Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

DRAINAGE PAROTID ABSCESS SIMPL

Facility

$7,090.00

Service Code	HCPCS 42300
Hospital Charge Code	5780215
Hospital Revenue Code	450
Min. Negotiated Rate	$55.90
Max. Negotiated Rate	$6,686.64
Rate for Payer: Aetna Commercial	$5,013.83
Rate for Payer: Aetna Medicare Advantage	$5,972.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,686.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,686.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,843.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,686.64
Rate for Payer: Cigna Commercial	$3,694.94
Rate for Payer: Cigna Medicare Advantage	$1,843.32
Rate for Payer: Clover Medicare Advantage	$1,751.15
Rate for Payer: EmblemHealth Commercial	$5,529.96
Rate for Payer: Humana Medicare Advantage	$1,898.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,843.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,843.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,063.50
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,843.32
Rate for Payer: Wellcare Medicare Advantage	$1,843.32
Rate for Payer: Wellpoint Medicaid Managed Care	$201.36

DRAINAGE PAROTID ABSCESS SIMPL

Facility

$7,090.00

Service Code	HCPCS 42300
Hospital Charge Code	5780215
Hospital Revenue Code	450
Min. Negotiated Rate	$1,063.50
Max. Negotiated Rate	$1,063.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,063.50

DRAINAGE POUCH CLAMP FOR

Facility

$20.00

Hospital Charge Code	270331645
Hospital Revenue Code	272
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

DRAINAGE POUCH CLAMP FOR

Facility

$20.00

Hospital Charge Code	270331645
Hospital Revenue Code	272
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$10.00
Rate for Payer: Aetna Commercial	$7.60
Rate for Payer: Aetna Medicare Advantage	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.10
Rate for Payer: Cigna Commercial	$10.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.20
Rate for Payer: Oxford Commercial	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$4.00
Rate for Payer: UnitedHealthcare Community & State	$0.63
Rate for Payer: Wellpoint Medicaid Managed Care	$0.57

DRAINAGE SCROTUM ABSCESS

Facility

$8,041.95

Service Code	HCPCS 55100
Hospital Charge Code	5792280
Hospital Revenue Code	450
Min. Negotiated Rate	$46.20
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,090.91
Rate for Payer: Qualcare PPO/HMO/WC	$1,206.29
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$228.39

DRAINAGE SCROTUM ABSCESS

Facility

$8,041.95

Service Code	HCPCS 55100
Hospital Charge Code	5792280
Hospital Revenue Code	450
Min. Negotiated Rate	$1,206.29
Max. Negotiated Rate	$1,206.29
Rate for Payer: Qualcare PPO/HMO/WC	$1,206.29

DRAINAGE SYSTEM CFS EXTERNA

Facility

$1,100.00

Service Code	HCPCS C1729
Hospital Charge Code	270667556
Hospital Revenue Code	278
Min. Negotiated Rate	$31.24
Max. Negotiated Rate	$550.00
Rate for Payer: Aetna Commercial	$418.00
Rate for Payer: Aetna Medicare Advantage	$330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$280.50
Rate for Payer: Cigna Commercial	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.20
Rate for Payer: Qualcare PPO/HMO/WC	$165.00
Rate for Payer: UnitedHealthcare Community & State	$34.76
Rate for Payer: Wellpoint Medicaid Managed Care	$31.24

DRAINAGE SYSTEM CFS EXTERNA

Facility

$1,100.00

Service Code	HCPCS C1729
Hospital Charge Code	270667556
Hospital Revenue Code	278
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$266.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.20
Rate for Payer: Qualcare PPO/HMO/WC	$165.00

DRAINAGE SYSTEM CSF

Facility

$925.00

Hospital Charge Code	270697050
Hospital Revenue Code	272
Min. Negotiated Rate	$26.27
Max. Negotiated Rate	$462.50
Rate for Payer: Aetna Commercial	$351.50
Rate for Payer: Aetna Medicare Advantage	$277.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.88
Rate for Payer: Cigna Commercial	$462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.50
Rate for Payer: Oxford Commercial	$185.00
Rate for Payer: Qualcare PPO/HMO/WC	$138.75
Rate for Payer: UnitedHealthcare Commercial	$185.00
Rate for Payer: UnitedHealthcare Community & State	$29.23
Rate for Payer: Wellpoint Medicaid Managed Care	$26.27

DRAINAGE SYSTEM CSF

Facility

$925.00

Hospital Charge Code	270697050
Hospital Revenue Code	272
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$138.75
Rate for Payer: Qualcare PPO/HMO/WC	$138.75

DRAINAGE TUBING 48 IN

Facility

$30.45

Hospital Charge Code	270681435
Hospital Revenue Code	272
Min. Negotiated Rate	$4.57
Max. Negotiated Rate	$4.57
Rate for Payer: Qualcare PPO/HMO/WC	$4.57

DRAINAGE TUBING 48 IN

Facility

$30.45

Hospital Charge Code	270681435
Hospital Revenue Code	272
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$15.22
Rate for Payer: Aetna Commercial	$11.57
Rate for Payer: Aetna Medicare Advantage	$9.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.76
Rate for Payer: Cigna Commercial	$15.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.92
Rate for Payer: Oxford Commercial	$6.09
Rate for Payer: Qualcare PPO/HMO/WC	$4.57
Rate for Payer: UnitedHealthcare Commercial	$6.09
Rate for Payer: UnitedHealthcare Community & State	$0.96
Rate for Payer: Wellpoint Medicaid Managed Care	$0.86

DRAINAGE TUBING 48 IN

Facility

$30.45

Hospital Charge Code	270681435O
Hospital Revenue Code	272
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$15.22
Rate for Payer: Aetna Commercial	$11.57
Rate for Payer: Aetna Medicare Advantage	$9.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.76
Rate for Payer: Cigna Commercial	$15.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.92
Rate for Payer: Oxford Commercial	$6.09
Rate for Payer: Qualcare PPO/HMO/WC	$4.57
Rate for Payer: UnitedHealthcare Commercial	$6.09
Rate for Payer: UnitedHealthcare Community & State	$0.96
Rate for Payer: Wellpoint Medicaid Managed Care	$0.86

DRAINAGE TUBING 48 IN

Facility

$30.45

Hospital Charge Code	270681435O
Hospital Revenue Code	272
Min. Negotiated Rate	$4.57
Max. Negotiated Rate	$4.57
Rate for Payer: Qualcare PPO/HMO/WC	$4.57

DRAINAGE WOUND DEVICE W/TRO

Facility

$1,430.00

Service Code	HCPCS C1729
Hospital Charge Code	270668012
Hospital Revenue Code	278
Min. Negotiated Rate	$40.61
Max. Negotiated Rate	$715.00
Rate for Payer: Aetna Commercial	$543.40
Rate for Payer: Aetna Medicare Advantage	$429.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$364.65
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	$364.65
Rate for Payer: Cigna Commercial	$715.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: Qualcare PPO/HMO/WC	$214.50
Rate for Payer: UnitedHealthcare Community & State	$45.19
Rate for Payer: Wellpoint Medicaid Managed Care	$40.61

DRAINAGE WOUND DEVICE W/TRO

Facility

$1,430.00

Service Code	HCPCS C1729
Hospital Charge Code	270668012
Hospital Revenue Code	278
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$346.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: Qualcare PPO/HMO/WC	$214.50

DRAIN ANGLED MALECOT 26FR

Facility

$230.00

Hospital Charge Code	270331378
Hospital Revenue Code	278
Min. Negotiated Rate	$6.53
Max. Negotiated Rate	$115.00
Rate for Payer: Aetna Commercial	$87.40
Rate for Payer: Aetna Medicare Advantage	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.65
Rate for Payer: Cigna Commercial	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.66
Rate for Payer: Qualcare PPO/HMO/WC	$34.50
Rate for Payer: UnitedHealthcare Community & State	$7.27
Rate for Payer: Wellpoint Medicaid Managed Care	$6.53

DRAIN ANGLED MALECOT 26FR

Facility

$230.00

Hospital Charge Code	270331378
Hospital Revenue Code	278
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$55.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.66
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

DRAIN BAG 96 LGTH 8MM ADAPTER

Facility

$40.25

Hospital Charge Code	270660057
Hospital Revenue Code	272
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$20.12
Rate for Payer: Aetna Commercial	$15.29
Rate for Payer: Aetna Medicare Advantage	$12.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.26
Rate for Payer: Cigna Commercial	$20.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.46
Rate for Payer: Oxford Commercial	$8.05
Rate for Payer: Qualcare PPO/HMO/WC	$6.04
Rate for Payer: UnitedHealthcare Commercial	$8.05
Rate for Payer: UnitedHealthcare Community & State	$1.27
Rate for Payer: Wellpoint Medicaid Managed Care	$1.14

DRAIN BAG 96 LGTH 8MM ADAPTER

Facility

$40.25

Hospital Charge Code	270660057
Hospital Revenue Code	272
Min. Negotiated Rate	$6.04
Max. Negotiated Rate	$6.04
Rate for Payer: Qualcare PPO/HMO/WC	$6.04

DRAIN BLAKE 10FR ROUN H

Facility

$77.45

Hospital Charge Code	270600376
Hospital Revenue Code	272
Min. Negotiated Rate	$2.20
Max. Negotiated Rate	$38.73
Rate for Payer: Aetna Commercial	$29.43
Rate for Payer: Aetna Medicare Advantage	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.75
Rate for Payer: Cigna Commercial	$38.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.14
Rate for Payer: Oxford Commercial	$15.49
Rate for Payer: Qualcare PPO/HMO/WC	$11.62
Rate for Payer: UnitedHealthcare Commercial	$15.49
Rate for Payer: UnitedHealthcare Community & State	$2.45
Rate for Payer: Wellpoint Medicaid Managed Care	$2.20

DRAIN BLAKE 10FR ROUN H

Facility

$77.45

Hospital Charge Code	270600376
Hospital Revenue Code	272
Min. Negotiated Rate	$11.62
Max. Negotiated Rate	$11.62
Rate for Payer: Qualcare PPO/HMO/WC	$11.62

DRAIN BLAKE 19 FR

Facility

$123.11

Hospital Charge Code	270655051
Hospital Revenue Code	272
Min. Negotiated Rate	$18.47
Max. Negotiated Rate	$18.47
Rate for Payer: Qualcare PPO/HMO/WC	$18.47

DRAIN BLAKE 19 FR

Facility

$123.11

Hospital Charge Code	270655051
Hospital Revenue Code	272
Min. Negotiated Rate	$3.50
Max. Negotiated Rate	$61.55
Rate for Payer: Aetna Commercial	$46.78
Rate for Payer: Aetna Medicare Advantage	$36.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.39
Rate for Payer: Cigna Commercial	$61.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.01
Rate for Payer: Oxford Commercial	$24.62
Rate for Payer: Qualcare PPO/HMO/WC	$18.47
Rate for Payer: UnitedHealthcare Commercial	$24.62
Rate for Payer: UnitedHealthcare Community & State	$3.89
Rate for Payer: Wellpoint Medicaid Managed Care	$3.50

DRAIN BLAKE HUBLESS 19fr ROUND

Facility

$82.15

Hospital Charge Code	270646027
Hospital Revenue Code	270
Min. Negotiated Rate	$12.32
Max. Negotiated Rate	$12.32
Rate for Payer: Qualcare PPO/HMO/WC	$12.32

Know your out-of-pocket cost for care.

All Charges