Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

LANG COMP GOAL STATUS

Facility

$0.01

Service Code	HCPCS G9160GN
Hospital Charge Code	84201163
Hospital Revenue Code	449
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

LANG COMP GOAL STATUS

Facility

$0.01

Service Code	HCPCS G9160GN
Hospital Charge Code	84201025
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

LANG EXPRESS CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G9162GN
Hospital Charge Code	84201035
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

LANG EXPRESS CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G9162GN
Hospital Charge Code	84201035
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

LANG EXPRESS CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G9162GN
Hospital Charge Code	84201165
Hospital Revenue Code	449
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

LANG EXPRESS CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G9162GN
Hospital Charge Code	84201165
Hospital Revenue Code	449
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

LANG EXPRESS D/C STATUS

Facility

$0.01

Service Code	HCPCS G9164GN
Hospital Charge Code	84201045
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

LANG EXPRESS D/C STATUS

Facility

$0.01

Service Code	HCPCS G9164GN
Hospital Charge Code	84201167
Hospital Revenue Code	449
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

LANG EXPRESS D/C STATUS

Facility

$0.01

Service Code	HCPCS G9164GN
Hospital Charge Code	84201045
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

LANG EXPRESS D/C STATUS

Facility

$0.01

Service Code	HCPCS G9164GN
Hospital Charge Code	84201167
Hospital Revenue Code	449
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

LANG EXPRESS GOAL STATUS

Facility

$0.01

Service Code	HCPCS G9163GN
Hospital Charge Code	84201040
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

LANG EXPRESS GOAL STATUS

Facility

$0.01

Service Code	HCPCS G9163GN
Hospital Charge Code	84201166
Hospital Revenue Code	449
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

LANG EXPRESS GOAL STATUS

Facility

$0.01

Service Code	HCPCS G9163GN
Hospital Charge Code	84201040
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

LANG EXPRESS GOAL STATUS

Facility

$0.01

Service Code	HCPCS G9163GN
Hospital Charge Code	84201166
Hospital Revenue Code	449
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

LANOXIN PEDIATRIC/0.1MG/1

Facility

$481.60

Service Code	NDC 70515026210
Hospital Charge Code	60633270
Hospital Revenue Code	250
Min. Negotiated Rate	$72.24
Max. Negotiated Rate	$72.24
Rate for Payer: Qualcare PPO/HMO/WC	$72.24

LANOXIN PEDIATRIC/0.1MG/1

Facility

$481.60

Service Code	NDC 70515026210
Hospital Charge Code	60633270
Hospital Revenue Code	250
Min. Negotiated Rate	$13.68
Max. Negotiated Rate	$240.80
Rate for Payer: Aetna Commercial	$183.01
Rate for Payer: Aetna Medicare Advantage	$144.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.81
Rate for Payer: Cigna Commercial	$240.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.22
Rate for Payer: Oxford Commercial	$96.32
Rate for Payer: Qualcare PPO/HMO/WC	$72.24
Rate for Payer: UnitedHealthcare Commercial	$96.32
Rate for Payer: UnitedHealthcare Community & State	$15.22
Rate for Payer: Wellpoint Medicaid Managed Care	$13.68

LANSINOH OINTMENT

Facility

$4.00

Service Code	NDC 12090000091
Hospital Charge Code	6063943123
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

LANSINOH OINTMENT

Facility

$4.00

Service Code	NDC 12090000091
Hospital Charge Code	6063943123
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

LANTHANUM CARBONATE1000MG CTAB

Facility

$75.17

Service Code	NDC 54092025490
Hospital Charge Code	60630028
Hospital Revenue Code	250
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$37.59
Rate for Payer: Aetna Commercial	$28.56
Rate for Payer: Aetna Medicare Advantage	$22.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.17
Rate for Payer: Cigna Commercial	$37.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.54
Rate for Payer: Oxford Commercial	$15.03
Rate for Payer: Qualcare PPO/HMO/WC	$11.28
Rate for Payer: UnitedHealthcare Commercial	$15.03
Rate for Payer: UnitedHealthcare Community & State	$2.38
Rate for Payer: Wellpoint Medicaid Managed Care	$2.13

LANTHANUM CARBONATE1000MG CTAB

Facility

$75.17

Service Code	NDC 54092025490
Hospital Charge Code	60630028
Hospital Revenue Code	250
Min. Negotiated Rate	$11.28
Max. Negotiated Rate	$11.28
Rate for Payer: Qualcare PPO/HMO/WC	$11.28

LANTHANUM CARBONATE 500MG CTAB

Facility

$75.17

Service Code	NDC 54092025290
Hospital Charge Code	60630026
Hospital Revenue Code	250
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$37.59
Rate for Payer: Aetna Commercial	$28.56
Rate for Payer: Aetna Medicare Advantage	$22.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.17
Rate for Payer: Cigna Commercial	$37.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.54
Rate for Payer: Oxford Commercial	$15.03
Rate for Payer: Qualcare PPO/HMO/WC	$11.28
Rate for Payer: UnitedHealthcare Commercial	$15.03
Rate for Payer: UnitedHealthcare Community & State	$2.38
Rate for Payer: Wellpoint Medicaid Managed Care	$2.13

LANTHANUM CARBONATE 500MG CTAB

Facility

$75.17

Service Code	NDC 54092025290
Hospital Charge Code	60630026
Hospital Revenue Code	250
Min. Negotiated Rate	$11.28
Max. Negotiated Rate	$11.28
Rate for Payer: Qualcare PPO/HMO/WC	$11.28

LANTUS INSULIN 10ML VIAL

Facility

$539.22

Service Code	HCPCS J1815
Hospital Charge Code	606390414
Hospital Revenue Code	636
Min. Negotiated Rate	$80.88
Max. Negotiated Rate	$130.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.49
Rate for Payer: Qualcare PPO/HMO/WC	$80.88

LANTUS INSULIN 10ML VIAL

Facility

$539.22

Service Code	HCPCS J1815
Hospital Charge Code	606390414
Hospital Revenue Code	636
Min. Negotiated Rate	$15.31
Max. Negotiated Rate	$269.61
Rate for Payer: Aetna Commercial	$204.90
Rate for Payer: Aetna Medicare Advantage	$161.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$137.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$137.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$137.50
Rate for Payer: Cigna Commercial	$269.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.49
Rate for Payer: Qualcare PPO/HMO/WC	$80.88
Rate for Payer: UnitedHealthcare Community & State	$17.04
Rate for Payer: Wellpoint Medicaid Managed Care	$15.31

LANTUS VIAL PER 50 UNITS

Facility

$4.00

Service Code	NDC 88222033
Hospital Charge Code	60632262
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

Know your out-of-pocket cost for care.

All Charges