Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CONSTRUCT BOWEL BLADDER

Facility

$27,828.20

Service Code	HCPCS 27828.2
Hospital Charge Code	1600000524
Hospital Revenue Code	360
Min. Negotiated Rate	$4,174.23
Max. Negotiated Rate	$4,174.23
Rate for Payer: Qualcare PPO/HMO/WC	$4,174.23

CONSTRUCT BOWEL BLADDER

Facility

$27,828.20

Service Code	HCPCS 27828.2
Hospital Charge Code	1600000524
Hospital Revenue Code	360
Min. Negotiated Rate	$790.32
Max. Negotiated Rate	$13,914.10
Rate for Payer: Aetna Commercial	$10,574.72
Rate for Payer: Aetna Medicare Advantage	$8,348.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,096.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,096.19
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	$7,096.19
Rate for Payer: Cigna Commercial	$13,914.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,235.33
Rate for Payer: Qualcare PPO/HMO/WC	$4,174.23
Rate for Payer: UnitedHealthcare Community & State	$879.37
Rate for Payer: Wellpoint Medicaid Managed Care	$790.32

CONSULTATION COMPREHENSIVE

Facility

$335.00

Service Code	HCPCS 88325
Hospital Charge Code	38477205
Hospital Revenue Code	312
Min. Negotiated Rate	$9.51
Max. Negotiated Rate	$734.21
Rate for Payer: Aetna Commercial	$550.53
Rate for Payer: Aetna Medicare Advantage	$655.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$734.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$734.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$202.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$734.21
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$202.40
Rate for Payer: Clover Medicare Advantage	$192.28
Rate for Payer: EmblemHealth Commercial	$607.20
Rate for Payer: Humana Medicare Advantage	$208.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$202.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.10
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.25
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$122.78
Rate for Payer: UnitedHealthcare Medicare Advantage	$202.40
Rate for Payer: Wellcare Medicare Advantage	$202.40
Rate for Payer: Wellpoint Medicaid Managed Care	$9.51

CONSULTATION COMPREHENSIVE

Facility

$335.00

Service Code	HCPCS 88325
Hospital Charge Code	38477205
Hospital Revenue Code	312
Min. Negotiated Rate	$50.25
Max. Negotiated Rate	$50.25
Rate for Payer: Qualcare PPO/HMO/WC	$50.25

CONSULTATION EXAPANDED 30 MIN

Facility

$405.00

Service Code	HCPCS 99242
Hospital Charge Code	75190240
Hospital Revenue Code	510
Min. Negotiated Rate	$60.75
Max. Negotiated Rate	$60.75
Rate for Payer: Qualcare PPO/HMO/WC	$60.75

CONSULTATION EXAPANDED 30 MIN

Facility

$405.00

Service Code	HCPCS 99242
Hospital Charge Code	75190240
Hospital Revenue Code	510
Min. Negotiated Rate	$11.50
Max. Negotiated Rate	$202.50
Rate for Payer: Aetna Commercial	$153.90
Rate for Payer: Aetna Medicare Advantage	$121.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$103.28
Rate for Payer: Cigna Commercial	$202.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.30
Rate for Payer: Qualcare PPO/HMO/WC	$60.75
Rate for Payer: UnitedHealthcare Community & State	$12.80
Rate for Payer: Wellpoint Medicaid Managed Care	$11.50

CONSULTATION HIGH COMPLEXITY

Facility

$867.00

Service Code	HCPCS 99245
Hospital Charge Code	75190245
Hospital Revenue Code	510
Min. Negotiated Rate	$130.05
Max. Negotiated Rate	$130.05
Rate for Payer: Qualcare PPO/HMO/WC	$130.05

CONSULTATION HIGH COMPLEXITY

Facility

$867.00

Service Code	HCPCS 99245
Hospital Charge Code	75190245
Hospital Revenue Code	510
Min. Negotiated Rate	$24.62
Max. Negotiated Rate	$433.50
Rate for Payer: Aetna Commercial	$329.46
Rate for Payer: Aetna Medicare Advantage	$260.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$221.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$221.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$221.09
Rate for Payer: Cigna Commercial	$433.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.42
Rate for Payer: Qualcare PPO/HMO/WC	$130.05
Rate for Payer: UnitedHealthcare Community & State	$27.40
Rate for Payer: Wellpoint Medicaid Managed Care	$24.62

CONT INHL TMT W/AERO MED ACUTE

Facility

$278.20

Service Code	HCPCS 94644
Hospital Charge Code	93950210
Hospital Revenue Code	410
Min. Negotiated Rate	$41.73
Max. Negotiated Rate	$41.73
Rate for Payer: Qualcare PPO/HMO/WC	$41.73

CONT INHL TMT W/AERO MED ACUTE

Facility

$278.20

Service Code	HCPCS 94644
Hospital Charge Code	93950210
Hospital Revenue Code	410
Min. Negotiated Rate	$7.90
Max. Negotiated Rate	$1,440.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.36
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.33
Rate for Payer: Oxford Commercial	$1,367.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.73
Rate for Payer: UnitedHealthcare Commercial	$1,440.00
Rate for Payer: UnitedHealthcare Community & State	$8.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$7.90

CONTOUR STAPLER

Facility

$633.00

Hospital Charge Code	270337852
Hospital Revenue Code	272
Min. Negotiated Rate	$94.95
Max. Negotiated Rate	$94.95
Rate for Payer: Qualcare PPO/HMO/WC	$94.95

CONTOUR STAPLER

Facility

$633.00

Hospital Charge Code	270337852
Hospital Revenue Code	272
Min. Negotiated Rate	$17.98
Max. Negotiated Rate	$316.50
Rate for Payer: Aetna Commercial	$240.54
Rate for Payer: Aetna Medicare Advantage	$189.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.41
Rate for Payer: Cigna Commercial	$316.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.58
Rate for Payer: Oxford Commercial	$126.60
Rate for Payer: Qualcare PPO/HMO/WC	$94.95
Rate for Payer: UnitedHealthcare Commercial	$126.60
Rate for Payer: UnitedHealthcare Community & State	$20.00
Rate for Payer: Wellpoint Medicaid Managed Care	$17.98

CONTOUR STAPLER RELOADS

Facility

$311.00

Hospital Charge Code	270337853
Hospital Revenue Code	272
Min. Negotiated Rate	$46.65
Max. Negotiated Rate	$46.65
Rate for Payer: Qualcare PPO/HMO/WC	$46.65

CONTOUR STAPLER RELOADS

Facility

$311.00

Hospital Charge Code	270337853
Hospital Revenue Code	272
Min. Negotiated Rate	$8.83
Max. Negotiated Rate	$155.50
Rate for Payer: Aetna Commercial	$118.18
Rate for Payer: Aetna Medicare Advantage	$93.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.31
Rate for Payer: Cigna Commercial	$155.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.86
Rate for Payer: Oxford Commercial	$62.20
Rate for Payer: Qualcare PPO/HMO/WC	$46.65
Rate for Payer: UnitedHealthcare Commercial	$62.20
Rate for Payer: UnitedHealthcare Community & State	$9.83
Rate for Payer: Wellpoint Medicaid Managed Care	$8.83

CONTOUR VL STENT

Facility

$1,034.70

Service Code	HCPCS C2617
Hospital Charge Code	270652854N
Hospital Revenue Code	278
Min. Negotiated Rate	$29.39
Max. Negotiated Rate	$517.35
Rate for Payer: Aetna Commercial	$393.19
Rate for Payer: Aetna Medicare Advantage	$310.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.85
Rate for Payer: Cigna Commercial	$517.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$250.40
Rate for Payer: Qualcare PPO/HMO/WC	$155.21
Rate for Payer: UnitedHealthcare Community & State	$32.70
Rate for Payer: Wellpoint Medicaid Managed Care	$29.39

CONTOUR VL STENT

Facility

$1,019.70

Service Code	HCPCS C2617
Hospital Charge Code	270652854S
Hospital Revenue Code	278
Min. Negotiated Rate	$28.96
Max. Negotiated Rate	$509.85
Rate for Payer: Aetna Commercial	$387.49
Rate for Payer: Aetna Medicare Advantage	$305.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.02
Rate for Payer: Cigna Commercial	$509.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.77
Rate for Payer: Qualcare PPO/HMO/WC	$152.96
Rate for Payer: UnitedHealthcare Community & State	$32.22
Rate for Payer: Wellpoint Medicaid Managed Care	$28.96

CONTOUR VL STENT

Facility

$1,019.70

Service Code	HCPCS C2617
Hospital Charge Code	270652854S
Hospital Revenue Code	278
Min. Negotiated Rate	$152.96
Max. Negotiated Rate	$246.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.77
Rate for Payer: Qualcare PPO/HMO/WC	$152.96

CONTOUR VL STENT

Facility

$1,019.70

Service Code	HCPCS C2617
Hospital Charge Code	270652854
Hospital Revenue Code	278
Min. Negotiated Rate	$152.96
Max. Negotiated Rate	$246.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.77
Rate for Payer: Qualcare PPO/HMO/WC	$152.96

CONTOUR VL STENT

Facility

$1,019.70

Service Code	HCPCS C2617
Hospital Charge Code	270652854
Hospital Revenue Code	278
Min. Negotiated Rate	$28.96
Max. Negotiated Rate	$509.85
Rate for Payer: Aetna Commercial	$387.49
Rate for Payer: Aetna Medicare Advantage	$305.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.02
Rate for Payer: Cigna Commercial	$509.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.77
Rate for Payer: Qualcare PPO/HMO/WC	$152.96
Rate for Payer: UnitedHealthcare Community & State	$32.22
Rate for Payer: Wellpoint Medicaid Managed Care	$28.96

CONTOUR VL STENT

Facility

$1,034.70

Service Code	HCPCS C2617
Hospital Charge Code	270652854N
Hospital Revenue Code	278
Min. Negotiated Rate	$155.21
Max. Negotiated Rate	$250.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$250.40
Rate for Payer: Qualcare PPO/HMO/WC	$155.21

CONTRA 2 UPN SELECTIV 5FR 65CM

Facility

$53.65

Hospital Charge Code	270663946
Hospital Revenue Code	272
Min. Negotiated Rate	$8.05
Max. Negotiated Rate	$8.05
Rate for Payer: Qualcare PPO/HMO/WC	$8.05

CONTRA 2 UPN SELECTIV 5FR 65CM

Facility

$53.65

Hospital Charge Code	270663946
Hospital Revenue Code	272
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$26.82
Rate for Payer: Aetna Commercial	$20.39
Rate for Payer: Aetna Medicare Advantage	$16.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.68
Rate for Payer: Cigna Commercial	$26.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.95
Rate for Payer: Oxford Commercial	$10.73
Rate for Payer: Qualcare PPO/HMO/WC	$8.05
Rate for Payer: UnitedHealthcare Commercial	$10.73
Rate for Payer: UnitedHealthcare Community & State	$1.70
Rate for Payer: Wellpoint Medicaid Managed Care	$1.52

CONTRAST BATH EA 15 MIN CQ

Facility

$106.00

Service Code	HCPCS 97034GP
Hospital Charge Code	409197034Q
Hospital Revenue Code	420
Min. Negotiated Rate	$15.90
Max. Negotiated Rate	$15.90
Rate for Payer: Qualcare PPO/HMO/WC	$15.90

CONTRAST BATH EA 15 MIN CQ

Facility

$106.00

Service Code	HCPCS 97034GP
Hospital Charge Code	409197034Q
Hospital Revenue Code	420
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$40.28
Rate for Payer: Aetna Medicare Advantage	$31.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.03
Rate for Payer: Cigna Commercial	$53.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.56
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.90
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$3.35
Rate for Payer: Wellpoint Medicaid Managed Care	$3.01

CONTRAST ECHO DEFINTY INJ UNIT

Facility

$559.10

Service Code	HCPCS Q9957
Hospital Charge Code	5300170
Hospital Revenue Code	636
Min. Negotiated Rate	$15.88
Max. Negotiated Rate	$279.55
Rate for Payer: Aetna Commercial	$212.46
Rate for Payer: Aetna Medicare Advantage	$167.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.57
Rate for Payer: Cigna Commercial	$279.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.30
Rate for Payer: Qualcare PPO/HMO/WC	$83.86
Rate for Payer: UnitedHealthcare Community & State	$17.67
Rate for Payer: Wellpoint Medicaid Managed Care	$15.88

Know your out-of-pocket cost for care.

All Charges