Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

DEFIBRILLATION CRT-DEFIB

Facility

$126,820.00

Service Code	HCPCS C1882
Hospital Charge Code	270674919
Hospital Revenue Code	275
Min. Negotiated Rate	$3,601.69
Max. Negotiated Rate	$63,410.00
Rate for Payer: Aetna Commercial	$48,191.60
Rate for Payer: Aetna Medicare Advantage	$38,046.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32,339.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32,339.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25,364.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32,339.10
Rate for Payer: Cigna Commercial	$63,410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30,690.44
Rate for Payer: Qualcare PPO/HMO/WC	$19,023.00
Rate for Payer: UnitedHealthcare Community & State	$4,007.51
Rate for Payer: Wellpoint Medicaid Managed Care	$3,601.69

DEFIBRILLATION CRT-DEFIB

Facility

$126,820.00

Service Code	HCPCS C1882
Hospital Charge Code	270674919
Hospital Revenue Code	275
Min. Negotiated Rate	$19,023.00
Max. Negotiated Rate	$30,690.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25,364.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30,690.44
Rate for Payer: Qualcare PPO/HMO/WC	$19,023.00

DEFIBRILLATOR CLARIA QUAD DF4

Facility

$130,740.00

Service Code	HCPCS C1882
Hospital Charge Code	270700885
Hospital Revenue Code	275
Min. Negotiated Rate	$19,611.00
Max. Negotiated Rate	$31,639.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26,148.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31,639.08
Rate for Payer: Qualcare PPO/HMO/WC	$19,611.00

DEFIBRILLATOR CLARIA QUAD DF4

Facility

$130,740.00

Service Code	HCPCS C1882
Hospital Charge Code	270700885
Hospital Revenue Code	275
Min. Negotiated Rate	$3,713.02
Max. Negotiated Rate	$65,370.00
Rate for Payer: Aetna Commercial	$49,681.20
Rate for Payer: Aetna Medicare Advantage	$39,222.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33,338.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33,338.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26,148.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33,338.70
Rate for Payer: Cigna Commercial	$65,370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31,639.08
Rate for Payer: Qualcare PPO/HMO/WC	$19,611.00
Rate for Payer: UnitedHealthcare Community & State	$4,131.38
Rate for Payer: Wellpoint Medicaid Managed Care	$3,713.02

DEFIBRILLATOR EVERA XT

Facility

$94,205.00

Hospital Charge Code	270670818
Hospital Revenue Code	275
Min. Negotiated Rate	$2,675.42
Max. Negotiated Rate	$47,102.50
Rate for Payer: Aetna Commercial	$35,797.90
Rate for Payer: Aetna Medicare Advantage	$28,261.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24,022.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24,022.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18,841.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24,022.28
Rate for Payer: Cigna Commercial	$47,102.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22,797.61
Rate for Payer: Qualcare PPO/HMO/WC	$14,130.75
Rate for Payer: UnitedHealthcare Community & State	$2,976.88
Rate for Payer: Wellpoint Medicaid Managed Care	$2,675.42

DEFIBRILLATOR EVERA XT

Facility

$94,205.00

Hospital Charge Code	270670818
Hospital Revenue Code	275
Min. Negotiated Rate	$14,130.75
Max. Negotiated Rate	$22,797.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18,841.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22,797.61
Rate for Payer: Qualcare PPO/HMO/WC	$14,130.75

DEFIBRILLATOR IMPLANTS

Facility

$46,298.21

Service Code	APR-DRG 1791
Min. Negotiated Rate	$45,390.40
Max. Negotiated Rate	$46,298.21
Rate for Payer: UnitedHealthcare Community & State	$45,390.40
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$46,298.21
Rate for Payer: Wellpoint Medicaid Managed Care	$45,390.40

DEFIBRILLATOR IMPLANTS

Facility

$52,324.41

Service Code	APR-DRG 1792
Min. Negotiated Rate	$51,298.44
Max. Negotiated Rate	$52,324.41
Rate for Payer: UnitedHealthcare Community & State	$51,298.44
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$52,324.41
Rate for Payer: Wellpoint Medicaid Managed Care	$51,298.44

DEFIBRILLATOR IMPLANTS

Facility

$63,567.91

Service Code	APR-DRG 1793
Min. Negotiated Rate	$62,321.48
Max. Negotiated Rate	$63,567.91
Rate for Payer: UnitedHealthcare Community & State	$62,321.48
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$63,567.91
Rate for Payer: Wellpoint Medicaid Managed Care	$62,321.48

DEFIBRILLATOR IMPLANTS

Facility

$91,078.33

Service Code	APR-DRG 1794
Min. Negotiated Rate	$89,292.48
Max. Negotiated Rate	$91,078.33
Rate for Payer: UnitedHealthcare Community & State	$89,292.48
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$91,078.33
Rate for Payer: Wellpoint Medicaid Managed Care	$89,292.48

DEFINITIVE ID, AEROBIC

Facility

$154.00

Service Code	HCPCS 87077
Hospital Charge Code	38475116
Hospital Revenue Code	309
Min. Negotiated Rate	$4.37
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$21.98
Rate for Payer: Aetna Medicare Advantage	$26.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.31
Rate for Payer: Cigna Commercial	$77.00
Rate for Payer: Cigna Medicare Advantage	$8.08
Rate for Payer: Clover Medicare Advantage	$7.68
Rate for Payer: EmblemHealth Commercial	$24.24
Rate for Payer: Humana Medicare Advantage	$8.32
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.04
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.10
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$6.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.08
Rate for Payer: Wellcare Medicare Advantage	$8.08
Rate for Payer: Wellpoint Medicaid Managed Care	$4.37

DEFINITIVE ID, AEROBIC

Facility

$154.00

Service Code	HCPCS 87077
Hospital Charge Code	38475116
Hospital Revenue Code	309
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$23.10
Rate for Payer: Qualcare PPO/HMO/WC	$23.10

DEFINITIVE ID, ANAEROBIC

Facility

$390.00

Service Code	HCPCS 87076
Hospital Charge Code	38475115
Hospital Revenue Code	309
Min. Negotiated Rate	$6.46
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$21.98
Rate for Payer: Aetna Medicare Advantage	$26.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.31
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$8.08
Rate for Payer: Clover Medicare Advantage	$7.68
Rate for Payer: EmblemHealth Commercial	$24.24
Rate for Payer: Humana Medicare Advantage	$8.32
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.08
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	$6.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.08
Rate for Payer: Wellcare Medicare Advantage	$8.08
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

DEFINITIVE ID, ANAEROBIC

Facility

$390.00

Service Code	HCPCS 87076
Hospital Charge Code	38475115
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS

Facility

$28,367.09

Service Code	APR-DRG 0424
Min. Negotiated Rate	$27,810.87
Max. Negotiated Rate	$28,367.09
Rate for Payer: UnitedHealthcare Community & State	$27,810.87
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$28,367.09
Rate for Payer: Wellpoint Medicaid Managed Care	$27,810.87

DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS

Facility

$9,027.37

Service Code	APR-DRG 0421
Min. Negotiated Rate	$8,850.36
Max. Negotiated Rate	$9,027.37
Rate for Payer: UnitedHealthcare Community & State	$8,850.36
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,027.37
Rate for Payer: Wellpoint Medicaid Managed Care	$8,850.36

DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS

Facility

$11,497.69

Service Code	APR-DRG 0422
Min. Negotiated Rate	$11,272.25
Max. Negotiated Rate	$11,497.69
Rate for Payer: UnitedHealthcare Community & State	$11,272.25
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,497.69
Rate for Payer: Wellpoint Medicaid Managed Care	$11,272.25

DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS

Facility

$15,646.20

Service Code	APR-DRG 0423
Min. Negotiated Rate	$15,339.41
Max. Negotiated Rate	$15,646.20
Rate for Payer: UnitedHealthcare Community & State	$15,339.41
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$15,646.20
Rate for Payer: Wellpoint Medicaid Managed Care	$15,339.41

DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC

Facility

$92,859.72

Service Code	MSDRG 056
Min. Negotiated Rate	$28,274.59
Max. Negotiated Rate	$92,859.72
Rate for Payer: Aetna Medicare Advantage	$92,859.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66,214.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66,214.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29,762.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66,214.95
Rate for Payer: Cigna Commercial	$51,788.87
Rate for Payer: Cigna Medicare Advantage	$29,762.73
Rate for Payer: Clover Medicare Advantage	$28,274.59
Rate for Payer: EmblemHealth Commercial	$89,288.19
Rate for Payer: Humana Medicare Advantage	$30,655.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$29,762.73
Rate for Payer: Oxford Commercial	$40,933.02
Rate for Payer: UnitedHealthcare Commercial	$54,790.31
Rate for Payer: UnitedHealthcare Medicare Advantage	$29,762.73
Rate for Payer: Wellcare Medicare Advantage	$29,762.73

DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC

Facility

$60,397.27

Service Code	MSDRG 057
Min. Negotiated Rate	$18,390.19
Max. Negotiated Rate	$60,397.27
Rate for Payer: Aetna Medicare Advantage	$60,397.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37,678.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37,678.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19,358.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37,678.80
Rate for Payer: Cigna Commercial	$28,882.81
Rate for Payer: Cigna Medicare Advantage	$19,358.10
Rate for Payer: Clover Medicare Advantage	$18,390.19
Rate for Payer: EmblemHealth Commercial	$58,074.30
Rate for Payer: Humana Medicare Advantage	$19,938.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19,358.10
Rate for Payer: Oxford Commercial	$22,828.47
Rate for Payer: UnitedHealthcare Commercial	$30,556.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$19,358.10
Rate for Payer: Wellcare Medicare Advantage	$19,358.10

DEHYDROEPIANDROSTERONE

Facility

$390.00

Service Code	HCPCS 82626
Hospital Charge Code	401182626
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

DEHYDROEPIANDROSTERONE

Facility

$390.00

Service Code	HCPCS 82626
Hospital Charge Code	401182626
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$68.73
Rate for Payer: Aetna Medicare Advantage	$81.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.67
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$25.27
Rate for Payer: Clover Medicare Advantage	$24.01
Rate for Payer: EmblemHealth Commercial	$75.81
Rate for Payer: Humana Medicare Advantage	$26.03
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$25.27
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	$20.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$25.27
Rate for Payer: Wellcare Medicare Advantage	$25.27
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

DEHYDROEPIANDROSTERONE (DHEA)

Facility

$880.00

Service Code	HCPCS 82626
Hospital Charge Code	38472248
Hospital Revenue Code	301
Min. Negotiated Rate	$132.00
Max. Negotiated Rate	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$132.00

DEHYDROEPIANDROSTERONE (DHEA)

Facility

$880.00

Service Code	HCPCS 82626
Hospital Charge Code	38472248
Hospital Revenue Code	301
Min. Negotiated Rate	$20.22
Max. Negotiated Rate	$440.00
Rate for Payer: Aetna Commercial	$68.73
Rate for Payer: Aetna Medicare Advantage	$81.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.67
Rate for Payer: Cigna Commercial	$440.00
Rate for Payer: Cigna Medicare Advantage	$25.27
Rate for Payer: Clover Medicare Advantage	$24.01
Rate for Payer: EmblemHealth Commercial	$75.81
Rate for Payer: Humana Medicare Advantage	$26.03
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$25.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.80
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$132.00
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$20.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$25.27
Rate for Payer: Wellcare Medicare Advantage	$25.27
Rate for Payer: Wellpoint Medicaid Managed Care	$24.99

DEHYDROEPIANDROSTERONE SULFATE

Facility

$880.00

Service Code	HCPCS 82627
Hospital Charge Code	38472251
Hospital Revenue Code	301
Min. Negotiated Rate	$132.00
Max. Negotiated Rate	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$132.00

Know your out-of-pocket cost for care.

All Charges