Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

IMMOBILIZER SHOULDER LG

Facility

$30.00

Hospital Charge Code	270677150
Hospital Revenue Code	270
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$15.00
Rate for Payer: Aetna Commercial	$11.40
Rate for Payer: Aetna Medicare Advantage	$9.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.65
Rate for Payer: Cigna Commercial	$15.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.80
Rate for Payer: Oxford Commercial	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.50
Rate for Payer: UnitedHealthcare Commercial	$6.00
Rate for Payer: UnitedHealthcare Community & State	$0.95
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

IMMOBILIZER SHOULDER MED

Facility

$30.00

Hospital Charge Code	270677149
Hospital Revenue Code	270
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.50

IMMOBILIZER SHOULDER MED

Facility

$30.00

Hospital Charge Code	270677149
Hospital Revenue Code	270
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$15.00
Rate for Payer: Aetna Commercial	$11.40
Rate for Payer: Aetna Medicare Advantage	$9.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.65
Rate for Payer: Cigna Commercial	$15.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.80
Rate for Payer: Oxford Commercial	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.50
Rate for Payer: UnitedHealthcare Commercial	$6.00
Rate for Payer: UnitedHealthcare Community & State	$0.95
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

IMMOBILIZER SHOULDER ONE SZ

Facility

$42.65

Service Code	HCPCS L3650
Hospital Charge Code	270302813
Hospital Revenue Code	274
Min. Negotiated Rate	$6.40
Max. Negotiated Rate	$10.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.32
Rate for Payer: Qualcare PPO/HMO/WC	$6.40

IMMOBILIZER SHOULDER ONE SZ

Facility

$42.65

Service Code	HCPCS L3650
Hospital Charge Code	270302813
Hospital Revenue Code	274
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$21.32
Rate for Payer: Aetna Commercial	$16.21
Rate for Payer: Aetna Medicare Advantage	$12.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.88
Rate for Payer: Cigna Commercial	$21.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.32
Rate for Payer: Qualcare PPO/HMO/WC	$6.40
Rate for Payer: UnitedHealthcare Community & State	$1.35
Rate for Payer: Wellpoint Medicaid Managed Care	$1.21

IMMOBILIZER SHOULDER SML

Facility

$30.00

Hospital Charge Code	270677148
Hospital Revenue Code	270
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$15.00
Rate for Payer: Aetna Commercial	$11.40
Rate for Payer: Aetna Medicare Advantage	$9.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.65
Rate for Payer: Cigna Commercial	$15.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.80
Rate for Payer: Oxford Commercial	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.50
Rate for Payer: UnitedHealthcare Commercial	$6.00
Rate for Payer: UnitedHealthcare Community & State	$0.95
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

IMMOBILIZER SHOULDER SML

Facility

$30.00

Hospital Charge Code	270677148
Hospital Revenue Code	270
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.50

IMMOBILIZER SHOULDER XL

Facility

$30.00

Hospital Charge Code	270677151
Hospital Revenue Code	270
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$15.00
Rate for Payer: Aetna Commercial	$11.40
Rate for Payer: Aetna Medicare Advantage	$9.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.65
Rate for Payer: Cigna Commercial	$15.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.80
Rate for Payer: Oxford Commercial	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.50
Rate for Payer: UnitedHealthcare Commercial	$6.00
Rate for Payer: UnitedHealthcare Community & State	$0.95
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

IMMOBILIZER SHOULDER XL

Facility

$30.00

Hospital Charge Code	270677151
Hospital Revenue Code	270
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.50

IMMUNE COMPLEX DETECTION(RALI

Facility

$348.00

Service Code	HCPCS 86332
Hospital Charge Code	38476216
Hospital Revenue Code	302
Min. Negotiated Rate	$52.20
Max. Negotiated Rate	$52.20
Rate for Payer: Qualcare PPO/HMO/WC	$52.20

IMMUNE COMPLEX DETECTION(RALI

Facility

$348.00

Service Code	HCPCS 86332
Hospital Charge Code	38476216
Hospital Revenue Code	302
Min. Negotiated Rate	$9.88
Max. Negotiated Rate	$174.00
Rate for Payer: Aetna Commercial	$66.29
Rate for Payer: Aetna Medicare Advantage	$78.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.40
Rate for Payer: Cigna Commercial	$174.00
Rate for Payer: Cigna Medicare Advantage	$24.37
Rate for Payer: Clover Medicare Advantage	$23.15
Rate for Payer: EmblemHealth Commercial	$73.11
Rate for Payer: Humana Medicare Advantage	$25.10
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.48
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.20
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$19.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.37
Rate for Payer: Wellcare Medicare Advantage	$24.37
Rate for Payer: Wellpoint Medicaid Managed Care	$9.88

IMMUNE GLOBULIN 10% 100ML

Facility

$4,783.80

Service Code	HCPCS J1568
Hospital Charge Code	6063943334
Hospital Revenue Code	636
Min. Negotiated Rate	$44.69
Max. Negotiated Rate	$1,157.68
Rate for Payer: Aetna Commercial	$127.95
Rate for Payer: Aetna Medicare Advantage	$152.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$47.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.64
Rate for Payer: Cigna Medicare Advantage	$47.04
Rate for Payer: Clover Medicare Advantage	$44.69
Rate for Payer: EmblemHealth Commercial	$141.12
Rate for Payer: Humana Medicare Advantage	$48.45
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$47.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,157.68
Rate for Payer: Qualcare PPO/HMO/WC	$717.57
Rate for Payer: UnitedHealthcare Community & State	$151.17
Rate for Payer: UnitedHealthcare Medicare Advantage	$47.04
Rate for Payer: Wellcare Medicare Advantage	$47.04
Rate for Payer: Wellpoint Medicaid Managed Care	$135.86

IMMUNE GLOBULIN 10% 100ML

Facility

$4,783.80

Service Code	HCPCS J1568
Hospital Charge Code	6063943334
Hospital Revenue Code	636
Min. Negotiated Rate	$717.57
Max. Negotiated Rate	$1,157.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,157.68
Rate for Payer: Qualcare PPO/HMO/WC	$717.57

IMMUNE GLOBULIN 10% 50ML

Facility

$2,391.90

Service Code	HCPCS J1568
Hospital Charge Code	6063943335
Hospital Revenue Code	636
Min. Negotiated Rate	$358.79
Max. Negotiated Rate	$578.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$578.84
Rate for Payer: Qualcare PPO/HMO/WC	$358.79

IMMUNE GLOBULIN 10% 50ML

Facility

$2,391.90

Service Code	HCPCS J1568
Hospital Charge Code	6063943335
Hospital Revenue Code	636
Min. Negotiated Rate	$44.69
Max. Negotiated Rate	$578.84
Rate for Payer: Aetna Commercial	$127.95
Rate for Payer: Aetna Medicare Advantage	$152.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$47.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.64
Rate for Payer: Cigna Medicare Advantage	$47.04
Rate for Payer: Clover Medicare Advantage	$44.69
Rate for Payer: EmblemHealth Commercial	$141.12
Rate for Payer: Humana Medicare Advantage	$48.45
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$47.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$578.84
Rate for Payer: Qualcare PPO/HMO/WC	$358.79
Rate for Payer: UnitedHealthcare Community & State	$75.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$47.04
Rate for Payer: Wellcare Medicare Advantage	$47.04
Rate for Payer: Wellpoint Medicaid Managed Care	$67.93

IMMUNFIX E-PHORSIS/URINE/CSF

Facility

$390.00

Service Code	HCPCS 86335
Hospital Charge Code	401086335
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$79.83
Rate for Payer: Aetna Medicare Advantage	$95.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.47
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$29.35
Rate for Payer: Clover Medicare Advantage	$27.88
Rate for Payer: EmblemHealth Commercial	$88.05
Rate for Payer: Humana Medicare Advantage	$30.23
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$29.35
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	$23.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.35
Rate for Payer: Wellcare Medicare Advantage	$29.35
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

IMMUNFIX E-PHORSIS/URINE/CSF

Facility

$390.00

Service Code	HCPCS 86335
Hospital Charge Code	401086335
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

IMMUNIZATION ADM THROUG 18YRS

Facility

$55.00

Service Code	HCPCS 90460
Hospital Charge Code	5780270
Hospital Revenue Code	771
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

IMMUNIZATION ADM THROUG 18YRS

Facility

$55.00

Service Code	HCPCS 90460
Hospital Charge Code	5780270
Hospital Revenue Code	771
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$20.90
Rate for Payer: Aetna Medicare Advantage	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.03
Rate for Payer: Cigna Commercial	$27.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.30
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.25
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1.56

IMMUNNOELECTROPHRESIS;OTHER FL

Facility

$157.00

Service Code	HCPCS 86325
Hospital Charge Code	38477171
Hospital Revenue Code	302
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$62.91
Rate for Payer: Aetna Medicare Advantage	$74.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.90
Rate for Payer: Cigna Commercial	$78.50
Rate for Payer: Cigna Medicare Advantage	$23.13
Rate for Payer: Clover Medicare Advantage	$21.97
Rate for Payer: EmblemHealth Commercial	$69.39
Rate for Payer: Humana Medicare Advantage	$23.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$23.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.82
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.55
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$18.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$23.13
Rate for Payer: Wellcare Medicare Advantage	$23.13
Rate for Payer: Wellpoint Medicaid Managed Care	$4.46

IMMUNNOELECTROPHRESIS;OTHER FL

Facility

$157.00

Service Code	HCPCS 86325
Hospital Charge Code	38477171
Hospital Revenue Code	302
Min. Negotiated Rate	$23.55
Max. Negotiated Rate	$23.55
Rate for Payer: Qualcare PPO/HMO/WC	$23.55

IMMUNOASSAY AB

Facility

$667.59

Service Code	HCPCS 83516
Hospital Charge Code	39708042A
Hospital Revenue Code	306
Min. Negotiated Rate	$9.22
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$31.36
Rate for Payer: Aetna Medicare Advantage	$37.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.83
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$11.53
Rate for Payer: Clover Medicare Advantage	$10.95
Rate for Payer: EmblemHealth Commercial	$34.59
Rate for Payer: Humana Medicare Advantage	$11.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.57
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.53
Rate for Payer: Wellcare Medicare Advantage	$11.53
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

IMMUNOASSAY AB

Facility

$667.59

Service Code	HCPCS 83516
Hospital Charge Code	39708042A
Hospital Revenue Code	306
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

IMMUNOASSAY INFECTIOUS AGENT

Facility

$667.59

Service Code	HCPCS 86317
Hospital Charge Code	401986317
Hospital Revenue Code	302
Min. Negotiated Rate	$11.99
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$40.77
Rate for Payer: Aetna Medicare Advantage	$48.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.38
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$14.99
Rate for Payer: Clover Medicare Advantage	$14.24
Rate for Payer: EmblemHealth Commercial	$44.97
Rate for Payer: Humana Medicare Advantage	$15.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.57
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$11.99
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.99
Rate for Payer: Wellcare Medicare Advantage	$14.99
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

IMMUNOASSAY INFECTIOUS AGENT

Facility

$667.59

Service Code	HCPCS 86317
Hospital Charge Code	401986317
Hospital Revenue Code	302
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

Know your out-of-pocket cost for care.

All Charges