Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

UROFORCE BALLOON 8MM X 6CM

Facility

$1,002.10

Service Code	HCPCS C1726
Hospital Charge Code	270682486
Hospital Revenue Code	278
Min. Negotiated Rate	$28.46
Max. Negotiated Rate	$501.05
Rate for Payer: Aetna Commercial	$380.80
Rate for Payer: Aetna Medicare Advantage	$300.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.54
Rate for Payer: Cigna Commercial	$501.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.51
Rate for Payer: Qualcare PPO/HMO/WC	$150.31
Rate for Payer: UnitedHealthcare Community & State	$31.67
Rate for Payer: Wellpoint Medicaid Managed Care	$28.46

UROFORCE BALLOON 8MM X 6CM

Facility

$1,002.10

Service Code	HCPCS C1726
Hospital Charge Code	270682486
Hospital Revenue Code	278
Min. Negotiated Rate	$150.31
Max. Negotiated Rate	$242.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.51
Rate for Payer: Qualcare PPO/HMO/WC	$150.31

UROLIFT 2 IMPLANT CARTRIDGE

Facility

$23,000.00

Hospital Charge Code	270702038
Hospital Revenue Code	278
Min. Negotiated Rate	$3,450.00
Max. Negotiated Rate	$5,566.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,566.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,450.00

UROLIFT 2 IMPLANT CARTRIDGE

Facility

$23,000.00

Hospital Charge Code	270702038
Hospital Revenue Code	278
Min. Negotiated Rate	$653.20
Max. Negotiated Rate	$11,500.00
Rate for Payer: Aetna Commercial	$8,740.00
Rate for Payer: Aetna Medicare Advantage	$6,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,865.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,865.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,865.00
Rate for Payer: Cigna Commercial	$11,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,566.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,450.00
Rate for Payer: UnitedHealthcare Community & State	$726.80
Rate for Payer: Wellpoint Medicaid Managed Care	$653.20

UROLIFT CARTRIDGE HANDLE KIT

Facility

$5,750.00

Hospital Charge Code	270702039
Hospital Revenue Code	278
Min. Negotiated Rate	$862.50
Max. Negotiated Rate	$1,391.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

UROLIFT CARTRIDGE HANDLE KIT

Facility

$5,750.00

Hospital Charge Code	270702039
Hospital Revenue Code	278
Min. Negotiated Rate	$163.30
Max. Negotiated Rate	$2,875.00
Rate for Payer: Aetna Commercial	$2,185.00
Rate for Payer: Aetna Medicare Advantage	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,466.25
Rate for Payer: Cigna Commercial	$2,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50
Rate for Payer: UnitedHealthcare Community & State	$181.70
Rate for Payer: Wellpoint Medicaid Managed Care	$163.30

UROLIFT CARTRIDGE HANDLE KIT

Facility

$5,750.00

Hospital Charge Code	270702309
Hospital Revenue Code	278
Min. Negotiated Rate	$862.50
Max. Negotiated Rate	$1,391.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

UROLIFT CARTRIDGE HANDLE KIT

Facility

$5,750.00

Hospital Charge Code	270702309
Hospital Revenue Code	278
Min. Negotiated Rate	$163.30
Max. Negotiated Rate	$2,875.00
Rate for Payer: Aetna Commercial	$2,185.00
Rate for Payer: Aetna Medicare Advantage	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,466.25
Rate for Payer: Cigna Commercial	$2,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50
Rate for Payer: UnitedHealthcare Community & State	$181.70
Rate for Payer: Wellpoint Medicaid Managed Care	$163.30

URO MAX HIGH PRESSURE URETERA

Facility

$1,085.00

Hospital Charge Code	270332488
Hospital Revenue Code	278
Min. Negotiated Rate	$162.75
Max. Negotiated Rate	$262.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$217.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.57
Rate for Payer: Qualcare PPO/HMO/WC	$162.75

URO MAX HIGH PRESSURE URETERA

Facility

$1,085.00

Hospital Charge Code	270332488
Hospital Revenue Code	278
Min. Negotiated Rate	$30.81
Max. Negotiated Rate	$542.50
Rate for Payer: Aetna Commercial	$412.30
Rate for Payer: Aetna Medicare Advantage	$325.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$276.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$276.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$217.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$276.68
Rate for Payer: Cigna Commercial	$542.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.57
Rate for Payer: Qualcare PPO/HMO/WC	$162.75
Rate for Payer: UnitedHealthcare Community & State	$34.29
Rate for Payer: Wellpoint Medicaid Managed Care	$30.81

URO MAX ULTRA BALLOON CATHETER

Facility

$1,741.15

Service Code	HCPCS C1726
Hospital Charge Code	270656990
Hospital Revenue Code	278
Min. Negotiated Rate	$261.17
Max. Negotiated Rate	$421.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$348.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$421.36
Rate for Payer: Qualcare PPO/HMO/WC	$261.17

URO MAX ULTRA BALLOON CATHETER

Facility

$1,741.15

Service Code	HCPCS C1726
Hospital Charge Code	270656990
Hospital Revenue Code	278
Min. Negotiated Rate	$49.45
Max. Negotiated Rate	$870.58
Rate for Payer: Aetna Commercial	$661.64
Rate for Payer: Aetna Medicare Advantage	$522.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$443.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$443.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$348.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$443.99
Rate for Payer: Cigna Commercial	$870.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$421.36
Rate for Payer: Qualcare PPO/HMO/WC	$261.17
Rate for Payer: UnitedHealthcare Community & State	$55.02
Rate for Payer: Wellpoint Medicaid Managed Care	$49.45

UROMAX ULTRA BALLOON DILATION

Facility

$1,741.15

Hospital Charge Code	270657032
Hospital Revenue Code	278
Min. Negotiated Rate	$49.45
Max. Negotiated Rate	$870.58
Rate for Payer: Aetna Commercial	$661.64
Rate for Payer: Aetna Medicare Advantage	$522.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$443.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$443.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$348.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$443.99
Rate for Payer: Cigna Commercial	$870.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$421.36
Rate for Payer: Qualcare PPO/HMO/WC	$261.17
Rate for Payer: UnitedHealthcare Community & State	$55.02
Rate for Payer: Wellpoint Medicaid Managed Care	$49.45

UROMAX ULTRA BALLOON DILATION

Facility

$1,741.15

Hospital Charge Code	270657032
Hospital Revenue Code	278
Min. Negotiated Rate	$261.17
Max. Negotiated Rate	$421.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$348.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$421.36
Rate for Payer: Qualcare PPO/HMO/WC	$261.17

UROVAC BLADDER EVACUATOR

Facility

$148.00

Hospital Charge Code	270332412
Hospital Revenue Code	272
Min. Negotiated Rate	$22.20
Max. Negotiated Rate	$22.20
Rate for Payer: Qualcare PPO/HMO/WC	$22.20

UROVAC BLADDER EVACUATOR

Facility

$148.00

Hospital Charge Code	270332412
Hospital Revenue Code	272
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$74.00
Rate for Payer: Aetna Commercial	$56.24
Rate for Payer: Aetna Medicare Advantage	$44.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.74
Rate for Payer: Cigna Commercial	$74.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.48
Rate for Payer: Oxford Commercial	$29.60
Rate for Payer: Qualcare PPO/HMO/WC	$22.20
Rate for Payer: UnitedHealthcare Commercial	$29.60
Rate for Payer: UnitedHealthcare Community & State	$4.68
Rate for Payer: Wellpoint Medicaid Managed Care	$4.20

URSODIOL 300 MG CAP

Facility

$49.25

Service Code	NDC 591315901
Hospital Charge Code	60628733
Hospital Revenue Code	250
Min. Negotiated Rate	$7.39
Max. Negotiated Rate	$7.39
Rate for Payer: Qualcare PPO/HMO/WC	$7.39

URSODIOL 300 MG CAP

Facility

$49.25

Service Code	NDC 591315901
Hospital Charge Code	60628733
Hospital Revenue Code	250
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$24.62
Rate for Payer: Aetna Commercial	$18.71
Rate for Payer: Aetna Medicare Advantage	$14.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.56
Rate for Payer: Cigna Commercial	$24.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.80
Rate for Payer: Oxford Commercial	$9.85
Rate for Payer: Qualcare PPO/HMO/WC	$7.39
Rate for Payer: UnitedHealthcare Commercial	$9.85
Rate for Payer: UnitedHealthcare Community & State	$1.56
Rate for Payer: Wellpoint Medicaid Managed Care	$1.40

URTERINE MANIPULATOR 4.5MM

Facility

$583.00

Hospital Charge Code	270332489
Hospital Revenue Code	272
Min. Negotiated Rate	$87.45
Max. Negotiated Rate	$87.45
Rate for Payer: Qualcare PPO/HMO/WC	$87.45

URTERINE MANIPULATOR 4.5MM

Facility

$583.00

Hospital Charge Code	270332489
Hospital Revenue Code	272
Min. Negotiated Rate	$16.56
Max. Negotiated Rate	$291.50
Rate for Payer: Aetna Commercial	$221.54
Rate for Payer: Aetna Medicare Advantage	$174.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$148.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$148.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$148.66
Rate for Payer: Cigna Commercial	$291.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.58
Rate for Payer: Oxford Commercial	$116.60
Rate for Payer: Qualcare PPO/HMO/WC	$87.45
Rate for Payer: UnitedHealthcare Commercial	$116.60
Rate for Payer: UnitedHealthcare Community & State	$18.42
Rate for Payer: Wellpoint Medicaid Managed Care	$16.56

US ABD AAA SCREEN

Facility

$6,700.00

Service Code	HCPCS 76706
Hospital Charge Code	404276706
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

US ABD AAA SCREEN

Facility

$6,700.00

Service Code	HCPCS 76706
Hospital Charge Code	404276706
Hospital Revenue Code	402
Min. Negotiated Rate	$74.28
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	$74.28
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

US ABDOMEN B SCAN COMPL

Facility

$6,700.00

Service Code	HCPCS 76700
Hospital Charge Code	2100014
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

US ABDOMEN B SCAN COMPL

Facility

$6,700.00

Service Code	HCPCS 76700
Hospital Charge Code	2100014
Hospital Revenue Code	402
Min. Negotiated Rate	$108.90
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	$108.90
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

US ABDOMEN LTD,SING ORG/QUAD

Facility

$6,700.00

Service Code	HCPCS 76705
Hospital Charge Code	2100015
Hospital Revenue Code	402
Min. Negotiated Rate	$72.60
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	$72.60
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

Know your out-of-pocket cost for care.

All Charges