Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

DIAGNOSTIC MAMMO UNI INC CAD

Facility

$4,500.00

Service Code	HCPCS 77065
Hospital Charge Code	85000901
Hospital Revenue Code	401
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$675.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

DIAGNOSTIC MAMMO UNI INC CAD

Facility

$4,500.00

Service Code	HCPCS 77065
Hospital Charge Code	9406403
Hospital Revenue Code	401
Min. Negotiated Rate	$106.36
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,170.00
Rate for Payer: Oxford Commercial	$1,688.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Commercial	$1,884.00
Rate for Payer: UnitedHealthcare Community & State	$142.20
Rate for Payer: Wellpoint Medicaid Managed Care	$127.80

DIAGNOSTIC MAMMO UNI INC CAD

Facility

$4,500.00

Service Code	HCPCS 77065
Hospital Charge Code	2709035
Hospital Revenue Code	401
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$675.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

DIAGNOSTIC MAMMO UNI INC CAD

Facility

$4,500.00

Service Code	HCPCS 77065
Hospital Charge Code	2709035
Hospital Revenue Code	401
Min. Negotiated Rate	$106.36
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,170.00
Rate for Payer: Oxford Commercial	$1,688.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Commercial	$1,884.00
Rate for Payer: UnitedHealthcare Community & State	$142.20
Rate for Payer: Wellpoint Medicaid Managed Care	$127.80

DIAGNOSTIC MAMMO UNI INC CAD

Facility

$4,500.00

Service Code	HCPCS 77065
Hospital Charge Code	94061495
Hospital Revenue Code	401
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$675.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

DIAGNOSTIC MAMMO UNI INC CAD

Facility

$4,500.00

Service Code	HCPCS 77065
Hospital Charge Code	85000901
Hospital Revenue Code	401
Min. Negotiated Rate	$106.36
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,170.00
Rate for Payer: Oxford Commercial	$1,688.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Commercial	$1,884.00
Rate for Payer: UnitedHealthcare Community & State	$142.20
Rate for Payer: Wellpoint Medicaid Managed Care	$127.80

DIAGNOSTIC MAMMO UNI INC CAD

Facility

$4,500.00

Service Code	HCPCS 77065
Hospital Charge Code	9406403
Hospital Revenue Code	401
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$675.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

DIAGNOSTIC T4-T12 INJ RR

Facility

$4,344.06

Service Code	HCPCS 64479
Hospital Charge Code	1600000391
Hospital Revenue Code	360
Min. Negotiated Rate	$123.37
Max. Negotiated Rate	$3,811.70
Rate for Payer: Aetna Commercial	$2,858.12
Rate for Payer: Aetna Medicare Advantage	$3,404.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,811.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,811.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,050.78
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	$3,811.70
Rate for Payer: Cigna Commercial	$2,106.27
Rate for Payer: Cigna Medicare Advantage	$1,050.78
Rate for Payer: Clover Medicare Advantage	$998.24
Rate for Payer: EmblemHealth Commercial	$3,152.34
Rate for Payer: Humana Medicare Advantage	$1,082.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,050.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,129.46
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$651.61
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$137.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,050.78
Rate for Payer: Wellcare Medicare Advantage	$1,050.78
Rate for Payer: Wellpoint Medicaid Managed Care	$123.37

DIAGNOSTIC T4-T12 INJ RR

Facility

$4,344.06

Service Code	HCPCS 64479
Hospital Charge Code	1600000391
Hospital Revenue Code	360
Min. Negotiated Rate	$651.61
Max. Negotiated Rate	$651.61
Rate for Payer: Qualcare PPO/HMO/WC	$651.61

DIALATION OF URETHRA

Facility

$18,162.80

Service Code	HCPCS 53665
Hospital Charge Code	1600000494
Hospital Revenue Code	360
Min. Negotiated Rate	$2,724.42
Max. Negotiated Rate	$2,724.42
Rate for Payer: Qualcare PPO/HMO/WC	$2,724.42

DIALATION OF URETHRA

Facility

$18,162.80

Service Code	HCPCS 53665
Hospital Charge Code	1600000494
Hospital Revenue Code	360
Min. Negotiated Rate	$515.82
Max. Negotiated Rate	$9,008.64
Rate for Payer: Aetna Commercial	$6,754.93
Rate for Payer: Aetna Medicare Advantage	$8,046.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,008.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,008.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,483.43
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	$9,008.64
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: Cigna Medicare Advantage	$2,483.43
Rate for Payer: Clover Medicare Advantage	$2,359.26
Rate for Payer: EmblemHealth Commercial	$7,450.29
Rate for Payer: Humana Medicare Advantage	$2,557.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,483.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,722.33
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,724.42
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$573.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,483.43
Rate for Payer: Wellcare Medicare Advantage	$2,483.43
Rate for Payer: Wellpoint Medicaid Managed Care	$515.82

DIALYSIS ACCESS SYSTEM

Facility

$21.40

Service Code	HCPCS C1881
Hospital Charge Code	4800905
Hospital Revenue Code	278
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$10.70
Rate for Payer: Aetna Commercial	$8.13
Rate for Payer: Aetna Medicare Advantage	$6.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.46
Rate for Payer: Cigna Commercial	$10.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.18
Rate for Payer: Qualcare PPO/HMO/WC	$3.21
Rate for Payer: UnitedHealthcare Community & State	$0.68
Rate for Payer: Wellpoint Medicaid Managed Care	$0.61

DIALYSIS ACCESS SYSTEM

Facility

$21.40

Service Code	HCPCS C1881
Hospital Charge Code	4800905
Hospital Revenue Code	278
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.18
Rate for Payer: Qualcare PPO/HMO/WC	$3.21

DIALYZER HIGH FLUX F250 OPTIFL

Facility

$72.10

Hospital Charge Code	270678522
Hospital Revenue Code	272
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$36.05
Rate for Payer: Aetna Commercial	$27.40
Rate for Payer: Aetna Medicare Advantage	$21.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.39
Rate for Payer: Cigna Commercial	$36.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.75
Rate for Payer: Oxford Commercial	$14.42
Rate for Payer: Qualcare PPO/HMO/WC	$10.81
Rate for Payer: UnitedHealthcare Commercial	$14.42
Rate for Payer: UnitedHealthcare Community & State	$2.28
Rate for Payer: Wellpoint Medicaid Managed Care	$2.05

DIALYZER HIGH FLUX F250 OPTIFL

Facility

$72.10

Hospital Charge Code	270678522
Hospital Revenue Code	272
Min. Negotiated Rate	$10.81
Max. Negotiated Rate	$10.81
Rate for Payer: Qualcare PPO/HMO/WC	$10.81

DIAMONDBCK 360 1.25MM SLD CRWN

Facility

$16,975.00

Service Code	HCPCS C1724
Hospital Charge Code	270677737
Hospital Revenue Code	278
Min. Negotiated Rate	$482.09
Max. Negotiated Rate	$8,487.50
Rate for Payer: Aetna Commercial	$6,450.50
Rate for Payer: Aetna Medicare Advantage	$5,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,328.62
Rate for Payer: Cigna Commercial	$8,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25
Rate for Payer: UnitedHealthcare Community & State	$536.41
Rate for Payer: Wellpoint Medicaid Managed Care	$482.09

DIAMONDBCK 360 1.25MM SLD CRWN

Facility

$16,975.00

Service Code	HCPCS C1724
Hospital Charge Code	270677737
Hospital Revenue Code	278
Min. Negotiated Rate	$2,546.25
Max. Negotiated Rate	$4,107.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25

DIAMOND BURR

Facility

$4,125.00

Hospital Charge Code	270703249
Hospital Revenue Code	272
Min. Negotiated Rate	$618.75
Max. Negotiated Rate	$618.75
Rate for Payer: Qualcare PPO/HMO/WC	$618.75

DIAMOND BURR

Facility

$4,125.00

Hospital Charge Code	270703249
Hospital Revenue Code	272
Min. Negotiated Rate	$117.15
Max. Negotiated Rate	$2,062.50
Rate for Payer: Aetna Commercial	$1,567.50
Rate for Payer: Aetna Medicare Advantage	$1,237.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,051.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,051.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,051.88
Rate for Payer: Cigna Commercial	$2,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,072.50
Rate for Payer: Oxford Commercial	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$618.75
Rate for Payer: UnitedHealthcare Commercial	$825.00
Rate for Payer: UnitedHealthcare Community & State	$130.35
Rate for Payer: Wellpoint Medicaid Managed Care	$117.15

DIAMOND BURR

Facility

$2,275.00

Hospital Charge Code	2707014146
Hospital Revenue Code	272
Min. Negotiated Rate	$64.61
Max. Negotiated Rate	$1,137.50
Rate for Payer: Aetna Commercial	$864.50
Rate for Payer: Aetna Medicare Advantage	$682.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$580.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$580.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$580.12
Rate for Payer: Cigna Commercial	$1,137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$591.50
Rate for Payer: Oxford Commercial	$455.00
Rate for Payer: Qualcare PPO/HMO/WC	$341.25
Rate for Payer: UnitedHealthcare Commercial	$455.00
Rate for Payer: UnitedHealthcare Community & State	$71.89
Rate for Payer: Wellpoint Medicaid Managed Care	$64.61

DIAMOND BURR

Facility

$2,275.00

Hospital Charge Code	2707014146
Hospital Revenue Code	272
Min. Negotiated Rate	$341.25
Max. Negotiated Rate	$341.25
Rate for Payer: Qualcare PPO/HMO/WC	$341.25

DIAMOND BURR

Facility

$2,275.00

Hospital Charge Code	270704146
Hospital Revenue Code	272
Min. Negotiated Rate	$64.61
Max. Negotiated Rate	$1,137.50
Rate for Payer: Aetna Commercial	$864.50
Rate for Payer: Aetna Medicare Advantage	$682.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$580.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$580.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$580.12
Rate for Payer: Cigna Commercial	$1,137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$591.50
Rate for Payer: Oxford Commercial	$455.00
Rate for Payer: Qualcare PPO/HMO/WC	$341.25
Rate for Payer: UnitedHealthcare Commercial	$455.00
Rate for Payer: UnitedHealthcare Community & State	$71.89
Rate for Payer: Wellpoint Medicaid Managed Care	$64.61

DIAMOND BURR

Facility

$2,275.00

Hospital Charge Code	270704146
Hospital Revenue Code	272
Min. Negotiated Rate	$341.25
Max. Negotiated Rate	$341.25
Rate for Payer: Qualcare PPO/HMO/WC	$341.25

DIANEAL PD2 4.25% SOL

Facility

$296.94

Service Code	NDC 941042952
Hospital Charge Code	606390441
Hospital Revenue Code	270
Min. Negotiated Rate	$8.43
Max. Negotiated Rate	$148.47
Rate for Payer: Aetna Commercial	$112.84
Rate for Payer: Aetna Medicare Advantage	$89.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.72
Rate for Payer: Cigna Commercial	$148.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.20
Rate for Payer: Oxford Commercial	$59.39
Rate for Payer: Qualcare PPO/HMO/WC	$44.54
Rate for Payer: UnitedHealthcare Commercial	$59.39
Rate for Payer: UnitedHealthcare Community & State	$9.38
Rate for Payer: Wellpoint Medicaid Managed Care	$8.43

DIANEAL PD2 4.25% SOL

Facility

$296.94

Service Code	NDC 941042952
Hospital Charge Code	606390441
Hospital Revenue Code	270
Min. Negotiated Rate	$44.54
Max. Negotiated Rate	$44.54
Rate for Payer: Qualcare PPO/HMO/WC	$44.54

Know your out-of-pocket cost for care.

All Charges