Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CRISIS PSYCHOTX MD EAADD 30MIN

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	4822708
Hospital Revenue Code	914
Min. Negotiated Rate	$7.81
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$104.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Community & State	$8.69
Rate for Payer: Wellpoint Medicaid Managed Care	$7.81

CRISIS PSYCHOTX MD EAADD 30MIN

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	4509708
Hospital Revenue Code	914
Min. Negotiated Rate	$7.81
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$104.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Community & State	$8.69
Rate for Payer: Wellpoint Medicaid Managed Care	$7.81

CRISIS PSYCHOTX MD EAADD 30MIN

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	4511708
Hospital Revenue Code	914
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

CRISIS PSYCHOTX MD EAADD 30MIN

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	4504708
Hospital Revenue Code	914
Min. Negotiated Rate	$7.81
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$104.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Community & State	$8.69
Rate for Payer: Wellpoint Medicaid Managed Care	$7.81

CRISIS PSYCHOTX MD EAADD 30MIN

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	4510708
Hospital Revenue Code	914
Min. Negotiated Rate	$7.81
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$104.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Community & State	$8.69
Rate for Payer: Wellpoint Medicaid Managed Care	$7.81

CRISIS PSYCHOTX MD EAADD 30MIN

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	4822708
Hospital Revenue Code	914
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

CRISIS PSYCHOTX MD EAADD 30MIN

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	4517708
Hospital Revenue Code	914
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

CRISIS PSYCHOTX MD EAADD 30MIN

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	4518708
Hospital Revenue Code	914
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

CRISIS PSYCHOTX MD EAADD 30MIN

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	4824708
Hospital Revenue Code	914
Min. Negotiated Rate	$7.81
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$104.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Community & State	$8.69
Rate for Payer: Wellpoint Medicaid Managed Care	$7.81

CRISIS PSYCHOTX MD EAADD 30MIN

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	4535708
Hospital Revenue Code	914
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

CRISIS PSYCHOTX MD EAADD 30MIN

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	4832708
Hospital Revenue Code	914
Min. Negotiated Rate	$7.81
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$104.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Community & State	$8.69
Rate for Payer: Wellpoint Medicaid Managed Care	$7.81

CRISIS PSYCHOTX MD EAADD 30MIN

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	4546708
Hospital Revenue Code	914
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

CRISIS PSYCHOTX MD EAADD 30MIN

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	4832708
Hospital Revenue Code	914
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

CRISIS PSYCHOTX MD EAADD 30MIN

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	4515708
Hospital Revenue Code	914
Min. Negotiated Rate	$7.81
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$104.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Community & State	$8.69
Rate for Payer: Wellpoint Medicaid Managed Care	$7.81

CRISIS PSYCHOTX MD EAADD 30MIN

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	4546708
Hospital Revenue Code	914
Min. Negotiated Rate	$7.81
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$104.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Community & State	$8.69
Rate for Payer: Wellpoint Medicaid Managed Care	$7.81

CRISIS PSYCHOTX MD EAADD 30MIN

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	4535708
Hospital Revenue Code	914
Min. Negotiated Rate	$7.81
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$104.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Community & State	$8.69
Rate for Payer: Wellpoint Medicaid Managed Care	$7.81

CRITIC AID AF OINT

Facility

$55.81

Service Code	NDC 11701006723
Hospital Charge Code	6063943264
Hospital Revenue Code	250
Min. Negotiated Rate	$8.37
Max. Negotiated Rate	$8.37
Rate for Payer: Qualcare PPO/HMO/WC	$8.37

CRITIC AID AF OINT

Facility

$55.81

Service Code	NDC 11701006723
Hospital Charge Code	6063943264
Hospital Revenue Code	250
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$27.91
Rate for Payer: Aetna Commercial	$21.21
Rate for Payer: Aetna Medicare Advantage	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.23
Rate for Payer: Cigna Commercial	$27.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.51
Rate for Payer: Oxford Commercial	$11.16
Rate for Payer: Qualcare PPO/HMO/WC	$8.37
Rate for Payer: UnitedHealthcare Commercial	$11.16
Rate for Payer: UnitedHealthcare Community & State	$1.76
Rate for Payer: Wellpoint Medicaid Managed Care	$1.59

CRITICAL CARE 1ST HOUR

Facility

$10,659.26

Service Code	HCPCS 99291
Hospital Charge Code	411099291
Hospital Revenue Code	361
Min. Negotiated Rate	$1,598.89
Max. Negotiated Rate	$1,598.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,598.89

CRITICAL CARE 1ST HOUR

Facility

$10,659.26

Service Code	HCPCS 99291
Hospital Charge Code	411099291
Hospital Revenue Code	361
Min. Negotiated Rate	$302.72
Max. Negotiated Rate	$3,559.81
Rate for Payer: Aetna Commercial	$2,669.24
Rate for Payer: Aetna Medicare Advantage	$3,179.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,559.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,559.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$981.34
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	$3,559.81
Rate for Payer: Cigna Commercial	$1,967.11
Rate for Payer: Cigna Medicare Advantage	$981.34
Rate for Payer: Clover Medicare Advantage	$932.27
Rate for Payer: EmblemHealth Commercial	$2,944.02
Rate for Payer: Humana Medicare Advantage	$1,010.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$981.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,771.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,598.89
Rate for Payer: UnitedHealthcare Community & State	$336.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$981.34
Rate for Payer: Wellcare Medicare Advantage	$981.34
Rate for Payer: Wellpoint Medicaid Managed Care	$302.72

CRITICAL EA ADDL 30 MIN

Facility

$837.50

Service Code	HCPCS 99292
Hospital Charge Code	411099292
Hospital Revenue Code	361
Min. Negotiated Rate	$125.62
Max. Negotiated Rate	$125.62
Rate for Payer: Qualcare PPO/HMO/WC	$125.62

CRITICAL EA ADDL 30 MIN

Facility

$837.50

Service Code	HCPCS 99292
Hospital Charge Code	411099292
Hospital Revenue Code	361
Min. Negotiated Rate	$23.79
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$318.25
Rate for Payer: Aetna Medicare Advantage	$251.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$213.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$213.56
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	$213.56
Rate for Payer: Cigna Commercial	$418.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.75
Rate for Payer: Qualcare PPO/HMO/WC	$125.62
Rate for Payer: UnitedHealthcare Community & State	$26.46
Rate for Payer: Wellpoint Medicaid Managed Care	$23.79

CRNEA HUMAN TISSUE IMPLNTABLE

Facility

$19,000.00

Service Code	HCPCS V2785
Hospital Charge Code	270660661
Hospital Revenue Code	810
Min. Negotiated Rate	$2,850.00
Max. Negotiated Rate	$2,850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00

CRNEA HUMAN TISSUE IMPLNTABLE

Facility

$19,000.00

Service Code	HCPCS V2785
Hospital Charge Code	270660661
Hospital Revenue Code	810
Min. Negotiated Rate	$539.60
Max. Negotiated Rate	$9,500.00
Rate for Payer: Aetna Commercial	$7,220.00
Rate for Payer: Aetna Medicare Advantage	$5,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,845.00
Rate for Payer: Cigna Commercial	$9,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,940.00
Rate for Payer: Oxford Commercial	$3,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00
Rate for Payer: UnitedHealthcare Commercial	$3,800.00
Rate for Payer: UnitedHealthcare Community & State	$600.40
Rate for Payer: Wellpoint Medicaid Managed Care	$539.60

CROSS CONNECTOR 48MM

Facility

$7,298.55

Service Code	HCPCS C1713
Hospital Charge Code	270704749
Hospital Revenue Code	278
Min. Negotiated Rate	$207.28
Max. Negotiated Rate	$3,649.28
Rate for Payer: Aetna Commercial	$2,773.45
Rate for Payer: Aetna Medicare Advantage	$2,189.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,861.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,861.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,459.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,861.13
Rate for Payer: Cigna Commercial	$3,649.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,766.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,094.78
Rate for Payer: UnitedHealthcare Community & State	$230.63
Rate for Payer: Wellpoint Medicaid Managed Care	$207.28

Know your out-of-pocket cost for care.

All Charges