Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

HCV GENOTYPE, LIPA

Facility

$1,769.40

Service Code	HCPCS 87902
Hospital Charge Code	39900308
Hospital Revenue Code	306
Min. Negotiated Rate	$50.25
Max. Negotiated Rate	$933.90
Rate for Payer: Aetna Commercial	$700.26
Rate for Payer: Aetna Medicare Advantage	$834.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$933.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$933.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$257.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$933.90
Rate for Payer: Cigna Commercial	$884.70
Rate for Payer: Cigna Medicare Advantage	$257.45
Rate for Payer: Clover Medicare Advantage	$244.58
Rate for Payer: EmblemHealth Commercial	$772.35
Rate for Payer: Humana Medicare Advantage	$265.17
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$257.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$460.04
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$265.41
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$205.96
Rate for Payer: UnitedHealthcare Medicare Advantage	$257.45
Rate for Payer: Wellcare Medicare Advantage	$257.45
Rate for Payer: Wellpoint Medicaid Managed Care	$50.25

HCV GENOTYPE, LIPA

Facility

$1,769.40

Service Code	HCPCS 87902
Hospital Charge Code	39900308
Hospital Revenue Code	306
Min. Negotiated Rate	$265.41
Max. Negotiated Rate	$265.41
Rate for Payer: Qualcare PPO/HMO/WC	$265.41

HCV RNA GENOTYPE

Facility

$1,823.20

Service Code	HCPCS 87902
Hospital Charge Code	38473153
Hospital Revenue Code	306
Min. Negotiated Rate	$51.78
Max. Negotiated Rate	$933.90
Rate for Payer: Aetna Commercial	$700.26
Rate for Payer: Aetna Medicare Advantage	$834.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$933.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$933.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$257.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$933.90
Rate for Payer: Cigna Commercial	$911.60
Rate for Payer: Cigna Medicare Advantage	$257.45
Rate for Payer: Clover Medicare Advantage	$244.58
Rate for Payer: EmblemHealth Commercial	$772.35
Rate for Payer: Humana Medicare Advantage	$265.17
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$257.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.03
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$273.48
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$205.96
Rate for Payer: UnitedHealthcare Medicare Advantage	$257.45
Rate for Payer: Wellcare Medicare Advantage	$257.45
Rate for Payer: Wellpoint Medicaid Managed Care	$51.78

HCV RNA GENOTYPE

Facility

$1,823.20

Service Code	HCPCS 87902
Hospital Charge Code	38473153
Hospital Revenue Code	306
Min. Negotiated Rate	$273.48
Max. Negotiated Rate	$273.48
Rate for Payer: Qualcare PPO/HMO/WC	$273.48

HCV RNA,PCR

Facility

$390.00

Service Code	HCPCS 87522
Hospital Charge Code	39900300
Hospital Revenue Code	306
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$201.30
Rate for Payer: Aetna Commercial	$116.52
Rate for Payer: Aetna Medicare Advantage	$138.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$201.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.40
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$42.84
Rate for Payer: Clover Medicare Advantage	$40.70
Rate for Payer: EmblemHealth Commercial	$128.52
Rate for Payer: Humana Medicare Advantage	$44.13
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$42.84
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	$34.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$42.84
Rate for Payer: Wellcare Medicare Advantage	$42.84
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

HCV RNA,PCR

Facility

$390.00

Service Code	HCPCS 87522
Hospital Charge Code	39900300
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HCV RNA,QL,PCR,PLASMA

Facility

$241.20

Service Code	HCPCS 87521
Hospital Charge Code	39900299
Hospital Revenue Code	306
Min. Negotiated Rate	$6.85
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$95.44
Rate for Payer: Aetna Medicare Advantage	$113.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.29
Rate for Payer: Cigna Commercial	$120.60
Rate for Payer: Cigna Medicare Advantage	$35.09
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.71
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.18
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$28.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Medicare Advantage	$35.09
Rate for Payer: Wellpoint Medicaid Managed Care	$6.85

HCV RNA,QL,PCR,PLASMA

Facility

$241.20

Service Code	HCPCS 87521
Hospital Charge Code	39900299
Hospital Revenue Code	306
Min. Negotiated Rate	$36.18
Max. Negotiated Rate	$36.18
Rate for Payer: Qualcare PPO/HMO/WC	$36.18

HCV VRNA GENOTYP 1NS5bRXRESIST

Facility

$776.05

Service Code	HCPCS 87902
Hospital Charge Code	401187902
Hospital Revenue Code	306
Min. Negotiated Rate	$22.04
Max. Negotiated Rate	$933.90
Rate for Payer: Aetna Commercial	$700.26
Rate for Payer: Aetna Medicare Advantage	$834.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$933.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$933.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$257.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$933.90
Rate for Payer: Cigna Commercial	$388.02
Rate for Payer: Cigna Medicare Advantage	$257.45
Rate for Payer: Clover Medicare Advantage	$244.58
Rate for Payer: EmblemHealth Commercial	$772.35
Rate for Payer: Humana Medicare Advantage	$265.17
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$257.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.77
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$116.41
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$205.96
Rate for Payer: UnitedHealthcare Medicare Advantage	$257.45
Rate for Payer: Wellcare Medicare Advantage	$257.45
Rate for Payer: Wellpoint Medicaid Managed Care	$22.04

HCV VRNA GENOTYP 1NS5bRXRESIST

Facility

$776.05

Service Code	HCPCS 87902
Hospital Charge Code	401187902
Hospital Revenue Code	306
Min. Negotiated Rate	$116.41
Max. Negotiated Rate	$116.41
Rate for Payer: Qualcare PPO/HMO/WC	$116.41

HD 5 US BAGLESS

Facility

$0.01

Hospital Charge Code	270703400
Hospital Revenue Code	278
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) NJ Health	$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

HD 5 US BAGLESS

Facility

$0.01

Hospital Charge Code	270703400
Hospital Revenue Code	278
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

HD FEM BIOLOX DELTA OPT 40MM

Facility

$11,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270699207
Hospital Revenue Code	278
Min. Negotiated Rate	$323.76
Max. Negotiated Rate	$5,700.00
Rate for Payer: Aetna Commercial	$4,332.00
Rate for Payer: Aetna Medicare Advantage	$3,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,907.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,907.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,280.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,907.00
Rate for Payer: Cigna Commercial	$5,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,758.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,710.00
Rate for Payer: UnitedHealthcare Community & State	$360.24
Rate for Payer: Wellpoint Medicaid Managed Care	$323.76

HD FEM BIOLOX DELTA OPT 40MM

Facility

$11,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270699207
Hospital Revenue Code	278
Min. Negotiated Rate	$1,710.00
Max. Negotiated Rate	$2,758.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,758.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,710.00

HD FEM BIOLOX D OPT 28MM OD

Facility

$8,286.00

Service Code	HCPCS C1776
Hospital Charge Code	270697542
Hospital Revenue Code	278
Min. Negotiated Rate	$1,242.90
Max. Negotiated Rate	$2,005.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,657.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,005.21
Rate for Payer: Qualcare PPO/HMO/WC	$1,242.90

HD FEM BIOLOX D OPT 28MM OD

Facility

$8,286.00

Service Code	HCPCS C1776
Hospital Charge Code	270697542
Hospital Revenue Code	278
Min. Negotiated Rate	$235.32
Max. Negotiated Rate	$4,143.00
Rate for Payer: Aetna Commercial	$3,148.68
Rate for Payer: Aetna Medicare Advantage	$2,485.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,112.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,112.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,657.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,112.93
Rate for Payer: Cigna Commercial	$4,143.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,005.21
Rate for Payer: Qualcare PPO/HMO/WC	$1,242.90
Rate for Payer: UnitedHealthcare Community & State	$261.84
Rate for Payer: Wellpoint Medicaid Managed Care	$235.32

HDL CHOLESTEROL

Facility

$390.00

Service Code	HCPCS 83718
Hospital Charge Code	3030194
Hospital Revenue Code	301
Min. Negotiated Rate	$6.55
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$22.28
Rate for Payer: Aetna Medicare Advantage	$26.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.71
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$8.19
Rate for Payer: Clover Medicare Advantage	$7.78
Rate for Payer: EmblemHealth Commercial	$24.57
Rate for Payer: Humana Medicare Advantage	$8.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.19
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	$6.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.19
Rate for Payer: Wellcare Medicare Advantage	$8.19
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

HDL CHOLESTEROL

Facility

$390.00

Service Code	HCPCS 83718
Hospital Charge Code	3030194
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HD SCORPION NEEDLE

Facility

$1,000.00

Hospital Charge Code	270702938
Hospital Revenue Code	270
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

HD SCORPION NEEDLE

Facility

$1,000.00

Hospital Charge Code	270702938
Hospital Revenue Code	270
Min. Negotiated Rate	$28.40
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Oxford Commercial	$200.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$200.00
Rate for Payer: UnitedHealthcare Community & State	$31.60
Rate for Payer: Wellpoint Medicaid Managed Care	$28.40

HE4 OVARIAN CA

Facility

$143.05

Service Code	HCPCS 86305
Hospital Charge Code	39900208
Hospital Revenue Code	302
Min. Negotiated Rate	$21.46
Max. Negotiated Rate	$21.46
Rate for Payer: Qualcare PPO/HMO/WC	$21.46

HE4 OVARIAN CA

Facility

$143.05

Service Code	HCPCS 86305
Hospital Charge Code	39900208
Hospital Revenue Code	302
Min. Negotiated Rate	$4.06
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$56.60
Rate for Payer: Aetna Medicare Advantage	$67.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.49
Rate for Payer: Cigna Commercial	$71.53
Rate for Payer: Cigna Medicare Advantage	$20.81
Rate for Payer: Clover Medicare Advantage	$19.77
Rate for Payer: EmblemHealth Commercial	$62.43
Rate for Payer: Humana Medicare Advantage	$21.43
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.19
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.46
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$16.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.81
Rate for Payer: Wellcare Medicare Advantage	$20.81
Rate for Payer: Wellpoint Medicaid Managed Care	$4.06

HE4 OVARIAN CANCER MONITORING

Facility

$390.00

Service Code	HCPCS 86305
Hospital Charge Code	401086305
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HE4 OVARIAN CANCER MONITORING

Facility

$390.00

Service Code	HCPCS 86305
Hospital Charge Code	401086305
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$56.60
Rate for Payer: Aetna Medicare Advantage	$67.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.49
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$20.81
Rate for Payer: Clover Medicare Advantage	$19.77
Rate for Payer: EmblemHealth Commercial	$62.43
Rate for Payer: Humana Medicare Advantage	$21.43
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20.81
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	$16.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.81
Rate for Payer: Wellcare Medicare Advantage	$20.81
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

HEAD 28 MM C-TAPER +5 OFFSET

Facility

$4,277.35

Service Code	HCPCS C1776
Hospital Charge Code	270682463
Hospital Revenue Code	278
Min. Negotiated Rate	$641.60
Max. Negotiated Rate	$1,035.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$855.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,035.12
Rate for Payer: Qualcare PPO/HMO/WC	$641.60

Know your out-of-pocket cost for care.

All Charges