Rate for Payer: UnitedHealthcare Commercial	$51.28
Rate for Payer: UnitedHealthcare Community & State	$8.10
Rate for Payer: Wellpoint Medicaid Managed Care	$7.28

ULTRASLING III BLK MEDIUM

Facility

$241.90

Hospital Charge Code	270669813
Hospital Revenue Code	270
Min. Negotiated Rate	$36.28
Max. Negotiated Rate	$36.28
Rate for Payer: Qualcare PPO/HMO/WC	$36.28

ULTRASLING III BLK MEDIUM

Facility

$241.90

Hospital Charge Code	270669813
Hospital Revenue Code	270
Min. Negotiated Rate	$6.87
Max. Negotiated Rate	$120.95
Rate for Payer: Aetna Commercial	$91.92
Rate for Payer: Aetna Medicare Advantage	$72.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.68
Rate for Payer: Cigna Commercial	$120.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.89
Rate for Payer: Oxford Commercial	$48.38
Rate for Payer: Qualcare PPO/HMO/WC	$36.28
Rate for Payer: UnitedHealthcare Commercial	$48.38
Rate for Payer: UnitedHealthcare Community & State	$7.64
Rate for Payer: Wellpoint Medicaid Managed Care	$6.87

ULTRASLING III BLK SMALL

Facility

$258.70

Hospital Charge Code	270669814
Hospital Revenue Code	270
Min. Negotiated Rate	$7.35
Max. Negotiated Rate	$129.35
Rate for Payer: Aetna Commercial	$98.31
Rate for Payer: Aetna Medicare Advantage	$77.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.97
Rate for Payer: Cigna Commercial	$129.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.26
Rate for Payer: Oxford Commercial	$51.74
Rate for Payer: Qualcare PPO/HMO/WC	$38.80
Rate for Payer: UnitedHealthcare Commercial	$51.74
Rate for Payer: UnitedHealthcare Community & State	$8.17
Rate for Payer: Wellpoint Medicaid Managed Care	$7.35

ULTRASLING III BLK SMALL

Facility

$258.70

Hospital Charge Code	270669814
Hospital Revenue Code	270
Min. Negotiated Rate	$38.80
Max. Negotiated Rate	$38.80
Rate for Payer: Qualcare PPO/HMO/WC	$38.80

ULTRASLING III BLK XTRA PAD LG

Facility

$241.90

Hospital Charge Code	270669812
Hospital Revenue Code	270
Min. Negotiated Rate	$6.87
Max. Negotiated Rate	$120.95
Rate for Payer: Aetna Commercial	$91.92
Rate for Payer: Aetna Medicare Advantage	$72.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.68
Rate for Payer: Cigna Commercial	$120.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.89
Rate for Payer: Oxford Commercial	$48.38
Rate for Payer: Qualcare PPO/HMO/WC	$36.28
Rate for Payer: UnitedHealthcare Commercial	$48.38
Rate for Payer: UnitedHealthcare Community & State	$7.64
Rate for Payer: Wellpoint Medicaid Managed Care	$6.87

ULTRASLING III BLK XTRA PAD LG

Facility

$241.90

Hospital Charge Code	270669812
Hospital Revenue Code	270
Min. Negotiated Rate	$36.28
Max. Negotiated Rate	$36.28
Rate for Payer: Qualcare PPO/HMO/WC	$36.28

ULTRASLING MEDIUM

Facility

$249.15

Hospital Charge Code	270666408
Hospital Revenue Code	270
Min. Negotiated Rate	$37.37
Max. Negotiated Rate	$37.37
Rate for Payer: Qualcare PPO/HMO/WC	$37.37

ULTRASLING MEDIUM

Facility

$249.15

Hospital Charge Code	270666408
Hospital Revenue Code	270
Min. Negotiated Rate	$7.08
Max. Negotiated Rate	$124.58
Rate for Payer: Aetna Commercial	$94.68
Rate for Payer: Aetna Medicare Advantage	$74.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.53
Rate for Payer: Cigna Commercial	$124.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.78
Rate for Payer: Oxford Commercial	$49.83
Rate for Payer: Qualcare PPO/HMO/WC	$37.37
Rate for Payer: UnitedHealthcare Commercial	$49.83
Rate for Payer: UnitedHealthcare Community & State	$7.87
Rate for Payer: Wellpoint Medicaid Managed Care	$7.08

ULTRASLING SMALL

Facility

$249.15

Hospital Charge Code	270666407
Hospital Revenue Code	270
Min. Negotiated Rate	$37.37
Max. Negotiated Rate	$37.37
Rate for Payer: Qualcare PPO/HMO/WC	$37.37

ULTRASLING SMALL

Facility

$249.15

Hospital Charge Code	270666407
Hospital Revenue Code	270
Min. Negotiated Rate	$7.08
Max. Negotiated Rate	$124.58
Rate for Payer: Aetna Commercial	$94.68
Rate for Payer: Aetna Medicare Advantage	$74.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.53
Rate for Payer: Cigna Commercial	$124.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.78
Rate for Payer: Oxford Commercial	$49.83
Rate for Payer: Qualcare PPO/HMO/WC	$37.37
Rate for Payer: UnitedHealthcare Commercial	$49.83
Rate for Payer: UnitedHealthcare Community & State	$7.87
Rate for Payer: Wellpoint Medicaid Managed Care	$7.08

ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC

Facility

$195,320.77

Service Code	MSDRG 278
Min. Negotiated Rate	$59,472.67
Max. Negotiated Rate	$195,320.77
Rate for Payer: Aetna Commercial	$140,968.20
Rate for Payer: Aetna Medicare Advantage	$195,320.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$62,602.81
Rate for Payer: Cigna Commercial	$124,087.30
Rate for Payer: Cigna Medicare Advantage	$62,602.81
Rate for Payer: Clover Medicare Advantage	$59,472.67
Rate for Payer: EmblemHealth Commercial	$187,808.43
Rate for Payer: Humana Medicare Advantage	$64,480.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$62,602.81
Rate for Payer: Oxford Commercial	$98,076.44
Rate for Payer: UnitedHealthcare Commercial	$131,278.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$62,602.81
Rate for Payer: Wellcare Medicare Advantage	$62,602.81

ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC

Facility

$133,403.71

Service Code	MSDRG 279
Min. Negotiated Rate	$40,619.72
Max. Negotiated Rate	$133,403.71
Rate for Payer: Aetna Commercial	$96,870.16
Rate for Payer: Aetna Medicare Advantage	$133,403.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$42,757.60
Rate for Payer: Cigna Commercial	$80,397.48
Rate for Payer: Cigna Medicare Advantage	$42,757.60
Rate for Payer: Clover Medicare Advantage	$40,619.72
Rate for Payer: EmblemHealth Commercial	$128,272.80
Rate for Payer: Humana Medicare Advantage	$44,040.33
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$42,757.60
Rate for Payer: Oxford Commercial	$63,544.77
Rate for Payer: UnitedHealthcare Commercial	$85,056.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$42,757.60
Rate for Payer: Wellcare Medicare Advantage	$42,757.60

ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM

Facility

$113,499.73

Service Code	MSDRG 173
Min. Negotiated Rate	$34,559.21
Max. Negotiated Rate	$113,499.73
Rate for Payer: Aetna Commercial	$82,694.30
Rate for Payer: Aetna Medicare Advantage	$113,499.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$36,378.12
Rate for Payer: Cigna Commercial	$66,352.89
Rate for Payer: Cigna Medicare Advantage	$36,378.12
Rate for Payer: Clover Medicare Advantage	$34,559.21
Rate for Payer: EmblemHealth Commercial	$109,134.36
Rate for Payer: Humana Medicare Advantage	$37,469.46
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$36,378.12
Rate for Payer: Oxford Commercial	$52,444.17
Rate for Payer: UnitedHealthcare Commercial	$70,198.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$36,378.12
Rate for Payer: Wellcare Medicare Advantage	$36,378.12

ULTRASOUND EA 15 MIN CQ

Facility

$65.65

Service Code	HCPCS 97035GP
Hospital Charge Code	409197035Q
Hospital Revenue Code	420
Min. Negotiated Rate	$1.86
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$24.95
Rate for Payer: Aetna Medicare Advantage	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.74
Rate for Payer: Cigna Commercial	$32.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.07
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.85
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$2.07
Rate for Payer: Wellpoint Medicaid Managed Care	$1.86

ULTRASOUND EA 15 MIN CQ

Facility

$65.65

Service Code	HCPCS 97035GP
Hospital Charge Code	409197035Q
Hospital Revenue Code	420
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$9.85
Rate for Payer: Qualcare PPO/HMO/WC	$9.85

ULTRASOUND ECHOENCEPHALGRAPHY

Facility

$6,700.00

Service Code	HCPCS 76506
Hospital Charge Code	2100106
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

ULTRASOUND ECHOENCEPHALGRAPHY

Facility

$6,700.00

Service Code	HCPCS 76506
Hospital Charge Code	2100106
Hospital Revenue Code	402
Min. Negotiated Rate	$69.30
Max. Negotiated Rate	$2,904.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$450.54
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$124.20
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,742.00
Rate for Payer: Oxford Commercial	$2,697.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$2,904.00
Rate for Payer: UnitedHealthcare Community & State	$211.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$190.28

ULTRASOUND, TRANSVAGINAL

Facility

$3,536.00

Service Code	CPT 76830
Hospital Revenue Code	360
Min. Negotiated Rate	$117.99
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
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	$450.54
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$124.20
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20

ULTRASOUND, TRANSVAGINAL

Facility

$2,298.80

Service Code	HCPCS 76830
Hospital Charge Code	83653115
Hospital Revenue Code	402
Min. Negotiated Rate	$65.29
Max. Negotiated Rate	$2,904.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$121.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$450.54
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$124.20
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$597.69
Rate for Payer: Oxford Commercial	$2,697.00
Rate for Payer: Qualcare PPO/HMO/WC	$344.82
Rate for Payer: UnitedHealthcare Commercial	$2,904.00
Rate for Payer: UnitedHealthcare Community & State	$72.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$65.29

ULTRASOUND, TRANSVAGINAL

Facility

$3,536.00

Service Code	CPT 76830
Hospital Charge Code	83653115
Hospital Revenue Code	360
Min. Negotiated Rate	$117.99
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
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	$450.54
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$124.20
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20

Know your out-of-pocket cost for care.

All Charges