Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ECNMY ULTRASND GEL 5 LTRE CUBE

Facility

$62.75

Hospital Charge Code	270663149
Hospital Revenue Code	270
Min. Negotiated Rate	$9.41
Max. Negotiated Rate	$9.41
Rate for Payer: Qualcare PPO/HMO/WC	$9.41

ECT SINGLE SEIZURE

Facility

$2,404.25

Service Code	HCPCS 90870
Hospital Charge Code	7500069
Hospital Revenue Code	901
Min. Negotiated Rate	$360.64
Max. Negotiated Rate	$360.64
Rate for Payer: Qualcare PPO/HMO/WC	$360.64

ECT SINGLE SEIZURE

Facility

$2,404.25

Service Code	HCPCS 90870
Hospital Charge Code	7500069
Hospital Revenue Code	901
Min. Negotiated Rate	$68.28
Max. Negotiated Rate	$3,700.81
Rate for Payer: Aetna Commercial	$2,774.97
Rate for Payer: Aetna Medicare Advantage	$3,305.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,700.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,700.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,020.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,700.81
Rate for Payer: Cigna Commercial	$2,044.99
Rate for Payer: Cigna Medicare Advantage	$1,020.21
Rate for Payer: Clover Medicare Advantage	$969.20
Rate for Payer: EmblemHealth Commercial	$3,060.63
Rate for Payer: Humana Medicare Advantage	$1,050.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,020.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$625.11
Rate for Payer: Qualcare PPO/HMO/WC	$360.64
Rate for Payer: UnitedHealthcare Community & State	$75.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,020.21
Rate for Payer: Wellcare Medicare Advantage	$1,020.21
Rate for Payer: Wellpoint Medicaid Managed Care	$68.28

ECT SINGLE SEIZURE

Facility

$6,615.00

Service Code	HCPCS 90870
Hospital Charge Code	1600540
Hospital Revenue Code	901
Min. Negotiated Rate	$110.62
Max. Negotiated Rate	$3,700.81
Rate for Payer: Aetna Commercial	$2,774.97
Rate for Payer: Aetna Medicare Advantage	$3,305.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,700.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,700.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,020.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,700.81
Rate for Payer: Cigna Commercial	$2,044.99
Rate for Payer: Cigna Medicare Advantage	$1,020.21
Rate for Payer: Clover Medicare Advantage	$969.20
Rate for Payer: EmblemHealth Commercial	$3,060.63
Rate for Payer: Humana Medicare Advantage	$1,050.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,020.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,719.90
Rate for Payer: Qualcare PPO/HMO/WC	$992.25
Rate for Payer: UnitedHealthcare Community & State	$209.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,020.21
Rate for Payer: Wellcare Medicare Advantage	$1,020.21
Rate for Payer: Wellpoint Medicaid Managed Care	$187.87

ECT SINGLE SEIZURE

Facility

$6,615.00

Service Code	HCPCS 90870
Hospital Charge Code	1600540
Hospital Revenue Code	901
Min. Negotiated Rate	$992.25
Max. Negotiated Rate	$992.25
Rate for Payer: Qualcare PPO/HMO/WC	$992.25

EDMS III BECKER

Facility

$981.00

Hospital Charge Code	270670474
Hospital Revenue Code	272
Min. Negotiated Rate	$147.15
Max. Negotiated Rate	$147.15
Rate for Payer: Qualcare PPO/HMO/WC	$147.15

EDMS III BECKER

Facility

$981.00

Hospital Charge Code	270670474
Hospital Revenue Code	272
Min. Negotiated Rate	$27.86
Max. Negotiated Rate	$490.50
Rate for Payer: Aetna Commercial	$372.78
Rate for Payer: Aetna Medicare Advantage	$294.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$250.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$250.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$250.16
Rate for Payer: Cigna Commercial	$490.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.06
Rate for Payer: Oxford Commercial	$196.20
Rate for Payer: Qualcare PPO/HMO/WC	$147.15
Rate for Payer: UnitedHealthcare Commercial	$196.20
Rate for Payer: UnitedHealthcare Community & State	$31.00
Rate for Payer: Wellpoint Medicaid Managed Care	$27.86

EDM VENTRICULAR CATHETER

Facility

$249.00

Hospital Charge Code	270335578
Hospital Revenue Code	272
Min. Negotiated Rate	$37.35
Max. Negotiated Rate	$37.35
Rate for Payer: Qualcare PPO/HMO/WC	$37.35

EDM VENTRICULAR CATHETER

Facility

$249.00

Hospital Charge Code	270335578
Hospital Revenue Code	272
Min. Negotiated Rate	$7.07
Max. Negotiated Rate	$124.50
Rate for Payer: Aetna Commercial	$94.62
Rate for Payer: Aetna Medicare Advantage	$74.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.49
Rate for Payer: Cigna Commercial	$124.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.74
Rate for Payer: Oxford Commercial	$49.80
Rate for Payer: Qualcare PPO/HMO/WC	$37.35
Rate for Payer: UnitedHealthcare Commercial	$49.80
Rate for Payer: UnitedHealthcare Community & State	$7.87
Rate for Payer: Wellpoint Medicaid Managed Care	$7.07

EDROPHONIUM CHLORIDE 10 MG/ML

Facility

$42.88

Service Code	NDC 67457019015
Hospital Charge Code	6063943195
Hospital Revenue Code	250
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$21.44
Rate for Payer: Aetna Commercial	$16.29
Rate for Payer: Aetna Medicare Advantage	$12.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.93
Rate for Payer: Cigna Commercial	$21.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.15
Rate for Payer: Oxford Commercial	$8.58
Rate for Payer: Qualcare PPO/HMO/WC	$6.43
Rate for Payer: UnitedHealthcare Commercial	$8.58
Rate for Payer: UnitedHealthcare Community & State	$1.36
Rate for Payer: Wellpoint Medicaid Managed Care	$1.22

EDROPHONIUM CHLORIDE 10 MG/ML

Facility

$42.88

Service Code	NDC 67457019015
Hospital Charge Code	6063943195
Hospital Revenue Code	250
Min. Negotiated Rate	$6.43
Max. Negotiated Rate	$6.43
Rate for Payer: Qualcare PPO/HMO/WC	$6.43

ED URINE PREGNANCY TEST

Facility

$697.62

Service Code	HCPCS 81025
Hospital Charge Code	5700265
Hospital Revenue Code	300
Min. Negotiated Rate	$104.64
Max. Negotiated Rate	$104.64
Rate for Payer: Qualcare PPO/HMO/WC	$104.64

ED URINE PREGNANCY TEST

Facility

$697.62

Service Code	HCPCS 81025
Hospital Charge Code	5700265
Hospital Revenue Code	300
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$348.81
Rate for Payer: Aetna Commercial	$23.42
Rate for Payer: Aetna Medicare Advantage	$27.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.61
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	$31.23
Rate for Payer: Cigna Commercial	$348.81
Rate for Payer: Cigna Medicare Advantage	$8.61
Rate for Payer: Clover Medicare Advantage	$8.18
Rate for Payer: EmblemHealth Commercial	$25.83
Rate for Payer: Humana Medicare Advantage	$8.87
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.38
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$104.64
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$6.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.61
Rate for Payer: Wellcare Medicare Advantage	$8.61
Rate for Payer: Wellpoint Medicaid Managed Care	$19.81

EEG AWAKE/DROWSY

Facility

$1,491.00

Service Code	HCPCS 95816
Hospital Charge Code	5500028
Hospital Revenue Code	740
Min. Negotiated Rate	$42.34
Max. Negotiated Rate	$5,943.00
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	$281.60
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	$387.66
Rate for Payer: Oxford Commercial	$5,237.00
Rate for Payer: Qualcare PPO/HMO/WC	$223.65
Rate for Payer: UnitedHealthcare Commercial	$5,943.00
Rate for Payer: UnitedHealthcare Community & State	$47.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$42.34

EEG AWAKE/DROWSY

Facility

$1,491.00

Service Code	HCPCS 95816
Hospital Charge Code	5500028
Hospital Revenue Code	740
Min. Negotiated Rate	$223.65
Max. Negotiated Rate	$223.65
Rate for Payer: Qualcare PPO/HMO/WC	$223.65

EEG AWAKE/SLEEP

Facility

$2,208.72

Service Code	HCPCS 95819
Hospital Charge Code	5500026
Hospital Revenue Code	740
Min. Negotiated Rate	$331.31
Max. Negotiated Rate	$331.31
Rate for Payer: Qualcare PPO/HMO/WC	$331.31

EEG AWAKE/SLEEP

Facility

$2,208.72

Service Code	HCPCS 95819
Hospital Charge Code	5500026
Hospital Revenue Code	740
Min. Negotiated Rate	$62.73
Max. Negotiated Rate	$5,943.00
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	$265.10
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	$574.27
Rate for Payer: Oxford Commercial	$5,237.00
Rate for Payer: Qualcare PPO/HMO/WC	$331.31
Rate for Payer: UnitedHealthcare Commercial	$5,943.00
Rate for Payer: UnitedHealthcare Community & State	$69.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$62.73

EEG BRAIN DEATH

Facility

$1,105.00

Service Code	HCPCS 95824
Hospital Charge Code	36540015
Hospital Revenue Code	740
Min. Negotiated Rate	$165.75
Max. Negotiated Rate	$165.75
Rate for Payer: Qualcare PPO/HMO/WC	$165.75

EEG BRAIN DEATH

Facility

$1,105.00

Service Code	HCPCS 95824
Hospital Charge Code	36540015
Hospital Revenue Code	740
Min. Negotiated Rate	$22.22
Max. Negotiated Rate	$5,943.00
Rate for Payer: Aetna Commercial	$1,205.83
Rate for Payer: Aetna Medicare Advantage	$1,436.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,608.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,608.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$443.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,608.14
Rate for Payer: Cigna Commercial	$888.63
Rate for Payer: Cigna Medicare Advantage	$443.32
Rate for Payer: Clover Medicare Advantage	$421.15
Rate for Payer: EmblemHealth Commercial	$1,329.96
Rate for Payer: Humana Medicare Advantage	$456.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$443.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$287.30
Rate for Payer: Oxford Commercial	$5,237.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.75
Rate for Payer: UnitedHealthcare Commercial	$5,943.00
Rate for Payer: UnitedHealthcare Community & State	$34.92
Rate for Payer: UnitedHealthcare Medicare Advantage	$443.32
Rate for Payer: Wellcare Medicare Advantage	$443.32
Rate for Payer: Wellpoint Medicaid Managed Care	$31.38

EEG CONT REC W VID EEG TECH

Facility

$1,481.95

Service Code	HCPCS 95700
Hospital Charge Code	403395700
Hospital Revenue Code	740
Min. Negotiated Rate	$222.29
Max. Negotiated Rate	$222.29
Rate for Payer: Qualcare PPO/HMO/WC	$222.29

EEG CONT REC W VID EEG TECH

Facility

$1,481.95

Service Code	HCPCS 95700
Hospital Charge Code	403395700
Hospital Revenue Code	740
Min. Negotiated Rate	$42.09
Max. Negotiated Rate	$5,943.00
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) 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	$385.31
Rate for Payer: Oxford Commercial	$5,237.00
Rate for Payer: Qualcare PPO/HMO/WC	$222.29
Rate for Payer: UnitedHealthcare Commercial	$5,943.00
Rate for Payer: UnitedHealthcare Community & State	$46.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$42.09

EEG ELECTROCEREBRAL SILENCE

Facility

$1,105.00

Service Code	HCPCS 95824
Hospital Charge Code	5400064
Hospital Revenue Code	740
Min. Negotiated Rate	$22.22
Max. Negotiated Rate	$5,943.00
Rate for Payer: Aetna Commercial	$1,205.83
Rate for Payer: Aetna Medicare Advantage	$1,436.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,608.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,608.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$443.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,608.14
Rate for Payer: Cigna Commercial	$888.63
Rate for Payer: Cigna Medicare Advantage	$443.32
Rate for Payer: Clover Medicare Advantage	$421.15
Rate for Payer: EmblemHealth Commercial	$1,329.96
Rate for Payer: Humana Medicare Advantage	$456.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$443.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$287.30
Rate for Payer: Oxford Commercial	$5,237.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.75
Rate for Payer: UnitedHealthcare Commercial	$5,943.00
Rate for Payer: UnitedHealthcare Community & State	$34.92
Rate for Payer: UnitedHealthcare Medicare Advantage	$443.32
Rate for Payer: Wellcare Medicare Advantage	$443.32
Rate for Payer: Wellpoint Medicaid Managed Care	$31.38

EEG ELECTROCEREBRAL SILENCE

Facility

$1,105.00

Service Code	HCPCS 95824
Hospital Charge Code	5400064
Hospital Revenue Code	740
Min. Negotiated Rate	$165.75
Max. Negotiated Rate	$165.75
Rate for Payer: Qualcare PPO/HMO/WC	$165.75

EEG FOR ECT

Facility

$1,290.00

Service Code	HCPCS 95816
Hospital Charge Code	84033005
Hospital Revenue Code	740
Min. Negotiated Rate	$36.64
Max. Negotiated Rate	$5,943.00
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	$281.60
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	$335.40
Rate for Payer: Oxford Commercial	$5,237.00
Rate for Payer: Qualcare PPO/HMO/WC	$193.50
Rate for Payer: UnitedHealthcare Commercial	$5,943.00
Rate for Payer: UnitedHealthcare Community & State	$40.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$36.64

EEG FOR ECT

Facility

$1,290.00

Service Code	HCPCS 95816
Hospital Charge Code	84033005
Hospital Revenue Code	740
Min. Negotiated Rate	$193.50
Max. Negotiated Rate	$193.50
Rate for Payer: Qualcare PPO/HMO/WC	$193.50

Know your out-of-pocket cost for care.

All Charges