Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ERYTHROPOIETIN

Facility

$440.00

Service Code	HCPCS 82668
Hospital Charge Code	38472257
Hospital Revenue Code	301
Min. Negotiated Rate	$12.50
Max. Negotiated Rate	$220.00
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	$220.00
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	$114.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.00
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	$12.50

ESCHAROTOMY SUBSEQUENT

Facility

$250.00

Service Code	HCPCS 16036
Hospital Charge Code	5780010
Hospital Revenue Code	450
Min. Negotiated Rate	$7.10
Max. Negotiated Rate	$140.00
Rate for Payer: Aetna Commercial	$95.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$7.10

ESCHAROTOMY SUBSEQUENT

Facility

$250.00

Service Code	HCPCS 16036
Hospital Charge Code	5780010
Hospital Revenue Code	450
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

ESCITALOPRAM 10 MG TAB

Facility

$55.07

Service Code	NDC 904642661
Hospital Charge Code	60629342
Hospital Revenue Code	250
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$27.54
Rate for Payer: Aetna Commercial	$20.93
Rate for Payer: Aetna Medicare Advantage	$16.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.04
Rate for Payer: Cigna Commercial	$27.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.32
Rate for Payer: Oxford Commercial	$11.01
Rate for Payer: Qualcare PPO/HMO/WC	$8.26
Rate for Payer: UnitedHealthcare Commercial	$11.01
Rate for Payer: UnitedHealthcare Community & State	$1.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1.56

ESCITALOPRAM 10 MG TAB

Facility

$55.07

Service Code	NDC 904642661
Hospital Charge Code	60629342
Hospital Revenue Code	250
Min. Negotiated Rate	$8.26
Max. Negotiated Rate	$8.26
Rate for Payer: Qualcare PPO/HMO/WC	$8.26

ESCITALOPRAM 20 MG TAB

Facility

$56.35

Service Code	NDC 456202001
Hospital Charge Code	60629343
Hospital Revenue Code	250
Min. Negotiated Rate	$8.45
Max. Negotiated Rate	$8.45
Rate for Payer: Qualcare PPO/HMO/WC	$8.45

ESCITALOPRAM 20 MG TAB

Facility

$56.35

Service Code	NDC 456202001
Hospital Charge Code	60629343
Hospital Revenue Code	250
Min. Negotiated Rate	$1.60
Max. Negotiated Rate	$28.18
Rate for Payer: Aetna Commercial	$21.41
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.37
Rate for Payer: Cigna Commercial	$28.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.65
Rate for Payer: Oxford Commercial	$11.27
Rate for Payer: Qualcare PPO/HMO/WC	$8.45
Rate for Payer: UnitedHealthcare Commercial	$11.27
Rate for Payer: UnitedHealthcare Community & State	$1.78
Rate for Payer: Wellpoint Medicaid Managed Care	$1.60

ESCITALOPRAM (LEXAPRO) 5MG TAB

Facility

$27.74

Service Code	NDC 93585001
Hospital Charge Code	60630130
Hospital Revenue Code	250
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$4.16
Rate for Payer: Qualcare PPO/HMO/WC	$4.16

ESCITALOPRAM (LEXAPRO) 5MG TAB

Facility

$27.74

Service Code	NDC 93585001
Hospital Charge Code	60630130
Hospital Revenue Code	250
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$13.87
Rate for Payer: Aetna Commercial	$10.54
Rate for Payer: Aetna Medicare Advantage	$8.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.07
Rate for Payer: Cigna Commercial	$13.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.21
Rate for Payer: Oxford Commercial	$5.55
Rate for Payer: Qualcare PPO/HMO/WC	$4.16
Rate for Payer: UnitedHealthcare Commercial	$5.55
Rate for Payer: UnitedHealthcare Community & State	$0.88
Rate for Payer: Wellpoint Medicaid Managed Care	$0.79

ES-EPSTEIN BARR

Facility

$109.00

Service Code	HCPCS 86664
Hospital Charge Code	38479428
Hospital Revenue Code	302
Min. Negotiated Rate	$16.35
Max. Negotiated Rate	$16.35
Rate for Payer: Qualcare PPO/HMO/WC	$16.35

ES-EPSTEIN BARR

Facility

$311.00

Service Code	HCPCS 87340
Hospital Charge Code	38479429
Hospital Revenue Code	306
Min. Negotiated Rate	$46.65
Max. Negotiated Rate	$46.65
Rate for Payer: Qualcare PPO/HMO/WC	$46.65

ES-EPSTEIN BARR

Facility

$109.00

Service Code	HCPCS 86664
Hospital Charge Code	38479428
Hospital Revenue Code	302
Min. Negotiated Rate	$3.10
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$41.59
Rate for Payer: Aetna Medicare Advantage	$49.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.29
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	$55.46
Rate for Payer: Cigna Commercial	$54.50
Rate for Payer: Cigna Medicare Advantage	$15.29
Rate for Payer: Clover Medicare Advantage	$14.53
Rate for Payer: EmblemHealth Commercial	$45.87
Rate for Payer: Humana Medicare Advantage	$15.75
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.34
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.35
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$12.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.29
Rate for Payer: Wellcare Medicare Advantage	$15.29
Rate for Payer: Wellpoint Medicaid Managed Care	$3.10

ES-EPSTEIN BARR

Facility

$311.00

Service Code	HCPCS 87340
Hospital Charge Code	38479429
Hospital Revenue Code	306
Min. Negotiated Rate	$8.26
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$28.10
Rate for Payer: Aetna Medicare Advantage	$33.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.47
Rate for Payer: Cigna Commercial	$155.50
Rate for Payer: Cigna Medicare Advantage	$10.33
Rate for Payer: Clover Medicare Advantage	$9.81
Rate for Payer: EmblemHealth Commercial	$30.99
Rate for Payer: Humana Medicare Advantage	$10.64
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.86
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.65
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$8.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.33
Rate for Payer: Wellcare Medicare Advantage	$10.33
Rate for Payer: Wellpoint Medicaid Managed Care	$8.83

ESLICARBAZEPINE

Facility

$529.45

Service Code	HCPCS 80339
Hospital Charge Code	401180339
Hospital Revenue Code	301
Min. Negotiated Rate	$79.42
Max. Negotiated Rate	$79.42
Rate for Payer: Qualcare PPO/HMO/WC	$79.42

ESLICARBAZEPINE

Facility

$529.45

Service Code	HCPCS 80339
Hospital Charge Code	401180339
Hospital Revenue Code	301
Min. Negotiated Rate	$15.04
Max. Negotiated Rate	$264.73
Rate for Payer: Aetna Commercial	$201.19
Rate for Payer: Aetna Medicare Advantage	$158.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.01
Rate for Payer: Cigna Commercial	$264.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.66
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$79.42
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$16.66
Rate for Payer: Wellpoint Medicaid Managed Care	$15.04

ESMOLOL 100 MG/10ML INJ

Facility

$147.87

Service Code	NDC 63323065210
Hospital Charge Code	60628613
Hospital Revenue Code	250
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$73.94
Rate for Payer: Aetna Commercial	$56.19
Rate for Payer: Aetna Medicare Advantage	$44.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.71
Rate for Payer: Cigna Commercial	$73.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.45
Rate for Payer: Oxford Commercial	$29.57
Rate for Payer: Qualcare PPO/HMO/WC	$22.18
Rate for Payer: UnitedHealthcare Commercial	$29.57
Rate for Payer: UnitedHealthcare Community & State	$4.67
Rate for Payer: Wellpoint Medicaid Managed Care	$4.20

ESMOLOL 100 MG/10ML INJ

Facility

$147.87

Service Code	NDC 63323065210
Hospital Charge Code	60628613
Hospital Revenue Code	250
Min. Negotiated Rate	$22.18
Max. Negotiated Rate	$22.18
Rate for Payer: Qualcare PPO/HMO/WC	$22.18

ESMOLOL 2500 MG/10ML INJ

Facility

$884.87

Service Code	NDC 10019005561
Hospital Charge Code	60627563
Hospital Revenue Code	250
Min. Negotiated Rate	$132.73
Max. Negotiated Rate	$132.73
Rate for Payer: Qualcare PPO/HMO/WC	$132.73

ESMOLOL 2500 MG/10ML INJ

Facility

$884.87

Service Code	NDC 10019005561
Hospital Charge Code	60627563
Hospital Revenue Code	250
Min. Negotiated Rate	$25.13
Max. Negotiated Rate	$442.44
Rate for Payer: Aetna Commercial	$336.25
Rate for Payer: Aetna Medicare Advantage	$265.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$225.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$225.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$225.64
Rate for Payer: Cigna Commercial	$442.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.07
Rate for Payer: Oxford Commercial	$176.97
Rate for Payer: Qualcare PPO/HMO/WC	$132.73
Rate for Payer: UnitedHealthcare Commercial	$176.97
Rate for Payer: UnitedHealthcare Community & State	$27.96
Rate for Payer: Wellpoint Medicaid Managed Care	$25.13

ESMOLOL(BREVIBLOCK)2500MG

Facility

$1,575.30

Service Code	NDC 10019005561
Hospital Charge Code	60630228
Hospital Revenue Code	250
Min. Negotiated Rate	$236.29
Max. Negotiated Rate	$236.29
Rate for Payer: Qualcare PPO/HMO/WC	$236.29

ESMOLOL(BREVIBLOCK)2500MG

Facility

$1,575.30

Service Code	NDC 10019005561
Hospital Charge Code	60630228
Hospital Revenue Code	250
Min. Negotiated Rate	$44.74
Max. Negotiated Rate	$787.65
Rate for Payer: Aetna Commercial	$598.61
Rate for Payer: Aetna Medicare Advantage	$472.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$401.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$401.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$401.70
Rate for Payer: Cigna Commercial	$787.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$409.58
Rate for Payer: Oxford Commercial	$315.06
Rate for Payer: Qualcare PPO/HMO/WC	$236.29
Rate for Payer: UnitedHealthcare Commercial	$315.06
Rate for Payer: UnitedHealthcare Community & State	$49.78
Rate for Payer: Wellpoint Medicaid Managed Care	$44.74

ESOMEPRAZOLE 40 MG INJ

Facility

$267.85

Hospital Charge Code	6063943355
Hospital Revenue Code	250
Min. Negotiated Rate	$7.61
Max. Negotiated Rate	$133.93
Rate for Payer: Aetna Commercial	$101.78
Rate for Payer: Aetna Medicare Advantage	$80.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.30
Rate for Payer: Cigna Commercial	$133.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.64
Rate for Payer: Oxford Commercial	$53.57
Rate for Payer: Qualcare PPO/HMO/WC	$40.18
Rate for Payer: UnitedHealthcare Commercial	$53.57
Rate for Payer: UnitedHealthcare Community & State	$8.46
Rate for Payer: Wellpoint Medicaid Managed Care	$7.61

ESOMEPRAZOLE 40 MG INJ

Facility

$267.85

Hospital Charge Code	6063943355
Hospital Revenue Code	250
Min. Negotiated Rate	$40.18
Max. Negotiated Rate	$40.18
Rate for Payer: Qualcare PPO/HMO/WC	$40.18

ESOPHAGEAL WALL STENT

Facility

$590.00

Hospital Charge Code	270335511
Hospital Revenue Code	278
Min. Negotiated Rate	$16.76
Max. Negotiated Rate	$295.00
Rate for Payer: Aetna Commercial	$224.20
Rate for Payer: Aetna Medicare Advantage	$177.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$150.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$150.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$118.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$150.45
Rate for Payer: Cigna Commercial	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.78
Rate for Payer: Qualcare PPO/HMO/WC	$88.50
Rate for Payer: UnitedHealthcare Community & State	$18.64
Rate for Payer: Wellpoint Medicaid Managed Care	$16.76

ESOPHAGEAL WALL STENT

Facility

$590.00

Hospital Charge Code	270335511
Hospital Revenue Code	278
Min. Negotiated Rate	$88.50
Max. Negotiated Rate	$142.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$118.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.78
Rate for Payer: Qualcare PPO/HMO/WC	$88.50

Know your out-of-pocket cost for care.

All Charges