Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ANALYZE NEUROSTIM COMPLEX

Facility

$460.72

Service Code	HCPCS 95972
Hospital Charge Code	1600000290
Hospital Revenue Code	360
Min. Negotiated Rate	$13.08
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$307.22
Rate for Payer: Aetna Medicare Advantage	$365.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$409.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$409.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$112.95
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	$409.73
Rate for Payer: Cigna Commercial	$226.40
Rate for Payer: Cigna Medicare Advantage	$112.95
Rate for Payer: Clover Medicare Advantage	$107.30
Rate for Payer: EmblemHealth Commercial	$338.85
Rate for Payer: Humana Medicare Advantage	$116.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$112.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.79
Rate for Payer: Qualcare PPO/HMO/WC	$69.11
Rate for Payer: UnitedHealthcare Community & State	$14.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$112.95
Rate for Payer: Wellcare Medicare Advantage	$112.95
Rate for Payer: Wellpoint Medicaid Managed Care	$13.08

ANA PATTERN

Facility

$390.00

Service Code	HCPCS 86039
Hospital Charge Code	397043302
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ANA PATTERN

Facility

$390.00

Service Code	HCPCS 86039
Hospital Charge Code	397043302
Hospital Revenue Code	302
Min. Negotiated Rate	$8.93
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$30.36
Rate for Payer: Aetna Medicare Advantage	$36.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.48
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$11.16
Rate for Payer: Clover Medicare Advantage	$10.60
Rate for Payer: EmblemHealth Commercial	$33.48
Rate for Payer: Humana Medicare Advantage	$11.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.16
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	$8.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.16
Rate for Payer: Wellcare Medicare Advantage	$11.16
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

ANAPLASMPHAGOCYTOPHABIGG&IGM-C

Facility

$117.55

Service Code	HCPCS 86666
Hospital Charge Code	401386666B
Hospital Revenue Code	302
Min. Negotiated Rate	$17.63
Max. Negotiated Rate	$17.63
Rate for Payer: Qualcare PPO/HMO/WC	$17.63

ANAPLASMPHAGOCYTOPHABIGG&IGM-C

Facility

$117.55

Service Code	HCPCS 86666
Hospital Charge Code	401386666B
Hospital Revenue Code	302
Min. Negotiated Rate	$3.34
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$27.69
Rate for Payer: Aetna Medicare Advantage	$32.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.93
Rate for Payer: Cigna Commercial	$58.77
Rate for Payer: Cigna Medicare Advantage	$10.18
Rate for Payer: Clover Medicare Advantage	$9.67
Rate for Payer: EmblemHealth Commercial	$30.54
Rate for Payer: Humana Medicare Advantage	$10.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.56
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.63
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$8.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.18
Rate for Payer: Wellcare Medicare Advantage	$10.18
Rate for Payer: Wellpoint Medicaid Managed Care	$3.34

ANAPROX/275MG/TAB

Facility

$15.34

Service Code	NDC 53746019301
Hospital Charge Code	60632458
Hospital Revenue Code	250
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$7.67
Rate for Payer: Aetna Commercial	$5.83
Rate for Payer: Aetna Medicare Advantage	$4.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.91
Rate for Payer: Cigna Commercial	$7.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.99
Rate for Payer: Oxford Commercial	$3.07
Rate for Payer: Qualcare PPO/HMO/WC	$2.30
Rate for Payer: UnitedHealthcare Commercial	$3.07
Rate for Payer: UnitedHealthcare Community & State	$0.48
Rate for Payer: Wellpoint Medicaid Managed Care	$0.44

ANAPROX/275MG/TAB

Facility

$15.34

Service Code	NDC 53746019301
Hospital Charge Code	60632458
Hospital Revenue Code	250
Min. Negotiated Rate	$2.30
Max. Negotiated Rate	$2.30
Rate for Payer: Qualcare PPO/HMO/WC	$2.30

ANAPROX DS/550MG/TAB

Facility

$23.92

Service Code	NDC 53746019401
Hospital Charge Code	60632460
Hospital Revenue Code	250
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$11.96
Rate for Payer: Aetna Commercial	$9.09
Rate for Payer: Aetna Medicare Advantage	$7.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.10
Rate for Payer: Cigna Commercial	$11.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.22
Rate for Payer: Oxford Commercial	$4.78
Rate for Payer: Qualcare PPO/HMO/WC	$3.59
Rate for Payer: UnitedHealthcare Commercial	$4.78
Rate for Payer: UnitedHealthcare Community & State	$0.76
Rate for Payer: Wellpoint Medicaid Managed Care	$0.68

ANAPROX DS/550MG/TAB

Facility

$23.92

Service Code	NDC 53746019401
Hospital Charge Code	60632460
Hospital Revenue Code	250
Min. Negotiated Rate	$3.59
Max. Negotiated Rate	$3.59
Rate for Payer: Qualcare PPO/HMO/WC	$3.59

ANA SCREEN IFA W RFLX TITR/PAT

Facility

$390.00

Service Code	HCPCS 86038
Hospital Charge Code	401387449
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ANA SCREEN IFA W RFLX TITR/PAT

Facility

$390.00

Service Code	HCPCS 86038
Hospital Charge Code	401387449
Hospital Revenue Code	302
Min. Negotiated Rate	$9.67
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$32.88
Rate for Payer: Aetna Medicare Advantage	$39.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.86
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.09
Rate for Payer: Clover Medicare Advantage	$11.49
Rate for Payer: EmblemHealth Commercial	$36.27
Rate for Payer: Humana Medicare Advantage	$12.45
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.09
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	$9.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.09
Rate for Payer: Wellcare Medicare Advantage	$12.09
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

ANASTROZOLE 1 MG TAB

Facility

$127.90

Service Code	NDC 310020130
Hospital Charge Code	60627362
Hospital Revenue Code	250
Min. Negotiated Rate	$19.18
Max. Negotiated Rate	$19.18
Rate for Payer: Qualcare PPO/HMO/WC	$19.18

ANASTROZOLE 1 MG TAB

Facility

$127.90

Service Code	NDC 310020130
Hospital Charge Code	60627362
Hospital Revenue Code	250
Min. Negotiated Rate	$3.63
Max. Negotiated Rate	$63.95
Rate for Payer: Aetna Commercial	$48.60
Rate for Payer: Aetna Medicare Advantage	$38.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.61
Rate for Payer: Cigna Commercial	$63.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.25
Rate for Payer: Oxford Commercial	$25.58
Rate for Payer: Qualcare PPO/HMO/WC	$19.18
Rate for Payer: UnitedHealthcare Commercial	$25.58
Rate for Payer: UnitedHealthcare Community & State	$4.04
Rate for Payer: Wellpoint Medicaid Managed Care	$3.63

ANA TITER

Facility

$427.00

Service Code	HCPCS 86039
Hospital Charge Code	38476046
Hospital Revenue Code	302
Min. Negotiated Rate	$8.93
Max. Negotiated Rate	$213.50
Rate for Payer: Aetna Commercial	$30.36
Rate for Payer: Aetna Medicare Advantage	$36.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.48
Rate for Payer: Cigna Commercial	$213.50
Rate for Payer: Cigna Medicare Advantage	$11.16
Rate for Payer: Clover Medicare Advantage	$10.60
Rate for Payer: EmblemHealth Commercial	$33.48
Rate for Payer: Humana Medicare Advantage	$11.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.02
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$64.05
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$8.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.16
Rate for Payer: Wellcare Medicare Advantage	$11.16
Rate for Payer: Wellpoint Medicaid Managed Care	$12.13

ANA TITER

Facility

$390.00

Service Code	HCPCS 86039
Hospital Charge Code	39900192
Hospital Revenue Code	302
Min. Negotiated Rate	$8.93
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$30.36
Rate for Payer: Aetna Medicare Advantage	$36.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.48
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$11.16
Rate for Payer: Clover Medicare Advantage	$10.60
Rate for Payer: EmblemHealth Commercial	$33.48
Rate for Payer: Humana Medicare Advantage	$11.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.16
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	$8.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.16
Rate for Payer: Wellcare Medicare Advantage	$11.16
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

ANA TITER

Facility

$427.00

Service Code	HCPCS 86039
Hospital Charge Code	38476046
Hospital Revenue Code	302
Min. Negotiated Rate	$64.05
Max. Negotiated Rate	$64.05
Rate for Payer: Qualcare PPO/HMO/WC	$64.05

ANA TITER

Facility

$390.00

Service Code	HCPCS 86039
Hospital Charge Code	39900192
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ANATOMIC BODY 128DEGREE SZ 6/8

Facility

$5,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270685583
Hospital Revenue Code	278
Min. Negotiated Rate	$862.50
Max. Negotiated Rate	$1,391.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

ANATOMIC BODY 128DEGREE SZ 6/8

Facility

$5,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270685583
Hospital Revenue Code	278
Min. Negotiated Rate	$163.30
Max. Negotiated Rate	$2,875.00
Rate for Payer: Aetna Commercial	$2,185.00
Rate for Payer: Aetna Medicare Advantage	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,466.25
Rate for Payer: Cigna Commercial	$2,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50
Rate for Payer: UnitedHealthcare Community & State	$181.70
Rate for Payer: Wellpoint Medicaid Managed Care	$163.30

ANATOMIC FIB LOCK LEFT 6H

Facility

$3,666.00

Service Code	HCPCS C1713
Hospital Charge Code	270682380
Hospital Revenue Code	278
Min. Negotiated Rate	$549.90
Max. Negotiated Rate	$887.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$733.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$887.17
Rate for Payer: Qualcare PPO/HMO/WC	$549.90

ANATOMIC FIB LOCK LEFT 6H

Facility

$3,666.00

Service Code	HCPCS C1713
Hospital Charge Code	270682380
Hospital Revenue Code	278
Min. Negotiated Rate	$104.11
Max. Negotiated Rate	$1,833.00
Rate for Payer: Aetna Commercial	$1,393.08
Rate for Payer: Aetna Medicare Advantage	$1,099.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$934.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$934.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$733.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$934.83
Rate for Payer: Cigna Commercial	$1,833.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$887.17
Rate for Payer: Qualcare PPO/HMO/WC	$549.90
Rate for Payer: UnitedHealthcare Community & State	$115.85
Rate for Payer: Wellpoint Medicaid Managed Care	$104.11

ANATOMIC FRACTURE HUMERAL HEAD

Facility

$11,133.95

Hospital Charge Code	270339510
Hospital Revenue Code	278
Min. Negotiated Rate	$1,670.09
Max. Negotiated Rate	$2,694.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,226.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,694.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,670.09

ANATOMIC FRACTURE HUMERAL HEAD

Facility

$11,133.95

Hospital Charge Code	270339510
Hospital Revenue Code	278
Min. Negotiated Rate	$316.20
Max. Negotiated Rate	$5,566.98
Rate for Payer: Aetna Commercial	$4,230.90
Rate for Payer: Aetna Medicare Advantage	$3,340.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,839.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,839.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,226.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,839.16
Rate for Payer: Cigna Commercial	$5,566.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,694.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,670.09
Rate for Payer: UnitedHealthcare Community & State	$351.83
Rate for Payer: Wellpoint Medicaid Managed Care	$316.20

ANATOMIC FRACTURE HUMERAL STEM

Facility

$24,409.90

Hospital Charge Code	270339511
Hospital Revenue Code	278
Min. Negotiated Rate	$3,661.49
Max. Negotiated Rate	$5,907.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,881.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,907.20
Rate for Payer: Qualcare PPO/HMO/WC	$3,661.49

ANATOMIC FRACTURE HUMERAL STEM

Facility

$24,409.90

Hospital Charge Code	270339511
Hospital Revenue Code	278
Min. Negotiated Rate	$693.24
Max. Negotiated Rate	$12,204.95
Rate for Payer: Aetna Commercial	$9,275.76
Rate for Payer: Aetna Medicare Advantage	$7,322.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,224.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,224.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,881.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,224.52
Rate for Payer: Cigna Commercial	$12,204.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,907.20
Rate for Payer: Qualcare PPO/HMO/WC	$3,661.49
Rate for Payer: UnitedHealthcare Community & State	$771.35
Rate for Payer: Wellpoint Medicaid Managed Care	$693.24

Know your out-of-pocket cost for care.

All Charges