Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ALDOSTERONE/PRA,LC/MS/MS I

Facility

$667.59

Service Code	HCPCS 82088
Hospital Charge Code	39990059A
Hospital Revenue Code	307
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

ALDOSTERONE/PRA,LC/MS/MS I

Facility

$667.59

Service Code	HCPCS 82088
Hospital Charge Code	39990059A
Hospital Revenue Code	307
Min. Negotiated Rate	$18.96
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$110.84
Rate for Payer: Aetna Medicare Advantage	$132.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$40.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.82
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$40.75
Rate for Payer: Clover Medicare Advantage	$38.71
Rate for Payer: EmblemHealth Commercial	$122.25
Rate for Payer: Humana Medicare Advantage	$41.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$40.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.57
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$32.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$40.75
Rate for Payer: Wellcare Medicare Advantage	$40.75
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

ALDOSTERONE/PRA,LC/MS/MS II

Facility

$667.59

Service Code	HCPCS 84244
Hospital Charge Code	39990059B
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

ALDOSTERONE/PRA,LC/MS/MS II

Facility

$667.59

Service Code	HCPCS 84244
Hospital Charge Code	39990059B
Hospital Revenue Code	301
Min. Negotiated Rate	$17.59
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$59.81
Rate for Payer: Aetna Medicare Advantage	$71.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.77
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$21.99
Rate for Payer: Clover Medicare Advantage	$20.89
Rate for Payer: EmblemHealth Commercial	$65.97
Rate for Payer: Humana Medicare Advantage	$22.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.57
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$17.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.99
Rate for Payer: Wellcare Medicare Advantage	$21.99
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

ALDOSTERONE, SERUM

Facility

$390.00

Service Code	HCPCS 82088
Hospital Charge Code	39900037
Hospital Revenue Code	307
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ALDOSTERONE, SERUM

Facility

$390.00

Service Code	HCPCS 82088
Hospital Charge Code	39900037
Hospital Revenue Code	307
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$110.84
Rate for Payer: Aetna Medicare Advantage	$132.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$40.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.82
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$40.75
Rate for Payer: Clover Medicare Advantage	$38.71
Rate for Payer: EmblemHealth Commercial	$122.25
Rate for Payer: Humana Medicare Advantage	$41.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$40.75
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	$32.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$40.75
Rate for Payer: Wellcare Medicare Advantage	$40.75
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

ALENDRONATE 10MG TABLET

Facility

$19.63

Service Code	NDC 115167808
Hospital Charge Code	60631037
Hospital Revenue Code	250
Min. Negotiated Rate	$2.94
Max. Negotiated Rate	$2.94
Rate for Payer: Qualcare PPO/HMO/WC	$2.94

ALENDRONATE 10MG TABLET

Facility

$19.63

Service Code	NDC 115167808
Hospital Charge Code	60631037
Hospital Revenue Code	250
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$9.81
Rate for Payer: Aetna Commercial	$7.46
Rate for Payer: Aetna Medicare Advantage	$5.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.01
Rate for Payer: Cigna Commercial	$9.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.10
Rate for Payer: Oxford Commercial	$3.93
Rate for Payer: Qualcare PPO/HMO/WC	$2.94
Rate for Payer: UnitedHealthcare Commercial	$3.93
Rate for Payer: UnitedHealthcare Community & State	$0.62
Rate for Payer: Wellpoint Medicaid Managed Care	$0.56

ALENDRONATE 70MG TAB

Facility

$137.08

Service Code	NDC 51079094205
Hospital Charge Code	60631039
Hospital Revenue Code	250
Min. Negotiated Rate	$3.89
Max. Negotiated Rate	$68.54
Rate for Payer: Aetna Commercial	$52.09
Rate for Payer: Aetna Medicare Advantage	$41.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.96
Rate for Payer: Cigna Commercial	$68.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.64
Rate for Payer: Oxford Commercial	$27.42
Rate for Payer: Qualcare PPO/HMO/WC	$20.56
Rate for Payer: UnitedHealthcare Commercial	$27.42
Rate for Payer: UnitedHealthcare Community & State	$4.33
Rate for Payer: Wellpoint Medicaid Managed Care	$3.89

ALENDRONATE 70MG TAB

Facility

$137.08

Service Code	NDC 51079094205
Hospital Charge Code	60631039
Hospital Revenue Code	250
Min. Negotiated Rate	$20.56
Max. Negotiated Rate	$20.56
Rate for Payer: Qualcare PPO/HMO/WC	$20.56

ALENDRONATE SOD 35MG TAB

Facility

$138.22

Service Code	NDC 16714063201
Hospital Charge Code	606390411
Hospital Revenue Code	250
Min. Negotiated Rate	$20.73
Max. Negotiated Rate	$20.73
Rate for Payer: Qualcare PPO/HMO/WC	$20.73

ALENDRONATE SOD 35MG TAB

Facility

$138.22

Service Code	NDC 16714063201
Hospital Charge Code	606390411
Hospital Revenue Code	250
Min. Negotiated Rate	$3.93
Max. Negotiated Rate	$69.11
Rate for Payer: Aetna Commercial	$52.52
Rate for Payer: Aetna Medicare Advantage	$41.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.25
Rate for Payer: Cigna Commercial	$69.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.94
Rate for Payer: Oxford Commercial	$27.64
Rate for Payer: Qualcare PPO/HMO/WC	$20.73
Rate for Payer: UnitedHealthcare Commercial	$27.64
Rate for Payer: UnitedHealthcare Community & State	$4.37
Rate for Payer: Wellpoint Medicaid Managed Care	$3.93

ALEUTAIN 24X30MM 10DEG LOR 9MM

Facility

$21,870.00

Hospital Charge Code	270670094
Hospital Revenue Code	278
Min. Negotiated Rate	$3,280.50
Max. Negotiated Rate	$5,292.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,374.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,292.54
Rate for Payer: Qualcare PPO/HMO/WC	$3,280.50

ALEUTAIN 24X30MM 10DEG LOR 9MM

Facility

$21,870.00

Hospital Charge Code	270670094
Hospital Revenue Code	278
Min. Negotiated Rate	$621.11
Max. Negotiated Rate	$10,935.00
Rate for Payer: Aetna Commercial	$8,310.60
Rate for Payer: Aetna Medicare Advantage	$6,561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,576.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,576.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,374.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,576.85
Rate for Payer: Cigna Commercial	$10,935.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,292.54
Rate for Payer: Qualcare PPO/HMO/WC	$3,280.50
Rate for Payer: UnitedHealthcare Community & State	$691.09
Rate for Payer: Wellpoint Medicaid Managed Care	$621.11

ALEUTAIN 24X30MM 10DG CON 13MM

Facility

$20,795.00

Hospital Charge Code	270670107
Hospital Revenue Code	278
Min. Negotiated Rate	$3,119.25
Max. Negotiated Rate	$5,032.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,159.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,032.39
Rate for Payer: Qualcare PPO/HMO/WC	$3,119.25

ALEUTAIN 24X30MM 10DG CON 13MM

Facility

$20,795.00

Hospital Charge Code	270670107
Hospital Revenue Code	278
Min. Negotiated Rate	$590.58
Max. Negotiated Rate	$10,397.50
Rate for Payer: Aetna Commercial	$7,902.10
Rate for Payer: Aetna Medicare Advantage	$6,238.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,302.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,302.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,159.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,302.73
Rate for Payer: Cigna Commercial	$10,397.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,032.39
Rate for Payer: Qualcare PPO/HMO/WC	$3,119.25
Rate for Payer: UnitedHealthcare Community & State	$657.12
Rate for Payer: Wellpoint Medicaid Managed Care	$590.58

ALEUTAIN 24X30MM 10DG LOR 11MM

Facility

$21,870.00

Hospital Charge Code	270670101
Hospital Revenue Code	278
Min. Negotiated Rate	$3,280.50
Max. Negotiated Rate	$5,292.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,374.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,292.54
Rate for Payer: Qualcare PPO/HMO/WC	$3,280.50

ALEUTAIN 24X30MM 10DG LOR 11MM

Facility

$21,870.00

Hospital Charge Code	270670101
Hospital Revenue Code	278
Min. Negotiated Rate	$621.11
Max. Negotiated Rate	$10,935.00
Rate for Payer: Aetna Commercial	$8,310.60
Rate for Payer: Aetna Medicare Advantage	$6,561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,576.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,576.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,374.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,576.85
Rate for Payer: Cigna Commercial	$10,935.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,292.54
Rate for Payer: Qualcare PPO/HMO/WC	$3,280.50
Rate for Payer: UnitedHealthcare Community & State	$691.09
Rate for Payer: Wellpoint Medicaid Managed Care	$621.11

ALEUTAIN 24X30MM 10DG LOR 13MM

Facility

$21,870.00

Hospital Charge Code	270670110
Hospital Revenue Code	278
Min. Negotiated Rate	$621.11
Max. Negotiated Rate	$10,935.00
Rate for Payer: Aetna Commercial	$8,310.60
Rate for Payer: Aetna Medicare Advantage	$6,561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,576.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,576.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,374.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,576.85
Rate for Payer: Cigna Commercial	$10,935.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,292.54
Rate for Payer: Qualcare PPO/HMO/WC	$3,280.50
Rate for Payer: UnitedHealthcare Community & State	$691.09
Rate for Payer: Wellpoint Medicaid Managed Care	$621.11

ALEUTAIN 24X30MM 10DG LOR 13MM

Facility

$21,870.00

Hospital Charge Code	270670110
Hospital Revenue Code	278
Min. Negotiated Rate	$3,280.50
Max. Negotiated Rate	$5,292.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,374.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,292.54
Rate for Payer: Qualcare PPO/HMO/WC	$3,280.50

ALEUTAIN 24X30MM 10DG LOR 15MM

Facility

$21,870.00

Hospital Charge Code	270670118
Hospital Revenue Code	278
Min. Negotiated Rate	$621.11
Max. Negotiated Rate	$10,935.00
Rate for Payer: Aetna Commercial	$8,310.60
Rate for Payer: Aetna Medicare Advantage	$6,561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,576.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,576.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,374.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,576.85
Rate for Payer: Cigna Commercial	$10,935.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,292.54
Rate for Payer: Qualcare PPO/HMO/WC	$3,280.50
Rate for Payer: UnitedHealthcare Community & State	$691.09
Rate for Payer: Wellpoint Medicaid Managed Care	$621.11

ALEUTAIN 24X30MM 10DG LOR 15MM

Facility

$21,870.00

Hospital Charge Code	270670118
Hospital Revenue Code	278
Min. Negotiated Rate	$3,280.50
Max. Negotiated Rate	$5,292.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,374.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,292.54
Rate for Payer: Qualcare PPO/HMO/WC	$3,280.50

ALEUTAIN 24X30MM 10DG LOR 17MM

Facility

$21,870.00

Hospital Charge Code	270670126
Hospital Revenue Code	278
Min. Negotiated Rate	$3,280.50
Max. Negotiated Rate	$5,292.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,374.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,292.54
Rate for Payer: Qualcare PPO/HMO/WC	$3,280.50

ALEUTAIN 24X30MM 10DG LOR 17MM

Facility

$21,870.00

Hospital Charge Code	270670126
Hospital Revenue Code	278
Min. Negotiated Rate	$621.11
Max. Negotiated Rate	$10,935.00
Rate for Payer: Aetna Commercial	$8,310.60
Rate for Payer: Aetna Medicare Advantage	$6,561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,576.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,576.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,374.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,576.85
Rate for Payer: Cigna Commercial	$10,935.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,292.54
Rate for Payer: Qualcare PPO/HMO/WC	$3,280.50
Rate for Payer: UnitedHealthcare Community & State	$691.09
Rate for Payer: Wellpoint Medicaid Managed Care	$621.11

ALEUTAIN 24X30MM 10DG LOR 19MM

Facility

$21,870.00

Hospital Charge Code	270670133
Hospital Revenue Code	278
Min. Negotiated Rate	$3,280.50
Max. Negotiated Rate	$5,292.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,374.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,292.54
Rate for Payer: Qualcare PPO/HMO/WC	$3,280.50

Know your out-of-pocket cost for care.

All Charges