Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

XR ELBOW 2 VIEWS BILATERAL

Facility

$5,100.00

Service Code	HCPCS 7307050
Hospital Charge Code	2011333
Hospital Revenue Code	320
Min. Negotiated Rate	$144.84
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.00
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$161.16
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

XR ELBOW COMPLETE BILATERAL

Facility

$6,601.19

Service Code	HCPCS 7308050
Hospital Charge Code	2011334
Hospital Revenue Code	320
Min. Negotiated Rate	$187.47
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.31
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$208.60
Rate for Payer: Wellpoint Medicaid Managed Care	$187.47

XR ELBOW COMPLETE BILATERAL

Facility

$6,601.19

Service Code	HCPCS 7308050
Hospital Charge Code	2011334
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

XR ELBOW LT 2 VIEWS

Facility

$339.00

Service Code	HCPCS 73070LT
Hospital Charge Code	2002418
Hospital Revenue Code	320
Min. Negotiated Rate	$9.63
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$128.82
Rate for Payer: Aetna Medicare Advantage	$101.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.44
Rate for Payer: Cigna Commercial	$169.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.14
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.85
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$10.71
Rate for Payer: Wellpoint Medicaid Managed Care	$9.63

XR ELBOW LT 2 VIEWS

Facility

$339.00

Service Code	HCPCS 73070LT
Hospital Charge Code	2002418
Hospital Revenue Code	320
Min. Negotiated Rate	$50.85
Max. Negotiated Rate	$50.85
Rate for Payer: Qualcare PPO/HMO/WC	$50.85

XR ELBOW MIN 3 VWS LT

Facility

$6,601.19

Service Code	HCPCS 73080LT
Hospital Charge Code	2000040
Hospital Revenue Code	320
Min. Negotiated Rate	$187.47
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.31
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$208.60
Rate for Payer: Wellpoint Medicaid Managed Care	$187.47

XR ELBOW MIN 3 VWS LT

Facility

$6,601.19

Service Code	HCPCS 73080LT
Hospital Charge Code	2000040
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

XR ELBOW MIN 3 VWS RT

Facility

$6,601.19

Service Code	HCPCS 73080RT
Hospital Charge Code	2000041
Hospital Revenue Code	320
Min. Negotiated Rate	$187.47
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.31
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$208.60
Rate for Payer: Wellpoint Medicaid Managed Care	$187.47

XR ELBOW MIN 3 VWS RT

Facility

$6,601.19

Service Code	HCPCS 73080RT
Hospital Charge Code	2000041
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

XR ELBOW RT 2 VIEWS

Facility

$339.00

Service Code	HCPCS 73070RT
Hospital Charge Code	2002419
Hospital Revenue Code	320
Min. Negotiated Rate	$50.85
Max. Negotiated Rate	$50.85
Rate for Payer: Qualcare PPO/HMO/WC	$50.85

XR ELBOW RT 2 VIEWS

Facility

$339.00

Service Code	HCPCS 73070RT
Hospital Charge Code	2002419
Hospital Revenue Code	320
Min. Negotiated Rate	$9.63
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$128.82
Rate for Payer: Aetna Medicare Advantage	$101.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.44
Rate for Payer: Cigna Commercial	$169.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.14
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.85
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$10.71
Rate for Payer: Wellpoint Medicaid Managed Care	$9.63

XR ERCP

Facility

$5,100.00

Service Code	HCPCS 74330
Hospital Charge Code	2001584
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR ERCP

Facility

$5,100.00

Service Code	HCPCS 74330
Hospital Charge Code	2001584
Hospital Revenue Code	320
Min. Negotiated Rate	$125.40
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.00
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$161.16
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

XR ESOPHAGUS

Facility

$6,601.19

Service Code	HCPCS 74220
Hospital Charge Code	2000222
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

XR ESOPHAGUS

Facility

$6,601.19

Service Code	HCPCS 74220
Hospital Charge Code	2000222
Hospital Revenue Code	320
Min. Negotiated Rate	$46.20
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$566.79
Rate for Payer: Aetna Medicare Advantage	$675.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$755.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$755.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$208.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$755.90
Rate for Payer: Cigna Commercial	$417.70
Rate for Payer: Cigna Medicare Advantage	$145.87
Rate for Payer: Clover Medicare Advantage	$197.96
Rate for Payer: EmblemHealth Commercial	$625.14
Rate for Payer: Humana Medicare Advantage	$214.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$208.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.31
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$208.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$208.38
Rate for Payer: Wellcare Medicare Advantage	$208.38
Rate for Payer: Wellpoint Medicaid Managed Care	$187.47

XR ESTABLISH ACCESS TO ARTERY

Facility

$533.00

Service Code	HCPCS 36100
Hospital Charge Code	7411420
Hospital Revenue Code	361
Min. Negotiated Rate	$15.14
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$202.54
Rate for Payer: Aetna Medicare Advantage	$159.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.91
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	$135.91
Rate for Payer: Cigna Commercial	$266.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.58
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$79.95
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$16.84
Rate for Payer: Wellpoint Medicaid Managed Care	$15.14

XR ESTABLISH ACCESS TO ARTERY

Facility

$533.00

Service Code	HCPCS 36100
Hospital Charge Code	7411420
Hospital Revenue Code	361
Min. Negotiated Rate	$79.95
Max. Negotiated Rate	$79.95
Rate for Payer: Qualcare PPO/HMO/WC	$79.95

XR ESTABLISH ACCESS TO ARTERY

Facility

$533.00

Service Code	HCPCS 36100
Hospital Charge Code	5600035
Hospital Revenue Code	361
Min. Negotiated Rate	$15.14
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$202.54
Rate for Payer: Aetna Medicare Advantage	$159.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.91
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	$135.91
Rate for Payer: Cigna Commercial	$266.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.58
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$79.95
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$16.84
Rate for Payer: Wellpoint Medicaid Managed Care	$15.14

XR ESTABLISH ACCESS TO ARTERY

Facility

$533.00

Service Code	HCPCS 36100
Hospital Charge Code	5600035
Hospital Revenue Code	361
Min. Negotiated Rate	$79.95
Max. Negotiated Rate	$79.95
Rate for Payer: Qualcare PPO/HMO/WC	$79.95

XR EYE/FOREIGN BODY LT

Facility

$5,100.00

Service Code	HCPCS 70030LT
Hospital Charge Code	2000420
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR EYE/FOREIGN BODY LT

Facility

$5,100.00

Service Code	HCPCS 70030LT
Hospital Charge Code	2000420
Hospital Revenue Code	320
Min. Negotiated Rate	$144.84
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.00
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$161.16
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

XR FACIAL BONES < 3 VIEW

Facility

$5,100.00

Service Code	HCPCS 70140
Hospital Charge Code	2011085
Hospital Revenue Code	320
Min. Negotiated Rate	$24.75
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$281.22
Rate for Payer: Aetna Medicare Advantage	$334.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$375.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$375.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$103.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$375.05
Rate for Payer: Cigna Commercial	$207.24
Rate for Payer: Cigna Medicare Advantage	$72.37
Rate for Payer: Clover Medicare Advantage	$98.22
Rate for Payer: EmblemHealth Commercial	$310.17
Rate for Payer: Humana Medicare Advantage	$106.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$103.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.00
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$161.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$103.39
Rate for Payer: Wellcare Medicare Advantage	$103.39
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$216.59
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

XR FACIAL BONES < 3 VIEW

Facility

$5,100.00

Service Code	HCPCS 70140
Hospital Charge Code	2011085
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR FACIAL BONES MIN 3 VWS

Facility

$5,100.00

Service Code	HCPCS 70150
Hospital Charge Code	2000362
Hospital Revenue Code	320
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$2,231.00
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	$33.00
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	$86.94
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	$1,326.00
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$161.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$316.08
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

XR FACIAL BONES MIN 3 VWS

Facility

$5,100.00

Service Code	HCPCS 70150
Hospital Charge Code	2000362
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

Know your out-of-pocket cost for care.

All Charges