Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

VERT INTERBODY 16X14X9MM 7D

Facility

$10,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270693815
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$2,480.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

VERY LONGCHAIN FATTY ACID

Facility

$124.10

Service Code	HCPCS 82726
Hospital Charge Code	39900079
Hospital Revenue Code	301
Min. Negotiated Rate	$18.61
Max. Negotiated Rate	$18.61
Rate for Payer: Qualcare PPO/HMO/WC	$18.61

VERY LONGCHAIN FATTY ACID

Facility

$124.10

Service Code	HCPCS 82726
Hospital Charge Code	39900079
Hospital Revenue Code	301
Min. Negotiated Rate	$3.52
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$53.72
Rate for Payer: Aetna Medicare Advantage	$63.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.64
Rate for Payer: Cigna Commercial	$62.05
Rate for Payer: Cigna Medicare Advantage	$19.75
Rate for Payer: Clover Medicare Advantage	$18.76
Rate for Payer: EmblemHealth Commercial	$59.25
Rate for Payer: Humana Medicare Advantage	$20.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.27
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.61
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.75
Rate for Payer: Wellcare Medicare Advantage	$19.75
Rate for Payer: Wellpoint Medicaid Managed Care	$3.52

VESSEL INJECTION PROCEDURE

Facility

$200.00

Service Code	HCPCS 36299
Hospital Charge Code	7411436
Hospital Revenue Code	361
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$76.00
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.00
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	$51.00
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.00
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$6.32
Rate for Payer: Wellpoint Medicaid Managed Care	$5.68

VESSEL INJECTION PROCEDURE

Facility

$200.00

Service Code	HCPCS 36299
Hospital Charge Code	5600233
Hospital Revenue Code	361
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

VESSEL INJECTION PROCEDURE

Facility

$200.00

Service Code	HCPCS 36299
Hospital Charge Code	5600233
Hospital Revenue Code	361
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$76.00
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.00
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	$51.00
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.00
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$6.32
Rate for Payer: Wellpoint Medicaid Managed Care	$5.68

VESSEL INJECTION PROCEDURE

Facility

$200.00

Service Code	HCPCS 36299
Hospital Charge Code	7411436
Hospital Revenue Code	361
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

VESSEL LOOP BLUE MAXI

Facility

$7.75

Hospital Charge Code	270654606
Hospital Revenue Code	272
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$1.16
Rate for Payer: Qualcare PPO/HMO/WC	$1.16

VESSEL LOOP BLUE MAXI

Facility

$7.75

Hospital Charge Code	270654606
Hospital Revenue Code	272
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$3.88
Rate for Payer: Aetna Commercial	$2.94
Rate for Payer: Aetna Medicare Advantage	$2.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.98
Rate for Payer: Cigna Commercial	$3.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.02
Rate for Payer: Oxford Commercial	$1.55
Rate for Payer: Qualcare PPO/HMO/WC	$1.16
Rate for Payer: UnitedHealthcare Commercial	$1.55
Rate for Payer: UnitedHealthcare Community & State	$0.24
Rate for Payer: Wellpoint Medicaid Managed Care	$0.22

VESSEL LOOP MAXI YELLOW STERIL

Facility

$13.73

Hospital Charge Code	270656241
Hospital Revenue Code	272
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$2.06
Rate for Payer: Qualcare PPO/HMO/WC	$2.06

VESSEL LOOP MAXI YELLOW STERIL

Facility

$13.73

Hospital Charge Code	270656241
Hospital Revenue Code	272
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$6.87
Rate for Payer: Aetna Commercial	$5.22
Rate for Payer: Aetna Medicare Advantage	$4.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.50
Rate for Payer: Cigna Commercial	$6.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.57
Rate for Payer: Oxford Commercial	$2.75
Rate for Payer: Qualcare PPO/HMO/WC	$2.06
Rate for Payer: UnitedHealthcare Commercial	$2.75
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.39

VESSEL MAPPING HEMO ACCESS

Facility

$6,700.00

Service Code	HCPCS G0365
Hospital Charge Code	2692240
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

VESSEL MAPPING HEMO ACCESS

Facility

$6,700.00

Service Code	HCPCS G0365
Hospital Charge Code	404270365
Hospital Revenue Code	402
Min. Negotiated Rate	$190.28
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) 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

VESSEL MAPPING HEMO ACCESS

Facility

$6,700.00

Service Code	HCPCS G0365
Hospital Charge Code	2692240
Hospital Revenue Code	402
Min. Negotiated Rate	$190.28
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) 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

VESSEL MAPPING HEMO ACCESS

Facility

$6,700.00

Service Code	HCPCS G0365
Hospital Charge Code	404270365
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

VESSEL MAPPING HEMO ACCESS BIL

Facility

$6,700.00

Service Code	HCPCS G0365
Hospital Charge Code	2692241
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

VESSEL MAPPING HEMO ACCESS BIL

Facility

$6,700.00

Service Code	HCPCS G0365
Hospital Charge Code	2692241
Hospital Revenue Code	402
Min. Negotiated Rate	$190.28
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) 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

VESSEL SEALER EXTEND

Facility

$3,125.00

Hospital Charge Code	270683865
Hospital Revenue Code	272
Min. Negotiated Rate	$88.75
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$1,187.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$812.50
Rate for Payer: Oxford Commercial	$625.00
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Commercial	$625.00
Rate for Payer: UnitedHealthcare Community & State	$98.75
Rate for Payer: Wellpoint Medicaid Managed Care	$88.75

VESSEL SEALER EXTEND

Facility

$3,125.00

Hospital Charge Code	270683865
Hospital Revenue Code	272
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$468.75
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

VESSEL UMBILICAL W/POWER CATH

Facility

$311.41

Hospital Charge Code	270654041
Hospital Revenue Code	270
Min. Negotiated Rate	$8.84
Max. Negotiated Rate	$155.71
Rate for Payer: Aetna Commercial	$118.34
Rate for Payer: Aetna Medicare Advantage	$93.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.41
Rate for Payer: Cigna Commercial	$155.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.97
Rate for Payer: Oxford Commercial	$62.28
Rate for Payer: Qualcare PPO/HMO/WC	$46.71
Rate for Payer: UnitedHealthcare Commercial	$62.28
Rate for Payer: UnitedHealthcare Community & State	$9.84
Rate for Payer: Wellpoint Medicaid Managed Care	$8.84

VESSEL UMBILICAL W/POWER CATH

Facility

$311.41

Hospital Charge Code	270654041
Hospital Revenue Code	270
Min. Negotiated Rate	$46.71
Max. Negotiated Rate	$46.71
Rate for Payer: Qualcare PPO/HMO/WC	$46.71

VESSLE SIZING CATH 100CM

Facility

$650.00

Hospital Charge Code	270686377
Hospital Revenue Code	272
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

VESSLE SIZING CATH 100CM

Facility

$650.00

Hospital Charge Code	270686377
Hospital Revenue Code	272
Min. Negotiated Rate	$18.46
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.00
Rate for Payer: Oxford Commercial	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Commercial	$130.00
Rate for Payer: UnitedHealthcare Community & State	$20.54
Rate for Payer: Wellpoint Medicaid Managed Care	$18.46

VFEND 50MG TAB

Facility

$148.14

Service Code	NDC 49317030
Hospital Charge Code	60635403
Hospital Revenue Code	250
Min. Negotiated Rate	$4.21
Max. Negotiated Rate	$74.07
Rate for Payer: Aetna Commercial	$56.29
Rate for Payer: Aetna Medicare Advantage	$44.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.78
Rate for Payer: Cigna Commercial	$74.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.52
Rate for Payer: Oxford Commercial	$29.63
Rate for Payer: Qualcare PPO/HMO/WC	$22.22
Rate for Payer: UnitedHealthcare Commercial	$29.63
Rate for Payer: UnitedHealthcare Community & State	$4.68
Rate for Payer: Wellpoint Medicaid Managed Care	$4.21

VFEND 50MG TAB

Facility

$148.14

Service Code	NDC 49317030
Hospital Charge Code	60635403
Hospital Revenue Code	250
Min. Negotiated Rate	$22.22
Max. Negotiated Rate	$22.22
Rate for Payer: Qualcare PPO/HMO/WC	$22.22

Know your out-of-pocket cost for care.

All Charges