Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

UREA NITROGEN, URINE

Facility

$160.00

Service Code	HCPCS 84540
Hospital Charge Code	38472655
Hospital Revenue Code	301
Min. Negotiated Rate	$4.45
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$15.12
Rate for Payer: Aetna Medicare Advantage	$18.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.17
Rate for Payer: Cigna Commercial	$80.00
Rate for Payer: Cigna Medicare Advantage	$5.56
Rate for Payer: Clover Medicare Advantage	$5.28
Rate for Payer: EmblemHealth Commercial	$16.68
Rate for Payer: Humana Medicare Advantage	$5.73
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.60
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$4.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.56
Rate for Payer: Wellcare Medicare Advantage	$5.56
Rate for Payer: Wellpoint Medicaid Managed Care	$4.54

UREA NITROGEN, URINE

Facility

$390.00

Service Code	HCPCS 84540
Hospital Charge Code	3030863
Hospital Revenue Code	301
Min. Negotiated Rate	$4.45
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$15.12
Rate for Payer: Aetna Medicare Advantage	$18.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.17
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.56
Rate for Payer: Clover Medicare Advantage	$5.28
Rate for Payer: EmblemHealth Commercial	$16.68
Rate for Payer: Humana Medicare Advantage	$5.73
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.56
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	$4.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.56
Rate for Payer: Wellcare Medicare Advantage	$5.56
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

UREA NITROGEN, URINE

Facility

$390.00

Service Code	HCPCS 84540
Hospital Charge Code	3030863
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

URETERAL ACCESS SHEATH 35 CM

Facility

$577.50

Hospital Charge Code	270682484
Hospital Revenue Code	272
Min. Negotiated Rate	$86.62
Max. Negotiated Rate	$86.62
Rate for Payer: Qualcare PPO/HMO/WC	$86.62

URETERAL ACCESS SHEATH 35 CM

Facility

$577.50

Hospital Charge Code	270682484
Hospital Revenue Code	272
Min. Negotiated Rate	$16.40
Max. Negotiated Rate	$288.75
Rate for Payer: Aetna Commercial	$219.45
Rate for Payer: Aetna Medicare Advantage	$173.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.26
Rate for Payer: Cigna Commercial	$288.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.15
Rate for Payer: Oxford Commercial	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$86.62
Rate for Payer: UnitedHealthcare Commercial	$115.50
Rate for Payer: UnitedHealthcare Community & State	$18.25
Rate for Payer: Wellpoint Medicaid Managed Care	$16.40

URETERAL ACCESS SHEATH 45 CM

Facility

$577.50

Hospital Charge Code	270682485
Hospital Revenue Code	272
Min. Negotiated Rate	$16.40
Max. Negotiated Rate	$288.75
Rate for Payer: Aetna Commercial	$219.45
Rate for Payer: Aetna Medicare Advantage	$173.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.26
Rate for Payer: Cigna Commercial	$288.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.15
Rate for Payer: Oxford Commercial	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$86.62
Rate for Payer: UnitedHealthcare Commercial	$115.50
Rate for Payer: UnitedHealthcare Community & State	$18.25
Rate for Payer: Wellpoint Medicaid Managed Care	$16.40

URETERAL ACCESS SHEATH 45 CM

Facility

$577.50

Hospital Charge Code	270682485
Hospital Revenue Code	272
Min. Negotiated Rate	$86.62
Max. Negotiated Rate	$86.62
Rate for Payer: Qualcare PPO/HMO/WC	$86.62

URETERAL CATH CONE TIP 10FR

Facility

$195.00

Hospital Charge Code	270331130
Hospital Revenue Code	278
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.19
Rate for Payer: Qualcare PPO/HMO/WC	$29.25

URETERAL CATH CONE TIP 10FR

Facility

$195.00

Hospital Charge Code	270331130
Hospital Revenue Code	278
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$97.50
Rate for Payer: Aetna Commercial	$74.10
Rate for Payer: Aetna Medicare Advantage	$58.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.73
Rate for Payer: Cigna Commercial	$97.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.19
Rate for Payer: Qualcare PPO/HMO/WC	$29.25
Rate for Payer: UnitedHealthcare Community & State	$6.16
Rate for Payer: Wellpoint Medicaid Managed Care	$5.54

URETERAL CATHETER OPEN TIP 6FR

Facility

$126.00

Hospital Charge Code	270331746
Hospital Revenue Code	278
Min. Negotiated Rate	$18.90
Max. Negotiated Rate	$30.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.49
Rate for Payer: Qualcare PPO/HMO/WC	$18.90

URETERAL CATHETER OPEN TIP 6FR

Facility

$126.00

Hospital Charge Code	270331746
Hospital Revenue Code	278
Min. Negotiated Rate	$3.58
Max. Negotiated Rate	$63.00
Rate for Payer: Aetna Commercial	$47.88
Rate for Payer: Aetna Medicare Advantage	$37.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.13
Rate for Payer: Cigna Commercial	$63.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.49
Rate for Payer: Qualcare PPO/HMO/WC	$18.90
Rate for Payer: UnitedHealthcare Community & State	$3.98
Rate for Payer: Wellpoint Medicaid Managed Care	$3.58

URETERAL ILLUMINATOR CATHETER

Facility

$709.00

Hospital Charge Code	270331756
Hospital Revenue Code	272
Min. Negotiated Rate	$106.35
Max. Negotiated Rate	$106.35
Rate for Payer: Qualcare PPO/HMO/WC	$106.35

URETERAL ILLUMINATOR CATHETER

Facility

$709.00

Hospital Charge Code	270331756
Hospital Revenue Code	272
Min. Negotiated Rate	$20.14
Max. Negotiated Rate	$354.50
Rate for Payer: Aetna Commercial	$269.42
Rate for Payer: Aetna Medicare Advantage	$212.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$180.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$180.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$180.79
Rate for Payer: Cigna Commercial	$354.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.34
Rate for Payer: Oxford Commercial	$141.80
Rate for Payer: Qualcare PPO/HMO/WC	$106.35
Rate for Payer: UnitedHealthcare Commercial	$141.80
Rate for Payer: UnitedHealthcare Community & State	$22.40
Rate for Payer: Wellpoint Medicaid Managed Care	$20.14

URETERAL UROMAX 5.8 FR X75cm

Facility

$2,182.15

Service Code	HCPCS C1726
Hospital Charge Code	270679680
Hospital Revenue Code	278
Min. Negotiated Rate	$61.97
Max. Negotiated Rate	$1,091.08
Rate for Payer: Aetna Commercial	$829.22
Rate for Payer: Aetna Medicare Advantage	$654.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$556.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$556.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$436.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$556.45
Rate for Payer: Cigna Commercial	$1,091.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$528.08
Rate for Payer: Qualcare PPO/HMO/WC	$327.32
Rate for Payer: UnitedHealthcare Community & State	$68.96
Rate for Payer: Wellpoint Medicaid Managed Care	$61.97

URETERAL UROMAX 5.8 FR X75cm

Facility

$2,182.15

Service Code	HCPCS C1726
Hospital Charge Code	270679680
Hospital Revenue Code	278
Min. Negotiated Rate	$327.32
Max. Negotiated Rate	$528.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$436.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$528.08
Rate for Payer: Qualcare PPO/HMO/WC	$327.32

URETEROSCOPE DIS 10X 7.5 FR

Facility

$3,240.00

Hospital Charge Code	270702750
Hospital Revenue Code	270
Min. Negotiated Rate	$92.02
Max. Negotiated Rate	$1,620.00
Rate for Payer: Aetna Commercial	$1,231.20
Rate for Payer: Aetna Medicare Advantage	$972.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$826.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$826.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$826.20
Rate for Payer: Cigna Commercial	$1,620.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$842.40
Rate for Payer: Oxford Commercial	$648.00
Rate for Payer: Qualcare PPO/HMO/WC	$486.00
Rate for Payer: UnitedHealthcare Commercial	$648.00
Rate for Payer: UnitedHealthcare Community & State	$102.38
Rate for Payer: Wellpoint Medicaid Managed Care	$92.02

URETEROSCOPE DIS 10X 7.5 FR

Facility

$3,240.00

Hospital Charge Code	270702750
Hospital Revenue Code	270
Min. Negotiated Rate	$486.00
Max. Negotiated Rate	$486.00
Rate for Payer: Qualcare PPO/HMO/WC	$486.00

URETEROSCOPIC RETRIEVAL LOOP

Facility

$588.00

Hospital Charge Code	270331490
Hospital Revenue Code	272
Min. Negotiated Rate	$88.20
Max. Negotiated Rate	$88.20
Rate for Payer: Qualcare PPO/HMO/WC	$88.20

URETEROSCOPIC RETRIEVAL LOOP

Facility

$588.00

Hospital Charge Code	270331490
Hospital Revenue Code	272
Min. Negotiated Rate	$16.70
Max. Negotiated Rate	$294.00
Rate for Payer: Aetna Commercial	$223.44
Rate for Payer: Aetna Medicare Advantage	$176.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.94
Rate for Payer: Cigna Commercial	$294.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.88
Rate for Payer: Oxford Commercial	$117.60
Rate for Payer: Qualcare PPO/HMO/WC	$88.20
Rate for Payer: UnitedHealthcare Commercial	$117.60
Rate for Payer: UnitedHealthcare Community & State	$18.58
Rate for Payer: Wellpoint Medicaid Managed Care	$16.70

URETERSCOPIC STONE BASKET 4

Facility

$1,111.00

Hospital Charge Code	270331788
Hospital Revenue Code	272
Min. Negotiated Rate	$31.55
Max. Negotiated Rate	$555.50
Rate for Payer: Aetna Commercial	$422.18
Rate for Payer: Aetna Medicare Advantage	$333.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$283.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$283.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$283.31
Rate for Payer: Cigna Commercial	$555.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$288.86
Rate for Payer: Oxford Commercial	$222.20
Rate for Payer: Qualcare PPO/HMO/WC	$166.65
Rate for Payer: UnitedHealthcare Commercial	$222.20
Rate for Payer: UnitedHealthcare Community & State	$35.11
Rate for Payer: Wellpoint Medicaid Managed Care	$31.55

URETERSCOPIC STONE BASKET 4

Facility

$1,111.00

Hospital Charge Code	270331788
Hospital Revenue Code	272
Min. Negotiated Rate	$166.65
Max. Negotiated Rate	$166.65
Rate for Payer: Qualcare PPO/HMO/WC	$166.65

URETHRAL AND TRANSURETHRAL PROCEDURES

Facility

$13,857.02

Service Code	APR-DRG 4462
Min. Negotiated Rate	$13,585.31
Max. Negotiated Rate	$13,857.02
Rate for Payer: UnitedHealthcare Community & State	$13,585.31
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,857.02
Rate for Payer: Wellpoint Medicaid Managed Care	$13,585.31

URETHRAL AND TRANSURETHRAL PROCEDURES

Facility

$38,232.84

Service Code	APR-DRG 4464
Min. Negotiated Rate	$37,483.18
Max. Negotiated Rate	$38,232.84
Rate for Payer: UnitedHealthcare Community & State	$37,483.18
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$38,232.84
Rate for Payer: Wellpoint Medicaid Managed Care	$37,483.18

URETHRAL AND TRANSURETHRAL PROCEDURES

Facility

$11,412.01

Service Code	APR-DRG 4461
Min. Negotiated Rate	$11,188.25
Max. Negotiated Rate	$11,412.01
Rate for Payer: UnitedHealthcare Community & State	$11,188.25
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,412.01
Rate for Payer: Wellpoint Medicaid Managed Care	$11,188.25

URETHRAL AND TRANSURETHRAL PROCEDURES

Facility

$21,850.75

Service Code	APR-DRG 4463
Min. Negotiated Rate	$21,422.30
Max. Negotiated Rate	$21,850.75
Rate for Payer: UnitedHealthcare Community & State	$21,422.30
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$21,850.75
Rate for Payer: Wellpoint Medicaid Managed Care	$21,422.30

Know your out-of-pocket cost for care.

All Charges