Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

US FINE NDL ASP W/IMAGE GUIDE

Facility

$2,403.20

Service Code	HCPCS 10022
Hospital Charge Code	2101153
Hospital Revenue Code	361
Min. Negotiated Rate	$360.48
Max. Negotiated Rate	$360.48
Rate for Payer: Qualcare PPO/HMO/WC	$360.48

US FOLLOW UP STUDY

Facility

$370.00

Service Code	HCPCS 76970
Hospital Charge Code	2101124
Hospital Revenue Code	402
Min. Negotiated Rate	$10.51
Max. Negotiated Rate	$2,904.00
Rate for Payer: Aetna Commercial	$140.60
Rate for Payer: Aetna Medicare Advantage	$111.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.35
Rate for Payer: Cigna Commercial	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.20
Rate for Payer: Oxford Commercial	$2,697.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.50
Rate for Payer: UnitedHealthcare Commercial	$2,904.00
Rate for Payer: UnitedHealthcare Community & State	$11.69
Rate for Payer: Wellpoint Medicaid Managed Care	$10.51

US FOLLOW UP STUDY

Facility

$370.00

Service Code	HCPCS 76970
Hospital Charge Code	2101124
Hospital Revenue Code	402
Min. Negotiated Rate	$55.50
Max. Negotiated Rate	$55.50
Rate for Payer: Qualcare PPO/HMO/WC	$55.50

US GALL BLADDER

Facility

$6,700.00

Service Code	HCPCS 76705
Hospital Charge Code	2100048
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

US GALL BLADDER

Facility

$6,700.00

Service Code	HCPCS 76705
Hospital Charge Code	2100048
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 GUIDANCE AMNIOCENTESIS

Facility

$954.00

Service Code	HCPCS 76946
Hospital Charge Code	2100154
Hospital Revenue Code	402
Min. Negotiated Rate	$27.09
Max. Negotiated Rate	$2,904.00
Rate for Payer: Aetna Commercial	$362.52
Rate for Payer: Aetna Medicare Advantage	$286.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$243.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$243.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$243.27
Rate for Payer: Cigna Commercial	$477.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.04
Rate for Payer: Oxford Commercial	$2,697.00
Rate for Payer: Qualcare PPO/HMO/WC	$143.10
Rate for Payer: UnitedHealthcare Commercial	$2,904.00
Rate for Payer: UnitedHealthcare Community & State	$30.15
Rate for Payer: Wellpoint Medicaid Managed Care	$27.09

US GUIDANCE AMNIOCENTESIS

Facility

$954.00

Service Code	HCPCS 76946
Hospital Charge Code	2100154
Hospital Revenue Code	402
Min. Negotiated Rate	$143.10
Max. Negotiated Rate	$143.10
Rate for Payer: Qualcare PPO/HMO/WC	$143.10

US GUIDANCE FOR INJ

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	1650117B
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 GUIDANCE FOR INJ

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	1650116B
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 GUIDANCE FOR INJ

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	1650117B
Hospital Revenue Code	402
Min. Negotiated Rate	$61.05
Max. Negotiated Rate	$3,350.00
Rate for Payer: Aetna Commercial	$2,546.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$3,350.00
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: Wellpoint Medicaid Managed Care	$190.28

US GUIDANCE FOR INJ

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	1650116B
Hospital Revenue Code	402
Min. Negotiated Rate	$61.05
Max. Negotiated Rate	$3,350.00
Rate for Payer: Aetna Commercial	$2,546.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$3,350.00
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: Wellpoint Medicaid Managed Care	$190.28

US GUIDANCE THORACENTESIS

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	2100220
Hospital Revenue Code	402
Min. Negotiated Rate	$61.05
Max. Negotiated Rate	$3,350.00
Rate for Payer: Aetna Commercial	$2,546.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$3,350.00
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: Wellpoint Medicaid Managed Care	$190.28

US GUIDANCE THORACENTESIS

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	2100220
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 GUIDANCE WIRE LOCALIZATION

Facility

$1,429.00

Service Code	HCPCS 76942
Hospital Charge Code	2100245
Hospital Revenue Code	402
Min. Negotiated Rate	$40.58
Max. Negotiated Rate	$2,904.00
Rate for Payer: Aetna Commercial	$543.02
Rate for Payer: Aetna Medicare Advantage	$428.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$364.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$364.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$364.39
Rate for Payer: Cigna Commercial	$714.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$371.54
Rate for Payer: Oxford Commercial	$2,697.00
Rate for Payer: Qualcare PPO/HMO/WC	$214.35
Rate for Payer: UnitedHealthcare Commercial	$2,904.00
Rate for Payer: UnitedHealthcare Community & State	$45.16
Rate for Payer: Wellpoint Medicaid Managed Care	$40.58

US GUIDANCE WIRE LOCALIZATION

Facility

$1,429.00

Service Code	HCPCS 76942
Hospital Charge Code	2100245
Hospital Revenue Code	402
Min. Negotiated Rate	$214.35
Max. Negotiated Rate	$214.35
Rate for Payer: Qualcare PPO/HMO/WC	$214.35

US GUIDED BREAST LOC LT

Facility

$776.25

Service Code	HCPCS 19285LT
Hospital Charge Code	2309102A
Hospital Revenue Code	361
Min. Negotiated Rate	$22.05
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$294.98
Rate for Payer: Aetna Medicare Advantage	$232.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.94
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	$197.94
Rate for Payer: Cigna Commercial	$388.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.82
Rate for Payer: Qualcare PPO/HMO/WC	$116.44
Rate for Payer: UnitedHealthcare Community & State	$24.53
Rate for Payer: Wellpoint Medicaid Managed Care	$22.05

US GUIDED BREAST LOC LT

Facility

$776.25

Service Code	HCPCS 19285LT
Hospital Charge Code	2309102A
Hospital Revenue Code	361
Min. Negotiated Rate	$116.44
Max. Negotiated Rate	$116.44
Rate for Payer: Qualcare PPO/HMO/WC	$116.44

US GUIDED BREAST LOC RT

Facility

$776.25

Service Code	HCPCS 19285RT
Hospital Charge Code	2309101A
Hospital Revenue Code	361
Min. Negotiated Rate	$116.44
Max. Negotiated Rate	$116.44
Rate for Payer: Qualcare PPO/HMO/WC	$116.44

US GUIDED BREAST LOC RT

Facility

$776.25

Service Code	HCPCS 19285RT
Hospital Charge Code	2309101A
Hospital Revenue Code	361
Min. Negotiated Rate	$22.05
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$294.98
Rate for Payer: Aetna Medicare Advantage	$232.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.94
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	$197.94
Rate for Payer: Cigna Commercial	$388.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.82
Rate for Payer: Qualcare PPO/HMO/WC	$116.44
Rate for Payer: UnitedHealthcare Community & State	$24.53
Rate for Payer: Wellpoint Medicaid Managed Care	$22.05

US GUIDED BRST BIOPSY 1ST LES

Facility

$6,346.20

Service Code	HCPCS 19083
Hospital Charge Code	87502808
Hospital Revenue Code	361
Min. Negotiated Rate	$951.93
Max. Negotiated Rate	$951.93
Rate for Payer: Qualcare PPO/HMO/WC	$951.93

US GUIDED BRST BIOPSY 1ST LES

Facility

$6,419.95

Service Code	HCPCS 19083LT
Hospital Charge Code	94064005L
Hospital Revenue Code	361
Min. Negotiated Rate	$182.33
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,439.58
Rate for Payer: Aetna Medicare Advantage	$1,925.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,637.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,637.09
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	$1,637.09
Rate for Payer: Cigna Commercial	$3,209.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,669.19
Rate for Payer: Qualcare PPO/HMO/WC	$962.99
Rate for Payer: UnitedHealthcare Community & State	$202.87
Rate for Payer: Wellpoint Medicaid Managed Care	$182.33

US GUIDED BRST BIOPSY 1ST LES

Facility

$6,419.95

Service Code	HCPCS 19083RT
Hospital Charge Code	94064005R
Hospital Revenue Code	361
Min. Negotiated Rate	$182.33
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,439.58
Rate for Payer: Aetna Medicare Advantage	$1,925.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,637.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,637.09
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	$1,637.09
Rate for Payer: Cigna Commercial	$3,209.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,669.19
Rate for Payer: Qualcare PPO/HMO/WC	$962.99
Rate for Payer: UnitedHealthcare Community & State	$202.87
Rate for Payer: Wellpoint Medicaid Managed Care	$182.33

US GUIDED BRST BIOPSY 1ST LES

Facility

$6,419.95

Service Code	HCPCS 19083RT
Hospital Charge Code	94064005R
Hospital Revenue Code	361
Min. Negotiated Rate	$962.99
Max. Negotiated Rate	$962.99
Rate for Payer: Qualcare PPO/HMO/WC	$962.99

US GUIDED BRST BIOPSY 1ST LES

Facility

$6,346.20

Service Code	HCPCS 19083
Hospital Charge Code	87502808
Hospital Revenue Code	361
Min. Negotiated Rate	$180.23
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,650.01
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$951.93
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$200.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$180.23

US GUIDED BRST BIOPSY 1ST LES

Facility

$12,839.90

Service Code	HCPCS 1908350
Hospital Charge Code	94064005
Hospital Revenue Code	361
Min. Negotiated Rate	$364.65
Max. Negotiated Rate	$6,419.95
Rate for Payer: Aetna Commercial	$4,879.16
Rate for Payer: Aetna Medicare Advantage	$3,851.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,274.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,274.17
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	$3,274.17
Rate for Payer: Cigna Commercial	$6,419.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,338.37
Rate for Payer: Qualcare PPO/HMO/WC	$1,925.98
Rate for Payer: UnitedHealthcare Community & State	$405.74
Rate for Payer: Wellpoint Medicaid Managed Care	$364.65

Know your out-of-pocket cost for care.

All Charges