Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

AMIKIN/250MG/1ML

Facility

$197.05

Service Code	NDC 703904003
Hospital Charge Code	60632432
Hospital Revenue Code	250
Min. Negotiated Rate	$5.60
Max. Negotiated Rate	$98.53
Rate for Payer: Aetna Commercial	$74.88
Rate for Payer: Aetna Medicare Advantage	$59.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.25
Rate for Payer: Cigna Commercial	$98.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.23
Rate for Payer: Oxford Commercial	$39.41
Rate for Payer: Qualcare PPO/HMO/WC	$29.56
Rate for Payer: UnitedHealthcare Commercial	$39.41
Rate for Payer: UnitedHealthcare Community & State	$6.23
Rate for Payer: Wellpoint Medicaid Managed Care	$5.60

AMILASE FLUID

Facility

$249.20

Service Code	HCPCS 82150
Hospital Charge Code	38479477
Hospital Revenue Code	301
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$17.63
Rate for Payer: Aetna Medicare Advantage	$21.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.51
Rate for Payer: Cigna Commercial	$124.60
Rate for Payer: Cigna Medicare Advantage	$6.48
Rate for Payer: Clover Medicare Advantage	$6.16
Rate for Payer: EmblemHealth Commercial	$19.44
Rate for Payer: Humana Medicare Advantage	$6.67
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.79
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.38
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$5.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.48
Rate for Payer: Wellcare Medicare Advantage	$6.48
Rate for Payer: Wellpoint Medicaid Managed Care	$7.08

AMILASE FLUID

Facility

$249.20

Service Code	HCPCS 82150
Hospital Charge Code	38479477
Hospital Revenue Code	301
Min. Negotiated Rate	$37.38
Max. Negotiated Rate	$37.38
Rate for Payer: Qualcare PPO/HMO/WC	$37.38

AMILORIDE 5 MG TAB

Facility

$8.64

Service Code	NDC 49884011701
Hospital Charge Code	60627974
Hospital Revenue Code	250
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$4.32
Rate for Payer: Aetna Commercial	$3.28
Rate for Payer: Aetna Medicare Advantage	$2.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.20
Rate for Payer: Cigna Commercial	$4.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.25
Rate for Payer: Oxford Commercial	$1.73
Rate for Payer: Qualcare PPO/HMO/WC	$1.30
Rate for Payer: UnitedHealthcare Commercial	$1.73
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.25

AMILORIDE 5 MG TAB

Facility

$8.64

Service Code	NDC 49884011701
Hospital Charge Code	60627974
Hospital Revenue Code	250
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$1.30
Rate for Payer: Qualcare PPO/HMO/WC	$1.30

AMINO ACID PANEL

Facility

$847.00

Service Code	HCPCS 82130
Hospital Charge Code	38472077
Hospital Revenue Code	301
Min. Negotiated Rate	$127.05
Max. Negotiated Rate	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$127.05

AMINO ACID PANEL

Facility

$847.00

Service Code	HCPCS 82130
Hospital Charge Code	38472077
Hospital Revenue Code	301
Min. Negotiated Rate	$24.05
Max. Negotiated Rate	$423.50
Rate for Payer: Aetna Commercial	$321.86
Rate for Payer: Aetna Medicare Advantage	$254.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$215.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$215.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$215.99
Rate for Payer: Cigna Commercial	$423.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.22
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.05
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$26.77
Rate for Payer: Wellpoint Medicaid Managed Care	$24.05

AMINO ACID PROFILE, QN, PLASMA

Facility

$667.59

Service Code	HCPCS 82139
Hospital Charge Code	3038131
Hospital Revenue Code	300
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$45.89
Rate for Payer: Aetna Medicare Advantage	$54.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$16.87
Rate for Payer: Clover Medicare Advantage	$16.03
Rate for Payer: EmblemHealth Commercial	$50.61
Rate for Payer: Humana Medicare Advantage	$17.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.87
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	$13.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.87
Rate for Payer: Wellcare Medicare Advantage	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

AMINO ACID PROFILE, QN, PLASMA

Facility

$667.59

Service Code	HCPCS 82139
Hospital Charge Code	3038131
Hospital Revenue Code	300
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

AMINO ACID QUALITATIVE

Facility

$98.00

Service Code	HCPCS 82128
Hospital Charge Code	38472083
Hospital Revenue Code	301
Min. Negotiated Rate	$2.78
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$37.73
Rate for Payer: Aetna Medicare Advantage	$44.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.31
Rate for Payer: Cigna Commercial	$49.00
Rate for Payer: Cigna Medicare Advantage	$13.87
Rate for Payer: Clover Medicare Advantage	$13.18
Rate for Payer: EmblemHealth Commercial	$41.61
Rate for Payer: Humana Medicare Advantage	$14.29
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.48
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.70
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$11.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.87
Rate for Payer: Wellcare Medicare Advantage	$13.87
Rate for Payer: Wellpoint Medicaid Managed Care	$2.78

AMINO ACID QUALITATIVE

Facility

$98.00

Service Code	HCPCS 82128
Hospital Charge Code	38472083
Hospital Revenue Code	301
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$14.70
Rate for Payer: Qualcare PPO/HMO/WC	$14.70

AMINO ACIDS,2-5,QUANT,EACH

Facility

$119.00

Service Code	HCPCS 82136
Hospital Charge Code	38473161
Hospital Revenue Code	301
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$53.34
Rate for Payer: Aetna Medicare Advantage	$63.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.14
Rate for Payer: Cigna Commercial	$59.50
Rate for Payer: Cigna Medicare Advantage	$19.61
Rate for Payer: Clover Medicare Advantage	$18.63
Rate for Payer: EmblemHealth Commercial	$58.83
Rate for Payer: Humana Medicare Advantage	$20.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.94
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.85
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$15.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.61
Rate for Payer: Wellcare Medicare Advantage	$19.61
Rate for Payer: Wellpoint Medicaid Managed Care	$3.38

AMINO ACIDS,2-5,QUANT,EACH

Facility

$119.00

Service Code	HCPCS 82136
Hospital Charge Code	38473161
Hospital Revenue Code	301
Min. Negotiated Rate	$17.85
Max. Negotiated Rate	$17.85
Rate for Payer: Qualcare PPO/HMO/WC	$17.85

AMINO ACIDS,6 OR MOR,QUANT

Facility

$119.00

Service Code	HCPCS 82139
Hospital Charge Code	38473162
Hospital Revenue Code	301
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$45.89
Rate for Payer: Aetna Medicare Advantage	$54.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$59.50
Rate for Payer: Cigna Medicare Advantage	$16.87
Rate for Payer: Clover Medicare Advantage	$16.03
Rate for Payer: EmblemHealth Commercial	$50.61
Rate for Payer: Humana Medicare Advantage	$17.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.94
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.85
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.87
Rate for Payer: Wellcare Medicare Advantage	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$3.38

AMINO ACIDS,6 OR MOR,QUANT

Facility

$119.00

Service Code	HCPCS 82139
Hospital Charge Code	38473162
Hospital Revenue Code	301
Min. Negotiated Rate	$17.85
Max. Negotiated Rate	$17.85
Rate for Payer: Qualcare PPO/HMO/WC	$17.85

AMINO ACIDS;SING,QUANT,EACH

Facility

$119.00

Service Code	HCPCS 82139
Hospital Charge Code	38473160
Hospital Revenue Code	301
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$45.89
Rate for Payer: Aetna Medicare Advantage	$54.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$59.50
Rate for Payer: Cigna Medicare Advantage	$16.87
Rate for Payer: Clover Medicare Advantage	$16.03
Rate for Payer: EmblemHealth Commercial	$50.61
Rate for Payer: Humana Medicare Advantage	$17.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.94
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.85
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.87
Rate for Payer: Wellcare Medicare Advantage	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$3.38

AMINO ACIDS;SING,QUANT,EACH

Facility

$119.00

Service Code	HCPCS 82139
Hospital Charge Code	38473160
Hospital Revenue Code	301
Min. Negotiated Rate	$17.85
Max. Negotiated Rate	$17.85
Rate for Payer: Qualcare PPO/HMO/WC	$17.85

AMINO ACID URINE QT

Facility

$1,500.00

Service Code	HCPCS 82139
Hospital Charge Code	397072025
Hospital Revenue Code	301
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

AMINO ACID URINE QT

Facility

$1,500.00

Service Code	HCPCS 82139
Hospital Charge Code	397072025
Hospital Revenue Code	301
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$45.89
Rate for Payer: Aetna Medicare Advantage	$54.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: Cigna Medicare Advantage	$16.87
Rate for Payer: Clover Medicare Advantage	$16.03
Rate for Payer: EmblemHealth Commercial	$50.61
Rate for Payer: Humana Medicare Advantage	$17.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.00
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.87
Rate for Payer: Wellcare Medicare Advantage	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$42.60

AMINOCAPROIC ACID 500 MG TAB

Facility

$163.68

Service Code	NDC 49411005030
Hospital Charge Code	60627520
Hospital Revenue Code	250
Min. Negotiated Rate	$24.55
Max. Negotiated Rate	$24.55
Rate for Payer: Qualcare PPO/HMO/WC	$24.55

AMINOCAPROIC ACID 500 MG TAB

Facility

$163.68

Service Code	NDC 49411005030
Hospital Charge Code	60627520
Hospital Revenue Code	250
Min. Negotiated Rate	$4.65
Max. Negotiated Rate	$81.84
Rate for Payer: Aetna Commercial	$62.20
Rate for Payer: Aetna Medicare Advantage	$49.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.74
Rate for Payer: Cigna Commercial	$81.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.56
Rate for Payer: Oxford Commercial	$32.74
Rate for Payer: Qualcare PPO/HMO/WC	$24.55
Rate for Payer: UnitedHealthcare Commercial	$32.74
Rate for Payer: UnitedHealthcare Community & State	$5.17
Rate for Payer: Wellpoint Medicaid Managed Care	$4.65

AMINOCAPROIC ACID INJ 5G/20ML

Facility

$18.02

Service Code	NDC 409434673
Hospital Charge Code	60627521
Hospital Revenue Code	250
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

AMINOCAPROIC ACID INJ 5G/20ML

Facility

$18.02

Service Code	NDC 409434673
Hospital Charge Code	60627521
Hospital Revenue Code	250
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$9.01
Rate for Payer: Aetna Commercial	$6.85
Rate for Payer: Aetna Medicare Advantage	$5.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.60
Rate for Payer: Cigna Commercial	$9.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.69
Rate for Payer: Oxford Commercial	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$3.60
Rate for Payer: UnitedHealthcare Community & State	$0.57
Rate for Payer: Wellpoint Medicaid Managed Care	$0.51

AMINOPHYLLINE 25 MG/ML INJ

Facility

$5.96

Service Code	HCPCS J0280
Hospital Charge Code	60628470
Hospital Revenue Code	636
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$1.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.44
Rate for Payer: Qualcare PPO/HMO/WC	$0.89

AMINOPHYLLINE 25 MG/ML INJ

Facility

$5.96

Service Code	HCPCS J0280
Hospital Charge Code	60628470
Hospital Revenue Code	636
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$2.98
Rate for Payer: Aetna Commercial	$2.26
Rate for Payer: Aetna Medicare Advantage	$1.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.52
Rate for Payer: Cigna Commercial	$2.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.44
Rate for Payer: Qualcare PPO/HMO/WC	$0.89
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.17

Know your out-of-pocket cost for care.

All Charges