Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

EPF KIT

Facility

$3,734.50

Service Code	HCPCS C1889
Hospital Charge Code	270703555
Hospital Revenue Code	278
Min. Negotiated Rate	$560.17
Max. Negotiated Rate	$903.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$746.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$903.75
Rate for Payer: Qualcare PPO/HMO/WC	$560.17

EPHEDRINE 50 MG/ML INJ

Facility

$353.63

Service Code	NDC 17478051500
Hospital Charge Code	6012488
Hospital Revenue Code	250
Min. Negotiated Rate	$10.04
Max. Negotiated Rate	$176.81
Rate for Payer: Aetna Commercial	$134.38
Rate for Payer: Aetna Medicare Advantage	$106.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$90.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$90.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$90.18
Rate for Payer: Cigna Commercial	$176.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.94
Rate for Payer: Oxford Commercial	$70.73
Rate for Payer: Qualcare PPO/HMO/WC	$53.04
Rate for Payer: UnitedHealthcare Commercial	$70.73
Rate for Payer: UnitedHealthcare Community & State	$11.17
Rate for Payer: Wellpoint Medicaid Managed Care	$10.04

EPHEDRINE 50 MG/ML INJ

Facility

$353.63

Service Code	NDC 17478051500
Hospital Charge Code	6012488
Hospital Revenue Code	250
Min. Negotiated Rate	$53.04
Max. Negotiated Rate	$53.04
Rate for Payer: Qualcare PPO/HMO/WC	$53.04

EPIDERMAL ANTIBODY 2

Facility

$390.00

Service Code	HCPCS 86255
Hospital Charge Code	38476310
Hospital Revenue Code	302
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.71
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
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	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

EPIDERMAL ANTIBODY 2

Facility

$390.00

Service Code	HCPCS 86255
Hospital Charge Code	38476310
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

EPID FLRSCNT ANTI TITERS 2

Facility

$245.00

Service Code	HCPCS 86256
Hospital Charge Code	38476311
Hospital Revenue Code	302
Min. Negotiated Rate	$6.96
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.71
Rate for Payer: Cigna Commercial	$122.50
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.70
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.75
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$6.96

EPID FLRSCNT ANTI TITERS 2

Facility

$245.00

Service Code	HCPCS 86256
Hospital Charge Code	38476311
Hospital Revenue Code	302
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$36.75
Rate for Payer: Qualcare PPO/HMO/WC	$36.75

EPIDURAL CATHETER & CONNECTOR

Facility

$1,017.00

Hospital Charge Code	270331632
Hospital Revenue Code	272
Min. Negotiated Rate	$28.88
Max. Negotiated Rate	$508.50
Rate for Payer: Aetna Commercial	$386.46
Rate for Payer: Aetna Medicare Advantage	$305.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$259.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$259.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$259.33
Rate for Payer: Cigna Commercial	$508.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$264.42
Rate for Payer: Oxford Commercial	$203.40
Rate for Payer: Qualcare PPO/HMO/WC	$152.55
Rate for Payer: UnitedHealthcare Commercial	$203.40
Rate for Payer: UnitedHealthcare Community & State	$32.14
Rate for Payer: Wellpoint Medicaid Managed Care	$28.88

EPIDURAL CATHETER & CONNECTOR

Facility

$1,017.00

Hospital Charge Code	270331632
Hospital Revenue Code	272
Min. Negotiated Rate	$152.55
Max. Negotiated Rate	$152.55
Rate for Payer: Qualcare PPO/HMO/WC	$152.55

EPIDURAL, CERV/THORACIC (SEP)

Facility

$3,103.00

Service Code	HCPCS 62310
Hospital Charge Code	84506025
Hospital Revenue Code	361
Min. Negotiated Rate	$465.45
Max. Negotiated Rate	$465.45
Rate for Payer: Qualcare PPO/HMO/WC	$465.45

EPIDURAL, CERV/THORACIC (SEP)

Facility

$3,103.00

Service Code	HCPCS 62310
Hospital Charge Code	84506025
Hospital Revenue Code	361
Min. Negotiated Rate	$88.13
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,179.14
Rate for Payer: Aetna Medicare Advantage	$930.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$791.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$791.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$791.26
Rate for Payer: Cigna Commercial	$1,551.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$806.78
Rate for Payer: Qualcare PPO/HMO/WC	$465.45
Rate for Payer: UnitedHealthcare Community & State	$98.05
Rate for Payer: Wellpoint Medicaid Managed Care	$88.13

EPIDURAL, LUMBAR/CAUDAL (SEP)

Facility

$3,103.00

Service Code	HCPCS 62311
Hospital Charge Code	84506030
Hospital Revenue Code	361
Min. Negotiated Rate	$88.13
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,179.14
Rate for Payer: Aetna Medicare Advantage	$930.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$791.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$791.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$791.26
Rate for Payer: Cigna Commercial	$1,551.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$806.78
Rate for Payer: Qualcare PPO/HMO/WC	$465.45
Rate for Payer: UnitedHealthcare Community & State	$98.05
Rate for Payer: Wellpoint Medicaid Managed Care	$88.13

EPIDURAL, LUMBAR/CAUDAL (SEP)

Facility

$3,103.00

Service Code	HCPCS 62311
Hospital Charge Code	84506030
Hospital Revenue Code	361
Min. Negotiated Rate	$465.45
Max. Negotiated Rate	$465.45
Rate for Payer: Qualcare PPO/HMO/WC	$465.45

EPIDURAL SET PERIFIX

Facility

$88.25

Hospital Charge Code	270684453
Hospital Revenue Code	272
Min. Negotiated Rate	$2.51
Max. Negotiated Rate	$44.12
Rate for Payer: Aetna Commercial	$33.53
Rate for Payer: Aetna Medicare Advantage	$26.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.50
Rate for Payer: Cigna Commercial	$44.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.95
Rate for Payer: Oxford Commercial	$17.65
Rate for Payer: Qualcare PPO/HMO/WC	$13.24
Rate for Payer: UnitedHealthcare Commercial	$17.65
Rate for Payer: UnitedHealthcare Community & State	$2.79
Rate for Payer: Wellpoint Medicaid Managed Care	$2.51

EPIDURAL SET PERIFIX

Facility

$88.25

Hospital Charge Code	270684453
Hospital Revenue Code	272
Min. Negotiated Rate	$13.24
Max. Negotiated Rate	$13.24
Rate for Payer: Qualcare PPO/HMO/WC	$13.24

EPIDURAL TRAY CONT. W/NDLE 17G

Facility

$429.00

Hospital Charge Code	270331780
Hospital Revenue Code	272
Min. Negotiated Rate	$64.35
Max. Negotiated Rate	$64.35
Rate for Payer: Qualcare PPO/HMO/WC	$64.35

EPIDURAL TRAY CONT. W/NDLE 17G

Facility

$429.00

Hospital Charge Code	270331780
Hospital Revenue Code	272
Min. Negotiated Rate	$12.18
Max. Negotiated Rate	$214.50
Rate for Payer: Aetna Commercial	$163.02
Rate for Payer: Aetna Medicare Advantage	$128.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.39
Rate for Payer: Cigna Commercial	$214.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.54
Rate for Payer: Oxford Commercial	$85.80
Rate for Payer: Qualcare PPO/HMO/WC	$64.35
Rate for Payer: UnitedHealthcare Commercial	$85.80
Rate for Payer: UnitedHealthcare Community & State	$13.56
Rate for Payer: Wellpoint Medicaid Managed Care	$12.18

EPIDURAL TRAYS COMBINED SPINAL

Facility

$306.55

Hospital Charge Code	270702891
Hospital Revenue Code	272
Min. Negotiated Rate	$45.98
Max. Negotiated Rate	$45.98
Rate for Payer: Qualcare PPO/HMO/WC	$45.98

EPIDURAL TRAYS COMBINED SPINAL

Facility

$306.55

Hospital Charge Code	270702891
Hospital Revenue Code	272
Min. Negotiated Rate	$8.71
Max. Negotiated Rate	$153.28
Rate for Payer: Aetna Commercial	$116.49
Rate for Payer: Aetna Medicare Advantage	$91.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.17
Rate for Payer: Cigna Commercial	$153.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.70
Rate for Payer: Oxford Commercial	$61.31
Rate for Payer: Qualcare PPO/HMO/WC	$45.98
Rate for Payer: UnitedHealthcare Commercial	$61.31
Rate for Payer: UnitedHealthcare Community & State	$9.69
Rate for Payer: Wellpoint Medicaid Managed Care	$8.71

EPIFIX PER SQ CM

Facility

$827.50

Service Code	HCPCS Q4186
Hospital Charge Code	9808328
Hospital Revenue Code	636
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$536.29
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$536.29
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.25
Rate for Payer: Qualcare PPO/HMO/WC	$124.12
Rate for Payer: UnitedHealthcare Community & State	$26.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$23.50

EPIFIX PER SQ CM

Facility

$827.50

Service Code	HCPCS Q4186
Hospital Charge Code	9808328
Hospital Revenue Code	636
Min. Negotiated Rate	$124.12
Max. Negotiated Rate	$200.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.25
Rate for Payer: Qualcare PPO/HMO/WC	$124.12

EPIFIX PER SQ CM JW

Facility

$827.50

Service Code	HCPCS Q4131JW
Hospital Charge Code	9808328W
Hospital Revenue Code	636
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$413.75
Rate for Payer: Aetna Commercial	$314.45
Rate for Payer: Aetna Medicare Advantage	$248.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.01
Rate for Payer: Cigna Commercial	$413.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.25
Rate for Payer: Qualcare PPO/HMO/WC	$124.12
Rate for Payer: UnitedHealthcare Community & State	$26.15
Rate for Payer: Wellpoint Medicaid Managed Care	$23.50

EPIFIX PER SQ CM JW

Facility

$827.50

Service Code	HCPCS Q4131JW
Hospital Charge Code	9808328W
Hospital Revenue Code	636
Min. Negotiated Rate	$124.12
Max. Negotiated Rate	$200.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.25
Rate for Payer: Qualcare PPO/HMO/WC	$124.12

EPINEPHRINE 1 1000 NASAL SOL

Facility

$718.64

Service Code	NDC 42023010301
Hospital Charge Code	60627451
Hospital Revenue Code	250
Min. Negotiated Rate	$107.80
Max. Negotiated Rate	$107.80
Rate for Payer: Qualcare PPO/HMO/WC	$107.80

EPINEPHRINE 1 1000 NASAL SOL

Facility

$718.64

Service Code	NDC 42023010301
Hospital Charge Code	60627451
Hospital Revenue Code	250
Min. Negotiated Rate	$20.41
Max. Negotiated Rate	$359.32
Rate for Payer: Aetna Commercial	$273.08
Rate for Payer: Aetna Medicare Advantage	$215.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.25
Rate for Payer: Cigna Commercial	$359.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.85
Rate for Payer: Oxford Commercial	$143.73
Rate for Payer: Qualcare PPO/HMO/WC	$107.80
Rate for Payer: UnitedHealthcare Commercial	$143.73
Rate for Payer: UnitedHealthcare Community & State	$22.71
Rate for Payer: Wellpoint Medicaid Managed Care	$20.41

Know your out-of-pocket cost for care.

All Charges