Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

AEP NEURODIAGNOSTIC I&R

Facility

$1,597.40

Service Code	HCPCS 92653
Hospital Charge Code	309292653
Hospital Revenue Code	471
Min. Negotiated Rate	$45.37
Max. Negotiated Rate	$1,823.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$930.53
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$415.32
Rate for Payer: Oxford Commercial	$1,606.00
Rate for Payer: Qualcare PPO/HMO/WC	$239.61
Rate for Payer: UnitedHealthcare Commercial	$1,823.00
Rate for Payer: UnitedHealthcare Community & State	$50.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$45.37

AEP NEURODIAGNOSTIC I&R

Facility

$1,597.40

Service Code	HCPCS 92653
Hospital Charge Code	309292653
Hospital Revenue Code	471
Min. Negotiated Rate	$239.61
Max. Negotiated Rate	$239.61
Rate for Payer: Qualcare PPO/HMO/WC	$239.61

AEP SCR AUDITORY POTENT W/STIM

Facility

$1,597.40

Service Code	HCPCS 92650
Hospital Charge Code	309292650
Hospital Revenue Code	471
Min. Negotiated Rate	$17.07
Max. Negotiated Rate	$1,823.00
Rate for Payer: Aetna Commercial	$607.01
Rate for Payer: Aetna Medicare Advantage	$479.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$407.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$407.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$407.34
Rate for Payer: Cigna Commercial	$798.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$415.32
Rate for Payer: Oxford Commercial	$1,606.00
Rate for Payer: Qualcare PPO/HMO/WC	$239.61
Rate for Payer: UnitedHealthcare Commercial	$1,823.00
Rate for Payer: UnitedHealthcare Community & State	$50.48
Rate for Payer: Wellpoint Medicaid Managed Care	$45.37

AEP SCR AUDITORY POTENT W/STIM

Facility

$1,597.40

Service Code	HCPCS 92650
Hospital Charge Code	309292650
Hospital Revenue Code	471
Min. Negotiated Rate	$239.61
Max. Negotiated Rate	$239.61
Rate for Payer: Qualcare PPO/HMO/WC	$239.61

AEP THRESHOLD EST MLT FREQ I&R

Facility

$1,597.40

Service Code	HCPCS 92652
Hospital Charge Code	403392652
Hospital Revenue Code	471
Min. Negotiated Rate	$45.37
Max. Negotiated Rate	$1,823.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$930.53
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$415.32
Rate for Payer: Oxford Commercial	$1,606.00
Rate for Payer: Qualcare PPO/HMO/WC	$239.61
Rate for Payer: UnitedHealthcare Commercial	$1,823.00
Rate for Payer: UnitedHealthcare Community & State	$50.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$45.37

AEP THRESHOLD EST MLT FREQ I&R

Facility

$1,597.40

Service Code	HCPCS 92652
Hospital Charge Code	403392652
Hospital Revenue Code	471
Min. Negotiated Rate	$239.61
Max. Negotiated Rate	$239.61
Rate for Payer: Qualcare PPO/HMO/WC	$239.61

AEP THRESHOLD EST MLT FREQ I&R

Facility

$1,597.40

Service Code	HCPCS 92652
Hospital Charge Code	309292652
Hospital Revenue Code	471
Min. Negotiated Rate	$239.61
Max. Negotiated Rate	$239.61
Rate for Payer: Qualcare PPO/HMO/WC	$239.61

AEP THRESHOLD EST MLT FREQ I&R

Facility

$1,597.40

Service Code	HCPCS 92652
Hospital Charge Code	309292652
Hospital Revenue Code	471
Min. Negotiated Rate	$45.37
Max. Negotiated Rate	$1,823.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$930.53
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$415.32
Rate for Payer: Oxford Commercial	$1,606.00
Rate for Payer: Qualcare PPO/HMO/WC	$239.61
Rate for Payer: UnitedHealthcare Commercial	$1,823.00
Rate for Payer: UnitedHealthcare Community & State	$50.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$45.37

AEQUALIS REVERSED II CENTERED

Facility

$20,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270657916
Hospital Revenue Code	278
Min. Negotiated Rate	$575.10
Max. Negotiated Rate	$10,125.00
Rate for Payer: Aetna Commercial	$7,695.00
Rate for Payer: Aetna Medicare Advantage	$6,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,163.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,163.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,163.75
Rate for Payer: Cigna Commercial	$10,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,900.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,037.50
Rate for Payer: UnitedHealthcare Community & State	$639.90
Rate for Payer: Wellpoint Medicaid Managed Care	$575.10

AEQUALIS REVERSED II CENTERED

Facility

$20,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270657916
Hospital Revenue Code	278
Min. Negotiated Rate	$3,037.50
Max. Negotiated Rate	$4,900.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,900.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,037.50

AERO AIRWAY STENT SYSTEM 12 X

Facility

$14,000.00

Service Code	HCPCS C2625
Hospital Charge Code	270678264
Hospital Revenue Code	278
Min. Negotiated Rate	$397.60
Max. Negotiated Rate	$7,000.00
Rate for Payer: Aetna Commercial	$5,320.00
Rate for Payer: Aetna Medicare Advantage	$4,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,570.00
Rate for Payer: Cigna Commercial	$7,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,388.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,100.00
Rate for Payer: UnitedHealthcare Community & State	$442.40
Rate for Payer: Wellpoint Medicaid Managed Care	$397.60

AERO AIRWAY STENT SYSTEM 12 X

Facility

$14,000.00

Service Code	HCPCS C2625
Hospital Charge Code	270678264
Hospital Revenue Code	278
Min. Negotiated Rate	$2,100.00
Max. Negotiated Rate	$3,388.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,388.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,100.00

AEROBIC ID

Facility

$35.30

Service Code	HCPCS 87147
Hospital Charge Code	39900493
Hospital Revenue Code	309
Min. Negotiated Rate	$5.29
Max. Negotiated Rate	$5.29
Rate for Payer: Qualcare PPO/HMO/WC	$5.29

AEROBIC ID

Facility

$35.30

Service Code	HCPCS 87147
Hospital Charge Code	39900493
Hospital Revenue Code	309
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$14.09
Rate for Payer: Aetna Medicare Advantage	$16.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.79
Rate for Payer: Cigna Commercial	$17.65
Rate for Payer: Cigna Medicare Advantage	$5.18
Rate for Payer: Clover Medicare Advantage	$4.92
Rate for Payer: EmblemHealth Commercial	$15.54
Rate for Payer: Humana Medicare Advantage	$5.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.18
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.29
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$4.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.18
Rate for Payer: Wellcare Medicare Advantage	$5.18
Rate for Payer: Wellpoint Medicaid Managed Care	$1.00

AETOS GLENOSPHERE 34MM CONCENT

Facility

$10,285.00

Service Code	HCPCS C1713
Hospital Charge Code	270704524
Hospital Revenue Code	278
Min. Negotiated Rate	$292.09
Max. Negotiated Rate	$5,142.50
Rate for Payer: Aetna Commercial	$3,908.30
Rate for Payer: Aetna Medicare Advantage	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,622.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,622.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,057.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,622.68
Rate for Payer: Cigna Commercial	$5,142.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,488.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,542.75
Rate for Payer: UnitedHealthcare Community & State	$325.01
Rate for Payer: Wellpoint Medicaid Managed Care	$292.09

AETOS GLENOSPHERE 34MM CONCENT

Facility

$10,285.00

Service Code	HCPCS C1713
Hospital Charge Code	270704524
Hospital Revenue Code	278
Min. Negotiated Rate	$1,542.75
Max. Negotiated Rate	$2,488.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,057.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,488.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,542.75

AETOS GLENOSPHERE 38MM CONCENT

Facility

$10,285.00

Service Code	HCPCS C1713
Hospital Charge Code	270704895
Hospital Revenue Code	278
Min. Negotiated Rate	$292.09
Max. Negotiated Rate	$5,142.50
Rate for Payer: Aetna Commercial	$3,908.30
Rate for Payer: Aetna Medicare Advantage	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,622.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,622.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,057.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,622.68
Rate for Payer: Cigna Commercial	$5,142.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,488.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,542.75
Rate for Payer: UnitedHealthcare Community & State	$325.01
Rate for Payer: Wellpoint Medicaid Managed Care	$292.09

AETOS GLENOSPHERE 38MM CONCENT

Facility

$10,285.00

Service Code	HCPCS C1713
Hospital Charge Code	270704895
Hospital Revenue Code	278
Min. Negotiated Rate	$1,542.75
Max. Negotiated Rate	$2,488.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,057.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,488.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,542.75

AETOS HUMERAL HEAD CONCENTRIC

Facility

$8,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270704905
Hospital Revenue Code	278
Min. Negotiated Rate	$249.92
Max. Negotiated Rate	$4,400.00
Rate for Payer: Aetna Commercial	$3,344.00
Rate for Payer: Aetna Medicare Advantage	$2,640.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,244.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,244.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,760.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,244.00
Rate for Payer: Cigna Commercial	$4,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,129.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,320.00
Rate for Payer: UnitedHealthcare Community & State	$278.08
Rate for Payer: Wellpoint Medicaid Managed Care	$249.92

AETOS HUMERAL HEAD CONCENTRIC

Facility

$8,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270704905
Hospital Revenue Code	278
Min. Negotiated Rate	$1,320.00
Max. Negotiated Rate	$2,129.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,760.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,129.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,320.00

AETOS META HUMERAL STEM SZ 1 S

Facility

$15,335.00

Service Code	HCPCS C1713
Hospital Charge Code	270704981
Hospital Revenue Code	278
Min. Negotiated Rate	$2,300.25
Max. Negotiated Rate	$3,711.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,067.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,711.07
Rate for Payer: Qualcare PPO/HMO/WC	$2,300.25

AETOS META HUMERAL STEM SZ 1 S

Facility

$15,335.00

Service Code	HCPCS C1713
Hospital Charge Code	270704981
Hospital Revenue Code	278
Min. Negotiated Rate	$435.51
Max. Negotiated Rate	$7,667.50
Rate for Payer: Aetna Commercial	$5,827.30
Rate for Payer: Aetna Medicare Advantage	$4,600.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,910.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,910.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,067.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,910.43
Rate for Payer: Cigna Commercial	$7,667.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,711.07
Rate for Payer: Qualcare PPO/HMO/WC	$2,300.25
Rate for Payer: UnitedHealthcare Community & State	$484.59
Rate for Payer: Wellpoint Medicaid Managed Care	$435.51

AETOS META HUMERAL STEM SZ 3 L

Facility

$15,335.00

Service Code	HCPCS C1713
Hospital Charge Code	270704904
Hospital Revenue Code	278
Min. Negotiated Rate	$2,300.25
Max. Negotiated Rate	$3,711.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,067.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,711.07
Rate for Payer: Qualcare PPO/HMO/WC	$2,300.25

AETOS META HUMERAL STEM SZ 3 L

Facility

$15,335.00

Service Code	HCPCS C1713
Hospital Charge Code	270704904
Hospital Revenue Code	278
Min. Negotiated Rate	$435.51
Max. Negotiated Rate	$7,667.50
Rate for Payer: Aetna Commercial	$5,827.30
Rate for Payer: Aetna Medicare Advantage	$4,600.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,910.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,910.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,067.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,910.43
Rate for Payer: Cigna Commercial	$7,667.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,711.07
Rate for Payer: Qualcare PPO/HMO/WC	$2,300.25
Rate for Payer: UnitedHealthcare Community & State	$484.59
Rate for Payer: Wellpoint Medicaid Managed Care	$435.51

AETOS REVERSE LINER 34MM/SMALL

Facility

$3,745.00

Service Code	HCPCS C1713
Hospital Charge Code	270704575
Hospital Revenue Code	278
Min. Negotiated Rate	$106.36
Max. Negotiated Rate	$1,872.50
Rate for Payer: Aetna Commercial	$1,423.10
Rate for Payer: Aetna Medicare Advantage	$1,123.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$954.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$954.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$749.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$954.98
Rate for Payer: Cigna Commercial	$1,872.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$906.29
Rate for Payer: Qualcare PPO/HMO/WC	$561.75
Rate for Payer: UnitedHealthcare Community & State	$118.34
Rate for Payer: Wellpoint Medicaid Managed Care	$106.36

Know your out-of-pocket cost for care.

All Charges