Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

INFLATION KIT

Facility

$156.80

Hospital Charge Code	270664784
Hospital Revenue Code	272
Min. Negotiated Rate	$23.52
Max. Negotiated Rate	$23.52
Rate for Payer: Qualcare PPO/HMO/WC	$23.52

INFLATION KIT

Facility

$156.80

Hospital Charge Code	270664784S
Hospital Revenue Code	272
Min. Negotiated Rate	$23.52
Max. Negotiated Rate	$23.52
Rate for Payer: Qualcare PPO/HMO/WC	$23.52

INFLATION KIT

Facility

$154.50

Hospital Charge Code	270664784N
Hospital Revenue Code	272
Min. Negotiated Rate	$23.18
Max. Negotiated Rate	$23.18
Rate for Payer: Qualcare PPO/HMO/WC	$23.18

INFLATOR CRYO P-CIU-4

Facility

$5,200.00

Service Code	HCPCS C1725
Hospital Charge Code	270634520
Hospital Revenue Code	278
Min. Negotiated Rate	$147.68
Max. Negotiated Rate	$2,600.00
Rate for Payer: Aetna Commercial	$1,976.00
Rate for Payer: Aetna Medicare Advantage	$1,560.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,326.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,326.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,326.00
Rate for Payer: Cigna Commercial	$2,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.40
Rate for Payer: Qualcare PPO/HMO/WC	$780.00
Rate for Payer: UnitedHealthcare Community & State	$164.32
Rate for Payer: Wellpoint Medicaid Managed Care	$147.68

INFLATOR CRYO P-CIU-4

Facility

$5,200.00

Service Code	HCPCS C1725
Hospital Charge Code	270634520
Hospital Revenue Code	278
Min. Negotiated Rate	$780.00
Max. Negotiated Rate	$1,258.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,040.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.40
Rate for Payer: Qualcare PPO/HMO/WC	$780.00

INFLATOR DEVICE, SYRINGE

Facility

$190.00

Hospital Charge Code	2008095
Hospital Revenue Code	272
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$95.00
Rate for Payer: Aetna Commercial	$72.20
Rate for Payer: Aetna Medicare Advantage	$57.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.45
Rate for Payer: Cigna Commercial	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.40
Rate for Payer: Oxford Commercial	$38.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.50
Rate for Payer: UnitedHealthcare Commercial	$38.00
Rate for Payer: UnitedHealthcare Community & State	$6.00
Rate for Payer: Wellpoint Medicaid Managed Care	$5.40

INFLATOR DEVICE, SYRINGE

Facility

$190.00

Hospital Charge Code	2008095
Hospital Revenue Code	272
Min. Negotiated Rate	$28.50
Max. Negotiated Rate	$28.50
Rate for Payer: Qualcare PPO/HMO/WC	$28.50

INFLATOR LEVEEN W/GA 10CC

Facility

$320.00

Service Code	HCPCS C1769
Hospital Charge Code	270601155
Hospital Revenue Code	278
Min. Negotiated Rate	$9.09
Max. Negotiated Rate	$160.00
Rate for Payer: Aetna Commercial	$121.60
Rate for Payer: Aetna Medicare Advantage	$96.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.60
Rate for Payer: Cigna Commercial	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: Qualcare PPO/HMO/WC	$48.00
Rate for Payer: UnitedHealthcare Community & State	$10.11
Rate for Payer: Wellpoint Medicaid Managed Care	$9.09

INFLATOR LEVEEN W/GA 10CC

Facility

$320.00

Service Code	HCPCS C1769
Hospital Charge Code	270601155
Hospital Revenue Code	278
Min. Negotiated Rate	$48.00
Max. Negotiated Rate	$77.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: Qualcare PPO/HMO/WC	$48.00

INF LEVEL 1 VISIT

Facility

$510.60

Service Code	HCPCS 99211
Hospital Charge Code	93500187
Hospital Revenue Code	510
Min. Negotiated Rate	$14.50
Max. Negotiated Rate	$255.30
Rate for Payer: Aetna Commercial	$194.03
Rate for Payer: Aetna Medicare Advantage	$153.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.20
Rate for Payer: Cigna Commercial	$255.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.76
Rate for Payer: Qualcare PPO/HMO/WC	$76.59
Rate for Payer: UnitedHealthcare Community & State	$16.13
Rate for Payer: Wellpoint Medicaid Managed Care	$14.50

INF LEVEL 1 VISIT

Facility

$510.60

Service Code	HCPCS 99211
Hospital Charge Code	93500187
Hospital Revenue Code	510
Min. Negotiated Rate	$76.59
Max. Negotiated Rate	$76.59
Rate for Payer: Qualcare PPO/HMO/WC	$76.59

INFLIXIMAB 100 MG VIAL

Facility

$7,463.06

Service Code	HCPCS J1745
Hospital Charge Code	60628795
Hospital Revenue Code	636
Min. Negotiated Rate	$29.49
Max. Negotiated Rate	$1,806.06
Rate for Payer: Aetna Commercial	$84.43
Rate for Payer: Aetna Medicare Advantage	$100.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$31.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.60
Rate for Payer: Cigna Medicare Advantage	$31.04
Rate for Payer: Clover Medicare Advantage	$29.49
Rate for Payer: EmblemHealth Commercial	$93.12
Rate for Payer: Humana Medicare Advantage	$31.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$31.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,806.06
Rate for Payer: Qualcare PPO/HMO/WC	$1,119.46
Rate for Payer: UnitedHealthcare Community & State	$235.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$31.04
Rate for Payer: Wellcare Medicare Advantage	$31.04
Rate for Payer: Wellpoint Medicaid Managed Care	$211.95

INFLIXIMAB 100 MG VIAL

Facility

$7,463.06

Service Code	HCPCS J1745
Hospital Charge Code	60628795
Hospital Revenue Code	636
Min. Negotiated Rate	$1,119.46
Max. Negotiated Rate	$1,806.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,806.06
Rate for Payer: Qualcare PPO/HMO/WC	$1,119.46

INFLIXIMAB-ABDA 100MG

Facility

$3,705.44

Service Code	HCPCS Q5104
Hospital Charge Code	606390474
Hospital Revenue Code	636
Min. Negotiated Rate	$25.46
Max. Negotiated Rate	$896.72
Rate for Payer: Aetna Commercial	$72.90
Rate for Payer: Aetna Medicare Advantage	$86.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.22
Rate for Payer: Cigna Medicare Advantage	$26.80
Rate for Payer: Clover Medicare Advantage	$25.46
Rate for Payer: EmblemHealth Commercial	$80.40
Rate for Payer: Humana Medicare Advantage	$27.60
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$896.72
Rate for Payer: Qualcare PPO/HMO/WC	$555.82
Rate for Payer: UnitedHealthcare Community & State	$117.09
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.80
Rate for Payer: Wellcare Medicare Advantage	$26.80
Rate for Payer: Wellpoint Medicaid Managed Care	$105.23

INFLIXIMAB-ABDA 100MG

Facility

$3,705.44

Service Code	HCPCS Q5104
Hospital Charge Code	606390474
Hospital Revenue Code	636
Min. Negotiated Rate	$555.82
Max. Negotiated Rate	$896.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$896.72
Rate for Payer: Qualcare PPO/HMO/WC	$555.82

INFLIXIMAB ANTI-DRUG AB(SERUM)

Facility

$250.00

Service Code	HCPCS 83520
Hospital Charge Code	401183520J
Hospital Revenue Code	301
Min. Negotiated Rate	$7.10
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$46.97
Rate for Payer: Aetna Medicare Advantage	$55.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.65
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: Cigna Medicare Advantage	$17.27
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.00
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.27
Rate for Payer: Wellcare Medicare Advantage	$17.27
Rate for Payer: Wellpoint Medicaid Managed Care	$7.10

INFLIXIMAB ANTI-DRUG AB(SERUM)

Facility

$250.00

Service Code	HCPCS 83520
Hospital Charge Code	401183520J
Hospital Revenue Code	301
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

INFLIXIMAB-DYYB 100MG VIAL

Facility

$3,567.01

Service Code	HCPCS Q5103
Hospital Charge Code	606390259
Hospital Revenue Code	636
Min. Negotiated Rate	$24.74
Max. Negotiated Rate	$863.22
Rate for Payer: Aetna Commercial	$70.83
Rate for Payer: Aetna Medicare Advantage	$84.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.46
Rate for Payer: Cigna Medicare Advantage	$26.04
Rate for Payer: Clover Medicare Advantage	$24.74
Rate for Payer: EmblemHealth Commercial	$78.12
Rate for Payer: Humana Medicare Advantage	$26.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$863.22
Rate for Payer: Qualcare PPO/HMO/WC	$535.05
Rate for Payer: UnitedHealthcare Community & State	$112.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.04
Rate for Payer: Wellcare Medicare Advantage	$26.04
Rate for Payer: Wellpoint Medicaid Managed Care	$101.30

INFLIXIMAB-DYYB 100MG VIAL

Facility

$3,567.01

Service Code	HCPCS Q5103
Hospital Charge Code	606390259
Hospital Revenue Code	636
Min. Negotiated Rate	$535.05
Max. Negotiated Rate	$863.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$863.22
Rate for Payer: Qualcare PPO/HMO/WC	$535.05

INFLIXIMAB LEVEL FOR IBD

Facility

$250.00

Service Code	HCPCS 80230
Hospital Charge Code	401180230
Hospital Revenue Code	301
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

INFLIXIMAB LEVEL FOR IBD

Facility

$250.00

Service Code	HCPCS 80230
Hospital Charge Code	401180230
Hospital Revenue Code	301
Min. Negotiated Rate	$7.10
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$104.91
Rate for Payer: Aetna Medicare Advantage	$124.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$139.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$139.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$38.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$139.91
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: Cigna Medicare Advantage	$38.57
Rate for Payer: Clover Medicare Advantage	$36.64
Rate for Payer: EmblemHealth Commercial	$115.71
Rate for Payer: Humana Medicare Advantage	$39.73
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$38.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.00
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$30.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$38.57
Rate for Payer: Wellcare Medicare Advantage	$38.57
Rate for Payer: Wellpoint Medicaid Managed Care	$7.10

INFLOW & OUTFLOW TUBING

Facility

$6,250.00

Hospital Charge Code	270662954
Hospital Revenue Code	270
Min. Negotiated Rate	$177.50
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,625.00
Rate for Payer: Oxford Commercial	$1,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Commercial	$1,250.00
Rate for Payer: UnitedHealthcare Community & State	$197.50
Rate for Payer: Wellpoint Medicaid Managed Care	$177.50

INFLOW & OUTFLOW TUBING

Facility

$6,250.00

Hospital Charge Code	270662954
Hospital Revenue Code	270
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$937.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

INFLOW TUBING

Facility

$630.00

Hospital Charge Code	270666124
Hospital Revenue Code	270
Min. Negotiated Rate	$94.50
Max. Negotiated Rate	$94.50
Rate for Payer: Qualcare PPO/HMO/WC	$94.50

INFLOW TUBING

Facility

$630.00

Hospital Charge Code	270666124
Hospital Revenue Code	270
Min. Negotiated Rate	$17.89
Max. Negotiated Rate	$315.00
Rate for Payer: Aetna Commercial	$239.40
Rate for Payer: Aetna Medicare Advantage	$189.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.65
Rate for Payer: Cigna Commercial	$315.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.80
Rate for Payer: Oxford Commercial	$126.00
Rate for Payer: Qualcare PPO/HMO/WC	$94.50
Rate for Payer: UnitedHealthcare Commercial	$126.00
Rate for Payer: UnitedHealthcare Community & State	$19.91
Rate for Payer: Wellpoint Medicaid Managed Care	$17.89

Know your out-of-pocket cost for care.

All Charges