Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CABLE SURGICAL 12FT DISPOSABLE

Facility

$375.00

Hospital Charge Code	270635176
Hospital Revenue Code	272
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

CABLE SURGICAL 12FT DISPOSABLE

Facility

$1,518.75

Hospital Charge Code	270635176S
Hospital Revenue Code	272
Min. Negotiated Rate	$43.13
Max. Negotiated Rate	$759.38
Rate for Payer: Aetna Commercial	$577.12
Rate for Payer: Aetna Medicare Advantage	$455.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$387.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$387.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$387.28
Rate for Payer: Cigna Commercial	$759.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$394.88
Rate for Payer: Oxford Commercial	$303.75
Rate for Payer: Qualcare PPO/HMO/WC	$227.81
Rate for Payer: UnitedHealthcare Commercial	$303.75
Rate for Payer: UnitedHealthcare Community & State	$47.99
Rate for Payer: Wellpoint Medicaid Managed Care	$43.13

CABLE SURGICAL 12FT DISPOSABLE

Facility

$1,518.75

Hospital Charge Code	270635176N
Hospital Revenue Code	272
Min. Negotiated Rate	$227.81
Max. Negotiated Rate	$227.81
Rate for Payer: Qualcare PPO/HMO/WC	$227.81

CABLE TEMP PACEMAKER

Facility

$875.00

Hospital Charge Code	270661504S
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

CABLE TEMP PACEMAKER

Facility

$875.00

Hospital Charge Code	270661504S
Hospital Revenue Code	272
Min. Negotiated Rate	$24.85
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$27.65
Rate for Payer: Wellpoint Medicaid Managed Care	$24.85

CABLE TRIAL LEAD

Facility

$1,500.00

Hospital Charge Code	270683668
Hospital Revenue Code	272
Min. Negotiated Rate	$42.60
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.00
Rate for Payer: Oxford Commercial	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Commercial	$300.00
Rate for Payer: UnitedHealthcare Community & State	$47.40
Rate for Payer: Wellpoint Medicaid Managed Care	$42.60

CABLE TRIAL LEAD

Facility

$1,500.00

Hospital Charge Code	270683668
Hospital Revenue Code	272
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

CABLE TROCH 2.0 750MM 120002

Facility

$2,170.00

Service Code	HCPCS C1713
Hospital Charge Code	270611651
Hospital Revenue Code	278
Min. Negotiated Rate	$325.50
Max. Negotiated Rate	$525.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$434.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$525.14
Rate for Payer: Qualcare PPO/HMO/WC	$325.50

CABLE TROCH 2.0 750MM 120002

Facility

$2,170.00

Service Code	HCPCS C1713
Hospital Charge Code	270611651
Hospital Revenue Code	278
Min. Negotiated Rate	$61.63
Max. Negotiated Rate	$1,085.00
Rate for Payer: Aetna Commercial	$824.60
Rate for Payer: Aetna Medicare Advantage	$651.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$553.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$553.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$434.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$553.35
Rate for Payer: Cigna Commercial	$1,085.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$525.14
Rate for Payer: Qualcare PPO/HMO/WC	$325.50
Rate for Payer: UnitedHealthcare Community & State	$68.57
Rate for Payer: Wellpoint Medicaid Managed Care	$61.63

CADASIL

Facility

$390.00

Hospital Charge Code	3035094X
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CADASIL

Facility

$390.00

Hospital Charge Code	3035094X
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

CAD BREAST MRI

Facility

$1,038.00

Hospital Charge Code	4045C8937
Hospital Revenue Code	610
Min. Negotiated Rate	$29.48
Max. Negotiated Rate	$6,130.00
Rate for Payer: Aetna Commercial	$394.44
Rate for Payer: Aetna Medicare Advantage	$311.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$264.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$264.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$264.69
Rate for Payer: Cigna Commercial	$519.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$269.88
Rate for Payer: Oxford Commercial	$5,427.00
Rate for Payer: Qualcare PPO/HMO/WC	$155.70
Rate for Payer: UnitedHealthcare Commercial	$6,130.00
Rate for Payer: UnitedHealthcare Community & State	$32.80
Rate for Payer: Wellpoint Medicaid Managed Care	$29.48

CAD BREAST MRI

Facility

$1,038.00

Hospital Charge Code	4045C8937
Hospital Revenue Code	610
Min. Negotiated Rate	$155.70
Max. Negotiated Rate	$155.70
Rate for Payer: Qualcare PPO/HMO/WC	$155.70

CAD-DIAGOSTIC MAMMOGRAPHY

Facility

$263.00

Service Code	HCPCS 77051
Hospital Charge Code	2008045
Hospital Revenue Code	401
Min. Negotiated Rate	$7.47
Max. Negotiated Rate	$1,884.00
Rate for Payer: Aetna Commercial	$99.94
Rate for Payer: Aetna Medicare Advantage	$78.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.06
Rate for Payer: Cigna Commercial	$131.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.38
Rate for Payer: Oxford Commercial	$1,688.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.45
Rate for Payer: UnitedHealthcare Commercial	$1,884.00
Rate for Payer: UnitedHealthcare Community & State	$8.31
Rate for Payer: Wellpoint Medicaid Managed Care	$7.47

CAD-DIAGOSTIC MAMMOGRAPHY

Facility

$263.00

Service Code	HCPCS 77051
Hospital Charge Code	2008045
Hospital Revenue Code	401
Min. Negotiated Rate	$39.45
Max. Negotiated Rate	$39.45
Rate for Payer: Qualcare PPO/HMO/WC	$39.45

CADEXOMER IODINE 0.9% GEL

Facility

$918.30

Service Code	NDC 40565012249
Hospital Charge Code	60630080
Hospital Revenue Code	250
Min. Negotiated Rate	$137.75
Max. Negotiated Rate	$137.75
Rate for Payer: Qualcare PPO/HMO/WC	$137.75

CADEXOMER IODINE 0.9% GEL

Facility

$918.30

Service Code	NDC 40565012249
Hospital Charge Code	60630080
Hospital Revenue Code	250
Min. Negotiated Rate	$26.08
Max. Negotiated Rate	$459.15
Rate for Payer: Aetna Commercial	$348.95
Rate for Payer: Aetna Medicare Advantage	$275.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$234.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$234.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$234.17
Rate for Payer: Cigna Commercial	$459.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.76
Rate for Payer: Oxford Commercial	$183.66
Rate for Payer: Qualcare PPO/HMO/WC	$137.75
Rate for Payer: UnitedHealthcare Commercial	$183.66
Rate for Payer: UnitedHealthcare Community & State	$29.02
Rate for Payer: Wellpoint Medicaid Managed Care	$26.08

CAD FOR DIAG MAMMO

Facility

$263.00

Service Code	HCPCS 77051
Hospital Charge Code	94061443
Hospital Revenue Code	401
Min. Negotiated Rate	$7.47
Max. Negotiated Rate	$1,884.00
Rate for Payer: Aetna Commercial	$99.94
Rate for Payer: Aetna Medicare Advantage	$78.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.06
Rate for Payer: Cigna Commercial	$131.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.38
Rate for Payer: Oxford Commercial	$1,688.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.45
Rate for Payer: UnitedHealthcare Commercial	$1,884.00
Rate for Payer: UnitedHealthcare Community & State	$8.31
Rate for Payer: Wellpoint Medicaid Managed Care	$7.47

CAD FOR DIAG MAMMO

Facility

$263.00

Service Code	HCPCS 77051
Hospital Charge Code	94061443
Hospital Revenue Code	401
Min. Negotiated Rate	$39.45
Max. Negotiated Rate	$39.45
Rate for Payer: Qualcare PPO/HMO/WC	$39.45

CADIUM,URINE

Facility

$372.00

Service Code	HCPCS 82300
Hospital Charge Code	38472144
Hospital Revenue Code	301
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

CADIUM,URINE

Facility

$372.00

Service Code	HCPCS 82300
Hospital Charge Code	38472144
Hospital Revenue Code	301
Min. Negotiated Rate	$10.56
Max. Negotiated Rate	$186.00
Rate for Payer: Aetna Commercial	$64.30
Rate for Payer: Aetna Medicare Advantage	$76.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.75
Rate for Payer: Cigna Commercial	$186.00
Rate for Payer: Cigna Medicare Advantage	$23.64
Rate for Payer: Clover Medicare Advantage	$22.46
Rate for Payer: EmblemHealth Commercial	$70.92
Rate for Payer: Humana Medicare Advantage	$24.35
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$23.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.72
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.80
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$18.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$23.64
Rate for Payer: Wellcare Medicare Advantage	$23.64
Rate for Payer: Wellpoint Medicaid Managed Care	$10.56

CADMIUM

Facility

$157.60

Hospital Charge Code	39990166B
Hospital Revenue Code	301
Min. Negotiated Rate	$4.48
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$59.89
Rate for Payer: Aetna Medicare Advantage	$47.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.19
Rate for Payer: Cigna Commercial	$78.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.98
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.64
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$4.98
Rate for Payer: Wellpoint Medicaid Managed Care	$4.48

CADMIUM

Facility

$390.00

Service Code	HCPCS 82300
Hospital Charge Code	401083018B
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CADMIUM

Facility

$390.00

Service Code	HCPCS 82300
Hospital Charge Code	401083018B
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$64.30
Rate for Payer: Aetna Medicare Advantage	$76.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.75
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$23.64
Rate for Payer: Clover Medicare Advantage	$22.46
Rate for Payer: EmblemHealth Commercial	$70.92
Rate for Payer: Humana Medicare Advantage	$24.35
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$23.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$18.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$23.64
Rate for Payer: Wellcare Medicare Advantage	$23.64
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

CADMIUM

Facility

$372.00

Service Code	HCPCS 82300
Hospital Charge Code	38473062
Hospital Revenue Code	301
Min. Negotiated Rate	$10.56
Max. Negotiated Rate	$186.00
Rate for Payer: Aetna Commercial	$64.30
Rate for Payer: Aetna Medicare Advantage	$76.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.75
Rate for Payer: Cigna Commercial	$186.00
Rate for Payer: Cigna Medicare Advantage	$23.64
Rate for Payer: Clover Medicare Advantage	$22.46
Rate for Payer: EmblemHealth Commercial	$70.92
Rate for Payer: Humana Medicare Advantage	$24.35
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$23.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.72
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.80
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$18.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$23.64
Rate for Payer: Wellcare Medicare Advantage	$23.64
Rate for Payer: Wellpoint Medicaid Managed Care	$10.56

Know your out-of-pocket cost for care.

All Charges