Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

HU AB,IFA W/RFX WB

Facility

$390.00

Service Code	HCPCS 86255
Hospital Charge Code	39900204
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HU AB,IFA W/RFX WB

Facility

$390.00

Service Code	HCPCS 86255
Hospital Charge Code	39900204
Hospital Revenue Code	302
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.71
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
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	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

HUIGREGTSE NDLE KNIFE PAPILL

Facility

$337.00

Hospital Charge Code	270334800
Hospital Revenue Code	272
Min. Negotiated Rate	$50.55
Max. Negotiated Rate	$50.55
Rate for Payer: Qualcare PPO/HMO/WC	$50.55

HUIGREGTSE NDLE KNIFE PAPILL

Facility

$337.00

Hospital Charge Code	270334800
Hospital Revenue Code	272
Min. Negotiated Rate	$9.57
Max. Negotiated Rate	$168.50
Rate for Payer: Aetna Commercial	$128.06
Rate for Payer: Aetna Medicare Advantage	$101.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.94
Rate for Payer: Cigna Commercial	$168.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.62
Rate for Payer: Oxford Commercial	$67.40
Rate for Payer: Qualcare PPO/HMO/WC	$50.55
Rate for Payer: UnitedHealthcare Commercial	$67.40
Rate for Payer: UnitedHealthcare Community & State	$10.65
Rate for Payer: Wellpoint Medicaid Managed Care	$9.57

HUMAN EPIDYDEMIS PROTEIN 4

Facility

$390.00

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

HUMAN EPIDYDEMIS PROTEIN 4

Facility

$390.00

Service Code	HCPCS 86305
Hospital Charge Code	401086305B
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

HUMAN INSULIN LISPRO INJ U-100

Facility

$93.02

Service Code	NDC 2753301
Hospital Charge Code	60628226
Hospital Revenue Code	250
Min. Negotiated Rate	$2.64
Max. Negotiated Rate	$46.51
Rate for Payer: Aetna Commercial	$35.35
Rate for Payer: Aetna Medicare Advantage	$27.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.72
Rate for Payer: Cigna Commercial	$46.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.19
Rate for Payer: Oxford Commercial	$18.60
Rate for Payer: Qualcare PPO/HMO/WC	$13.95
Rate for Payer: UnitedHealthcare Commercial	$18.60
Rate for Payer: UnitedHealthcare Community & State	$2.94
Rate for Payer: Wellpoint Medicaid Managed Care	$2.64

HUMAN INSULIN LISPRO INJ U-100

Facility

$93.02

Service Code	NDC 2753301
Hospital Charge Code	60628226
Hospital Revenue Code	250
Min. Negotiated Rate	$13.95
Max. Negotiated Rate	$13.95
Rate for Payer: Qualcare PPO/HMO/WC	$13.95

HUMAN METAPNEUMOVIRUS RNA

Facility

$1,433.80

Service Code	HCPCS 87798
Hospital Charge Code	401087798
Hospital Revenue Code	306
Min. Negotiated Rate	$28.07
Max. Negotiated Rate	$716.90
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	$130.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.29
Rate for Payer: Cigna Commercial	$716.90
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	$372.79
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$215.07
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	$40.72

HUMAN METAPNEUMOVIRUS RNA

Facility

$1,433.80

Service Code	HCPCS 87798
Hospital Charge Code	401087798
Hospital Revenue Code	306
Min. Negotiated Rate	$215.07
Max. Negotiated Rate	$215.07
Rate for Payer: Qualcare PPO/HMO/WC	$215.07

HUMERAL ADAPTER 5mm MIDDLE SEG

Facility

$8,392.35

Service Code	HCPCS C1776
Hospital Charge Code	270679731
Hospital Revenue Code	278
Min. Negotiated Rate	$238.34
Max. Negotiated Rate	$4,196.18
Rate for Payer: Aetna Commercial	$3,189.09
Rate for Payer: Aetna Medicare Advantage	$2,517.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,140.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,140.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,678.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,140.05
Rate for Payer: Cigna Commercial	$4,196.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,030.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,258.85
Rate for Payer: UnitedHealthcare Community & State	$265.20
Rate for Payer: Wellpoint Medicaid Managed Care	$238.34

HUMERAL ADAPTER 5mm MIDDLE SEG

Facility

$8,392.35

Service Code	HCPCS C1776
Hospital Charge Code	270679731
Hospital Revenue Code	278
Min. Negotiated Rate	$1,258.85
Max. Negotiated Rate	$2,030.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,678.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,030.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,258.85

HUMERAL ADAPTER TRAY +10MM

Facility

$8,392.35

Service Code	HCPCS C1776
Hospital Charge Code	270673291
Hospital Revenue Code	278
Min. Negotiated Rate	$238.34
Max. Negotiated Rate	$4,196.18
Rate for Payer: Aetna Commercial	$3,189.09
Rate for Payer: Aetna Medicare Advantage	$2,517.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,140.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,140.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,678.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,140.05
Rate for Payer: Cigna Commercial	$4,196.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,030.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,258.85
Rate for Payer: UnitedHealthcare Community & State	$265.20
Rate for Payer: Wellpoint Medicaid Managed Care	$238.34

HUMERAL ADAPTER TRAY +10MM

Facility

$8,392.35

Service Code	HCPCS C1776
Hospital Charge Code	270673291
Hospital Revenue Code	278
Min. Negotiated Rate	$1,258.85
Max. Negotiated Rate	$2,030.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,678.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,030.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,258.85

HUMERAL BEARING

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270668580
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$847.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

HUMERAL BEARING

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270668580
Hospital Revenue Code	278
Min. Negotiated Rate	$99.40
Max. Negotiated Rate	$1,750.00
Rate for Payer: Aetna Commercial	$1,330.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00
Rate for Payer: UnitedHealthcare Community & State	$110.60
Rate for Payer: Wellpoint Medicaid Managed Care	$99.40

HUMERAL BEARING 44X36MM

Facility

$7,945.00

Hospital Charge Code	270670924
Hospital Revenue Code	278
Min. Negotiated Rate	$225.64
Max. Negotiated Rate	$3,972.50
Rate for Payer: Aetna Commercial	$3,019.10
Rate for Payer: Aetna Medicare Advantage	$2,383.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,025.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,025.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,589.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,025.97
Rate for Payer: Cigna Commercial	$3,972.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,922.69
Rate for Payer: Qualcare PPO/HMO/WC	$1,191.75
Rate for Payer: UnitedHealthcare Community & State	$251.06
Rate for Payer: Wellpoint Medicaid Managed Care	$225.64

HUMERAL BEARING 44X36MM

Facility

$7,945.00

Hospital Charge Code	270670924
Hospital Revenue Code	278
Min. Negotiated Rate	$1,191.75
Max. Negotiated Rate	$1,922.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,589.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,922.69
Rate for Payer: Qualcare PPO/HMO/WC	$1,191.75

HUMERAL BODY FINNED REVERSE

Facility

$9,955.00

Service Code	HCPCS C1776
Hospital Charge Code	270672167
Hospital Revenue Code	278
Min. Negotiated Rate	$282.72
Max. Negotiated Rate	$4,977.50
Rate for Payer: Aetna Commercial	$3,782.90
Rate for Payer: Aetna Medicare Advantage	$2,986.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,538.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,538.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,991.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,538.53
Rate for Payer: Cigna Commercial	$4,977.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,409.11
Rate for Payer: Qualcare PPO/HMO/WC	$1,493.25
Rate for Payer: UnitedHealthcare Community & State	$314.58
Rate for Payer: Wellpoint Medicaid Managed Care	$282.72

HUMERAL BODY FINNED REVERSE

Facility

$9,955.00

Service Code	HCPCS C1776
Hospital Charge Code	270672167
Hospital Revenue Code	278
Min. Negotiated Rate	$1,493.25
Max. Negotiated Rate	$2,409.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,991.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,409.11
Rate for Payer: Qualcare PPO/HMO/WC	$1,493.25

HUMERAL BODY FINNED REV SHORT

Facility

$17,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270680552
Hospital Revenue Code	278
Min. Negotiated Rate	$2,581.50
Max. Negotiated Rate	$4,164.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,442.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,164.82
Rate for Payer: Qualcare PPO/HMO/WC	$2,581.50

HUMERAL BODY FINNED REV SHORT

Facility

$17,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270680552
Hospital Revenue Code	278
Min. Negotiated Rate	$488.76
Max. Negotiated Rate	$8,605.00
Rate for Payer: Aetna Commercial	$6,539.80
Rate for Payer: Aetna Medicare Advantage	$5,163.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,388.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,388.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,442.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,388.55
Rate for Payer: Cigna Commercial	$8,605.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,164.82
Rate for Payer: Qualcare PPO/HMO/WC	$2,581.50
Rate for Payer: UnitedHealthcare Community & State	$543.84
Rate for Payer: Wellpoint Medicaid Managed Care	$488.76

HUMERAL BODY FINNED W/SCREW

Facility

$14,670.00

Service Code	HCPCS C1776
Hospital Charge Code	270672313
Hospital Revenue Code	278
Min. Negotiated Rate	$416.63
Max. Negotiated Rate	$7,335.00
Rate for Payer: Aetna Commercial	$5,574.60
Rate for Payer: Aetna Medicare Advantage	$4,401.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,740.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,740.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,934.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,740.85
Rate for Payer: Cigna Commercial	$7,335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,550.14
Rate for Payer: Qualcare PPO/HMO/WC	$2,200.50
Rate for Payer: UnitedHealthcare Community & State	$463.57
Rate for Payer: Wellpoint Medicaid Managed Care	$416.63

HUMERAL BODY FINNED W/SCREW

Facility

$14,670.00

Service Code	HCPCS C1776
Hospital Charge Code	270672313
Hospital Revenue Code	278
Min. Negotiated Rate	$2,200.50
Max. Negotiated Rate	$3,550.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,934.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,550.14
Rate for Payer: Qualcare PPO/HMO/WC	$2,200.50

HUMERAL BODYLONG

Facility

$20,000.00

Hospital Charge Code	270669577
Hospital Revenue Code	278
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

Know your out-of-pocket cost for care.

All Charges