Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

HEALON GV PRO 0.85ML

Facility

$955.22

Service Code	NDC 50474065165
Hospital Charge Code	606390481
Hospital Revenue Code	272
Min. Negotiated Rate	$143.28
Max. Negotiated Rate	$143.28
Rate for Payer: Qualcare PPO/HMO/WC	$143.28

HEALTH RISK ASSESEMENT

Facility

$442.00

Service Code	HCPCS 99420
Hospital Charge Code	9200090
Hospital Revenue Code	520
Min. Negotiated Rate	$66.30
Max. Negotiated Rate	$66.30
Rate for Payer: Qualcare PPO/HMO/WC	$66.30

HEALTH RISK ASSESEMENT

Facility

$442.00

Service Code	HCPCS 99420
Hospital Charge Code	9200090
Hospital Revenue Code	520
Min. Negotiated Rate	$12.55
Max. Negotiated Rate	$221.00
Rate for Payer: Aetna Commercial	$167.96
Rate for Payer: Aetna Medicare Advantage	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.71
Rate for Payer: Cigna Commercial	$221.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.92
Rate for Payer: Qualcare PPO/HMO/WC	$66.30
Rate for Payer: UnitedHealthcare Community & State	$13.97
Rate for Payer: Wellpoint Medicaid Managed Care	$12.55

HEALTH START ENROLLMENT

Facility

$174.55

Service Code	HCPCS 9924152HD
Hospital Charge Code	83652500
Hospital Revenue Code	514
Min. Negotiated Rate	$26.18
Max. Negotiated Rate	$26.18
Rate for Payer: Qualcare PPO/HMO/WC	$26.18

HEALTH START ENROLLMENT

Facility

$174.55

Service Code	HCPCS 9924152HD
Hospital Charge Code	83652500
Hospital Revenue Code	514
Min. Negotiated Rate	$4.96
Max. Negotiated Rate	$87.28
Rate for Payer: Aetna Commercial	$66.33
Rate for Payer: Aetna Medicare Advantage	$52.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.51
Rate for Payer: Cigna Commercial	$87.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.38
Rate for Payer: Qualcare PPO/HMO/WC	$26.18
Rate for Payer: UnitedHealthcare Community & State	$5.52
Rate for Payer: Wellpoint Medicaid Managed Care	$4.96

HEALTHSTART INIT ANTE VISIT

Facility

$140.80

Service Code	HCPCS 99201SB
Hospital Charge Code	83652506
Hospital Revenue Code	514
Min. Negotiated Rate	$4.00
Max. Negotiated Rate	$70.40
Rate for Payer: Aetna Commercial	$53.50
Rate for Payer: Aetna Medicare Advantage	$42.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.90
Rate for Payer: Cigna Commercial	$70.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.61
Rate for Payer: Qualcare PPO/HMO/WC	$21.12
Rate for Payer: UnitedHealthcare Community & State	$4.45
Rate for Payer: Wellpoint Medicaid Managed Care	$4.00

HEALTHSTART INIT ANTE VISIT

Facility

$140.80

Service Code	HCPCS 99201SB
Hospital Charge Code	83652506
Hospital Revenue Code	514
Min. Negotiated Rate	$21.12
Max. Negotiated Rate	$21.12
Rate for Payer: Qualcare PPO/HMO/WC	$21.12

HEALTH START PRENATAL DEVELOP

Facility

$174.55

Service Code	HCPCS 9924122HD
Hospital Charge Code	83652502
Hospital Revenue Code	514
Min. Negotiated Rate	$4.96
Max. Negotiated Rate	$87.28
Rate for Payer: Aetna Commercial	$66.33
Rate for Payer: Aetna Medicare Advantage	$52.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.51
Rate for Payer: Cigna Commercial	$87.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.38
Rate for Payer: Qualcare PPO/HMO/WC	$26.18
Rate for Payer: UnitedHealthcare Community & State	$5.52
Rate for Payer: Wellpoint Medicaid Managed Care	$4.96

HEALTH START PRENATAL DEVELOP

Facility

$174.55

Service Code	HCPCS 9924122HD
Hospital Charge Code	83652502
Hospital Revenue Code	514
Min. Negotiated Rate	$26.18
Max. Negotiated Rate	$26.18
Rate for Payer: Qualcare PPO/HMO/WC	$26.18

HEALTHSTART SUBANTE 4-6 VISITS

Facility

$1,974.70

Service Code	HCPCS 59425SB
Hospital Charge Code	83652508
Hospital Revenue Code	514
Min. Negotiated Rate	$296.20
Max. Negotiated Rate	$296.20
Rate for Payer: Qualcare PPO/HMO/WC	$296.20

HEALTHSTART SUBANTE 4-6 VISITS

Facility

$1,974.70

Service Code	HCPCS 59425SB
Hospital Charge Code	83652508
Hospital Revenue Code	514
Min. Negotiated Rate	$56.08
Max. Negotiated Rate	$987.35
Rate for Payer: Aetna Commercial	$750.39
Rate for Payer: Aetna Medicare Advantage	$592.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$503.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$503.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$503.55
Rate for Payer: Cigna Commercial	$987.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$513.42
Rate for Payer: Qualcare PPO/HMO/WC	$296.20
Rate for Payer: UnitedHealthcare Community & State	$62.40
Rate for Payer: Wellpoint Medicaid Managed Care	$56.08

HEALTH START SUB PLAN 2ND TRI

Facility

$174.55

Service Code	HCPCS 99241
Hospital Charge Code	83652504
Hospital Revenue Code	514
Min. Negotiated Rate	$26.18
Max. Negotiated Rate	$26.18
Rate for Payer: Qualcare PPO/HMO/WC	$26.18

HEALTH START SUB PLAN 2ND TRI

Facility

$174.55

Service Code	HCPCS 99241
Hospital Charge Code	83652504
Hospital Revenue Code	514
Min. Negotiated Rate	$4.96
Max. Negotiated Rate	$87.28
Rate for Payer: Aetna Commercial	$66.33
Rate for Payer: Aetna Medicare Advantage	$52.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.51
Rate for Payer: Cigna Commercial	$87.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.38
Rate for Payer: Qualcare PPO/HMO/WC	$26.18
Rate for Payer: UnitedHealthcare Community & State	$5.52
Rate for Payer: Wellpoint Medicaid Managed Care	$4.96

HEARING SCREEN

Facility

$447.30

Service Code	HCPCS 92511
Hospital Charge Code	83090010
Hospital Revenue Code	471
Min. Negotiated Rate	$67.09
Max. Negotiated Rate	$67.09
Rate for Payer: Qualcare PPO/HMO/WC	$67.09

HEARING SCREEN

Facility

$27.00

Service Code	HCPCS 92511
Hospital Charge Code	83092020
Hospital Revenue Code	471
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.05

HEARING SCREEN

Facility

$447.30

Service Code	HCPCS 92511
Hospital Charge Code	83090010
Hospital Revenue Code	471
Min. Negotiated Rate	$12.70
Max. Negotiated Rate	$1,823.00
Rate for Payer: Aetna Commercial	$645.02
Rate for Payer: Aetna Medicare Advantage	$768.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$860.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$860.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$237.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$860.23
Rate for Payer: Cigna Commercial	$475.34
Rate for Payer: Cigna Medicare Advantage	$237.14
Rate for Payer: Clover Medicare Advantage	$225.28
Rate for Payer: EmblemHealth Commercial	$711.42
Rate for Payer: Humana Medicare Advantage	$244.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$237.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.30
Rate for Payer: Oxford Commercial	$1,606.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.09
Rate for Payer: UnitedHealthcare Commercial	$1,823.00
Rate for Payer: UnitedHealthcare Community & State	$14.13
Rate for Payer: UnitedHealthcare Medicare Advantage	$237.14
Rate for Payer: Wellcare Medicare Advantage	$237.14
Rate for Payer: Wellpoint Medicaid Managed Care	$12.70

HEARING SCREEN

Facility

$27.00

Service Code	HCPCS 92551
Hospital Charge Code	83080035
Hospital Revenue Code	471
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$1,823.00
Rate for Payer: Aetna Commercial	$10.26
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.88
Rate for Payer: Cigna Commercial	$13.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.02
Rate for Payer: Oxford Commercial	$1,606.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.05
Rate for Payer: UnitedHealthcare Commercial	$1,823.00
Rate for Payer: UnitedHealthcare Community & State	$0.85
Rate for Payer: Wellpoint Medicaid Managed Care	$0.77

HEARING SCREEN

Facility

$27.00

Service Code	HCPCS 92551
Hospital Charge Code	83080035
Hospital Revenue Code	471
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.05

HEARING SCREEN

Facility

$27.00

Service Code	HCPCS 92511
Hospital Charge Code	83092020
Hospital Revenue Code	471
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$1,823.00
Rate for Payer: Aetna Commercial	$645.02
Rate for Payer: Aetna Medicare Advantage	$768.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$860.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$860.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$237.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$860.23
Rate for Payer: Cigna Commercial	$475.34
Rate for Payer: Cigna Medicare Advantage	$237.14
Rate for Payer: Clover Medicare Advantage	$225.28
Rate for Payer: EmblemHealth Commercial	$711.42
Rate for Payer: Humana Medicare Advantage	$244.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$237.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.02
Rate for Payer: Oxford Commercial	$1,606.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.05
Rate for Payer: UnitedHealthcare Commercial	$1,823.00
Rate for Payer: UnitedHealthcare Community & State	$0.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$237.14
Rate for Payer: Wellcare Medicare Advantage	$237.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.77

HEART AND/OR LUNG TRANSPLANT

Facility

$324,902.20

Service Code	APR-DRG 0024
Min. Negotiated Rate	$318,531.57
Max. Negotiated Rate	$324,902.20
Rate for Payer: UnitedHealthcare Community & State	$318,531.57
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$324,902.20
Rate for Payer: Wellpoint Medicaid Managed Care	$318,531.57

HEART AND/OR LUNG TRANSPLANT

Facility

$205,632.29

Service Code	APR-DRG 0023
Min. Negotiated Rate	$201,600.28
Max. Negotiated Rate	$205,632.29
Rate for Payer: UnitedHealthcare Community & State	$201,600.28
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$205,632.29
Rate for Payer: Wellpoint Medicaid Managed Care	$201,600.28

HEART AND/OR LUNG TRANSPLANT

Facility

$147,999.30

Service Code	APR-DRG 0022
Min. Negotiated Rate	$145,097.35
Max. Negotiated Rate	$147,999.30
Rate for Payer: UnitedHealthcare Community & State	$145,097.35
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$147,999.30
Rate for Payer: Wellpoint Medicaid Managed Care	$145,097.35

HEART AND/OR LUNG TRANSPLANT

Facility

$121,670.00

Service Code	APR-DRG 0021
Min. Negotiated Rate	$119,284.31
Max. Negotiated Rate	$121,670.00
Rate for Payer: UnitedHealthcare Community & State	$119,284.31
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$121,670.00
Rate for Payer: Wellpoint Medicaid Managed Care	$119,284.31

HEART FAILURE

Facility

$23,054.28

Service Code	APR-DRG 1944
Min. Negotiated Rate	$22,602.24
Max. Negotiated Rate	$23,054.28
Rate for Payer: UnitedHealthcare Community & State	$22,602.24
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$23,054.28
Rate for Payer: Wellpoint Medicaid Managed Care	$22,602.24

HEART FAILURE

Facility

$9,170.63

Service Code	APR-DRG 1942
Min. Negotiated Rate	$8,990.81
Max. Negotiated Rate	$9,170.63
Rate for Payer: UnitedHealthcare Community & State	$8,990.81
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,170.63
Rate for Payer: Wellpoint Medicaid Managed Care	$8,990.81

Know your out-of-pocket cost for care.

All Charges