Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

FLOW CYTOMETRY;EA ADD'L MARKER

Facility

$101.00

Service Code	HCPCS 88185
Hospital Charge Code	38474161
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,INT 2-8 MARKERS

Facility

$292.00

Service Code	HCPCS 88187
Hospital Charge Code	38474050
Hospital Revenue Code	311
Min. Negotiated Rate	$43.80
Max. Negotiated Rate	$43.80
Rate for Payer: Qualcare PPO/HMO/WC	$43.80

FLOW CYTOMETRY,INT 2-8 MARKERS

Facility

$292.00

Service Code	HCPCS 88187
Hospital Charge Code	38474050
Hospital Revenue Code	311
Min. Negotiated Rate	$8.29
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$110.96
Rate for Payer: Aetna Medicare Advantage	$87.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.46
Rate for Payer: Cigna Commercial	$146.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.92
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.80
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$27.70
Rate for Payer: Wellpoint Medicaid Managed Care	$8.29

FLOW CYTOMETRY INT 9-15 MARKER

Facility

$307.00

Service Code	HCPCS 88188
Hospital Charge Code	38474051
Hospital Revenue Code	311
Min. Negotiated Rate	$46.05
Max. Negotiated Rate	$46.05
Rate for Payer: Qualcare PPO/HMO/WC	$46.05

FLOW CYTOMETRY INT 9-15 MARKER

Facility

$307.00

Service Code	HCPCS 88188
Hospital Charge Code	38474051
Hospital Revenue Code	311
Min. Negotiated Rate	$8.72
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$116.66
Rate for Payer: Aetna Medicare Advantage	$92.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.28
Rate for Payer: Cigna Commercial	$153.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.82
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.05
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$47.85
Rate for Payer: Wellpoint Medicaid Managed Care	$8.72

FLOW CYTOMETRY TC 1 MARKER

Facility

$1,263.00

Service Code	HCPCS 88184
Hospital Charge Code	401088184A
Hospital Revenue Code	301
Min. Negotiated Rate	$189.45
Max. Negotiated Rate	$189.45
Rate for Payer: Qualcare PPO/HMO/WC	$189.45

FLOW CYTOMETRY TC 1 MARKER

Facility

$1,263.00

Service Code	HCPCS 88184
Hospital Charge Code	401088184A
Hospital Revenue Code	301
Min. Negotiated Rate	$35.87
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) NJ Health	$43.89
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	$328.38
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$189.45
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	$35.87

FLOW CYTOMETRY TC 1 MARKER

Facility

$16.38

Service Code	HCPCS 88184
Hospital Charge Code	401030580A
Hospital Revenue Code	311
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$2.46
Rate for Payer: Qualcare PPO/HMO/WC	$2.46

FLOW CYTOMETRY TC 1 MARKER

Facility

$16.38

Service Code	HCPCS 88184
Hospital Charge Code	401030580A
Hospital Revenue Code	311
Min. Negotiated Rate	$0.47
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	$4.26
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.46
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	$0.47

FLOW CYTOMETRY TC ADD-ON X 22

Facility

$360.45

Service Code	HCPCS 88185
Hospital Charge Code	401030580B
Hospital Revenue Code	311
Min. Negotiated Rate	$54.07
Max. Negotiated Rate	$54.07
Rate for Payer: Qualcare PPO/HMO/WC	$54.07

FLOW CYTOMETRY TC ADD-ON X 22

Facility

$360.45

Service Code	HCPCS 88185
Hospital Charge Code	401030580B
Hospital Revenue Code	311
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$180.22
Rate for Payer: Aetna Commercial	$136.97
Rate for Payer: Aetna Medicare Advantage	$108.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.91
Rate for Payer: Cigna Commercial	$180.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.72
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.07
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$19.54
Rate for Payer: Wellpoint Medicaid Managed Care	$10.24

FLOWMETER 8LPM DISS NUT NIPPLE

Facility

$119.75

Hospital Charge Code	270669890
Hospital Revenue Code	272
Min. Negotiated Rate	$3.40
Max. Negotiated Rate	$59.88
Rate for Payer: Aetna Commercial	$45.51
Rate for Payer: Aetna Medicare Advantage	$35.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.54
Rate for Payer: Cigna Commercial	$59.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.14
Rate for Payer: Oxford Commercial	$23.95
Rate for Payer: Qualcare PPO/HMO/WC	$17.96
Rate for Payer: UnitedHealthcare Commercial	$23.95
Rate for Payer: UnitedHealthcare Community & State	$3.78
Rate for Payer: Wellpoint Medicaid Managed Care	$3.40

FLOWMETER 8LPM DISS NUT NIPPLE

Facility

$119.75

Hospital Charge Code	270669890
Hospital Revenue Code	272
Min. Negotiated Rate	$17.96
Max. Negotiated Rate	$17.96
Rate for Payer: Qualcare PPO/HMO/WC	$17.96

FLOWPORT CANN OBTURATOR 165MM

Facility

$1,954.05

Hospital Charge Code	270670491
Hospital Revenue Code	272
Min. Negotiated Rate	$55.50
Max. Negotiated Rate	$977.02
Rate for Payer: Aetna Commercial	$742.54
Rate for Payer: Aetna Medicare Advantage	$586.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$498.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$498.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$498.28
Rate for Payer: Cigna Commercial	$977.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$508.05
Rate for Payer: Oxford Commercial	$390.81
Rate for Payer: Qualcare PPO/HMO/WC	$293.11
Rate for Payer: UnitedHealthcare Commercial	$390.81
Rate for Payer: UnitedHealthcare Community & State	$61.75
Rate for Payer: Wellpoint Medicaid Managed Care	$55.50

FLOWPORT CANN OBTURATOR 165MM

Facility

$1,954.05

Hospital Charge Code	270670491
Hospital Revenue Code	272
Min. Negotiated Rate	$293.11
Max. Negotiated Rate	$293.11
Rate for Payer: Qualcare PPO/HMO/WC	$293.11

FLOWTRIEVER SYSTEM

Facility

$55,000.00

Service Code	HCPCS C1757
Hospital Charge Code	270697576
Hospital Revenue Code	278
Min. Negotiated Rate	$8,250.00
Max. Negotiated Rate	$13,310.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,250.00

FLOWTRIEVER SYSTEM

Facility

$55,000.00

Service Code	HCPCS C1757
Hospital Charge Code	270697576
Hospital Revenue Code	278
Min. Negotiated Rate	$1,562.00
Max. Negotiated Rate	$27,500.00
Rate for Payer: Aetna Commercial	$20,900.00
Rate for Payer: Aetna Medicare Advantage	$16,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,025.00
Rate for Payer: Cigna Commercial	$27,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,250.00
Rate for Payer: UnitedHealthcare Community & State	$1,738.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1,562.00

FLOWTRIEVER SYSTEM

Facility

$55,000.00

Service Code	HCPCS C1757
Hospital Charge Code	270697576S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,562.00
Max. Negotiated Rate	$27,500.00
Rate for Payer: Aetna Commercial	$20,900.00
Rate for Payer: Aetna Medicare Advantage	$16,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,025.00
Rate for Payer: Cigna Commercial	$27,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,250.00
Rate for Payer: UnitedHealthcare Community & State	$1,738.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1,562.00

FLOWTRIEVER SYSTEM

Facility

$55,000.00

Service Code	HCPCS C1757
Hospital Charge Code	270697576S
Hospital Revenue Code	278
Min. Negotiated Rate	$8,250.00
Max. Negotiated Rate	$13,310.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,250.00

FLUAD HIGH DOSE VACCINE

Facility

$46.79

Service Code	HCPCS 90694
Hospital Charge Code	412390694
Hospital Revenue Code	636
Min. Negotiated Rate	$1.33
Max. Negotiated Rate	$23.39
Rate for Payer: Aetna Commercial	$17.78
Rate for Payer: Aetna Medicare Advantage	$14.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.93
Rate for Payer: Cigna Commercial	$23.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.32
Rate for Payer: Qualcare PPO/HMO/WC	$7.02
Rate for Payer: UnitedHealthcare Community & State	$1.48
Rate for Payer: Wellpoint Medicaid Managed Care	$1.33

FLUAD HIGH DOSE VACCINE

Facility

$46.79

Service Code	HCPCS 90694
Hospital Charge Code	412390694
Hospital Revenue Code	636
Min. Negotiated Rate	$7.02
Max. Negotiated Rate	$11.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.32
Rate for Payer: Qualcare PPO/HMO/WC	$7.02

FLUAD TRI 0.5 ML 2024-25

Facility

$0.01

Service Code	HCPCS 90653
Hospital Charge Code	606390626
Hospital Revenue Code	636
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

FLUAD TRI 0.5 ML 2024-25

Facility

$0.01

Service Code	HCPCS 90653
Hospital Charge Code	606390626
Hospital Revenue Code	636
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

FLUARIX 0.5ML 2024-25

Facility

$0.01

Service Code	HCPCS 90656
Hospital Charge Code	606390625
Hospital Revenue Code	636
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

FLUARIX 0.5ML 2024-25

Facility

$0.01

Service Code	HCPCS 90656
Hospital Charge Code	606390625
Hospital Revenue Code	636
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Know your out-of-pocket cost for care.

All Charges