Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ALBUMIN HUMAN 25% 12.5GM/50 ML

Facility

$603.00

Service Code	HCPCS P9047
Hospital Charge Code	60627497
Hospital Revenue Code	636
Min. Negotiated Rate	$90.45
Max. Negotiated Rate	$145.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.93
Rate for Payer: Qualcare PPO/HMO/WC	$90.45

ALBUMIN HUMAN 25% 12.5GM/50 ML

Facility

$603.00

Service Code	HCPCS P9047
Hospital Charge Code	60627497
Hospital Revenue Code	636
Min. Negotiated Rate	$17.13
Max. Negotiated Rate	$192.55
Rate for Payer: Aetna Commercial	$144.38
Rate for Payer: Aetna Medicare Advantage	$171.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$53.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.55
Rate for Payer: Cigna Medicare Advantage	$53.08
Rate for Payer: Clover Medicare Advantage	$50.43
Rate for Payer: EmblemHealth Commercial	$159.24
Rate for Payer: Humana Medicare Advantage	$54.67
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$53.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.93
Rate for Payer: Qualcare PPO/HMO/WC	$90.45
Rate for Payer: UnitedHealthcare Community & State	$19.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$53.08
Rate for Payer: Wellcare Medicare Advantage	$53.08
Rate for Payer: Wellpoint Medicaid Managed Care	$17.13

ALBUMIN HUMAN 5% 12.5GM/250 ML

Facility

$603.00

Service Code	HCPCS P9045
Hospital Charge Code	60627498
Hospital Revenue Code	636
Min. Negotiated Rate	$90.45
Max. Negotiated Rate	$145.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.93
Rate for Payer: Qualcare PPO/HMO/WC	$90.45

ALBUMIN HUMAN 5% 12.5GM/250 ML

Facility

$603.00

Service Code	HCPCS P9045
Hospital Charge Code	60627498
Hospital Revenue Code	636
Min. Negotiated Rate	$17.13
Max. Negotiated Rate	$192.55
Rate for Payer: Aetna Commercial	$144.38
Rate for Payer: Aetna Medicare Advantage	$171.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$53.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.55
Rate for Payer: Cigna Medicare Advantage	$53.08
Rate for Payer: Clover Medicare Advantage	$50.43
Rate for Payer: EmblemHealth Commercial	$159.24
Rate for Payer: Humana Medicare Advantage	$54.67
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$53.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.93
Rate for Payer: Qualcare PPO/HMO/WC	$90.45
Rate for Payer: UnitedHealthcare Community & State	$19.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$53.08
Rate for Payer: Wellcare Medicare Advantage	$53.08
Rate for Payer: Wellpoint Medicaid Managed Care	$17.13

ALBUMIN HUMAN 5% RENAL 250 ML

Facility

$450.00

Hospital Charge Code	60627498R
Hospital Revenue Code	636
Min. Negotiated Rate	$12.78
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$171.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Community & State	$14.22
Rate for Payer: Wellpoint Medicaid Managed Care	$12.78

ALBUMIN HUMAN 5% RENAL 250 ML

Facility

$450.00

Hospital Charge Code	60627498R
Hospital Revenue Code	636
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$108.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

ALBUMIN,PERICARDIAL FLUID

Facility

$390.00

Service Code	HCPCS 82042
Hospital Charge Code	39900324
Hospital Revenue Code	307
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ALBUMIN,PERICARDIAL FLUID

Facility

$390.00

Service Code	HCPCS 82042
Hospital Charge Code	39900324
Hospital Revenue Code	307
Min. Negotiated Rate	$6.22
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$21.16
Rate for Payer: Aetna Medicare Advantage	$25.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.22
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$7.78
Rate for Payer: Clover Medicare Advantage	$7.39
Rate for Payer: EmblemHealth Commercial	$23.34
Rate for Payer: Humana Medicare Advantage	$8.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.78
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	$6.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.78
Rate for Payer: Wellcare Medicare Advantage	$7.78
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

Albumin, Peritoneal Fluid

Facility

$83.25

Service Code	HCPCS 82042
Hospital Charge Code	39888025
Hospital Revenue Code	307
Min. Negotiated Rate	$12.49
Max. Negotiated Rate	$12.49
Rate for Payer: Qualcare PPO/HMO/WC	$12.49

Albumin, Peritoneal Fluid

Facility

$83.25

Service Code	HCPCS 82042
Hospital Charge Code	39888025
Hospital Revenue Code	307
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$21.16
Rate for Payer: Aetna Medicare Advantage	$25.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.22
Rate for Payer: Cigna Commercial	$41.62
Rate for Payer: Cigna Medicare Advantage	$7.78
Rate for Payer: Clover Medicare Advantage	$7.39
Rate for Payer: EmblemHealth Commercial	$23.34
Rate for Payer: Humana Medicare Advantage	$8.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.64
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.49
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$6.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.78
Rate for Payer: Wellcare Medicare Advantage	$7.78
Rate for Payer: Wellpoint Medicaid Managed Care	$2.36

ALBUMIN, PERITONEAL FLUID

Facility

$667.59

Service Code	HCPCS 82042
Hospital Charge Code	39900033
Hospital Revenue Code	307
Min. Negotiated Rate	$6.22
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$21.16
Rate for Payer: Aetna Medicare Advantage	$25.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.22
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$7.78
Rate for Payer: Clover Medicare Advantage	$7.39
Rate for Payer: EmblemHealth Commercial	$23.34
Rate for Payer: Humana Medicare Advantage	$8.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.78
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	$6.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.78
Rate for Payer: Wellcare Medicare Advantage	$7.78
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

ALBUMIN, PERITONEAL FLUID

Facility

$667.59

Service Code	HCPCS 82042
Hospital Charge Code	39900033
Hospital Revenue Code	307
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

ALBUMIN,PLEURAL FLUID

Facility

$390.00

Service Code	HCPCS 82042
Hospital Charge Code	39900323
Hospital Revenue Code	307
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ALBUMIN,PLEURAL FLUID

Facility

$390.00

Service Code	HCPCS 82042
Hospital Charge Code	39900323
Hospital Revenue Code	307
Min. Negotiated Rate	$6.22
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$21.16
Rate for Payer: Aetna Medicare Advantage	$25.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.22
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$7.78
Rate for Payer: Clover Medicare Advantage	$7.39
Rate for Payer: EmblemHealth Commercial	$23.34
Rate for Payer: Humana Medicare Advantage	$8.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.78
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	$6.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.78
Rate for Payer: Wellcare Medicare Advantage	$7.78
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

ALBUMIN SERUM

Facility

$667.59

Service Code	HCPCS 82040
Hospital Charge Code	3002847
Hospital Revenue Code	307
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

ALBUMIN SERUM

Facility

$667.59

Service Code	HCPCS 82040
Hospital Charge Code	3002847
Hospital Revenue Code	307
Min. Negotiated Rate	$2.97
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$13.46
Rate for Payer: Aetna Medicare Advantage	$16.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.96
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$4.95
Rate for Payer: Clover Medicare Advantage	$4.70
Rate for Payer: EmblemHealth Commercial	$14.85
Rate for Payer: Humana Medicare Advantage	$5.10
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.95
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	$3.96
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.95
Rate for Payer: Wellcare Medicare Advantage	$4.95
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

ALBUTERAL 2.5MG IPRA 0.5MG

Facility

$100.00

Hospital Charge Code	83652539
Hospital Revenue Code	250
Min. Negotiated Rate	$2.84
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Commercial	$38.00
Rate for Payer: Aetna Medicare Advantage	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.50
Rate for Payer: Cigna Commercial	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.00
Rate for Payer: Oxford Commercial	$20.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$20.00
Rate for Payer: UnitedHealthcare Community & State	$3.16
Rate for Payer: Wellpoint Medicaid Managed Care	$2.84

ALBUTERAL 2.5MG IPRA 0.5MG

Facility

$100.00

Hospital Charge Code	83652539
Hospital Revenue Code	250
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

ALBUTEROL2.5MG/IPRATRPM O.5MG

Facility

$14.67

Service Code	NDC 487020103
Hospital Charge Code	60629271
Hospital Revenue Code	250
Min. Negotiated Rate	$2.20
Max. Negotiated Rate	$2.20
Rate for Payer: Qualcare PPO/HMO/WC	$2.20

ALBUTEROL2.5MG/IPRATRPM O.5MG

Facility

$14.67

Service Code	NDC 487020103
Hospital Charge Code	60629271
Hospital Revenue Code	250
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$7.33
Rate for Payer: Aetna Commercial	$5.57
Rate for Payer: Aetna Medicare Advantage	$4.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.74
Rate for Payer: Cigna Commercial	$7.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.81
Rate for Payer: Oxford Commercial	$2.93
Rate for Payer: Qualcare PPO/HMO/WC	$2.20
Rate for Payer: UnitedHealthcare Commercial	$2.93
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.42

ALBUTEROL 2MG/5ML UD

Facility

$4.29

Service Code	NDC 50383074016
Hospital Charge Code	60635051
Hospital Revenue Code	250
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$0.64
Rate for Payer: Qualcare PPO/HMO/WC	$0.64

ALBUTEROL 2MG/5ML UD

Facility

$4.29

Service Code	NDC 50383074016
Hospital Charge Code	60635051
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.15
Rate for Payer: Aetna Commercial	$1.63
Rate for Payer: Aetna Medicare Advantage	$1.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.09
Rate for Payer: Cigna Commercial	$2.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.12
Rate for Payer: Oxford Commercial	$0.86
Rate for Payer: Qualcare PPO/HMO/WC	$0.64
Rate for Payer: UnitedHealthcare Commercial	$0.86
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.12

ALBUTEROL 90 MCG INHALER

Facility

$1,254.24

Service Code	NDC 54569616600
Hospital Charge Code	60627439
Hospital Revenue Code	250
Min. Negotiated Rate	$188.14
Max. Negotiated Rate	$188.14
Rate for Payer: Qualcare PPO/HMO/WC	$188.14

ALBUTEROL 90 MCG INHALER

Facility

$1,254.24

Service Code	NDC 54569616600
Hospital Charge Code	60627439
Hospital Revenue Code	250
Min. Negotiated Rate	$35.62
Max. Negotiated Rate	$627.12
Rate for Payer: Aetna Commercial	$476.61
Rate for Payer: Aetna Medicare Advantage	$376.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$319.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$319.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$319.83
Rate for Payer: Cigna Commercial	$627.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$326.10
Rate for Payer: Oxford Commercial	$250.85
Rate for Payer: Qualcare PPO/HMO/WC	$188.14
Rate for Payer: UnitedHealthcare Commercial	$250.85
Rate for Payer: UnitedHealthcare Community & State	$39.63
Rate for Payer: Wellpoint Medicaid Managed Care	$35.62

ALBUTEROL INH 0.083% 3 ML

Facility

$5.36

Service Code	NDC 487950101
Hospital Charge Code	6005870
Hospital Revenue Code	250
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.80

Know your out-of-pocket cost for care.

All Charges