Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

IAC W/WO CONTRAST

Facility

$9,500.00

Service Code	HCPCS 70480
Hospital Charge Code	2200178
Hospital Revenue Code	351
Min. Negotiated Rate	$86.94
Max. Negotiated Rate	$3,916.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$226.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$450.54
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$86.94
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,470.00
Rate for Payer: Oxford Commercial	$3,774.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$3,916.00
Rate for Payer: UnitedHealthcare Community & State	$300.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$269.80

IAC W/WO CONTRAST

Facility

$9,500.00

Service Code	HCPCS 70480
Hospital Charge Code	2200178
Hospital Revenue Code	351
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

IBANDRONATE SODIUM 1MG INJ

Facility

$3,530.83

Service Code	HCPCS J1740
Hospital Charge Code	60632241
Hospital Revenue Code	636
Min. Negotiated Rate	$529.62
Max. Negotiated Rate	$854.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$854.46
Rate for Payer: Qualcare PPO/HMO/WC	$529.62

IBANDRONATE SODIUM 1MG INJ

Facility

$3,530.83

Service Code	HCPCS J1740
Hospital Charge Code	60632241
Hospital Revenue Code	636
Min. Negotiated Rate	$100.28
Max. Negotiated Rate	$1,765.41
Rate for Payer: Aetna Commercial	$1,341.72
Rate for Payer: Aetna Medicare Advantage	$1,059.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$900.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$900.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$900.36
Rate for Payer: Cigna Commercial	$1,765.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$854.46
Rate for Payer: Qualcare PPO/HMO/WC	$529.62
Rate for Payer: UnitedHealthcare Community & State	$111.57
Rate for Payer: Wellpoint Medicaid Managed Care	$100.28

IBD DIFFERENTIATION PANEL

Facility

$390.00

Service Code	HCPCS 8667191
Hospital Charge Code	39990078D
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

IBD DIFFERENTIATION PANEL

Facility

$390.00

Service Code	HCPCS 8667191
Hospital Charge Code	39990078D
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

IBD DIFFERENTIATION PANEL I

Facility

$390.00

Service Code	HCPCS 8602191
Hospital Charge Code	39990078C
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

IBD DIFFERENTIATION PANEL I

Facility

$390.00

Service Code	HCPCS 8602191
Hospital Charge Code	39990078C
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

IBD DIFFERENTIATION PANEL I

Facility

$390.00

Service Code	HCPCS 8602191
Hospital Charge Code	39990078B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

IBD DIFFERENTIATION PANEL I

Facility

$390.00

Service Code	HCPCS 8602191
Hospital Charge Code	39990078A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

IBD DIFFERENTIATION PANEL I

Facility

$390.00

Service Code	HCPCS 8602191
Hospital Charge Code	39990078B
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

IBD DIFFERENTIATION PANEL I

Facility

$390.00

Service Code	HCPCS 8602191
Hospital Charge Code	39990078A
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

IBD DIFFERENTIATION PANEL V

Facility

$390.00

Service Code	HCPCS 8667191
Hospital Charge Code	39990078E
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

IBD DIFFERENTIATION PANEL V

Facility

$390.00

Service Code	HCPCS 8667191
Hospital Charge Code	39990078E
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

IBD PANEL I

Facility

$103.50

Service Code	HCPCS 8602191
Hospital Charge Code	39990079A
Hospital Revenue Code	302
Min. Negotiated Rate	$2.94
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$39.33
Rate for Payer: Aetna Medicare Advantage	$31.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.39
Rate for Payer: Cigna Commercial	$51.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.91
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.53
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$3.27
Rate for Payer: Wellpoint Medicaid Managed Care	$2.94

IBD PANEL I

Facility

$103.50

Service Code	HCPCS 8602191
Hospital Charge Code	39990079A
Hospital Revenue Code	302
Min. Negotiated Rate	$15.53
Max. Negotiated Rate	$15.53
Rate for Payer: Qualcare PPO/HMO/WC	$15.53

IBD PANEL II

Facility

$103.50

Service Code	HCPCS 8602191
Hospital Charge Code	39990079B
Hospital Revenue Code	302
Min. Negotiated Rate	$15.53
Max. Negotiated Rate	$15.53
Rate for Payer: Qualcare PPO/HMO/WC	$15.53

IBD PANEL II

Facility

$103.50

Service Code	HCPCS 8602191
Hospital Charge Code	39990079B
Hospital Revenue Code	302
Min. Negotiated Rate	$2.94
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$39.33
Rate for Payer: Aetna Medicare Advantage	$31.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.39
Rate for Payer: Cigna Commercial	$51.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.91
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.53
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$3.27
Rate for Payer: Wellpoint Medicaid Managed Care	$2.94

IBD PANEL III

Facility

$103.50

Service Code	HCPCS 8602191
Hospital Charge Code	39990079C
Hospital Revenue Code	302
Min. Negotiated Rate	$2.94
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$39.33
Rate for Payer: Aetna Medicare Advantage	$31.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.39
Rate for Payer: Cigna Commercial	$51.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.91
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.53
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$3.27
Rate for Payer: Wellpoint Medicaid Managed Care	$2.94

IBD PANEL III

Facility

$103.50

Service Code	HCPCS 8602191
Hospital Charge Code	39990079C
Hospital Revenue Code	302
Min. Negotiated Rate	$15.53
Max. Negotiated Rate	$15.53
Rate for Payer: Qualcare PPO/HMO/WC	$15.53

IBD PANEL IV

Facility

$84.25

Service Code	HCPCS 8667191
Hospital Charge Code	39990079D
Hospital Revenue Code	302
Min. Negotiated Rate	$12.64
Max. Negotiated Rate	$12.64
Rate for Payer: Qualcare PPO/HMO/WC	$12.64

IBD PANEL IV

Facility

$84.25

Service Code	HCPCS 8667191
Hospital Charge Code	39990079D
Hospital Revenue Code	302
Min. Negotiated Rate	$2.39
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$32.02
Rate for Payer: Aetna Medicare Advantage	$25.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.48
Rate for Payer: Cigna Commercial	$42.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.91
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.64
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$2.66
Rate for Payer: Wellpoint Medicaid Managed Care	$2.39

IBD PANEL V

Facility

$84.25

Service Code	HCPCS 8667191
Hospital Charge Code	39990079E
Hospital Revenue Code	302
Min. Negotiated Rate	$12.64
Max. Negotiated Rate	$12.64
Rate for Payer: Qualcare PPO/HMO/WC	$12.64

IBD PANEL V

Facility

$84.25

Service Code	HCPCS 8667191
Hospital Charge Code	39990079E
Hospital Revenue Code	302
Min. Negotiated Rate	$2.39
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$32.02
Rate for Payer: Aetna Medicare Advantage	$25.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.48
Rate for Payer: Cigna Commercial	$42.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.91
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.64
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$2.66
Rate for Payer: Wellpoint Medicaid Managed Care	$2.39

IB KIT MINI PEEK FT JUMPSTART

Facility

$14,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270696137
Hospital Revenue Code	278
Min. Negotiated Rate	$424.58
Max. Negotiated Rate	$7,475.00
Rate for Payer: Aetna Commercial	$5,681.00
Rate for Payer: Aetna Medicare Advantage	$4,485.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,812.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,812.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,812.25
Rate for Payer: Cigna Commercial	$7,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,617.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,242.50
Rate for Payer: UnitedHealthcare Community & State	$472.42
Rate for Payer: Wellpoint Medicaid Managed Care	$424.58

Know your out-of-pocket cost for care.

All Charges