Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

EMTRIVA ORAL SOLN 10MG/ML

Facility

$5.63

Service Code	NDC 61958060201
Hospital Charge Code	60635533
Hospital Revenue Code	250
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$2.81
Rate for Payer: Aetna Commercial	$2.14
Rate for Payer: Aetna Medicare Advantage	$1.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.44
Rate for Payer: Cigna Commercial	$2.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.46
Rate for Payer: Oxford Commercial	$1.13
Rate for Payer: Qualcare PPO/HMO/WC	$0.84
Rate for Payer: UnitedHealthcare Commercial	$1.13
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

ENA AB (SM/RNP)

Facility

$390.00

Service Code	HCPCS 86235
Hospital Charge Code	39990026EX
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ENA AB (SM/RNP)

Facility

$390.00

Service Code	HCPCS 86235
Hospital Charge Code	39990026EX
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$48.77
Rate for Payer: Aetna Medicare Advantage	$58.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.04
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$17.93
Rate for Payer: Clover Medicare Advantage	$17.03
Rate for Payer: EmblemHealth Commercial	$53.79
Rate for Payer: Humana Medicare Advantage	$18.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.93
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	$14.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.93
Rate for Payer: Wellcare Medicare Advantage	$17.93
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

ENA AB (SM/RNP) I

Facility

$123.25

Service Code	HCPCS 8623591
Hospital Charge Code	39990026A
Hospital Revenue Code	306
Min. Negotiated Rate	$3.50
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$46.84
Rate for Payer: Aetna Medicare Advantage	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.43
Rate for Payer: Cigna Commercial	$61.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.05
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.49
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$3.89
Rate for Payer: Wellpoint Medicaid Managed Care	$3.50

ENA AB (SM/RNP) I

Facility

$123.25

Service Code	HCPCS 8623591
Hospital Charge Code	39990026A
Hospital Revenue Code	306
Min. Negotiated Rate	$18.49
Max. Negotiated Rate	$18.49
Rate for Payer: Qualcare PPO/HMO/WC	$18.49

ENA AB (SM/RNP) II

Facility

$123.25

Service Code	HCPCS 8623591
Hospital Charge Code	39990026B
Hospital Revenue Code	306
Min. Negotiated Rate	$3.50
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$46.84
Rate for Payer: Aetna Medicare Advantage	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.43
Rate for Payer: Cigna Commercial	$61.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.05
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.49
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$3.89
Rate for Payer: Wellpoint Medicaid Managed Care	$3.50

ENA AB (SM/RNP) II

Facility

$123.25

Service Code	HCPCS 8623591
Hospital Charge Code	39990026B
Hospital Revenue Code	306
Min. Negotiated Rate	$18.49
Max. Negotiated Rate	$18.49
Rate for Payer: Qualcare PPO/HMO/WC	$18.49

ENALAPRIL 10MG TABLET

Facility

$8.71

Service Code	NDC 68084039101
Hospital Charge Code	60632216
Hospital Revenue Code	250
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$4.36
Rate for Payer: Aetna Commercial	$3.31
Rate for Payer: Aetna Medicare Advantage	$2.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.22
Rate for Payer: Cigna Commercial	$4.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.26
Rate for Payer: Oxford Commercial	$1.74
Rate for Payer: Qualcare PPO/HMO/WC	$1.31
Rate for Payer: UnitedHealthcare Commercial	$1.74
Rate for Payer: UnitedHealthcare Community & State	$0.28
Rate for Payer: Wellpoint Medicaid Managed Care	$0.25

ENALAPRIL 10MG TABLET

Facility

$8.71

Service Code	NDC 68084039101
Hospital Charge Code	60632216
Hospital Revenue Code	250
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$1.31
Rate for Payer: Qualcare PPO/HMO/WC	$1.31

ENALAPRIL 1.25 MG/ML INJ

Facility

$13.74

Service Code	NDC 409212201
Hospital Charge Code	6009443
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$6.87
Rate for Payer: Aetna Commercial	$5.22
Rate for Payer: Aetna Medicare Advantage	$4.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.50
Rate for Payer: Cigna Commercial	$6.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.57
Rate for Payer: Oxford Commercial	$2.75
Rate for Payer: Qualcare PPO/HMO/WC	$2.06
Rate for Payer: UnitedHealthcare Commercial	$2.75
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.39

ENALAPRIL 1.25 MG/ML INJ

Facility

$13.74

Service Code	NDC 409212201
Hospital Charge Code	6009443
Hospital Revenue Code	250
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$2.06
Rate for Payer: Qualcare PPO/HMO/WC	$2.06

ENALAPRIL 2.5MG 2ML INJ

Facility

$23.25

Service Code	NDC 409212202
Hospital Charge Code	6063943103
Hospital Revenue Code	250
Min. Negotiated Rate	$0.66
Max. Negotiated Rate	$11.62
Rate for Payer: Aetna Commercial	$8.84
Rate for Payer: Aetna Medicare Advantage	$6.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.93
Rate for Payer: Cigna Commercial	$11.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.04
Rate for Payer: Oxford Commercial	$4.65
Rate for Payer: Qualcare PPO/HMO/WC	$3.49
Rate for Payer: UnitedHealthcare Commercial	$4.65
Rate for Payer: UnitedHealthcare Community & State	$0.73
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

ENALAPRIL 2.5MG 2ML INJ

Facility

$23.25

Service Code	NDC 409212202
Hospital Charge Code	6063943103
Hospital Revenue Code	250
Min. Negotiated Rate	$3.49
Max. Negotiated Rate	$3.49
Rate for Payer: Qualcare PPO/HMO/WC	$3.49

ENALAPRIL 2.5MG TABLET

Facility

$9.78

Service Code	NDC 904560961
Hospital Charge Code	60632217
Hospital Revenue Code	250
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$4.89
Rate for Payer: Aetna Commercial	$3.72
Rate for Payer: Aetna Medicare Advantage	$2.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.49
Rate for Payer: Cigna Commercial	$4.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.54
Rate for Payer: Oxford Commercial	$1.96
Rate for Payer: Qualcare PPO/HMO/WC	$1.47
Rate for Payer: UnitedHealthcare Commercial	$1.96
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.28

ENALAPRIL 2.5MG TABLET

Facility

$9.78

Service Code	NDC 904560961
Hospital Charge Code	60632217
Hospital Revenue Code	250
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$1.47
Rate for Payer: Qualcare PPO/HMO/WC	$1.47

enalaprilat

Facility

$10.01

Hospital Charge Code	6063943301
Hospital Revenue Code	250
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$5.00
Rate for Payer: Aetna Commercial	$3.80
Rate for Payer: Aetna Medicare Advantage	$3.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.55
Rate for Payer: Cigna Commercial	$5.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.60
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.50
Rate for Payer: UnitedHealthcare Commercial	$2.00
Rate for Payer: UnitedHealthcare Community & State	$0.32
Rate for Payer: Wellpoint Medicaid Managed Care	$0.28

enalaprilat

Facility

$10.01

Hospital Charge Code	6063943301
Hospital Revenue Code	250
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.50

ENCEPHALITIS ANTIBODIES

Facility

$274.00

Service Code	HCPCS 86317
Hospital Charge Code	38476025
Hospital Revenue Code	302
Min. Negotiated Rate	$41.10
Max. Negotiated Rate	$41.10
Rate for Payer: Qualcare PPO/HMO/WC	$41.10

ENCEPHALITIS ANTIBODIES

Facility

$274.00

Service Code	HCPCS 86317
Hospital Charge Code	38476025
Hospital Revenue Code	302
Min. Negotiated Rate	$7.78
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$40.77
Rate for Payer: Aetna Medicare Advantage	$48.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.38
Rate for Payer: Cigna Commercial	$137.00
Rate for Payer: Cigna Medicare Advantage	$14.99
Rate for Payer: Clover Medicare Advantage	$14.24
Rate for Payer: EmblemHealth Commercial	$44.97
Rate for Payer: Humana Medicare Advantage	$15.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.24
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.10
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$11.99
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.99
Rate for Payer: Wellcare Medicare Advantage	$14.99
Rate for Payer: Wellpoint Medicaid Managed Care	$7.78

ENCEPHALITIS, CALFORNIA

Facility

$93.00

Service Code	HCPCS 86651
Hospital Charge Code	38478087
Hospital Revenue Code	302
Min. Negotiated Rate	$13.95
Max. Negotiated Rate	$13.95
Rate for Payer: Qualcare PPO/HMO/WC	$13.95

ENCEPHALITIS, CALFORNIA

Facility

$93.00

Service Code	HCPCS 86651
Hospital Charge Code	38478087
Hospital Revenue Code	302
Min. Negotiated Rate	$2.64
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$35.88
Rate for Payer: Aetna Medicare Advantage	$42.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.19
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	$47.85
Rate for Payer: Cigna Commercial	$46.50
Rate for Payer: Cigna Medicare Advantage	$13.19
Rate for Payer: Clover Medicare Advantage	$12.53
Rate for Payer: EmblemHealth Commercial	$39.57
Rate for Payer: Humana Medicare Advantage	$13.59
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.18
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.95
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.19
Rate for Payer: Wellcare Medicare Advantage	$13.19
Rate for Payer: Wellpoint Medicaid Managed Care	$2.64

ENCEPHALITIS CALIFORNIA

Facility

$93.00

Service Code	HCPCS 86651
Hospital Charge Code	38479411
Hospital Revenue Code	302
Min. Negotiated Rate	$13.95
Max. Negotiated Rate	$13.95
Rate for Payer: Qualcare PPO/HMO/WC	$13.95

ENCEPHALITIS CALIFORNIA

Facility

$93.00

Service Code	HCPCS 86651
Hospital Charge Code	38479411
Hospital Revenue Code	302
Min. Negotiated Rate	$2.64
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$35.88
Rate for Payer: Aetna Medicare Advantage	$42.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.19
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	$47.85
Rate for Payer: Cigna Commercial	$46.50
Rate for Payer: Cigna Medicare Advantage	$13.19
Rate for Payer: Clover Medicare Advantage	$12.53
Rate for Payer: EmblemHealth Commercial	$39.57
Rate for Payer: Humana Medicare Advantage	$13.59
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.18
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.95
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.19
Rate for Payer: Wellcare Medicare Advantage	$13.19
Rate for Payer: Wellpoint Medicaid Managed Care	$2.64

ENCEPHALITIS EAST, EQUINE

Facility

$93.00

Service Code	HCPCS 86652
Hospital Charge Code	38478088
Hospital Revenue Code	302
Min. Negotiated Rate	$2.64
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$35.88
Rate for Payer: Aetna Medicare Advantage	$42.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.19
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	$47.85
Rate for Payer: Cigna Commercial	$46.50
Rate for Payer: Cigna Medicare Advantage	$13.19
Rate for Payer: Clover Medicare Advantage	$12.53
Rate for Payer: EmblemHealth Commercial	$39.57
Rate for Payer: Humana Medicare Advantage	$13.59
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.18
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.95
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.19
Rate for Payer: Wellcare Medicare Advantage	$13.19
Rate for Payer: Wellpoint Medicaid Managed Care	$2.64

ENCEPHALITIS EAST, EQUINE

Facility

$93.00

Service Code	HCPCS 86652
Hospital Charge Code	38478088
Hospital Revenue Code	302
Min. Negotiated Rate	$13.95
Max. Negotiated Rate	$13.95
Rate for Payer: Qualcare PPO/HMO/WC	$13.95

Know your out-of-pocket cost for care.

All Charges