Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

Homocysteine nutritional

Facility

$390.00

Service Code	HCPCS 83090
Hospital Charge Code	39708022
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$48.74
Rate for Payer: Aetna Medicare Advantage	$58.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.00
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$17.92
Rate for Payer: Clover Medicare Advantage	$17.02
Rate for Payer: EmblemHealth Commercial	$53.76
Rate for Payer: Humana Medicare Advantage	$18.46
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.92
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	$14.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.92
Rate for Payer: Wellcare Medicare Advantage	$17.92
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

Homocysteine nutritional

Facility

$390.00

Service Code	HCPCS 83090
Hospital Charge Code	39708022
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HOMOCYSTINE, URINE

Facility

$169.00

Service Code	HCPCS 82615
Hospital Charge Code	38473074
Hospital Revenue Code	301
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$25.98
Rate for Payer: Aetna Medicare Advantage	$30.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.64
Rate for Payer: Cigna Commercial	$84.50
Rate for Payer: Cigna Medicare Advantage	$9.55
Rate for Payer: Clover Medicare Advantage	$9.07
Rate for Payer: EmblemHealth Commercial	$28.65
Rate for Payer: Humana Medicare Advantage	$9.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.94
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.35
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$7.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.55
Rate for Payer: Wellcare Medicare Advantage	$9.55
Rate for Payer: Wellpoint Medicaid Managed Care	$4.80

HOMOCYSTINE, URINE

Facility

$169.00

Service Code	HCPCS 82615
Hospital Charge Code	38473074
Hospital Revenue Code	301
Min. Negotiated Rate	$25.35
Max. Negotiated Rate	$25.35
Rate for Payer: Qualcare PPO/HMO/WC	$25.35

HOMOGENTISIC ACID,URINE

Facility

$148.00

Service Code	HCPCS 81005
Hospital Charge Code	38473075
Hospital Revenue Code	307
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$5.90
Rate for Payer: Aetna Medicare Advantage	$7.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.87
Rate for Payer: Cigna Commercial	$74.00
Rate for Payer: Cigna Medicare Advantage	$2.17
Rate for Payer: Clover Medicare Advantage	$2.06
Rate for Payer: EmblemHealth Commercial	$6.51
Rate for Payer: Humana Medicare Advantage	$2.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.48
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.20
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$1.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.17
Rate for Payer: Wellcare Medicare Advantage	$2.17
Rate for Payer: Wellpoint Medicaid Managed Care	$4.20

HOMOGENTISIC ACID,URINE

Facility

$148.00

Service Code	HCPCS 81005
Hospital Charge Code	38473075
Hospital Revenue Code	307
Min. Negotiated Rate	$22.20
Max. Negotiated Rate	$22.20
Rate for Payer: Qualcare PPO/HMO/WC	$22.20

HOMOVANILLIC ACID (HVA)

Facility

$136.00

Service Code	HCPCS 83150
Hospital Charge Code	38477155
Hospital Revenue Code	301
Min. Negotiated Rate	$3.86
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$60.96
Rate for Payer: Aetna Medicare Advantage	$72.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.29
Rate for Payer: Cigna Commercial	$68.00
Rate for Payer: Cigna Medicare Advantage	$22.41
Rate for Payer: Clover Medicare Advantage	$21.29
Rate for Payer: EmblemHealth Commercial	$67.23
Rate for Payer: Humana Medicare Advantage	$23.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.36
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.40
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$17.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.41
Rate for Payer: Wellcare Medicare Advantage	$22.41
Rate for Payer: Wellpoint Medicaid Managed Care	$3.86

HOMOVANILLIC ACID (HVA)

Facility

$136.00

Service Code	HCPCS 83150
Hospital Charge Code	38477155
Hospital Revenue Code	301
Min. Negotiated Rate	$20.40
Max. Negotiated Rate	$20.40
Rate for Payer: Qualcare PPO/HMO/WC	$20.40

HOOD FLYTE

Facility

$232.13

Hospital Charge Code	270660463
Hospital Revenue Code	272
Min. Negotiated Rate	$6.59
Max. Negotiated Rate	$116.06
Rate for Payer: Aetna Commercial	$88.21
Rate for Payer: Aetna Medicare Advantage	$69.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.19
Rate for Payer: Cigna Commercial	$116.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.35
Rate for Payer: Oxford Commercial	$46.43
Rate for Payer: Qualcare PPO/HMO/WC	$34.82
Rate for Payer: UnitedHealthcare Commercial	$46.43
Rate for Payer: UnitedHealthcare Community & State	$7.34
Rate for Payer: Wellpoint Medicaid Managed Care	$6.59

HOOD FLYTE

Facility

$232.13

Hospital Charge Code	270660463
Hospital Revenue Code	272
Min. Negotiated Rate	$34.82
Max. Negotiated Rate	$34.82
Rate for Payer: Qualcare PPO/HMO/WC	$34.82

HOOD W/HI EFFECIENCY FI 601436

Facility

$104.17

Hospital Charge Code	270601436
Hospital Revenue Code	272
Min. Negotiated Rate	$15.63
Max. Negotiated Rate	$15.63
Rate for Payer: Qualcare PPO/HMO/WC	$15.63

HOOD W/HI EFFECIENCY FI 601436

Facility

$104.17

Hospital Charge Code	270601436
Hospital Revenue Code	272
Min. Negotiated Rate	$2.96
Max. Negotiated Rate	$52.09
Rate for Payer: Aetna Commercial	$39.58
Rate for Payer: Aetna Medicare Advantage	$31.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.56
Rate for Payer: Cigna Commercial	$52.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.08
Rate for Payer: Oxford Commercial	$20.83
Rate for Payer: Qualcare PPO/HMO/WC	$15.63
Rate for Payer: UnitedHealthcare Commercial	$20.83
Rate for Payer: UnitedHealthcare Community & State	$3.29
Rate for Payer: Wellpoint Medicaid Managed Care	$2.96

HOOK 10MM WIDE BLADE

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270691060
Hospital Revenue Code	278
Min. Negotiated Rate	$85.20
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$94.80
Rate for Payer: Wellpoint Medicaid Managed Care	$85.20

HOOK 10MM WIDE BLADE

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270691060
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

HOOK CABLE MINI (J)

Facility

$200.00

Hospital Charge Code	270671695
Hospital Revenue Code	272
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

HOOK CABLE MINI (J)

Facility

$200.00

Hospital Charge Code	270671695
Hospital Revenue Code	272
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$100.00
Rate for Payer: Aetna Commercial	$76.00
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.00
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.00
Rate for Payer: Oxford Commercial	$40.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00
Rate for Payer: UnitedHealthcare Commercial	$40.00
Rate for Payer: UnitedHealthcare Community & State	$6.32
Rate for Payer: Wellpoint Medicaid Managed Care	$5.68

HOOK DOUBLE JOSEPH

Facility

$149.15

Hospital Charge Code	270697815
Hospital Revenue Code	272
Min. Negotiated Rate	$22.37
Max. Negotiated Rate	$22.37
Rate for Payer: Qualcare PPO/HMO/WC	$22.37

HOOK DOUBLE JOSEPH

Facility

$149.15

Hospital Charge Code	270697815
Hospital Revenue Code	272
Min. Negotiated Rate	$4.24
Max. Negotiated Rate	$74.58
Rate for Payer: Aetna Commercial	$56.68
Rate for Payer: Aetna Medicare Advantage	$44.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.03
Rate for Payer: Cigna Commercial	$74.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.78
Rate for Payer: Oxford Commercial	$29.83
Rate for Payer: Qualcare PPO/HMO/WC	$22.37
Rate for Payer: UnitedHealthcare Commercial	$29.83
Rate for Payer: UnitedHealthcare Community & State	$4.71
Rate for Payer: Wellpoint Medicaid Managed Care	$4.24

HOOK MACRO SHAVER AND TUBESET

Facility

$2,775.50

Hospital Charge Code	270692976
Hospital Revenue Code	272
Min. Negotiated Rate	$78.82
Max. Negotiated Rate	$1,387.75
Rate for Payer: Aetna Commercial	$1,054.69
Rate for Payer: Aetna Medicare Advantage	$832.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$707.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$707.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$707.75
Rate for Payer: Cigna Commercial	$1,387.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$721.63
Rate for Payer: Oxford Commercial	$555.10
Rate for Payer: Qualcare PPO/HMO/WC	$416.32
Rate for Payer: UnitedHealthcare Commercial	$555.10
Rate for Payer: UnitedHealthcare Community & State	$87.71
Rate for Payer: Wellpoint Medicaid Managed Care	$78.82

HOOK MACRO SHAVER AND TUBESET

Facility

$2,775.50

Hospital Charge Code	270692976
Hospital Revenue Code	272
Min. Negotiated Rate	$416.32
Max. Negotiated Rate	$416.32
Rate for Payer: Qualcare PPO/HMO/WC	$416.32

HOOK NARROW 12MM

Facility

$6,775.00

Hospital Charge Code	270667963
Hospital Revenue Code	278
Min. Negotiated Rate	$192.41
Max. Negotiated Rate	$3,387.50
Rate for Payer: Aetna Commercial	$2,574.50
Rate for Payer: Aetna Medicare Advantage	$2,032.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,727.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,727.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,727.62
Rate for Payer: Cigna Commercial	$3,387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,639.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,016.25
Rate for Payer: UnitedHealthcare Community & State	$214.09
Rate for Payer: Wellpoint Medicaid Managed Care	$192.41

HOOK NARROW 12MM

Facility

$6,775.00

Hospital Charge Code	270667963
Hospital Revenue Code	278
Min. Negotiated Rate	$1,016.25
Max. Negotiated Rate	$1,639.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,639.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,016.25

HOOK NARROW BLADE

Facility

$4,000.00

Hospital Charge Code	270669371
Hospital Revenue Code	272
Min. Negotiated Rate	$113.60
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,040.00
Rate for Payer: Oxford Commercial	$800.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Commercial	$800.00
Rate for Payer: UnitedHealthcare Community & State	$126.40
Rate for Payer: Wellpoint Medicaid Managed Care	$113.60

HOOK NARROW BLADE

Facility

$4,000.00

Hospital Charge Code	270669371
Hospital Revenue Code	272
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$600.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

HOOK NARROW BLADE 12

Facility

$4,000.00

Hospital Charge Code	270659842
Hospital Revenue Code	272
Min. Negotiated Rate	$113.60
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,040.00
Rate for Payer: Oxford Commercial	$800.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Commercial	$800.00
Rate for Payer: UnitedHealthcare Community & State	$126.40
Rate for Payer: Wellpoint Medicaid Managed Care	$113.60

Know your out-of-pocket cost for care.

All Charges