Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ALBUTEROL INH 0.083% 3 ML

Facility

$5.36

Service Code	NDC 487950101
Hospital Charge Code	6005870
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$2.68
Rate for Payer: Aetna Commercial	$2.04
Rate for Payer: Aetna Medicare Advantage	$1.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.37
Rate for Payer: Cigna Commercial	$2.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.39
Rate for Payer: Oxford Commercial	$1.07
Rate for Payer: Qualcare PPO/HMO/WC	$0.80
Rate for Payer: UnitedHealthcare Commercial	$1.07
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

ALBUTEROL INH.0.83MG/ML SOL

Facility

$19.00

Hospital Charge Code	83652547
Hospital Revenue Code	250
Min. Negotiated Rate	$2.85
Max. Negotiated Rate	$2.85
Rate for Payer: Qualcare PPO/HMO/WC	$2.85

ALBUTEROL INH.0.83MG/ML SOL

Facility

$19.00

Hospital Charge Code	83652547
Hospital Revenue Code	250
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$9.50
Rate for Payer: Aetna Commercial	$7.22
Rate for Payer: Aetna Medicare Advantage	$5.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.84
Rate for Payer: Cigna Commercial	$9.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.94
Rate for Payer: Oxford Commercial	$3.80
Rate for Payer: Qualcare PPO/HMO/WC	$2.85
Rate for Payer: UnitedHealthcare Commercial	$3.80
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.54

ALBUTEROL-IPRATROPIUM INHALER

Facility

$2,237.80

Service Code	NDC 597002402
Hospital Charge Code	60628929
Hospital Revenue Code	250
Min. Negotiated Rate	$63.55
Max. Negotiated Rate	$1,118.90
Rate for Payer: Aetna Commercial	$850.36
Rate for Payer: Aetna Medicare Advantage	$671.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.64
Rate for Payer: Cigna Commercial	$1,118.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$581.83
Rate for Payer: Oxford Commercial	$447.56
Rate for Payer: Qualcare PPO/HMO/WC	$335.67
Rate for Payer: UnitedHealthcare Commercial	$447.56
Rate for Payer: UnitedHealthcare Community & State	$70.71
Rate for Payer: Wellpoint Medicaid Managed Care	$63.55

ALBUTEROL-IPRATROPIUM INHALER

Facility

$2,237.80

Service Code	NDC 597002402
Hospital Charge Code	60628929
Hospital Revenue Code	250
Min. Negotiated Rate	$335.67
Max. Negotiated Rate	$335.67
Rate for Payer: Qualcare PPO/HMO/WC	$335.67

ALBUTEROL SULFT 0.042% 3ML SOL

Facility

$10.65

Service Code	NDC 487990401
Hospital Charge Code	60630093
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$5.33
Rate for Payer: Aetna Commercial	$4.05
Rate for Payer: Aetna Medicare Advantage	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.72
Rate for Payer: Cigna Commercial	$5.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.77
Rate for Payer: Oxford Commercial	$2.13
Rate for Payer: Qualcare PPO/HMO/WC	$1.60
Rate for Payer: UnitedHealthcare Commercial	$2.13
Rate for Payer: UnitedHealthcare Community & State	$0.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

ALBUTEROL SULFT 0.042% 3ML SOL

Facility

$10.65

Service Code	NDC 487990401
Hospital Charge Code	60630093
Hospital Revenue Code	250
Min. Negotiated Rate	$1.60
Max. Negotiated Rate	$1.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.60

ALCIAN BLUE STAIN

Facility

$1,529.00

Service Code	HCPCS 88313
Hospital Charge Code	3005251
Hospital Revenue Code	310
Min. Negotiated Rate	$229.35
Max. Negotiated Rate	$229.35
Rate for Payer: Qualcare PPO/HMO/WC	$229.35

ALCIAN BLUE STAIN

Facility

$1,529.00

Service Code	HCPCS 88313
Hospital Charge Code	3005251
Hospital Revenue Code	310
Min. Negotiated Rate	$43.42
Max. Negotiated Rate	$573.36
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.36
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$397.54
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$229.35
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$68.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$43.42

ALCOHOL 70%

Facility

$6.88

Hospital Charge Code	270650527
Hospital Revenue Code	272
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$1.03
Rate for Payer: Qualcare PPO/HMO/WC	$1.03

ALCOHOL 70%

Facility

$6.88

Hospital Charge Code	270650527
Hospital Revenue Code	272
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$3.44
Rate for Payer: Aetna Commercial	$2.61
Rate for Payer: Aetna Medicare Advantage	$2.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.75
Rate for Payer: Cigna Commercial	$3.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.79
Rate for Payer: Oxford Commercial	$1.38
Rate for Payer: Qualcare PPO/HMO/WC	$1.03
Rate for Payer: UnitedHealthcare Commercial	$1.38
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

ALCOHOL ABUSE AND DEPENDENCE

Facility

$12,185.84

Service Code	APR-DRG 7753
Min. Negotiated Rate	$11,946.90
Max. Negotiated Rate	$12,185.84
Rate for Payer: UnitedHealthcare Community & State	$11,946.90
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,185.84
Rate for Payer: Wellpoint Medicaid Managed Care	$11,946.90

ALCOHOL ABUSE AND DEPENDENCE

Facility

$28,104.52

Service Code	APR-DRG 7754
Min. Negotiated Rate	$27,553.45
Max. Negotiated Rate	$28,104.52
Rate for Payer: UnitedHealthcare Community & State	$27,553.45
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$28,104.52
Rate for Payer: Wellpoint Medicaid Managed Care	$27,553.45

ALCOHOL ABUSE AND DEPENDENCE

Facility

$5,246.78

Service Code	APR-DRG 7751
Min. Negotiated Rate	$5,143.90
Max. Negotiated Rate	$5,246.78
Rate for Payer: UnitedHealthcare Community & State	$5,143.90
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,246.78
Rate for Payer: Wellpoint Medicaid Managed Care	$5,143.90

ALCOHOL ABUSE AND DEPENDENCE

Facility

$7,086.47

Service Code	APR-DRG 7752
Min. Negotiated Rate	$6,947.52
Max. Negotiated Rate	$7,086.47
Rate for Payer: UnitedHealthcare Community & State	$6,947.52
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,086.47
Rate for Payer: Wellpoint Medicaid Managed Care	$6,947.52

ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY

Facility

$9,698.69

Service Code	APR-DRG 7723
Min. Negotiated Rate	$9,508.52
Max. Negotiated Rate	$9,698.69
Rate for Payer: UnitedHealthcare Community & State	$9,508.52
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,698.69
Rate for Payer: Wellpoint Medicaid Managed Care	$9,508.52

ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY

Facility

$26,207.16

Service Code	APR-DRG 7724
Min. Negotiated Rate	$25,693.29
Max. Negotiated Rate	$26,207.16
Rate for Payer: UnitedHealthcare Community & State	$25,693.29
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$26,207.16
Rate for Payer: Wellpoint Medicaid Managed Care	$25,693.29

ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY

Facility

$7,762.03

Service Code	APR-DRG 7722
Min. Negotiated Rate	$7,609.83
Max. Negotiated Rate	$7,762.03
Rate for Payer: UnitedHealthcare Community & State	$7,609.83
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,762.03
Rate for Payer: Wellpoint Medicaid Managed Care	$7,609.83

ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY

Facility

$6,354.80

Service Code	APR-DRG 7721
Min. Negotiated Rate	$6,230.20
Max. Negotiated Rate	$6,354.80
Rate for Payer: UnitedHealthcare Community & State	$6,230.20
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,354.80
Rate for Payer: Wellpoint Medicaid Managed Care	$6,230.20

ALCOHOL DEHYDRATED 98% INJ

Facility

$1,406.40

Hospital Charge Code	6063943053
Hospital Revenue Code	250
Min. Negotiated Rate	$210.96
Max. Negotiated Rate	$210.96
Rate for Payer: Qualcare PPO/HMO/WC	$210.96

ALCOHOL DEHYDRATED 98% INJ

Facility

$1,406.40

Hospital Charge Code	6063943053
Hospital Revenue Code	250
Min. Negotiated Rate	$39.94
Max. Negotiated Rate	$703.20
Rate for Payer: Aetna Commercial	$534.43
Rate for Payer: Aetna Medicare Advantage	$421.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$358.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$358.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$358.63
Rate for Payer: Cigna Commercial	$703.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$365.66
Rate for Payer: Oxford Commercial	$281.28
Rate for Payer: Qualcare PPO/HMO/WC	$210.96
Rate for Payer: UnitedHealthcare Commercial	$281.28
Rate for Payer: UnitedHealthcare Community & State	$44.44
Rate for Payer: Wellpoint Medicaid Managed Care	$39.94

ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA

Facility

$38,954.70

Service Code	MSDRG 894
Min. Negotiated Rate	$7,161.00
Max. Negotiated Rate	$38,954.70
Rate for Payer: Aetna Commercial	$29,602.47
Rate for Payer: Aetna Medicare Advantage	$38,954.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,756.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,791.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,791.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,161.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,485.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,791.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,756.00
Rate for Payer: Cigna Commercial	$13,752.55
Rate for Payer: Cigna Medicare Advantage	$12,485.48
Rate for Payer: Clover Medicare Advantage	$11,861.21
Rate for Payer: EmblemHealth Commercial	$37,456.44
Rate for Payer: Humana Medicare Advantage	$12,860.04
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,485.48
Rate for Payer: Oxford Commercial	$10,869.78
Rate for Payer: UnitedHealthcare Commercial	$14,549.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,485.48
Rate for Payer: Wellcare Medicare Advantage	$12,485.48

ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC

Facility

$74,598.58

Service Code	MSDRG 896
Min. Negotiated Rate	$7,161.00
Max. Negotiated Rate	$74,598.58
Rate for Payer: Aetna Commercial	$54,988.47
Rate for Payer: Aetna Medicare Advantage	$74,598.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,756.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,314.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,314.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,161.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23,909.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,756.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49,314.90
Rate for Payer: Cigna Commercial	$38,903.51
Rate for Payer: Cigna Medicare Advantage	$23,909.80
Rate for Payer: Clover Medicare Advantage	$22,714.31
Rate for Payer: EmblemHealth Commercial	$71,729.40
Rate for Payer: Humana Medicare Advantage	$24,627.09
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$23,909.80
Rate for Payer: Oxford Commercial	$30,748.66
Rate for Payer: UnitedHealthcare Commercial	$41,158.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$23,909.80
Rate for Payer: Wellcare Medicare Advantage	$23,909.80

ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC

Facility

$47,355.45

Service Code	MSDRG 897
Min. Negotiated Rate	$7,161.00
Max. Negotiated Rate	$47,355.45
Rate for Payer: Aetna Commercial	$35,585.60
Rate for Payer: Aetna Medicare Advantage	$47,355.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,826.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,756.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,161.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,826.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,178.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,756.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,826.30
Rate for Payer: Cigna Commercial	$19,680.26
Rate for Payer: Cigna Medicare Advantage	$15,178.03
Rate for Payer: Clover Medicare Advantage	$14,419.13
Rate for Payer: EmblemHealth Commercial	$45,534.09
Rate for Payer: Humana Medicare Advantage	$15,633.37
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,178.03
Rate for Payer: Oxford Commercial	$15,554.94
Rate for Payer: UnitedHealthcare Commercial	$20,820.84
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,178.03
Rate for Payer: Wellcare Medicare Advantage	$15,178.03

ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY

Facility

$64,188.51

Service Code	MSDRG 895
Min. Negotiated Rate	$7,161.00
Max. Negotiated Rate	$64,188.51
Rate for Payer: Aetna Commercial	$47,574.30
Rate for Payer: Aetna Medicare Advantage	$64,188.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44,605.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,756.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44,605.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,161.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,573.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44,605.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,756.00
Rate for Payer: Cigna Commercial	$31,557.97
Rate for Payer: Cigna Medicare Advantage	$20,573.24
Rate for Payer: Clover Medicare Advantage	$19,544.58
Rate for Payer: EmblemHealth Commercial	$61,719.72
Rate for Payer: Humana Medicare Advantage	$21,190.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20,573.24
Rate for Payer: Oxford Commercial	$24,942.87
Rate for Payer: UnitedHealthcare Commercial	$33,386.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,573.24
Rate for Payer: Wellcare Medicare Advantage	$20,573.24

Know your out-of-pocket cost for care.

All Charges