Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

APPLIER LIGACLIP MED 20 MCM20

Facility

$258.58

Hospital Charge Code	270608750
Hospital Revenue Code	272
Min. Negotiated Rate	$38.79
Max. Negotiated Rate	$38.79
Rate for Payer: Qualcare PPO/HMO/WC	$38.79

APPLIER LIGACLIP MED 20 MCM20

Facility

$258.58

Hospital Charge Code	270608750
Hospital Revenue Code	272
Min. Negotiated Rate	$7.34
Max. Negotiated Rate	$129.29
Rate for Payer: Aetna Commercial	$98.26
Rate for Payer: Aetna Medicare Advantage	$77.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.94
Rate for Payer: Cigna Commercial	$129.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.23
Rate for Payer: Oxford Commercial	$51.72
Rate for Payer: Qualcare PPO/HMO/WC	$38.79
Rate for Payer: UnitedHealthcare Commercial	$51.72
Rate for Payer: UnitedHealthcare Community & State	$8.17
Rate for Payer: Wellpoint Medicaid Managed Care	$7.34

APPL MULTLAY COMPRS ARM/HAND

Facility

$331.68

Service Code	HCPCS 29584
Hospital Charge Code	9808330
Hospital Revenue Code	510
Min. Negotiated Rate	$49.75
Max. Negotiated Rate	$49.75
Rate for Payer: Qualcare PPO/HMO/WC	$49.75

APPL MULTLAY COMPRS ARM/HAND

Facility

$331.68

Service Code	HCPCS 29584
Hospital Charge Code	9808330
Hospital Revenue Code	510
Min. Negotiated Rate	$9.42
Max. Negotiated Rate	$700.29
Rate for Payer: Aetna Commercial	$525.10
Rate for Payer: Aetna Medicare Advantage	$625.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$700.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$700.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$193.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$700.29
Rate for Payer: Cigna Commercial	$386.97
Rate for Payer: Cigna Medicare Advantage	$193.05
Rate for Payer: Clover Medicare Advantage	$183.40
Rate for Payer: EmblemHealth Commercial	$579.15
Rate for Payer: Humana Medicare Advantage	$198.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$193.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.24
Rate for Payer: Qualcare PPO/HMO/WC	$49.75
Rate for Payer: UnitedHealthcare Community & State	$10.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$193.05
Rate for Payer: Wellcare Medicare Advantage	$193.05
Rate for Payer: Wellpoint Medicaid Managed Care	$9.42

APPLY FINGER SPLINT STATIC

Facility

$322.82

Service Code	HCPCS 29130
Hospital Charge Code	412329130
Hospital Revenue Code	361
Min. Negotiated Rate	$48.42
Max. Negotiated Rate	$48.42
Rate for Payer: Qualcare PPO/HMO/WC	$48.42

APPLY FINGER SPLINT STATIC

Facility

$322.82

Service Code	HCPCS 29130
Hospital Charge Code	412329130
Hospital Revenue Code	361
Min. Negotiated Rate	$9.17
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
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	$573.36
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.93
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.42
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$10.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$9.17

APPLY LONG LEG CAST BRACE

Facility

$1,360.45

Service Code	HCPCS 29358
Hospital Charge Code	412329358
Hospital Revenue Code	361
Min. Negotiated Rate	$204.07
Max. Negotiated Rate	$204.07
Rate for Payer: Qualcare PPO/HMO/WC	$204.07

APPLY LONG LEG CAST BRACE

Facility

$1,360.45

Service Code	HCPCS 29358
Hospital Charge Code	412329358
Hospital Revenue Code	361
Min. Negotiated Rate	$38.64
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$903.80
Rate for Payer: Aetna Medicare Advantage	$1,076.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,205.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,205.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$332.28
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	$1,205.35
Rate for Payer: Cigna Commercial	$666.07
Rate for Payer: Cigna Medicare Advantage	$332.28
Rate for Payer: Clover Medicare Advantage	$315.67
Rate for Payer: EmblemHealth Commercial	$996.84
Rate for Payer: Humana Medicare Advantage	$342.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$332.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$353.72
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$204.07
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$42.99
Rate for Payer: UnitedHealthcare Medicare Advantage	$332.28
Rate for Payer: Wellcare Medicare Advantage	$332.28
Rate for Payer: Wellpoint Medicaid Managed Care	$38.64

APPLY MULTI-LAYR COMP UPPR LEG

Facility

$1,225.95

Service Code	HCPCS 29582
Hospital Charge Code	9808211
Hospital Revenue Code	510
Min. Negotiated Rate	$183.89
Max. Negotiated Rate	$183.89
Rate for Payer: Qualcare PPO/HMO/WC	$183.89

APPLY MULTI-LAYR COMP UPPR LEG

Facility

$1,225.95

Service Code	HCPCS 29582
Hospital Charge Code	9808211
Hospital Revenue Code	510
Min. Negotiated Rate	$34.82
Max. Negotiated Rate	$612.98
Rate for Payer: Aetna Commercial	$465.86
Rate for Payer: Aetna Medicare Advantage	$367.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$312.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$312.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$312.62
Rate for Payer: Cigna Commercial	$612.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.75
Rate for Payer: Qualcare PPO/HMO/WC	$183.89
Rate for Payer: UnitedHealthcare Community & State	$38.74
Rate for Payer: Wellpoint Medicaid Managed Care	$34.82

APPLY MULTLAY COMPRS UPR ARM

Facility

$331.68

Service Code	HCPCS 29583
Hospital Charge Code	9808329
Hospital Revenue Code	510
Min. Negotiated Rate	$9.42
Max. Negotiated Rate	$165.84
Rate for Payer: Aetna Commercial	$126.04
Rate for Payer: Aetna Medicare Advantage	$99.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.58
Rate for Payer: Cigna Commercial	$165.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.24
Rate for Payer: Qualcare PPO/HMO/WC	$49.75
Rate for Payer: UnitedHealthcare Community & State	$10.48
Rate for Payer: Wellpoint Medicaid Managed Care	$9.42

APPLY MULTLAY COMPRS UPR ARM

Facility

$331.68

Service Code	HCPCS 29583
Hospital Charge Code	9808329
Hospital Revenue Code	510
Min. Negotiated Rate	$49.75
Max. Negotiated Rate	$49.75
Rate for Payer: Qualcare PPO/HMO/WC	$49.75

APPY,DN FR INDICAT PURPS

Facility

$9,108.00

Service Code	HCPCS 44955
Hospital Charge Code	1600000530
Hospital Revenue Code	360
Min. Negotiated Rate	$258.67
Max. Negotiated Rate	$4,554.00
Rate for Payer: Aetna Commercial	$3,461.04
Rate for Payer: Aetna Medicare Advantage	$2,732.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,322.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,322.54
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	$2,322.54
Rate for Payer: Cigna Commercial	$4,554.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,368.08
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,366.20
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$287.81
Rate for Payer: Wellpoint Medicaid Managed Care	$258.67

APPY,DN FR INDICAT PURPS

Facility

$9,108.00

Service Code	HCPCS 44955
Hospital Charge Code	1600000530
Hospital Revenue Code	360
Min. Negotiated Rate	$1,366.20
Max. Negotiated Rate	$1,366.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,366.20

APPY,FRR RUPT APNDX W PETONIT

Facility

$10,777.75

Service Code	HCPCS 44960
Hospital Charge Code	16000979
Hospital Revenue Code	360
Min. Negotiated Rate	$306.09
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$4,095.55
Rate for Payer: Aetna Medicare Advantage	$3,233.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,748.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,748.33
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	$2,748.33
Rate for Payer: Cigna Commercial	$5,388.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,802.22
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,616.66
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$340.58
Rate for Payer: Wellpoint Medicaid Managed Care	$306.09

APPY,FRR RUPT APNDX W PETONIT

Facility

$10,777.75

Service Code	HCPCS 44960
Hospital Charge Code	16000979
Hospital Revenue Code	360
Min. Negotiated Rate	$1,616.66
Max. Negotiated Rate	$1,616.66
Rate for Payer: Qualcare PPO/HMO/WC	$1,616.66

APREPITANT 125MG CAP

Facility

$1,756.94

Service Code	HCPCS J8501
Hospital Charge Code	6063943056
Hospital Revenue Code	636
Min. Negotiated Rate	$49.90
Max. Negotiated Rate	$878.47
Rate for Payer: Aetna Commercial	$667.64
Rate for Payer: Aetna Medicare Advantage	$527.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.02
Rate for Payer: Cigna Commercial	$878.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$425.18
Rate for Payer: Qualcare PPO/HMO/WC	$263.54
Rate for Payer: UnitedHealthcare Community & State	$55.52
Rate for Payer: Wellpoint Medicaid Managed Care	$49.90

APREPITANT 125MG CAP

Facility

$1,756.94

Service Code	HCPCS J8501
Hospital Charge Code	6063943056
Hospital Revenue Code	636
Min. Negotiated Rate	$263.54
Max. Negotiated Rate	$425.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$425.18
Rate for Payer: Qualcare PPO/HMO/WC	$263.54

APREPITANT 80MG CAP

Facility

$1,124.53

Service Code	HCPCS J8501
Hospital Charge Code	6063943057
Hospital Revenue Code	636
Min. Negotiated Rate	$168.68
Max. Negotiated Rate	$272.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.14
Rate for Payer: Qualcare PPO/HMO/WC	$168.68

APREPITANT 80MG CAP

Facility

$1,124.53

Service Code	HCPCS J8501
Hospital Charge Code	6063943057
Hospital Revenue Code	636
Min. Negotiated Rate	$31.94
Max. Negotiated Rate	$562.26
Rate for Payer: Aetna Commercial	$427.32
Rate for Payer: Aetna Medicare Advantage	$337.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.76
Rate for Payer: Cigna Commercial	$562.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.14
Rate for Payer: Qualcare PPO/HMO/WC	$168.68
Rate for Payer: UnitedHealthcare Community & State	$35.54
Rate for Payer: Wellpoint Medicaid Managed Care	$31.94

APTT MIXING STUDIES I

Facility

$390.00

Service Code	HCPCS 85732
Hospital Charge Code	3035067A
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

APTT MIXING STUDIES I

Facility

$390.00

Service Code	HCPCS 85732
Hospital Charge Code	3035067A
Hospital Revenue Code	305
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$17.60
Rate for Payer: Aetna Medicare Advantage	$20.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.47
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$6.47
Rate for Payer: Clover Medicare Advantage	$6.15
Rate for Payer: EmblemHealth Commercial	$19.41
Rate for Payer: Humana Medicare Advantage	$6.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.47
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	$5.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.47
Rate for Payer: Wellcare Medicare Advantage	$6.47
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

APTT MIXING STUDIES II

Facility

$390.00

Service Code	HCPCS 85730
Hospital Charge Code	3035067B
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

APTT MIXING STUDIES II

Facility

$390.00

Service Code	HCPCS 85730
Hospital Charge Code	3035067B
Hospital Revenue Code	305
Min. Negotiated Rate	$4.81
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$16.35
Rate for Payer: Aetna Medicare Advantage	$19.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.80
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$6.01
Rate for Payer: Clover Medicare Advantage	$5.71
Rate for Payer: EmblemHealth Commercial	$18.03
Rate for Payer: Humana Medicare Advantage	$6.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.01
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	$4.81
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.01
Rate for Payer: Wellcare Medicare Advantage	$6.01
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

APTT MIXING STUDIES III

Facility

$390.00

Service Code	HCPCS 85732
Hospital Charge Code	3035067C
Hospital Revenue Code	300
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$17.60
Rate for Payer: Aetna Medicare Advantage	$20.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.47
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$6.47
Rate for Payer: Clover Medicare Advantage	$6.15
Rate for Payer: EmblemHealth Commercial	$19.41
Rate for Payer: Humana Medicare Advantage	$6.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.47
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	$5.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.47
Rate for Payer: Wellcare Medicare Advantage	$6.47
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

Know your out-of-pocket cost for care.

All Charges