Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

HYDRATION INF EA ADDL HR

Facility

$412.88

Service Code	HCPCS 96361
Hospital Charge Code	100139
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	1600533
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	1600533
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	93500015
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	2011455
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	3401120
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	73050905
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	74308230
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	100135
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	411096361
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	$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	100138
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	3401115
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	8200520
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	8200520
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	3401115
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	1500111
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

$598.74

Service Code	HCPCS 96361
Hospital Charge Code	5700388
Hospital Revenue Code	450
Min. Negotiated Rate	$17.00
Max. Negotiated Rate	$201.80
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	$155.67
Rate for Payer: Qualcare PPO/HMO/WC	$89.81
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$55.63
Rate for Payer: Wellcare Medicare Advantage	$55.63
Rate for Payer: Wellpoint Medicaid Managed Care	$17.00

HYDRATION INF EA ADDL HR

Facility

$412.88

Service Code	HCPCS 96361
Hospital Charge Code	100136
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	93500013
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	411096361
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	3401145
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	5100785
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	100133
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	100134
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