Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

FLOUR,NON INF.AB SCREEN(2)

Facility

$225.00

Service Code	HCPCS 86255
Hospital Charge Code	38476258
Hospital Revenue Code	302
Min. Negotiated Rate	$6.39
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	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.71
Rate for Payer: Cigna Commercial	$112.50
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	$58.50
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
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	$6.39

FLOUR,NON INF.AB SCREEN(2)

Facility

$225.00

Service Code	HCPCS 86255
Hospital Charge Code	38476258
Hospital Revenue Code	302
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

FLOUR.NON INF.AB SCREEN(3)

Facility

$225.00

Service Code	HCPCS 86255
Hospital Charge Code	38476259
Hospital Revenue Code	302
Min. Negotiated Rate	$6.39
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	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.71
Rate for Payer: Cigna Commercial	$112.50
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	$58.50
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
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	$6.39

FLOUR.NON INF.AB SCREEN(3)

Facility

$225.00

Service Code	HCPCS 86255
Hospital Charge Code	38476259
Hospital Revenue Code	302
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

FLOUR.NON INF.AB SCREEN(4)

Facility

$225.00

Service Code	HCPCS 86255
Hospital Charge Code	38476260
Hospital Revenue Code	302
Min. Negotiated Rate	$6.39
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	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.71
Rate for Payer: Cigna Commercial	$112.50
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	$58.50
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
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	$6.39

FLOUR.NON INF.AB SCREEN(4)

Facility

$225.00

Service Code	HCPCS 86255
Hospital Charge Code	38476260
Hospital Revenue Code	302
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

FLOUROSCOPY- 1 HR

Facility

$3,032.40

Service Code	HCPCS 76000
Hospital Charge Code	84506085
Hospital Revenue Code	320
Min. Negotiated Rate	$454.86
Max. Negotiated Rate	$454.86
Rate for Payer: Qualcare PPO/HMO/WC	$454.86

FLOUROSCOPY- 1 HR

Facility

$3,032.40

Service Code	HCPCS 76000
Hospital Charge Code	84506085
Hospital Revenue Code	320
Min. Negotiated Rate	$81.67
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$771.04
Rate for Payer: Aetna Medicare Advantage	$918.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,028.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,028.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$283.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,028.29
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: Cigna Medicare Advantage	$198.43
Rate for Payer: Clover Medicare Advantage	$269.30
Rate for Payer: EmblemHealth Commercial	$850.41
Rate for Payer: Humana Medicare Advantage	$291.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$283.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$788.42
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$454.86
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$95.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$86.12

FLOWABLE 10CC OAFL-10

Facility

$13,320.00

Service Code	HCPCS C1889
Hospital Charge Code	270704064
Hospital Revenue Code	278
Min. Negotiated Rate	$1,998.00
Max. Negotiated Rate	$3,223.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,664.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,223.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,998.00

FLOWABLE 10CC OAFL-10

Facility

$13,320.00

Service Code	HCPCS C1889
Hospital Charge Code	270704064
Hospital Revenue Code	278
Min. Negotiated Rate	$378.29
Max. Negotiated Rate	$6,660.00
Rate for Payer: Aetna Commercial	$5,061.60
Rate for Payer: Aetna Medicare Advantage	$3,996.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,396.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,396.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,664.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,396.60
Rate for Payer: Cigna Commercial	$6,660.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,223.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,998.00
Rate for Payer: UnitedHealthcare Community & State	$420.91
Rate for Payer: Wellpoint Medicaid Managed Care	$378.29

FLOWABLE, 2.5CC

Facility

$5,065.00

Hospital Charge Code	270703497
Hospital Revenue Code	278
Min. Negotiated Rate	$143.85
Max. Negotiated Rate	$2,532.50
Rate for Payer: Aetna Commercial	$1,924.70
Rate for Payer: Aetna Medicare Advantage	$1,519.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,291.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,291.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,013.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,291.58
Rate for Payer: Cigna Commercial	$2,532.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,225.73
Rate for Payer: Qualcare PPO/HMO/WC	$759.75
Rate for Payer: UnitedHealthcare Community & State	$160.05
Rate for Payer: Wellpoint Medicaid Managed Care	$143.85

FLOWABLE, 2.5CC

Facility

$5,065.00

Hospital Charge Code	270703497
Hospital Revenue Code	278
Min. Negotiated Rate	$759.75
Max. Negotiated Rate	$1,225.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,013.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,225.73
Rate for Payer: Qualcare PPO/HMO/WC	$759.75

FLOW CYTOM, CELL SURF,CYTO

Facility

$101.00

Service Code	HCPCS 88184
Hospital Charge Code	38476306
Hospital Revenue Code	311
Min. Negotiated Rate	$2.87
Max. Negotiated Rate	$1,544.73
Rate for Payer: Aetna Commercial	$1,158.28
Rate for Payer: Aetna Medicare Advantage	$1,379.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,544.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,544.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$425.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,544.73
Rate for Payer: Cigna Commercial	$853.60
Rate for Payer: Cigna Medicare Advantage	$425.84
Rate for Payer: Clover Medicare Advantage	$404.55
Rate for Payer: EmblemHealth Commercial	$1,277.52
Rate for Payer: Humana Medicare Advantage	$438.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$425.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.26
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.15
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$64.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$425.84
Rate for Payer: Wellcare Medicare Advantage	$425.84
Rate for Payer: Wellpoint Medicaid Managed Care	$2.87

FLOW CYTOM, CELL SURF,CYTO

Facility

$101.00

Service Code	HCPCS 88184
Hospital Charge Code	38476306
Hospital Revenue Code	311
Min. Negotiated Rate	$15.15
Max. Negotiated Rate	$15.15
Rate for Payer: Qualcare PPO/HMO/WC	$15.15

FLOW CYTOMETRY

Facility

$310.00

Service Code	HCPCS 88182
Hospital Charge Code	38474157
Hospital Revenue Code	311
Min. Negotiated Rate	$46.50
Max. Negotiated Rate	$46.50
Rate for Payer: Qualcare PPO/HMO/WC	$46.50

FLOW CYTOMETRY

Facility

$310.00

Service Code	HCPCS 88182
Hospital Charge Code	38474157
Hospital Revenue Code	311
Min. Negotiated Rate	$8.80
Max. Negotiated Rate	$224.58
Rate for Payer: Aetna Commercial	$168.40
Rate for Payer: Aetna Medicare Advantage	$200.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$61.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.58
Rate for Payer: Cigna Commercial	$124.10
Rate for Payer: Cigna Medicare Advantage	$61.91
Rate for Payer: Clover Medicare Advantage	$58.81
Rate for Payer: EmblemHealth Commercial	$185.73
Rate for Payer: Humana Medicare Advantage	$63.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$61.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.60
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$136.61
Rate for Payer: UnitedHealthcare Medicare Advantage	$61.91
Rate for Payer: Wellcare Medicare Advantage	$61.91
Rate for Payer: Wellpoint Medicaid Managed Care	$8.80

FLOW CYTOMETRY;16 OR MORE

Facility

$217.00

Service Code	HCPCS 88189
Hospital Charge Code	38474162
Hospital Revenue Code	311
Min. Negotiated Rate	$6.16
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$82.46
Rate for Payer: Aetna Medicare Advantage	$65.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.34
Rate for Payer: Cigna Commercial	$108.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.42
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.55
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$64.66
Rate for Payer: Wellpoint Medicaid Managed Care	$6.16

FLOW CYTOMETRY;16 OR MORE

Facility

$217.00

Service Code	HCPCS 88189
Hospital Charge Code	38474162
Hospital Revenue Code	311
Min. Negotiated Rate	$32.55
Max. Negotiated Rate	$32.55
Rate for Payer: Qualcare PPO/HMO/WC	$32.55

FLOW CYTOMETRY ADDL MARKER

Facility

$631.50

Service Code	HCPCS 88185
Hospital Charge Code	401088184B
Hospital Revenue Code	301
Min. Negotiated Rate	$94.72
Max. Negotiated Rate	$94.72
Rate for Payer: Qualcare PPO/HMO/WC	$94.72

FLOW CYTOMETRY ADDL MARKER

Facility

$631.50

Service Code	HCPCS 88185
Hospital Charge Code	401088184B
Hospital Revenue Code	301
Min. Negotiated Rate	$17.93
Max. Negotiated Rate	$315.75
Rate for Payer: Aetna Commercial	$239.97
Rate for Payer: Aetna Medicare Advantage	$189.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.03
Rate for Payer: Cigna Commercial	$315.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.19
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$94.72
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$19.54
Rate for Payer: Wellpoint Medicaid Managed Care	$17.93

FLOW CYTOMETRY ADDL MARKER

Facility

$390.00

Service Code	HCPCS 88185
Hospital Charge Code	401088185
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FLOW CYTOMETRY ADDL MARKER

Facility

$390.00

Service Code	HCPCS 88185
Hospital Charge Code	401088185
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$19.54
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

FLOW CYTOMETRY:CELL CYCLE

Facility

$217.00

Service Code	HCPCS 88182
Hospital Charge Code	38474151
Hospital Revenue Code	311
Min. Negotiated Rate	$32.55
Max. Negotiated Rate	$32.55
Rate for Payer: Qualcare PPO/HMO/WC	$32.55

FLOW CYTOMETRY:CELL CYCLE

Facility

$217.00

Service Code	HCPCS 88182
Hospital Charge Code	38474151
Hospital Revenue Code	311
Min. Negotiated Rate	$6.16
Max. Negotiated Rate	$224.58
Rate for Payer: Aetna Commercial	$168.40
Rate for Payer: Aetna Medicare Advantage	$200.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$61.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.58
Rate for Payer: Cigna Commercial	$124.10
Rate for Payer: Cigna Medicare Advantage	$61.91
Rate for Payer: Clover Medicare Advantage	$58.81
Rate for Payer: EmblemHealth Commercial	$185.73
Rate for Payer: Humana Medicare Advantage	$63.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$61.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.42
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.55
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$136.61
Rate for Payer: UnitedHealthcare Medicare Advantage	$61.91
Rate for Payer: Wellcare Medicare Advantage	$61.91
Rate for Payer: Wellpoint Medicaid Managed Care	$6.16

FLOW CYTOMETRY;EA ADD'L MARKER

Facility

$101.00

Service Code	HCPCS 88185
Hospital Charge Code	38474161
Hospital Revenue Code	311
Min. Negotiated Rate	$2.87
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$38.38
Rate for Payer: Aetna Medicare Advantage	$30.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.75
Rate for Payer: Cigna Commercial	$50.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.26
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.15
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$19.54
Rate for Payer: Wellpoint Medicaid Managed Care	$2.87

Know your out-of-pocket cost for care.

All Charges