Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

COVER TRANSDUC INTRAOP 610367

Facility

$29.58

Hospital Charge Code	270626733
Hospital Revenue Code	272
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$14.79
Rate for Payer: Aetna Commercial	$11.24
Rate for Payer: Aetna Medicare Advantage	$8.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.54
Rate for Payer: Cigna Commercial	$14.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.69
Rate for Payer: Oxford Commercial	$5.92
Rate for Payer: Qualcare PPO/HMO/WC	$4.44
Rate for Payer: UnitedHealthcare Commercial	$5.92
Rate for Payer: UnitedHealthcare Community & State	$0.93
Rate for Payer: Wellpoint Medicaid Managed Care	$0.84

COVER TRANSDUC INTRAOP 610367

Facility

$29.58

Hospital Charge Code	270626733
Hospital Revenue Code	272
Min. Negotiated Rate	$4.44
Max. Negotiated Rate	$4.44
Rate for Payer: Qualcare PPO/HMO/WC	$4.44

COVER VERTEB BODY LOCKING 6MM

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270694366
Hospital Revenue Code	278
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

COVER VERTEB BODY LOCKING 6MM

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270694366
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

COVID19 AMPLIFIED PROBE TECHNI

Facility

$387.00

Service Code	HCPCS 87635
Hospital Charge Code	401387635
Hospital Revenue Code	306
Min. Negotiated Rate	$10.99
Max. Negotiated Rate	$193.50
Rate for Payer: Aetna Commercial	$139.56
Rate for Payer: Aetna Medicare Advantage	$166.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$186.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$186.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$51.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$186.13
Rate for Payer: Cigna Commercial	$193.50
Rate for Payer: Cigna Medicare Advantage	$51.31
Rate for Payer: Clover Medicare Advantage	$48.74
Rate for Payer: EmblemHealth Commercial	$153.93
Rate for Payer: Humana Medicare Advantage	$52.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$51.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.62
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.05
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$41.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$51.31
Rate for Payer: Wellcare Medicare Advantage	$51.31
Rate for Payer: Wellpoint Medicaid Managed Care	$10.99

COVID19 AMPLIFIED PROBE TECHNI

Facility

$387.00

Service Code	HCPCS 87635
Hospital Charge Code	401387635
Hospital Revenue Code	306
Min. Negotiated Rate	$58.05
Max. Negotiated Rate	$58.05
Rate for Payer: Qualcare PPO/HMO/WC	$58.05

COVID19 QL REAL TIME RT-PCR

Facility

$387.00

Service Code	HCPCS 87635
Hospital Charge Code	401387635A
Hospital Revenue Code	306
Min. Negotiated Rate	$10.99
Max. Negotiated Rate	$193.50
Rate for Payer: Aetna Commercial	$139.56
Rate for Payer: Aetna Medicare Advantage	$166.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$186.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$186.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$51.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$186.13
Rate for Payer: Cigna Commercial	$193.50
Rate for Payer: Cigna Medicare Advantage	$51.31
Rate for Payer: Clover Medicare Advantage	$48.74
Rate for Payer: EmblemHealth Commercial	$153.93
Rate for Payer: Humana Medicare Advantage	$52.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$51.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.62
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.05
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$41.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$51.31
Rate for Payer: Wellcare Medicare Advantage	$51.31
Rate for Payer: Wellpoint Medicaid Managed Care	$10.99

COVID19 QL REAL TIME RT-PCR

Facility

$387.00

Service Code	HCPCS 87635
Hospital Charge Code	401387635A
Hospital Revenue Code	306
Min. Negotiated Rate	$58.05
Max. Negotiated Rate	$58.05
Rate for Payer: Qualcare PPO/HMO/WC	$58.05

COXSACKIE A AB (2,4,7,9,1 I

Facility

$390.00

Service Code	HCPCS 8665891
Hospital Charge Code	39990039A
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

COXSACKIE A AB (2,4,7,9,1 I

Facility

$390.00

Service Code	HCPCS 8665891
Hospital Charge Code	39990039A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

COXSACKIE A AB (2,4,7,9,1 II

Facility

$390.00

Service Code	HCPCS 8665891
Hospital Charge Code	39990039B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

COXSACKIE A AB (2,4,7,9,1 II

Facility

$390.00

Service Code	HCPCS 8665891
Hospital Charge Code	39990039B
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

COXSACKIE A AB (2,4,7,9,1 III

Facility

$390.00

Service Code	HCPCS 8665891
Hospital Charge Code	39990039C
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

COXSACKIE A AB (2,4,7,9,1 III

Facility

$390.00

Service Code	HCPCS 8665891
Hospital Charge Code	39990039C
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

COXSACKIE A AB (2,4,7,9,1 IV

Facility

$390.00

Service Code	HCPCS 8665891
Hospital Charge Code	39990039D
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

COXSACKIE A AB (2,4,7,9,1 IV

Facility

$390.00

Service Code	HCPCS 8665891
Hospital Charge Code	39990039D
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

COXSACKIE A AB (2,4,7,9,1 V

Facility

$390.00

Service Code	HCPCS 8665891
Hospital Charge Code	39990039E
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

COXSACKIE A AB (2,4,7,9,1 V

Facility

$390.00

Service Code	HCPCS 8665891
Hospital Charge Code	39990039E
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

COXSACKIE A AB (2,4,7,9,1 VI

Facility

$390.00

Service Code	HCPCS 8665891
Hospital Charge Code	39990039F
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

COXSACKIE A AB (2,4,7,9,1 VI

Facility

$390.00

Service Code	HCPCS 8665891
Hospital Charge Code	39990039F
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

COXSACKIE B1-B6 AB I

Facility

$390.00

Service Code	HCPCS 8665891
Hospital Charge Code	39990040A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

COXSACKIE B1-B6 AB I

Facility

$390.00

Service Code	HCPCS 8665891
Hospital Charge Code	39990040A
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

COXSACKIE B1-B6 AB II

Facility

$390.00

Service Code	HCPCS 8665891
Hospital Charge Code	39990040B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

COXSACKIE B1-B6 AB II

Facility

$390.00

Service Code	HCPCS 8665891
Hospital Charge Code	39990040B
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

COXSACKIE B1-B6 AB III

Facility

$390.00

Service Code	HCPCS 8665891
Hospital Charge Code	39990040C
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Know your out-of-pocket cost for care.

All Charges