Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

XR FEMUR BILATERAL

Facility

$857.00

Hospital Charge Code	2011337
Hospital Revenue Code	320
Min. Negotiated Rate	$24.34
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$325.66
Rate for Payer: Aetna Medicare Advantage	$257.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$218.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$218.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$218.53
Rate for Payer: Cigna Commercial	$428.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.82
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$128.55
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$27.08
Rate for Payer: Wellpoint Medicaid Managed Care	$24.34

XR FEMUR BILATERAL

Facility

$857.00

Hospital Charge Code	2011337
Hospital Revenue Code	320
Min. Negotiated Rate	$128.55
Max. Negotiated Rate	$128.55
Rate for Payer: Qualcare PPO/HMO/WC	$128.55

XR FEMUR LT

Facility

$361.00

Hospital Charge Code	2000131
Hospital Revenue Code	320
Min. Negotiated Rate	$54.15
Max. Negotiated Rate	$54.15
Rate for Payer: Qualcare PPO/HMO/WC	$54.15

XR FEMUR LT

Facility

$361.00

Hospital Charge Code	2000131
Hospital Revenue Code	320
Min. Negotiated Rate	$10.25
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$137.18
Rate for Payer: Aetna Medicare Advantage	$108.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.06
Rate for Payer: Cigna Commercial	$180.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.86
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.15
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$11.41
Rate for Payer: Wellpoint Medicaid Managed Care	$10.25

XR FEMUR RT

Facility

$361.00

Hospital Charge Code	2000132
Hospital Revenue Code	320
Min. Negotiated Rate	$10.25
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$137.18
Rate for Payer: Aetna Medicare Advantage	$108.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.06
Rate for Payer: Cigna Commercial	$180.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.86
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.15
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$11.41
Rate for Payer: Wellpoint Medicaid Managed Care	$10.25

XR FEMUR RT

Facility

$361.00

Hospital Charge Code	2000132
Hospital Revenue Code	320
Min. Negotiated Rate	$54.15
Max. Negotiated Rate	$54.15
Rate for Payer: Qualcare PPO/HMO/WC	$54.15

XR FILM SCREEN DIAG BI CONVERT

Facility

$1,059.00

Service Code	HCPCS 77056
Hospital Charge Code	2002566
Hospital Revenue Code	401
Min. Negotiated Rate	$158.85
Max. Negotiated Rate	$158.85
Rate for Payer: Qualcare PPO/HMO/WC	$158.85

XR FILM SCREEN DIAG BI CONVERT

Facility

$1,059.00

Service Code	HCPCS 77056
Hospital Charge Code	2002566
Hospital Revenue Code	401
Min. Negotiated Rate	$30.08
Max. Negotiated Rate	$1,884.00
Rate for Payer: Aetna Commercial	$402.42
Rate for Payer: Aetna Medicare Advantage	$317.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$270.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$270.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$270.05
Rate for Payer: Cigna Commercial	$529.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$275.34
Rate for Payer: Oxford Commercial	$1,688.00
Rate for Payer: Qualcare PPO/HMO/WC	$158.85
Rate for Payer: UnitedHealthcare Commercial	$1,884.00
Rate for Payer: UnitedHealthcare Community & State	$33.46
Rate for Payer: Wellpoint Medicaid Managed Care	$30.08

XR FILM SCREEN DIAG UNI CONV

Facility

$777.50

Service Code	HCPCS 77055
Hospital Charge Code	2002582
Hospital Revenue Code	401
Min. Negotiated Rate	$22.08
Max. Negotiated Rate	$1,884.00
Rate for Payer: Aetna Commercial	$295.45
Rate for Payer: Aetna Medicare Advantage	$233.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.26
Rate for Payer: Cigna Commercial	$388.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$202.15
Rate for Payer: Oxford Commercial	$1,688.00
Rate for Payer: Qualcare PPO/HMO/WC	$116.62
Rate for Payer: UnitedHealthcare Commercial	$1,884.00
Rate for Payer: UnitedHealthcare Community & State	$24.57
Rate for Payer: Wellpoint Medicaid Managed Care	$22.08

XR FILM SCREEN DIAG UNI CONV

Facility

$777.50

Service Code	HCPCS 77055
Hospital Charge Code	2002582
Hospital Revenue Code	401
Min. Negotiated Rate	$116.62
Max. Negotiated Rate	$116.62
Rate for Payer: Qualcare PPO/HMO/WC	$116.62

XR FINE NDL ASPIR W/IMAGE GUID

Facility

$2,403.20

Service Code	HCPCS 10022
Hospital Charge Code	2001635
Hospital Revenue Code	361
Min. Negotiated Rate	$68.25
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$913.22
Rate for Payer: Aetna Medicare Advantage	$720.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.82
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	$612.82
Rate for Payer: Cigna Commercial	$1,201.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.83
Rate for Payer: Qualcare PPO/HMO/WC	$360.48
Rate for Payer: UnitedHealthcare Community & State	$75.94
Rate for Payer: Wellpoint Medicaid Managed Care	$68.25

XR FINE NDL ASPIR W/IMAGE GUID

Facility

$2,403.20

Service Code	HCPCS 10022
Hospital Charge Code	2001635
Hospital Revenue Code	361
Min. Negotiated Rate	$360.48
Max. Negotiated Rate	$360.48
Rate for Payer: Qualcare PPO/HMO/WC	$360.48

XR FISTULOGRAM

Facility

$5,100.00

Service Code	HCPCS 76080
Hospital Charge Code	2000321
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR FISTULOGRAM

Facility

$5,100.00

Service Code	HCPCS 76080
Hospital Charge Code	2000321
Hospital Revenue Code	320
Min. Negotiated Rate	$34.65
Max. Negotiated Rate	$2,354.83
Rate for Payer: Aetna Commercial	$1,765.72
Rate for Payer: Aetna Medicare Advantage	$2,103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,354.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,354.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$649.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,354.83
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: Cigna Medicare Advantage	$454.41
Rate for Payer: Clover Medicare Advantage	$616.70
Rate for Payer: EmblemHealth Commercial	$1,947.48
Rate for Payer: Humana Medicare Advantage	$668.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$649.16
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	$649.16
Rate for Payer: Wellcare Medicare Advantage	$649.16
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

XR FLUORO GUIDE CV ACCESS DEV

Facility

$8,692.60

Service Code	HCPCS 77001
Hospital Charge Code	2004405
Hospital Revenue Code	320
Min. Negotiated Rate	$1,303.89
Max. Negotiated Rate	$1,303.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,303.89

XR FLUORO GUIDE CV ACCESS DEV

Facility

$8,692.60

Service Code	HCPCS 77001
Hospital Charge Code	2004405
Hospital Revenue Code	320
Min. Negotiated Rate	$47.26
Max. Negotiated Rate	$4,346.30
Rate for Payer: Aetna Commercial	$3,303.19
Rate for Payer: Aetna Medicare Advantage	$2,607.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,216.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,216.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,216.61
Rate for Payer: Cigna Commercial	$4,346.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,260.08
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,303.89
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$274.69
Rate for Payer: Wellpoint Medicaid Managed Care	$246.87

XR FLUORO LOC NDL/CATH SPINE

Facility

$5,100.00

Service Code	HCPCS 77003
Hospital Charge Code	2004888
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR FLUORO LOC NDL/CATH SPINE

Facility

$5,100.00

Service Code	HCPCS 77003
Hospital Charge Code	2004888
Hospital Revenue Code	320
Min. Negotiated Rate	$33.36
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	$33.36
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 FLUORO LUMBA PUNC SPIN TAP

Facility

$5,100.00

Service Code	HCPCS 77002
Hospital Charge Code	2004406
Hospital Revenue Code	320
Min. Negotiated Rate	$47.26
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	$47.26
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 FLUORO LUMBA PUNC SPIN TAP

Facility

$5,100.00

Service Code	HCPCS 77002
Hospital Charge Code	2004406
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR FOOT 2 VIEWS BILATERAL

Facility

$6,601.19

Service Code	HCPCS 7362050
Hospital Charge Code	2011340
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

XR FOOT 2 VIEWS BILATERAL

Facility

$6,601.19

Service Code	HCPCS 7362050
Hospital Charge Code	2011340
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 FOOT COMPLETE BILATERAL

Facility

$6,601.19

Service Code	HCPCS 7363050
Hospital Charge Code	2011341
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

XR FOOT COMPLETE BILATERAL

Facility

$6,601.19

Service Code	HCPCS 7363050
Hospital Charge Code	2011341
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 FOOT LT

Facility

$6,601.19

Service Code	HCPCS 73630LT
Hospital Charge Code	2000164
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

Know your out-of-pocket cost for care.

All Charges