Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

MANOMETER FOR CUFF

Facility

$167.00

Hospital Charge Code	270665164
Hospital Revenue Code	270
Min. Negotiated Rate	$25.05
Max. Negotiated Rate	$25.05
Rate for Payer: Qualcare PPO/HMO/WC	$25.05

MAN ROADRUNNER EXTRA SUPPORT

Facility

$612.50

Hospital Charge Code	270660263
Hospital Revenue Code	272
Min. Negotiated Rate	$17.39
Max. Negotiated Rate	$306.25
Rate for Payer: Aetna Commercial	$232.75
Rate for Payer: Aetna Medicare Advantage	$183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.19
Rate for Payer: Cigna Commercial	$306.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.25
Rate for Payer: Oxford Commercial	$122.50
Rate for Payer: Qualcare PPO/HMO/WC	$91.88
Rate for Payer: UnitedHealthcare Commercial	$122.50
Rate for Payer: UnitedHealthcare Community & State	$19.36
Rate for Payer: Wellpoint Medicaid Managed Care	$17.39

MAN ROADRUNNER EXTRA SUPPORT

Facility

$612.50

Hospital Charge Code	270660263
Hospital Revenue Code	272
Min. Negotiated Rate	$91.88
Max. Negotiated Rate	$91.88
Rate for Payer: Qualcare PPO/HMO/WC	$91.88

MANUAL RETIC COUNT

Facility

$57.00

Service Code	HCPCS 85044
Hospital Charge Code	38479051
Hospital Revenue Code	301
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$11.72
Rate for Payer: Aetna Medicare Advantage	$13.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.31
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	$15.63
Rate for Payer: Cigna Commercial	$28.50
Rate for Payer: Cigna Medicare Advantage	$4.31
Rate for Payer: Clover Medicare Advantage	$4.09
Rate for Payer: EmblemHealth Commercial	$12.93
Rate for Payer: Humana Medicare Advantage	$4.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.82
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.55
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$3.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.31
Rate for Payer: Wellcare Medicare Advantage	$4.31
Rate for Payer: Wellpoint Medicaid Managed Care	$1.62

MANUAL RETIC COUNT

Facility

$57.00

Service Code	HCPCS 85044
Hospital Charge Code	38479051
Hospital Revenue Code	301
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$8.55
Rate for Payer: Qualcare PPO/HMO/WC	$8.55

MANUAL THERAPY EA 15 MIN CQ

Facility

$141.65

Service Code	HCPCS 97140GP
Hospital Charge Code	409197140Q
Hospital Revenue Code	420
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$21.25
Rate for Payer: Qualcare PPO/HMO/WC	$21.25

MANUAL THERAPY EA 15 MIN CQ

Facility

$141.65

Service Code	HCPCS 97140GP
Hospital Charge Code	409197140Q
Hospital Revenue Code	420
Min. Negotiated Rate	$4.02
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$53.83
Rate for Payer: Aetna Medicare Advantage	$42.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.12
Rate for Payer: Cigna Commercial	$70.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.83
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.25
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$4.48
Rate for Payer: Wellpoint Medicaid Managed Care	$4.02

MANUAL THRPY EACH 15 MINUTES

Facility

$142.00

Service Code	HCPCS 97001GP
Hospital Charge Code	1008105
Hospital Revenue Code	420
Min. Negotiated Rate	$4.03
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$53.96
Rate for Payer: Aetna Medicare Advantage	$42.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.21
Rate for Payer: Cigna Commercial	$71.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.92
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.30
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$4.49
Rate for Payer: Wellpoint Medicaid Managed Care	$4.03

MANUAL THRPY EACH 15 MINUTES

Facility

$142.00

Service Code	HCPCS 97001GP
Hospital Charge Code	1008105
Hospital Revenue Code	420
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$21.30
Rate for Payer: Qualcare PPO/HMO/WC	$21.30

MAPPING OF SENTINEL LYMPH NODE

Facility

$3,482.00

Service Code	HCPCS 38900
Hospital Charge Code	16000431
Hospital Revenue Code	360
Min. Negotiated Rate	$522.30
Max. Negotiated Rate	$522.30
Rate for Payer: Qualcare PPO/HMO/WC	$522.30

MAPPING OF SENTINEL LYMPH NODE

Facility

$3,482.00

Service Code	HCPCS 38900
Hospital Charge Code	16000431
Hospital Revenue Code	360
Min. Negotiated Rate	$98.89
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,323.16
Rate for Payer: Aetna Medicare Advantage	$1,044.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$887.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$887.91
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	$887.91
Rate for Payer: Cigna Commercial	$1,741.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$905.32
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$522.30
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$110.03
Rate for Payer: Wellpoint Medicaid Managed Care	$98.89

MAQUET QUADROX OXYGENATOR

Facility

$7,962.45

Hospital Charge Code	2703110A
Hospital Revenue Code	272
Min. Negotiated Rate	$1,194.37
Max. Negotiated Rate	$1,194.37
Rate for Payer: Qualcare PPO/HMO/WC	$1,194.37

MAQUET QUADROX OXYGENATOR

Facility

$7,962.45

Hospital Charge Code	2703110A
Hospital Revenue Code	272
Min. Negotiated Rate	$226.13
Max. Negotiated Rate	$3,981.22
Rate for Payer: Aetna Commercial	$3,025.73
Rate for Payer: Aetna Medicare Advantage	$2,388.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,030.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,030.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,030.42
Rate for Payer: Cigna Commercial	$3,981.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,070.24
Rate for Payer: Oxford Commercial	$1,592.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,194.37
Rate for Payer: UnitedHealthcare Commercial	$1,592.49
Rate for Payer: UnitedHealthcare Community & State	$251.61
Rate for Payer: Wellpoint Medicaid Managed Care	$226.13

MARCAINE 0.25% 10ML

Facility

$12.93

Service Code	NDC 409115901
Hospital Charge Code	606350928
Hospital Revenue Code	250
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$6.46
Rate for Payer: Aetna Commercial	$4.91
Rate for Payer: Aetna Medicare Advantage	$3.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.30
Rate for Payer: Cigna Commercial	$6.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.36
Rate for Payer: Oxford Commercial	$2.59
Rate for Payer: Qualcare PPO/HMO/WC	$1.94
Rate for Payer: UnitedHealthcare Commercial	$2.59
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

MARCAINE 0.25% 10ML

Facility

$12.93

Service Code	NDC 409115901
Hospital Charge Code	606350928
Hospital Revenue Code	250
Min. Negotiated Rate	$1.94
Max. Negotiated Rate	$1.94
Rate for Payer: Qualcare PPO/HMO/WC	$1.94

MARCAINE 0.5% 10ML VIAL

Facility

$25.19

Service Code	NDC 409156010
Hospital Charge Code	606350953
Hospital Revenue Code	250
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$12.60
Rate for Payer: Aetna Commercial	$9.57
Rate for Payer: Aetna Medicare Advantage	$7.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.42
Rate for Payer: Cigna Commercial	$12.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.55
Rate for Payer: Oxford Commercial	$5.04
Rate for Payer: Qualcare PPO/HMO/WC	$3.78
Rate for Payer: UnitedHealthcare Commercial	$5.04
Rate for Payer: UnitedHealthcare Community & State	$0.80
Rate for Payer: Wellpoint Medicaid Managed Care	$0.72

MARCAINE 0.5% 10ML VIAL

Facility

$25.19

Service Code	NDC 409156010
Hospital Charge Code	606350953
Hospital Revenue Code	250
Min. Negotiated Rate	$3.78
Max. Negotiated Rate	$3.78
Rate for Payer: Qualcare PPO/HMO/WC	$3.78

MARCAINE 0.5% 50ML

Facility

$33.77

Service Code	NDC 409161050
Hospital Charge Code	6063943295
Hospital Revenue Code	250
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$16.89
Rate for Payer: Aetna Commercial	$12.83
Rate for Payer: Aetna Medicare Advantage	$10.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.61
Rate for Payer: Cigna Commercial	$16.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.78
Rate for Payer: Oxford Commercial	$6.75
Rate for Payer: Qualcare PPO/HMO/WC	$5.07
Rate for Payer: UnitedHealthcare Commercial	$6.75
Rate for Payer: UnitedHealthcare Community & State	$1.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.96

MARCAINE 0.5% 50ML

Facility

$33.77

Service Code	NDC 409161050
Hospital Charge Code	6063943295
Hospital Revenue Code	250
Min. Negotiated Rate	$5.07
Max. Negotiated Rate	$5.07
Rate for Payer: Qualcare PPO/HMO/WC	$5.07

MARCAINE.25%W EPI1:200000 50ML

Facility

$53.27

Service Code	NDC 409381201
Hospital Charge Code	606390545
Hospital Revenue Code	250
Min. Negotiated Rate	$7.99
Max. Negotiated Rate	$7.99
Rate for Payer: Qualcare PPO/HMO/WC	$7.99

MARCAINE.25%W EPI1:200000 50ML

Facility

$53.27

Service Code	NDC 409381201
Hospital Charge Code	606390545
Hospital Revenue Code	250
Min. Negotiated Rate	$1.51
Max. Negotiated Rate	$26.64
Rate for Payer: Aetna Commercial	$20.24
Rate for Payer: Aetna Medicare Advantage	$15.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.58
Rate for Payer: Cigna Commercial	$26.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.85
Rate for Payer: Oxford Commercial	$10.65
Rate for Payer: Qualcare PPO/HMO/WC	$7.99
Rate for Payer: UnitedHealthcare Commercial	$10.65
Rate for Payer: UnitedHealthcare Community & State	$1.68
Rate for Payer: Wellpoint Medicaid Managed Care	$1.51

MARCAINE W EPI 0.5% 1 200000

Facility

$25.46

Service Code	NDC 409174910
Hospital Charge Code	606380002
Hospital Revenue Code	250
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$12.73
Rate for Payer: Aetna Commercial	$9.67
Rate for Payer: Aetna Medicare Advantage	$7.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.49
Rate for Payer: Cigna Commercial	$12.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.62
Rate for Payer: Oxford Commercial	$5.09
Rate for Payer: Qualcare PPO/HMO/WC	$3.82
Rate for Payer: UnitedHealthcare Commercial	$5.09
Rate for Payer: UnitedHealthcare Community & State	$0.80
Rate for Payer: Wellpoint Medicaid Managed Care	$0.72

MARCAINE W EPI 0.5% 1 200000

Facility

$25.46

Service Code	NDC 409174910
Hospital Charge Code	606380002
Hospital Revenue Code	250
Min. Negotiated Rate	$3.82
Max. Negotiated Rate	$3.82
Rate for Payer: Qualcare PPO/HMO/WC	$3.82

MARDIS URETERAL STENT 6FRX24CM

Facility

$955.00

Hospital Charge Code	270332071
Hospital Revenue Code	278
Min. Negotiated Rate	$143.25
Max. Negotiated Rate	$231.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.11
Rate for Payer: Qualcare PPO/HMO/WC	$143.25

MARDIS URETERAL STENT 6FRX24CM

Facility

$955.00

Hospital Charge Code	270332071
Hospital Revenue Code	278
Min. Negotiated Rate	$27.12
Max. Negotiated Rate	$477.50
Rate for Payer: Aetna Commercial	$362.90
Rate for Payer: Aetna Medicare Advantage	$286.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$243.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$243.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$243.53
Rate for Payer: Cigna Commercial	$477.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.11
Rate for Payer: Qualcare PPO/HMO/WC	$143.25
Rate for Payer: UnitedHealthcare Community & State	$30.18
Rate for Payer: Wellpoint Medicaid Managed Care	$27.12

Know your out-of-pocket cost for care.

All Charges