Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CONIZATION OF CERVIX-LEEP

Facility

$24,422.22

Service Code	HCPCS 57522
Hospital Charge Code	160000217
Hospital Revenue Code	360
Min. Negotiated Rate	$693.59
Max. Negotiated Rate	$13,950.60
Rate for Payer: Aetna Commercial	$10,460.55
Rate for Payer: Aetna Medicare Advantage	$12,460.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,950.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,950.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,845.79
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	$13,950.60
Rate for Payer: Cigna Commercial	$7,708.87
Rate for Payer: Cigna Medicare Advantage	$3,845.79
Rate for Payer: Clover Medicare Advantage	$3,653.50
Rate for Payer: EmblemHealth Commercial	$11,537.37
Rate for Payer: Humana Medicare Advantage	$3,961.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,845.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,349.78
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,663.33
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$771.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,845.79
Rate for Payer: Wellcare Medicare Advantage	$3,845.79
Rate for Payer: Wellpoint Medicaid Managed Care	$693.59

CONJUGATED ESTROG INJ 25MG/5ML

Facility

$1,615.10

Service Code	HCPCS J1410
Hospital Charge Code	60628222
Hospital Revenue Code	636
Min. Negotiated Rate	$45.87
Max. Negotiated Rate	$1,420.96
Rate for Payer: Aetna Commercial	$1,065.48
Rate for Payer: Aetna Medicare Advantage	$1,269.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,420.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,420.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$391.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$415.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,420.96
Rate for Payer: Cigna Medicare Advantage	$391.72
Rate for Payer: Clover Medicare Advantage	$372.13
Rate for Payer: EmblemHealth Commercial	$1,175.16
Rate for Payer: Humana Medicare Advantage	$403.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$391.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.85
Rate for Payer: Qualcare PPO/HMO/WC	$242.26
Rate for Payer: UnitedHealthcare Community & State	$51.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$391.72
Rate for Payer: Wellcare Medicare Advantage	$391.72
Rate for Payer: Wellpoint Medicaid Managed Care	$45.87

CONJUGATED ESTROG INJ 25MG/5ML

Facility

$1,615.10

Service Code	HCPCS J1410
Hospital Charge Code	60628222
Hospital Revenue Code	636
Min. Negotiated Rate	$242.26
Max. Negotiated Rate	$390.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.85
Rate for Payer: Qualcare PPO/HMO/WC	$242.26

CONJUGATED ESTROG TAB 0.3MG

Facility

$8.24

Service Code	NDC 46110081
Hospital Charge Code	60628219
Hospital Revenue Code	250
Min. Negotiated Rate	$1.24
Max. Negotiated Rate	$1.24
Rate for Payer: Qualcare PPO/HMO/WC	$1.24

CONJUGATED ESTROG TAB 0.3MG

Facility

$8.24

Service Code	NDC 46110081
Hospital Charge Code	60628219
Hospital Revenue Code	250
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$4.12
Rate for Payer: Aetna Commercial	$3.13
Rate for Payer: Aetna Medicare Advantage	$2.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.10
Rate for Payer: Cigna Commercial	$4.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.14
Rate for Payer: Oxford Commercial	$1.65
Rate for Payer: Qualcare PPO/HMO/WC	$1.24
Rate for Payer: UnitedHealthcare Commercial	$1.65
Rate for Payer: UnitedHealthcare Community & State	$0.26
Rate for Payer: Wellpoint Medicaid Managed Care	$0.23

CONJUGATED ESTROG TAB 0.625MG

Facility

$7.10

Service Code	NDC 46110281
Hospital Charge Code	60628220
Hospital Revenue Code	250
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$1.06
Rate for Payer: Qualcare PPO/HMO/WC	$1.06

CONJUGATED ESTROG TAB 0.625MG

Facility

$7.10

Service Code	NDC 46110281
Hospital Charge Code	60628220
Hospital Revenue Code	250
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$3.55
Rate for Payer: Aetna Commercial	$2.70
Rate for Payer: Aetna Medicare Advantage	$2.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.81
Rate for Payer: Cigna Commercial	$3.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.85
Rate for Payer: Oxford Commercial	$1.42
Rate for Payer: Qualcare PPO/HMO/WC	$1.06
Rate for Payer: UnitedHealthcare Commercial	$1.42
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

CONJUGATED ESTROG TAB 1.25MG

Facility

$8.58

Service Code	NDC 52959022200
Hospital Charge Code	60628221
Hospital Revenue Code	250
Min. Negotiated Rate	$1.29
Max. Negotiated Rate	$1.29
Rate for Payer: Qualcare PPO/HMO/WC	$1.29

CONJUGATED ESTROG TAB 1.25MG

Facility

$8.58

Service Code	NDC 52959022200
Hospital Charge Code	60628221
Hospital Revenue Code	250
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$4.29
Rate for Payer: Aetna Commercial	$3.26
Rate for Payer: Aetna Medicare Advantage	$2.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.19
Rate for Payer: Cigna Commercial	$4.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.23
Rate for Payer: Oxford Commercial	$1.72
Rate for Payer: Qualcare PPO/HMO/WC	$1.29
Rate for Payer: UnitedHealthcare Commercial	$1.72
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

CONJUGATED ESTROG VAG CRM

Facility

$2,742.65

Service Code	NDC 46087221
Hospital Charge Code	60628214
Hospital Revenue Code	250
Min. Negotiated Rate	$411.40
Max. Negotiated Rate	$411.40
Rate for Payer: Qualcare PPO/HMO/WC	$411.40

CONJUGATED ESTROG VAG CRM

Facility

$2,742.65

Service Code	NDC 46087221
Hospital Charge Code	60628214
Hospital Revenue Code	250
Min. Negotiated Rate	$77.89
Max. Negotiated Rate	$1,371.33
Rate for Payer: Aetna Commercial	$1,042.21
Rate for Payer: Aetna Medicare Advantage	$822.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$699.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$699.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$699.38
Rate for Payer: Cigna Commercial	$1,371.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$713.09
Rate for Payer: Oxford Commercial	$548.53
Rate for Payer: Qualcare PPO/HMO/WC	$411.40
Rate for Payer: UnitedHealthcare Commercial	$548.53
Rate for Payer: UnitedHealthcare Community & State	$86.67
Rate for Payer: Wellpoint Medicaid Managed Care	$77.89

CONNECTING NUT M8 SHORT

Facility

$120.00

Hospital Charge Code	270674287
Hospital Revenue Code	272
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

CONNECTING NUT M8 SHORT

Facility

$120.00

Hospital Charge Code	270674287
Hospital Revenue Code	272
Min. Negotiated Rate	$3.41
Max. Negotiated Rate	$60.00
Rate for Payer: Aetna Commercial	$45.60
Rate for Payer: Aetna Medicare Advantage	$36.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.60
Rate for Payer: Cigna Commercial	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.20
Rate for Payer: Oxford Commercial	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00
Rate for Payer: UnitedHealthcare Commercial	$24.00
Rate for Payer: UnitedHealthcare Community & State	$3.79
Rate for Payer: Wellpoint Medicaid Managed Care	$3.41

CONNECTING SCREW

Facility

$520.00

Service Code	HCPCS C1713
Hospital Charge Code	270686084
Hospital Revenue Code	278
Min. Negotiated Rate	$14.77
Max. Negotiated Rate	$260.00
Rate for Payer: Aetna Commercial	$197.60
Rate for Payer: Aetna Medicare Advantage	$156.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.60
Rate for Payer: Cigna Commercial	$260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.84
Rate for Payer: Qualcare PPO/HMO/WC	$78.00
Rate for Payer: UnitedHealthcare Community & State	$16.43
Rate for Payer: Wellpoint Medicaid Managed Care	$14.77

CONNECTING SCREW

Facility

$520.00

Service Code	HCPCS C1713
Hospital Charge Code	270686084
Hospital Revenue Code	278
Min. Negotiated Rate	$78.00
Max. Negotiated Rate	$125.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.84
Rate for Payer: Qualcare PPO/HMO/WC	$78.00

CONNECTION ROD LONG

Facility

$51.75

Service Code	HCPCS C1713
Hospital Charge Code	270678087
Hospital Revenue Code	278
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$25.88
Rate for Payer: Aetna Commercial	$19.66
Rate for Payer: Aetna Medicare Advantage	$15.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.20
Rate for Payer: Cigna Commercial	$25.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.52
Rate for Payer: Qualcare PPO/HMO/WC	$7.76
Rate for Payer: UnitedHealthcare Community & State	$1.64
Rate for Payer: Wellpoint Medicaid Managed Care	$1.47

CONNECTION ROD LONG

Facility

$51.75

Service Code	HCPCS C1713
Hospital Charge Code	270678087
Hospital Revenue Code	278
Min. Negotiated Rate	$7.76
Max. Negotiated Rate	$12.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.52
Rate for Payer: Qualcare PPO/HMO/WC	$7.76

CONNECTIVE TISSUE DISORDERS

Facility

$8,436.11

Service Code	APR-DRG 3461
Min. Negotiated Rate	$8,270.70
Max. Negotiated Rate	$8,436.11
Rate for Payer: UnitedHealthcare Community & State	$8,270.70
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,436.11
Rate for Payer: Wellpoint Medicaid Managed Care	$8,270.70

CONNECTIVE TISSUE DISORDERS

Facility

$35,564.58

Service Code	APR-DRG 3464
Min. Negotiated Rate	$34,867.24
Max. Negotiated Rate	$35,564.58
Rate for Payer: UnitedHealthcare Community & State	$34,867.24
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$35,564.58
Rate for Payer: Wellpoint Medicaid Managed Care	$34,867.24

CONNECTIVE TISSUE DISORDERS

Facility

$17,192.46

Service Code	APR-DRG 3463
Min. Negotiated Rate	$16,855.35
Max. Negotiated Rate	$17,192.46
Rate for Payer: UnitedHealthcare Community & State	$16,855.35
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,192.46
Rate for Payer: Wellpoint Medicaid Managed Care	$16,855.35

CONNECTIVE TISSUE DISORDERS

Facility

$11,351.59

Service Code	APR-DRG 3462
Min. Negotiated Rate	$11,129.01
Max. Negotiated Rate	$11,351.59
Rate for Payer: UnitedHealthcare Community & State	$11,129.01
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,351.59
Rate for Payer: Wellpoint Medicaid Managed Care	$11,129.01

CONNECTIVE TISSUE DISORDERS WITH CC

Facility

$55,904.69

Service Code	MSDRG 546
Min. Negotiated Rate	$17,022.26
Max. Negotiated Rate	$55,904.69
Rate for Payer: Aetna Commercial	$41,674.47
Rate for Payer: Aetna Medicare Advantage	$55,904.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33,246.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33,246.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17,918.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33,246.00
Rate for Payer: Cigna Commercial	$25,712.75
Rate for Payer: Cigna Medicare Advantage	$17,918.17
Rate for Payer: Clover Medicare Advantage	$17,022.26
Rate for Payer: EmblemHealth Commercial	$53,754.51
Rate for Payer: Humana Medicare Advantage	$18,455.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17,918.17
Rate for Payer: Oxford Commercial	$20,322.91
Rate for Payer: UnitedHealthcare Commercial	$27,202.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$17,918.17
Rate for Payer: Wellcare Medicare Advantage	$17,918.17

CONNECTIVE TISSUE DISORDERS WITH MCC

Facility

$97,870.44

Service Code	MSDRG 545
Min. Negotiated Rate	$29,800.29
Max. Negotiated Rate	$97,870.44
Rate for Payer: Aetna Commercial	$71,562.93
Rate for Payer: Aetna Medicare Advantage	$97,870.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68,985.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68,985.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$31,368.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68,985.45
Rate for Payer: Cigna Commercial	$55,324.54
Rate for Payer: Cigna Medicare Advantage	$31,368.73
Rate for Payer: Clover Medicare Advantage	$29,800.29
Rate for Payer: EmblemHealth Commercial	$94,106.19
Rate for Payer: Humana Medicare Advantage	$32,309.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$31,368.73
Rate for Payer: Oxford Commercial	$43,727.55
Rate for Payer: UnitedHealthcare Commercial	$58,530.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$31,368.73
Rate for Payer: Wellcare Medicare Advantage	$31,368.73

CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC

Facility

$45,883.16

Service Code	MSDRG 547
Min. Negotiated Rate	$13,970.83
Max. Negotiated Rate	$45,883.16
Rate for Payer: Aetna Commercial	$34,537.00
Rate for Payer: Aetna Medicare Advantage	$45,883.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,718.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,718.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14,706.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,718.10
Rate for Payer: Cigna Commercial	$18,641.41
Rate for Payer: Cigna Medicare Advantage	$14,706.14
Rate for Payer: Clover Medicare Advantage	$13,970.83
Rate for Payer: EmblemHealth Commercial	$44,118.42
Rate for Payer: Humana Medicare Advantage	$15,147.32
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14,706.14
Rate for Payer: Oxford Commercial	$14,733.84
Rate for Payer: UnitedHealthcare Commercial	$19,721.78
Rate for Payer: UnitedHealthcare Medicare Advantage	$14,706.14
Rate for Payer: Wellcare Medicare Advantage	$14,706.14

CONNECTOR 25 MM LATERNAL

Facility

$4,285.00

Service Code	HCPCS C1713
Hospital Charge Code	270685953
Hospital Revenue Code	278
Min. Negotiated Rate	$642.75
Max. Negotiated Rate	$1,036.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$857.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,036.97
Rate for Payer: Qualcare PPO/HMO/WC	$642.75

Know your out-of-pocket cost for care.

All Charges