Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

DRUG SCREEN QUANTALCOHOLS

Facility

$190.45

Service Code	HCPCS 80320
Hospital Charge Code	3039005
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	$16.66
Rate for Payer: Wellpoint Medicaid Managed Care	$5.41

DRUG SCREEN QUANTALCOHOLS

Facility

$190.45

Service Code	HCPCS 80320
Hospital Charge Code	3036031
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	$16.66
Rate for Payer: Wellpoint Medicaid Managed Care	$5.41

DRUG SCREEN QUANTALCOHOLS

Facility

$190.45

Service Code	HCPCS 80320
Hospital Charge Code	3036031
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 QUANTALCOHOLS

Facility

$190.45

Service Code	HCPCS 80320
Hospital Charge Code	3039005
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

DRUG TEST PRESUMP CHEM ANLYZR

Facility

$390.00

Service Code	HCPCS 80307
Hospital Charge Code	3088547
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

DRUG TEST PRESUMP CHEM ANLYZR

Facility

$390.00

Service Code	HCPCS 80307
Hospital Charge Code	3066037
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$225.41
Rate for Payer: Aetna Commercial	$169.02
Rate for Payer: Aetna Medicare Advantage	$201.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$225.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$225.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$62.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$225.41
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$62.14
Rate for Payer: Clover Medicare Advantage	$59.03
Rate for Payer: EmblemHealth Commercial	$186.42
Rate for Payer: Humana Medicare Advantage	$64.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$62.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$49.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$62.14
Rate for Payer: Wellcare Medicare Advantage	$62.14
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

DRUG TEST PRESUMP CHEM ANLYZR

Facility

$390.00

Service Code	HCPCS 80307
Hospital Charge Code	3066037
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

DRUG TEST PRESUMP CHEM ANLYZR

Facility

$390.00

Service Code	HCPCS 80307
Hospital Charge Code	3088547
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$225.41
Rate for Payer: Aetna Commercial	$169.02
Rate for Payer: Aetna Medicare Advantage	$201.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$225.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$225.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$62.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$225.41
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$62.14
Rate for Payer: Clover Medicare Advantage	$59.03
Rate for Payer: EmblemHealth Commercial	$186.42
Rate for Payer: Humana Medicare Advantage	$64.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$62.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$49.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$62.14
Rate for Payer: Wellcare Medicare Advantage	$62.14
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

DRUG TEST PRESUMP CHEM ANLYZR

Facility

$390.00

Service Code	HCPCS 80307
Hospital Charge Code	39990169
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

DRUG TEST PRESUMP CHEM ANLYZR

Facility

$390.00

Service Code	HCPCS 80307
Hospital Charge Code	39990169
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$225.41
Rate for Payer: Aetna Commercial	$169.02
Rate for Payer: Aetna Medicare Advantage	$201.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$225.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$225.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$62.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$225.41
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$62.14
Rate for Payer: Clover Medicare Advantage	$59.03
Rate for Payer: EmblemHealth Commercial	$186.42
Rate for Payer: Humana Medicare Advantage	$64.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$62.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$49.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$62.14
Rate for Payer: Wellcare Medicare Advantage	$62.14
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

DRUG TEST PRESUMP DIR OPT OBS

Facility

$390.00

Service Code	HCPCS 80305
Hospital Charge Code	39990167
Hospital Revenue Code	301
Min. Negotiated Rate	$9.87
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$34.27
Rate for Payer: Aetna Medicare Advantage	$40.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.71
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.60
Rate for Payer: Clover Medicare Advantage	$11.97
Rate for Payer: EmblemHealth Commercial	$37.80
Rate for Payer: Humana Medicare Advantage	$12.98
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.60
Rate for Payer: Wellcare Medicare Advantage	$12.60
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

DRUG TEST PRESUMP DIR OPT OBS

Facility

$390.00

Service Code	HCPCS 80305
Hospital Charge Code	39990167
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

DRUG TEST PRESUMP DIR OPT OBS

Facility

$390.00

Service Code	HCPCS 80305
Hospital Charge Code	3066035
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

DRUG TEST PRESUMP DIR OPT OBS

Facility

$390.00

Service Code	HCPCS 80305
Hospital Charge Code	3038545
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

DRUG TEST PRESUMP DIR OPT OBS

Facility

$390.00

Service Code	HCPCS 80305
Hospital Charge Code	3038545
Hospital Revenue Code	301
Min. Negotiated Rate	$9.87
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$34.27
Rate for Payer: Aetna Medicare Advantage	$40.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.71
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.60
Rate for Payer: Clover Medicare Advantage	$11.97
Rate for Payer: EmblemHealth Commercial	$37.80
Rate for Payer: Humana Medicare Advantage	$12.98
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.60
Rate for Payer: Wellcare Medicare Advantage	$12.60
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

DRUG TEST PRESUMP DIR OPT OBS

Facility

$390.00

Service Code	HCPCS 80305
Hospital Charge Code	3066035
Hospital Revenue Code	301
Min. Negotiated Rate	$9.87
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$34.27
Rate for Payer: Aetna Medicare Advantage	$40.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.71
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.60
Rate for Payer: Clover Medicare Advantage	$11.97
Rate for Payer: EmblemHealth Commercial	$37.80
Rate for Payer: Humana Medicare Advantage	$12.98
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.60
Rate for Payer: Wellcare Medicare Advantage	$12.60
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

DRUG TEST PRESUMP INSTR ASSIST

Facility

$390.00

Service Code	HCPCS 80306
Hospital Charge Code	39990168
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$46.62
Rate for Payer: Aetna Medicare Advantage	$55.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.18
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$17.14
Rate for Payer: Clover Medicare Advantage	$16.28
Rate for Payer: EmblemHealth Commercial	$51.42
Rate for Payer: Humana Medicare Advantage	$17.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.14
Rate for Payer: Wellcare Medicare Advantage	$17.14
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

DRUG TEST PRESUMP INSTR ASSIST

Facility

$390.00

Service Code	HCPCS 80306
Hospital Charge Code	39990168
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

DRUG TEST PRESUMP INSTR ASSIST

Facility

$390.00

Service Code	HCPCS 80306
Hospital Charge Code	3038546
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

DRUG TEST PRESUMP INSTR ASSIST

Facility

$390.00

Service Code	HCPCS 80306
Hospital Charge Code	3038546
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$46.62
Rate for Payer: Aetna Medicare Advantage	$55.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.18
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$17.14
Rate for Payer: Clover Medicare Advantage	$16.28
Rate for Payer: EmblemHealth Commercial	$51.42
Rate for Payer: Humana Medicare Advantage	$17.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.14
Rate for Payer: Wellcare Medicare Advantage	$17.14
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

DRUG TEST PRESUMP INSTR ASSIST

Facility

$390.00

Service Code	HCPCS 80306
Hospital Charge Code	3066036
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$46.62
Rate for Payer: Aetna Medicare Advantage	$55.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.18
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$17.14
Rate for Payer: Clover Medicare Advantage	$16.28
Rate for Payer: EmblemHealth Commercial	$51.42
Rate for Payer: Humana Medicare Advantage	$17.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.14
Rate for Payer: Wellcare Medicare Advantage	$17.14
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

DRUG TEST PRESUMP INSTR ASSIST

Facility

$390.00

Service Code	HCPCS 80306
Hospital Charge Code	3066036
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

DRUG TOX TRAMADOL QNT URINE

Facility

$425.00

Service Code	HCPCS 80373
Hospital Charge Code	401080373
Hospital Revenue Code	301
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

DRUG TOX TRAMADOL QNT URINE

Facility

$425.00

Service Code	HCPCS 80373
Hospital Charge Code	401080373
Hospital Revenue Code	301
Min. Negotiated Rate	$12.07
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.50
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$16.66
Rate for Payer: Wellpoint Medicaid Managed Care	$12.07

DRVVT SCR W/RFL PHOS NEUT

Facility

$65.80

Service Code	HCPCS 85613
Hospital Charge Code	39900181
Hospital Revenue Code	305
Min. Negotiated Rate	$9.87
Max. Negotiated Rate	$9.87
Rate for Payer: Qualcare PPO/HMO/WC	$9.87

Know your out-of-pocket cost for care.

All Charges