Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

INFLU A AND B RNA PCR

Facility

$584.80

Service Code	HCPCS 87502
Hospital Charge Code	39900297
Hospital Revenue Code	306
Min. Negotiated Rate	$87.72
Max. Negotiated Rate	$87.72
Rate for Payer: Qualcare PPO/HMO/WC	$87.72

INFLU A AND B RNA PCR

Facility

$584.80

Service Code	HCPCS 87502
Hospital Charge Code	39900297
Hospital Revenue Code	306
Min. Negotiated Rate	$16.61
Max. Negotiated Rate	$347.51
Rate for Payer: Aetna Commercial	$260.58
Rate for Payer: Aetna Medicare Advantage	$310.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$347.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$347.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$95.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$347.51
Rate for Payer: Cigna Commercial	$292.40
Rate for Payer: Cigna Medicare Advantage	$95.80
Rate for Payer: Clover Medicare Advantage	$91.01
Rate for Payer: EmblemHealth Commercial	$287.40
Rate for Payer: Humana Medicare Advantage	$98.67
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$95.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.05
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.72
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$76.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$95.80
Rate for Payer: Wellcare Medicare Advantage	$95.80
Rate for Payer: Wellpoint Medicaid Managed Care	$16.61

INFLUENZA A/B/RSV RNA QL RTPCR

Facility

$791.90

Service Code	HCPCS 87631
Hospital Charge Code	401391989
Hospital Revenue Code	306
Min. Negotiated Rate	$118.78
Max. Negotiated Rate	$118.78
Rate for Payer: Qualcare PPO/HMO/WC	$118.78

INFLUENZA A/B/RSV RNA QL RTPCR

Facility

$791.90

Service Code	HCPCS 87631
Hospital Charge Code	401391989
Hospital Revenue Code	306
Min. Negotiated Rate	$22.49
Max. Negotiated Rate	$517.39
Rate for Payer: Aetna Commercial	$387.95
Rate for Payer: Aetna Medicare Advantage	$462.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$517.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$517.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$142.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$279.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$517.39
Rate for Payer: Cigna Commercial	$395.95
Rate for Payer: Cigna Medicare Advantage	$142.63
Rate for Payer: Clover Medicare Advantage	$135.50
Rate for Payer: EmblemHealth Commercial	$427.89
Rate for Payer: Humana Medicare Advantage	$146.91
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$142.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.89
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$118.78
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$114.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$142.63
Rate for Payer: Wellcare Medicare Advantage	$142.63
Rate for Payer: Wellpoint Medicaid Managed Care	$22.49

INFLUENZA AB,TYPE A & B I

Facility

$390.00

Service Code	HCPCS 8671091
Hospital Charge Code	39990041A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

INFLUENZA AB,TYPE A & B I

Facility

$390.00

Service Code	HCPCS 8671091
Hospital Charge Code	39990041A
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

INFLUENZA AB,TYPE A & B II

Facility

$390.00

Service Code	HCPCS 8671091
Hospital Charge Code	39990041B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

INFLUENZA AB,TYPE A & B II

Facility

$390.00

Service Code	HCPCS 8671091
Hospital Charge Code	39990041B
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

INFLUENZA ANTIGENT

Facility

$142.00

Service Code	HCPCS 86710
Hospital Charge Code	38476205
Hospital Revenue Code	302
Min. Negotiated Rate	$4.03
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$36.86
Rate for Payer: Aetna Medicare Advantage	$43.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.15
Rate for Payer: Cigna Commercial	$71.00
Rate for Payer: Cigna Medicare Advantage	$13.55
Rate for Payer: Clover Medicare Advantage	$12.87
Rate for Payer: EmblemHealth Commercial	$40.65
Rate for Payer: Humana Medicare Advantage	$13.96
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.92
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.30
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.84
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.55
Rate for Payer: Wellcare Medicare Advantage	$13.55
Rate for Payer: Wellpoint Medicaid Managed Care	$4.03

INFLUENZA ANTIGENT

Facility

$142.00

Service Code	HCPCS 86710
Hospital Charge Code	38476205
Hospital Revenue Code	302
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$21.30
Rate for Payer: Qualcare PPO/HMO/WC	$21.30

INFLUENZA B

Facility

$142.00

Service Code	HCPCS 86710
Hospital Charge Code	38479063
Hospital Revenue Code	302
Min. Negotiated Rate	$4.03
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$36.86
Rate for Payer: Aetna Medicare Advantage	$43.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.15
Rate for Payer: Cigna Commercial	$71.00
Rate for Payer: Cigna Medicare Advantage	$13.55
Rate for Payer: Clover Medicare Advantage	$12.87
Rate for Payer: EmblemHealth Commercial	$40.65
Rate for Payer: Humana Medicare Advantage	$13.96
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.92
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.30
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.84
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.55
Rate for Payer: Wellcare Medicare Advantage	$13.55
Rate for Payer: Wellpoint Medicaid Managed Care	$4.03

INFLUENZA B

Facility

$142.00

Service Code	HCPCS 86710
Hospital Charge Code	38479063
Hospital Revenue Code	302
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$21.30
Rate for Payer: Qualcare PPO/HMO/WC	$21.30

INFLUENZA TRIVALENT(A&B) 0.5ML

Facility

$59.97

Service Code	HCPCS 90656
Hospital Charge Code	60629317
Hospital Revenue Code	636
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$14.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.51
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

INFLUENZA TRIVALENT(A&B) 0.5ML

Facility

$59.97

Service Code	HCPCS 90656
Hospital Charge Code	60629317
Hospital Revenue Code	636
Min. Negotiated Rate	$1.70
Max. Negotiated Rate	$29.98
Rate for Payer: Aetna Commercial	$22.79
Rate for Payer: Aetna Medicare Advantage	$17.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.29
Rate for Payer: Cigna Commercial	$29.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.51
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Community & State	$1.90
Rate for Payer: Wellpoint Medicaid Managed Care	$1.70

INFLUENZA TYPE A/B RNA, RT-PCR

Facility

$479.00

Service Code	HCPCS 87502
Hospital Charge Code	401387502
Hospital Revenue Code	306
Min. Negotiated Rate	$13.60
Max. Negotiated Rate	$347.51
Rate for Payer: Aetna Commercial	$260.58
Rate for Payer: Aetna Medicare Advantage	$310.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$347.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$347.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$95.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$347.51
Rate for Payer: Cigna Commercial	$239.50
Rate for Payer: Cigna Medicare Advantage	$95.80
Rate for Payer: Clover Medicare Advantage	$91.01
Rate for Payer: EmblemHealth Commercial	$287.40
Rate for Payer: Humana Medicare Advantage	$98.67
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$95.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.54
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$71.85
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$76.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$95.80
Rate for Payer: Wellcare Medicare Advantage	$95.80
Rate for Payer: Wellpoint Medicaid Managed Care	$13.60

INFLUENZA TYPE A/B RNA, RT-PCR

Facility

$479.00

Service Code	HCPCS 87502
Hospital Charge Code	401387502
Hospital Revenue Code	306
Min. Negotiated Rate	$71.85
Max. Negotiated Rate	$71.85
Rate for Payer: Qualcare PPO/HMO/WC	$71.85

INFLUENZA VA PRESERVAT FREE

Facility

$107.20

Service Code	HCPCS 90656
Hospital Charge Code	83652311
Hospital Revenue Code	636
Min. Negotiated Rate	$3.04
Max. Negotiated Rate	$53.60
Rate for Payer: Aetna Commercial	$40.74
Rate for Payer: Aetna Medicare Advantage	$32.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.34
Rate for Payer: Cigna Commercial	$53.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.94
Rate for Payer: Qualcare PPO/HMO/WC	$16.08
Rate for Payer: UnitedHealthcare Community & State	$3.39
Rate for Payer: Wellpoint Medicaid Managed Care	$3.04

INFLUENZA VA PRESERVAT FREE

Facility

$107.20

Service Code	HCPCS 90656
Hospital Charge Code	83652311
Hospital Revenue Code	636
Min. Negotiated Rate	$16.08
Max. Negotiated Rate	$25.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.94
Rate for Payer: Qualcare PPO/HMO/WC	$16.08

INFLUENZA VC-NO PRE <3YR

Facility

$76.92

Service Code	HCPCS 90655
Hospital Charge Code	83652603
Hospital Revenue Code	636
Min. Negotiated Rate	$11.54
Max. Negotiated Rate	$18.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.61
Rate for Payer: Qualcare PPO/HMO/WC	$11.54

INFLUENZA VC-NO PRE <3YR

Facility

$76.92

Service Code	HCPCS 90655
Hospital Charge Code	83652603
Hospital Revenue Code	636
Min. Negotiated Rate	$2.18
Max. Negotiated Rate	$38.46
Rate for Payer: Aetna Commercial	$29.23
Rate for Payer: Aetna Medicare Advantage	$23.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.61
Rate for Payer: Cigna Commercial	$38.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.61
Rate for Payer: Qualcare PPO/HMO/WC	$11.54
Rate for Payer: UnitedHealthcare Community & State	$2.43
Rate for Payer: Wellpoint Medicaid Managed Care	$2.18

INFLUENZA VIRUS VACC/5ML

Facility

$99.36

Service Code	HCPCS Q2035
Hospital Charge Code	60634525
Hospital Revenue Code	636
Min. Negotiated Rate	$14.90
Max. Negotiated Rate	$24.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.05
Rate for Payer: Qualcare PPO/HMO/WC	$14.90

INFLUENZA VIRUS VACC/5ML

Facility

$99.36

Service Code	HCPCS Q2035
Hospital Charge Code	60634525
Hospital Revenue Code	636
Min. Negotiated Rate	$2.82
Max. Negotiated Rate	$49.68
Rate for Payer: Aetna Commercial	$37.76
Rate for Payer: Aetna Medicare Advantage	$29.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.34
Rate for Payer: Cigna Commercial	$49.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.05
Rate for Payer: Qualcare PPO/HMO/WC	$14.90
Rate for Payer: UnitedHealthcare Community & State	$3.14
Rate for Payer: Wellpoint Medicaid Managed Care	$2.82

INFLUX DEMIN CORTICAL BONE FIB

Facility

$1,865.00

Service Code	HCPCS C1762
Hospital Charge Code	270703817
Hospital Revenue Code	278
Min. Negotiated Rate	$52.97
Max. Negotiated Rate	$932.50
Rate for Payer: Aetna Commercial	$708.70
Rate for Payer: Aetna Medicare Advantage	$559.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$475.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$475.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$373.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$475.57
Rate for Payer: Cigna Commercial	$932.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$451.33
Rate for Payer: Qualcare PPO/HMO/WC	$279.75
Rate for Payer: UnitedHealthcare Community & State	$58.93
Rate for Payer: Wellpoint Medicaid Managed Care	$52.97

INFLUX DEMIN CORTICAL BONE FIB

Facility

$1,865.00

Service Code	HCPCS C1762
Hospital Charge Code	270703817
Hospital Revenue Code	278
Min. Negotiated Rate	$279.75
Max. Negotiated Rate	$451.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$373.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$451.33
Rate for Payer: Qualcare PPO/HMO/WC	$279.75

INFLUX DEMINERALIZED CORTICAL

Facility

$6,430.00

Service Code	HCPCS C1765
Hospital Charge Code	270703847
Hospital Revenue Code	278
Min. Negotiated Rate	$182.61
Max. Negotiated Rate	$3,215.00
Rate for Payer: Aetna Commercial	$2,443.40
Rate for Payer: Aetna Medicare Advantage	$1,929.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,639.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,639.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,286.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,639.65
Rate for Payer: Cigna Commercial	$3,215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,556.06
Rate for Payer: Qualcare PPO/HMO/WC	$964.50
Rate for Payer: UnitedHealthcare Community & State	$203.19
Rate for Payer: Wellpoint Medicaid Managed Care	$182.61

Know your out-of-pocket cost for care.

All Charges