Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

INF CONCURRENT THERAPEUTIC

Facility

$2,800.00

Service Code	HCPCS 96368
Hospital Charge Code	3401042
Hospital Revenue Code	260
Min. Negotiated Rate	$12.32
Max. Negotiated Rate	$1,400.00
Rate for Payer: Aetna Commercial	$1,064.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$728.00
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$88.48
Rate for Payer: Wellpoint Medicaid Managed Care	$79.52

INF CONCURRENT THERAPEUTIC

Facility

$335.00

Service Code	HCPCS 96368
Hospital Charge Code	270329882
Hospital Revenue Code	260
Min. Negotiated Rate	$9.51
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$127.30
Rate for Payer: Aetna Medicare Advantage	$100.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.42
Rate for Payer: Cigna Commercial	$167.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.10
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.25
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$10.59
Rate for Payer: Wellpoint Medicaid Managed Care	$9.51

INF CONCURRENT THERAPEUTIC

Facility

$2,800.00

Service Code	HCPCS 96368
Hospital Charge Code	93500047
Hospital Revenue Code	260
Min. Negotiated Rate	$12.32
Max. Negotiated Rate	$1,400.00
Rate for Payer: Aetna Commercial	$1,064.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$728.00
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$88.48
Rate for Payer: Wellpoint Medicaid Managed Care	$79.52

INF CONCURRENT THERAPEUTIC

Facility

$2,800.00

Service Code	HCPCS 96368
Hospital Charge Code	3401042
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

INF CONCURRENT THERAPEUTIC

Facility

$335.00

Service Code	HCPCS 96368
Hospital Charge Code	270329882
Hospital Revenue Code	260
Min. Negotiated Rate	$50.25
Max. Negotiated Rate	$50.25
Rate for Payer: Qualcare PPO/HMO/WC	$50.25

INF CONCURRENT THERAPEUTIC

Facility

$2,800.00

Service Code	HCPCS 96368
Hospital Charge Code	100129
Hospital Revenue Code	260
Min. Negotiated Rate	$12.32
Max. Negotiated Rate	$1,400.00
Rate for Payer: Aetna Commercial	$1,064.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$728.00
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$88.48
Rate for Payer: Wellpoint Medicaid Managed Care	$79.52

INF CONCURRENT THERAPEUTIC

Facility

$2,800.00

Service Code	HCPCS 96368
Hospital Charge Code	93500047
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

INF CONCURRENT THERAPEUTIC

Facility

$2,800.00

Service Code	HCPCS 96368
Hospital Charge Code	100129
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

INF CONCURRENT THERAPEUTIC

Facility

$2,800.00

Service Code	HCPCS 96368
Hospital Charge Code	73190101
Hospital Revenue Code	260
Min. Negotiated Rate	$12.32
Max. Negotiated Rate	$1,400.00
Rate for Payer: Aetna Commercial	$1,064.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$728.00
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$88.48
Rate for Payer: Wellpoint Medicaid Managed Care	$79.52

INF CONCURRENT THERAPEUTIC

Facility

$2,800.00

Service Code	HCPCS 96368
Hospital Charge Code	73190101
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

INF CONCURRENT THERAPEUTIC

Facility

$260.00

Service Code	HCPCS 96368
Hospital Charge Code	5700405
Hospital Revenue Code	450
Min. Negotiated Rate	$39.00
Max. Negotiated Rate	$39.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.00

INF CONCURRENT THERAPEUTIC

Facility

$260.00

Service Code	HCPCS 96368
Hospital Charge Code	5700405
Hospital Revenue Code	450
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$140.00
Rate for Payer: Aetna Commercial	$98.80
Rate for Payer: Aetna Medicare Advantage	$78.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.30
Rate for Payer: Cigna Commercial	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.60
Rate for Payer: Qualcare PPO/HMO/WC	$39.00
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$7.38

INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC

Facility

$50,394.74

Service Code	MSDRG 758
Min. Negotiated Rate	$15,344.55
Max. Negotiated Rate	$50,394.74
Rate for Payer: Aetna Commercial	$37,750.23
Rate for Payer: Aetna Medicare Advantage	$50,394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27,427.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27,427.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16,152.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27,427.95
Rate for Payer: Cigna Commercial	$21,824.85
Rate for Payer: Cigna Medicare Advantage	$16,152.16
Rate for Payer: Clover Medicare Advantage	$15,344.55
Rate for Payer: EmblemHealth Commercial	$48,456.48
Rate for Payer: Humana Medicare Advantage	$16,636.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16,152.16
Rate for Payer: Oxford Commercial	$17,249.98
Rate for Payer: UnitedHealthcare Commercial	$23,089.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$16,152.16
Rate for Payer: Wellcare Medicare Advantage	$16,152.16

INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC

Facility

$64,703.43

Service Code	MSDRG 757
Min. Negotiated Rate	$19,701.37
Max. Negotiated Rate	$64,703.43
Rate for Payer: Aetna Commercial	$47,941.03
Rate for Payer: Aetna Medicare Advantage	$64,703.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41,280.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41,280.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,738.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41,280.45
Rate for Payer: Cigna Commercial	$31,921.35
Rate for Payer: Cigna Medicare Advantage	$20,738.28
Rate for Payer: Clover Medicare Advantage	$19,701.37
Rate for Payer: EmblemHealth Commercial	$62,214.84
Rate for Payer: Humana Medicare Advantage	$21,360.43
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20,738.28
Rate for Payer: Oxford Commercial	$25,230.08
Rate for Payer: UnitedHealthcare Commercial	$33,771.36
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,738.28
Rate for Payer: Wellcare Medicare Advantage	$20,738.28

INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC

Facility

$40,430.18

Service Code	MSDRG 759
Min. Negotiated Rate	$11,692.63
Max. Negotiated Rate	$40,430.18
Rate for Payer: Aetna Commercial	$30,653.36
Rate for Payer: Aetna Medicare Advantage	$40,430.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18,008.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18,008.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,958.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18,008.25
Rate for Payer: Cigna Commercial	$14,793.63
Rate for Payer: Cigna Medicare Advantage	$12,958.39
Rate for Payer: Clover Medicare Advantage	$12,310.47
Rate for Payer: EmblemHealth Commercial	$38,875.17
Rate for Payer: Humana Medicare Advantage	$13,347.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,958.39
Rate for Payer: Oxford Commercial	$11,692.63
Rate for Payer: UnitedHealthcare Commercial	$15,651.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,958.39
Rate for Payer: Wellcare Medicare Advantage	$12,958.39

INFECTIONS OF UPPER RESPIRATORY TRACT

Facility

$9,798.34

Service Code	APR-DRG 1133
Min. Negotiated Rate	$9,606.22
Max. Negotiated Rate	$9,798.34
Rate for Payer: UnitedHealthcare Community & State	$9,606.22
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,798.34
Rate for Payer: Wellpoint Medicaid Managed Care	$9,606.22

INFECTIONS OF UPPER RESPIRATORY TRACT

Facility

$6,524.79

Service Code	APR-DRG 1132
Min. Negotiated Rate	$6,396.85
Max. Negotiated Rate	$6,524.79
Rate for Payer: UnitedHealthcare Community & State	$6,396.85
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,524.79
Rate for Payer: Wellpoint Medicaid Managed Care	$6,396.85

INFECTIONS OF UPPER RESPIRATORY TRACT

Facility

$19,407.13

Service Code	APR-DRG 1134
Min. Negotiated Rate	$19,026.60
Max. Negotiated Rate	$19,407.13
Rate for Payer: UnitedHealthcare Community & State	$19,026.60
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$19,407.13
Rate for Payer: Wellpoint Medicaid Managed Care	$19,026.60

INFECTIONS OF UPPER RESPIRATORY TRACT

Facility

$4,481.40

Service Code	APR-DRG 1131
Min. Negotiated Rate	$4,393.53
Max. Negotiated Rate	$4,481.40
Rate for Payer: UnitedHealthcare Community & State	$4,393.53
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,481.40
Rate for Payer: Wellpoint Medicaid Managed Care	$4,393.53

INFECTIOUS AGENT DETECTION DNA

Facility

$282.00

Service Code	HCPCS 87800
Hospital Charge Code	38475119
Hospital Revenue Code	306
Min. Negotiated Rate	$42.30
Max. Negotiated Rate	$42.30
Rate for Payer: Qualcare PPO/HMO/WC	$42.30

INFECTIOUS AGENT DETECTION DNA

Facility

$282.00

Service Code	HCPCS 87800
Hospital Charge Code	38475119
Hospital Revenue Code	306
Min. Negotiated Rate	$8.01
Max. Negotiated Rate	$158.41
Rate for Payer: Aetna Commercial	$118.78
Rate for Payer: Aetna Medicare Advantage	$141.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$43.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.41
Rate for Payer: Cigna Commercial	$141.00
Rate for Payer: Cigna Medicare Advantage	$43.67
Rate for Payer: Clover Medicare Advantage	$41.49
Rate for Payer: EmblemHealth Commercial	$131.01
Rate for Payer: Humana Medicare Advantage	$44.98
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$43.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.32
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.30
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$34.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$43.67
Rate for Payer: Wellcare Medicare Advantage	$43.67
Rate for Payer: Wellpoint Medicaid Managed Care	$8.01

INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE

Facility

$13,675.82

Service Code	APR-DRG 7101
Min. Negotiated Rate	$13,407.67
Max. Negotiated Rate	$13,675.82
Rate for Payer: UnitedHealthcare Community & State	$13,407.67
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,675.82
Rate for Payer: Wellpoint Medicaid Managed Care	$13,407.67

INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE

Facility

$32,776.85

Service Code	APR-DRG 7103
Min. Negotiated Rate	$32,134.17
Max. Negotiated Rate	$32,776.85
Rate for Payer: UnitedHealthcare Community & State	$32,134.17
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$32,776.85
Rate for Payer: Wellpoint Medicaid Managed Care	$32,134.17

INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE

Facility

$19,959.07

Service Code	APR-DRG 7102
Min. Negotiated Rate	$19,567.72
Max. Negotiated Rate	$19,959.07
Rate for Payer: UnitedHealthcare Community & State	$19,567.72
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$19,959.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19,567.72

INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE

Facility

$58,804.28

Service Code	APR-DRG 7104
Min. Negotiated Rate	$57,651.25
Max. Negotiated Rate	$58,804.28
Rate for Payer: UnitedHealthcare Community & State	$57,651.25
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$58,804.28
Rate for Payer: Wellpoint Medicaid Managed Care	$57,651.25

Know your out-of-pocket cost for care.

All Charges