Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

Heparin Sodium 1000units/1mL v

Facility

$45.63

Hospital Charge Code	4509074
Hospital Revenue Code	636
Min. Negotiated Rate	$6.84
Max. Negotiated Rate	$11.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.04
Rate for Payer: Qualcare PPO/HMO/WC	$6.84

HEPARIN SOD PORC 1000U/ML 30ML

Facility

$4.00

Service Code	HCPCS J1644
Hospital Charge Code	6063943204
Hospital Revenue Code	636
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.97
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

HEPARIN SOD PORC 1000U/ML 30ML

Facility

$4.00

Service Code	HCPCS J1644
Hospital Charge Code	6063943204
Hospital Revenue Code	636
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.97
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

HEPARIN XA

Facility

$65.00

Hospital Charge Code	38479071
Hospital Revenue Code	305
Min. Negotiated Rate	$1.85
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$24.70
Rate for Payer: Aetna Medicare Advantage	$19.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.57
Rate for Payer: Cigna Commercial	$32.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.90
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.75
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$2.05
Rate for Payer: Wellpoint Medicaid Managed Care	$1.85

HEPARIN XA

Facility

$65.00

Hospital Charge Code	38479071
Hospital Revenue Code	305
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$9.75
Rate for Payer: Qualcare PPO/HMO/WC	$9.75

HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS

Facility

$12,951.22

Service Code	APR-DRG 2793
Min. Negotiated Rate	$12,697.27
Max. Negotiated Rate	$12,951.22
Rate for Payer: UnitedHealthcare Community & State	$12,697.27
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,951.22
Rate for Payer: Wellpoint Medicaid Managed Care	$12,697.27

HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS

Facility

$27,186.05

Service Code	APR-DRG 2794
Min. Negotiated Rate	$26,652.99
Max. Negotiated Rate	$27,186.05
Rate for Payer: UnitedHealthcare Community & State	$26,652.99
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27,186.05
Rate for Payer: Wellpoint Medicaid Managed Care	$26,652.99

HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS

Facility

$8,469.81

Service Code	APR-DRG 2792
Min. Negotiated Rate	$8,303.74
Max. Negotiated Rate	$8,469.81
Rate for Payer: UnitedHealthcare Community & State	$8,303.74
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,469.81
Rate for Payer: Wellpoint Medicaid Managed Care	$8,303.74

HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS

Facility

$6,727.01

Service Code	APR-DRG 2791
Min. Negotiated Rate	$6,595.11
Max. Negotiated Rate	$6,727.01
Rate for Payer: UnitedHealthcare Community & State	$6,595.11
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,727.01
Rate for Payer: Wellpoint Medicaid Managed Care	$6,595.11

HEPATIC FUNCTION A

Facility

$653.80

Service Code	HCPCS 80076
Hospital Charge Code	38472002
Hospital Revenue Code	301
Min. Negotiated Rate	$98.07
Max. Negotiated Rate	$98.07
Rate for Payer: Qualcare PPO/HMO/WC	$98.07

HEPATIC FUNCTION A

Facility

$653.80

Service Code	HCPCS 80076
Hospital Charge Code	38472002
Hospital Revenue Code	301
Min. Negotiated Rate	$6.54
Max. Negotiated Rate	$326.90
Rate for Payer: Aetna Commercial	$22.22
Rate for Payer: Aetna Medicare Advantage	$26.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.64
Rate for Payer: Cigna Commercial	$326.90
Rate for Payer: Cigna Medicare Advantage	$8.17
Rate for Payer: Clover Medicare Advantage	$7.76
Rate for Payer: EmblemHealth Commercial	$24.51
Rate for Payer: Humana Medicare Advantage	$8.42
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.99
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$98.07
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$6.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.17
Rate for Payer: Wellcare Medicare Advantage	$8.17
Rate for Payer: Wellpoint Medicaid Managed Care	$18.57

HEPATIC FUNCTION PROFILE

Facility

$1,189.30

Service Code	HCPCS 80076
Hospital Charge Code	3004844
Hospital Revenue Code	301
Min. Negotiated Rate	$6.54
Max. Negotiated Rate	$594.65
Rate for Payer: Aetna Commercial	$22.22
Rate for Payer: Aetna Medicare Advantage	$26.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.64
Rate for Payer: Cigna Commercial	$594.65
Rate for Payer: Cigna Medicare Advantage	$8.17
Rate for Payer: Clover Medicare Advantage	$7.76
Rate for Payer: EmblemHealth Commercial	$24.51
Rate for Payer: Humana Medicare Advantage	$8.42
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$309.22
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$178.40
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$6.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.17
Rate for Payer: Wellcare Medicare Advantage	$8.17
Rate for Payer: Wellpoint Medicaid Managed Care	$33.78

HEPATIC FUNCTION PROFILE

Facility

$1,189.30

Service Code	HCPCS 80076
Hospital Charge Code	3004844
Hospital Revenue Code	301
Min. Negotiated Rate	$178.40
Max. Negotiated Rate	$178.40
Rate for Payer: Qualcare PPO/HMO/WC	$178.40

HEPATIT B INJ40MCG/ML DIALYSIS

Facility

$416.07

Service Code	HCPCS 90747
Hospital Charge Code	60628304P
Hospital Revenue Code	636
Min. Negotiated Rate	$62.41
Max. Negotiated Rate	$100.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.69
Rate for Payer: Qualcare PPO/HMO/WC	$62.41

HEPATIT B INJ40MCG/ML DIALYSIS

Facility

$416.07

Service Code	HCPCS 90747
Hospital Charge Code	60628304P
Hospital Revenue Code	636
Min. Negotiated Rate	$11.82
Max. Negotiated Rate	$208.03
Rate for Payer: Aetna Commercial	$158.11
Rate for Payer: Aetna Medicare Advantage	$124.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.10
Rate for Payer: Cigna Commercial	$208.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.69
Rate for Payer: Qualcare PPO/HMO/WC	$62.41
Rate for Payer: UnitedHealthcare Community & State	$13.15
Rate for Payer: Wellpoint Medicaid Managed Care	$11.82

HEPATIT B INJ40MCG/ML DIALYSIS

Facility

$416.07

Service Code	NDC 58160082111
Hospital Charge Code	60628304
Hospital Revenue Code	636
Min. Negotiated Rate	$62.41
Max. Negotiated Rate	$100.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.69
Rate for Payer: Qualcare PPO/HMO/WC	$62.41

HEPATIT B INJ40MCG/ML DIALYSIS

Facility

$416.07

Service Code	NDC 58160082111
Hospital Charge Code	60628304
Hospital Revenue Code	636
Min. Negotiated Rate	$11.82
Max. Negotiated Rate	$208.03
Rate for Payer: Aetna Commercial	$158.11
Rate for Payer: Aetna Medicare Advantage	$124.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.10
Rate for Payer: Cigna Commercial	$208.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.69
Rate for Payer: Qualcare PPO/HMO/WC	$62.41
Rate for Payer: UnitedHealthcare Community & State	$13.15
Rate for Payer: Wellpoint Medicaid Managed Care	$11.82

HEPATITIS A ADLT VAC50U/ML INJ

Facility

$510.61

Service Code	NDC 6484100
Hospital Charge Code	60628864
Hospital Revenue Code	250
Min. Negotiated Rate	$14.50
Max. Negotiated Rate	$255.31
Rate for Payer: Aetna Commercial	$194.03
Rate for Payer: Aetna Medicare Advantage	$153.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.21
Rate for Payer: Cigna Commercial	$255.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.76
Rate for Payer: Oxford Commercial	$102.12
Rate for Payer: Qualcare PPO/HMO/WC	$76.59
Rate for Payer: UnitedHealthcare Commercial	$102.12
Rate for Payer: UnitedHealthcare Community & State	$16.14
Rate for Payer: Wellpoint Medicaid Managed Care	$14.50

HEPATITIS A ADLT VAC50U/ML INJ

Facility

$510.61

Service Code	NDC 6484100
Hospital Charge Code	60628864
Hospital Revenue Code	250
Min. Negotiated Rate	$76.59
Max. Negotiated Rate	$76.59
Rate for Payer: Qualcare PPO/HMO/WC	$76.59

HEPATITIS A (ADULT)

Facility

$171.79

Service Code	HCPCS 90632
Hospital Charge Code	93950065
Hospital Revenue Code	636
Min. Negotiated Rate	$25.77
Max. Negotiated Rate	$41.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.57
Rate for Payer: Qualcare PPO/HMO/WC	$25.77

HEPATITIS A (ADULT)

Facility

$171.79

Service Code	HCPCS 90632
Hospital Charge Code	93950065
Hospital Revenue Code	636
Min. Negotiated Rate	$4.88
Max. Negotiated Rate	$87.27
Rate for Payer: Aetna Commercial	$65.28
Rate for Payer: Aetna Medicare Advantage	$51.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.81
Rate for Payer: Cigna Commercial	$85.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.57
Rate for Payer: Qualcare PPO/HMO/WC	$25.77
Rate for Payer: UnitedHealthcare Community & State	$5.43
Rate for Payer: Wellpoint Medicaid Managed Care	$4.88

Hepatitis A Antibody, IgM

Facility

$76.80

Service Code	HCPCS 86709
Hospital Charge Code	39888022
Hospital Revenue Code	302
Min. Negotiated Rate	$2.18
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$30.63
Rate for Payer: Aetna Medicare Advantage	$36.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.85
Rate for Payer: Cigna Commercial	$38.40
Rate for Payer: Cigna Medicare Advantage	$11.26
Rate for Payer: Clover Medicare Advantage	$10.70
Rate for Payer: EmblemHealth Commercial	$33.78
Rate for Payer: Humana Medicare Advantage	$11.60
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.97
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.52
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.26
Rate for Payer: Wellcare Medicare Advantage	$11.26
Rate for Payer: Wellpoint Medicaid Managed Care	$2.18

Hepatitis A Antibody, IgM

Facility

$76.80

Service Code	HCPCS 86709
Hospital Charge Code	39888022
Hospital Revenue Code	302
Min. Negotiated Rate	$11.52
Max. Negotiated Rate	$11.52
Rate for Payer: Qualcare PPO/HMO/WC	$11.52

HEPATITIS A IGM

Facility

$76.80

Service Code	HCPCS 86709
Hospital Charge Code	39900517
Hospital Revenue Code	302
Min. Negotiated Rate	$11.52
Max. Negotiated Rate	$11.52
Rate for Payer: Qualcare PPO/HMO/WC	$11.52

HEPATITIS A IGM

Facility

$76.80

Service Code	HCPCS 86709
Hospital Charge Code	39900517
Hospital Revenue Code	302
Min. Negotiated Rate	$2.18
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$30.63
Rate for Payer: Aetna Medicare Advantage	$36.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.85
Rate for Payer: Cigna Commercial	$38.40
Rate for Payer: Cigna Medicare Advantage	$11.26
Rate for Payer: Clover Medicare Advantage	$10.70
Rate for Payer: EmblemHealth Commercial	$33.78
Rate for Payer: Humana Medicare Advantage	$11.60
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.97
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.52
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.26
Rate for Payer: Wellcare Medicare Advantage	$11.26
Rate for Payer: Wellpoint Medicaid Managed Care	$2.18

Know your out-of-pocket cost for care.

All Charges