Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ER TX ULNAR STYLOID FX

Facility

$1,050.00

Service Code	HCPCS 25650
Hospital Charge Code	5700573
Hospital Revenue Code	450
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$157.50
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

ER TX ULNAR STYLOID FX

Facility

$1,050.00

Service Code	HCPCS 25650
Hospital Charge Code	5700573
Hospital Revenue Code	450
Min. Negotiated Rate	$29.82
Max. Negotiated Rate	$1,063.04
Rate for Payer: Aetna Commercial	$797.10
Rate for Payer: Aetna Medicare Advantage	$949.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,063.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,063.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$293.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,063.04
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: Cigna Medicare Advantage	$293.05
Rate for Payer: Clover Medicare Advantage	$278.40
Rate for Payer: EmblemHealth Commercial	$879.15
Rate for Payer: Humana Medicare Advantage	$301.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$293.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$273.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.50
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$293.05
Rate for Payer: Wellcare Medicare Advantage	$293.05
Rate for Payer: Wellpoint Medicaid Managed Care	$29.82

ER URETHRAL REPAIR PROC

Facility

$16,607.90

Service Code	HCPCS 53502
Hospital Charge Code	93500201
Hospital Revenue Code	450
Min. Negotiated Rate	$2,491.18
Max. Negotiated Rate	$2,491.18
Rate for Payer: Qualcare PPO/HMO/WC	$2,491.18

ER URETHRAL REPAIR PROC

Facility

$16,607.90

Service Code	HCPCS 53502
Hospital Charge Code	93500201
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$15,191.14
Rate for Payer: Aetna Commercial	$11,390.73
Rate for Payer: Aetna Medicare Advantage	$13,568.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,191.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,191.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,187.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$161.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,191.14
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: Cigna Medicare Advantage	$4,187.77
Rate for Payer: Clover Medicare Advantage	$3,978.38
Rate for Payer: EmblemHealth Commercial	$12,563.31
Rate for Payer: Humana Medicare Advantage	$4,313.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,187.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,318.05
Rate for Payer: Qualcare PPO/HMO/WC	$2,491.18
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,187.77
Rate for Payer: Wellcare Medicare Advantage	$4,187.77
Rate for Payer: Wellpoint Medicaid Managed Care	$471.66

ER VAGINAL DELIVERY ANY METHOD

Facility

$8,455.00

Service Code	HCPCS 59409
Hospital Charge Code	5700801
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$13,950.60
Rate for Payer: Aetna Commercial	$10,460.55
Rate for Payer: Aetna Medicare Advantage	$12,460.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,950.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,950.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,845.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$459.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,950.60
Rate for Payer: Cigna Commercial	$7,708.87
Rate for Payer: Cigna Medicare Advantage	$3,845.79
Rate for Payer: Clover Medicare Advantage	$3,653.50
Rate for Payer: EmblemHealth Commercial	$11,537.37
Rate for Payer: Humana Medicare Advantage	$3,961.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,845.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,198.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,268.25
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,845.79
Rate for Payer: Wellcare Medicare Advantage	$3,845.79
Rate for Payer: Wellpoint Medicaid Managed Care	$240.12

ER VAGINAL DELIVERY ANY METHOD

Facility

$8,455.00

Service Code	HCPCS 59409
Hospital Charge Code	5700801
Hospital Revenue Code	450
Min. Negotiated Rate	$1,268.25
Max. Negotiated Rate	$1,268.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,268.25

ER VENIPUNCTURE

Facility

$667.59

Service Code	HCPCS 36415
Hospital Charge Code	5700634
Hospital Revenue Code	300
Min. Negotiated Rate	$3.27
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$25.40
Rate for Payer: Aetna Medicare Advantage	$30.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.88
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$9.34
Rate for Payer: Clover Medicare Advantage	$8.87
Rate for Payer: EmblemHealth Commercial	$28.02
Rate for Payer: Humana Medicare Advantage	$9.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.34
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	$4.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.34
Rate for Payer: Wellcare Medicare Advantage	$9.34
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

ER VENIPUNCTURE

Facility

$667.59

Service Code	HCPCS 36415
Hospital Charge Code	5700634
Hospital Revenue Code	300
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

ER WOUND EXPLORATION OF EXTREM

Facility

$5,321.00

Service Code	HCPCS 20103
Hospital Charge Code	5700545
Hospital Revenue Code	450
Min. Negotiated Rate	$133.79
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	$133.79
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: Wellcare New Jersey Medicaid/Family Care	$1,950.58
Rate for Payer: Wellpoint Medicaid Managed Care	$151.12

ER WOUND EXPLORATION OF EXTREM

Facility

$5,321.00

Service Code	HCPCS 20103
Hospital Charge Code	5700545
Hospital Revenue Code	450
Min. Negotiated Rate	$798.15
Max. Negotiated Rate	$798.15
Rate for Payer: Qualcare PPO/HMO/WC	$798.15

ERYTHROMYCIN BASE 250 MG TAB

Facility

$4.15

Service Code	NDC 66267009020
Hospital Charge Code	6022446
Hospital Revenue Code	251
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.08
Rate for Payer: Aetna Commercial	$1.58
Rate for Payer: Aetna Medicare Advantage	$1.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.06
Rate for Payer: Cigna Commercial	$2.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.08
Rate for Payer: Oxford Commercial	$0.83
Rate for Payer: Qualcare PPO/HMO/WC	$0.62
Rate for Payer: UnitedHealthcare Commercial	$0.83
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.12

ERYTHROMYCIN BASE 250 MG TAB

Facility

$4.15

Service Code	NDC 66267009020
Hospital Charge Code	6022446
Hospital Revenue Code	251
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$0.62
Rate for Payer: Qualcare PPO/HMO/WC	$0.62

ERYTHROMYCIN IVPB 500MG/NS100M

Facility

$54.74

Service Code	HCPCS J1364
Hospital Charge Code	60627279
Hospital Revenue Code	636
Min. Negotiated Rate	$1.55
Max. Negotiated Rate	$27.37
Rate for Payer: Aetna Commercial	$20.80
Rate for Payer: Aetna Medicare Advantage	$16.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.96
Rate for Payer: Cigna Commercial	$27.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.21
Rate for Payer: UnitedHealthcare Community & State	$1.73
Rate for Payer: Wellpoint Medicaid Managed Care	$1.55

ERYTHROMYCIN IVPB 500MG/NS100M

Facility

$54.74

Service Code	HCPCS J1364
Hospital Charge Code	60627279
Hospital Revenue Code	636
Min. Negotiated Rate	$8.21
Max. Negotiated Rate	$13.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.21

ERYTHROMYCIN LACTOB 500MG

Facility

$427.46

Service Code	HCPCS J1364
Hospital Charge Code	60634627
Hospital Revenue Code	636
Min. Negotiated Rate	$64.12
Max. Negotiated Rate	$103.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.45
Rate for Payer: Qualcare PPO/HMO/WC	$64.12

ERYTHROMYCIN LACTOB 500MG

Facility

$427.46

Service Code	HCPCS J1364
Hospital Charge Code	60634627
Hospital Revenue Code	636
Min. Negotiated Rate	$12.14
Max. Negotiated Rate	$213.73
Rate for Payer: Aetna Commercial	$162.43
Rate for Payer: Aetna Medicare Advantage	$128.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.00
Rate for Payer: Cigna Commercial	$213.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.45
Rate for Payer: Qualcare PPO/HMO/WC	$64.12
Rate for Payer: UnitedHealthcare Community & State	$13.51
Rate for Payer: Wellpoint Medicaid Managed Care	$12.14

ERYTHROMYCIN OPH OINT .5% 3.5G

Facility

$120.33

Service Code	NDC 574402435
Hospital Charge Code	60628011
Hospital Revenue Code	250
Min. Negotiated Rate	$18.05
Max. Negotiated Rate	$18.05
Rate for Payer: Qualcare PPO/HMO/WC	$18.05

ERYTHROMYCIN OPH OINT .5% 3.5G

Facility

$120.33

Service Code	NDC 574402435
Hospital Charge Code	60628011
Hospital Revenue Code	250
Min. Negotiated Rate	$3.42
Max. Negotiated Rate	$60.16
Rate for Payer: Aetna Commercial	$45.73
Rate for Payer: Aetna Medicare Advantage	$36.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.68
Rate for Payer: Cigna Commercial	$60.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.29
Rate for Payer: Oxford Commercial	$24.07
Rate for Payer: Qualcare PPO/HMO/WC	$18.05
Rate for Payer: UnitedHealthcare Commercial	$24.07
Rate for Payer: UnitedHealthcare Community & State	$3.80
Rate for Payer: Wellpoint Medicaid Managed Care	$3.42

ERYTHROMYCIN SSP 200MG/5ML

Facility

$24.12

Service Code	NDC 24338013213
Hospital Charge Code	60629131
Hospital Revenue Code	250
Min. Negotiated Rate	$0.69
Max. Negotiated Rate	$12.06
Rate for Payer: Aetna Commercial	$9.17
Rate for Payer: Aetna Medicare Advantage	$7.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.15
Rate for Payer: Cigna Commercial	$12.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.27
Rate for Payer: Oxford Commercial	$4.82
Rate for Payer: Qualcare PPO/HMO/WC	$3.62
Rate for Payer: UnitedHealthcare Commercial	$4.82
Rate for Payer: UnitedHealthcare Community & State	$0.76
Rate for Payer: Wellpoint Medicaid Managed Care	$0.69

ERYTHROMYCIN SSP 200MG/5ML

Facility

$24.12

Service Code	NDC 24338013213
Hospital Charge Code	60629131
Hospital Revenue Code	250
Min. Negotiated Rate	$3.62
Max. Negotiated Rate	$3.62
Rate for Payer: Qualcare PPO/HMO/WC	$3.62

ERYTHROMYCIN TAB EC 250MG

Facility

$4.00

Service Code	NDC 24338010213
Hospital Charge Code	60627273
Hospital Revenue Code	251
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

ERYTHROMYCIN TAB EC 250MG

Facility

$4.00

Service Code	NDC 24338010213
Hospital Charge Code	60627273
Hospital Revenue Code	251
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ERYTHROPOIETIN

Facility

$390.00

Service Code	HCPCS 82668
Hospital Charge Code	39900074
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ERYTHROPOIETIN

Facility

$390.00

Service Code	HCPCS 82668
Hospital Charge Code	39900074
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$51.11
Rate for Payer: Aetna Medicare Advantage	$60.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.16
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$18.79
Rate for Payer: Clover Medicare Advantage	$17.85
Rate for Payer: EmblemHealth Commercial	$56.37
Rate for Payer: Humana Medicare Advantage	$19.35
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.79
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	$15.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.79
Rate for Payer: Wellcare Medicare Advantage	$18.79
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

ERYTHROPOIETIN

Facility

$440.00

Service Code	HCPCS 82668
Hospital Charge Code	38472257
Hospital Revenue Code	301
Min. Negotiated Rate	$66.00
Max. Negotiated Rate	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.00

Know your out-of-pocket cost for care.

All Charges