Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CH OCCULT BLOOD, STOOL

Facility

$390.00

Service Code	HCPCS 82270
Hospital Charge Code	397073027
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH OCCULT BLOOD, STOOL

Facility

$390.00

Service Code	HCPCS 82270
Hospital Charge Code	397073027
Hospital Revenue Code	301
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$11.91
Rate for Payer: Aetna Medicare Advantage	$14.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.89
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$4.38
Rate for Payer: Clover Medicare Advantage	$4.16
Rate for Payer: EmblemHealth Commercial	$13.14
Rate for Payer: Humana Medicare Advantage	$4.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.38
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	$3.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.38
Rate for Payer: Wellcare Medicare Advantage	$4.38
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

CHOLANGIOLGRAPHY CANNULA UNIT

Facility

$1,003.00

Hospital Charge Code	270331592
Hospital Revenue Code	272
Min. Negotiated Rate	$150.45
Max. Negotiated Rate	$150.45
Rate for Payer: Qualcare PPO/HMO/WC	$150.45

CHOLANGIOLGRAPHY CANNULA UNIT

Facility

$1,003.00

Hospital Charge Code	270331592
Hospital Revenue Code	272
Min. Negotiated Rate	$28.49
Max. Negotiated Rate	$501.50
Rate for Payer: Aetna Commercial	$381.14
Rate for Payer: Aetna Medicare Advantage	$300.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.76
Rate for Payer: Cigna Commercial	$501.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.78
Rate for Payer: Oxford Commercial	$200.60
Rate for Payer: Qualcare PPO/HMO/WC	$150.45
Rate for Payer: UnitedHealthcare Commercial	$200.60
Rate for Payer: UnitedHealthcare Community & State	$31.69
Rate for Payer: Wellpoint Medicaid Managed Care	$28.49

CHOLECALCIFEROL 1,000 IU TAB

Facility

$4.00

Service Code	NDC 904582460
Hospital Charge Code	6063943190
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

CHOLECALCIFEROL 1,000 IU TAB

Facility

$4.00

Service Code	NDC 904582460
Hospital Charge Code	6063943190
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

CHOLECALCIFEROL 50MCG TAB

Facility

$26.47

Service Code	NDC 80681013200
Hospital Charge Code	606390394
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$13.23
Rate for Payer: Aetna Commercial	$10.06
Rate for Payer: Aetna Medicare Advantage	$7.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.75
Rate for Payer: Cigna Commercial	$13.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.88
Rate for Payer: Oxford Commercial	$5.29
Rate for Payer: Qualcare PPO/HMO/WC	$3.97
Rate for Payer: UnitedHealthcare Commercial	$5.29
Rate for Payer: UnitedHealthcare Community & State	$0.84
Rate for Payer: Wellpoint Medicaid Managed Care	$0.75

CHOLECALCIFEROL 50MCG TAB

Facility

$26.47

Service Code	NDC 80681013200
Hospital Charge Code	606390394
Hospital Revenue Code	250
Min. Negotiated Rate	$3.97
Max. Negotiated Rate	$3.97
Rate for Payer: Qualcare PPO/HMO/WC	$3.97

CHOLECYSTCTMY,W CHOLANGIGRPHY

Facility

$12,472.00

Service Code	HCPCS 47605
Hospital Charge Code	16000984
Hospital Revenue Code	360
Min. Negotiated Rate	$354.20
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$4,739.36
Rate for Payer: Aetna Medicare Advantage	$3,741.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,180.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,180.36
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	$3,180.36
Rate for Payer: Cigna Commercial	$6,236.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,242.72
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,870.80
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$394.12
Rate for Payer: Wellpoint Medicaid Managed Care	$354.20

CHOLECYSTCTMY,W CHOLANGIGRPHY

Facility

$12,472.00

Service Code	HCPCS 47605
Hospital Charge Code	16000984
Hospital Revenue Code	360
Min. Negotiated Rate	$1,870.80
Max. Negotiated Rate	$1,870.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,870.80

CHOLECYSTCTMY W EXP OF CMN DCT

Facility

$13,892.20

Service Code	HCPCS 47610
Hospital Charge Code	160000252
Hospital Revenue Code	360
Min. Negotiated Rate	$2,083.83
Max. Negotiated Rate	$2,083.83
Rate for Payer: Qualcare PPO/HMO/WC	$2,083.83

CHOLECYSTCTMY W EXP OF CMN DCT

Facility

$13,892.20

Service Code	HCPCS 47610
Hospital Charge Code	160000252
Hospital Revenue Code	360
Min. Negotiated Rate	$394.54
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$5,279.04
Rate for Payer: Aetna Medicare Advantage	$4,167.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,542.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,542.51
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	$3,542.51
Rate for Payer: Cigna Commercial	$6,946.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,611.97
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,083.83
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$438.99
Rate for Payer: Wellpoint Medicaid Managed Care	$394.54

CHOLECYSTECTOMY

Facility

$23,649.76

Service Code	APR-DRG 2633
Min. Negotiated Rate	$23,186.04
Max. Negotiated Rate	$23,649.76
Rate for Payer: UnitedHealthcare Community & State	$23,186.04
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$23,649.76
Rate for Payer: Wellpoint Medicaid Managed Care	$23,186.04

CHOLECYSTECTOMY

Facility

$44,249.22

Service Code	APR-DRG 2634
Min. Negotiated Rate	$43,381.59
Max. Negotiated Rate	$44,249.22
Rate for Payer: UnitedHealthcare Community & State	$43,381.59
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$44,249.22
Rate for Payer: Wellpoint Medicaid Managed Care	$43,381.59

CHOLECYSTECTOMY

Facility

$14,799.36

Service Code	APR-DRG 2631
Min. Negotiated Rate	$14,509.18
Max. Negotiated Rate	$14,799.36
Rate for Payer: UnitedHealthcare Community & State	$14,509.18
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$14,799.36
Rate for Payer: Wellpoint Medicaid Managed Care	$14,509.18

CHOLECYSTECTOMY

Facility

$18,692.35

Service Code	APR-DRG 2632
Min. Negotiated Rate	$18,325.83
Max. Negotiated Rate	$18,692.35
Rate for Payer: UnitedHealthcare Community & State	$18,325.83
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$18,692.35
Rate for Payer: Wellpoint Medicaid Managed Care	$18,325.83

CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC

Facility

$84,759.11

Service Code	MSDRG 415
Min. Negotiated Rate	$25,808.06
Max. Negotiated Rate	$84,759.11
Rate for Payer: Aetna Commercial	$62,224.90
Rate for Payer: Aetna Medicare Advantage	$84,759.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54,855.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54,855.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27,166.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54,855.90
Rate for Payer: Cigna Commercial	$46,072.94
Rate for Payer: Cigna Medicare Advantage	$27,166.38
Rate for Payer: Clover Medicare Advantage	$25,808.06
Rate for Payer: EmblemHealth Commercial	$81,499.14
Rate for Payer: Humana Medicare Advantage	$27,981.37
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27,166.38
Rate for Payer: Oxford Commercial	$36,415.25
Rate for Payer: UnitedHealthcare Commercial	$48,743.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$27,166.38
Rate for Payer: Wellcare Medicare Advantage	$27,166.38

CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC

Facility

$132,019.87

Service Code	MSDRG 414
Min. Negotiated Rate	$40,198.36
Max. Negotiated Rate	$132,019.87
Rate for Payer: Aetna Commercial	$95,884.56
Rate for Payer: Aetna Medicare Advantage	$132,019.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97,798.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97,798.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$42,314.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97,798.65
Rate for Payer: Cigna Commercial	$79,421.04
Rate for Payer: Cigna Medicare Advantage	$42,314.06
Rate for Payer: Clover Medicare Advantage	$40,198.36
Rate for Payer: EmblemHealth Commercial	$126,942.18
Rate for Payer: Humana Medicare Advantage	$43,583.48
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$42,314.06
Rate for Payer: Oxford Commercial	$62,773.01
Rate for Payer: UnitedHealthcare Commercial	$84,023.92
Rate for Payer: UnitedHealthcare Medicare Advantage	$42,314.06
Rate for Payer: Wellcare Medicare Advantage	$42,314.06

CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC

Facility

$62,536.16

Service Code	MSDRG 416
Min. Negotiated Rate	$19,041.46
Max. Negotiated Rate	$62,536.16
Rate for Payer: Aetna Commercial	$46,397.46
Rate for Payer: Aetna Medicare Advantage	$62,536.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37,124.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37,124.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,043.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37,124.70
Rate for Payer: Cigna Commercial	$30,392.05
Rate for Payer: Cigna Medicare Advantage	$20,043.64
Rate for Payer: Clover Medicare Advantage	$19,041.46
Rate for Payer: EmblemHealth Commercial	$60,130.92
Rate for Payer: Humana Medicare Advantage	$20,644.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20,043.64
Rate for Payer: Oxford Commercial	$24,021.35
Rate for Payer: UnitedHealthcare Commercial	$32,153.43
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,043.64
Rate for Payer: Wellcare Medicare Advantage	$20,043.64

CHOLECYSTECTOMY,OPEN

Facility

$11,857.60

Service Code	HCPCS 47600
Hospital Charge Code	16000983
Hospital Revenue Code	360
Min. Negotiated Rate	$336.76
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$4,505.89
Rate for Payer: Aetna Medicare Advantage	$3,557.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,023.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,023.69
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	$3,023.69
Rate for Payer: Cigna Commercial	$5,928.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,082.98
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,778.64
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$374.70
Rate for Payer: Wellpoint Medicaid Managed Care	$336.76

CHOLECYSTECTOMY,OPEN

Facility

$11,857.60

Service Code	HCPCS 47600
Hospital Charge Code	16000983
Hospital Revenue Code	360
Min. Negotiated Rate	$1,778.64
Max. Negotiated Rate	$1,778.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,778.64

CHOLECYSTECTOMY WITH C.D.E. WITH CC

Facility

$85,890.17

Service Code	MSDRG 412
Min. Negotiated Rate	$26,152.46
Max. Negotiated Rate	$85,890.17
Rate for Payer: Aetna Commercial	$63,030.47
Rate for Payer: Aetna Medicare Advantage	$85,890.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57,349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57,349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27,528.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57,349.35
Rate for Payer: Cigna Commercial	$46,871.03
Rate for Payer: Cigna Medicare Advantage	$27,528.90
Rate for Payer: Clover Medicare Advantage	$26,152.46
Rate for Payer: EmblemHealth Commercial	$82,586.70
Rate for Payer: Humana Medicare Advantage	$28,354.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27,528.90
Rate for Payer: Oxford Commercial	$37,046.05
Rate for Payer: UnitedHealthcare Commercial	$49,587.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$27,528.90
Rate for Payer: Wellcare Medicare Advantage	$27,528.90

CHOLECYSTECTOMY WITH C.D.E. WITH MCC

Facility

$123,827.65

Service Code	MSDRG 411
Min. Negotiated Rate	$37,703.93
Max. Negotiated Rate	$123,827.65
Rate for Payer: Aetna Commercial	$90,049.98
Rate for Payer: Aetna Medicare Advantage	$123,827.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84,223.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84,223.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$39,688.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84,223.20
Rate for Payer: Cigna Commercial	$73,640.47
Rate for Payer: Cigna Medicare Advantage	$39,688.35
Rate for Payer: Clover Medicare Advantage	$37,703.93
Rate for Payer: EmblemHealth Commercial	$119,065.05
Rate for Payer: Humana Medicare Advantage	$40,879.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$39,688.35
Rate for Payer: Oxford Commercial	$58,204.15
Rate for Payer: UnitedHealthcare Commercial	$77,908.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$39,688.35
Rate for Payer: Wellcare Medicare Advantage	$39,688.35

CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC

Facility

$71,925.73

Service Code	MSDRG 413
Min. Negotiated Rate	$21,900.46
Max. Negotiated Rate	$71,925.73
Rate for Payer: Aetna Commercial	$53,084.83
Rate for Payer: Aetna Medicare Advantage	$71,925.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41,834.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41,834.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23,053.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41,834.55
Rate for Payer: Cigna Commercial	$37,017.53
Rate for Payer: Cigna Medicare Advantage	$23,053.12
Rate for Payer: Clover Medicare Advantage	$21,900.46
Rate for Payer: EmblemHealth Commercial	$69,159.36
Rate for Payer: Humana Medicare Advantage	$23,744.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$23,053.12
Rate for Payer: Oxford Commercial	$29,258.01
Rate for Payer: UnitedHealthcare Commercial	$39,162.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$23,053.12
Rate for Payer: Wellcare Medicare Advantage	$23,053.12

CHOLESTEROL

Facility

$278.00

Service Code	HCPCS 82465
Hospital Charge Code	38472194
Hospital Revenue Code	301
Min. Negotiated Rate	$3.48
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$11.83
Rate for Payer: Aetna Medicare Advantage	$14.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.78
Rate for Payer: Cigna Commercial	$139.00
Rate for Payer: Cigna Medicare Advantage	$4.35
Rate for Payer: Clover Medicare Advantage	$4.13
Rate for Payer: EmblemHealth Commercial	$13.05
Rate for Payer: Humana Medicare Advantage	$4.48
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.28
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.70
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$3.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.35
Rate for Payer: Wellcare Medicare Advantage	$4.35
Rate for Payer: Wellpoint Medicaid Managed Care	$7.90

Know your out-of-pocket cost for care.

All Charges