Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

FROZEN SECTION ADD BLOCK

Facility

$390.00

Service Code	HCPCS 88332
Hospital Charge Code	3004942
Hospital Revenue Code	310
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) 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	$43.90
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

FROZEN SECTION ADD BLOCK

Facility

$390.00

Service Code	HCPCS 88332
Hospital Charge Code	3004942
Hospital Revenue Code	310
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FROZEN SECTION ADDTIONAL SURGE

Facility

$186.00

Service Code	HCPCS 88332
Hospital Charge Code	38474034
Hospital Revenue Code	310
Min. Negotiated Rate	$5.28
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$70.68
Rate for Payer: Aetna Medicare Advantage	$55.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.43
Rate for Payer: Cigna Commercial	$93.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.36
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.90
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$43.90
Rate for Payer: Wellpoint Medicaid Managed Care	$5.28

FROZEN SECTION ADDTIONAL SURGE

Facility

$186.00

Service Code	HCPCS 88332
Hospital Charge Code	38474034
Hospital Revenue Code	310
Min. Negotiated Rate	$27.90
Max. Negotiated Rate	$27.90
Rate for Payer: Qualcare PPO/HMO/WC	$27.90

FROZEN SECTION DURING SURGERY

Facility

$401.00

Service Code	HCPCS 88331
Hospital Charge Code	38474031
Hospital Revenue Code	310
Min. Negotiated Rate	$60.15
Max. Negotiated Rate	$60.15
Rate for Payer: Qualcare PPO/HMO/WC	$60.15

FROZEN SECTION DURING SURGERY

Facility

$401.00

Service Code	HCPCS 88331
Hospital Charge Code	38474031
Hospital Revenue Code	310
Min. Negotiated Rate	$11.39
Max. Negotiated Rate	$734.21
Rate for Payer: Aetna Commercial	$550.53
Rate for Payer: Aetna Medicare Advantage	$655.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$734.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$734.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$202.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$734.21
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$202.40
Rate for Payer: Clover Medicare Advantage	$192.28
Rate for Payer: EmblemHealth Commercial	$607.20
Rate for Payer: Humana Medicare Advantage	$208.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$202.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.26
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.15
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$81.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$202.40
Rate for Payer: Wellcare Medicare Advantage	$202.40
Rate for Payer: Wellpoint Medicaid Managed Care	$11.39

FROZEN THAWED RBC,DEGLYCEROLYZ

Facility

$2,167.00

Hospital Charge Code	38471034
Hospital Revenue Code	390
Min. Negotiated Rate	$61.54
Max. Negotiated Rate	$1,167.00
Rate for Payer: Aetna Commercial	$823.46
Rate for Payer: Aetna Medicare Advantage	$650.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$552.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$552.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$552.59
Rate for Payer: Cigna Commercial	$1,083.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$563.42
Rate for Payer: Oxford Commercial	$1,028.00
Rate for Payer: Qualcare PPO/HMO/WC	$325.05
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$68.48
Rate for Payer: Wellpoint Medicaid Managed Care	$61.54

FROZEN THAWED RBC,DEGLYCEROLYZ

Facility

$2,167.00

Hospital Charge Code	38471034
Hospital Revenue Code	390
Min. Negotiated Rate	$325.05
Max. Negotiated Rate	$325.05
Rate for Payer: Qualcare PPO/HMO/WC	$325.05

FRUCTOSAMINE

Facility

$667.59

Service Code	HCPCS 82985
Hospital Charge Code	39900088
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

FRUCTOSAMINE

Facility

$667.59

Service Code	HCPCS 82985
Hospital Charge Code	39900088
Hospital Revenue Code	301
Min. Negotiated Rate	$10.89
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$45.59
Rate for Payer: Aetna Medicare Advantage	$54.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.80
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$16.76
Rate for Payer: Clover Medicare Advantage	$15.92
Rate for Payer: EmblemHealth Commercial	$50.28
Rate for Payer: Humana Medicare Advantage	$17.26
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.76
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	$13.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.76
Rate for Payer: Wellcare Medicare Advantage	$16.76
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

FRUCTOSAMINE, SERUM

Facility

$446.00

Service Code	HCPCS 82985
Hospital Charge Code	38474105
Hospital Revenue Code	301
Min. Negotiated Rate	$66.90
Max. Negotiated Rate	$66.90
Rate for Payer: Qualcare PPO/HMO/WC	$66.90

FRUCTOSAMINE, SERUM

Facility

$446.00

Service Code	HCPCS 82985
Hospital Charge Code	38474105
Hospital Revenue Code	301
Min. Negotiated Rate	$10.89
Max. Negotiated Rate	$223.00
Rate for Payer: Aetna Commercial	$45.59
Rate for Payer: Aetna Medicare Advantage	$54.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.80
Rate for Payer: Cigna Commercial	$223.00
Rate for Payer: Cigna Medicare Advantage	$16.76
Rate for Payer: Clover Medicare Advantage	$15.92
Rate for Payer: EmblemHealth Commercial	$50.28
Rate for Payer: Humana Medicare Advantage	$17.26
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$115.96
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.90
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.76
Rate for Payer: Wellcare Medicare Advantage	$16.76
Rate for Payer: Wellpoint Medicaid Managed Care	$12.67

FRUCTOSE,SEMEN,QN

Facility

$390.00

Service Code	HCPCS 82757
Hospital Charge Code	39900081
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$47.16
Rate for Payer: Aetna Medicare Advantage	$56.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.90
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$17.34
Rate for Payer: Clover Medicare Advantage	$16.47
Rate for Payer: EmblemHealth Commercial	$52.02
Rate for Payer: Humana Medicare Advantage	$17.86
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.34
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	$13.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.34
Rate for Payer: Wellcare Medicare Advantage	$17.34
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

FRUCTOSE,SEMEN,QN

Facility

$390.00

Service Code	HCPCS 82757
Hospital Charge Code	39900081
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

F-SERIES CANN SCREW 2.0X40MM

Facility

$1,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270681049
Hospital Revenue Code	278
Min. Negotiated Rate	$44.02
Max. Negotiated Rate	$775.00
Rate for Payer: Aetna Commercial	$589.00
Rate for Payer: Aetna Medicare Advantage	$465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$310.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$395.25
Rate for Payer: Cigna Commercial	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.10
Rate for Payer: Qualcare PPO/HMO/WC	$232.50
Rate for Payer: UnitedHealthcare Community & State	$48.98
Rate for Payer: Wellpoint Medicaid Managed Care	$44.02

F-SERIES CANN SCREW 2.0X40MM

Facility

$1,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270681049
Hospital Revenue Code	278
Min. Negotiated Rate	$232.50
Max. Negotiated Rate	$375.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$310.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.10
Rate for Payer: Qualcare PPO/HMO/WC	$232.50

F-SERIES CANN SCREW 2.0X45MM

Facility

$1,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270681048
Hospital Revenue Code	278
Min. Negotiated Rate	$232.50
Max. Negotiated Rate	$375.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$310.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.10
Rate for Payer: Qualcare PPO/HMO/WC	$232.50

F-SERIES CANN SCREW 2.0X45MM

Facility

$1,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270681048
Hospital Revenue Code	278
Min. Negotiated Rate	$44.02
Max. Negotiated Rate	$775.00
Rate for Payer: Aetna Commercial	$589.00
Rate for Payer: Aetna Medicare Advantage	$465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$310.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$395.25
Rate for Payer: Cigna Commercial	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.10
Rate for Payer: Qualcare PPO/HMO/WC	$232.50
Rate for Payer: UnitedHealthcare Community & State	$48.98
Rate for Payer: Wellpoint Medicaid Managed Care	$44.02

F-SERIES CANN SCREW 4.0 X 45MM

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270679981
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$393.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

F-SERIES CANN SCREW 4.0 X 45MM

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270679981
Hospital Revenue Code	278
Min. Negotiated Rate	$46.15
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$617.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Community & State	$51.35
Rate for Payer: Wellpoint Medicaid Managed Care	$46.15

FSH

Facility

$192.85

Service Code	HCPCS 83001
Hospital Charge Code	39900416
Hospital Revenue Code	301
Min. Negotiated Rate	$28.93
Max. Negotiated Rate	$28.93
Rate for Payer: Qualcare PPO/HMO/WC	$28.93

FSH

Facility

$192.85

Service Code	HCPCS 83001
Hospital Charge Code	39900416
Hospital Revenue Code	301
Min. Negotiated Rate	$5.48
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$50.54
Rate for Payer: Aetna Medicare Advantage	$60.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.40
Rate for Payer: Cigna Commercial	$96.42
Rate for Payer: Cigna Medicare Advantage	$18.58
Rate for Payer: Clover Medicare Advantage	$17.65
Rate for Payer: EmblemHealth Commercial	$55.74
Rate for Payer: Humana Medicare Advantage	$19.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.14
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.93
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.58
Rate for Payer: Wellcare Medicare Advantage	$18.58
Rate for Payer: Wellpoint Medicaid Managed Care	$5.48

FSH

Facility

$633.00

Service Code	HCPCS 83001
Hospital Charge Code	38472284
Hospital Revenue Code	301
Min. Negotiated Rate	$14.86
Max. Negotiated Rate	$316.50
Rate for Payer: Aetna Commercial	$50.54
Rate for Payer: Aetna Medicare Advantage	$60.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.40
Rate for Payer: Cigna Commercial	$316.50
Rate for Payer: Cigna Medicare Advantage	$18.58
Rate for Payer: Clover Medicare Advantage	$17.65
Rate for Payer: EmblemHealth Commercial	$55.74
Rate for Payer: Humana Medicare Advantage	$19.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.58
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$94.95
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.58
Rate for Payer: Wellcare Medicare Advantage	$18.58
Rate for Payer: Wellpoint Medicaid Managed Care	$17.98

FSH

Facility

$633.00

Service Code	HCPCS 83001
Hospital Charge Code	38472284
Hospital Revenue Code	301
Min. Negotiated Rate	$94.95
Max. Negotiated Rate	$94.95
Rate for Payer: Qualcare PPO/HMO/WC	$94.95

FTA -ABS

Facility

$124.00

Service Code	HCPCS 86780
Hospital Charge Code	38476210
Hospital Revenue Code	302
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$18.60
Rate for Payer: Qualcare PPO/HMO/WC	$18.60

Know your out-of-pocket cost for care.

All Charges