Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

FP SCREENING VISUAL ACUITY,QUA

Facility

$35.00

Service Code	HCPCS 99173
Hospital Charge Code	83652391
Hospital Revenue Code	920
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$2,301.00
Rate for Payer: Aetna Commercial	$13.30
Rate for Payer: Aetna Medicare Advantage	$10.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.93
Rate for Payer: Cigna Commercial	$17.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.10
Rate for Payer: Oxford Commercial	$2,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.25
Rate for Payer: UnitedHealthcare Commercial	$2,301.00
Rate for Payer: UnitedHealthcare Community & State	$1.11
Rate for Payer: Wellpoint Medicaid Managed Care	$0.99

FP SCREENING VISUAL ACUITY,QUA

Facility

$35.00

Service Code	HCPCS 99173
Hospital Charge Code	83652391
Hospital Revenue Code	920
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$5.25
Rate for Payer: Qualcare PPO/HMO/WC	$5.25

FP SMKNG&TOBACCO CESS COUNSLG

Facility

$123.00

Service Code	HCPCS 99406
Hospital Charge Code	83652505
Hospital Revenue Code	942
Min. Negotiated Rate	$18.45
Max. Negotiated Rate	$18.45
Rate for Payer: Qualcare PPO/HMO/WC	$18.45

FP SMKNG&TOBACCO CESS COUNSLG

Facility

$123.00

Service Code	HCPCS 99406
Hospital Charge Code	83652505
Hospital Revenue Code	942
Min. Negotiated Rate	$3.49
Max. Negotiated Rate	$1,203.00
Rate for Payer: Aetna Commercial	$121.07
Rate for Payer: Aetna Medicare Advantage	$144.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$44.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.46
Rate for Payer: Cigna Commercial	$89.22
Rate for Payer: Cigna Medicare Advantage	$44.51
Rate for Payer: Clover Medicare Advantage	$42.28
Rate for Payer: EmblemHealth Commercial	$133.53
Rate for Payer: Humana Medicare Advantage	$45.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$44.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.98
Rate for Payer: Oxford Commercial	$1,060.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.45
Rate for Payer: UnitedHealthcare Commercial	$1,203.00
Rate for Payer: UnitedHealthcare Community & State	$3.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$44.51
Rate for Payer: Wellcare Medicare Advantage	$44.51
Rate for Payer: Wellpoint Medicaid Managed Care	$3.49

FP SMK&TOBACCO CESS COUNSELING

Facility

$123.00

Service Code	HCPCS 99407
Hospital Charge Code	83652507
Hospital Revenue Code	942
Min. Negotiated Rate	$18.45
Max. Negotiated Rate	$18.45
Rate for Payer: Qualcare PPO/HMO/WC	$18.45

FP SMK&TOBACCO CESS COUNSELING

Facility

$123.00

Service Code	HCPCS 99407
Hospital Charge Code	83652507
Hospital Revenue Code	942
Min. Negotiated Rate	$3.49
Max. Negotiated Rate	$1,203.00
Rate for Payer: Aetna Commercial	$121.07
Rate for Payer: Aetna Medicare Advantage	$144.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$44.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.46
Rate for Payer: Cigna Commercial	$89.22
Rate for Payer: Cigna Medicare Advantage	$44.51
Rate for Payer: Clover Medicare Advantage	$42.28
Rate for Payer: EmblemHealth Commercial	$133.53
Rate for Payer: Humana Medicare Advantage	$45.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$44.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.98
Rate for Payer: Oxford Commercial	$1,060.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.45
Rate for Payer: UnitedHealthcare Commercial	$1,203.00
Rate for Payer: UnitedHealthcare Community & State	$3.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$44.51
Rate for Payer: Wellcare Medicare Advantage	$44.51
Rate for Payer: Wellpoint Medicaid Managed Care	$3.49

FP SMOKE & TOBAC CESS COU 3-10

Facility

$123.00

Service Code	HCPCS 99406
Hospital Charge Code	87502380
Hospital Revenue Code	510
Min. Negotiated Rate	$3.49
Max. Negotiated Rate	$161.46
Rate for Payer: Aetna Commercial	$121.07
Rate for Payer: Aetna Medicare Advantage	$144.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$44.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.46
Rate for Payer: Cigna Commercial	$89.22
Rate for Payer: Cigna Medicare Advantage	$44.51
Rate for Payer: Clover Medicare Advantage	$42.28
Rate for Payer: EmblemHealth Commercial	$133.53
Rate for Payer: Humana Medicare Advantage	$45.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$44.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.98
Rate for Payer: Qualcare PPO/HMO/WC	$18.45
Rate for Payer: UnitedHealthcare Community & State	$3.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$44.51
Rate for Payer: Wellcare Medicare Advantage	$44.51
Rate for Payer: Wellpoint Medicaid Managed Care	$3.49

FP SMOKE & TOBAC CESS COU 3-10

Facility

$123.00

Service Code	HCPCS 99406
Hospital Charge Code	87502380
Hospital Revenue Code	510
Min. Negotiated Rate	$18.45
Max. Negotiated Rate	$18.45
Rate for Payer: Qualcare PPO/HMO/WC	$18.45

FP SMOKE&TOB CESS COUNSL>10MIN

Facility

$123.00

Service Code	HCPCS 99407
Hospital Charge Code	87502385
Hospital Revenue Code	510
Min. Negotiated Rate	$18.45
Max. Negotiated Rate	$18.45
Rate for Payer: Qualcare PPO/HMO/WC	$18.45

FP SMOKE&TOB CESS COUNSL>10MIN

Facility

$123.00

Service Code	HCPCS 99407
Hospital Charge Code	87502385
Hospital Revenue Code	510
Min. Negotiated Rate	$3.49
Max. Negotiated Rate	$161.46
Rate for Payer: Aetna Commercial	$121.07
Rate for Payer: Aetna Medicare Advantage	$144.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$44.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.46
Rate for Payer: Cigna Commercial	$89.22
Rate for Payer: Cigna Medicare Advantage	$44.51
Rate for Payer: Clover Medicare Advantage	$42.28
Rate for Payer: EmblemHealth Commercial	$133.53
Rate for Payer: Humana Medicare Advantage	$45.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$44.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.98
Rate for Payer: Qualcare PPO/HMO/WC	$18.45
Rate for Payer: UnitedHealthcare Community & State	$3.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$44.51
Rate for Payer: Wellcare Medicare Advantage	$44.51
Rate for Payer: Wellpoint Medicaid Managed Care	$3.49

FP SP ENGERIX HEP B PED 10MCG

Facility

$50.00

Service Code	HCPCS 90744
Hospital Charge Code	83652599
Hospital Revenue Code	636
Min. Negotiated Rate	$1.42
Max. Negotiated Rate	$36.26
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.10
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.42

FP SP ENGERIX HEP B PED 10MCG

Facility

$50.00

Service Code	HCPCS 90744
Hospital Charge Code	83652599
Hospital Revenue Code	636
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$12.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.10
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

FP SP TD TOX>7 YRS& OLDER-N P

Facility

$130.18

Service Code	HCPCS 90714
Hospital Charge Code	83652601
Hospital Revenue Code	636
Min. Negotiated Rate	$3.70
Max. Negotiated Rate	$65.09
Rate for Payer: Aetna Commercial	$49.47
Rate for Payer: Aetna Medicare Advantage	$39.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.20
Rate for Payer: Cigna Commercial	$65.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$19.53
Rate for Payer: UnitedHealthcare Community & State	$4.11
Rate for Payer: Wellpoint Medicaid Managed Care	$3.70

FP SP TD TOX>7 YRS& OLDER-N P

Facility

$130.18

Service Code	HCPCS 90714
Hospital Charge Code	83652601
Hospital Revenue Code	636
Min. Negotiated Rate	$19.53
Max. Negotiated Rate	$31.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$19.53

FP SUBUNGUAL HEMATOMA EVACUAT

Facility

$696.50

Service Code	HCPCS 11740
Hospital Charge Code	87502490
Hospital Revenue Code	761
Min. Negotiated Rate	$17.85
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	$17.85
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	$181.09
Rate for Payer: Oxford Commercial	$139.30
Rate for Payer: Qualcare PPO/HMO/WC	$104.47
Rate for Payer: UnitedHealthcare Commercial	$139.30
Rate for Payer: UnitedHealthcare Community & State	$22.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$197.37
Rate for Payer: Wellpoint Medicaid Managed Care	$19.78

FP SUBUNGUAL HEMATOMA EVACUAT

Facility

$696.50

Service Code	HCPCS 11740
Hospital Charge Code	87502490
Hospital Revenue Code	761
Min. Negotiated Rate	$104.47
Max. Negotiated Rate	$104.47
Rate for Payer: Qualcare PPO/HMO/WC	$104.47

FP SUBUNGUAL HEMATOMA EVACUAT

Facility

$177.00

Service Code	HCPCS 11740
Hospital Charge Code	83652055
Hospital Revenue Code	761
Min. Negotiated Rate	$26.55
Max. Negotiated Rate	$26.55
Rate for Payer: Qualcare PPO/HMO/WC	$26.55

FP SUBUNGUAL HEMATOMA EVACUAT

Facility

$177.00

Service Code	HCPCS 11740
Hospital Charge Code	83652055
Hospital Revenue Code	761
Min. Negotiated Rate	$5.03
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	$17.85
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	$46.02
Rate for Payer: Oxford Commercial	$35.40
Rate for Payer: Qualcare PPO/HMO/WC	$26.55
Rate for Payer: UnitedHealthcare Commercial	$35.40
Rate for Payer: UnitedHealthcare Community & State	$5.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$197.37
Rate for Payer: Wellpoint Medicaid Managed Care	$5.03

FP TYMPANOMETER

Facility

$203.70

Service Code	HCPCS 92567
Hospital Charge Code	87502710
Hospital Revenue Code	471
Min. Negotiated Rate	$30.55
Max. Negotiated Rate	$30.55
Rate for Payer: Qualcare PPO/HMO/WC	$30.55

FP TYMPANOMETER

Facility

$203.70

Service Code	HCPCS 92567
Hospital Charge Code	87502710
Hospital Revenue Code	471
Min. Negotiated Rate	$5.79
Max. Negotiated Rate	$1,823.00
Rate for Payer: Aetna Commercial	$120.69
Rate for Payer: Aetna Medicare Advantage	$143.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.95
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: Cigna Medicare Advantage	$44.37
Rate for Payer: Clover Medicare Advantage	$42.15
Rate for Payer: EmblemHealth Commercial	$133.11
Rate for Payer: Humana Medicare Advantage	$45.70
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$44.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.96
Rate for Payer: Oxford Commercial	$1,606.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.55
Rate for Payer: UnitedHealthcare Commercial	$1,823.00
Rate for Payer: UnitedHealthcare Community & State	$6.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$44.37
Rate for Payer: Wellcare Medicare Advantage	$44.37
Rate for Payer: Wellpoint Medicaid Managed Care	$5.79

FP VACC ADM

Facility

$156.00

Service Code	HCPCS 90471
Hospital Charge Code	83652518
Hospital Revenue Code	771
Min. Negotiated Rate	$4.43
Max. Negotiated Rate	$310.30
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$310.30
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.56
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.40
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$4.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$4.43

FP VACC ADM

Facility

$156.00

Service Code	HCPCS 90471
Hospital Charge Code	83652518
Hospital Revenue Code	771
Min. Negotiated Rate	$23.40
Max. Negotiated Rate	$23.40
Rate for Payer: Qualcare PPO/HMO/WC	$23.40

FRACTIONATION

Facility

$215.20

Service Code	HCPCS 83704
Hospital Charge Code	39900525
Hospital Revenue Code	301
Min. Negotiated Rate	$32.28
Max. Negotiated Rate	$32.28
Rate for Payer: Qualcare PPO/HMO/WC	$32.28

FRACTIONATION

Facility

$215.20

Service Code	HCPCS 83704
Hospital Charge Code	39900525
Hospital Revenue Code	301
Min. Negotiated Rate	$6.11
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$93.00
Rate for Payer: Aetna Medicare Advantage	$110.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$34.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.02
Rate for Payer: Cigna Commercial	$107.60
Rate for Payer: Cigna Medicare Advantage	$34.19
Rate for Payer: Clover Medicare Advantage	$32.48
Rate for Payer: EmblemHealth Commercial	$102.57
Rate for Payer: Humana Medicare Advantage	$35.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$34.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.95
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.28
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$27.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$34.19
Rate for Payer: Wellcare Medicare Advantage	$34.19
Rate for Payer: Wellpoint Medicaid Managed Care	$6.11

FRACTURE ASSESSMENT VIA DXA

Facility

$352.40

Service Code	HCPCS 77086
Hospital Charge Code	85000890
Hospital Revenue Code	409
Min. Negotiated Rate	$52.86
Max. Negotiated Rate	$52.86
Rate for Payer: Qualcare PPO/HMO/WC	$52.86

Know your out-of-pocket cost for care.

All Charges