Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

HIP W/WO PELVIS MIN 4V LT

Facility

$593.26

Service Code	HCPCS 73503LT
Hospital Charge Code	75190641
Hospital Revenue Code	320
Min. Negotiated Rate	$88.99
Max. Negotiated Rate	$88.99
Rate for Payer: Qualcare PPO/HMO/WC	$88.99

HIP W/WO PELVIS MIN 4V RT

Facility

$593.26

Service Code	HCPCS 73503RT
Hospital Charge Code	75190643
Hospital Revenue Code	320
Min. Negotiated Rate	$88.99
Max. Negotiated Rate	$88.99
Rate for Payer: Qualcare PPO/HMO/WC	$88.99

HIP W/WO PELVIS MIN 4V RT

Facility

$593.26

Service Code	HCPCS 73503RT
Hospital Charge Code	75190643
Hospital Revenue Code	320
Min. Negotiated Rate	$16.85
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$225.44
Rate for Payer: Aetna Medicare Advantage	$177.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.28
Rate for Payer: Cigna Commercial	$296.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.25
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$88.99
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$18.75
Rate for Payer: Wellpoint Medicaid Managed Care	$16.85

HIP W/WO PELVIS MIN 4V RT

Facility

$593.26

Service Code	HCPCS 73503RT
Hospital Charge Code	94270270
Hospital Revenue Code	320
Min. Negotiated Rate	$88.99
Max. Negotiated Rate	$88.99
Rate for Payer: Qualcare PPO/HMO/WC	$88.99

HIP W/WO PELVIS MIN 4V RT

Facility

$593.26

Service Code	HCPCS 73503RT
Hospital Charge Code	94270270
Hospital Revenue Code	320
Min. Negotiated Rate	$16.85
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$225.44
Rate for Payer: Aetna Medicare Advantage	$177.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.28
Rate for Payer: Cigna Commercial	$296.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.25
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$88.99
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$18.75
Rate for Payer: Wellpoint Medicaid Managed Care	$16.85

HIP W/WO PELVIS MIN 4V RT

Facility

$593.26

Service Code	HCPCS 73503RT
Hospital Charge Code	94061490
Hospital Revenue Code	320
Min. Negotiated Rate	$88.99
Max. Negotiated Rate	$88.99
Rate for Payer: Qualcare PPO/HMO/WC	$88.99

HIP W/WO PELVIS MIN 4V RT

Facility

$5,100.00

Service Code	HCPCS 73503RT
Hospital Charge Code	2011549
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

HIP W/WO PELVIS MIN 4V RT

Facility

$593.26

Service Code	HCPCS 73503RT
Hospital Charge Code	94061490
Hospital Revenue Code	320
Min. Negotiated Rate	$16.85
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$225.44
Rate for Payer: Aetna Medicare Advantage	$177.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.28
Rate for Payer: Cigna Commercial	$296.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.25
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$88.99
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$18.75
Rate for Payer: Wellpoint Medicaid Managed Care	$16.85

HIP W/WO PELVIS MIN 4V RT

Facility

$5,100.00

Service Code	HCPCS 73503RT
Hospital Charge Code	2011549
Hospital Revenue Code	320
Min. Negotiated Rate	$144.84
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.00
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$161.16
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

HISTAMINE

Facility

$390.00

Service Code	HCPCS 83088
Hospital Charge Code	39900458
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$80.32
Rate for Payer: Aetna Medicare Advantage	$95.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.12
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$29.53
Rate for Payer: Clover Medicare Advantage	$28.05
Rate for Payer: EmblemHealth Commercial	$88.59
Rate for Payer: Humana Medicare Advantage	$30.42
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$29.53
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	$23.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.53
Rate for Payer: Wellcare Medicare Advantage	$29.53
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

HISTAMINE

Facility

$534.00

Service Code	HCPCS 83088
Hospital Charge Code	38473078
Hospital Revenue Code	301
Min. Negotiated Rate	$15.17
Max. Negotiated Rate	$267.00
Rate for Payer: Aetna Commercial	$80.32
Rate for Payer: Aetna Medicare Advantage	$95.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.12
Rate for Payer: Cigna Commercial	$267.00
Rate for Payer: Cigna Medicare Advantage	$29.53
Rate for Payer: Clover Medicare Advantage	$28.05
Rate for Payer: EmblemHealth Commercial	$88.59
Rate for Payer: Humana Medicare Advantage	$30.42
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$29.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.84
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$80.10
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$23.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.53
Rate for Payer: Wellcare Medicare Advantage	$29.53
Rate for Payer: Wellpoint Medicaid Managed Care	$15.17

HISTAMINE

Facility

$534.00

Service Code	HCPCS 83088
Hospital Charge Code	38473078
Hospital Revenue Code	301
Min. Negotiated Rate	$80.10
Max. Negotiated Rate	$80.10
Rate for Payer: Qualcare PPO/HMO/WC	$80.10

HISTAMINE

Facility

$390.00

Service Code	HCPCS 83088
Hospital Charge Code	39900458
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HISTAMINE RELEASE

Facility

$390.00

Service Code	HCPCS 86343
Hospital Charge Code	39900219
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HISTAMINE RELEASE

Facility

$390.00

Service Code	HCPCS 86343
Hospital Charge Code	39900219
Hospital Revenue Code	302
Min. Negotiated Rate	$9.97
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$33.89
Rate for Payer: Aetna Medicare Advantage	$40.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.20
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.46
Rate for Payer: Clover Medicare Advantage	$11.84
Rate for Payer: EmblemHealth Commercial	$37.38
Rate for Payer: Humana Medicare Advantage	$12.83
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.46
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	$9.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.46
Rate for Payer: Wellcare Medicare Advantage	$12.46
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

HISTO GROSS

Facility

$465.00

Service Code	HCPCS 88300
Hospital Charge Code	3004967
Hospital Revenue Code	312
Min. Negotiated Rate	$13.21
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$93.46
Rate for Payer: Aetna Medicare Advantage	$111.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$34.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.64
Rate for Payer: Cigna Commercial	$68.87
Rate for Payer: Cigna Medicare Advantage	$34.36
Rate for Payer: Clover Medicare Advantage	$32.64
Rate for Payer: EmblemHealth Commercial	$103.08
Rate for Payer: Humana Medicare Advantage	$35.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$34.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.90
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$69.75
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$34.36
Rate for Payer: Wellcare Medicare Advantage	$34.36
Rate for Payer: Wellpoint Medicaid Managed Care	$13.21

HISTO GROSS

Facility

$465.00

Service Code	HCPCS 88300
Hospital Charge Code	3004967
Hospital Revenue Code	312
Min. Negotiated Rate	$69.75
Max. Negotiated Rate	$69.75
Rate for Payer: Qualcare PPO/HMO/WC	$69.75

HISTO KIDNEY BIOPSY AST

Facility

$1,082.30

Service Code	HCPCS 88342
Hospital Charge Code	3005261
Hospital Revenue Code	310
Min. Negotiated Rate	$162.34
Max. Negotiated Rate	$162.34
Rate for Payer: Qualcare PPO/HMO/WC	$162.34

HISTO KIDNEY BIOPSY AST

Facility

$1,082.30

Service Code	HCPCS 88342
Hospital Charge Code	3005261
Hospital Revenue Code	310
Min. Negotiated Rate	$30.74
Max. Negotiated Rate	$734.21
Rate for Payer: Aetna Commercial	$550.53
Rate for Payer: Aetna Medicare Advantage	$655.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$734.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$734.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$202.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$734.21
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$202.40
Rate for Payer: Clover Medicare Advantage	$192.28
Rate for Payer: EmblemHealth Commercial	$607.20
Rate for Payer: Humana Medicare Advantage	$208.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$202.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$281.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$162.34
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$86.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$202.40
Rate for Payer: Wellcare Medicare Advantage	$202.40
Rate for Payer: Wellpoint Medicaid Managed Care	$30.74

HISTONE ANTIBODY

Facility

$390.00

Service Code	HCPCS 83516
Hospital Charge Code	39900457
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HISTONE ANTIBODY

Facility

$390.00

Service Code	HCPCS 83516
Hospital Charge Code	39900457
Hospital Revenue Code	301
Min. Negotiated Rate	$9.22
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$31.36
Rate for Payer: Aetna Medicare Advantage	$37.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.83
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$11.53
Rate for Payer: Clover Medicare Advantage	$10.95
Rate for Payer: EmblemHealth Commercial	$34.59
Rate for Payer: Humana Medicare Advantage	$11.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.53
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	$9.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.53
Rate for Payer: Wellcare Medicare Advantage	$11.53
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

HISTOPLASMA AB,ID

Facility

$390.00

Service Code	HCPCS 86698
Hospital Charge Code	39900243
Hospital Revenue Code	302
Min. Negotiated Rate	$11.03
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$37.51
Rate for Payer: Aetna Medicare Advantage	$44.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.79
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	$50.02
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$13.79
Rate for Payer: Clover Medicare Advantage	$13.10
Rate for Payer: EmblemHealth Commercial	$41.37
Rate for Payer: Humana Medicare Advantage	$14.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.79
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	$11.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.79
Rate for Payer: Wellcare Medicare Advantage	$13.79
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

HISTOPLASMA AB,ID

Facility

$390.00

Service Code	HCPCS 86698
Hospital Charge Code	39900243
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HISTOPLASMA ANTIBODIES

Facility

$88.00

Service Code	HCPCS 86698
Hospital Charge Code	38476040
Hospital Revenue Code	302
Min. Negotiated Rate	$2.50
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$37.51
Rate for Payer: Aetna Medicare Advantage	$44.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.79
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	$50.02
Rate for Payer: Cigna Commercial	$44.00
Rate for Payer: Cigna Medicare Advantage	$13.79
Rate for Payer: Clover Medicare Advantage	$13.10
Rate for Payer: EmblemHealth Commercial	$41.37
Rate for Payer: Humana Medicare Advantage	$14.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.88
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.20
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$11.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.79
Rate for Payer: Wellcare Medicare Advantage	$13.79
Rate for Payer: Wellpoint Medicaid Managed Care	$2.50

HISTOPLASMA ANTIBODIES

Facility

$88.00

Service Code	HCPCS 86698
Hospital Charge Code	38476040
Hospital Revenue Code	302
Min. Negotiated Rate	$13.20
Max. Negotiated Rate	$13.20
Rate for Payer: Qualcare PPO/HMO/WC	$13.20

Know your out-of-pocket cost for care.

All Charges