Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

DRUG ABUSE PANEL 9,SERUM II

Facility

$499.75

Hospital Charge Code	39990001B
Hospital Revenue Code	301
Min. Negotiated Rate	$14.19
Max. Negotiated Rate	$249.88
Rate for Payer: Aetna Commercial	$189.91
Rate for Payer: Aetna Medicare Advantage	$149.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.44
Rate for Payer: Cigna Commercial	$249.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.94
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.96
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$15.79
Rate for Payer: Wellpoint Medicaid Managed Care	$14.19

DRUG ABUSE PANEL 9,SERUM II

Facility

$499.75

Hospital Charge Code	39990001B
Hospital Revenue Code	301
Min. Negotiated Rate	$74.96
Max. Negotiated Rate	$74.96
Rate for Payer: Qualcare PPO/HMO/WC	$74.96

DRUG ABUSE PANEL 9,SERUM III

Facility

$499.75

Service Code	HCPCS 8010191
Hospital Charge Code	39990001C
Hospital Revenue Code	301
Min. Negotiated Rate	$74.96
Max. Negotiated Rate	$74.96
Rate for Payer: Qualcare PPO/HMO/WC	$74.96

DRUG ABUSE PANEL 9,SERUM III

Facility

$499.75

Service Code	HCPCS 8010191
Hospital Charge Code	39990001C
Hospital Revenue Code	301
Min. Negotiated Rate	$14.19
Max. Negotiated Rate	$249.88
Rate for Payer: Aetna Commercial	$189.91
Rate for Payer: Aetna Medicare Advantage	$149.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.44
Rate for Payer: Cigna Commercial	$249.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.94
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.96
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$15.79
Rate for Payer: Wellpoint Medicaid Managed Care	$14.19

DRUG ABUSE PANEL 9,SERUM IV

Facility

$499.75

Hospital Charge Code	39990001D
Hospital Revenue Code	301
Min. Negotiated Rate	$74.96
Max. Negotiated Rate	$74.96
Rate for Payer: Qualcare PPO/HMO/WC	$74.96

DRUG ABUSE PANEL 9,SERUM IV

Facility

$499.75

Hospital Charge Code	39990001D
Hospital Revenue Code	301
Min. Negotiated Rate	$14.19
Max. Negotiated Rate	$249.88
Rate for Payer: Aetna Commercial	$189.91
Rate for Payer: Aetna Medicare Advantage	$149.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.44
Rate for Payer: Cigna Commercial	$249.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.94
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.96
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$15.79
Rate for Payer: Wellpoint Medicaid Managed Care	$14.19

DRUG ABUSE PANEL 9,SERUM IX

Facility

$499.75

Hospital Charge Code	39990001I
Hospital Revenue Code	301
Min. Negotiated Rate	$14.19
Max. Negotiated Rate	$249.88
Rate for Payer: Aetna Commercial	$189.91
Rate for Payer: Aetna Medicare Advantage	$149.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.44
Rate for Payer: Cigna Commercial	$249.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.94
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.96
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$15.79
Rate for Payer: Wellpoint Medicaid Managed Care	$14.19

DRUG ABUSE PANEL 9,SERUM IX

Facility

$499.75

Hospital Charge Code	39990001I
Hospital Revenue Code	301
Min. Negotiated Rate	$74.96
Max. Negotiated Rate	$74.96
Rate for Payer: Qualcare PPO/HMO/WC	$74.96

DRUG ABUSE PANEL 9,SERUM V

Facility

$499.75

Hospital Charge Code	39990001E
Hospital Revenue Code	301
Min. Negotiated Rate	$74.96
Max. Negotiated Rate	$74.96
Rate for Payer: Qualcare PPO/HMO/WC	$74.96

DRUG ABUSE PANEL 9,SERUM V

Facility

$499.75

Hospital Charge Code	39990001E
Hospital Revenue Code	301
Min. Negotiated Rate	$14.19
Max. Negotiated Rate	$249.88
Rate for Payer: Aetna Commercial	$189.91
Rate for Payer: Aetna Medicare Advantage	$149.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.44
Rate for Payer: Cigna Commercial	$249.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.94
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.96
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$15.79
Rate for Payer: Wellpoint Medicaid Managed Care	$14.19

DRUG ABUSE PANEL 9,SERUM VI

Facility

$499.75

Service Code	HCPCS 8010191
Hospital Charge Code	39990001F
Hospital Revenue Code	301
Min. Negotiated Rate	$14.19
Max. Negotiated Rate	$249.88
Rate for Payer: Aetna Commercial	$189.91
Rate for Payer: Aetna Medicare Advantage	$149.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.44
Rate for Payer: Cigna Commercial	$249.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.94
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.96
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$15.79
Rate for Payer: Wellpoint Medicaid Managed Care	$14.19

DRUG ABUSE PANEL 9,SERUM VI

Facility

$499.75

Service Code	HCPCS 8010191
Hospital Charge Code	39990001F
Hospital Revenue Code	301
Min. Negotiated Rate	$74.96
Max. Negotiated Rate	$74.96
Rate for Payer: Qualcare PPO/HMO/WC	$74.96

DRUG ABUSE PANEL 9,SERUM VII

Facility

$499.75

Hospital Charge Code	39990001G
Hospital Revenue Code	301
Min. Negotiated Rate	$14.19
Max. Negotiated Rate	$249.88
Rate for Payer: Aetna Commercial	$189.91
Rate for Payer: Aetna Medicare Advantage	$149.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.44
Rate for Payer: Cigna Commercial	$249.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.94
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.96
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$15.79
Rate for Payer: Wellpoint Medicaid Managed Care	$14.19

DRUG ABUSE PANEL 9,SERUM VII

Facility

$499.75

Hospital Charge Code	39990001G
Hospital Revenue Code	301
Min. Negotiated Rate	$74.96
Max. Negotiated Rate	$74.96
Rate for Payer: Qualcare PPO/HMO/WC	$74.96

DRUG ABUSE PANEL 9,SERUM VIII

Facility

$499.75

Hospital Charge Code	39990001H
Hospital Revenue Code	301
Min. Negotiated Rate	$14.19
Max. Negotiated Rate	$249.88
Rate for Payer: Aetna Commercial	$189.91
Rate for Payer: Aetna Medicare Advantage	$149.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.44
Rate for Payer: Cigna Commercial	$249.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.94
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.96
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$15.79
Rate for Payer: Wellpoint Medicaid Managed Care	$14.19

DRUG ABUSE PANEL 9,SERUM VIII

Facility

$499.75

Hospital Charge Code	39990001H
Hospital Revenue Code	301
Min. Negotiated Rate	$74.96
Max. Negotiated Rate	$74.96
Rate for Payer: Qualcare PPO/HMO/WC	$74.96

DRUG ADMIN & HEMODYNMIC MEAS

Facility

$12,026.00

Service Code	HCPCS 93463
Hospital Charge Code	411093463
Hospital Revenue Code	481
Min. Negotiated Rate	$341.54
Max. Negotiated Rate	$6,013.00
Rate for Payer: Aetna Commercial	$4,569.88
Rate for Payer: Aetna Medicare Advantage	$3,607.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,066.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,066.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,066.63
Rate for Payer: Cigna Commercial	$6,013.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,126.76
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,803.90
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$380.02
Rate for Payer: Wellpoint Medicaid Managed Care	$341.54

DRUG ADMIN & HEMODYNMIC MEAS

Facility

$12,026.00

Service Code	HCPCS 93463
Hospital Charge Code	411093463
Hospital Revenue Code	481
Min. Negotiated Rate	$1,803.90
Max. Negotiated Rate	$1,803.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,803.90

DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE

Facility

$3,550.26

Service Code	APR-DRG 7701
Min. Negotiated Rate	$3,480.65
Max. Negotiated Rate	$3,550.26
Rate for Payer: UnitedHealthcare Community & State	$3,480.65
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$3,550.26
Rate for Payer: Wellpoint Medicaid Managed Care	$3,480.65

DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE

Facility

$5,307.12

Service Code	APR-DRG 7702
Min. Negotiated Rate	$5,203.06
Max. Negotiated Rate	$5,307.12
Rate for Payer: UnitedHealthcare Community & State	$5,203.06
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,307.12
Rate for Payer: Wellpoint Medicaid Managed Care	$5,203.06

DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE

Facility

$8,284.48

Service Code	APR-DRG 7703
Min. Negotiated Rate	$8,122.04
Max. Negotiated Rate	$8,284.48
Rate for Payer: UnitedHealthcare Community & State	$8,122.04
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,284.48
Rate for Payer: Wellpoint Medicaid Managed Care	$8,122.04

DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE

Facility

$17,793.53

Service Code	APR-DRG 7704
Min. Negotiated Rate	$17,444.64
Max. Negotiated Rate	$17,793.53
Rate for Payer: UnitedHealthcare Community & State	$17,444.64
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,793.53
Rate for Payer: Wellpoint Medicaid Managed Care	$17,444.64

DRUG SCREEN AMPHETAMINES 1/2

Facility

$190.45

Service Code	HCPCS 80324
Hospital Charge Code	39990208
Hospital Revenue Code	301
Min. Negotiated Rate	$5.41
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$72.37
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.52
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$17.62
Rate for Payer: Wellpoint Medicaid Managed Care	$5.41

DRUG SCREEN AMPHETAMINES 1/2

Facility

$190.45

Service Code	HCPCS 80324
Hospital Charge Code	3039008
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

DRUG SCREEN AMPHETAMINES 1/2

Facility

$190.45

Service Code	HCPCS 80324
Hospital Charge Code	3039008
Hospital Revenue Code	301
Min. Negotiated Rate	$5.41
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$72.37
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.52
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$17.62
Rate for Payer: Wellpoint Medicaid Managed Care	$5.41

Know your out-of-pocket cost for care.

All Charges