Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

INFLUX DEMINERALIZED CORTICAL

Facility

$910.00

Hospital Charge Code	270703472
Hospital Revenue Code	278
Min. Negotiated Rate	$136.50
Max. Negotiated Rate	$220.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.22
Rate for Payer: Qualcare PPO/HMO/WC	$136.50

INFLUX DEMINERALIZED CORTICAL

Facility

$6,430.00

Service Code	HCPCS C1765
Hospital Charge Code	270703847
Hospital Revenue Code	278
Min. Negotiated Rate	$964.50
Max. Negotiated Rate	$1,556.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,286.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,556.06
Rate for Payer: Qualcare PPO/HMO/WC	$964.50

INFLUX DEMINERALIZED CORTICAL

Facility

$910.00

Hospital Charge Code	270703472
Hospital Revenue Code	278
Min. Negotiated Rate	$25.84
Max. Negotiated Rate	$455.00
Rate for Payer: Aetna Commercial	$345.80
Rate for Payer: Aetna Medicare Advantage	$273.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$232.05
Rate for Payer: Cigna Commercial	$455.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.22
Rate for Payer: Qualcare PPO/HMO/WC	$136.50
Rate for Payer: UnitedHealthcare Community & State	$28.76
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

INFLUX PROTEIOS XL

Facility

$14,725.00

Service Code	HCPCS C1889
Hospital Charge Code	270704461
Hospital Revenue Code	278
Min. Negotiated Rate	$418.19
Max. Negotiated Rate	$7,362.50
Rate for Payer: Aetna Commercial	$5,595.50
Rate for Payer: Aetna Medicare Advantage	$4,417.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,754.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,754.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,945.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,754.88
Rate for Payer: Cigna Commercial	$7,362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,563.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,208.75
Rate for Payer: UnitedHealthcare Community & State	$465.31
Rate for Payer: Wellpoint Medicaid Managed Care	$418.19

INFLUX PROTEIOS XL

Facility

$14,725.00

Service Code	HCPCS C1889
Hospital Charge Code	270704461
Hospital Revenue Code	278
Min. Negotiated Rate	$2,208.75
Max. Negotiated Rate	$3,563.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,945.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,563.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,208.75

INFLUX SPARC 5CC

Facility

$9,750.00

Service Code	HCPCS C1765
Hospital Charge Code	270705849
Hospital Revenue Code	278
Min. Negotiated Rate	$1,462.50
Max. Negotiated Rate	$2,359.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,359.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.50

INFLUX SPARC 5CC

Facility

$9,750.00

Service Code	HCPCS C1765
Hospital Charge Code	270705849
Hospital Revenue Code	278
Min. Negotiated Rate	$276.90
Max. Negotiated Rate	$4,875.00
Rate for Payer: Aetna Commercial	$3,705.00
Rate for Payer: Aetna Medicare Advantage	$2,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,486.25
Rate for Payer: Cigna Commercial	$4,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,359.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.50
Rate for Payer: UnitedHealthcare Community & State	$308.10
Rate for Payer: Wellpoint Medicaid Managed Care	$276.90

INF THERAP DIFF DRUG 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96367
Hospital Charge Code	395096367
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

INF THERAP DIFF DRUG 1ST HR

Facility

$1,610.84

Service Code	HCPCS 96367
Hospital Charge Code	73050925
Hospital Revenue Code	260
Min. Negotiated Rate	$241.63
Max. Negotiated Rate	$241.63
Rate for Payer: Qualcare PPO/HMO/WC	$241.63

INF THERAP DIFF DRUG 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96367
Hospital Charge Code	93500045
Hospital Revenue Code	260
Min. Negotiated Rate	$19.80
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$310.30
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
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: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$79.52

INF THERAP DIFF DRUG 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96367
Hospital Charge Code	93500045
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

INF THERAP DIFF DRUG 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96367
Hospital Charge Code	3401041
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

INF THERAP DIFF DRUG 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96367
Hospital Charge Code	270339105
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

INF THERAP DIFF DRUG 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96367
Hospital Charge Code	3401070
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

INF THERAP DIFF DRUG 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96367
Hospital Charge Code	3401070
Hospital Revenue Code	260
Min. Negotiated Rate	$19.80
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$310.30
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
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: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$79.52

INF THERAP DIFF DRUG 1ST HR

Facility

$1,610.84

Service Code	HCPCS 96367
Hospital Charge Code	74308245
Hospital Revenue Code	260
Min. Negotiated Rate	$19.80
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$310.30
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$418.82
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$241.63
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$50.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$45.75

INF THERAP DIFF DRUG 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96367
Hospital Charge Code	395096367
Hospital Revenue Code	260
Min. Negotiated Rate	$19.80
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$310.30
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
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: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$79.52

INF THERAP DIFF DRUG 1ST HR

Facility

$1,610.84

Service Code	HCPCS 96367
Hospital Charge Code	73237023
Hospital Revenue Code	260
Min. Negotiated Rate	$241.63
Max. Negotiated Rate	$241.63
Rate for Payer: Qualcare PPO/HMO/WC	$241.63

INF THERAP DIFF DRUG 1ST HR

Facility

$1,610.84

Service Code	HCPCS 96367
Hospital Charge Code	73237023
Hospital Revenue Code	260
Min. Negotiated Rate	$19.80
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$310.30
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$418.82
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$241.63
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$50.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$45.75

INF THERAP DIFF DRUG 1ST HR

Facility

$1,610.84

Service Code	HCPCS 96367
Hospital Charge Code	74308245
Hospital Revenue Code	260
Min. Negotiated Rate	$241.63
Max. Negotiated Rate	$241.63
Rate for Payer: Qualcare PPO/HMO/WC	$241.63

INF THERAP DIFF DRUG 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96367
Hospital Charge Code	3401041
Hospital Revenue Code	260
Min. Negotiated Rate	$19.80
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$310.30
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
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: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$79.52

INF THERAP DIFF DRUG 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96367
Hospital Charge Code	73190099
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

INF THERAP DIFF DRUG 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96367
Hospital Charge Code	73190099
Hospital Revenue Code	260
Min. Negotiated Rate	$19.80
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$310.30
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
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: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$79.52

INF THERAP DIFF DRUG 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96367
Hospital Charge Code	270339105
Hospital Revenue Code	260
Min. Negotiated Rate	$19.80
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$310.30
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
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: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$79.52

INF THERAP DIFF DRUG 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96367
Hospital Charge Code	100128
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

Know your out-of-pocket cost for care.

All Charges