Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

DELIVERY CANNULA&TAMP 8G 10CM

Facility

$267.30

Hospital Charge Code	270645740
Hospital Revenue Code	272
Min. Negotiated Rate	$40.09
Max. Negotiated Rate	$40.09
Rate for Payer: Qualcare PPO/HMO/WC	$40.09

DELIVERY FEE

Facility

$245.00

Hospital Charge Code	270657510
Hospital Revenue Code	270
Min. Negotiated Rate	$6.96
Max. Negotiated Rate	$122.50
Rate for Payer: Aetna Commercial	$93.10
Rate for Payer: Aetna Medicare Advantage	$73.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.48
Rate for Payer: Cigna Commercial	$122.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.70
Rate for Payer: Oxford Commercial	$49.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.75
Rate for Payer: UnitedHealthcare Commercial	$49.00
Rate for Payer: UnitedHealthcare Community & State	$7.74
Rate for Payer: Wellpoint Medicaid Managed Care	$6.96

DELIVERY FEE

Facility

$245.00

Hospital Charge Code	270657510
Hospital Revenue Code	270
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$36.75
Rate for Payer: Qualcare PPO/HMO/WC	$36.75

DELIVERY NEEDLES, STERILE

Facility

$235.50

Hospital Charge Code	270659780
Hospital Revenue Code	272
Min. Negotiated Rate	$35.33
Max. Negotiated Rate	$35.33
Rate for Payer: Qualcare PPO/HMO/WC	$35.33

DELIVERY NEEDLES, STERILE

Facility

$235.50

Hospital Charge Code	270659780
Hospital Revenue Code	272
Min. Negotiated Rate	$6.69
Max. Negotiated Rate	$117.75
Rate for Payer: Aetna Commercial	$89.49
Rate for Payer: Aetna Medicare Advantage	$70.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.05
Rate for Payer: Cigna Commercial	$117.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.23
Rate for Payer: Oxford Commercial	$47.10
Rate for Payer: Qualcare PPO/HMO/WC	$35.33
Rate for Payer: UnitedHealthcare Commercial	$47.10
Rate for Payer: UnitedHealthcare Community & State	$7.44
Rate for Payer: Wellpoint Medicaid Managed Care	$6.69

DELIVERY SYSTEM FMT LOWER

Facility

$2,425.00

Hospital Charge Code	270683731
Hospital Revenue Code	272
Min. Negotiated Rate	$68.87
Max. Negotiated Rate	$1,212.50
Rate for Payer: Aetna Commercial	$921.50
Rate for Payer: Aetna Medicare Advantage	$727.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$618.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$618.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$618.38
Rate for Payer: Cigna Commercial	$1,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$630.50
Rate for Payer: Oxford Commercial	$485.00
Rate for Payer: Qualcare PPO/HMO/WC	$363.75
Rate for Payer: UnitedHealthcare Commercial	$485.00
Rate for Payer: UnitedHealthcare Community & State	$76.63
Rate for Payer: Wellpoint Medicaid Managed Care	$68.87

DELIVERY SYSTEM FMT LOWER

Facility

$2,425.00

Hospital Charge Code	270683731
Hospital Revenue Code	272
Min. Negotiated Rate	$363.75
Max. Negotiated Rate	$363.75
Rate for Payer: Qualcare PPO/HMO/WC	$363.75

DELIVERY SYSTEM FMT UPPER

Facility

$2,425.00

Hospital Charge Code	270683732
Hospital Revenue Code	272
Min. Negotiated Rate	$363.75
Max. Negotiated Rate	$363.75
Rate for Payer: Qualcare PPO/HMO/WC	$363.75

DELIVERY SYSTEM FMT UPPER

Facility

$2,425.00

Hospital Charge Code	270683732
Hospital Revenue Code	272
Min. Negotiated Rate	$68.87
Max. Negotiated Rate	$1,212.50
Rate for Payer: Aetna Commercial	$921.50
Rate for Payer: Aetna Medicare Advantage	$727.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$618.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$618.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$618.38
Rate for Payer: Cigna Commercial	$1,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$630.50
Rate for Payer: Oxford Commercial	$485.00
Rate for Payer: Qualcare PPO/HMO/WC	$363.75
Rate for Payer: UnitedHealthcare Commercial	$485.00
Rate for Payer: UnitedHealthcare Community & State	$76.63
Rate for Payer: Wellpoint Medicaid Managed Care	$68.87

DELIVERY SYST RX BILIARY

Facility

$399.25

Hospital Charge Code	270677724
Hospital Revenue Code	272
Min. Negotiated Rate	$11.34
Max. Negotiated Rate	$199.62
Rate for Payer: Aetna Commercial	$151.72
Rate for Payer: Aetna Medicare Advantage	$119.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.81
Rate for Payer: Cigna Commercial	$199.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.81
Rate for Payer: Oxford Commercial	$79.85
Rate for Payer: Qualcare PPO/HMO/WC	$59.89
Rate for Payer: UnitedHealthcare Commercial	$79.85
Rate for Payer: UnitedHealthcare Community & State	$12.62
Rate for Payer: Wellpoint Medicaid Managed Care	$11.34

DELIVERY SYST RX BILIARY

Facility

$399.25

Hospital Charge Code	270677724
Hospital Revenue Code	272
Min. Negotiated Rate	$59.89
Max. Negotiated Rate	$59.89
Rate for Payer: Qualcare PPO/HMO/WC	$59.89

DEL L & D NURSE LOC W/NO PROC

Facility

$10,100.00

Service Code	HCPCS 99211
Hospital Charge Code	73190115
Hospital Revenue Code	720
Min. Negotiated Rate	$286.84
Max. Negotiated Rate	$5,050.00
Rate for Payer: Aetna Commercial	$3,838.00
Rate for Payer: Aetna Medicare Advantage	$3,030.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,575.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,575.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,575.50
Rate for Payer: Cigna Commercial	$5,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,626.00
Rate for Payer: Oxford Commercial	$4,053.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,515.00
Rate for Payer: UnitedHealthcare Commercial	$4,601.00
Rate for Payer: UnitedHealthcare Community & State	$319.16
Rate for Payer: Wellpoint Medicaid Managed Care	$286.84

DEL L & D NURSE LOC W/NO PROC

Facility

$10,100.00

Service Code	HCPCS 99211
Hospital Charge Code	73190115
Hospital Revenue Code	720
Min. Negotiated Rate	$1,515.00
Max. Negotiated Rate	$1,515.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,515.00

DEL NON STRESS TEST 1+ HRS

Facility

$1,898.40

Service Code	HCPCS 59025
Hospital Charge Code	73190019
Hospital Revenue Code	920
Min. Negotiated Rate	$53.91
Max. Negotiated Rate	$2,301.00
Rate for Payer: Aetna Commercial	$653.29
Rate for Payer: Aetna Medicare Advantage	$778.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$871.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$871.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$240.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$871.25
Rate for Payer: Cigna Commercial	$481.45
Rate for Payer: Cigna Medicare Advantage	$240.18
Rate for Payer: Clover Medicare Advantage	$228.17
Rate for Payer: EmblemHealth Commercial	$720.54
Rate for Payer: Humana Medicare Advantage	$247.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$240.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$493.58
Rate for Payer: Oxford Commercial	$2,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$284.76
Rate for Payer: UnitedHealthcare Commercial	$2,301.00
Rate for Payer: UnitedHealthcare Community & State	$59.99
Rate for Payer: UnitedHealthcare Medicare Advantage	$240.18
Rate for Payer: Wellcare Medicare Advantage	$240.18
Rate for Payer: Wellpoint Medicaid Managed Care	$53.91

DEL NON STRESS TEST 1+ HRS

Facility

$1,898.40

Service Code	HCPCS 59025
Hospital Charge Code	73190019
Hospital Revenue Code	920
Min. Negotiated Rate	$284.76
Max. Negotiated Rate	$284.76
Rate for Payer: Qualcare PPO/HMO/WC	$284.76

DEL OB/US>/= 14WKS SNGL FETUS

Facility

$6,700.00

Service Code	HCPCS 76805
Hospital Charge Code	73190057
Hospital Revenue Code	402
Min. Negotiated Rate	$106.59
Max. Negotiated Rate	$2,904.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$450.54
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$124.20
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,742.00
Rate for Payer: Oxford Commercial	$2,697.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$2,904.00
Rate for Payer: UnitedHealthcare Community & State	$211.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.88
Rate for Payer: Wellpoint Medicaid Managed Care	$190.28

DEL OB/US>/= 14WKS SNGL FETUS

Facility

$6,700.00

Service Code	HCPCS 76805
Hospital Charge Code	73190057
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

DEL OB/US DETAILED ADDL FETUS

Facility

$6,700.00

Service Code	HCPCS 76812
Hospital Charge Code	73190063
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

DEL OB/US DETAILED ADDL FETUS

Facility

$6,700.00

Service Code	HCPCS 76812
Hospital Charge Code	73190063
Hospital Revenue Code	402
Min. Negotiated Rate	$190.28
Max. Negotiated Rate	$3,350.00
Rate for Payer: Aetna Commercial	$2,546.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$201.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$3,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,742.00
Rate for Payer: Oxford Commercial	$2,697.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$2,904.00
Rate for Payer: UnitedHealthcare Community & State	$211.72
Rate for Payer: Wellpoint Medicaid Managed Care	$190.28

DEL OXYTOXIN TEST

Facility

$10,100.00

Service Code	HCPCS 59020
Hospital Charge Code	73190017
Hospital Revenue Code	720
Min. Negotiated Rate	$1,515.00
Max. Negotiated Rate	$1,515.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,515.00

DEL OXYTOXIN TEST

Facility

$10,100.00

Service Code	HCPCS 59020
Hospital Charge Code	73190017
Hospital Revenue Code	720
Min. Negotiated Rate	$43.66
Max. Negotiated Rate	$4,601.00
Rate for Payer: Aetna Commercial	$653.29
Rate for Payer: Aetna Medicare Advantage	$778.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$871.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$871.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$240.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$871.25
Rate for Payer: Cigna Commercial	$481.45
Rate for Payer: Cigna Medicare Advantage	$240.18
Rate for Payer: Clover Medicare Advantage	$228.17
Rate for Payer: EmblemHealth Commercial	$720.54
Rate for Payer: Humana Medicare Advantage	$247.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$240.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,626.00
Rate for Payer: Oxford Commercial	$4,053.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,515.00
Rate for Payer: UnitedHealthcare Commercial	$4,601.00
Rate for Payer: UnitedHealthcare Community & State	$319.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$240.18
Rate for Payer: Wellcare Medicare Advantage	$240.18
Rate for Payer: Wellpoint Medicaid Managed Care	$286.84

DEL ROUTINE VAG DEL 1ST HR

Facility

$10,100.00

Service Code	HCPCS 59409
Hospital Charge Code	73190033
Hospital Revenue Code	720
Min. Negotiated Rate	$286.84
Max. Negotiated Rate	$13,950.60
Rate for Payer: Aetna Commercial	$10,460.55
Rate for Payer: Aetna Medicare Advantage	$12,460.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,950.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,950.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,845.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$459.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,950.60
Rate for Payer: Cigna Commercial	$7,708.87
Rate for Payer: Cigna Medicare Advantage	$3,845.79
Rate for Payer: Clover Medicare Advantage	$3,653.50
Rate for Payer: EmblemHealth Commercial	$11,537.37
Rate for Payer: Humana Medicare Advantage	$3,961.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,845.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,626.00
Rate for Payer: Oxford Commercial	$4,053.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,515.00
Rate for Payer: UnitedHealthcare Commercial	$4,601.00
Rate for Payer: UnitedHealthcare Community & State	$319.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,845.79
Rate for Payer: Wellcare Medicare Advantage	$3,845.79
Rate for Payer: Wellpoint Medicaid Managed Care	$286.84

DEL ROUTINE VAG DEL 1ST HR

Facility

$10,100.00

Service Code	HCPCS 59409
Hospital Charge Code	73190033
Hospital Revenue Code	720
Min. Negotiated Rate	$1,515.00
Max. Negotiated Rate	$1,515.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,515.00

DEL ROUTINE VAG DEL EA ADD HR

Facility

$10,100.00

Hospital Charge Code	73190034
Hospital Revenue Code	720
Min. Negotiated Rate	$1,515.00
Max. Negotiated Rate	$1,515.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,515.00

DEL ROUTINE VAG DEL EA ADD HR

Facility

$10,100.00

Hospital Charge Code	73190034
Hospital Revenue Code	720
Min. Negotiated Rate	$286.84
Max. Negotiated Rate	$5,050.00
Rate for Payer: Aetna Commercial	$3,838.00
Rate for Payer: Aetna Medicare Advantage	$3,030.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,575.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,575.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,575.50
Rate for Payer: Cigna Commercial	$5,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,626.00
Rate for Payer: Oxford Commercial	$4,053.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,515.00
Rate for Payer: UnitedHealthcare Commercial	$4,601.00
Rate for Payer: UnitedHealthcare Community & State	$319.16
Rate for Payer: Wellpoint Medicaid Managed Care	$286.84

Know your out-of-pocket cost for care.

All Charges