Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

EPSTEIN-BARR VIRUS ANTI,VCA,I

Facility

$239.00

Service Code	HCPCS 86665
Hospital Charge Code	38479427
Hospital Revenue Code	302
Min. Negotiated Rate	$35.85
Max. Negotiated Rate	$35.85
Rate for Payer: Qualcare PPO/HMO/WC	$35.85

EPSTEIN-BARR VIRUS ANTI,VCA,I

Facility

$239.00

Service Code	HCPCS 86665
Hospital Charge Code	38479427
Hospital Revenue Code	302
Min. Negotiated Rate	$6.79
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$49.34
Rate for Payer: Aetna Medicare Advantage	$58.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.14
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	$65.80
Rate for Payer: Cigna Commercial	$119.50
Rate for Payer: Cigna Medicare Advantage	$18.14
Rate for Payer: Clover Medicare Advantage	$17.23
Rate for Payer: EmblemHealth Commercial	$54.42
Rate for Payer: Humana Medicare Advantage	$18.68
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.14
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.85
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.14
Rate for Payer: Wellcare Medicare Advantage	$18.14
Rate for Payer: Wellpoint Medicaid Managed Care	$6.79

EPSTEIN-BARR VIRUS ANTI VCA,IG

Facility

$239.00

Service Code	HCPCS 86665
Hospital Charge Code	38479426
Hospital Revenue Code	302
Min. Negotiated Rate	$6.79
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$49.34
Rate for Payer: Aetna Medicare Advantage	$58.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.14
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	$65.80
Rate for Payer: Cigna Commercial	$119.50
Rate for Payer: Cigna Medicare Advantage	$18.14
Rate for Payer: Clover Medicare Advantage	$17.23
Rate for Payer: EmblemHealth Commercial	$54.42
Rate for Payer: Humana Medicare Advantage	$18.68
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.14
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.85
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.14
Rate for Payer: Wellcare Medicare Advantage	$18.14
Rate for Payer: Wellpoint Medicaid Managed Care	$6.79

EPSTEIN-BARR VIRUS ANTI VCA,IG

Facility

$239.00

Service Code	HCPCS 86665
Hospital Charge Code	38479426
Hospital Revenue Code	302
Min. Negotiated Rate	$35.85
Max. Negotiated Rate	$35.85
Rate for Payer: Qualcare PPO/HMO/WC	$35.85

EPSTEIN-BARR VIRUS ANTI VCA,IG

Facility

$239.00

Service Code	HCPCS 86665
Hospital Charge Code	38476108
Hospital Revenue Code	302
Min. Negotiated Rate	$35.85
Max. Negotiated Rate	$35.85
Rate for Payer: Qualcare PPO/HMO/WC	$35.85

EPSTEIN-BARR VIRUS ANTI VCA,IG

Facility

$239.00

Service Code	HCPCS 86665
Hospital Charge Code	38476108
Hospital Revenue Code	302
Min. Negotiated Rate	$6.79
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$49.34
Rate for Payer: Aetna Medicare Advantage	$58.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.14
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	$65.80
Rate for Payer: Cigna Commercial	$119.50
Rate for Payer: Cigna Medicare Advantage	$18.14
Rate for Payer: Clover Medicare Advantage	$17.23
Rate for Payer: EmblemHealth Commercial	$54.42
Rate for Payer: Humana Medicare Advantage	$18.68
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.14
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.85
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.14
Rate for Payer: Wellcare Medicare Advantage	$18.14
Rate for Payer: Wellpoint Medicaid Managed Care	$6.79

EPSTEIN BARR VIRUS DNA QNT PCR

Facility

$1,897.40

Service Code	HCPCS 87799
Hospital Charge Code	401087799
Hospital Revenue Code	301
Min. Negotiated Rate	$284.61
Max. Negotiated Rate	$284.61
Rate for Payer: Qualcare PPO/HMO/WC	$284.61

EPSTEIN BARR VIRUS DNA QNT PCR

Facility

$1,897.40

Service Code	HCPCS 87799
Hospital Charge Code	401087799
Hospital Revenue Code	301
Min. Negotiated Rate	$34.27
Max. Negotiated Rate	$948.70
Rate for Payer: Aetna Commercial	$116.52
Rate for Payer: Aetna Medicare Advantage	$138.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.40
Rate for Payer: Cigna Commercial	$948.70
Rate for Payer: Cigna Medicare Advantage	$42.84
Rate for Payer: Clover Medicare Advantage	$40.70
Rate for Payer: EmblemHealth Commercial	$128.52
Rate for Payer: Humana Medicare Advantage	$44.13
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$42.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$493.32
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$284.61
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$34.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$42.84
Rate for Payer: Wellcare Medicare Advantage	$42.84
Rate for Payer: Wellpoint Medicaid Managed Care	$53.89

EPTIFIBATIDE 20 MG/10ML INJ

Facility

$1,271.79

Service Code	HCPCS J1327
Hospital Charge Code	60628970
Hospital Revenue Code	636
Min. Negotiated Rate	$3.10
Max. Negotiated Rate	$307.77
Rate for Payer: Aetna Commercial	$8.87
Rate for Payer: Aetna Medicare Advantage	$10.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.83
Rate for Payer: Cigna Medicare Advantage	$3.26
Rate for Payer: Clover Medicare Advantage	$3.10
Rate for Payer: EmblemHealth Commercial	$9.78
Rate for Payer: Humana Medicare Advantage	$3.36
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.77
Rate for Payer: Qualcare PPO/HMO/WC	$190.77
Rate for Payer: UnitedHealthcare Community & State	$40.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.26
Rate for Payer: Wellcare Medicare Advantage	$3.26
Rate for Payer: Wellpoint Medicaid Managed Care	$36.12

EPTIFIBATIDE 20 MG/10ML INJ

Facility

$1,271.79

Service Code	HCPCS J1327
Hospital Charge Code	60628970
Hospital Revenue Code	636
Min. Negotiated Rate	$190.77
Max. Negotiated Rate	$307.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.77
Rate for Payer: Qualcare PPO/HMO/WC	$190.77

EPTIFIBATIDE 75 MG/100ML INJ

Facility

$2,923.81

Service Code	HCPCS J1327
Hospital Charge Code	60628969
Hospital Revenue Code	636
Min. Negotiated Rate	$438.57
Max. Negotiated Rate	$707.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$707.56
Rate for Payer: Qualcare PPO/HMO/WC	$438.57

EPTIFIBATIDE 75 MG/100ML INJ

Facility

$2,923.81

Service Code	HCPCS J1327
Hospital Charge Code	60628969
Hospital Revenue Code	636
Min. Negotiated Rate	$3.10
Max. Negotiated Rate	$707.56
Rate for Payer: Aetna Commercial	$8.87
Rate for Payer: Aetna Medicare Advantage	$10.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.83
Rate for Payer: Cigna Medicare Advantage	$3.26
Rate for Payer: Clover Medicare Advantage	$3.10
Rate for Payer: EmblemHealth Commercial	$9.78
Rate for Payer: Humana Medicare Advantage	$3.36
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$707.56
Rate for Payer: Qualcare PPO/HMO/WC	$438.57
Rate for Payer: UnitedHealthcare Community & State	$92.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.26
Rate for Payer: Wellcare Medicare Advantage	$3.26
Rate for Payer: Wellpoint Medicaid Managed Care	$83.04

EPZICOM 600/300MG

Facility

$316.31

Service Code	NDC 49702020613
Hospital Charge Code	60635561
Hospital Revenue Code	250
Min. Negotiated Rate	$47.45
Max. Negotiated Rate	$47.45
Rate for Payer: Qualcare PPO/HMO/WC	$47.45

EPZICOM 600/300MG

Facility

$316.31

Service Code	NDC 49702020613
Hospital Charge Code	60635561
Hospital Revenue Code	250
Min. Negotiated Rate	$8.98
Max. Negotiated Rate	$158.16
Rate for Payer: Aetna Commercial	$120.20
Rate for Payer: Aetna Medicare Advantage	$94.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.66
Rate for Payer: Cigna Commercial	$158.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.24
Rate for Payer: Oxford Commercial	$63.26
Rate for Payer: Qualcare PPO/HMO/WC	$47.45
Rate for Payer: UnitedHealthcare Commercial	$63.26
Rate for Payer: UnitedHealthcare Community & State	$10.00
Rate for Payer: Wellpoint Medicaid Managed Care	$8.98

EQUILIZER ALLEN

Facility

$1,474.85

Hospital Charge Code	270677421
Hospital Revenue Code	272
Min. Negotiated Rate	$41.89
Max. Negotiated Rate	$737.42
Rate for Payer: Aetna Commercial	$560.44
Rate for Payer: Aetna Medicare Advantage	$442.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.09
Rate for Payer: Cigna Commercial	$737.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$383.46
Rate for Payer: Oxford Commercial	$294.97
Rate for Payer: Qualcare PPO/HMO/WC	$221.23
Rate for Payer: UnitedHealthcare Commercial	$294.97
Rate for Payer: UnitedHealthcare Community & State	$46.61
Rate for Payer: Wellpoint Medicaid Managed Care	$41.89

EQUILIZER ALLEN

Facility

$1,474.85

Hospital Charge Code	270677421
Hospital Revenue Code	272
Min. Negotiated Rate	$221.23
Max. Negotiated Rate	$221.23
Rate for Payer: Qualcare PPO/HMO/WC	$221.23

EQUINOXE REVERSE SHOULDER GLEN

Facility

$6,470.00

Service Code	HCPCS C1776
Hospital Charge Code	270687750
Hospital Revenue Code	278
Min. Negotiated Rate	$970.50
Max. Negotiated Rate	$1,565.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,294.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,565.74
Rate for Payer: Qualcare PPO/HMO/WC	$970.50

EQUINOXE REVERSE SHOULDER GLEN

Facility

$6,470.00

Service Code	HCPCS C1776
Hospital Charge Code	270687750
Hospital Revenue Code	278
Min. Negotiated Rate	$183.75
Max. Negotiated Rate	$3,235.00
Rate for Payer: Aetna Commercial	$2,458.60
Rate for Payer: Aetna Medicare Advantage	$1,941.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,649.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,649.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,294.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,649.85
Rate for Payer: Cigna Commercial	$3,235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,565.74
Rate for Payer: Qualcare PPO/HMO/WC	$970.50
Rate for Payer: UnitedHealthcare Community & State	$204.45
Rate for Payer: Wellpoint Medicaid Managed Care	$183.75

EQUINOX PRES HUM STEM PRES FIT

Facility

$9,170.00

Service Code	HCPCS C1776
Hospital Charge Code	270686661
Hospital Revenue Code	278
Min. Negotiated Rate	$1,375.50
Max. Negotiated Rate	$2,219.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,834.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,219.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,375.50

EQUINOX PRES HUM STEM PRES FIT

Facility

$9,170.00

Service Code	HCPCS C1776
Hospital Charge Code	270686661
Hospital Revenue Code	278
Min. Negotiated Rate	$260.43
Max. Negotiated Rate	$4,585.00
Rate for Payer: Aetna Commercial	$3,484.60
Rate for Payer: Aetna Medicare Advantage	$2,751.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,338.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,338.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,834.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,338.35
Rate for Payer: Cigna Commercial	$4,585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,219.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,375.50
Rate for Payer: UnitedHealthcare Community & State	$289.77
Rate for Payer: Wellpoint Medicaid Managed Care	$260.43

EQUIPMENT / EVALUATION ADJUST

Facility

$60.00

Hospital Charge Code	1008405
Hospital Revenue Code	429
Min. Negotiated Rate	$1.70
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$22.80
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$1.90
Rate for Payer: Wellpoint Medicaid Managed Care	$1.70

EQUIPMENT / EVALUATION ADJUST

Facility

$60.00

Hospital Charge Code	1008420
Hospital Revenue Code	439
Min. Negotiated Rate	$1.70
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$22.80
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$1.90
Rate for Payer: Wellpoint Medicaid Managed Care	$1.70

EQUIPMENT / EVALUATION ADJUST

Facility

$60.00

Hospital Charge Code	1008420
Hospital Revenue Code	439
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

EQUIPMENT / EVALUATION ADJUST

Facility

$60.00

Hospital Charge Code	1008405
Hospital Revenue Code	429
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

ER-ABDOMEN PROCEDURE

Facility

$5,904.00

Service Code	HCPCS 49999
Hospital Charge Code	5790160
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$3,908.70
Rate for Payer: Aetna Commercial	$2,930.85
Rate for Payer: Aetna Medicare Advantage	$3,491.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,908.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,908.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,077.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,908.70
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: Cigna Medicare Advantage	$1,077.52
Rate for Payer: Clover Medicare Advantage	$1,023.64
Rate for Payer: EmblemHealth Commercial	$3,232.56
Rate for Payer: Humana Medicare Advantage	$1,109.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,077.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,535.04
Rate for Payer: Qualcare PPO/HMO/WC	$885.60
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,077.52
Rate for Payer: Wellcare Medicare Advantage	$1,077.52
Rate for Payer: Wellpoint Medicaid Managed Care	$167.67

Know your out-of-pocket cost for care.

All Charges