Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ACROMIOCLA JOINTS-BIL

Facility

$5,100.00

Service Code	HCPCS 73050
Hospital Charge Code	94061103
Hospital Revenue Code	320
Min. Negotiated Rate	$29.70
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$281.22
Rate for Payer: Aetna Medicare Advantage	$334.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$375.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$375.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$103.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$375.05
Rate for Payer: Cigna Commercial	$207.24
Rate for Payer: Cigna Medicare Advantage	$72.37
Rate for Payer: Clover Medicare Advantage	$98.22
Rate for Payer: EmblemHealth Commercial	$310.17
Rate for Payer: Humana Medicare Advantage	$106.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$103.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.00
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$161.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$103.39
Rate for Payer: Wellcare Medicare Advantage	$103.39
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$216.59
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

ACROMIOPL/ACROMIONECT,PRTL LT

Facility

$44,916.00

Service Code	HCPCS 23130
Hospital Charge Code	16000675
Hospital Revenue Code	360
Min. Negotiated Rate	$1,275.61
Max. Negotiated Rate	$14,100.89
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
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	$14,100.89
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,678.16
Rate for Payer: Oxford Commercial	$11,677.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,737.40
Rate for Payer: UnitedHealthcare Commercial	$12,906.00
Rate for Payer: UnitedHealthcare Community & State	$1,419.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$1,275.61

ACROMIOPL/ACROMIONECT,PRTL LT

Facility

$44,916.00

Service Code	HCPCS 23130
Hospital Charge Code	16000675
Hospital Revenue Code	360
Min. Negotiated Rate	$6,737.40
Max. Negotiated Rate	$6,737.40
Rate for Payer: Qualcare PPO/HMO/WC	$6,737.40

ACROMIOPLASTY ELECTRODE

Facility

$604.00

Hospital Charge Code	270330635
Hospital Revenue Code	272
Min. Negotiated Rate	$90.60
Max. Negotiated Rate	$90.60
Rate for Payer: Qualcare PPO/HMO/WC	$90.60

ACROMIOPLASTY ELECTRODE

Facility

$604.00

Hospital Charge Code	270330635
Hospital Revenue Code	272
Min. Negotiated Rate	$17.15
Max. Negotiated Rate	$302.00
Rate for Payer: Aetna Commercial	$229.52
Rate for Payer: Aetna Medicare Advantage	$181.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.02
Rate for Payer: Cigna Commercial	$302.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.04
Rate for Payer: Oxford Commercial	$120.80
Rate for Payer: Qualcare PPO/HMO/WC	$90.60
Rate for Payer: UnitedHealthcare Commercial	$120.80
Rate for Payer: UnitedHealthcare Community & State	$19.09
Rate for Payer: Wellpoint Medicaid Managed Care	$17.15

ACROSOFT LENS 18.5

Facility

$745.00

Hospital Charge Code	270666996
Hospital Revenue Code	276
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$180.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75

ACROSOFT LENS 18.5

Facility

$745.00

Hospital Charge Code	270666996
Hospital Revenue Code	276
Min. Negotiated Rate	$21.16
Max. Negotiated Rate	$372.50
Rate for Payer: Aetna Commercial	$283.10
Rate for Payer: Aetna Medicare Advantage	$223.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.97
Rate for Payer: Cigna Commercial	$372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75
Rate for Payer: UnitedHealthcare Community & State	$23.54
Rate for Payer: Wellpoint Medicaid Managed Care	$21.16

ACROSOFT LENS 24.0D

Facility

$745.00

Hospital Charge Code	270675781
Hospital Revenue Code	276
Min. Negotiated Rate	$21.16
Max. Negotiated Rate	$372.50
Rate for Payer: Aetna Commercial	$283.10
Rate for Payer: Aetna Medicare Advantage	$223.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.97
Rate for Payer: Cigna Commercial	$372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75
Rate for Payer: UnitedHealthcare Community & State	$23.54
Rate for Payer: Wellpoint Medicaid Managed Care	$21.16

ACROSOFT LENS 24.0D

Facility

$745.00

Hospital Charge Code	270675781
Hospital Revenue Code	276
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$180.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75

ACROSOFT LENS 24.5D

Facility

$745.00

Hospital Charge Code	270666695
Hospital Revenue Code	276
Min. Negotiated Rate	$21.16
Max. Negotiated Rate	$372.50
Rate for Payer: Aetna Commercial	$283.10
Rate for Payer: Aetna Medicare Advantage	$223.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.97
Rate for Payer: Cigna Commercial	$372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75
Rate for Payer: UnitedHealthcare Community & State	$23.54
Rate for Payer: Wellpoint Medicaid Managed Care	$21.16

ACROSOFT LENS 24.5D

Facility

$745.00

Hospital Charge Code	270666695
Hospital Revenue Code	276
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$180.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75

ACROSOFT LENS 25.00

Facility

$745.00

Service Code	HCPCS V2632
Hospital Charge Code	270666997
Hospital Revenue Code	276
Min. Negotiated Rate	$21.16
Max. Negotiated Rate	$372.50
Rate for Payer: Aetna Commercial	$283.10
Rate for Payer: Aetna Medicare Advantage	$223.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.97
Rate for Payer: Cigna Commercial	$372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75
Rate for Payer: UnitedHealthcare Community & State	$23.54
Rate for Payer: Wellpoint Medicaid Managed Care	$21.16

ACROSOFT LENS 25.00

Facility

$745.00

Service Code	HCPCS V2632
Hospital Charge Code	270666997
Hospital Revenue Code	276
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$180.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75

ACRYSOF LENS 20.5

Facility

$745.00

Hospital Charge Code	270667810
Hospital Revenue Code	276
Min. Negotiated Rate	$21.16
Max. Negotiated Rate	$372.50
Rate for Payer: Aetna Commercial	$283.10
Rate for Payer: Aetna Medicare Advantage	$223.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.97
Rate for Payer: Cigna Commercial	$372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75
Rate for Payer: UnitedHealthcare Community & State	$23.54
Rate for Payer: Wellpoint Medicaid Managed Care	$21.16

ACRYSOF LENS 20.5

Facility

$745.00

Hospital Charge Code	270667810
Hospital Revenue Code	276
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$180.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75

ACRYSOF LENS 27.5

Facility

$745.00

Hospital Charge Code	270667809
Hospital Revenue Code	276
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$180.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75

ACRYSOF LENS 27.5

Facility

$745.00

Hospital Charge Code	270667809
Hospital Revenue Code	276
Min. Negotiated Rate	$21.16
Max. Negotiated Rate	$372.50
Rate for Payer: Aetna Commercial	$283.10
Rate for Payer: Aetna Medicare Advantage	$223.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.97
Rate for Payer: Cigna Commercial	$372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75
Rate for Payer: UnitedHealthcare Community & State	$23.54
Rate for Payer: Wellpoint Medicaid Managed Care	$21.16

ACRYSOF LENS 29.00

Facility

$750.00

Hospital Charge Code	270668381
Hospital Revenue Code	276
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$23.70
Rate for Payer: Wellpoint Medicaid Managed Care	$21.30

ACRYSOF LENS 29.00

Facility

$750.00

Hospital Charge Code	270668381
Hospital Revenue Code	276
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

ACRYSOF LENS 9.5

Facility

$745.00

Hospital Charge Code	270667808
Hospital Revenue Code	276
Min. Negotiated Rate	$21.16
Max. Negotiated Rate	$372.50
Rate for Payer: Aetna Commercial	$283.10
Rate for Payer: Aetna Medicare Advantage	$223.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.97
Rate for Payer: Cigna Commercial	$372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75
Rate for Payer: UnitedHealthcare Community & State	$23.54
Rate for Payer: Wellpoint Medicaid Managed Care	$21.16

ACRYSOF LENS 9.5

Facility

$745.00

Hospital Charge Code	270667808
Hospital Revenue Code	276
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$180.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75

ACRYSOF NATURAL IOL W. BLU

Facility

$375.00

Hospital Charge Code	270665496
Hospital Revenue Code	276
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$11.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.65

ACRYSOF NATURAL IOL W. BLU

Facility

$375.00

Hospital Charge Code	270665496
Hospital Revenue Code	276
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

ACRYSOFT LENS 21.5

Facility

$745.00

Hospital Charge Code	270669985
Hospital Revenue Code	276
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$180.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75

ACRYSOFT LENS 21.5

Facility

$745.00

Hospital Charge Code	270669985
Hospital Revenue Code	276
Min. Negotiated Rate	$21.16
Max. Negotiated Rate	$372.50
Rate for Payer: Aetna Commercial	$283.10
Rate for Payer: Aetna Medicare Advantage	$223.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.97
Rate for Payer: Cigna Commercial	$372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75
Rate for Payer: UnitedHealthcare Community & State	$23.54
Rate for Payer: Wellpoint Medicaid Managed Care	$21.16

Know your out-of-pocket cost for care.

All Charges