Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ADAPTER YPORT FEEDING 20F

Facility

$35.88

Hospital Charge Code	270619410
Hospital Revenue Code	270
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$17.94
Rate for Payer: Aetna Commercial	$13.63
Rate for Payer: Aetna Medicare Advantage	$10.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.15
Rate for Payer: Cigna Commercial	$17.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.33
Rate for Payer: Oxford Commercial	$7.18
Rate for Payer: Qualcare PPO/HMO/WC	$5.38
Rate for Payer: UnitedHealthcare Commercial	$7.18
Rate for Payer: UnitedHealthcare Community & State	$1.13
Rate for Payer: Wellpoint Medicaid Managed Care	$1.02

ADAPTER YPORT FEEDING 20F

Facility

$35.88

Hospital Charge Code	270619410
Hospital Revenue Code	270
Min. Negotiated Rate	$5.38
Max. Negotiated Rate	$5.38
Rate for Payer: Qualcare PPO/HMO/WC	$5.38

ADAPTOR TAPER VERSA 25MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697700
Hospital Revenue Code	278
Min. Negotiated Rate	$28.40
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$31.60
Rate for Payer: Wellpoint Medicaid Managed Care	$28.40

ADAPTOR TAPER VERSA 25MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697700
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

ADAPTOR TEE AEROGEN SOLO 15MM

Facility

$96.95

Hospital Charge Code	270690911
Hospital Revenue Code	272
Min. Negotiated Rate	$14.54
Max. Negotiated Rate	$14.54
Rate for Payer: Qualcare PPO/HMO/WC	$14.54

ADAPTOR TEE AEROGEN SOLO 15MM

Facility

$96.95

Hospital Charge Code	270690911
Hospital Revenue Code	272
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$48.48
Rate for Payer: Aetna Commercial	$36.84
Rate for Payer: Aetna Medicare Advantage	$29.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.72
Rate for Payer: Cigna Commercial	$48.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.21
Rate for Payer: Oxford Commercial	$19.39
Rate for Payer: Qualcare PPO/HMO/WC	$14.54
Rate for Payer: UnitedHealthcare Commercial	$19.39
Rate for Payer: UnitedHealthcare Community & State	$3.06
Rate for Payer: Wellpoint Medicaid Managed Care	$2.75

ADAPTOR TIBIAL TRAY OFFSET 5MM

Facility

$4,260.00

Service Code	HCPCS C1776
Hospital Charge Code	270665686
Hospital Revenue Code	278
Min. Negotiated Rate	$120.98
Max. Negotiated Rate	$2,130.00
Rate for Payer: Aetna Commercial	$1,618.80
Rate for Payer: Aetna Medicare Advantage	$1,278.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,086.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,086.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$852.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,086.30
Rate for Payer: Cigna Commercial	$2,130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,030.92
Rate for Payer: Qualcare PPO/HMO/WC	$639.00
Rate for Payer: UnitedHealthcare Community & State	$134.62
Rate for Payer: Wellpoint Medicaid Managed Care	$120.98

ADAPTOR TIBIAL TRAY OFFSET 5MM

Facility

$4,260.00

Service Code	HCPCS C1776
Hospital Charge Code	270665686
Hospital Revenue Code	278
Min. Negotiated Rate	$639.00
Max. Negotiated Rate	$1,030.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$852.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,030.92
Rate for Payer: Qualcare PPO/HMO/WC	$639.00

ADAPTOR TRIMANO

Facility

$5,000.00

Hospital Charge Code	270676550
Hospital Revenue Code	272
Min. Negotiated Rate	$142.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.00
Rate for Payer: Oxford Commercial	$1,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Commercial	$1,000.00
Rate for Payer: UnitedHealthcare Community & State	$158.00
Rate for Payer: Wellpoint Medicaid Managed Care	$142.00

ADAPTOR TRIMANO

Facility

$5,000.00

Hospital Charge Code	270676550
Hospital Revenue Code	272
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$750.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

ADDITIONAL SPINAL- FUSION

Facility

$22,894.84

Service Code	HCPCS 22585
Hospital Charge Code	16000498
Hospital Revenue Code	360
Min. Negotiated Rate	$3,434.23
Max. Negotiated Rate	$3,434.23
Rate for Payer: Qualcare PPO/HMO/WC	$3,434.23

ADDITIONAL SPINAL- FUSION

Facility

$22,894.84

Service Code	HCPCS 22585
Hospital Charge Code	16000498
Hospital Revenue Code	360
Min. Negotiated Rate	$650.21
Max. Negotiated Rate	$14,869.00
Rate for Payer: Aetna Commercial	$8,700.04
Rate for Payer: Aetna Medicare Advantage	$6,868.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,838.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,838.18
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	$5,838.18
Rate for Payer: Cigna Commercial	$11,447.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,952.66
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,434.23
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$723.48
Rate for Payer: Wellpoint Medicaid Managed Care	$650.21

ADDTL THROMB ANY VESSEL

Facility

$11,744.00

Service Code	HCPCS 37185
Hospital Charge Code	411037185
Hospital Revenue Code	361
Min. Negotiated Rate	$333.53
Max. Negotiated Rate	$5,872.00
Rate for Payer: Aetna Commercial	$4,462.72
Rate for Payer: Aetna Medicare Advantage	$3,523.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,994.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,994.72
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	$2,994.72
Rate for Payer: Cigna Commercial	$5,872.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,053.44
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,761.60
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$371.11
Rate for Payer: Wellpoint Medicaid Managed Care	$333.53

ADDTL THROMB ANY VESSEL

Facility

$11,744.00

Service Code	HCPCS 37185
Hospital Charge Code	366837185
Hospital Revenue Code	361
Min. Negotiated Rate	$333.53
Max. Negotiated Rate	$5,872.00
Rate for Payer: Aetna Commercial	$4,462.72
Rate for Payer: Aetna Medicare Advantage	$3,523.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,994.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,994.72
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	$2,994.72
Rate for Payer: Cigna Commercial	$5,872.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,053.44
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,761.60
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$371.11
Rate for Payer: Wellpoint Medicaid Managed Care	$333.53

ADDTL THROMB ANY VESSEL

Facility

$11,744.00

Service Code	HCPCS 37185
Hospital Charge Code	411037185
Hospital Revenue Code	361
Min. Negotiated Rate	$1,761.60
Max. Negotiated Rate	$1,761.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,761.60

ADDTL THROMB ANY VESSEL

Facility

$11,744.00

Service Code	HCPCS 37185
Hospital Charge Code	366837185
Hospital Revenue Code	361
Min. Negotiated Rate	$1,761.60
Max. Negotiated Rate	$1,761.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,761.60

ADD WALKER CAST

Facility

$458.00

Service Code	HCPCS 29440
Hospital Charge Code	5780150
Hospital Revenue Code	450
Min. Negotiated Rate	$13.01
Max. Negotiated Rate	$700.29
Rate for Payer: Aetna Commercial	$525.10
Rate for Payer: Aetna Medicare Advantage	$625.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$700.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$700.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$193.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$700.29
Rate for Payer: Cigna Commercial	$386.97
Rate for Payer: Cigna Medicare Advantage	$193.05
Rate for Payer: Clover Medicare Advantage	$183.40
Rate for Payer: EmblemHealth Commercial	$579.15
Rate for Payer: Humana Medicare Advantage	$198.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$193.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.08
Rate for Payer: Qualcare PPO/HMO/WC	$68.70
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$193.05
Rate for Payer: Wellcare Medicare Advantage	$193.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.01

ADD WALKER CAST

Facility

$458.00

Service Code	HCPCS 29440
Hospital Charge Code	5780150
Hospital Revenue Code	450
Min. Negotiated Rate	$68.70
Max. Negotiated Rate	$68.70
Rate for Payer: Qualcare PPO/HMO/WC	$68.70

ADENOCARD 12MG/4ML VIAL

Facility

$183.45

Service Code	HCPCS J0153
Hospital Charge Code	60635637
Hospital Revenue Code	636
Min. Negotiated Rate	$27.52
Max. Negotiated Rate	$44.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.39
Rate for Payer: Qualcare PPO/HMO/WC	$27.52

ADENOCARD 12MG/4ML VIAL

Facility

$183.45

Service Code	HCPCS J0153
Hospital Charge Code	60635637
Hospital Revenue Code	636
Min. Negotiated Rate	$5.21
Max. Negotiated Rate	$91.72
Rate for Payer: Aetna Commercial	$69.71
Rate for Payer: Aetna Medicare Advantage	$55.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.78
Rate for Payer: Cigna Commercial	$91.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.39
Rate for Payer: Qualcare PPO/HMO/WC	$27.52
Rate for Payer: UnitedHealthcare Community & State	$5.80
Rate for Payer: Wellpoint Medicaid Managed Care	$5.21

ADENOIDECTOMY,AGE 12 OR OVER

Facility

$22,083.40

Service Code	HCPCS 42831
Hospital Charge Code	1600000635
Hospital Revenue Code	360
Min. Negotiated Rate	$627.17
Max. Negotiated Rate	$14,288.18
Rate for Payer: Aetna Commercial	$10,713.67
Rate for Payer: Aetna Medicare Advantage	$12,761.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,288.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,288.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,938.85
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	$14,288.18
Rate for Payer: Cigna Commercial	$7,895.42
Rate for Payer: Cigna Medicare Advantage	$3,938.85
Rate for Payer: Clover Medicare Advantage	$3,741.91
Rate for Payer: EmblemHealth Commercial	$11,816.55
Rate for Payer: Humana Medicare Advantage	$4,057.02
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,938.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,741.68
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,312.51
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$697.84
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,938.85
Rate for Payer: Wellcare Medicare Advantage	$3,938.85
Rate for Payer: Wellpoint Medicaid Managed Care	$627.17

ADENOIDECTOMY,AGE 12 OR OVER

Facility

$22,083.40

Service Code	HCPCS 42831
Hospital Charge Code	1600000635
Hospital Revenue Code	360
Min. Negotiated Rate	$3,312.51
Max. Negotiated Rate	$3,312.51
Rate for Payer: Qualcare PPO/HMO/WC	$3,312.51

ADENOSINE 6 MG/2 ML INJ

Facility

$42.61

Service Code	HCPCS J0153
Hospital Charge Code	60627544
Hospital Revenue Code	636
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$10.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.31
Rate for Payer: Qualcare PPO/HMO/WC	$6.39

ADENOSINE 6 MG/2 ML INJ

Facility

$42.61

Service Code	HCPCS J0153
Hospital Charge Code	60627544
Hospital Revenue Code	636
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$21.30
Rate for Payer: Aetna Commercial	$16.19
Rate for Payer: Aetna Medicare Advantage	$12.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.87
Rate for Payer: Cigna Commercial	$21.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.31
Rate for Payer: Qualcare PPO/HMO/WC	$6.39
Rate for Payer: UnitedHealthcare Community & State	$1.35
Rate for Payer: Wellpoint Medicaid Managed Care	$1.21

ADENOSINE (ADENOSCAN) 90MG/30M

Facility

$2,125.91

Service Code	HCPCS J0153
Hospital Charge Code	60630194
Hospital Revenue Code	636
Min. Negotiated Rate	$60.38
Max. Negotiated Rate	$1,062.95
Rate for Payer: Aetna Commercial	$807.85
Rate for Payer: Aetna Medicare Advantage	$637.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$542.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$542.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$542.11
Rate for Payer: Cigna Commercial	$1,062.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.47
Rate for Payer: Qualcare PPO/HMO/WC	$318.89
Rate for Payer: UnitedHealthcare Community & State	$67.18
Rate for Payer: Wellpoint Medicaid Managed Care	$60.38

Know your out-of-pocket cost for care.

All Charges