Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

COIL TARGET TETRA 3.5MMX8CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270699418S
Hospital Revenue Code	278
Min. Negotiated Rate	$298.65
Max. Negotiated Rate	$5,258.00
Rate for Payer: Aetna Commercial	$3,996.08
Rate for Payer: Aetna Medicare Advantage	$3,154.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,681.58
Rate for Payer: Cigna Commercial	$5,258.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40
Rate for Payer: UnitedHealthcare Community & State	$332.31
Rate for Payer: Wellpoint Medicaid Managed Care	$298.65

COIL TARGET TETRA 3.5MMX8CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270699418S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.40
Max. Negotiated Rate	$2,544.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40

COIL TARG XL 360 SOFT 10X40CM

Facility

$15,205.50

Service Code	HCPCS C1889
Hospital Charge Code	270698372S
Hospital Revenue Code	278
Min. Negotiated Rate	$431.84
Max. Negotiated Rate	$7,602.75
Rate for Payer: Aetna Commercial	$5,778.09
Rate for Payer: Aetna Medicare Advantage	$4,561.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,877.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,877.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,041.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,877.40
Rate for Payer: Cigna Commercial	$7,602.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,679.73
Rate for Payer: Qualcare PPO/HMO/WC	$2,280.82
Rate for Payer: UnitedHealthcare Community & State	$480.49
Rate for Payer: Wellpoint Medicaid Managed Care	$431.84

COIL TARG XL 360 SOFT 10X40CM

Facility

$15,205.50

Service Code	HCPCS C1889
Hospital Charge Code	270698372S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,280.82
Max. Negotiated Rate	$3,679.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,041.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,679.73
Rate for Payer: Qualcare PPO/HMO/WC	$2,280.82

COIL TARG XL 360 SOFT 12X45CM

Facility

$15,205.50

Service Code	HCPCS C1889
Hospital Charge Code	270698373S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,280.82
Max. Negotiated Rate	$3,679.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,041.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,679.73
Rate for Payer: Qualcare PPO/HMO/WC	$2,280.82

COIL TARG XL 360 SOFT 12X45CM

Facility

$15,205.50

Service Code	HCPCS C1889
Hospital Charge Code	270698373S
Hospital Revenue Code	278
Min. Negotiated Rate	$431.84
Max. Negotiated Rate	$7,602.75
Rate for Payer: Aetna Commercial	$5,778.09
Rate for Payer: Aetna Medicare Advantage	$4,561.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,877.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,877.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,041.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,877.40
Rate for Payer: Cigna Commercial	$7,602.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,679.73
Rate for Payer: Qualcare PPO/HMO/WC	$2,280.82
Rate for Payer: UnitedHealthcare Community & State	$480.49
Rate for Payer: Wellpoint Medicaid Managed Care	$431.84

COIL TARG XL 360 SOFT 9X30CM

Facility

$15,205.50

Service Code	HCPCS C1889
Hospital Charge Code	270698374S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,280.82
Max. Negotiated Rate	$3,679.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,041.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,679.73
Rate for Payer: Qualcare PPO/HMO/WC	$2,280.82

COIL TARG XL 360 SOFT 9X30CM

Facility

$15,205.50

Service Code	HCPCS C1889
Hospital Charge Code	270698374S
Hospital Revenue Code	278
Min. Negotiated Rate	$431.84
Max. Negotiated Rate	$7,602.75
Rate for Payer: Aetna Commercial	$5,778.09
Rate for Payer: Aetna Medicare Advantage	$4,561.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,877.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,877.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,041.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,877.40
Rate for Payer: Cigna Commercial	$7,602.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,679.73
Rate for Payer: Qualcare PPO/HMO/WC	$2,280.82
Rate for Payer: UnitedHealthcare Community & State	$480.49
Rate for Payer: Wellpoint Medicaid Managed Care	$431.84

COIL ULTRASOUND ENHANCE17X10CM

Facility

$360.00

Service Code	HCPCS A4648
Hospital Charge Code	270654054
Hospital Revenue Code	278
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$87.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.12
Rate for Payer: Qualcare PPO/HMO/WC	$54.00

COIL ULTRASOUND ENHANCE17X10CM

Facility

$360.00

Service Code	HCPCS A4648
Hospital Charge Code	270654054
Hospital Revenue Code	278
Min. Negotiated Rate	$10.22
Max. Negotiated Rate	$180.00
Rate for Payer: Aetna Commercial	$136.80
Rate for Payer: Aetna Medicare Advantage	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.80
Rate for Payer: Cigna Commercial	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.12
Rate for Payer: Qualcare PPO/HMO/WC	$54.00
Rate for Payer: UnitedHealthcare Community & State	$11.38
Rate for Payer: Wellpoint Medicaid Managed Care	$10.22

COLAPINTO RING TIPS SET

Facility

$469.70

Hospital Charge Code	270658308
Hospital Revenue Code	272
Min. Negotiated Rate	$70.45
Max. Negotiated Rate	$70.45
Rate for Payer: Qualcare PPO/HMO/WC	$70.45

COLAPINTO RING TIPS SET

Facility

$469.70

Hospital Charge Code	270658308
Hospital Revenue Code	272
Min. Negotiated Rate	$13.34
Max. Negotiated Rate	$234.85
Rate for Payer: Aetna Commercial	$178.49
Rate for Payer: Aetna Medicare Advantage	$140.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.77
Rate for Payer: Cigna Commercial	$234.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.12
Rate for Payer: Oxford Commercial	$93.94
Rate for Payer: Qualcare PPO/HMO/WC	$70.45
Rate for Payer: UnitedHealthcare Commercial	$93.94
Rate for Payer: UnitedHealthcare Community & State	$14.84
Rate for Payer: Wellpoint Medicaid Managed Care	$13.34

COLAPINTO RING TIPS SET

Facility

$469.70

Hospital Charge Code	270658308O
Hospital Revenue Code	272
Min. Negotiated Rate	$13.34
Max. Negotiated Rate	$234.85
Rate for Payer: Aetna Commercial	$178.49
Rate for Payer: Aetna Medicare Advantage	$140.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.77
Rate for Payer: Cigna Commercial	$234.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.12
Rate for Payer: Oxford Commercial	$93.94
Rate for Payer: Qualcare PPO/HMO/WC	$70.45
Rate for Payer: UnitedHealthcare Commercial	$93.94
Rate for Payer: UnitedHealthcare Community & State	$14.84
Rate for Payer: Wellpoint Medicaid Managed Care	$13.34

COLAPINTO RING TIPS SET

Facility

$469.70

Hospital Charge Code	270658308O
Hospital Revenue Code	272
Min. Negotiated Rate	$70.45
Max. Negotiated Rate	$70.45
Rate for Payer: Qualcare PPO/HMO/WC	$70.45

COLCHICINE 0.6 MG TAB

Facility

$50.25

Service Code	NDC 66993016502
Hospital Charge Code	60628521
Hospital Revenue Code	250
Min. Negotiated Rate	$7.54
Max. Negotiated Rate	$7.54
Rate for Payer: Qualcare PPO/HMO/WC	$7.54

COLCHICINE 0.6 MG TAB

Facility

$50.25

Service Code	NDC 66993016502
Hospital Charge Code	60628521
Hospital Revenue Code	250
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$25.12
Rate for Payer: Aetna Commercial	$19.09
Rate for Payer: Aetna Medicare Advantage	$15.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.81
Rate for Payer: Cigna Commercial	$25.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.06
Rate for Payer: Oxford Commercial	$10.05
Rate for Payer: Qualcare PPO/HMO/WC	$7.54
Rate for Payer: UnitedHealthcare Commercial	$10.05
Rate for Payer: UnitedHealthcare Community & State	$1.59
Rate for Payer: Wellpoint Medicaid Managed Care	$1.43

COL CHROMOTOGRAPHY QUAL/QUANT

Facility

$120.45

Service Code	HCPCS 82542
Hospital Charge Code	401382725C
Hospital Revenue Code	306
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$18.07
Rate for Payer: Qualcare PPO/HMO/WC	$18.07

COL CHROMOTOGRAPHY QUAL/QUANT

Facility

$120.45

Service Code	HCPCS 82542
Hospital Charge Code	401382725C
Hospital Revenue Code	306
Min. Negotiated Rate	$3.42
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$65.52
Rate for Payer: Aetna Medicare Advantage	$78.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.39
Rate for Payer: Cigna Commercial	$60.23
Rate for Payer: Cigna Medicare Advantage	$24.09
Rate for Payer: Clover Medicare Advantage	$22.89
Rate for Payer: EmblemHealth Commercial	$72.27
Rate for Payer: Humana Medicare Advantage	$24.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.32
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.07
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$19.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.09
Rate for Payer: Wellcare Medicare Advantage	$24.09
Rate for Payer: Wellpoint Medicaid Managed Care	$3.42

COLD AGGLUTINATION

Facility

$102.00

Service Code	HCPCS 86157
Hospital Charge Code	38476012
Hospital Revenue Code	302
Min. Negotiated Rate	$15.30
Max. Negotiated Rate	$15.30
Rate for Payer: Qualcare PPO/HMO/WC	$15.30

COLD AGGLUTINATION

Facility

$102.00

Service Code	HCPCS 86157
Hospital Charge Code	38476012
Hospital Revenue Code	302
Min. Negotiated Rate	$2.90
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$21.92
Rate for Payer: Aetna Medicare Advantage	$26.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.24
Rate for Payer: Cigna Commercial	$51.00
Rate for Payer: Cigna Medicare Advantage	$8.06
Rate for Payer: Clover Medicare Advantage	$7.66
Rate for Payer: EmblemHealth Commercial	$24.18
Rate for Payer: Humana Medicare Advantage	$8.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.52
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.30
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$6.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.06
Rate for Payer: Wellcare Medicare Advantage	$8.06
Rate for Payer: Wellpoint Medicaid Managed Care	$2.90

COLD AGGLUTININ SCREEN

Facility

$34.00

Service Code	HCPCS 86156
Hospital Charge Code	38476256
Hospital Revenue Code	312
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$5.10
Rate for Payer: Qualcare PPO/HMO/WC	$5.10

COLD AGGLUTININ SCREEN

Facility

$34.00

Service Code	HCPCS 86156
Hospital Charge Code	38476256
Hospital Revenue Code	312
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$21.95
Rate for Payer: Aetna Medicare Advantage	$26.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.27
Rate for Payer: Cigna Commercial	$17.00
Rate for Payer: Cigna Medicare Advantage	$8.07
Rate for Payer: Clover Medicare Advantage	$7.67
Rate for Payer: EmblemHealth Commercial	$24.21
Rate for Payer: Humana Medicare Advantage	$8.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.84
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.10
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$6.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.07
Rate for Payer: Wellcare Medicare Advantage	$8.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.97

COLD AGGLUTININ SCREEN

Facility

$390.00

Service Code	HCPCS 86156
Hospital Charge Code	3100183
Hospital Revenue Code	300
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$21.95
Rate for Payer: Aetna Medicare Advantage	$26.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.07
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	$29.27
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$8.07
Rate for Payer: Clover Medicare Advantage	$7.67
Rate for Payer: EmblemHealth Commercial	$24.21
Rate for Payer: Humana Medicare Advantage	$8.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.07
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	$6.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.07
Rate for Payer: Wellcare Medicare Advantage	$8.07
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

COLD AGGLUTININ SCREEN

Facility

$390.00

Service Code	HCPCS 86156
Hospital Charge Code	3100183
Hospital Revenue Code	300
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

COLD AGGLUTININ TITER

Facility

$390.00

Service Code	HCPCS 86157
Hospital Charge Code	3000841
Hospital Revenue Code	302
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$21.92
Rate for Payer: Aetna Medicare Advantage	$26.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.24
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$8.06
Rate for Payer: Clover Medicare Advantage	$7.66
Rate for Payer: EmblemHealth Commercial	$24.18
Rate for Payer: Humana Medicare Advantage	$8.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.06
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	$6.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.06
Rate for Payer: Wellcare Medicare Advantage	$8.06
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

Know your out-of-pocket cost for care.

All Charges