Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

LINR VIVACR DM BEAR 28X40MM

Facility

$13,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270693906
Hospital Revenue Code	278
Min. Negotiated Rate	$383.40
Max. Negotiated Rate	$6,750.00
Rate for Payer: Aetna Commercial	$5,130.00
Rate for Payer: Aetna Medicare Advantage	$4,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,442.50
Rate for Payer: Cigna Commercial	$6,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00
Rate for Payer: UnitedHealthcare Community & State	$426.60
Rate for Payer: Wellpoint Medicaid Managed Care	$383.40

LINR VIVACR DM BEAR 28X40MM

Facility

$13,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270693906
Hospital Revenue Code	278
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$3,267.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

LIOTHYRONINE TAB 25MCG

Facility

$11.93

Service Code	NDC 60793011601
Hospital Charge Code	60628259
Hospital Revenue Code	250
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$5.96
Rate for Payer: Aetna Commercial	$4.53
Rate for Payer: Aetna Medicare Advantage	$3.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.04
Rate for Payer: Cigna Commercial	$5.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.10
Rate for Payer: Oxford Commercial	$2.39
Rate for Payer: Qualcare PPO/HMO/WC	$1.79
Rate for Payer: UnitedHealthcare Commercial	$2.39
Rate for Payer: UnitedHealthcare Community & State	$0.38
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

LIOTHYRONINE TAB 25MCG

Facility

$11.93

Service Code	NDC 60793011601
Hospital Charge Code	60628259
Hospital Revenue Code	250
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$1.79
Rate for Payer: Qualcare PPO/HMO/WC	$1.79

LIOTHYRONINE TAB 5MCG

Facility

$9.11

Service Code	NDC 60793011501
Hospital Charge Code	60628260
Hospital Revenue Code	250
Min. Negotiated Rate	$1.37
Max. Negotiated Rate	$1.37
Rate for Payer: Qualcare PPO/HMO/WC	$1.37

LIOTHYRONINE TAB 5MCG

Facility

$9.11

Service Code	NDC 60793011501
Hospital Charge Code	60628260
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$4.55
Rate for Payer: Aetna Commercial	$3.46
Rate for Payer: Aetna Medicare Advantage	$2.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.32
Rate for Payer: Cigna Commercial	$4.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.37
Rate for Payer: Oxford Commercial	$1.82
Rate for Payer: Qualcare PPO/HMO/WC	$1.37
Rate for Payer: UnitedHealthcare Commercial	$1.82
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

LIPASE

Facility

$317.80

Service Code	HCPCS 83690
Hospital Charge Code	38472455
Hospital Revenue Code	301
Min. Negotiated Rate	$5.51
Max. Negotiated Rate	$158.90
Rate for Payer: Aetna Commercial	$18.74
Rate for Payer: Aetna Medicare Advantage	$22.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.99
Rate for Payer: Cigna Commercial	$158.90
Rate for Payer: Cigna Medicare Advantage	$6.89
Rate for Payer: Clover Medicare Advantage	$6.55
Rate for Payer: EmblemHealth Commercial	$20.67
Rate for Payer: Humana Medicare Advantage	$7.10
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.63
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$47.67
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$5.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.89
Rate for Payer: Wellcare Medicare Advantage	$6.89
Rate for Payer: Wellpoint Medicaid Managed Care	$9.03

LIPASE

Facility

$317.80

Service Code	HCPCS 83690
Hospital Charge Code	38472455
Hospital Revenue Code	301
Min. Negotiated Rate	$47.67
Max. Negotiated Rate	$47.67
Rate for Payer: Qualcare PPO/HMO/WC	$47.67

LIPASE, JP DRAINAGE

Facility

$47.35

Service Code	HCPCS 83690
Hospital Charge Code	39900103
Hospital Revenue Code	301
Min. Negotiated Rate	$7.10
Max. Negotiated Rate	$7.10
Rate for Payer: Qualcare PPO/HMO/WC	$7.10

LIPASE, JP DRAINAGE

Facility

$47.35

Service Code	HCPCS 83690
Hospital Charge Code	39900103
Hospital Revenue Code	301
Min. Negotiated Rate	$1.34
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$18.74
Rate for Payer: Aetna Medicare Advantage	$22.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.99
Rate for Payer: Cigna Commercial	$23.68
Rate for Payer: Cigna Medicare Advantage	$6.89
Rate for Payer: Clover Medicare Advantage	$6.55
Rate for Payer: EmblemHealth Commercial	$20.67
Rate for Payer: Humana Medicare Advantage	$7.10
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.31
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.10
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$5.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.89
Rate for Payer: Wellcare Medicare Advantage	$6.89
Rate for Payer: Wellpoint Medicaid Managed Care	$1.34

LIPASE, SERUM

Facility

$707.67

Service Code	HCPCS 83690
Hospital Charge Code	3001823
Hospital Revenue Code	301
Min. Negotiated Rate	$106.15
Max. Negotiated Rate	$106.15
Rate for Payer: Qualcare PPO/HMO/WC	$106.15

LIPASE, SERUM

Facility

$707.67

Service Code	HCPCS 83690
Hospital Charge Code	3001823
Hospital Revenue Code	301
Min. Negotiated Rate	$5.51
Max. Negotiated Rate	$353.83
Rate for Payer: Aetna Commercial	$18.74
Rate for Payer: Aetna Medicare Advantage	$22.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.99
Rate for Payer: Cigna Commercial	$353.83
Rate for Payer: Cigna Medicare Advantage	$6.89
Rate for Payer: Clover Medicare Advantage	$6.55
Rate for Payer: EmblemHealth Commercial	$20.67
Rate for Payer: Humana Medicare Advantage	$7.10
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.99
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$106.15
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$5.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.89
Rate for Payer: Wellcare Medicare Advantage	$6.89
Rate for Payer: Wellpoint Medicaid Managed Care	$20.10

LIPID

Facility

$758.80

Service Code	HCPCS 80061
Hospital Charge Code	38479458
Hospital Revenue Code	301
Min. Negotiated Rate	$10.71
Max. Negotiated Rate	$379.40
Rate for Payer: Aetna Commercial	$36.42
Rate for Payer: Aetna Medicare Advantage	$43.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.57
Rate for Payer: Cigna Commercial	$379.40
Rate for Payer: Cigna Medicare Advantage	$13.39
Rate for Payer: Clover Medicare Advantage	$12.72
Rate for Payer: EmblemHealth Commercial	$40.17
Rate for Payer: Humana Medicare Advantage	$13.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$197.29
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$113.82
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.39
Rate for Payer: Wellcare Medicare Advantage	$13.39
Rate for Payer: Wellpoint Medicaid Managed Care	$21.55

LIPID

Facility

$758.80

Service Code	HCPCS 80061
Hospital Charge Code	38472023
Hospital Revenue Code	301
Min. Negotiated Rate	$113.82
Max. Negotiated Rate	$113.82
Rate for Payer: Qualcare PPO/HMO/WC	$113.82

LIPID

Facility

$758.80

Service Code	HCPCS 80061
Hospital Charge Code	38472023
Hospital Revenue Code	301
Min. Negotiated Rate	$10.71
Max. Negotiated Rate	$379.40
Rate for Payer: Aetna Commercial	$36.42
Rate for Payer: Aetna Medicare Advantage	$43.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.57
Rate for Payer: Cigna Commercial	$379.40
Rate for Payer: Cigna Medicare Advantage	$13.39
Rate for Payer: Clover Medicare Advantage	$12.72
Rate for Payer: EmblemHealth Commercial	$40.17
Rate for Payer: Humana Medicare Advantage	$13.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$197.29
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$113.82
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.39
Rate for Payer: Wellcare Medicare Advantage	$13.39
Rate for Payer: Wellpoint Medicaid Managed Care	$21.55

LIPID

Facility

$758.80

Service Code	HCPCS 80061
Hospital Charge Code	38479458
Hospital Revenue Code	301
Min. Negotiated Rate	$113.82
Max. Negotiated Rate	$113.82
Rate for Payer: Qualcare PPO/HMO/WC	$113.82

LIPID PROFILE PANEL

Facility

$1,475.31

Service Code	HCPCS 80061
Hospital Charge Code	3006459
Hospital Revenue Code	301
Min. Negotiated Rate	$10.71
Max. Negotiated Rate	$737.65
Rate for Payer: Aetna Commercial	$36.42
Rate for Payer: Aetna Medicare Advantage	$43.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.57
Rate for Payer: Cigna Commercial	$737.65
Rate for Payer: Cigna Medicare Advantage	$13.39
Rate for Payer: Clover Medicare Advantage	$12.72
Rate for Payer: EmblemHealth Commercial	$40.17
Rate for Payer: Humana Medicare Advantage	$13.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$383.58
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$221.30
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.39
Rate for Payer: Wellcare Medicare Advantage	$13.39
Rate for Payer: Wellpoint Medicaid Managed Care	$41.90

LIPID PROFILE PANEL

Facility

$1,475.31

Service Code	HCPCS 80061
Hospital Charge Code	3006459
Hospital Revenue Code	301
Min. Negotiated Rate	$221.30
Max. Negotiated Rate	$221.30
Rate for Payer: Qualcare PPO/HMO/WC	$221.30

LIPID RESCUE KIT

Facility

$257.88

Service Code	NDC 338051904
Hospital Charge Code	606351002
Hospital Revenue Code	250
Min. Negotiated Rate	$7.32
Max. Negotiated Rate	$128.94
Rate for Payer: Aetna Commercial	$97.99
Rate for Payer: Aetna Medicare Advantage	$77.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.76
Rate for Payer: Cigna Commercial	$128.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.05
Rate for Payer: Oxford Commercial	$51.58
Rate for Payer: Qualcare PPO/HMO/WC	$38.68
Rate for Payer: UnitedHealthcare Commercial	$51.58
Rate for Payer: UnitedHealthcare Community & State	$8.15
Rate for Payer: Wellpoint Medicaid Managed Care	$7.32

LIPID RESCUE KIT

Facility

$257.88

Service Code	NDC 338051904
Hospital Charge Code	606351002
Hospital Revenue Code	250
Min. Negotiated Rate	$38.68
Max. Negotiated Rate	$38.68
Rate for Payer: Qualcare PPO/HMO/WC	$38.68

LIPIDS STOOL, QUAL

Facility

$264.00

Service Code	HCPCS 82705
Hospital Charge Code	38472030
Hospital Revenue Code	301
Min. Negotiated Rate	$39.60
Max. Negotiated Rate	$39.60
Rate for Payer: Qualcare PPO/HMO/WC	$39.60

LIPIDS STOOL, QUAL

Facility

$264.00

Service Code	HCPCS 82705
Hospital Charge Code	38472030
Hospital Revenue Code	301
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$13.87
Rate for Payer: Aetna Medicare Advantage	$16.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.50
Rate for Payer: Cigna Commercial	$132.00
Rate for Payer: Cigna Medicare Advantage	$5.10
Rate for Payer: Clover Medicare Advantage	$4.84
Rate for Payer: EmblemHealth Commercial	$15.30
Rate for Payer: Humana Medicare Advantage	$5.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.64
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.60
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$4.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.10
Rate for Payer: Wellcare Medicare Advantage	$5.10
Rate for Payer: Wellpoint Medicaid Managed Care	$7.50

LIPOPROTEIN (A)

Facility

$91.00

Service Code	HCPCS 83695
Hospital Charge Code	38477110
Hospital Revenue Code	301
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$13.65
Rate for Payer: Qualcare PPO/HMO/WC	$13.65

LIPOPROTEIN (A)

Facility

$91.00

Service Code	HCPCS 83695
Hospital Charge Code	38477110
Hospital Revenue Code	301
Min. Negotiated Rate	$2.58
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$38.95
Rate for Payer: Aetna Medicare Advantage	$46.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.95
Rate for Payer: Cigna Commercial	$45.50
Rate for Payer: Cigna Medicare Advantage	$14.32
Rate for Payer: Clover Medicare Advantage	$13.60
Rate for Payer: EmblemHealth Commercial	$42.96
Rate for Payer: Humana Medicare Advantage	$14.75
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.66
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.65
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$11.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.32
Rate for Payer: Wellcare Medicare Advantage	$14.32
Rate for Payer: Wellpoint Medicaid Managed Care	$2.58

LIPOPROTEIN (A)

Facility

$390.00

Service Code	HCPCS 83695
Hospital Charge Code	39900104
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Know your out-of-pocket cost for care.

All Charges