Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	1600525
Hospital Revenue Code	260
Min. Negotiated Rate	$50.89
Max. Negotiated Rate	$50.89
Rate for Payer: Qualcare PPO/HMO/WC	$50.89

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	1600525
Hospital Revenue Code	260
Min. Negotiated Rate	$8.84
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$128.91
Rate for Payer: Aetna Medicare Advantage	$101.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.51
Rate for Payer: Cigna Commercial	$169.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.20
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.89
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$10.72
Rate for Payer: Wellpoint Medicaid Managed Care	$9.63

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	100116
Hospital Revenue Code	260
Min. Negotiated Rate	$8.84
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$128.91
Rate for Payer: Aetna Medicare Advantage	$101.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.51
Rate for Payer: Cigna Commercial	$169.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.20
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.89
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$10.72
Rate for Payer: Wellpoint Medicaid Managed Care	$9.63

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	1500106
Hospital Revenue Code	260
Min. Negotiated Rate	$50.89
Max. Negotiated Rate	$50.89
Rate for Payer: Qualcare PPO/HMO/WC	$50.89

IV PUSH EA ADDL DRUG SAME

Facility

$2,800.00

Service Code	HCPCS 96375
Hospital Charge Code	321796376
Hospital Revenue Code	260
Min. Negotiated Rate	$52.85
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$151.31
Rate for Payer: Aetna Medicare Advantage	$180.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$55.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.80
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: Cigna Medicare Advantage	$55.63
Rate for Payer: Clover Medicare Advantage	$52.85
Rate for Payer: EmblemHealth Commercial	$166.89
Rate for Payer: Humana Medicare Advantage	$57.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$55.63
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	$55.63
Rate for Payer: Wellcare Medicare Advantage	$55.63
Rate for Payer: Wellpoint Medicaid Managed Care	$79.52

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	3400260
Hospital Revenue Code	260
Min. Negotiated Rate	$50.89
Max. Negotiated Rate	$50.89
Rate for Payer: Qualcare PPO/HMO/WC	$50.89

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	2400614
Hospital Revenue Code	260
Min. Negotiated Rate	$50.89
Max. Negotiated Rate	$50.89
Rate for Payer: Qualcare PPO/HMO/WC	$50.89

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	411096376
Hospital Revenue Code	260
Min. Negotiated Rate	$50.89
Max. Negotiated Rate	$50.89
Rate for Payer: Qualcare PPO/HMO/WC	$50.89

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	73190113
Hospital Revenue Code	260
Min. Negotiated Rate	$50.89
Max. Negotiated Rate	$50.89
Rate for Payer: Qualcare PPO/HMO/WC	$50.89

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	100116
Hospital Revenue Code	260
Min. Negotiated Rate	$50.89
Max. Negotiated Rate	$50.89
Rate for Payer: Qualcare PPO/HMO/WC	$50.89

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	93500077
Hospital Revenue Code	260
Min. Negotiated Rate	$8.84
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$128.91
Rate for Payer: Aetna Medicare Advantage	$101.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.51
Rate for Payer: Cigna Commercial	$169.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.20
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.89
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$10.72
Rate for Payer: Wellpoint Medicaid Managed Care	$9.63

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	1500106
Hospital Revenue Code	260
Min. Negotiated Rate	$8.84
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$128.91
Rate for Payer: Aetna Medicare Advantage	$101.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.51
Rate for Payer: Cigna Commercial	$169.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.20
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.89
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$10.72
Rate for Payer: Wellpoint Medicaid Managed Care	$9.63

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	73237027
Hospital Revenue Code	260
Min. Negotiated Rate	$8.84
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$128.91
Rate for Payer: Aetna Medicare Advantage	$101.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.51
Rate for Payer: Cigna Commercial	$169.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.20
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.89
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$10.72
Rate for Payer: Wellpoint Medicaid Managed Care	$9.63

IV PUSH EA ADDL DRUG SAME

Facility

$440.91

Service Code	HCPCS 96376
Hospital Charge Code	395096376
Hospital Revenue Code	260
Min. Negotiated Rate	$8.84
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$167.55
Rate for Payer: Aetna Medicare Advantage	$132.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.43
Rate for Payer: Cigna Commercial	$220.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.64
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.14
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$13.93
Rate for Payer: Wellpoint Medicaid Managed Care	$12.52

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	411096376
Hospital Revenue Code	260
Min. Negotiated Rate	$8.84
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$128.91
Rate for Payer: Aetna Medicare Advantage	$101.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.51
Rate for Payer: Cigna Commercial	$169.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.20
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.89
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$10.72
Rate for Payer: Wellpoint Medicaid Managed Care	$9.63

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	270339106
Hospital Revenue Code	260
Min. Negotiated Rate	$8.84
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$128.91
Rate for Payer: Aetna Medicare Advantage	$101.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.51
Rate for Payer: Cigna Commercial	$169.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.20
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.89
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$10.72
Rate for Payer: Wellpoint Medicaid Managed Care	$9.63

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	2300907
Hospital Revenue Code	260
Min. Negotiated Rate	$8.84
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$128.91
Rate for Payer: Aetna Medicare Advantage	$101.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.51
Rate for Payer: Cigna Commercial	$169.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.20
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.89
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$10.72
Rate for Payer: Wellpoint Medicaid Managed Care	$9.63

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	2250413
Hospital Revenue Code	260
Min. Negotiated Rate	$8.84
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$128.91
Rate for Payer: Aetna Medicare Advantage	$101.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.51
Rate for Payer: Cigna Commercial	$169.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.20
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.89
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$10.72
Rate for Payer: Wellpoint Medicaid Managed Care	$9.63

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	93500077
Hospital Revenue Code	260
Min. Negotiated Rate	$50.89
Max. Negotiated Rate	$50.89
Rate for Payer: Qualcare PPO/HMO/WC	$50.89

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	4501034
Hospital Revenue Code	260
Min. Negotiated Rate	$50.89
Max. Negotiated Rate	$50.89
Rate for Payer: Qualcare PPO/HMO/WC	$50.89

IV PUSH EA ADDL DRUG SAME

Facility

$633.74

Service Code	HCPCS 96376
Hospital Charge Code	5700444
Hospital Revenue Code	450
Min. Negotiated Rate	$95.06
Max. Negotiated Rate	$95.06
Rate for Payer: Qualcare PPO/HMO/WC	$95.06

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	2300907
Hospital Revenue Code	260
Min. Negotiated Rate	$50.89
Max. Negotiated Rate	$50.89
Rate for Payer: Qualcare PPO/HMO/WC	$50.89

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	3400260
Hospital Revenue Code	260
Min. Negotiated Rate	$8.84
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$128.91
Rate for Payer: Aetna Medicare Advantage	$101.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.51
Rate for Payer: Cigna Commercial	$169.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.20
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.89
Rate for Payer: UnitedHealthcare Commercial	$1,235.00
Rate for Payer: UnitedHealthcare Community & State	$10.72
Rate for Payer: Wellpoint Medicaid Managed Care	$9.63

IV PUSH EA ADDL DRUG SAME

Facility

$633.74

Service Code	HCPCS 96376
Hospital Charge Code	5700444
Hospital Revenue Code	450
Min. Negotiated Rate	$8.84
Max. Negotiated Rate	$316.87
Rate for Payer: Aetna Commercial	$240.82
Rate for Payer: Aetna Medicare Advantage	$190.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.60
Rate for Payer: Cigna Commercial	$316.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.77
Rate for Payer: Qualcare PPO/HMO/WC	$95.06
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$18.00

IV PUSH EA ADDL DRUG SAME

Facility

$339.24

Service Code	HCPCS 96376
Hospital Charge Code	5700258
Hospital Revenue Code	260
Min. Negotiated Rate	$50.89
Max. Negotiated Rate	$50.89
Rate for Payer: Qualcare PPO/HMO/WC	$50.89

Know your out-of-pocket cost for care.

All Charges