Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

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

APTT MIXING STUDIES IV

Facility

$390.00

Service Code	HCPCS 85732
Hospital Charge Code	3035067D
Hospital Revenue Code	300
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

APTT MIXING STUDIES IV

Facility

$390.00

Service Code	HCPCS 85732
Hospital Charge Code	3035067D
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

AQP4 ANTIBODY NMO-IGG ELISA

Facility

$815.50

Service Code	HCPCS 83516
Hospital Charge Code	401083516
Hospital Revenue Code	301
Min. Negotiated Rate	$122.33
Max. Negotiated Rate	$122.33
Rate for Payer: Qualcare PPO/HMO/WC	$122.33

AQP4 ANTIBODY NMO-IGG ELISA

Facility

$815.50

Service Code	HCPCS 83516
Hospital Charge Code	401083516
Hospital Revenue Code	301
Min. Negotiated Rate	$9.22
Max. Negotiated Rate	$407.75
Rate for Payer: Aetna Commercial	$31.36
Rate for Payer: Aetna Medicare Advantage	$37.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.83
Rate for Payer: Cigna Commercial	$407.75
Rate for Payer: Cigna Medicare Advantage	$11.53
Rate for Payer: Clover Medicare Advantage	$10.95
Rate for Payer: EmblemHealth Commercial	$34.59
Rate for Payer: Humana Medicare Advantage	$11.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$212.03
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$122.33
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.53
Rate for Payer: Wellcare Medicare Advantage	$11.53
Rate for Payer: Wellpoint Medicaid Managed Care	$23.16

AQUAMANTUS MBS W/LIGHT

Facility

$3,420.00

Hospital Charge Code	270667850
Hospital Revenue Code	272
Min. Negotiated Rate	$97.13
Max. Negotiated Rate	$1,710.00
Rate for Payer: Aetna Commercial	$1,299.60
Rate for Payer: Aetna Medicare Advantage	$1,026.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$872.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$872.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$872.10
Rate for Payer: Cigna Commercial	$1,710.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$889.20
Rate for Payer: Oxford Commercial	$684.00
Rate for Payer: Qualcare PPO/HMO/WC	$513.00
Rate for Payer: UnitedHealthcare Commercial	$684.00
Rate for Payer: UnitedHealthcare Community & State	$108.07
Rate for Payer: Wellpoint Medicaid Managed Care	$97.13

AQUAMANTUS MBS W/LIGHT

Facility

$3,420.00

Hospital Charge Code	270667850
Hospital Revenue Code	272
Min. Negotiated Rate	$513.00
Max. Negotiated Rate	$513.00
Rate for Payer: Qualcare PPO/HMO/WC	$513.00

AQUAMATICS BI POLAR SEALER 6.0

Facility

$2,756.25

Hospital Charge Code	270667262
Hospital Revenue Code	272
Min. Negotiated Rate	$78.28
Max. Negotiated Rate	$1,378.12
Rate for Payer: Aetna Commercial	$1,047.38
Rate for Payer: Aetna Medicare Advantage	$826.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$702.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$702.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$702.84
Rate for Payer: Cigna Commercial	$1,378.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$716.62
Rate for Payer: Oxford Commercial	$551.25
Rate for Payer: Qualcare PPO/HMO/WC	$413.44
Rate for Payer: UnitedHealthcare Commercial	$551.25
Rate for Payer: UnitedHealthcare Community & State	$87.10
Rate for Payer: Wellpoint Medicaid Managed Care	$78.28

AQUAMATICS BI POLAR SEALER 6.0

Facility

$2,756.25

Hospital Charge Code	270667262
Hospital Revenue Code	272
Min. Negotiated Rate	$413.44
Max. Negotiated Rate	$413.44
Rate for Payer: Qualcare PPO/HMO/WC	$413.44

AQUAPORIN R AB IGG CBA

Facility

$2,640.00

Service Code	HCPCS 86255
Hospital Charge Code	401086255
Hospital Revenue Code	302
Min. Negotiated Rate	$396.00
Max. Negotiated Rate	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$396.00

AQUAPORIN R AB IGG CBA

Facility

$2,640.00

Service Code	HCPCS 86255
Hospital Charge Code	401086255
Hospital Revenue Code	302
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$1,320.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.71
Rate for Payer: Cigna Commercial	$1,320.00
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$686.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$396.00
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$74.98

AQUA SHIELD CAP

Facility

$55.00

Hospital Charge Code	270657702
Hospital Revenue Code	270
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$27.50
Rate for Payer: Aetna Commercial	$20.90
Rate for Payer: Aetna Medicare Advantage	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.03
Rate for Payer: Cigna Commercial	$27.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.30
Rate for Payer: Oxford Commercial	$11.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.25
Rate for Payer: UnitedHealthcare Commercial	$11.00
Rate for Payer: UnitedHealthcare Community & State	$1.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1.56

AQUA SHIELD CAP

Facility

$55.00

Hospital Charge Code	270657702
Hospital Revenue Code	270
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

AQULX FLD CNTRL SYSTM CAN KIT

Facility

$1,895.00

Hospital Charge Code	270661101
Hospital Revenue Code	270
Min. Negotiated Rate	$53.82
Max. Negotiated Rate	$947.50
Rate for Payer: Aetna Commercial	$720.10
Rate for Payer: Aetna Medicare Advantage	$568.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$483.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$483.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$483.23
Rate for Payer: Cigna Commercial	$947.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$492.70
Rate for Payer: Oxford Commercial	$379.00
Rate for Payer: Qualcare PPO/HMO/WC	$284.25
Rate for Payer: UnitedHealthcare Commercial	$379.00
Rate for Payer: UnitedHealthcare Community & State	$59.88
Rate for Payer: Wellpoint Medicaid Managed Care	$53.82

AQULX FLD CNTRL SYSTM CAN KIT

Facility

$1,895.00

Hospital Charge Code	270661101
Hospital Revenue Code	270
Min. Negotiated Rate	$284.25
Max. Negotiated Rate	$284.25
Rate for Payer: Qualcare PPO/HMO/WC	$284.25

ARBOVIRAL ENCEPHALITIS A/B IGM

Facility

$268.00

Service Code	HCPCS 86255
Hospital Charge Code	38476198
Hospital Revenue Code	302
Min. Negotiated Rate	$7.61
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.71
Rate for Payer: Cigna Commercial	$134.00
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.68
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.20
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$7.61

ARBOVIRAL ENCEPHALITIS A/B IGM

Facility

$268.00

Service Code	HCPCS 86255
Hospital Charge Code	38476198
Hospital Revenue Code	302
Min. Negotiated Rate	$40.20
Max. Negotiated Rate	$40.20
Rate for Payer: Qualcare PPO/HMO/WC	$40.20

ARBOVIRAL ENCEPHALTIS A/B IGG

Facility

$268.00

Service Code	HCPCS 86255
Hospital Charge Code	38476196
Hospital Revenue Code	302
Min. Negotiated Rate	$40.20
Max. Negotiated Rate	$40.20
Rate for Payer: Qualcare PPO/HMO/WC	$40.20

ARBOVIRAL ENCEPHALTIS A/B IGG

Facility

$268.00

Service Code	HCPCS 86255
Hospital Charge Code	38476196
Hospital Revenue Code	302
Min. Negotiated Rate	$7.61
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.71
Rate for Payer: Cigna Commercial	$134.00
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.68
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.20
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$7.61

ARBOVIRUS AB PANL,IFA,SER I

Facility

$390.00

Service Code	HCPCS 8665191
Hospital Charge Code	39990093A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ARBOVIRUS AB PANL,IFA,SER I

Facility

$390.00

Service Code	HCPCS 8665291
Hospital Charge Code	39990093C
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ARBOVIRUS AB PANL,IFA,SER I

Facility

$390.00

Service Code	HCPCS 8665191
Hospital Charge Code	39990093B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ARBOVIRUS AB PANL,IFA,SER I

Facility

$390.00

Service Code	HCPCS 8665291
Hospital Charge Code	39990093D
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ARBOVIRUS AB PANL,IFA,SER I

Facility

$390.00

Service Code	HCPCS 8665291
Hospital Charge Code	39990093C
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

ARBOVIRUS AB PANL,IFA,SER I

Facility

$390.00

Service Code	HCPCS 8665291
Hospital Charge Code	39990093D
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

Know your out-of-pocket cost for care.

All Charges