Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ENDOVEN THER CHEM ADHES SBSQ

Facility

$29,358.35

Service Code	HCPCS 36483
Hospital Charge Code	421036483
Hospital Revenue Code	761
Min. Negotiated Rate	$4,403.75
Max. Negotiated Rate	$4,403.75
Rate for Payer: Qualcare PPO/HMO/WC	$4,403.75

ENDOVIVE REPLACEMENT KIT 24FR

Facility

$136.50

Hospital Charge Code	270660084
Hospital Revenue Code	272
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$20.48
Rate for Payer: Qualcare PPO/HMO/WC	$20.48

ENDOVIVE REPLACEMENT KIT 24FR

Facility

$136.50

Hospital Charge Code	270660084
Hospital Revenue Code	272
Min. Negotiated Rate	$3.88
Max. Negotiated Rate	$68.25
Rate for Payer: Aetna Commercial	$51.87
Rate for Payer: Aetna Medicare Advantage	$40.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.81
Rate for Payer: Cigna Commercial	$68.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.49
Rate for Payer: Oxford Commercial	$27.30
Rate for Payer: Qualcare PPO/HMO/WC	$20.48
Rate for Payer: UnitedHealthcare Commercial	$27.30
Rate for Payer: UnitedHealthcare Community & State	$4.31
Rate for Payer: Wellpoint Medicaid Managed Care	$3.88

ENDOVIVE STD REPL KIT 18 FR

Facility

$136.50

Hospital Charge Code	270660083
Hospital Revenue Code	272
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$20.48
Rate for Payer: Qualcare PPO/HMO/WC	$20.48

ENDOVIVE STD REPL KIT 18 FR

Facility

$136.50

Hospital Charge Code	270660083
Hospital Revenue Code	272
Min. Negotiated Rate	$3.88
Max. Negotiated Rate	$68.25
Rate for Payer: Aetna Commercial	$51.87
Rate for Payer: Aetna Medicare Advantage	$40.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.81
Rate for Payer: Cigna Commercial	$68.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.49
Rate for Payer: Oxford Commercial	$27.30
Rate for Payer: Qualcare PPO/HMO/WC	$20.48
Rate for Payer: UnitedHealthcare Commercial	$27.30
Rate for Payer: UnitedHealthcare Community & State	$4.31
Rate for Payer: Wellpoint Medicaid Managed Care	$3.88

ENDOVIVE STD REPL KIT 20FR

Facility

$136.50

Hospital Charge Code	270646740
Hospital Revenue Code	272
Min. Negotiated Rate	$3.88
Max. Negotiated Rate	$68.25
Rate for Payer: Aetna Commercial	$51.87
Rate for Payer: Aetna Medicare Advantage	$40.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.81
Rate for Payer: Cigna Commercial	$68.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.49
Rate for Payer: Oxford Commercial	$27.30
Rate for Payer: Qualcare PPO/HMO/WC	$20.48
Rate for Payer: UnitedHealthcare Commercial	$27.30
Rate for Payer: UnitedHealthcare Community & State	$4.31
Rate for Payer: Wellpoint Medicaid Managed Care	$3.88

ENDOVIVE STD REPL KIT 20FR

Facility

$136.50

Hospital Charge Code	270646740
Hospital Revenue Code	272
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$20.48
Rate for Payer: Qualcare PPO/HMO/WC	$20.48

ENDOWRIST STAPLER 45 W

Facility

$908.30

Hospital Charge Code	270677734
Hospital Revenue Code	272
Min. Negotiated Rate	$136.25
Max. Negotiated Rate	$136.25
Rate for Payer: Qualcare PPO/HMO/WC	$136.25

ENDOWRIST STAPLER 45 W

Facility

$908.30

Hospital Charge Code	270677734
Hospital Revenue Code	272
Min. Negotiated Rate	$25.80
Max. Negotiated Rate	$454.15
Rate for Payer: Aetna Commercial	$345.15
Rate for Payer: Aetna Medicare Advantage	$272.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.62
Rate for Payer: Cigna Commercial	$454.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.16
Rate for Payer: Oxford Commercial	$181.66
Rate for Payer: Qualcare PPO/HMO/WC	$136.25
Rate for Payer: UnitedHealthcare Commercial	$181.66
Rate for Payer: UnitedHealthcare Community & State	$28.70
Rate for Payer: Wellpoint Medicaid Managed Care	$25.80

END TIDAL CO2

Facility

$2,476.94

Service Code	HCPCS 94770
Hospital Charge Code	411094770
Hospital Revenue Code	460
Min. Negotiated Rate	$70.35
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$941.24
Rate for Payer: Aetna Medicare Advantage	$743.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.62
Rate for Payer: Cigna Commercial	$1,238.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$644.00
Rate for Payer: Oxford Commercial	$2,184.00
Rate for Payer: Qualcare PPO/HMO/WC	$371.54
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$78.27
Rate for Payer: Wellpoint Medicaid Managed Care	$70.35

END TIDAL CO2

Facility

$2,476.94

Service Code	HCPCS 94770
Hospital Charge Code	411094770
Hospital Revenue Code	460
Min. Negotiated Rate	$371.54
Max. Negotiated Rate	$371.54
Rate for Payer: Qualcare PPO/HMO/WC	$371.54

END TIDAL CO2

Facility

$10,357.02

Service Code	HCPCS 94770
Hospital Charge Code	9501295
Hospital Revenue Code	460
Min. Negotiated Rate	$1,553.55
Max. Negotiated Rate	$1,553.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,553.55

END TIDAL CO2

Facility

$10,357.02

Service Code	HCPCS 94770
Hospital Charge Code	9501295
Hospital Revenue Code	460
Min. Negotiated Rate	$294.14
Max. Negotiated Rate	$5,178.51
Rate for Payer: Aetna Commercial	$3,935.67
Rate for Payer: Aetna Medicare Advantage	$3,107.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,641.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,641.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,641.04
Rate for Payer: Cigna Commercial	$5,178.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,692.83
Rate for Payer: Oxford Commercial	$2,184.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,553.55
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$327.28
Rate for Payer: Wellpoint Medicaid Managed Care	$294.14

ENHANCED LIVER FIBROSIS (ELF)

Facility

$340.00

Service Code	HCPCS 81517
Hospital Charge Code	397080022
Hospital Revenue Code	310
Min. Negotiated Rate	$9.66
Max. Negotiated Rate	$639.13
Rate for Payer: Aetna Commercial	$479.24
Rate for Payer: Aetna Medicare Advantage	$570.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$639.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$639.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$176.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$639.13
Rate for Payer: Cigna Commercial	$170.00
Rate for Payer: Cigna Medicare Advantage	$176.19
Rate for Payer: Clover Medicare Advantage	$167.38
Rate for Payer: EmblemHealth Commercial	$528.57
Rate for Payer: Humana Medicare Advantage	$181.48
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$176.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.00
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$176.19
Rate for Payer: Wellcare Medicare Advantage	$176.19
Rate for Payer: Wellpoint Medicaid Managed Care	$9.66

ENHANCED LIVER FIBROSIS (ELF)

Facility

$340.00

Service Code	HCPCS 81517
Hospital Charge Code	397080022
Hospital Revenue Code	310
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$51.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

ENISYL/500MG/TAB

Facility

$4.00

Service Code	NDC 536673101
Hospital Charge Code	60632936
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

ENISYL/500MG/TAB

Facility

$4.00

Service Code	NDC 536673101
Hospital Charge Code	60632936
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ENOXAPARIN 100 MG SYRINGE

Facility

$605.08

Service Code	HCPCS J1650
Hospital Charge Code	60628902
Hospital Revenue Code	636
Min. Negotiated Rate	$17.18
Max. Negotiated Rate	$302.54
Rate for Payer: Aetna Commercial	$229.93
Rate for Payer: Aetna Medicare Advantage	$181.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.30
Rate for Payer: Cigna Commercial	$302.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.43
Rate for Payer: Qualcare PPO/HMO/WC	$90.76
Rate for Payer: UnitedHealthcare Community & State	$19.12
Rate for Payer: Wellpoint Medicaid Managed Care	$17.18

ENOXAPARIN 100 MG SYRINGE

Facility

$605.08

Service Code	HCPCS J1650
Hospital Charge Code	60628902
Hospital Revenue Code	636
Min. Negotiated Rate	$90.76
Max. Negotiated Rate	$146.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.43
Rate for Payer: Qualcare PPO/HMO/WC	$90.76

ENOXAPARIN 120 MG SYRINGE

Facility

$726.28

Service Code	HCPCS J1650
Hospital Charge Code	60629832
Hospital Revenue Code	636
Min. Negotiated Rate	$20.63
Max. Negotiated Rate	$363.14
Rate for Payer: Aetna Commercial	$275.99
Rate for Payer: Aetna Medicare Advantage	$217.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$185.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$185.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$185.20
Rate for Payer: Cigna Commercial	$363.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.76
Rate for Payer: Qualcare PPO/HMO/WC	$108.94
Rate for Payer: UnitedHealthcare Community & State	$22.95
Rate for Payer: Wellpoint Medicaid Managed Care	$20.63

ENOXAPARIN 120 MG SYRINGE

Facility

$726.28

Service Code	HCPCS J1650
Hospital Charge Code	60629832
Hospital Revenue Code	636
Min. Negotiated Rate	$108.94
Max. Negotiated Rate	$175.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.76
Rate for Payer: Qualcare PPO/HMO/WC	$108.94

ENOXAPARIN 150 MG SYRINGE

Facility

$998.77

Service Code	HCPCS J1650
Hospital Charge Code	60635382
Hospital Revenue Code	636
Min. Negotiated Rate	$28.37
Max. Negotiated Rate	$499.38
Rate for Payer: Aetna Commercial	$379.53
Rate for Payer: Aetna Medicare Advantage	$299.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$254.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$254.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$254.69
Rate for Payer: Cigna Commercial	$499.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$241.70
Rate for Payer: Qualcare PPO/HMO/WC	$149.82
Rate for Payer: UnitedHealthcare Community & State	$31.56
Rate for Payer: Wellpoint Medicaid Managed Care	$28.37

ENOXAPARIN 150 MG SYRINGE

Facility

$998.77

Service Code	HCPCS J1650
Hospital Charge Code	60635382
Hospital Revenue Code	636
Min. Negotiated Rate	$149.82
Max. Negotiated Rate	$241.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$241.70
Rate for Payer: Qualcare PPO/HMO/WC	$149.82

ENOXAPARIN 30 MG SYRINGE

Facility

$181.57

Service Code	HCPCS J1650
Hospital Charge Code	60627505
Hospital Revenue Code	636
Min. Negotiated Rate	$5.16
Max. Negotiated Rate	$90.78
Rate for Payer: Aetna Commercial	$69.00
Rate for Payer: Aetna Medicare Advantage	$54.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.30
Rate for Payer: Cigna Commercial	$90.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.94
Rate for Payer: Qualcare PPO/HMO/WC	$27.24
Rate for Payer: UnitedHealthcare Community & State	$5.74
Rate for Payer: Wellpoint Medicaid Managed Care	$5.16

ENOXAPARIN 30 MG SYRINGE

Facility

$181.57

Service Code	HCPCS J1650
Hospital Charge Code	60627505
Hospital Revenue Code	636
Min. Negotiated Rate	$27.24
Max. Negotiated Rate	$43.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.94
Rate for Payer: Qualcare PPO/HMO/WC	$27.24

Know your out-of-pocket cost for care.

All Charges