Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY

Facility

$32,323.26

Service Code	APR-DRG 5113
Min. Negotiated Rate	$31,689.47
Max. Negotiated Rate	$32,323.26
Rate for Payer: UnitedHealthcare Community & State	$31,689.47
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$32,323.26
Rate for Payer: Wellpoint Medicaid Managed Care	$31,689.47

UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC

Facility

$84,566.35

Service Code	MSDRG 737
Min. Negotiated Rate	$25,749.37
Max. Negotiated Rate	$84,566.35
Rate for Payer: Aetna Commercial	$62,087.63
Rate for Payer: Aetna Medicare Advantage	$84,566.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54,578.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54,578.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27,104.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54,578.85
Rate for Payer: Cigna Commercial	$45,936.96
Rate for Payer: Cigna Medicare Advantage	$27,104.60
Rate for Payer: Clover Medicare Advantage	$25,749.37
Rate for Payer: EmblemHealth Commercial	$81,313.80
Rate for Payer: Humana Medicare Advantage	$27,917.74
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27,104.60
Rate for Payer: Oxford Commercial	$36,307.77
Rate for Payer: UnitedHealthcare Commercial	$48,599.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$27,104.60
Rate for Payer: Wellcare Medicare Advantage	$27,104.60

UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC

Facility

$132,395.83

Service Code	MSDRG 736
Min. Negotiated Rate	$40,312.83
Max. Negotiated Rate	$132,395.83
Rate for Payer: Aetna Commercial	$96,152.34
Rate for Payer: Aetna Medicare Advantage	$132,395.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107,772.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107,772.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$42,434.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107,772.45
Rate for Payer: Cigna Commercial	$79,686.33
Rate for Payer: Cigna Medicare Advantage	$42,434.56
Rate for Payer: Clover Medicare Advantage	$40,312.83
Rate for Payer: EmblemHealth Commercial	$127,303.68
Rate for Payer: Humana Medicare Advantage	$43,707.60
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$42,434.56
Rate for Payer: Oxford Commercial	$62,982.69
Rate for Payer: UnitedHealthcare Commercial	$84,304.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$42,434.56
Rate for Payer: Wellcare Medicare Advantage	$42,434.56

UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC

Facility

$65,859.86

Service Code	MSDRG 738
Min. Negotiated Rate	$20,053.48
Max. Negotiated Rate	$65,859.86
Rate for Payer: Aetna Commercial	$48,764.67
Rate for Payer: Aetna Medicare Advantage	$65,859.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37,678.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37,678.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,108.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37,678.80
Rate for Payer: Cigna Commercial	$32,737.27
Rate for Payer: Cigna Medicare Advantage	$21,108.93
Rate for Payer: Clover Medicare Advantage	$20,053.48
Rate for Payer: EmblemHealth Commercial	$63,326.79
Rate for Payer: Humana Medicare Advantage	$21,742.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21,108.93
Rate for Payer: Oxford Commercial	$25,874.97
Rate for Payer: UnitedHealthcare Commercial	$34,634.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$21,108.93
Rate for Payer: Wellcare Medicare Advantage	$21,108.93

UTLTY CART W/3 TUB SHELVES BLU

Facility

$712.50

Hospital Charge Code	270662654
Hospital Revenue Code	270
Min. Negotiated Rate	$106.88
Max. Negotiated Rate	$106.88
Rate for Payer: Qualcare PPO/HMO/WC	$106.88

UTLTY CART W/3 TUB SHELVES BLU

Facility

$712.50

Hospital Charge Code	270662654
Hospital Revenue Code	270
Min. Negotiated Rate	$20.23
Max. Negotiated Rate	$356.25
Rate for Payer: Aetna Commercial	$270.75
Rate for Payer: Aetna Medicare Advantage	$213.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.69
Rate for Payer: Cigna Commercial	$356.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.25
Rate for Payer: Oxford Commercial	$142.50
Rate for Payer: Qualcare PPO/HMO/WC	$106.88
Rate for Payer: UnitedHealthcare Commercial	$142.50
Rate for Payer: UnitedHealthcare Community & State	$22.52
Rate for Payer: Wellpoint Medicaid Managed Care	$20.23

V92 CELLULAR BONE MATRIX

Facility

$3,750.00

Service Code	HCPCS C1762
Hospital Charge Code	270687475
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

V92 CELLULAR BONE MATRIX

Facility

$3,750.00

Service Code	HCPCS C1762
Hospital Charge Code	270687475
Hospital Revenue Code	278
Min. Negotiated Rate	$106.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$118.50
Rate for Payer: Wellpoint Medicaid Managed Care	$106.50

VABGUARD DCM TIBILA BEARING 16

Facility

$12,565.00

Service Code	HCPCS C1713
Hospital Charge Code	270665906
Hospital Revenue Code	278
Min. Negotiated Rate	$1,884.75
Max. Negotiated Rate	$3,040.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,513.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,040.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,884.75

VABGUARD DCM TIBILA BEARING 16

Facility

$12,565.00

Service Code	HCPCS C1713
Hospital Charge Code	270665906
Hospital Revenue Code	278
Min. Negotiated Rate	$356.85
Max. Negotiated Rate	$6,282.50
Rate for Payer: Aetna Commercial	$4,774.70
Rate for Payer: Aetna Medicare Advantage	$3,769.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,204.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,204.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,513.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,204.07
Rate for Payer: Cigna Commercial	$6,282.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,040.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,884.75
Rate for Payer: UnitedHealthcare Community & State	$397.05
Rate for Payer: Wellpoint Medicaid Managed Care	$356.85

VACC ADMIN < 18 YRS EA ADD VAC

Facility

$31.00

Service Code	HCPCS 90461
Hospital Charge Code	87502705
Hospital Revenue Code	771
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$11.78
Rate for Payer: Aetna Medicare Advantage	$9.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.91
Rate for Payer: Cigna Commercial	$15.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.06
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.65
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$0.98
Rate for Payer: Wellpoint Medicaid Managed Care	$0.88

VACC ADMIN < 18 YRS EA ADD VAC

Facility

$31.00

Service Code	HCPCS 90461
Hospital Charge Code	87502705
Hospital Revenue Code	771
Min. Negotiated Rate	$4.65
Max. Negotiated Rate	$4.65
Rate for Payer: Qualcare PPO/HMO/WC	$4.65

VACC ADMIN < 18 YRS INIT VACC

Facility

$41.00

Service Code	HCPCS 90460
Hospital Charge Code	87502700
Hospital Revenue Code	771
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$15.58
Rate for Payer: Aetna Medicare Advantage	$12.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.46
Rate for Payer: Cigna Commercial	$20.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.66
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.15
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.30
Rate for Payer: Wellpoint Medicaid Managed Care	$1.16

VACC ADMIN < 18 YRS INIT VACC

Facility

$41.00

Service Code	HCPCS 90460
Hospital Charge Code	87502700
Hospital Revenue Code	771
Min. Negotiated Rate	$6.15
Max. Negotiated Rate	$6.15
Rate for Payer: Qualcare PPO/HMO/WC	$6.15

VACCESS POWER POR 8FR

Facility

$1,075.00

Service Code	HCPCS C1788
Hospital Charge Code	270653938
Hospital Revenue Code	278
Min. Negotiated Rate	$30.53
Max. Negotiated Rate	$537.50
Rate for Payer: Aetna Commercial	$408.50
Rate for Payer: Aetna Medicare Advantage	$322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.12
Rate for Payer: Cigna Commercial	$537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: Qualcare PPO/HMO/WC	$161.25
Rate for Payer: UnitedHealthcare Community & State	$33.97
Rate for Payer: Wellpoint Medicaid Managed Care	$30.53

VACCESS POWER POR 8FR

Facility

$1,075.00

Service Code	HCPCS C1788
Hospital Charge Code	270653938
Hospital Revenue Code	278
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

VACCINE ADMIN EA ADDL

Facility

$20.38

Service Code	HCPCS 90472
Hospital Charge Code	100143
Hospital Revenue Code	771
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$7.74
Rate for Payer: Aetna Medicare Advantage	$6.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.20
Rate for Payer: Cigna Commercial	$10.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.30
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.06
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$0.64
Rate for Payer: Wellpoint Medicaid Managed Care	$0.58

VACCINE ADMIN EA ADDL

Facility

$20.38

Service Code	HCPCS 90472
Hospital Charge Code	5700810
Hospital Revenue Code	771
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$3.06
Rate for Payer: Qualcare PPO/HMO/WC	$3.06

VACCINE ADMIN EA ADDL

Facility

$20.38

Service Code	HCPCS 90472
Hospital Charge Code	93950063
Hospital Revenue Code	771
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$3.06
Rate for Payer: Qualcare PPO/HMO/WC	$3.06

VACCINE ADMIN EA ADDL

Facility

$156.00

Service Code	HCPCS 90472
Hospital Charge Code	3408015
Hospital Revenue Code	771
Min. Negotiated Rate	$23.40
Max. Negotiated Rate	$23.40
Rate for Payer: Qualcare PPO/HMO/WC	$23.40

VACCINE ADMIN EA ADDL

Facility

$156.00

Service Code	HCPCS 90472
Hospital Charge Code	3408015
Hospital Revenue Code	771
Min. Negotiated Rate	$4.43
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$59.28
Rate for Payer: Aetna Medicare Advantage	$46.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.78
Rate for Payer: Cigna Commercial	$78.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.56
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.40
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$4.93
Rate for Payer: Wellpoint Medicaid Managed Care	$4.43

VACCINE ADMIN EA ADDL

Facility

$20.38

Service Code	HCPCS 90472
Hospital Charge Code	93500184
Hospital Revenue Code	771
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$3.06
Rate for Payer: Qualcare PPO/HMO/WC	$3.06

VACCINE ADMIN EA ADDL

Facility

$20.38

Service Code	HCPCS 90472
Hospital Charge Code	87502255
Hospital Revenue Code	771
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$7.74
Rate for Payer: Aetna Medicare Advantage	$6.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.20
Rate for Payer: Cigna Commercial	$10.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.30
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.06
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$0.64
Rate for Payer: Wellpoint Medicaid Managed Care	$0.58

VACCINE ADMIN EA ADDL

Facility

$20.35

Service Code	HCPCS 90472
Hospital Charge Code	8200501
Hospital Revenue Code	771
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$7.73
Rate for Payer: Aetna Medicare Advantage	$6.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.19
Rate for Payer: Cigna Commercial	$10.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.29
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.05
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$0.64
Rate for Payer: Wellpoint Medicaid Managed Care	$0.58

VACCINE ADMIN EA ADDL

Facility

$20.38

Service Code	HCPCS 90472
Hospital Charge Code	93950063
Hospital Revenue Code	771
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$7.74
Rate for Payer: Aetna Medicare Advantage	$6.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.20
Rate for Payer: Cigna Commercial	$10.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.30
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.06
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$0.64
Rate for Payer: Wellpoint Medicaid Managed Care	$0.58

Know your out-of-pocket cost for care.

All Charges