Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

HYDRATION INF 1ST HR

Facility

$1,334.09

Service Code	HCPCS 96360
Hospital Charge Code	395096360
Hospital Revenue Code	260
Min. Negotiated Rate	$200.11
Max. Negotiated Rate	$200.11
Rate for Payer: Qualcare PPO/HMO/WC	$200.11

HYDRATION INF 1ST HR

Facility

$1,610.84

Service Code	HCPCS 96360
Hospital Charge Code	2300910
Hospital Revenue Code	260
Min. Negotiated Rate	$241.63
Max. Negotiated Rate	$241.63
Rate for Payer: Qualcare PPO/HMO/WC	$241.63

HYDRATION INF 1ST HR

Facility

$1,610.84

Service Code	HCPCS 96360
Hospital Charge Code	2301097
Hospital Revenue Code	260
Min. Negotiated Rate	$241.63
Max. Negotiated Rate	$241.63
Rate for Payer: Qualcare PPO/HMO/WC	$241.63

HYDRATION INF 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96360
Hospital Charge Code	100130
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

HYDRATION INF 1ST HR

Facility

$1,610.84

Service Code	HCPCS 96360
Hospital Charge Code	1001170
Hospital Revenue Code	260
Min. Negotiated Rate	$45.75
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$687.34
Rate for Payer: Aetna Medicare Advantage	$818.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$916.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$916.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$252.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$916.67
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: Cigna Medicare Advantage	$252.70
Rate for Payer: Clover Medicare Advantage	$240.06
Rate for Payer: EmblemHealth Commercial	$758.10
Rate for Payer: Humana Medicare Advantage	$260.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$252.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$418.82
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$241.63
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$50.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$252.70
Rate for Payer: Wellcare Medicare Advantage	$252.70
Rate for Payer: Wellpoint Medicaid Managed Care	$45.75

HYDRATION INF 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96360
Hospital Charge Code	366896360
Hospital Revenue Code	260
Min. Negotiated Rate	$79.52
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$687.34
Rate for Payer: Aetna Medicare Advantage	$818.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$916.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$916.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$252.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$916.67
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: Cigna Medicare Advantage	$252.70
Rate for Payer: Clover Medicare Advantage	$240.06
Rate for Payer: EmblemHealth Commercial	$758.10
Rate for Payer: Humana Medicare Advantage	$260.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$252.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$728.00
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$88.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$252.70
Rate for Payer: Wellcare Medicare Advantage	$252.70
Rate for Payer: Wellpoint Medicaid Managed Care	$79.52

HYDRATION INF 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96360
Hospital Charge Code	83653125
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

HYDRATION INF 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96360
Hospital Charge Code	366896360
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

HYDRATION INF 1ST HR

Facility

$1,610.84

Service Code	HCPCS 96360
Hospital Charge Code	3401110
Hospital Revenue Code	260
Min. Negotiated Rate	$241.63
Max. Negotiated Rate	$241.63
Rate for Payer: Qualcare PPO/HMO/WC	$241.63

HYDRATION INF 1ST HR

Facility

$1,610.84

Service Code	HCPCS 96360
Hospital Charge Code	8200519
Hospital Revenue Code	260
Min. Negotiated Rate	$45.75
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$687.34
Rate for Payer: Aetna Medicare Advantage	$818.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$916.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$916.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$252.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$916.67
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: Cigna Medicare Advantage	$252.70
Rate for Payer: Clover Medicare Advantage	$240.06
Rate for Payer: EmblemHealth Commercial	$758.10
Rate for Payer: Humana Medicare Advantage	$260.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$252.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$418.82
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$241.63
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$50.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$252.70
Rate for Payer: Wellcare Medicare Advantage	$252.70
Rate for Payer: Wellpoint Medicaid Managed Care	$45.75

HYDRATION INF EA ADDL HR

Facility

$412.88

Service Code	HCPCS 96361
Hospital Charge Code	93500017
Hospital Revenue Code	260
Min. Negotiated Rate	$11.73
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$151.31
Rate for Payer: Aetna Medicare Advantage	$180.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$55.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.80
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: Cigna Medicare Advantage	$55.63
Rate for Payer: Clover Medicare Advantage	$52.85
Rate for Payer: EmblemHealth Commercial	$166.89
Rate for Payer: Humana Medicare Advantage	$57.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$55.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.35
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$61.93
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$13.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$55.63
Rate for Payer: Wellcare Medicare Advantage	$55.63
Rate for Payer: Wellpoint Medicaid Managed Care	$11.73

HYDRATION INF EA ADDL HR

Facility

$412.88

Service Code	HCPCS 96361
Hospital Charge Code	93500015
Hospital Revenue Code	260
Min. Negotiated Rate	$11.73
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$151.31
Rate for Payer: Aetna Medicare Advantage	$180.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$55.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.80
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: Cigna Medicare Advantage	$55.63
Rate for Payer: Clover Medicare Advantage	$52.85
Rate for Payer: EmblemHealth Commercial	$166.89
Rate for Payer: Humana Medicare Advantage	$57.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$55.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.35
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$61.93
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$13.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$55.63
Rate for Payer: Wellcare Medicare Advantage	$55.63
Rate for Payer: Wellpoint Medicaid Managed Care	$11.73

HYDRATION INF EA ADDL HR

Facility

$412.88

Service Code	HCPCS 96361
Hospital Charge Code	2301098
Hospital Revenue Code	260
Min. Negotiated Rate	$11.73
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$151.31
Rate for Payer: Aetna Medicare Advantage	$180.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$55.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.80
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: Cigna Medicare Advantage	$55.63
Rate for Payer: Clover Medicare Advantage	$52.85
Rate for Payer: EmblemHealth Commercial	$166.89
Rate for Payer: Humana Medicare Advantage	$57.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$55.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.35
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$61.93
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$13.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$55.63
Rate for Payer: Wellcare Medicare Advantage	$55.63
Rate for Payer: Wellpoint Medicaid Managed Care	$11.73

HYDRATION INF EA ADDL HR

Facility

$412.88

Service Code	HCPCS 96361
Hospital Charge Code	2011455
Hospital Revenue Code	260
Min. Negotiated Rate	$11.73
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$151.31
Rate for Payer: Aetna Medicare Advantage	$180.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$55.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.80
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: Cigna Medicare Advantage	$55.63
Rate for Payer: Clover Medicare Advantage	$52.85
Rate for Payer: EmblemHealth Commercial	$166.89
Rate for Payer: Humana Medicare Advantage	$57.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$55.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.35
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$61.93
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$13.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$55.63
Rate for Payer: Wellcare Medicare Advantage	$55.63
Rate for Payer: Wellpoint Medicaid Managed Care	$11.73

HYDRATION INF EA ADDL HR

Facility

$412.88

Service Code	HCPCS 96361
Hospital Charge Code	100139
Hospital Revenue Code	260
Min. Negotiated Rate	$11.73
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$151.31
Rate for Payer: Aetna Medicare Advantage	$180.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$55.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.80
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: Cigna Medicare Advantage	$55.63
Rate for Payer: Clover Medicare Advantage	$52.85
Rate for Payer: EmblemHealth Commercial	$166.89
Rate for Payer: Humana Medicare Advantage	$57.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$55.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.35
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$61.93
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$13.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$55.63
Rate for Payer: Wellcare Medicare Advantage	$55.63
Rate for Payer: Wellpoint Medicaid Managed Care	$11.73

HYDRATION INF EA ADDL HR

Facility

$412.88

Service Code	HCPCS 96361
Hospital Charge Code	100133
Hospital Revenue Code	260
Min. Negotiated Rate	$61.93
Max. Negotiated Rate	$61.93
Rate for Payer: Qualcare PPO/HMO/WC	$61.93

HYDRATION INF EA ADDL HR

Facility

$412.88

Service Code	HCPCS 96361
Hospital Charge Code	100132
Hospital Revenue Code	260
Min. Negotiated Rate	$61.93
Max. Negotiated Rate	$61.93
Rate for Payer: Qualcare PPO/HMO/WC	$61.93

HYDRATION INF EA ADDL HR

Facility

$412.88

Service Code	HCPCS 96361
Hospital Charge Code	93500017
Hospital Revenue Code	260
Min. Negotiated Rate	$61.93
Max. Negotiated Rate	$61.93
Rate for Payer: Qualcare PPO/HMO/WC	$61.93

HYDRATION INF EA ADDL HR

Facility

$412.88

Service Code	HCPCS 96361
Hospital Charge Code	1500111
Hospital Revenue Code	260
Min. Negotiated Rate	$11.73
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$151.31
Rate for Payer: Aetna Medicare Advantage	$180.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$55.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.80
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: Cigna Medicare Advantage	$55.63
Rate for Payer: Clover Medicare Advantage	$52.85
Rate for Payer: EmblemHealth Commercial	$166.89
Rate for Payer: Humana Medicare Advantage	$57.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$55.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.35
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$61.93
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$13.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$55.63
Rate for Payer: Wellcare Medicare Advantage	$55.63
Rate for Payer: Wellpoint Medicaid Managed Care	$11.73

HYDRATION INF EA ADDL HR

Facility

$412.88

Service Code	HCPCS 96361
Hospital Charge Code	1001171
Hospital Revenue Code	260
Min. Negotiated Rate	$11.73
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$151.31
Rate for Payer: Aetna Medicare Advantage	$180.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$55.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.80
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: Cigna Medicare Advantage	$55.63
Rate for Payer: Clover Medicare Advantage	$52.85
Rate for Payer: EmblemHealth Commercial	$166.89
Rate for Payer: Humana Medicare Advantage	$57.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$55.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.35
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$61.93
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$13.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$55.63
Rate for Payer: Wellcare Medicare Advantage	$55.63
Rate for Payer: Wellpoint Medicaid Managed Care	$11.73

HYDRATION INF EA ADDL HR

Facility

$412.88

Service Code	HCPCS 96361
Hospital Charge Code	73190091
Hospital Revenue Code	260
Min. Negotiated Rate	$61.93
Max. Negotiated Rate	$61.93
Rate for Payer: Qualcare PPO/HMO/WC	$61.93

HYDRATION INF EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96361
Hospital Charge Code	395096361
Hospital Revenue Code	260
Min. Negotiated Rate	$9.43
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$151.31
Rate for Payer: Aetna Medicare Advantage	$180.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$55.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.80
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: Cigna Medicare Advantage	$55.63
Rate for Payer: Clover Medicare Advantage	$52.85
Rate for Payer: EmblemHealth Commercial	$166.89
Rate for Payer: Humana Medicare Advantage	$57.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$55.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.29
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.78
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$10.49
Rate for Payer: UnitedHealthcare Medicare Advantage	$55.63
Rate for Payer: Wellcare Medicare Advantage	$55.63
Rate for Payer: Wellpoint Medicaid Managed Care	$9.43

HYDRATION INF EA ADDL HR

Facility

$412.88

Service Code	HCPCS 96361
Hospital Charge Code	83653130
Hospital Revenue Code	260
Min. Negotiated Rate	$11.73
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$151.31
Rate for Payer: Aetna Medicare Advantage	$180.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$55.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.80
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: Cigna Medicare Advantage	$55.63
Rate for Payer: Clover Medicare Advantage	$52.85
Rate for Payer: EmblemHealth Commercial	$166.89
Rate for Payer: Humana Medicare Advantage	$57.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$55.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.35
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$61.93
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$13.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$55.63
Rate for Payer: Wellcare Medicare Advantage	$55.63
Rate for Payer: Wellpoint Medicaid Managed Care	$11.73

HYDRATION INF EA ADDL HR

Facility

$412.88

Service Code	HCPCS 96361
Hospital Charge Code	73237020
Hospital Revenue Code	260
Min. Negotiated Rate	$11.73
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$151.31
Rate for Payer: Aetna Medicare Advantage	$180.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$55.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.80
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: Cigna Medicare Advantage	$55.63
Rate for Payer: Clover Medicare Advantage	$52.85
Rate for Payer: EmblemHealth Commercial	$166.89
Rate for Payer: Humana Medicare Advantage	$57.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$55.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.35
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$61.93
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$13.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$55.63
Rate for Payer: Wellcare Medicare Advantage	$55.63
Rate for Payer: Wellpoint Medicaid Managed Care	$11.73

HYDRATION INF EA ADDL HR

Facility

$412.88

Service Code	HCPCS 96361
Hospital Charge Code	83653130
Hospital Revenue Code	260
Min. Negotiated Rate	$61.93
Max. Negotiated Rate	$61.93
Rate for Payer: Qualcare PPO/HMO/WC	$61.93

Know your out-of-pocket cost for care.

All Charges