Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ARBOVIRUS AB PNL,IFA,CSF VII

Facility

$390.00

Service Code	HCPCS 8665491
Hospital Charge Code	39990094H
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ARCOM XL 28 X 38MM

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270688599
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

ARCOM XL 28 X 38MM

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270688599
Hospital Revenue Code	278
Min. Negotiated Rate	$106.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$118.50
Rate for Payer: Wellpoint Medicaid Managed Care	$106.50

ARCOS 16X150MM SPL TPR DIST

Facility

$18,660.00

Service Code	HCPCS C1776
Hospital Charge Code	270686540
Hospital Revenue Code	278
Min. Negotiated Rate	$2,799.00
Max. Negotiated Rate	$4,515.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,732.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,515.72
Rate for Payer: Qualcare PPO/HMO/WC	$2,799.00

ARCOS 16X150MM SPL TPR DIST

Facility

$18,660.00

Service Code	HCPCS C1776
Hospital Charge Code	270686540
Hospital Revenue Code	278
Min. Negotiated Rate	$529.94
Max. Negotiated Rate	$9,330.00
Rate for Payer: Aetna Commercial	$7,090.80
Rate for Payer: Aetna Medicare Advantage	$5,598.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,758.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,758.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,732.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,758.30
Rate for Payer: Cigna Commercial	$9,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,515.72
Rate for Payer: Qualcare PPO/HMO/WC	$2,799.00
Rate for Payer: UnitedHealthcare Community & State	$589.66
Rate for Payer: Wellpoint Medicaid Managed Care	$529.94

ARCOS 17X200MM CYL DIST

Facility

$18,660.00

Service Code	HCPCS C1776
Hospital Charge Code	270688683
Hospital Revenue Code	278
Min. Negotiated Rate	$2,799.00
Max. Negotiated Rate	$4,515.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,732.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,515.72
Rate for Payer: Qualcare PPO/HMO/WC	$2,799.00

ARCOS 17X200MM CYL DIST

Facility

$18,660.00

Service Code	HCPCS C1776
Hospital Charge Code	270688683
Hospital Revenue Code	278
Min. Negotiated Rate	$529.94
Max. Negotiated Rate	$9,330.00
Rate for Payer: Aetna Commercial	$7,090.80
Rate for Payer: Aetna Medicare Advantage	$5,598.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,758.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,758.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,732.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,758.30
Rate for Payer: Cigna Commercial	$9,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,515.72
Rate for Payer: Qualcare PPO/HMO/WC	$2,799.00
Rate for Payer: UnitedHealthcare Community & State	$589.66
Rate for Payer: Wellpoint Medicaid Managed Care	$529.94

ARCOS 18X190MM SPL TPR DIST

Facility

$18,660.00

Service Code	HCPCS C1776
Hospital Charge Code	270686542
Hospital Revenue Code	278
Min. Negotiated Rate	$529.94
Max. Negotiated Rate	$9,330.00
Rate for Payer: Aetna Commercial	$7,090.80
Rate for Payer: Aetna Medicare Advantage	$5,598.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,758.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,758.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,732.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,758.30
Rate for Payer: Cigna Commercial	$9,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,515.72
Rate for Payer: Qualcare PPO/HMO/WC	$2,799.00
Rate for Payer: UnitedHealthcare Community & State	$589.66
Rate for Payer: Wellpoint Medicaid Managed Care	$529.94

ARCOS 18X190MM SPL TPR DIST

Facility

$18,660.00

Service Code	HCPCS C1776
Hospital Charge Code	270686542
Hospital Revenue Code	278
Min. Negotiated Rate	$2,799.00
Max. Negotiated Rate	$4,515.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,732.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,515.72
Rate for Payer: Qualcare PPO/HMO/WC	$2,799.00

ARCOS 1PC 18X210MM+0CALC STD

Facility

$37,495.00

Hospital Charge Code	270702527
Hospital Revenue Code	278
Min. Negotiated Rate	$1,064.86
Max. Negotiated Rate	$18,747.50
Rate for Payer: Aetna Commercial	$14,248.10
Rate for Payer: Aetna Medicare Advantage	$11,248.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,561.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,561.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,499.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,561.23
Rate for Payer: Cigna Commercial	$18,747.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,073.79
Rate for Payer: Qualcare PPO/HMO/WC	$5,624.25
Rate for Payer: UnitedHealthcare Community & State	$1,184.84
Rate for Payer: Wellpoint Medicaid Managed Care	$1,064.86

ARCOS 1PC 18X210MM+0CALC STD

Facility

$37,495.00

Hospital Charge Code	270702527
Hospital Revenue Code	278
Min. Negotiated Rate	$5,624.25
Max. Negotiated Rate	$9,073.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,499.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,073.79
Rate for Payer: Qualcare PPO/HMO/WC	$5,624.25

ARCOS CON CON SZ A HI 50MM

Facility

$36,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270686541
Hospital Revenue Code	278
Min. Negotiated Rate	$1,028.36
Max. Negotiated Rate	$18,105.00
Rate for Payer: Aetna Commercial	$13,759.80
Rate for Payer: Aetna Medicare Advantage	$10,863.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,233.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,233.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,233.55
Rate for Payer: Cigna Commercial	$18,105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,762.82
Rate for Payer: Qualcare PPO/HMO/WC	$5,431.50
Rate for Payer: UnitedHealthcare Community & State	$1,144.24
Rate for Payer: Wellpoint Medicaid Managed Care	$1,028.36

ARCOS CON CON SZ A HI 50MM

Facility

$36,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270686541
Hospital Revenue Code	278
Min. Negotiated Rate	$5,431.50
Max. Negotiated Rate	$8,762.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,242.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,762.82
Rate for Payer: Qualcare PPO/HMO/WC	$5,431.50

ARCOS CON SZ A STD 50MM

Facility

$39,420.00

Service Code	HCPCS C1776
Hospital Charge Code	270675924
Hospital Revenue Code	278
Min. Negotiated Rate	$5,913.00
Max. Negotiated Rate	$9,539.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,884.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,539.64
Rate for Payer: Qualcare PPO/HMO/WC	$5,913.00

ARCOS CON SZ A STD 50MM

Facility

$39,420.00

Service Code	HCPCS C1776
Hospital Charge Code	270675924
Hospital Revenue Code	278
Min. Negotiated Rate	$1,119.53
Max. Negotiated Rate	$19,710.00
Rate for Payer: Aetna Commercial	$14,979.60
Rate for Payer: Aetna Medicare Advantage	$11,826.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,052.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,052.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,884.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,052.10
Rate for Payer: Cigna Commercial	$19,710.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,539.64
Rate for Payer: Qualcare PPO/HMO/WC	$5,913.00
Rate for Payer: UnitedHealthcare Community & State	$1,245.67
Rate for Payer: Wellpoint Medicaid Managed Care	$1,119.53

ARCUS GUIDED ACCESS

Facility

$6,600.00

Hospital Charge Code	270703563
Hospital Revenue Code	278
Min. Negotiated Rate	$990.00
Max. Negotiated Rate	$1,597.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,597.20
Rate for Payer: Qualcare PPO/HMO/WC	$990.00

ARCUS GUIDED ACCESS

Facility

$6,600.00

Hospital Charge Code	270703563
Hospital Revenue Code	278
Min. Negotiated Rate	$187.44
Max. Negotiated Rate	$3,300.00
Rate for Payer: Aetna Commercial	$2,508.00
Rate for Payer: Aetna Medicare Advantage	$1,980.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.00
Rate for Payer: Cigna Commercial	$3,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,597.20
Rate for Payer: Qualcare PPO/HMO/WC	$990.00
Rate for Payer: UnitedHealthcare Community & State	$208.56
Rate for Payer: Wellpoint Medicaid Managed Care	$187.44

ARCUS GUIDED ACCESS

Facility

$6,600.00

Hospital Charge Code	270703550
Hospital Revenue Code	278
Min. Negotiated Rate	$187.44
Max. Negotiated Rate	$3,300.00
Rate for Payer: Aetna Commercial	$2,508.00
Rate for Payer: Aetna Medicare Advantage	$1,980.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.00
Rate for Payer: Cigna Commercial	$3,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,597.20
Rate for Payer: Qualcare PPO/HMO/WC	$990.00
Rate for Payer: UnitedHealthcare Community & State	$208.56
Rate for Payer: Wellpoint Medicaid Managed Care	$187.44

ARCUS GUIDED ACCESS

Facility

$6,600.00

Hospital Charge Code	270703550
Hospital Revenue Code	278
Min. Negotiated Rate	$990.00
Max. Negotiated Rate	$1,597.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,597.20
Rate for Payer: Qualcare PPO/HMO/WC	$990.00

ARFORMOTEROL 15MC G/2ML

Facility

$150.82

Service Code	NDC 63402091130
Hospital Charge Code	60629947
Hospital Revenue Code	250
Min. Negotiated Rate	$4.28
Max. Negotiated Rate	$75.41
Rate for Payer: Aetna Commercial	$57.31
Rate for Payer: Aetna Medicare Advantage	$45.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.46
Rate for Payer: Cigna Commercial	$75.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.21
Rate for Payer: Oxford Commercial	$30.16
Rate for Payer: Qualcare PPO/HMO/WC	$22.62
Rate for Payer: UnitedHealthcare Commercial	$30.16
Rate for Payer: UnitedHealthcare Community & State	$4.77
Rate for Payer: Wellpoint Medicaid Managed Care	$4.28

ARFORMOTEROL 15MC G/2ML

Facility

$150.82

Service Code	NDC 63402091130
Hospital Charge Code	60629947
Hospital Revenue Code	250
Min. Negotiated Rate	$22.62
Max. Negotiated Rate	$22.62
Rate for Payer: Qualcare PPO/HMO/WC	$22.62

ARGININE VASOPRESSIN

Facility

$390.00

Service Code	HCPCS 84588
Hospital Charge Code	39900148
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$92.32
Rate for Payer: Aetna Medicare Advantage	$109.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$33.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$123.12
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$33.94
Rate for Payer: Clover Medicare Advantage	$32.24
Rate for Payer: EmblemHealth Commercial	$101.82
Rate for Payer: Humana Medicare Advantage	$34.96
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$33.94
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	$27.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$33.94
Rate for Payer: Wellcare Medicare Advantage	$33.94
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

ARGININE VASOPRESSIN

Facility

$416.00

Service Code	HCPCS 84588
Hospital Charge Code	38473080
Hospital Revenue Code	301
Min. Negotiated Rate	$62.40
Max. Negotiated Rate	$62.40
Rate for Payer: Qualcare PPO/HMO/WC	$62.40

ARGININE VASOPRESSIN

Facility

$390.00

Service Code	HCPCS 84588
Hospital Charge Code	39900148
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ARGININE VASOPRESSIN

Facility

$416.00

Service Code	HCPCS 84588
Hospital Charge Code	38473080
Hospital Revenue Code	301
Min. Negotiated Rate	$11.81
Max. Negotiated Rate	$208.00
Rate for Payer: Aetna Commercial	$92.32
Rate for Payer: Aetna Medicare Advantage	$109.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$33.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$123.12
Rate for Payer: Cigna Commercial	$208.00
Rate for Payer: Cigna Medicare Advantage	$33.94
Rate for Payer: Clover Medicare Advantage	$32.24
Rate for Payer: EmblemHealth Commercial	$101.82
Rate for Payer: Humana Medicare Advantage	$34.96
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$33.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.16
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.40
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$27.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$33.94
Rate for Payer: Wellcare Medicare Advantage	$33.94
Rate for Payer: Wellpoint Medicaid Managed Care	$11.81

Know your out-of-pocket cost for care.

All Charges