Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ER GASTRIC LAVAGE

Facility

$528.00

Service Code	HCPCS 43753
Hospital Charge Code	5700811
Hospital Revenue Code	450
Min. Negotiated Rate	$79.20
Max. Negotiated Rate	$79.20
Rate for Payer: Qualcare PPO/HMO/WC	$79.20

ER GENITAL SURGERY PROCEDURE

Facility

$1,336.45

Service Code	HCPCS 55899
Hospital Charge Code	5790190
Hospital Revenue Code	450
Min. Negotiated Rate	$200.47
Max. Negotiated Rate	$200.47
Rate for Payer: Qualcare PPO/HMO/WC	$200.47

ER GENITAL SURGERY PROCEDURE

Facility

$1,336.45

Service Code	HCPCS 55899
Hospital Charge Code	5790190
Hospital Revenue Code	450
Min. Negotiated Rate	$37.96
Max. Negotiated Rate	$1,076.75
Rate for Payer: Aetna Commercial	$807.38
Rate for Payer: Aetna Medicare Advantage	$961.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,076.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,076.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$296.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,076.75
Rate for Payer: Cigna Commercial	$594.98
Rate for Payer: Cigna Medicare Advantage	$296.83
Rate for Payer: Clover Medicare Advantage	$281.99
Rate for Payer: EmblemHealth Commercial	$890.49
Rate for Payer: Humana Medicare Advantage	$305.73
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$296.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$347.48
Rate for Payer: Qualcare PPO/HMO/WC	$200.47
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$296.83
Rate for Payer: Wellcare Medicare Advantage	$296.83
Rate for Payer: Wellpoint Medicaid Managed Care	$37.96

ER GLUCOSE FINGERSTICK

Facility

$390.00

Service Code	HCPCS 82948
Hospital Charge Code	5700999
Hospital Revenue Code	301
Min. Negotiated Rate	$2.48
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$13.71
Rate for Payer: Aetna Medicare Advantage	$16.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.28
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.04
Rate for Payer: Clover Medicare Advantage	$4.79
Rate for Payer: EmblemHealth Commercial	$15.12
Rate for Payer: Humana Medicare Advantage	$5.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.04
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	$4.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.04
Rate for Payer: Wellcare Medicare Advantage	$5.04
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

ER GLUCOSE FINGERSTICK

Facility

$390.00

Service Code	HCPCS 82948
Hospital Charge Code	5700999
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ERGOCALCIFEROL 50000 IU SGL

Facility

$13.20

Service Code	NDC 64380073706
Hospital Charge Code	60628493
Hospital Revenue Code	250
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$1.98
Rate for Payer: Qualcare PPO/HMO/WC	$1.98

ERGOCALCIFEROL 50000 IU SGL

Facility

$13.20

Service Code	NDC 64380073706
Hospital Charge Code	60628493
Hospital Revenue Code	250
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$6.60
Rate for Payer: Aetna Commercial	$5.02
Rate for Payer: Aetna Medicare Advantage	$3.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.37
Rate for Payer: Cigna Commercial	$6.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.43
Rate for Payer: Oxford Commercial	$2.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.98
Rate for Payer: UnitedHealthcare Commercial	$2.64
Rate for Payer: UnitedHealthcare Community & State	$0.42
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

ERIBULIN MESYLATE 0.5MG/ML INJ

Facility

$7,863.12

Service Code	HCPCS J9179
Hospital Charge Code	60630227
Hospital Revenue Code	636
Min. Negotiated Rate	$72.92
Max. Negotiated Rate	$1,902.88
Rate for Payer: Aetna Commercial	$208.79
Rate for Payer: Aetna Medicare Advantage	$248.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$278.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$278.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$76.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$278.45
Rate for Payer: Cigna Medicare Advantage	$76.76
Rate for Payer: Clover Medicare Advantage	$72.92
Rate for Payer: EmblemHealth Commercial	$230.28
Rate for Payer: Humana Medicare Advantage	$79.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$76.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,902.88
Rate for Payer: Qualcare PPO/HMO/WC	$1,179.47
Rate for Payer: UnitedHealthcare Community & State	$248.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$76.76
Rate for Payer: Wellcare Medicare Advantage	$76.76
Rate for Payer: Wellpoint Medicaid Managed Care	$223.31

ERIBULIN MESYLATE 0.5MG/ML INJ

Facility

$7,863.12

Service Code	HCPCS J9179
Hospital Charge Code	60630227
Hospital Revenue Code	636
Min. Negotiated Rate	$1,179.47
Max. Negotiated Rate	$1,902.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,902.88
Rate for Payer: Qualcare PPO/HMO/WC	$1,179.47

ER I&D ABSCESS COMPLCATED/MULT

Facility

$610.00

Service Code	HCPCS 10061
Hospital Charge Code	5700502
Hospital Revenue Code	450
Min. Negotiated Rate	$17.32
Max. Negotiated Rate	$1,751.90
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$121.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,751.90
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.60
Rate for Payer: Qualcare PPO/HMO/WC	$91.50
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$17.32

ER I&D ABSCESS COMPLCATED/MULT

Facility

$610.00

Service Code	HCPCS 10061
Hospital Charge Code	5700502
Hospital Revenue Code	450
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$91.50
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

ER I&D ABS PERITONSILLAR

Facility

$1,453.00

Service Code	HCPCS 42700
Hospital Charge Code	5700648
Hospital Revenue Code	450
Min. Negotiated Rate	$41.27
Max. Negotiated Rate	$1,020.71
Rate for Payer: Aetna Commercial	$765.35
Rate for Payer: Aetna Medicare Advantage	$911.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$281.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.71
Rate for Payer: Cigna Commercial	$564.04
Rate for Payer: Cigna Medicare Advantage	$281.38
Rate for Payer: Clover Medicare Advantage	$267.31
Rate for Payer: EmblemHealth Commercial	$844.14
Rate for Payer: Humana Medicare Advantage	$289.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$281.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$377.78
Rate for Payer: Qualcare PPO/HMO/WC	$217.95
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$281.38
Rate for Payer: Wellcare Medicare Advantage	$281.38
Rate for Payer: Wellpoint Medicaid Managed Care	$41.27

ER I&D ABS PERITONSILLAR

Facility

$1,453.00

Service Code	HCPCS 42700
Hospital Charge Code	5700648
Hospital Revenue Code	450
Min. Negotiated Rate	$217.95
Max. Negotiated Rate	$217.95
Rate for Payer: Qualcare PPO/HMO/WC	$217.95

ER I&D BARTHOLIN'S GLAND

Facility

$942.15

Service Code	HCPCS 56420
Hospital Charge Code	5700800
Hospital Revenue Code	450
Min. Negotiated Rate	$141.32
Max. Negotiated Rate	$141.32
Rate for Payer: Qualcare PPO/HMO/WC	$141.32

ER I&D BARTHOLIN'S GLAND

Facility

$942.15

Service Code	HCPCS 56420
Hospital Charge Code	5700800
Hospital Revenue Code	450
Min. Negotiated Rate	$26.76
Max. Negotiated Rate	$871.25
Rate for Payer: Aetna Commercial	$653.29
Rate for Payer: Aetna Medicare Advantage	$778.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$871.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$871.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$240.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$871.25
Rate for Payer: Cigna Commercial	$481.45
Rate for Payer: Cigna Medicare Advantage	$240.18
Rate for Payer: Clover Medicare Advantage	$228.17
Rate for Payer: EmblemHealth Commercial	$720.54
Rate for Payer: Humana Medicare Advantage	$247.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$240.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$244.96
Rate for Payer: Qualcare PPO/HMO/WC	$141.32
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$240.18
Rate for Payer: Wellcare Medicare Advantage	$240.18
Rate for Payer: Wellpoint Medicaid Managed Care	$26.76

ER I&D DENTAL ABSCESS

Facility

$680.00

Service Code	HCPCS 41800
Hospital Charge Code	5700647
Hospital Revenue Code	450
Min. Negotiated Rate	$102.00
Max. Negotiated Rate	$102.00
Rate for Payer: Qualcare PPO/HMO/WC	$102.00

ER I&D DENTAL ABSCESS

Facility

$680.00

Service Code	HCPCS 41800
Hospital Charge Code	5700647
Hospital Revenue Code	450
Min. Negotiated Rate	$19.31
Max. Negotiated Rate	$573.36
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.36
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.80
Rate for Payer: Qualcare PPO/HMO/WC	$102.00
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$19.31

ER I&D EAR ABSCESS SIMPL

Facility

$610.00

Service Code	HCPCS 69000
Hospital Charge Code	5700807
Hospital Revenue Code	450
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$91.50
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

ER I&D EAR ABSCESS SIMPL

Facility

$610.00

Service Code	HCPCS 69000
Hospital Charge Code	5700807
Hospital Revenue Code	450
Min. Negotiated Rate	$17.32
Max. Negotiated Rate	$3,051.74
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,051.74
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.60
Rate for Payer: Qualcare PPO/HMO/WC	$91.50
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$17.32

ER I&D FINGER ABSCESS COMPLX

Facility

$5,321.00

Service Code	HCPCS 26011
Hospital Charge Code	5700749
Hospital Revenue Code	450
Min. Negotiated Rate	$798.15
Max. Negotiated Rate	$798.15
Rate for Payer: Qualcare PPO/HMO/WC	$798.15

ER I&D FINGER ABSCESS COMPLX

Facility

$5,321.00

Service Code	HCPCS 26011
Hospital Charge Code	5700749
Hospital Revenue Code	450
Min. Negotiated Rate	$96.22
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,383.46
Rate for Payer: Qualcare PPO/HMO/WC	$798.15
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$151.12

ER I&D FINGER ABSCESS SIMPLE

Facility

$610.00

Service Code	HCPCS 26010
Hospital Charge Code	5700574
Hospital Revenue Code	450
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$91.50
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

ER I&D FINGER ABSCESS SIMPLE

Facility

$610.00

Service Code	HCPCS 26010
Hospital Charge Code	5700574
Hospital Revenue Code	450
Min. Negotiated Rate	$17.32
Max. Negotiated Rate	$864.65
Rate for Payer: Aetna Commercial	$648.34
Rate for Payer: Aetna Medicare Advantage	$772.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$864.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$864.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$238.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$864.65
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: Cigna Medicare Advantage	$238.36
Rate for Payer: Clover Medicare Advantage	$226.44
Rate for Payer: EmblemHealth Commercial	$715.08
Rate for Payer: Humana Medicare Advantage	$245.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$238.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.60
Rate for Payer: Qualcare PPO/HMO/WC	$91.50
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$17.32

ER I&D HAND BURSA

Facility

$8,259.00

Service Code	HCPCS 23931
Hospital Charge Code	5700737
Hospital Revenue Code	450
Min. Negotiated Rate	$25.96
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,147.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,238.85
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$234.56

ER I&D HAND BURSA

Facility

$8,259.00

Service Code	HCPCS 23931
Hospital Charge Code	5700737
Hospital Revenue Code	450
Min. Negotiated Rate	$1,238.85
Max. Negotiated Rate	$1,238.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,238.85

Know your out-of-pocket cost for care.

All Charges