Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CH ALPHA 1 ANTIT, PHENOT

Facility

$390.00

Service Code	HCPCS 82104
Hospital Charge Code	397073056
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CHAMBER AUTO FEED

Facility

$51.74

Hospital Charge Code	270643696
Hospital Revenue Code	270
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$25.87
Rate for Payer: Aetna Commercial	$19.66
Rate for Payer: Aetna Medicare Advantage	$15.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.19
Rate for Payer: Cigna Commercial	$25.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.45
Rate for Payer: Oxford Commercial	$10.35
Rate for Payer: Qualcare PPO/HMO/WC	$7.76
Rate for Payer: UnitedHealthcare Commercial	$10.35
Rate for Payer: UnitedHealthcare Community & State	$1.63
Rate for Payer: Wellpoint Medicaid Managed Care	$1.47

CHAMBER AUTO FEED

Facility

$51.74

Hospital Charge Code	270643696
Hospital Revenue Code	270
Min. Negotiated Rate	$7.76
Max. Negotiated Rate	$7.76
Rate for Payer: Qualcare PPO/HMO/WC	$7.76

CHAMBER I/C GRAFT 10CC

Facility

$5,648.00

Service Code	HCPCS C1713
Hospital Charge Code	270655438
Hospital Revenue Code	278
Min. Negotiated Rate	$160.40
Max. Negotiated Rate	$2,824.00
Rate for Payer: Aetna Commercial	$2,146.24
Rate for Payer: Aetna Medicare Advantage	$1,694.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,440.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,440.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,129.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,440.24
Rate for Payer: Cigna Commercial	$2,824.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,366.82
Rate for Payer: Qualcare PPO/HMO/WC	$847.20
Rate for Payer: UnitedHealthcare Community & State	$178.48
Rate for Payer: Wellpoint Medicaid Managed Care	$160.40

CHAMBER I/C GRAFT 10CC

Facility

$5,648.00

Service Code	HCPCS C1713
Hospital Charge Code	270655438
Hospital Revenue Code	278
Min. Negotiated Rate	$847.20
Max. Negotiated Rate	$1,366.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,129.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,366.82
Rate for Payer: Qualcare PPO/HMO/WC	$847.20

CHAMBER I/C GRAFT 15cc

Facility

$7,726.50

Hospital Charge Code	270669951
Hospital Revenue Code	278
Min. Negotiated Rate	$219.43
Max. Negotiated Rate	$3,863.25
Rate for Payer: Aetna Commercial	$2,936.07
Rate for Payer: Aetna Medicare Advantage	$2,317.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,970.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,970.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,545.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,970.26
Rate for Payer: Cigna Commercial	$3,863.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,869.81
Rate for Payer: Qualcare PPO/HMO/WC	$1,158.97
Rate for Payer: UnitedHealthcare Community & State	$244.16
Rate for Payer: Wellpoint Medicaid Managed Care	$219.43

CHAMBER I/C GRAFT 15cc

Facility

$7,726.50

Hospital Charge Code	270669951
Hospital Revenue Code	278
Min. Negotiated Rate	$1,158.97
Max. Negotiated Rate	$1,869.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,545.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,869.81
Rate for Payer: Qualcare PPO/HMO/WC	$1,158.97

CHAMBER MEMBRANE BALANCING

Facility

$550.00

Hospital Charge Code	270676771
Hospital Revenue Code	272
Min. Negotiated Rate	$15.62
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.00
Rate for Payer: Oxford Commercial	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Commercial	$110.00
Rate for Payer: UnitedHealthcare Community & State	$17.38
Rate for Payer: Wellpoint Medicaid Managed Care	$15.62

CHAMBER MEMBRANE BALANCING

Facility

$550.00

Hospital Charge Code	270676771
Hospital Revenue Code	272
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

CHAMBER VALUE OPTICHAMBER LARG

Facility

$75.03

Service Code	HCPCS A4627
Hospital Charge Code	270690908
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

CHAMBER VALUE OPTICHAMBER LARG

Facility

$75.03

Service Code	HCPCS A4627
Hospital Charge Code	270690908
Hospital Revenue Code	272
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$37.52
Rate for Payer: Aetna Commercial	$28.51
Rate for Payer: Aetna Medicare Advantage	$22.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.13
Rate for Payer: Cigna Commercial	$37.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.51
Rate for Payer: Oxford Commercial	$15.01
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.01
Rate for Payer: UnitedHealthcare Community & State	$2.37
Rate for Payer: Wellpoint Medicaid Managed Care	$2.13

CHAMBER VALUE OPTICHAMBER MED

Facility

$66.67

Service Code	HCPCS A4627
Hospital Charge Code	270690909
Hospital Revenue Code	272
Min. Negotiated Rate	$10.00
Max. Negotiated Rate	$10.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.00

CHAMBER VALUE OPTICHAMBER MED

Facility

$66.67

Service Code	HCPCS A4627
Hospital Charge Code	270690909
Hospital Revenue Code	272
Min. Negotiated Rate	$1.89
Max. Negotiated Rate	$33.34
Rate for Payer: Aetna Commercial	$25.33
Rate for Payer: Aetna Medicare Advantage	$20.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.00
Rate for Payer: Cigna Commercial	$33.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.33
Rate for Payer: Oxford Commercial	$13.33
Rate for Payer: Qualcare PPO/HMO/WC	$10.00
Rate for Payer: UnitedHealthcare Commercial	$13.33
Rate for Payer: UnitedHealthcare Community & State	$2.11
Rate for Payer: Wellpoint Medicaid Managed Care	$1.89

CHAMBER VALUE OPTICHAMBER S

Facility

$26.90

Service Code	HCPCS A4627
Hospital Charge Code	270690907
Hospital Revenue Code	272
Min. Negotiated Rate	$0.76
Max. Negotiated Rate	$13.45
Rate for Payer: Aetna Commercial	$10.22
Rate for Payer: Aetna Medicare Advantage	$8.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.86
Rate for Payer: Cigna Commercial	$13.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.99
Rate for Payer: Oxford Commercial	$5.38
Rate for Payer: Qualcare PPO/HMO/WC	$4.04
Rate for Payer: UnitedHealthcare Commercial	$5.38
Rate for Payer: UnitedHealthcare Community & State	$0.85
Rate for Payer: Wellpoint Medicaid Managed Care	$0.76

CHAMBER VALUE OPTICHAMBER S

Facility

$26.90

Service Code	HCPCS A4627
Hospital Charge Code	270690907
Hospital Revenue Code	272
Min. Negotiated Rate	$4.04
Max. Negotiated Rate	$4.04
Rate for Payer: Qualcare PPO/HMO/WC	$4.04

CH AMYLASE RANDOM URINE

Facility

$390.00

Service Code	HCPCS 82150
Hospital Charge Code	397073106
Hospital Revenue Code	301
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$17.63
Rate for Payer: Aetna Medicare Advantage	$21.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.51
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$6.48
Rate for Payer: Clover Medicare Advantage	$6.16
Rate for Payer: EmblemHealth Commercial	$19.44
Rate for Payer: Humana Medicare Advantage	$6.67
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.48
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	$5.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.48
Rate for Payer: Wellcare Medicare Advantage	$6.48
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

CH AMYLASE RANDOM URINE

Facility

$390.00

Service Code	HCPCS 82150
Hospital Charge Code	397073106
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH ANA

Facility

$667.59

Service Code	HCPCS 86038
Hospital Charge Code	397041355
Hospital Revenue Code	302
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

CH ANA

Facility

$667.59

Service Code	HCPCS 86038
Hospital Charge Code	397041355
Hospital Revenue Code	302
Min. Negotiated Rate	$9.67
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$32.88
Rate for Payer: Aetna Medicare Advantage	$39.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.86
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$12.09
Rate for Payer: Clover Medicare Advantage	$11.49
Rate for Payer: EmblemHealth Commercial	$36.27
Rate for Payer: Humana Medicare Advantage	$12.45
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.57
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.09
Rate for Payer: Wellcare Medicare Advantage	$12.09
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

CH ANA TITER

Facility

$390.00

Service Code	HCPCS 86039
Hospital Charge Code	397041297
Hospital Revenue Code	302
Min. Negotiated Rate	$8.93
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$30.36
Rate for Payer: Aetna Medicare Advantage	$36.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.16
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	$40.48
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$11.16
Rate for Payer: Clover Medicare Advantage	$10.60
Rate for Payer: EmblemHealth Commercial	$33.48
Rate for Payer: Humana Medicare Advantage	$11.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.16
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	$8.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.16
Rate for Payer: Wellcare Medicare Advantage	$11.16
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

CH ANA TITER

Facility

$390.00

Service Code	HCPCS 86039
Hospital Charge Code	397041297
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CHANGE OF BLADDER TUBE

Facility

$1,076.57

Service Code	HCPCS 51705
Hospital Charge Code	160000191
Hospital Revenue Code	360
Min. Negotiated Rate	$30.57
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$807.38
Rate for Payer: Aetna Medicare Advantage	$961.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,076.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,076.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$296.83
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	$1,076.75
Rate for Payer: Cigna Commercial	$594.98
Rate for Payer: Cigna Medicare Advantage	$296.83
Rate for Payer: Clover Medicare Advantage	$281.99
Rate for Payer: EmblemHealth Commercial	$890.49
Rate for Payer: Humana Medicare Advantage	$305.73
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$296.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$279.91
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$161.49
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$34.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$296.83
Rate for Payer: Wellcare Medicare Advantage	$296.83
Rate for Payer: Wellpoint Medicaid Managed Care	$30.57

CHANGE OF BLADDER TUBE

Facility

$1,076.57

Service Code	HCPCS 51705
Hospital Charge Code	160000191
Hospital Revenue Code	360
Min. Negotiated Rate	$161.49
Max. Negotiated Rate	$161.49
Rate for Payer: Qualcare PPO/HMO/WC	$161.49

CHANGE UTERINE STENT PERCUT

Facility

$12,062.25

Service Code	HCPCS 50382
Hospital Charge Code	1600000704
Hospital Revenue Code	360
Min. Negotiated Rate	$1,809.34
Max. Negotiated Rate	$1,809.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,809.34

CHANGE UTERINE STENT PERCUT

Facility

$12,062.25

Service Code	HCPCS 50382
Hospital Charge Code	1600000704
Hospital Revenue Code	360
Min. Negotiated Rate	$342.57
Max. Negotiated Rate	$9,008.64
Rate for Payer: Aetna Commercial	$6,754.93
Rate for Payer: Aetna Medicare Advantage	$8,046.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,008.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,008.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,483.43
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	$9,008.64
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: Cigna Medicare Advantage	$2,483.43
Rate for Payer: Clover Medicare Advantage	$2,359.26
Rate for Payer: EmblemHealth Commercial	$7,450.29
Rate for Payer: Humana Medicare Advantage	$2,557.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,483.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,136.18
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,809.34
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$381.17
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,483.43
Rate for Payer: Wellcare Medicare Advantage	$2,483.43
Rate for Payer: Wellpoint Medicaid Managed Care	$342.57

Know your out-of-pocket cost for care.

All Charges