Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

EASYCLIP 18MM 14-14MM

Facility

$8,490.00

Hospital Charge Code	270674062
Hospital Revenue Code	278
Min. Negotiated Rate	$1,273.50
Max. Negotiated Rate	$2,054.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,698.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,054.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,273.50

EASYCLIP 18MM 14-14MM

Facility

$8,490.00

Hospital Charge Code	270674062
Hospital Revenue Code	278
Min. Negotiated Rate	$241.12
Max. Negotiated Rate	$4,245.00
Rate for Payer: Aetna Commercial	$3,226.20
Rate for Payer: Aetna Medicare Advantage	$2,547.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,164.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,164.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,698.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,164.95
Rate for Payer: Cigna Commercial	$4,245.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,054.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,273.50
Rate for Payer: UnitedHealthcare Community & State	$268.28
Rate for Payer: Wellpoint Medicaid Managed Care	$241.12

EASYCLIP 20MM 20-20MM

Facility

$10,720.00

Hospital Charge Code	270674059
Hospital Revenue Code	278
Min. Negotiated Rate	$304.45
Max. Negotiated Rate	$5,360.00
Rate for Payer: Aetna Commercial	$4,073.60
Rate for Payer: Aetna Medicare Advantage	$3,216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,733.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,733.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,144.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,733.60
Rate for Payer: Cigna Commercial	$5,360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,594.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,608.00
Rate for Payer: UnitedHealthcare Community & State	$338.75
Rate for Payer: Wellpoint Medicaid Managed Care	$304.45

EASYCLIP 20MM 20-20MM

Facility

$10,720.00

Hospital Charge Code	270674059
Hospital Revenue Code	278
Min. Negotiated Rate	$1,608.00
Max. Negotiated Rate	$2,594.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,144.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,594.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,608.00

EASY CLIP FIXATION SYS 8-8-8MM

Facility

$4,563.00

Service Code	HCPCS C1713
Hospital Charge Code	270674964
Hospital Revenue Code	278
Min. Negotiated Rate	$129.59
Max. Negotiated Rate	$2,281.50
Rate for Payer: Aetna Commercial	$1,733.94
Rate for Payer: Aetna Medicare Advantage	$1,368.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,163.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,163.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$912.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,163.57
Rate for Payer: Cigna Commercial	$2,281.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,104.25
Rate for Payer: Qualcare PPO/HMO/WC	$684.45
Rate for Payer: UnitedHealthcare Community & State	$144.19
Rate for Payer: Wellpoint Medicaid Managed Care	$129.59

EASY CLIP FIXATION SYS 8-8-8MM

Facility

$4,563.00

Service Code	HCPCS C1713
Hospital Charge Code	270674964
Hospital Revenue Code	278
Min. Negotiated Rate	$684.45
Max. Negotiated Rate	$1,104.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$912.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,104.25
Rate for Payer: Qualcare PPO/HMO/WC	$684.45

EASYFUSE IMPLT PROC PACK 15X12

Facility

$6,625.00

Hospital Charge Code	270704039
Hospital Revenue Code	272
Min. Negotiated Rate	$993.75
Max. Negotiated Rate	$993.75
Rate for Payer: Qualcare PPO/HMO/WC	$993.75

EASYFUSE IMPLT PROC PACK 15X12

Facility

$6,625.00

Hospital Charge Code	270704039
Hospital Revenue Code	272
Min. Negotiated Rate	$188.15
Max. Negotiated Rate	$3,312.50
Rate for Payer: Aetna Commercial	$2,517.50
Rate for Payer: Aetna Medicare Advantage	$1,987.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,689.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,689.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,689.38
Rate for Payer: Cigna Commercial	$3,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,722.50
Rate for Payer: Oxford Commercial	$1,325.00
Rate for Payer: Qualcare PPO/HMO/WC	$993.75
Rate for Payer: UnitedHealthcare Commercial	$1,325.00
Rate for Payer: UnitedHealthcare Community & State	$209.35
Rate for Payer: Wellpoint Medicaid Managed Care	$188.15

EASYFUSE INST PK MID HINDFOOT

Facility

$1,465.00

Hospital Charge Code	270700662
Hospital Revenue Code	272
Min. Negotiated Rate	$41.61
Max. Negotiated Rate	$732.50
Rate for Payer: Aetna Commercial	$556.70
Rate for Payer: Aetna Medicare Advantage	$439.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$373.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$373.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$373.57
Rate for Payer: Cigna Commercial	$732.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$380.90
Rate for Payer: Oxford Commercial	$293.00
Rate for Payer: Qualcare PPO/HMO/WC	$219.75
Rate for Payer: UnitedHealthcare Commercial	$293.00
Rate for Payer: UnitedHealthcare Community & State	$46.29
Rate for Payer: Wellpoint Medicaid Managed Care	$41.61

EASYFUSE INST PK MID HINDFOOT

Facility

$1,465.00

Hospital Charge Code	270700662
Hospital Revenue Code	272
Min. Negotiated Rate	$219.75
Max. Negotiated Rate	$219.75
Rate for Payer: Qualcare PPO/HMO/WC	$219.75

EATING DISORDERS

Facility

$49,406.17

Service Code	APR-DRG 7594
Min. Negotiated Rate	$48,437.42
Max. Negotiated Rate	$49,406.17
Rate for Payer: UnitedHealthcare Community & State	$48,437.42
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$49,406.17
Rate for Payer: Wellpoint Medicaid Managed Care	$48,437.42

EATING DISORDERS

Facility

$17,696.57

Service Code	APR-DRG 7593
Min. Negotiated Rate	$17,349.58
Max. Negotiated Rate	$17,696.57
Rate for Payer: UnitedHealthcare Community & State	$17,349.58
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,696.57
Rate for Payer: Wellpoint Medicaid Managed Care	$17,349.58

EATING DISORDERS

Facility

$10,579.24

Service Code	APR-DRG 7591
Min. Negotiated Rate	$10,371.80
Max. Negotiated Rate	$10,579.24
Rate for Payer: UnitedHealthcare Community & State	$10,371.80
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,579.24
Rate for Payer: Wellpoint Medicaid Managed Care	$10,371.80

EATING DISORDERS

Facility

$12,270.06

Service Code	APR-DRG 7592
Min. Negotiated Rate	$12,029.47
Max. Negotiated Rate	$12,270.06
Rate for Payer: UnitedHealthcare Community & State	$12,029.47
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,270.06
Rate for Payer: Wellpoint Medicaid Managed Care	$12,029.47

EBNA AB (IGG)

Facility

$105.15

Service Code	HCPCS 86664
Hospital Charge Code	39900234
Hospital Revenue Code	302
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$41.59
Rate for Payer: Aetna Medicare Advantage	$49.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.46
Rate for Payer: Cigna Commercial	$52.58
Rate for Payer: Cigna Medicare Advantage	$15.29
Rate for Payer: Clover Medicare Advantage	$14.53
Rate for Payer: EmblemHealth Commercial	$45.87
Rate for Payer: Humana Medicare Advantage	$15.75
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.34
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.77
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$12.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.29
Rate for Payer: Wellcare Medicare Advantage	$15.29
Rate for Payer: Wellpoint Medicaid Managed Care	$2.99

EBNA AB (IGG)

Facility

$105.15

Service Code	HCPCS 86664
Hospital Charge Code	39900234
Hospital Revenue Code	302
Min. Negotiated Rate	$15.77
Max. Negotiated Rate	$15.77
Rate for Payer: Qualcare PPO/HMO/WC	$15.77

EBNA ANTIBODY IGG

Facility

$390.00

Service Code	HCPCS 86664
Hospital Charge Code	38476267
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$41.59
Rate for Payer: Aetna Medicare Advantage	$49.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.46
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$15.29
Rate for Payer: Clover Medicare Advantage	$14.53
Rate for Payer: EmblemHealth Commercial	$45.87
Rate for Payer: Humana Medicare Advantage	$15.75
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.29
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	$12.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.29
Rate for Payer: Wellcare Medicare Advantage	$15.29
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

EBNA ANTIBODY IGG

Facility

$390.00

Service Code	HCPCS 86664
Hospital Charge Code	38476267
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

EBV CAPSID AB (IGG)

Facility

$390.00

Service Code	HCPCS 86665
Hospital Charge Code	39900235
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

EBV CAPSID AB (IGG)

Facility

$390.00

Service Code	HCPCS 86665
Hospital Charge Code	39900235
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$49.34
Rate for Payer: Aetna Medicare Advantage	$58.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.80
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$18.14
Rate for Payer: Clover Medicare Advantage	$17.23
Rate for Payer: EmblemHealth Commercial	$54.42
Rate for Payer: Humana Medicare Advantage	$18.68
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.14
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	$14.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.14
Rate for Payer: Wellcare Medicare Advantage	$18.14
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

EBV DNA QUANT REAL TIME PCR

Facility

$667.59

Service Code	HCPCS 87799
Hospital Charge Code	401187799
Hospital Revenue Code	306
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

EBV DNA QUANT REAL TIME PCR

Facility

$667.59

Service Code	HCPCS 87799
Hospital Charge Code	401187799
Hospital Revenue Code	306
Min. Negotiated Rate	$18.96
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$116.52
Rate for Payer: Aetna Medicare Advantage	$138.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.40
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$42.84
Rate for Payer: Clover Medicare Advantage	$40.70
Rate for Payer: EmblemHealth Commercial	$128.52
Rate for Payer: Humana Medicare Advantage	$44.13
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$42.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.57
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$34.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$42.84
Rate for Payer: Wellcare Medicare Advantage	$42.84
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

EBV EA AB

Facility

$90.15

Service Code	HCPCS 86663
Hospital Charge Code	39900233
Hospital Revenue Code	302
Min. Negotiated Rate	$2.56
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$35.69
Rate for Payer: Aetna Medicare Advantage	$42.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.59
Rate for Payer: Cigna Commercial	$45.08
Rate for Payer: Cigna Medicare Advantage	$13.12
Rate for Payer: Clover Medicare Advantage	$12.46
Rate for Payer: EmblemHealth Commercial	$39.36
Rate for Payer: Humana Medicare Advantage	$13.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.44
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.52
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.12
Rate for Payer: Wellcare Medicare Advantage	$13.12
Rate for Payer: Wellpoint Medicaid Managed Care	$2.56

EBV EA AB

Facility

$90.15

Service Code	HCPCS 86663
Hospital Charge Code	39900233
Hospital Revenue Code	302
Min. Negotiated Rate	$13.52
Max. Negotiated Rate	$13.52
Rate for Payer: Qualcare PPO/HMO/WC	$13.52

EBV EA (D) AB IGG

Facility

$667.59

Service Code	HCPCS 86663
Hospital Charge Code	39900371
Hospital Revenue Code	302
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

Know your out-of-pocket cost for care.

All Charges