Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

APLIGRAF 7.5CM

Facility

$6,475.00

Service Code	HCPCS Q4101
Hospital Charge Code	270619908
Hospital Revenue Code	636
Min. Negotiated Rate	$971.25
Max. Negotiated Rate	$1,566.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,566.95
Rate for Payer: Qualcare PPO/HMO/WC	$971.25

APLIGRAFT (SKIN GRAFT) IMPLANT

Facility

$6,263.00

Hospital Charge Code	270339427
Hospital Revenue Code	636
Min. Negotiated Rate	$939.45
Max. Negotiated Rate	$1,515.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,515.65
Rate for Payer: Qualcare PPO/HMO/WC	$939.45

APLIGRAFT (SKIN GRAFT) IMPLANT

Facility

$6,263.00

Hospital Charge Code	270339427
Hospital Revenue Code	636
Min. Negotiated Rate	$177.87
Max. Negotiated Rate	$3,131.50
Rate for Payer: Aetna Commercial	$2,379.94
Rate for Payer: Aetna Medicare Advantage	$1,878.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,597.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,597.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,597.07
Rate for Payer: Cigna Commercial	$3,131.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,515.65
Rate for Payer: Qualcare PPO/HMO/WC	$939.45
Rate for Payer: UnitedHealthcare Community & State	$197.91
Rate for Payer: Wellpoint Medicaid Managed Care	$177.87

APLIGRAFT (SKIN GRAFT)IMPLANT

Facility

$7,170.00

Hospital Charge Code	270335484
Hospital Revenue Code	636
Min. Negotiated Rate	$203.63
Max. Negotiated Rate	$3,585.00
Rate for Payer: Aetna Commercial	$2,724.60
Rate for Payer: Aetna Medicare Advantage	$2,151.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,828.35
Rate for Payer: Cigna Commercial	$3,585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50
Rate for Payer: UnitedHealthcare Community & State	$226.57
Rate for Payer: Wellpoint Medicaid Managed Care	$203.63

APLIGRAFT (SKIN GRAFT)IMPLANT

Facility

$7,170.00

Hospital Charge Code	270335484
Hospital Revenue Code	636
Min. Negotiated Rate	$1,075.50
Max. Negotiated Rate	$1,735.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50

APLIGRAFT TISSUE 199

Facility

$11,083.30

Service Code	HCPCS Q4101
Hospital Charge Code	270655637
Hospital Revenue Code	636
Min. Negotiated Rate	$1,662.49
Max. Negotiated Rate	$2,682.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,682.16
Rate for Payer: Qualcare PPO/HMO/WC	$1,662.49

APLIGRAFT TISSUE 199

Facility

$11,083.30

Service Code	HCPCS Q4101
Hospital Charge Code	270655637
Hospital Revenue Code	636
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$2,682.16
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$536.29
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,682.16
Rate for Payer: Qualcare PPO/HMO/WC	$1,662.49
Rate for Payer: UnitedHealthcare Community & State	$350.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$314.77

APLISOL 5TU 10 TEST VIAL PPD

Facility

$4.00

Hospital Charge Code	83652623
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

APLISOL 5TU 10 TEST VIAL PPD

Facility

$4.00

Hospital Charge Code	83652549
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

APLISOL 5TU 10 TEST VIAL PPD

Facility

$4.00

Hospital Charge Code	83652549
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

APLISOL 5TU 10 TEST VIAL PPD

Facility

$4.00

Hospital Charge Code	83652623
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

APLY BNE FIXATION DEVC>1 PLANE

Facility

$30,595.00

Service Code	HCPCS 20692
Hospital Charge Code	1600000412
Hospital Revenue Code	360
Min. Negotiated Rate	$4,589.25
Max. Negotiated Rate	$4,589.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25

APLY BNE FIXATION DEVC>1 PLANE

Facility

$30,595.00

Service Code	HCPCS 20692
Hospital Charge Code	1600000412
Hospital Revenue Code	360
Min. Negotiated Rate	$966.80
Max. Negotiated Rate	$55,329.13
Rate for Payer: Aetna Commercial	$41,487.32
Rate for Payer: Aetna Medicare Advantage	$49,418.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55,329.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55,329.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,252.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55,329.13
Rate for Payer: Cigna Commercial	$30,573.98
Rate for Payer: Cigna Medicare Advantage	$15,252.69
Rate for Payer: Clover Medicare Advantage	$14,490.06
Rate for Payer: EmblemHealth Commercial	$45,758.07
Rate for Payer: Humana Medicare Advantage	$15,710.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,252.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,954.70
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$966.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,252.69
Rate for Payer: Wellcare Medicare Advantage	$15,252.69
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$34,593.91
Rate for Payer: Wellpoint Medicaid Managed Care	$33,915.60

APLY BNE FIXATION DEVC 1PLANE

Facility

$30,595.00

Service Code	HCPCS 20690
Hospital Charge Code	16000372
Hospital Revenue Code	360
Min. Negotiated Rate	$966.80
Max. Negotiated Rate	$31,271.12
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,271.12
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,954.70
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$966.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$15,880.57
Rate for Payer: Wellpoint Medicaid Managed Care	$15,569.19

APLY BNE FIXATION DEVC 1PLANE

Facility

$30,595.00

Service Code	HCPCS 20690
Hospital Charge Code	16000372
Hospital Revenue Code	360
Min. Negotiated Rate	$4,589.25
Max. Negotiated Rate	$4,589.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25

APLY SPINE PROSTH DEVICE

Facility

$23,774.45

Service Code	HCPCS 22853
Hospital Charge Code	16000242
Hospital Revenue Code	360
Min. Negotiated Rate	$751.27
Max. Negotiated Rate	$11,887.23
Rate for Payer: Aetna Commercial	$9,034.29
Rate for Payer: Aetna Medicare Advantage	$7,132.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,062.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,062.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,062.48
Rate for Payer: Cigna Commercial	$11,887.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,181.36
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,566.17
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$751.27

APLY SPINE PROSTH DEVICE

Facility

$23,774.45

Service Code	HCPCS 22853
Hospital Charge Code	16000242
Hospital Revenue Code	360
Min. Negotiated Rate	$3,566.17
Max. Negotiated Rate	$3,566.17
Rate for Payer: Qualcare PPO/HMO/WC	$3,566.17

APO E GENOTYPE

Facility

$429.00

Service Code	HCPCS 83890
Hospital Charge Code	38472935
Hospital Revenue Code	301
Min. Negotiated Rate	$64.35
Max. Negotiated Rate	$64.35
Rate for Payer: Qualcare PPO/HMO/WC	$64.35

APO E GENOTYPE

Facility

$429.00

Service Code	HCPCS 83890
Hospital Charge Code	38472935
Hospital Revenue Code	301
Min. Negotiated Rate	$12.18
Max. Negotiated Rate	$214.50
Rate for Payer: Aetna Commercial	$163.02
Rate for Payer: Aetna Medicare Advantage	$128.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.39
Rate for Payer: Cigna Commercial	$214.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.54
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$64.35
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.56
Rate for Payer: Wellpoint Medicaid Managed Care	$12.18

APOLIPOPROTEIN A-1

Facility

$109.00

Service Code	HCPCS 82172
Hospital Charge Code	38479459
Hospital Revenue Code	301
Min. Negotiated Rate	$3.10
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$57.36
Rate for Payer: Aetna Medicare Advantage	$68.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$54.50
Rate for Payer: Cigna Medicare Advantage	$21.09
Rate for Payer: Clover Medicare Advantage	$20.04
Rate for Payer: EmblemHealth Commercial	$63.27
Rate for Payer: Humana Medicare Advantage	$21.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.34
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.35
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.09
Rate for Payer: Wellcare Medicare Advantage	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$3.10

APOLIPOPROTEIN A-1

Facility

$109.00

Service Code	HCPCS 82172
Hospital Charge Code	38479459
Hospital Revenue Code	301
Min. Negotiated Rate	$16.35
Max. Negotiated Rate	$16.35
Rate for Payer: Qualcare PPO/HMO/WC	$16.35

APOLIPOPROTEIN A-1

Facility

$106.50

Service Code	HCPCS 82172
Hospital Charge Code	39900044
Hospital Revenue Code	301
Min. Negotiated Rate	$3.02
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$57.36
Rate for Payer: Aetna Medicare Advantage	$68.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$53.25
Rate for Payer: Cigna Medicare Advantage	$21.09
Rate for Payer: Clover Medicare Advantage	$20.04
Rate for Payer: EmblemHealth Commercial	$63.27
Rate for Payer: Humana Medicare Advantage	$21.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.69
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.97
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.09
Rate for Payer: Wellcare Medicare Advantage	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$3.02

APOLIPOPROTEIN A-1

Facility

$109.00

Service Code	HCPCS 82172
Hospital Charge Code	38472019
Hospital Revenue Code	301
Min. Negotiated Rate	$16.35
Max. Negotiated Rate	$16.35
Rate for Payer: Qualcare PPO/HMO/WC	$16.35

APOLIPOPROTEIN A-1

Facility

$109.00

Service Code	HCPCS 82172
Hospital Charge Code	38472019
Hospital Revenue Code	301
Min. Negotiated Rate	$3.10
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$57.36
Rate for Payer: Aetna Medicare Advantage	$68.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$54.50
Rate for Payer: Cigna Medicare Advantage	$21.09
Rate for Payer: Clover Medicare Advantage	$20.04
Rate for Payer: EmblemHealth Commercial	$63.27
Rate for Payer: Humana Medicare Advantage	$21.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.34
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.35
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.09
Rate for Payer: Wellcare Medicare Advantage	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$3.10

APOLIPOPROTEIN A-1

Facility

$106.50

Service Code	HCPCS 82172
Hospital Charge Code	39900044
Hospital Revenue Code	301
Min. Negotiated Rate	$15.97
Max. Negotiated Rate	$15.97
Rate for Payer: Qualcare PPO/HMO/WC	$15.97

Know your out-of-pocket cost for care.

All Charges