Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

HBV6

Facility

$390.00

Service Code	HCPCS 87350
Hospital Charge Code	39708025F
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HCG PREG TEST,SERUM,QUAL

Facility

$296.00

Service Code	HCPCS 84703
Hospital Charge Code	38477017
Hospital Revenue Code	301
Min. Negotiated Rate	$44.40
Max. Negotiated Rate	$44.40
Rate for Payer: Qualcare PPO/HMO/WC	$44.40

HCG PREG TEST,SERUM,QUAL

Facility

$296.00

Service Code	HCPCS 84703
Hospital Charge Code	38477017
Hospital Revenue Code	301
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$20.45
Rate for Payer: Aetna Medicare Advantage	$24.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.28
Rate for Payer: Cigna Commercial	$148.00
Rate for Payer: Cigna Medicare Advantage	$7.52
Rate for Payer: Clover Medicare Advantage	$7.14
Rate for Payer: EmblemHealth Commercial	$22.56
Rate for Payer: Humana Medicare Advantage	$7.75
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.96
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.40
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$6.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.52
Rate for Payer: Wellcare Medicare Advantage	$7.52
Rate for Payer: Wellpoint Medicaid Managed Care	$8.41

HCG,QUANT

Facility

$886.20

Service Code	HCPCS 84702
Hospital Charge Code	38479096
Hospital Revenue Code	301
Min. Negotiated Rate	$132.93
Max. Negotiated Rate	$132.93
Rate for Payer: Qualcare PPO/HMO/WC	$132.93

HCG,QUANT

Facility

$886.20

Service Code	HCPCS 84702
Hospital Charge Code	38479096
Hospital Revenue Code	301
Min. Negotiated Rate	$12.04
Max. Negotiated Rate	$443.10
Rate for Payer: Aetna Commercial	$40.94
Rate for Payer: Aetna Medicare Advantage	$48.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.59
Rate for Payer: Cigna Commercial	$443.10
Rate for Payer: Cigna Medicare Advantage	$15.05
Rate for Payer: Clover Medicare Advantage	$14.30
Rate for Payer: EmblemHealth Commercial	$45.15
Rate for Payer: Humana Medicare Advantage	$15.50
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.41
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$132.93
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$12.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.05
Rate for Payer: Wellcare Medicare Advantage	$15.05
Rate for Payer: Wellpoint Medicaid Managed Care	$25.17

HCG,QUANT

Facility

$886.20

Service Code	HCPCS 84702
Hospital Charge Code	38472203
Hospital Revenue Code	301
Min. Negotiated Rate	$132.93
Max. Negotiated Rate	$132.93
Rate for Payer: Qualcare PPO/HMO/WC	$132.93

HCG,QUANT

Facility

$886.20

Service Code	HCPCS 84702
Hospital Charge Code	38472203
Hospital Revenue Code	301
Min. Negotiated Rate	$12.04
Max. Negotiated Rate	$443.10
Rate for Payer: Aetna Commercial	$40.94
Rate for Payer: Aetna Medicare Advantage	$48.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.59
Rate for Payer: Cigna Commercial	$443.10
Rate for Payer: Cigna Medicare Advantage	$15.05
Rate for Payer: Clover Medicare Advantage	$14.30
Rate for Payer: EmblemHealth Commercial	$45.15
Rate for Payer: Humana Medicare Advantage	$15.50
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.41
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$132.93
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$12.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.05
Rate for Payer: Wellcare Medicare Advantage	$15.05
Rate for Payer: Wellpoint Medicaid Managed Care	$25.17

HCG QUANTTV

Facility

$886.20

Service Code	HCPCS 84702
Hospital Charge Code	38479481
Hospital Revenue Code	301
Min. Negotiated Rate	$12.04
Max. Negotiated Rate	$443.10
Rate for Payer: Aetna Commercial	$40.94
Rate for Payer: Aetna Medicare Advantage	$48.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.59
Rate for Payer: Cigna Commercial	$443.10
Rate for Payer: Cigna Medicare Advantage	$15.05
Rate for Payer: Clover Medicare Advantage	$14.30
Rate for Payer: EmblemHealth Commercial	$45.15
Rate for Payer: Humana Medicare Advantage	$15.50
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.41
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$132.93
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$12.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.05
Rate for Payer: Wellcare Medicare Advantage	$15.05
Rate for Payer: Wellpoint Medicaid Managed Care	$25.17

HCG QUANTTV

Facility

$886.20

Service Code	HCPCS 84702
Hospital Charge Code	38479481
Hospital Revenue Code	301
Min. Negotiated Rate	$132.93
Max. Negotiated Rate	$132.93
Rate for Payer: Qualcare PPO/HMO/WC	$132.93

HCG TOTAL

Facility

$520.00

Service Code	HCPCS 82677
Hospital Charge Code	38479484
Hospital Revenue Code	301
Min. Negotiated Rate	$78.00
Max. Negotiated Rate	$78.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.00

HCG TOTAL

Facility

$520.00

Service Code	HCPCS 82677
Hospital Charge Code	38479484
Hospital Revenue Code	301
Min. Negotiated Rate	$14.77
Max. Negotiated Rate	$260.00
Rate for Payer: Aetna Commercial	$65.77
Rate for Payer: Aetna Medicare Advantage	$78.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.18
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	$87.71
Rate for Payer: Cigna Commercial	$260.00
Rate for Payer: Cigna Medicare Advantage	$24.18
Rate for Payer: Clover Medicare Advantage	$22.97
Rate for Payer: EmblemHealth Commercial	$72.54
Rate for Payer: Humana Medicare Advantage	$24.91
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.20
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.00
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$19.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.18
Rate for Payer: Wellcare Medicare Advantage	$24.18
Rate for Payer: Wellpoint Medicaid Managed Care	$14.77

HCG,TUMOR MARKER

Facility

$390.00

Service Code	HCPCS 84702
Hospital Charge Code	3007243
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HCG,TUMOR MARKER

Facility

$390.00

Service Code	HCPCS 84702
Hospital Charge Code	3007243
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$40.94
Rate for Payer: Aetna Medicare Advantage	$48.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.59
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$15.05
Rate for Payer: Clover Medicare Advantage	$14.30
Rate for Payer: EmblemHealth Commercial	$45.15
Rate for Payer: Humana Medicare Advantage	$15.50
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.05
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	$12.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.05
Rate for Payer: Wellcare Medicare Advantage	$15.05
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

HCL, FREE AND TOTAL

Facility

$63.00

Service Code	HCPCS 82926
Hospital Charge Code	38472377
Hospital Revenue Code	301
Min. Negotiated Rate	$9.45
Max. Negotiated Rate	$9.45
Rate for Payer: Qualcare PPO/HMO/WC	$9.45

HCL, FREE AND TOTAL

Facility

$63.00

Service Code	HCPCS 82926
Hospital Charge Code	38472377
Hospital Revenue Code	301
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$23.94
Rate for Payer: Aetna Medicare Advantage	$18.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.07
Rate for Payer: Cigna Commercial	$31.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.38
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.45
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$1.99
Rate for Payer: Wellpoint Medicaid Managed Care	$1.79

HC PEGGED GLENOID A-40

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686873
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

HC PEGGED GLENOID A-40

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686873
Hospital Revenue Code	278
Min. Negotiated Rate	$142.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Community & State	$158.00
Rate for Payer: Wellpoint Medicaid Managed Care	$142.00

HCT (HEMATOCRIT)

Facility

$667.59

Service Code	HCPCS 85014
Hospital Charge Code	3002912
Hospital Revenue Code	305
Min. Negotiated Rate	$1.90
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$6.45
Rate for Payer: Aetna Medicare Advantage	$7.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.60
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$2.37
Rate for Payer: Clover Medicare Advantage	$2.25
Rate for Payer: EmblemHealth Commercial	$7.11
Rate for Payer: Humana Medicare Advantage	$2.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2.37
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	$1.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.37
Rate for Payer: Wellcare Medicare Advantage	$2.37
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

HCT (HEMATOCRIT)

Facility

$667.59

Service Code	HCPCS 85014
Hospital Charge Code	3002912
Hospital Revenue Code	305
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

HCV AB

Facility

$98.10

Service Code	HCPCS 86803
Hospital Charge Code	39900260
Hospital Revenue Code	302
Min. Negotiated Rate	$14.71
Max. Negotiated Rate	$14.71
Rate for Payer: Qualcare PPO/HMO/WC	$14.71

HCV AB

Facility

$98.10

Service Code	HCPCS 86803
Hospital Charge Code	39900260
Hospital Revenue Code	302
Min. Negotiated Rate	$2.79
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$38.81
Rate for Payer: Aetna Medicare Advantage	$46.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.76
Rate for Payer: Cigna Commercial	$49.05
Rate for Payer: Cigna Medicare Advantage	$14.27
Rate for Payer: Clover Medicare Advantage	$13.56
Rate for Payer: EmblemHealth Commercial	$42.81
Rate for Payer: Humana Medicare Advantage	$14.70
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.51
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.71
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$11.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.27
Rate for Payer: Wellcare Medicare Advantage	$14.27
Rate for Payer: Wellpoint Medicaid Managed Care	$2.79

HCV AB,RIBA

Facility

$106.50

Service Code	HCPCS 86804
Hospital Charge Code	39900261
Hospital Revenue Code	302
Min. Negotiated Rate	$3.02
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$42.13
Rate for Payer: Aetna Medicare Advantage	$50.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.19
Rate for Payer: Cigna Commercial	$53.25
Rate for Payer: Cigna Medicare Advantage	$15.49
Rate for Payer: Clover Medicare Advantage	$14.72
Rate for Payer: EmblemHealth Commercial	$46.47
Rate for Payer: Humana Medicare Advantage	$15.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.69
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.97
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$12.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.49
Rate for Payer: Wellcare Medicare Advantage	$15.49
Rate for Payer: Wellpoint Medicaid Managed Care	$3.02

HCV AB,RIBA

Facility

$106.50

Service Code	HCPCS 86804
Hospital Charge Code	39900261
Hospital Revenue Code	302
Min. Negotiated Rate	$15.97
Max. Negotiated Rate	$15.97
Rate for Payer: Qualcare PPO/HMO/WC	$15.97

HCV Antibody

Facility

$98.10

Service Code	HCPCS 86803
Hospital Charge Code	39888008
Hospital Revenue Code	302
Min. Negotiated Rate	$2.79
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$38.81
Rate for Payer: Aetna Medicare Advantage	$46.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.76
Rate for Payer: Cigna Commercial	$49.05
Rate for Payer: Cigna Medicare Advantage	$14.27
Rate for Payer: Clover Medicare Advantage	$13.56
Rate for Payer: EmblemHealth Commercial	$42.81
Rate for Payer: Humana Medicare Advantage	$14.70
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.51
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.71
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$11.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.27
Rate for Payer: Wellcare Medicare Advantage	$14.27
Rate for Payer: Wellpoint Medicaid Managed Care	$2.79

HCV Antibody

Facility

$98.10

Service Code	HCPCS 86803
Hospital Charge Code	39888008
Hospital Revenue Code	302
Min. Negotiated Rate	$14.71
Max. Negotiated Rate	$14.71
Rate for Payer: Qualcare PPO/HMO/WC	$14.71

Know your out-of-pocket cost for care.

All Charges