Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ALCOHOL,ETHYL

Facility

$583.80

Service Code	HCPCS 80320
Hospital Charge Code	38472033
Hospital Revenue Code	301
Min. Negotiated Rate	$87.57
Max. Negotiated Rate	$87.57
Rate for Payer: Qualcare PPO/HMO/WC	$87.57

ALCOHOL,ETHYL

Facility

$583.80

Service Code	HCPCS 80320
Hospital Charge Code	38472033
Hospital Revenue Code	301
Min. Negotiated Rate	$16.58
Max. Negotiated Rate	$291.90
Rate for Payer: Aetna Commercial	$221.84
Rate for Payer: Aetna Medicare Advantage	$175.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$148.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$148.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$148.87
Rate for Payer: Cigna Commercial	$291.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.79
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.57
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$16.66
Rate for Payer: Wellpoint Medicaid Managed Care	$16.58

ALCOHOL,ETHYL,QL,URINE

Facility

$499.75

Service Code	HCPCS 80320
Hospital Charge Code	39900407
Hospital Revenue Code	301
Min. Negotiated Rate	$74.96
Max. Negotiated Rate	$74.96
Rate for Payer: Qualcare PPO/HMO/WC	$74.96

ALCOHOL,ETHYL,QL,URINE

Facility

$499.75

Service Code	HCPCS 80320
Hospital Charge Code	39900407
Hospital Revenue Code	301
Min. Negotiated Rate	$14.19
Max. Negotiated Rate	$249.88
Rate for Payer: Aetna Commercial	$189.91
Rate for Payer: Aetna Medicare Advantage	$149.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.44
Rate for Payer: Cigna Commercial	$249.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.94
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.96
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$16.66
Rate for Payer: Wellpoint Medicaid Managed Care	$14.19

ALCOHOL, ETHYL, QN

Facility

$390.00

Service Code	HCPCS 80320
Hospital Charge Code	39900035
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ALCOHOL, ETHYL, QN

Facility

$390.00

Service Code	HCPCS 80320
Hospital Charge Code	39900035
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$16.66
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

ALCOHOL, ETHYL, QUANT,URINE***

Facility

$92.00

Service Code	HCPCS 80320
Hospital Charge Code	3031127
Hospital Revenue Code	301
Min. Negotiated Rate	$13.80
Max. Negotiated Rate	$13.80
Rate for Payer: Qualcare PPO/HMO/WC	$13.80

ALCOHOL, ETHYL, QUANT,URINE***

Facility

$92.00

Service Code	HCPCS 80320
Hospital Charge Code	3031127
Hospital Revenue Code	301
Min. Negotiated Rate	$2.61
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$34.96
Rate for Payer: Aetna Medicare Advantage	$27.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.46
Rate for Payer: Cigna Commercial	$46.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.92
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.80
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$16.66
Rate for Payer: Wellpoint Medicaid Managed Care	$2.61

ALCOHOL ETHYL URINE QUANT***

Facility

$146.00

Service Code	HCPCS 80320
Hospital Charge Code	3009891
Hospital Revenue Code	301
Min. Negotiated Rate	$21.90
Max. Negotiated Rate	$21.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.90

ALCOHOL ETHYL URINE QUANT***

Facility

$146.00

Service Code	HCPCS 80320
Hospital Charge Code	3009891
Hospital Revenue Code	301
Min. Negotiated Rate	$4.15
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$55.48
Rate for Payer: Aetna Medicare Advantage	$43.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.23
Rate for Payer: Cigna Commercial	$73.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.96
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.90
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$16.66
Rate for Payer: Wellpoint Medicaid Managed Care	$4.15

ALCOHOLIC LIVER DISEASE

Facility

$7,075.26

Service Code	APR-DRG 2801
Min. Negotiated Rate	$6,936.53
Max. Negotiated Rate	$7,075.26
Rate for Payer: UnitedHealthcare Community & State	$6,936.53
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,075.26
Rate for Payer: Wellpoint Medicaid Managed Care	$6,936.53

ALCOHOLIC LIVER DISEASE

Facility

$9,136.93

Service Code	APR-DRG 2802
Min. Negotiated Rate	$8,957.77
Max. Negotiated Rate	$9,136.93
Rate for Payer: UnitedHealthcare Community & State	$8,957.77
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,136.93
Rate for Payer: Wellpoint Medicaid Managed Care	$8,957.77

ALCOHOLIC LIVER DISEASE

Facility

$29,108.59

Service Code	APR-DRG 2804
Min. Negotiated Rate	$28,537.83
Max. Negotiated Rate	$29,108.59
Rate for Payer: UnitedHealthcare Community & State	$28,537.83
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$29,108.59
Rate for Payer: Wellpoint Medicaid Managed Care	$28,537.83

ALCOHOLIC LIVER DISEASE

Facility

$13,915.98

Service Code	APR-DRG 2803
Min. Negotiated Rate	$13,643.12
Max. Negotiated Rate	$13,915.98
Rate for Payer: UnitedHealthcare Community & State	$13,643.12
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,915.98
Rate for Payer: Wellpoint Medicaid Managed Care	$13,643.12

ALCOHOL,ISOPROPYL

Facility

$572.00

Service Code	HCPCS 84600
Hospital Charge Code	38473088
Hospital Revenue Code	301
Min. Negotiated Rate	$13.69
Max. Negotiated Rate	$286.00
Rate for Payer: Aetna Commercial	$46.54
Rate for Payer: Aetna Medicare Advantage	$55.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.07
Rate for Payer: Cigna Commercial	$286.00
Rate for Payer: Cigna Medicare Advantage	$17.11
Rate for Payer: Clover Medicare Advantage	$16.25
Rate for Payer: EmblemHealth Commercial	$51.33
Rate for Payer: Humana Medicare Advantage	$17.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.72
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$85.80
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.11
Rate for Payer: Wellcare Medicare Advantage	$17.11
Rate for Payer: Wellpoint Medicaid Managed Care	$16.24

ALCOHOL,ISOPROPYL

Facility

$572.00

Service Code	HCPCS 84600
Hospital Charge Code	38473088
Hospital Revenue Code	301
Min. Negotiated Rate	$85.80
Max. Negotiated Rate	$85.80
Rate for Payer: Qualcare PPO/HMO/WC	$85.80

ALCOHOL,METHYL

Facility

$572.00

Service Code	HCPCS 84600
Hospital Charge Code	38473089
Hospital Revenue Code	301
Min. Negotiated Rate	$85.80
Max. Negotiated Rate	$85.80
Rate for Payer: Qualcare PPO/HMO/WC	$85.80

ALCOHOL,METHYL

Facility

$572.00

Service Code	HCPCS 84600
Hospital Charge Code	38473089
Hospital Revenue Code	301
Min. Negotiated Rate	$13.69
Max. Negotiated Rate	$286.00
Rate for Payer: Aetna Commercial	$46.54
Rate for Payer: Aetna Medicare Advantage	$55.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.07
Rate for Payer: Cigna Commercial	$286.00
Rate for Payer: Cigna Medicare Advantage	$17.11
Rate for Payer: Clover Medicare Advantage	$16.25
Rate for Payer: EmblemHealth Commercial	$51.33
Rate for Payer: Humana Medicare Advantage	$17.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.72
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$85.80
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.11
Rate for Payer: Wellcare Medicare Advantage	$17.11
Rate for Payer: Wellpoint Medicaid Managed Care	$16.24

ALCOHOL,METHYL,BLOOD

Facility

$110.50

Service Code	HCPCS 84600
Hospital Charge Code	39900152
Hospital Revenue Code	301
Min. Negotiated Rate	$16.57
Max. Negotiated Rate	$16.57
Rate for Payer: Qualcare PPO/HMO/WC	$16.57

ALCOHOL,METHYL,BLOOD

Facility

$110.50

Service Code	HCPCS 84600
Hospital Charge Code	39900152
Hospital Revenue Code	301
Min. Negotiated Rate	$3.14
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$46.54
Rate for Payer: Aetna Medicare Advantage	$55.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.07
Rate for Payer: Cigna Commercial	$55.25
Rate for Payer: Cigna Medicare Advantage	$17.11
Rate for Payer: Clover Medicare Advantage	$16.25
Rate for Payer: EmblemHealth Commercial	$51.33
Rate for Payer: Humana Medicare Advantage	$17.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.73
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.57
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.11
Rate for Payer: Wellcare Medicare Advantage	$17.11
Rate for Payer: Wellpoint Medicaid Managed Care	$3.14

ALCOHOLS BIOMARKERS 1OR 2

Facility

$190.45

Service Code	HCPCS 80321
Hospital Charge Code	3036034
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

ALCOHOLS BIOMARKERS 1OR 2

Facility

$190.45

Service Code	HCPCS 80321
Hospital Charge Code	38430006
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

ALCOHOLS BIOMARKERS 1OR 2

Facility

$190.45

Service Code	HCPCS 80321
Hospital Charge Code	3036034
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

ALCOHOLS BIOMARKERS 1OR 2

Facility

$190.45

Service Code	HCPCS 80321
Hospital Charge Code	39990206
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

ALCOHOLS BIOMARKERS 1OR 2

Facility

$190.45

Service Code	HCPCS 80321
Hospital Charge Code	38430006
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

Know your out-of-pocket cost for care.

All Charges