Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CONVERT NEPHROSTOMY CATH RT

Facility

$3,090.18

Service Code	HCPCS 50434RT
Hospital Charge Code	2011582
Hospital Revenue Code	361
Min. Negotiated Rate	$87.76
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,174.27
Rate for Payer: Aetna Medicare Advantage	$927.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$788.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$788.00
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	$788.00
Rate for Payer: Cigna Commercial	$1,545.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$803.45
Rate for Payer: Qualcare PPO/HMO/WC	$463.53
Rate for Payer: UnitedHealthcare Community & State	$97.65
Rate for Payer: Wellpoint Medicaid Managed Care	$87.76

CONVERT NEPHROSTOMY CATH RT

Facility

$3,090.18

Service Code	HCPCS 50434RT
Hospital Charge Code	2011582
Hospital Revenue Code	361
Min. Negotiated Rate	$463.53
Max. Negotiated Rate	$463.53
Rate for Payer: Qualcare PPO/HMO/WC	$463.53

CONVERTOR SPECIMEN

Facility

$9.78

Hospital Charge Code	270651486
Hospital Revenue Code	272
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$1.47
Rate for Payer: Qualcare PPO/HMO/WC	$1.47

CONVERTOR SPECIMEN

Facility

$9.78

Hospital Charge Code	270651486
Hospital Revenue Code	272
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$4.89
Rate for Payer: Aetna Commercial	$3.72
Rate for Payer: Aetna Medicare Advantage	$2.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.49
Rate for Payer: Cigna Commercial	$4.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.54
Rate for Payer: Oxford Commercial	$1.96
Rate for Payer: Qualcare PPO/HMO/WC	$1.47
Rate for Payer: UnitedHealthcare Commercial	$1.96
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.28

COOLCUT TORPEDO 4.2MM 19CM

Facility

$505.00

Hospital Charge Code	270679504
Hospital Revenue Code	272
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$75.75
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

COOLCUT TORPEDO 4.2MM 19CM

Facility

$505.00

Hospital Charge Code	270679504
Hospital Revenue Code	272
Min. Negotiated Rate	$14.34
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$191.90
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.75
Rate for Payer: UnitedHealthcare Commercial	$101.00
Rate for Payer: UnitedHealthcare Community & State	$15.96
Rate for Payer: Wellpoint Medicaid Managed Care	$14.34

COPE NEPHROUETERSTOMY 22 F

Facility

$687.45

Hospital Charge Code	270703091
Hospital Revenue Code	278
Min. Negotiated Rate	$103.12
Max. Negotiated Rate	$166.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.36
Rate for Payer: Qualcare PPO/HMO/WC	$103.12

COPE NEPHROUETERSTOMY 22 F

Facility

$687.45

Hospital Charge Code	270703091
Hospital Revenue Code	278
Min. Negotiated Rate	$19.52
Max. Negotiated Rate	$343.73
Rate for Payer: Aetna Commercial	$261.23
Rate for Payer: Aetna Medicare Advantage	$206.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$175.30
Rate for Payer: Cigna Commercial	$343.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.36
Rate for Payer: Qualcare PPO/HMO/WC	$103.12
Rate for Payer: UnitedHealthcare Community & State	$21.72
Rate for Payer: Wellpoint Medicaid Managed Care	$19.52

COPE NEPHTOUERTEROSTOMY 24 F

Facility

$687.45

Hospital Charge Code	270703092
Hospital Revenue Code	278
Min. Negotiated Rate	$19.52
Max. Negotiated Rate	$343.73
Rate for Payer: Aetna Commercial	$261.23
Rate for Payer: Aetna Medicare Advantage	$206.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$175.30
Rate for Payer: Cigna Commercial	$343.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.36
Rate for Payer: Qualcare PPO/HMO/WC	$103.12
Rate for Payer: UnitedHealthcare Community & State	$21.72
Rate for Payer: Wellpoint Medicaid Managed Care	$19.52

COPE NEPHTOUERTEROSTOMY 24 F

Facility

$687.45

Hospital Charge Code	270703092
Hospital Revenue Code	278
Min. Negotiated Rate	$103.12
Max. Negotiated Rate	$166.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.36
Rate for Payer: Qualcare PPO/HMO/WC	$103.12

COPEPTIN (SERUM)

Facility

$249.25

Service Code	HCPCS 86255
Hospital Charge Code	401186255Z
Hospital Revenue Code	302
Min. Negotiated Rate	$7.08
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
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	$43.71
Rate for Payer: Cigna Commercial	$124.62
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.81
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.39
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$7.08

COPEPTIN (SERUM)

Facility

$249.25

Service Code	HCPCS 86255
Hospital Charge Code	401186255Z
Hospital Revenue Code	302
Min. Negotiated Rate	$37.39
Max. Negotiated Rate	$37.39
Rate for Payer: Qualcare PPO/HMO/WC	$37.39

COPEPTIN SERUM

Facility

$249.25

Service Code	HCPCS 86255
Hospital Charge Code	401186255W
Hospital Revenue Code	302
Min. Negotiated Rate	$7.08
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
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	$43.71
Rate for Payer: Cigna Commercial	$124.62
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.81
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.39
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$7.08

COPEPTIN SERUM

Facility

$249.25

Service Code	HCPCS 86255
Hospital Charge Code	401186255W
Hospital Revenue Code	302
Min. Negotiated Rate	$37.39
Max. Negotiated Rate	$37.39
Rate for Payer: Qualcare PPO/HMO/WC	$37.39

COPPER

Facility

$146.00

Service Code	HCPCS 82525
Hospital Charge Code	38472218
Hospital Revenue Code	301
Min. Negotiated Rate	$4.15
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$33.76
Rate for Payer: Aetna Medicare Advantage	$40.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.41
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	$45.02
Rate for Payer: Cigna Commercial	$73.00
Rate for Payer: Cigna Medicare Advantage	$12.41
Rate for Payer: Clover Medicare Advantage	$11.79
Rate for Payer: EmblemHealth Commercial	$37.23
Rate for Payer: Humana Medicare Advantage	$12.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.96
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.90
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.41
Rate for Payer: Wellcare Medicare Advantage	$12.41
Rate for Payer: Wellpoint Medicaid Managed Care	$4.15

COPPER

Facility

$146.00

Service Code	HCPCS 82525
Hospital Charge Code	38472218
Hospital Revenue Code	301
Min. Negotiated Rate	$21.90
Max. Negotiated Rate	$21.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.90

COPPER,24 HOUR URINE

Facility

$390.00

Service Code	HCPCS 82525
Hospital Charge Code	3003663A
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

COPPER,24 HOUR URINE

Facility

$390.00

Service Code	HCPCS 82525
Hospital Charge Code	3003663A
Hospital Revenue Code	301
Min. Negotiated Rate	$9.93
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$33.76
Rate for Payer: Aetna Medicare Advantage	$40.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.41
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	$45.02
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.41
Rate for Payer: Clover Medicare Advantage	$11.79
Rate for Payer: EmblemHealth Commercial	$37.23
Rate for Payer: Humana Medicare Advantage	$12.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.41
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	$9.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.41
Rate for Payer: Wellcare Medicare Advantage	$12.41
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

COPPER,SERUM

Facility

$667.59

Service Code	HCPCS 82525
Hospital Charge Code	39900064
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

COPPER,SERUM

Facility

$667.59

Service Code	HCPCS 82525
Hospital Charge Code	39900064
Hospital Revenue Code	301
Min. Negotiated Rate	$9.93
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$33.76
Rate for Payer: Aetna Medicare Advantage	$40.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.41
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	$45.02
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$12.41
Rate for Payer: Clover Medicare Advantage	$11.79
Rate for Payer: EmblemHealth Commercial	$37.23
Rate for Payer: Humana Medicare Advantage	$12.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.41
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	$9.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.41
Rate for Payer: Wellcare Medicare Advantage	$12.41
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

COPPER, URINE

Facility

$85.30

Service Code	HCPCS 82525
Hospital Charge Code	39900063
Hospital Revenue Code	301
Min. Negotiated Rate	$12.79
Max. Negotiated Rate	$12.79
Rate for Payer: Qualcare PPO/HMO/WC	$12.79

COPPER, URINE

Facility

$85.30

Service Code	HCPCS 82525
Hospital Charge Code	39900063
Hospital Revenue Code	301
Min. Negotiated Rate	$2.42
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$33.76
Rate for Payer: Aetna Medicare Advantage	$40.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.41
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	$45.02
Rate for Payer: Cigna Commercial	$42.65
Rate for Payer: Cigna Medicare Advantage	$12.41
Rate for Payer: Clover Medicare Advantage	$11.79
Rate for Payer: EmblemHealth Commercial	$37.23
Rate for Payer: Humana Medicare Advantage	$12.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.18
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.79
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.41
Rate for Payer: Wellcare Medicare Advantage	$12.41
Rate for Payer: Wellpoint Medicaid Managed Care	$2.42

CORCORDE BUL LOR 9x11x23

Facility

$19,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270677191
Hospital Revenue Code	278
Min. Negotiated Rate	$2,887.50
Max. Negotiated Rate	$4,658.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.50

CORCORDE BUL LOR 9x11x23

Facility

$19,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270677191
Hospital Revenue Code	278
Min. Negotiated Rate	$546.70
Max. Negotiated Rate	$9,625.00
Rate for Payer: Aetna Commercial	$7,315.00
Rate for Payer: Aetna Medicare Advantage	$5,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,908.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,908.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,908.75
Rate for Payer: Cigna Commercial	$9,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.50
Rate for Payer: UnitedHealthcare Community & State	$608.30
Rate for Payer: Wellpoint Medicaid Managed Care	$546.70

CORD ACTIVE ELECTROSURGICAL

Facility

$468.20

Hospital Charge Code	270678684
Hospital Revenue Code	272
Min. Negotiated Rate	$13.30
Max. Negotiated Rate	$234.10
Rate for Payer: Aetna Commercial	$177.92
Rate for Payer: Aetna Medicare Advantage	$140.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.39
Rate for Payer: Cigna Commercial	$234.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.73
Rate for Payer: Oxford Commercial	$93.64
Rate for Payer: Qualcare PPO/HMO/WC	$70.23
Rate for Payer: UnitedHealthcare Commercial	$93.64
Rate for Payer: UnitedHealthcare Community & State	$14.80
Rate for Payer: Wellpoint Medicaid Managed Care	$13.30

Know your out-of-pocket cost for care.

All Charges