Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

HYPNOTHERAPY CHILD

Facility

$750.00

Service Code	HCPCS 90880
Hospital Charge Code	4515523
Hospital Revenue Code	914
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

HYPNOTHERAPY CHILD

Facility

$750.00

Service Code	HCPCS 90880
Hospital Charge Code	4527523
Hospital Revenue Code	914
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$437.80
Rate for Payer: Aetna Commercial	$328.28
Rate for Payer: Aetna Medicare Advantage	$391.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$437.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$437.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$120.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$437.80
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: Cigna Medicare Advantage	$120.69
Rate for Payer: Clover Medicare Advantage	$114.66
Rate for Payer: EmblemHealth Commercial	$362.07
Rate for Payer: Humana Medicare Advantage	$124.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$120.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$23.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$120.69
Rate for Payer: Wellcare Medicare Advantage	$120.69
Rate for Payer: Wellpoint Medicaid Managed Care	$21.30

HYPOGLYCEMIC PANEL SERUM/PLSMA

Facility

$500.00

Service Code	HCPCS 83789
Hospital Charge Code	401083789
Hospital Revenue Code	301
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$65.58
Rate for Payer: Aetna Medicare Advantage	$78.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.46
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: Cigna Medicare Advantage	$24.11
Rate for Payer: Clover Medicare Advantage	$22.90
Rate for Payer: EmblemHealth Commercial	$72.33
Rate for Payer: Humana Medicare Advantage	$24.83
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$19.29
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.11
Rate for Payer: Wellcare Medicare Advantage	$24.11
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

HYPOGLYCEMIC PANEL SERUM/PLSMA

Facility

$500.00

Service Code	HCPCS 83789
Hospital Charge Code	401083789
Hospital Revenue Code	301
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

HYPOTEARS 1% OPHTH/30ML

Facility

$58.69

Service Code	NDC 536197072
Hospital Charge Code	60633142
Hospital Revenue Code	250
Min. Negotiated Rate	$1.67
Max. Negotiated Rate	$29.34
Rate for Payer: Aetna Commercial	$22.30
Rate for Payer: Aetna Medicare Advantage	$17.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.97
Rate for Payer: Cigna Commercial	$29.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.26
Rate for Payer: Oxford Commercial	$11.74
Rate for Payer: Qualcare PPO/HMO/WC	$8.80
Rate for Payer: UnitedHealthcare Commercial	$11.74
Rate for Payer: UnitedHealthcare Community & State	$1.85
Rate for Payer: Wellpoint Medicaid Managed Care	$1.67

HYPOTEARS 1% OPHTH/30ML

Facility

$58.69

Service Code	NDC 536197072
Hospital Charge Code	60633142
Hospital Revenue Code	250
Min. Negotiated Rate	$8.80
Max. Negotiated Rate	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$8.80

HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS

Facility

$4,798.78

Service Code	APR-DRG 4221
Min. Negotiated Rate	$4,704.69
Max. Negotiated Rate	$4,798.78
Rate for Payer: UnitedHealthcare Community & State	$4,704.69
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,798.78
Rate for Payer: Wellpoint Medicaid Managed Care	$4,704.69

HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS

Facility

$16,747.24

Service Code	APR-DRG 4224
Min. Negotiated Rate	$16,418.86
Max. Negotiated Rate	$16,747.24
Rate for Payer: UnitedHealthcare Community & State	$16,418.86
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$16,747.24
Rate for Payer: Wellpoint Medicaid Managed Care	$16,418.86

HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS

Facility

$6,933.46

Service Code	APR-DRG 4222
Min. Negotiated Rate	$6,797.51
Max. Negotiated Rate	$6,933.46
Rate for Payer: UnitedHealthcare Community & State	$6,797.51
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,933.46
Rate for Payer: Wellpoint Medicaid Managed Care	$6,797.51

HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS

Facility

$10,101.68

Service Code	APR-DRG 4223
Min. Negotiated Rate	$9,903.61
Max. Negotiated Rate	$10,101.68
Rate for Payer: UnitedHealthcare Community & State	$9,903.61
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,101.68
Rate for Payer: Wellpoint Medicaid Managed Care	$9,903.61

HYPROCURE DEVICE SZ 6

Facility

$7,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270677410
Hospital Revenue Code	278
Min. Negotiated Rate	$1,087.50
Max. Negotiated Rate	$1,754.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,754.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,087.50

HYPROCURE DEVICE SZ 6

Facility

$7,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270677410
Hospital Revenue Code	278
Min. Negotiated Rate	$205.90
Max. Negotiated Rate	$3,625.00
Rate for Payer: Aetna Commercial	$2,755.00
Rate for Payer: Aetna Medicare Advantage	$2,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,848.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,848.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,848.75
Rate for Payer: Cigna Commercial	$3,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,754.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,087.50
Rate for Payer: UnitedHealthcare Community & State	$229.10
Rate for Payer: Wellpoint Medicaid Managed Care	$205.90

HYPROCURE DEVICE SZ7

Facility

$9,900.00

Hospital Charge Code	270675464
Hospital Revenue Code	278
Min. Negotiated Rate	$1,485.00
Max. Negotiated Rate	$2,395.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,395.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,485.00

HYPROCURE DEVICE SZ7

Facility

$9,900.00

Hospital Charge Code	270675464
Hospital Revenue Code	278
Min. Negotiated Rate	$281.16
Max. Negotiated Rate	$4,950.00
Rate for Payer: Aetna Commercial	$3,762.00
Rate for Payer: Aetna Medicare Advantage	$2,970.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,524.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,524.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,980.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,524.50
Rate for Payer: Cigna Commercial	$4,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,395.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,485.00
Rate for Payer: UnitedHealthcare Community & State	$312.84
Rate for Payer: Wellpoint Medicaid Managed Care	$281.16

HYPROCURE SIZE 10

Facility

$9,950.00

Service Code	HCPCS C1776
Hospital Charge Code	270679093
Hospital Revenue Code	278
Min. Negotiated Rate	$1,492.50
Max. Negotiated Rate	$2,407.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,990.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,407.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,492.50

HYPROCURE SIZE 10

Facility

$9,950.00

Service Code	HCPCS C1776
Hospital Charge Code	270679093
Hospital Revenue Code	278
Min. Negotiated Rate	$282.58
Max. Negotiated Rate	$4,975.00
Rate for Payer: Aetna Commercial	$3,781.00
Rate for Payer: Aetna Medicare Advantage	$2,985.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,537.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,537.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,537.25
Rate for Payer: Cigna Commercial	$4,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,407.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,492.50
Rate for Payer: UnitedHealthcare Community & State	$314.42
Rate for Payer: Wellpoint Medicaid Managed Care	$282.58

HYSTERECTOMY KIT W/T-TUBE 200M

Facility

$136.00

Hospital Charge Code	270332079
Hospital Revenue Code	272
Min. Negotiated Rate	$20.40
Max. Negotiated Rate	$20.40
Rate for Payer: Qualcare PPO/HMO/WC	$20.40

HYSTERECTOMY KIT W/T-TUBE 200M

Facility

$136.00

Hospital Charge Code	270332079
Hospital Revenue Code	272
Min. Negotiated Rate	$3.86
Max. Negotiated Rate	$68.00
Rate for Payer: Aetna Commercial	$51.68
Rate for Payer: Aetna Medicare Advantage	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.68
Rate for Payer: Cigna Commercial	$68.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.36
Rate for Payer: Oxford Commercial	$27.20
Rate for Payer: Qualcare PPO/HMO/WC	$20.40
Rate for Payer: UnitedHealthcare Commercial	$27.20
Rate for Payer: UnitedHealthcare Community & State	$4.30
Rate for Payer: Wellpoint Medicaid Managed Care	$3.86

HYSTERECTOMY,TOTAL ABDOMINAL

Facility

$11,332.50

Service Code	HCPCS 58150
Hospital Charge Code	16001005
Hospital Revenue Code	360
Min. Negotiated Rate	$1,699.88
Max. Negotiated Rate	$1,699.88
Rate for Payer: Qualcare PPO/HMO/WC	$1,699.88

HYSTERECTOMY,TOTAL ABDOMINAL

Facility

$11,332.50

Service Code	HCPCS 58150
Hospital Charge Code	16001005
Hospital Revenue Code	360
Min. Negotiated Rate	$321.84
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$4,306.35
Rate for Payer: Aetna Medicare Advantage	$3,399.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,889.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,889.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,889.79
Rate for Payer: Cigna Commercial	$5,666.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,946.45
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,699.88
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$358.11
Rate for Payer: Wellpoint Medicaid Managed Care	$321.84

HYSTEROSALPINGOGRAM

Facility

$5,100.00

Service Code	HCPCS 74740
Hospital Charge Code	321074740
Hospital Revenue Code	320
Min. Negotiated Rate	$46.20
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$771.04
Rate for Payer: Aetna Medicare Advantage	$918.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,028.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,028.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$283.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,028.29
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: Cigna Medicare Advantage	$198.43
Rate for Payer: Clover Medicare Advantage	$269.30
Rate for Payer: EmblemHealth Commercial	$850.41
Rate for Payer: Humana Medicare Advantage	$291.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$283.47
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: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

HYSTEROSALPINGOGRAM

Facility

$5,100.00

Service Code	HCPCS 74740
Hospital Charge Code	321074740
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

HYSTEROSALPINGOGRAM

Facility

$5,100.00

Service Code	HCPCS 74740
Hospital Charge Code	5701122
Hospital Revenue Code	320
Min. Negotiated Rate	$46.20
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$771.04
Rate for Payer: Aetna Medicare Advantage	$918.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,028.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,028.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$283.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,028.29
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: Cigna Medicare Advantage	$198.43
Rate for Payer: Clover Medicare Advantage	$269.30
Rate for Payer: EmblemHealth Commercial	$850.41
Rate for Payer: Humana Medicare Advantage	$291.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$283.47
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: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

HYSTEROSALPINGOGRAM

Facility

$5,100.00

Service Code	HCPCS 74740
Hospital Charge Code	5701122
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

HYSTEROSCOPY DIAGNOSTIC_

Facility

$28,242.08

Service Code	HCPCS 58555
Hospital Charge Code	1600000252
Hospital Revenue Code	360
Min. Negotiated Rate	$802.08
Max. Negotiated Rate	$13,950.60
Rate for Payer: Aetna Commercial	$10,460.55
Rate for Payer: Aetna Medicare Advantage	$12,460.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,950.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,950.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,845.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,950.60
Rate for Payer: Cigna Commercial	$7,708.87
Rate for Payer: Cigna Medicare Advantage	$3,845.79
Rate for Payer: Clover Medicare Advantage	$3,653.50
Rate for Payer: EmblemHealth Commercial	$11,537.37
Rate for Payer: Humana Medicare Advantage	$3,961.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,845.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,342.94
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,236.31
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$892.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,845.79
Rate for Payer: Wellcare Medicare Advantage	$3,845.79
Rate for Payer: Wellpoint Medicaid Managed Care	$802.08

Know your out-of-pocket cost for care.

All Charges