Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

LYMPHANGIOGRAPHY PELV/ABD BILA

Facility

$2,417.00

Service Code	HCPCS 75807
Hospital Charge Code	7411707
Hospital Revenue Code	320
Min. Negotiated Rate	$362.55
Max. Negotiated Rate	$362.55
Rate for Payer: Qualcare PPO/HMO/WC	$362.55

LYMPHANGIOGRAPHY PELV/ABD BILA

Facility

$2,417.00

Service Code	HCPCS 75807
Hospital Charge Code	2680350
Hospital Revenue Code	320
Min. Negotiated Rate	$362.55
Max. Negotiated Rate	$362.55
Rate for Payer: Qualcare PPO/HMO/WC	$362.55

LYMPHANGIOGRAPHY PELV/ABD BILA

Facility

$2,417.00

Service Code	HCPCS 75807
Hospital Charge Code	2680350
Hospital Revenue Code	320
Min. Negotiated Rate	$68.64
Max. Negotiated Rate	$13,607.37
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,607.37
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$2,625.82
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$628.42
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$362.55
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$76.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$68.64

LYMPHANGIOGRAPHY PELV/ABD BILA

Facility

$2,417.00

Service Code	HCPCS 75807
Hospital Charge Code	7411707
Hospital Revenue Code	320
Min. Negotiated Rate	$68.64
Max. Negotiated Rate	$13,607.37
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,607.37
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$2,625.82
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$628.42
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$362.55
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$76.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$68.64

LYMPHANGIOGRAPHY PELV/ABD UNIL

Facility

$2,417.00

Service Code	HCPCS 75805
Hospital Charge Code	2680345
Hospital Revenue Code	320
Min. Negotiated Rate	$68.64
Max. Negotiated Rate	$13,607.37
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$174.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,607.37
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$2,625.82
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$628.42
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$362.55
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$76.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$68.64

LYMPHANGIOGRAPHY PELV/ABD UNIL

Facility

$2,417.00

Service Code	HCPCS 75805
Hospital Charge Code	2680345
Hospital Revenue Code	320
Min. Negotiated Rate	$362.55
Max. Negotiated Rate	$362.55
Rate for Payer: Qualcare PPO/HMO/WC	$362.55

LYMPHANGIOGRAPHY PELV/ABD UNIL

Facility

$2,417.00

Service Code	HCPCS 75805
Hospital Charge Code	7411706
Hospital Revenue Code	320
Min. Negotiated Rate	$68.64
Max. Negotiated Rate	$13,607.37
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$174.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,607.37
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$2,625.82
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$628.42
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$362.55
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$76.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$68.64

LYMPHANGIOGRAPHY PELV/ABD UNIL

Facility

$2,417.00

Service Code	HCPCS 75805
Hospital Charge Code	7411706
Hospital Revenue Code	320
Min. Negotiated Rate	$362.55
Max. Negotiated Rate	$362.55
Rate for Payer: Qualcare PPO/HMO/WC	$362.55

LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR

Facility

$15,705.16

Service Code	APR-DRG 6943
Min. Negotiated Rate	$15,397.22
Max. Negotiated Rate	$15,705.16
Rate for Payer: UnitedHealthcare Community & State	$15,397.22
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$15,705.16
Rate for Payer: Wellpoint Medicaid Managed Care	$15,397.22

LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR

Facility

$28,067.97

Service Code	APR-DRG 6944
Min. Negotiated Rate	$27,517.62
Max. Negotiated Rate	$28,067.97
Rate for Payer: UnitedHealthcare Community & State	$27,517.62
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$28,067.97
Rate for Payer: Wellpoint Medicaid Managed Care	$27,517.62

LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR

Facility

$10,486.49

Service Code	APR-DRG 6942
Min. Negotiated Rate	$10,280.87
Max. Negotiated Rate	$10,486.49
Rate for Payer: UnitedHealthcare Community & State	$10,280.87
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,486.49
Rate for Payer: Wellpoint Medicaid Managed Care	$10,280.87

LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR

Facility

$8,301.30

Service Code	APR-DRG 6941
Min. Negotiated Rate	$8,138.53
Max. Negotiated Rate	$8,301.30
Rate for Payer: UnitedHealthcare Community & State	$8,138.53
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,301.30
Rate for Payer: Wellpoint Medicaid Managed Care	$8,138.53

LYMPH NODE-SUPER-BI

Facility

$9,303.00

Service Code	HCPCS 3850550
Hospital Charge Code	2101190
Hospital Revenue Code	361
Min. Negotiated Rate	$1,395.45
Max. Negotiated Rate	$1,395.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,395.45

LYMPH NODE-SUPER-BI

Facility

$9,303.00

Service Code	HCPCS 3850550
Hospital Charge Code	2101190
Hospital Revenue Code	361
Min. Negotiated Rate	$264.21
Max. Negotiated Rate	$4,651.50
Rate for Payer: Aetna Commercial	$3,535.14
Rate for Payer: Aetna Medicare Advantage	$2,790.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,372.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,372.26
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	$2,372.26
Rate for Payer: Cigna Commercial	$4,651.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,418.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,395.45
Rate for Payer: UnitedHealthcare Community & State	$293.97
Rate for Payer: Wellpoint Medicaid Managed Care	$264.21

LYMPH NODE-SUPER-LT

Facility

$6,202.00

Service Code	HCPCS 38505LT
Hospital Charge Code	2250444
Hospital Revenue Code	361
Min. Negotiated Rate	$176.14
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,356.76
Rate for Payer: Aetna Medicare Advantage	$1,860.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,581.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,581.51
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	$1,581.51
Rate for Payer: Cigna Commercial	$3,101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,612.52
Rate for Payer: Qualcare PPO/HMO/WC	$930.30
Rate for Payer: UnitedHealthcare Community & State	$195.98
Rate for Payer: Wellpoint Medicaid Managed Care	$176.14

LYMPH NODE-SUPER-LT

Facility

$6,202.00

Service Code	HCPCS 38505LT
Hospital Charge Code	2250444
Hospital Revenue Code	361
Min. Negotiated Rate	$930.30
Max. Negotiated Rate	$930.30
Rate for Payer: Qualcare PPO/HMO/WC	$930.30

LYMPH NODE-SUPER-LT

Facility

$6,202.00

Service Code	HCPCS 38505LT
Hospital Charge Code	2101191
Hospital Revenue Code	361
Min. Negotiated Rate	$930.30
Max. Negotiated Rate	$930.30
Rate for Payer: Qualcare PPO/HMO/WC	$930.30

LYMPH NODE-SUPER-LT

Facility

$6,202.00

Service Code	HCPCS 38505LT
Hospital Charge Code	2101191
Hospital Revenue Code	361
Min. Negotiated Rate	$176.14
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,356.76
Rate for Payer: Aetna Medicare Advantage	$1,860.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,581.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,581.51
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	$1,581.51
Rate for Payer: Cigna Commercial	$3,101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,612.52
Rate for Payer: Qualcare PPO/HMO/WC	$930.30
Rate for Payer: UnitedHealthcare Community & State	$195.98
Rate for Payer: Wellpoint Medicaid Managed Care	$176.14

LYMPHOCYTE SUBSET 1 I

Facility

$390.00

Service Code	HCPCS 86355
Hospital Charge Code	39990132A
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$102.63
Rate for Payer: Aetna Medicare Advantage	$122.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$37.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.87
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$37.73
Rate for Payer: Clover Medicare Advantage	$35.84
Rate for Payer: EmblemHealth Commercial	$113.19
Rate for Payer: Humana Medicare Advantage	$38.86
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$37.73
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	$30.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$37.73
Rate for Payer: Wellcare Medicare Advantage	$37.73
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

LYMPHOCYTE SUBSET 1 I

Facility

$390.00

Service Code	HCPCS 86355
Hospital Charge Code	39990132A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

LYMPHOCYTE SUBSET 1 II

Facility

$390.00

Service Code	HCPCS 86357
Hospital Charge Code	39990132B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

LYMPHOCYTE SUBSET 1 II

Facility

$390.00

Service Code	HCPCS 86357
Hospital Charge Code	39990132B
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$102.63
Rate for Payer: Aetna Medicare Advantage	$122.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$37.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.87
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$37.73
Rate for Payer: Clover Medicare Advantage	$35.84
Rate for Payer: EmblemHealth Commercial	$113.19
Rate for Payer: Humana Medicare Advantage	$38.86
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$37.73
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	$30.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$37.73
Rate for Payer: Wellcare Medicare Advantage	$37.73
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

LYMPHOCYTE SUBSET 1 III

Facility

$390.00

Service Code	HCPCS 86359
Hospital Charge Code	39990132C
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$102.63
Rate for Payer: Aetna Medicare Advantage	$122.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$37.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.87
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$37.73
Rate for Payer: Clover Medicare Advantage	$35.84
Rate for Payer: EmblemHealth Commercial	$113.19
Rate for Payer: Humana Medicare Advantage	$38.86
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$37.73
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	$30.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$37.73
Rate for Payer: Wellcare Medicare Advantage	$37.73
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

LYMPHOCYTE SUBSET 1 III

Facility

$390.00

Service Code	HCPCS 86359
Hospital Charge Code	39990132C
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

LYMPHOCYTE SUBSET 1 IV

Facility

$390.00

Service Code	HCPCS 86360
Hospital Charge Code	39990132D
Hospital Revenue Code	302
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