Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

DIGESTIVE MALIGNANCY

Facility

$11,569.26

Service Code	APR-DRG 2402
Min. Negotiated Rate	$11,342.41
Max. Negotiated Rate	$11,569.26
Rate for Payer: UnitedHealthcare Community & State	$11,342.41
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,569.26
Rate for Payer: Wellpoint Medicaid Managed Care	$11,342.41

DIGESTIVE MALIGNANCY

Facility

$9,655.16

Service Code	APR-DRG 2401
Min. Negotiated Rate	$9,465.84
Max. Negotiated Rate	$9,655.16
Rate for Payer: UnitedHealthcare Community & State	$9,465.84
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,655.16
Rate for Payer: Wellpoint Medicaid Managed Care	$9,465.84

DIGESTIVE MALIGNANCY WITH CC

Facility

$57,680.25

Service Code	MSDRG 375
Min. Negotiated Rate	$17,562.90
Max. Negotiated Rate	$57,680.25
Rate for Payer: Aetna Commercial	$42,939.04
Rate for Payer: Aetna Medicare Advantage	$57,680.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33,246.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33,246.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18,487.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33,246.00
Rate for Payer: Cigna Commercial	$26,965.61
Rate for Payer: Cigna Medicare Advantage	$18,487.26
Rate for Payer: Clover Medicare Advantage	$17,562.90
Rate for Payer: EmblemHealth Commercial	$55,461.78
Rate for Payer: Humana Medicare Advantage	$19,041.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18,487.26
Rate for Payer: Oxford Commercial	$21,313.15
Rate for Payer: UnitedHealthcare Commercial	$28,528.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$18,487.26
Rate for Payer: Wellcare Medicare Advantage	$18,487.26

DIGESTIVE MALIGNANCY WITH MCC

Facility

$87,033.80

Service Code	MSDRG 374
Min. Negotiated Rate	$26,500.68
Max. Negotiated Rate	$87,033.80
Rate for Payer: Aetna Commercial	$63,844.98
Rate for Payer: Aetna Medicare Advantage	$87,033.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58,180.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58,180.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27,895.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58,180.50
Rate for Payer: Cigna Commercial	$47,678.04
Rate for Payer: Cigna Medicare Advantage	$27,895.45
Rate for Payer: Clover Medicare Advantage	$26,500.68
Rate for Payer: EmblemHealth Commercial	$83,686.35
Rate for Payer: Humana Medicare Advantage	$28,732.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27,895.45
Rate for Payer: Oxford Commercial	$37,683.89
Rate for Payer: UnitedHealthcare Commercial	$50,441.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$27,895.45
Rate for Payer: Wellcare Medicare Advantage	$27,895.45

DIGESTIVE MALIGNANCY WITHOUT CC/MCC

Facility

$48,666.57

Service Code	MSDRG 376
Min. Negotiated Rate	$14,818.35
Max. Negotiated Rate	$48,666.57
Rate for Payer: Aetna Commercial	$36,519.39
Rate for Payer: Aetna Medicare Advantage	$48,666.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24,657.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24,657.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,598.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24,657.45
Rate for Payer: Cigna Commercial	$20,605.42
Rate for Payer: Cigna Medicare Advantage	$15,598.26
Rate for Payer: Clover Medicare Advantage	$14,818.35
Rate for Payer: EmblemHealth Commercial	$46,794.78
Rate for Payer: Humana Medicare Advantage	$16,066.21
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,598.26
Rate for Payer: Oxford Commercial	$16,286.17
Rate for Payer: UnitedHealthcare Commercial	$21,799.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,598.26
Rate for Payer: Wellcare Medicare Advantage	$15,598.26

DIGITAL DIAG ADD VIEWS BIL

Facility

$784.00

Service Code	HCPCS G0204
Hospital Charge Code	94061455
Hospital Revenue Code	401
Min. Negotiated Rate	$22.27
Max. Negotiated Rate	$1,884.00
Rate for Payer: Aetna Commercial	$297.92
Rate for Payer: Aetna Medicare Advantage	$235.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$199.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$199.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$199.92
Rate for Payer: Cigna Commercial	$392.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$203.84
Rate for Payer: Oxford Commercial	$1,688.00
Rate for Payer: Qualcare PPO/HMO/WC	$117.60
Rate for Payer: UnitedHealthcare Commercial	$1,884.00
Rate for Payer: UnitedHealthcare Community & State	$24.77
Rate for Payer: Wellpoint Medicaid Managed Care	$22.27

DIGITAL DIAG ADD VIEWS BIL

Facility

$784.00

Service Code	HCPCS G0204
Hospital Charge Code	94061455
Hospital Revenue Code	401
Min. Negotiated Rate	$117.60
Max. Negotiated Rate	$117.60
Rate for Payer: Qualcare PPO/HMO/WC	$117.60

DIGITAL DIAG ADD VIEWS LT

Facility

$438.00

Service Code	HCPCS G0206
Hospital Charge Code	94061457
Hospital Revenue Code	401
Min. Negotiated Rate	$12.44
Max. Negotiated Rate	$1,884.00
Rate for Payer: Aetna Commercial	$166.44
Rate for Payer: Aetna Medicare Advantage	$131.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.69
Rate for Payer: Cigna Commercial	$219.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.88
Rate for Payer: Oxford Commercial	$1,688.00
Rate for Payer: Qualcare PPO/HMO/WC	$65.70
Rate for Payer: UnitedHealthcare Commercial	$1,884.00
Rate for Payer: UnitedHealthcare Community & State	$13.84
Rate for Payer: Wellpoint Medicaid Managed Care	$12.44

DIGITAL DIAG ADD VIEWS LT

Facility

$438.00

Service Code	HCPCS G0206
Hospital Charge Code	94061457
Hospital Revenue Code	401
Min. Negotiated Rate	$65.70
Max. Negotiated Rate	$65.70
Rate for Payer: Qualcare PPO/HMO/WC	$65.70

DIGITAL DIAG ADD VIEWS RT

Facility

$438.00

Service Code	HCPCS G0206
Hospital Charge Code	94061459
Hospital Revenue Code	401
Min. Negotiated Rate	$12.44
Max. Negotiated Rate	$1,884.00
Rate for Payer: Aetna Commercial	$166.44
Rate for Payer: Aetna Medicare Advantage	$131.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.69
Rate for Payer: Cigna Commercial	$219.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.88
Rate for Payer: Oxford Commercial	$1,688.00
Rate for Payer: Qualcare PPO/HMO/WC	$65.70
Rate for Payer: UnitedHealthcare Commercial	$1,884.00
Rate for Payer: UnitedHealthcare Community & State	$13.84
Rate for Payer: Wellpoint Medicaid Managed Care	$12.44

DIGITAL DIAG ADD VIEWS RT

Facility

$438.00

Service Code	HCPCS G0206
Hospital Charge Code	94061459
Hospital Revenue Code	401
Min. Negotiated Rate	$65.70
Max. Negotiated Rate	$65.70
Rate for Payer: Qualcare PPO/HMO/WC	$65.70

DIGITAL DIAG MAMMO BIL

Facility

$784.00

Service Code	HCPCS G0204
Hospital Charge Code	94061447
Hospital Revenue Code	401
Min. Negotiated Rate	$22.27
Max. Negotiated Rate	$1,884.00
Rate for Payer: Aetna Commercial	$297.92
Rate for Payer: Aetna Medicare Advantage	$235.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$199.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$199.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$199.92
Rate for Payer: Cigna Commercial	$392.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$203.84
Rate for Payer: Oxford Commercial	$1,688.00
Rate for Payer: Qualcare PPO/HMO/WC	$117.60
Rate for Payer: UnitedHealthcare Commercial	$1,884.00
Rate for Payer: UnitedHealthcare Community & State	$24.77
Rate for Payer: Wellpoint Medicaid Managed Care	$22.27

DIGITAL DIAG MAMMO BIL

Facility

$784.00

Service Code	HCPCS G0204
Hospital Charge Code	94061447
Hospital Revenue Code	401
Min. Negotiated Rate	$117.60
Max. Negotiated Rate	$117.60
Rate for Payer: Qualcare PPO/HMO/WC	$117.60

DIGITAL DIAG MAMMO LT

Facility

$438.00

Service Code	HCPCS G0206
Hospital Charge Code	94061449
Hospital Revenue Code	401
Min. Negotiated Rate	$65.70
Max. Negotiated Rate	$65.70
Rate for Payer: Qualcare PPO/HMO/WC	$65.70

DIGITAL DIAG MAMMO LT

Facility

$438.00

Service Code	HCPCS G0206
Hospital Charge Code	94061449
Hospital Revenue Code	401
Min. Negotiated Rate	$12.44
Max. Negotiated Rate	$1,884.00
Rate for Payer: Aetna Commercial	$166.44
Rate for Payer: Aetna Medicare Advantage	$131.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.69
Rate for Payer: Cigna Commercial	$219.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.88
Rate for Payer: Oxford Commercial	$1,688.00
Rate for Payer: Qualcare PPO/HMO/WC	$65.70
Rate for Payer: UnitedHealthcare Commercial	$1,884.00
Rate for Payer: UnitedHealthcare Community & State	$13.84
Rate for Payer: Wellpoint Medicaid Managed Care	$12.44

DIGITAL MAMMO UNI RT

Facility

$438.00

Service Code	HCPCS G0206
Hospital Charge Code	94061451
Hospital Revenue Code	401
Min. Negotiated Rate	$12.44
Max. Negotiated Rate	$1,884.00
Rate for Payer: Aetna Commercial	$166.44
Rate for Payer: Aetna Medicare Advantage	$131.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.69
Rate for Payer: Cigna Commercial	$219.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.88
Rate for Payer: Oxford Commercial	$1,688.00
Rate for Payer: Qualcare PPO/HMO/WC	$65.70
Rate for Payer: UnitedHealthcare Commercial	$1,884.00
Rate for Payer: UnitedHealthcare Community & State	$13.84
Rate for Payer: Wellpoint Medicaid Managed Care	$12.44

DIGITAL MAMMO UNI RT

Facility

$438.00

Service Code	HCPCS G0206
Hospital Charge Code	94061451
Hospital Revenue Code	401
Min. Negotiated Rate	$65.70
Max. Negotiated Rate	$65.70
Rate for Payer: Qualcare PPO/HMO/WC	$65.70

DIGITAL RECTAL EXAM

Facility

$67.00

Service Code	HCPCS G0102
Hospital Charge Code	87502815
Hospital Revenue Code	510
Min. Negotiated Rate	$10.05
Max. Negotiated Rate	$10.05
Rate for Payer: Qualcare PPO/HMO/WC	$10.05

DIGITAL RECTAL EXAM

Facility

$67.00

Service Code	HCPCS G0102
Hospital Charge Code	87502670
Hospital Revenue Code	770
Min. Negotiated Rate	$10.05
Max. Negotiated Rate	$10.05
Rate for Payer: Qualcare PPO/HMO/WC	$10.05

DIGITAL RECTAL EXAM

Facility

$67.00

Service Code	HCPCS G0102
Hospital Charge Code	87502815
Hospital Revenue Code	510
Min. Negotiated Rate	$1.90
Max. Negotiated Rate	$33.50
Rate for Payer: Aetna Commercial	$25.46
Rate for Payer: Aetna Medicare Advantage	$20.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.09
Rate for Payer: Cigna Commercial	$33.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.42
Rate for Payer: Qualcare PPO/HMO/WC	$10.05
Rate for Payer: UnitedHealthcare Community & State	$2.12
Rate for Payer: Wellpoint Medicaid Managed Care	$1.90

DIGITAL RECTAL EXAM

Facility

$67.00

Service Code	HCPCS G0102
Hospital Charge Code	87502670
Hospital Revenue Code	770
Min. Negotiated Rate	$1.90
Max. Negotiated Rate	$33.50
Rate for Payer: Aetna Commercial	$25.46
Rate for Payer: Aetna Medicare Advantage	$20.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.09
Rate for Payer: Cigna Commercial	$33.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.42
Rate for Payer: Oxford Commercial	$13.40
Rate for Payer: Qualcare PPO/HMO/WC	$10.05
Rate for Payer: UnitedHealthcare Commercial	$13.40
Rate for Payer: UnitedHealthcare Community & State	$2.12
Rate for Payer: Wellpoint Medicaid Managed Care	$1.90

DIGITAL UNILAT MAMMO SCRN

Facility

$950.20

Service Code	HCPCS G020252
Hospital Charge Code	94061475
Hospital Revenue Code	403
Min. Negotiated Rate	$26.99
Max. Negotiated Rate	$1,884.00
Rate for Payer: Aetna Commercial	$361.08
Rate for Payer: Aetna Medicare Advantage	$285.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.30
Rate for Payer: Cigna Commercial	$475.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$247.05
Rate for Payer: Oxford Commercial	$1,688.00
Rate for Payer: Qualcare PPO/HMO/WC	$142.53
Rate for Payer: UnitedHealthcare Commercial	$1,884.00
Rate for Payer: UnitedHealthcare Community & State	$30.03
Rate for Payer: Wellpoint Medicaid Managed Care	$26.99

DIGITAL UNILAT MAMMO SCRN

Facility

$950.20

Service Code	HCPCS G020252
Hospital Charge Code	94061475
Hospital Revenue Code	403
Min. Negotiated Rate	$142.53
Max. Negotiated Rate	$142.53
Rate for Payer: Qualcare PPO/HMO/WC	$142.53

DIGITOXIN

Facility

$292.00

Service Code	HCPCS 80299
Hospital Charge Code	38472404
Hospital Revenue Code	301
Min. Negotiated Rate	$43.80
Max. Negotiated Rate	$43.80
Rate for Payer: Qualcare PPO/HMO/WC	$43.80

DIGITOXIN

Facility

$292.00

Service Code	HCPCS 80299
Hospital Charge Code	38472404
Hospital Revenue Code	301
Min. Negotiated Rate	$8.29
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$50.70
Rate for Payer: Aetna Medicare Advantage	$60.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.62
Rate for Payer: Cigna Commercial	$146.00
Rate for Payer: Cigna Medicare Advantage	$18.64
Rate for Payer: Clover Medicare Advantage	$17.71
Rate for Payer: EmblemHealth Commercial	$55.92
Rate for Payer: Humana Medicare Advantage	$19.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.92
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.80
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Medicare Advantage	$18.64
Rate for Payer: Wellpoint Medicaid Managed Care	$8.29

Know your out-of-pocket cost for care.

All Charges