Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

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	$1,925.98
Max. Negotiated Rate	$1,925.98
Rate for Payer: Qualcare PPO/HMO/WC	$1,925.98

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	$962.99
Max. Negotiated Rate	$962.99
Rate for Payer: Qualcare PPO/HMO/WC	$962.99

US GUIDED BRST BIOPSY ADD LES

Facility

$3,173.10

Service Code	HCPCS 19084
Hospital Charge Code	94064007R
Hospital Revenue Code	361
Min. Negotiated Rate	$90.12
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,205.78
Rate for Payer: Aetna Medicare Advantage	$951.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$809.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$809.14
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	$809.14
Rate for Payer: Cigna Commercial	$1,586.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$825.01
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$475.96
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$100.27
Rate for Payer: Wellpoint Medicaid Managed Care	$90.12

US GUIDED BRST BIOPSY ADD LES

Facility

$6,346.20

Service Code	HCPCS 19084
Hospital Charge Code	94064007
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 ADD LES

Facility

$6,346.20

Service Code	HCPCS 19084
Hospital Charge Code	94064007
Hospital Revenue Code	361
Min. Negotiated Rate	$180.23
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,411.56
Rate for Payer: Aetna Medicare Advantage	$1,903.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,618.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,618.28
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	$1,618.28
Rate for Payer: Cigna Commercial	$3,173.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,650.01
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$951.93
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$200.54
Rate for Payer: Wellpoint Medicaid Managed Care	$180.23

US GUIDED BRST BIOPSY ADD LES

Facility

$3,173.10

Service Code	HCPCS 19084
Hospital Charge Code	94064007L
Hospital Revenue Code	361
Min. Negotiated Rate	$90.12
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,205.78
Rate for Payer: Aetna Medicare Advantage	$951.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$809.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$809.14
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	$809.14
Rate for Payer: Cigna Commercial	$1,586.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$825.01
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$475.96
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$100.27
Rate for Payer: Wellpoint Medicaid Managed Care	$90.12

US GUIDED BRST BIOPSY ADD LES

Facility

$3,173.10

Service Code	HCPCS 19084
Hospital Charge Code	94064007L
Hospital Revenue Code	361
Min. Negotiated Rate	$475.96
Max. Negotiated Rate	$475.96
Rate for Payer: Qualcare PPO/HMO/WC	$475.96

US GUIDED BRST BIOPSY ADD LES

Facility

$3,173.10

Service Code	HCPCS 19084
Hospital Charge Code	87502809
Hospital Revenue Code	361
Min. Negotiated Rate	$90.12
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,205.78
Rate for Payer: Aetna Medicare Advantage	$951.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$809.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$809.14
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	$809.14
Rate for Payer: Cigna Commercial	$1,586.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$825.01
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$475.96
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$100.27
Rate for Payer: Wellpoint Medicaid Managed Care	$90.12

US GUIDED BRST BIOPSY ADD LES

Facility

$3,173.10

Service Code	HCPCS 19084
Hospital Charge Code	87502809
Hospital Revenue Code	361
Min. Negotiated Rate	$475.96
Max. Negotiated Rate	$475.96
Rate for Payer: Qualcare PPO/HMO/WC	$475.96

US GUIDED BRST BIOPSY ADD LES

Facility

$3,173.10

Service Code	HCPCS 19084
Hospital Charge Code	94064007R
Hospital Revenue Code	361
Min. Negotiated Rate	$475.96
Max. Negotiated Rate	$475.96
Rate for Payer: Qualcare PPO/HMO/WC	$475.96

US GUIDED COMPRESS ART FL

Facility

$6,700.00

Service Code	HCPCS 76936
Hospital Charge Code	2692010
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 GUIDED COMPRESS ART FL

Facility

$6,700.00

Service Code	HCPCS 76936
Hospital Charge Code	2692010
Hospital Revenue Code	402
Min. Negotiated Rate	$190.28
Max. Negotiated Rate	$2,904.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$287.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$930.53
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
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	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$190.28

US GUIDED NEEDLE BIOPSY

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	2100238
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 GUIDED NEEDLE BIOPSY

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	2100238
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 GUIDED NEEDLE INS

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	366876942
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 GUIDED NEEDLE INS

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	7411169
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 GUIDED NEEDLE INS

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	7411169
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 GUIDED NEEDLE INS

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	366876942
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 GUIDED NEEDLE INSERT

Facility

$9,500.00

Service Code	HCPCS 76942
Hospital Charge Code	2250453
Hospital Revenue Code	402
Min. Negotiated Rate	$61.05
Max. Negotiated Rate	$4,750.00
Rate for Payer: Aetna Commercial	$3,610.00
Rate for Payer: Aetna Medicare Advantage	$2,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,422.50
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	$2,422.50
Rate for Payer: Cigna Commercial	$4,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,470.00
Rate for Payer: Oxford Commercial	$2,697.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$2,904.00
Rate for Payer: UnitedHealthcare Community & State	$300.20
Rate for Payer: Wellpoint Medicaid Managed Care	$269.80

US GUIDED NEEDLE INSERT

Facility

$9,500.00

Service Code	HCPCS 76942
Hospital Charge Code	2250453
Hospital Revenue Code	402
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

US GUIDED NEEDLE PLACEMENT

Facility

$2,085.70

Service Code	HCPCS 76942
Hospital Charge Code	1600000374
Hospital Revenue Code	360
Min. Negotiated Rate	$312.86
Max. Negotiated Rate	$312.86
Rate for Payer: Qualcare PPO/HMO/WC	$312.86

US GUIDED NEEDLE PLACEMENT

Facility

$2,085.70

Service Code	HCPCS 76942
Hospital Charge Code	1600000374
Hospital Revenue Code	360
Min. Negotiated Rate	$59.23
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$792.57
Rate for Payer: Aetna Medicare Advantage	$625.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$531.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$531.85
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	$531.85
Rate for Payer: Cigna Commercial	$1,042.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$542.28
Rate for Payer: Qualcare PPO/HMO/WC	$312.86
Rate for Payer: UnitedHealthcare Community & State	$65.91
Rate for Payer: Wellpoint Medicaid Managed Care	$59.23

US GUIDED THROM PSEUDOAN CLINC

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	23011001B
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 GUIDED THROM PSEUDOAN CLINC

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	23011001B
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 GUIDE PERICARDIOCENTESIS

Facility

$859.00

Service Code	HCPCS 76930
Hospital Charge Code	2680360
Hospital Revenue Code	402
Min. Negotiated Rate	$128.85
Max. Negotiated Rate	$128.85
Rate for Payer: Qualcare PPO/HMO/WC	$128.85

Know your out-of-pocket cost for care.

All Charges