Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

MARIJUANA

Facility

$324.00

Service Code	HCPCS 80300
Hospital Charge Code	38472476
Hospital Revenue Code	301
Min. Negotiated Rate	$9.20
Max. Negotiated Rate	$162.00
Rate for Payer: Aetna Commercial	$123.12
Rate for Payer: Aetna Medicare Advantage	$97.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.62
Rate for Payer: Cigna Commercial	$162.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.24
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.60
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.24
Rate for Payer: Wellpoint Medicaid Managed Care	$9.20

MARIJUANA

Facility

$324.00

Service Code	HCPCS 80300
Hospital Charge Code	38472476
Hospital Revenue Code	301
Min. Negotiated Rate	$48.60
Max. Negotiated Rate	$48.60
Rate for Payer: Qualcare PPO/HMO/WC	$48.60

MARIJUANA CONFIRMATION

Facility

$124.10

Service Code	HCPCS 82542
Hospital Charge Code	39900068
Hospital Revenue Code	301
Min. Negotiated Rate	$3.52
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$65.52
Rate for Payer: Aetna Medicare Advantage	$78.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.39
Rate for Payer: Cigna Commercial	$62.05
Rate for Payer: Cigna Medicare Advantage	$24.09
Rate for Payer: Clover Medicare Advantage	$22.89
Rate for Payer: EmblemHealth Commercial	$72.27
Rate for Payer: Humana Medicare Advantage	$24.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.27
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.61
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$19.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.09
Rate for Payer: Wellcare Medicare Advantage	$24.09
Rate for Payer: Wellpoint Medicaid Managed Care	$3.52

MARIJUANA CONFIRMATION

Facility

$124.10

Service Code	HCPCS 82542
Hospital Charge Code	39900068
Hospital Revenue Code	301
Min. Negotiated Rate	$18.61
Max. Negotiated Rate	$18.61
Rate for Payer: Qualcare PPO/HMO/WC	$18.61

MARKER BREAST BX TUMARK-Q

Facility

$375.00

Service Code	HCPCS A4648
Hospital Charge Code	270669923R
Hospital Revenue Code	278
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$11.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.65

MARKER BREAST BX TUMARK-Q

Facility

$375.00

Service Code	HCPCS A4648
Hospital Charge Code	270669923
Hospital Revenue Code	278
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$11.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.65

MARKER BREAST BX TUMARK-Q

Facility

$375.00

Service Code	HCPCS A4648
Hospital Charge Code	270669923R
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MARKER BREAST BX TUMARK-Q

Facility

$375.00

Service Code	HCPCS A4648
Hospital Charge Code	270669923
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MARKER BX BREAST SMARKMSS1

Facility

$403.75

Service Code	HCPCS A4648
Hospital Charge Code	270664833R
Hospital Revenue Code	278
Min. Negotiated Rate	$60.56
Max. Negotiated Rate	$97.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.71
Rate for Payer: Qualcare PPO/HMO/WC	$60.56

MARKER BX BREAST SMARKMSS1

Facility

$403.75

Service Code	HCPCS A4648
Hospital Charge Code	270664833R
Hospital Revenue Code	278
Min. Negotiated Rate	$11.47
Max. Negotiated Rate	$201.88
Rate for Payer: Aetna Commercial	$153.43
Rate for Payer: Aetna Medicare Advantage	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.96
Rate for Payer: Cigna Commercial	$201.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.71
Rate for Payer: Qualcare PPO/HMO/WC	$60.56
Rate for Payer: UnitedHealthcare Community & State	$12.76
Rate for Payer: Wellpoint Medicaid Managed Care	$11.47

MARKERBXEVIVASMARKSHAPE1 13MM

Facility

$359.15

Service Code	HCPCS A4648
Hospital Charge Code	270675352R
Hospital Revenue Code	278
Min. Negotiated Rate	$10.20
Max. Negotiated Rate	$179.57
Rate for Payer: Aetna Commercial	$136.48
Rate for Payer: Aetna Medicare Advantage	$107.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.58
Rate for Payer: Cigna Commercial	$179.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.91
Rate for Payer: Qualcare PPO/HMO/WC	$53.87
Rate for Payer: UnitedHealthcare Community & State	$11.35
Rate for Payer: Wellpoint Medicaid Managed Care	$10.20

MARKERBXEVIVASMARKSHAPE1 13MM

Facility

$359.15

Service Code	HCPCS A4648
Hospital Charge Code	270675352R
Hospital Revenue Code	278
Min. Negotiated Rate	$53.87
Max. Negotiated Rate	$86.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.91
Rate for Payer: Qualcare PPO/HMO/WC	$53.87

MARKER BX SITE TRIMMEK

Facility

$3,800.00

Hospital Charge Code	270664834
Hospital Revenue Code	270
Min. Negotiated Rate	$107.92
Max. Negotiated Rate	$1,900.00
Rate for Payer: Aetna Commercial	$1,444.00
Rate for Payer: Aetna Medicare Advantage	$1,140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$969.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$969.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$969.00
Rate for Payer: Cigna Commercial	$1,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$988.00
Rate for Payer: Oxford Commercial	$760.00
Rate for Payer: Qualcare PPO/HMO/WC	$570.00
Rate for Payer: UnitedHealthcare Commercial	$760.00
Rate for Payer: UnitedHealthcare Community & State	$120.08
Rate for Payer: Wellpoint Medicaid Managed Care	$107.92

MARKER BX SITE TRIMMEK

Facility

$3,800.00

Hospital Charge Code	270664834
Hospital Revenue Code	270
Min. Negotiated Rate	$570.00
Max. Negotiated Rate	$570.00
Rate for Payer: Qualcare PPO/HMO/WC	$570.00

MARKER BX SMARK EVIVA 3RD SH

Facility

$403.75

Service Code	HCPCS A4648
Hospital Charge Code	270675459R
Hospital Revenue Code	278
Min. Negotiated Rate	$60.56
Max. Negotiated Rate	$97.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.71
Rate for Payer: Qualcare PPO/HMO/WC	$60.56

MARKER BX SMARK EVIVA 3RD SH

Facility

$403.75

Service Code	HCPCS A4648
Hospital Charge Code	270675459R
Hospital Revenue Code	278
Min. Negotiated Rate	$11.47
Max. Negotiated Rate	$201.88
Rate for Payer: Aetna Commercial	$153.43
Rate for Payer: Aetna Medicare Advantage	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.96
Rate for Payer: Cigna Commercial	$201.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.71
Rate for Payer: Qualcare PPO/HMO/WC	$60.56
Rate for Payer: UnitedHealthcare Community & State	$12.76
Rate for Payer: Wellpoint Medicaid Managed Care	$11.47

MARKER BX TI SMARK-CELERO-12

Facility

$412.25

Service Code	HCPCS A4648
Hospital Charge Code	270697947
Hospital Revenue Code	278
Min. Negotiated Rate	$61.84
Max. Negotiated Rate	$99.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.76
Rate for Payer: Qualcare PPO/HMO/WC	$61.84

MARKER BX TI SMARK-CELERO-12

Facility

$412.25

Service Code	HCPCS A4648
Hospital Charge Code	270697947
Hospital Revenue Code	278
Min. Negotiated Rate	$11.71
Max. Negotiated Rate	$206.12
Rate for Payer: Aetna Commercial	$156.66
Rate for Payer: Aetna Medicare Advantage	$123.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.12
Rate for Payer: Cigna Commercial	$206.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.76
Rate for Payer: Qualcare PPO/HMO/WC	$61.84
Rate for Payer: UnitedHealthcare Community & State	$13.03
Rate for Payer: Wellpoint Medicaid Managed Care	$11.71

MARKERBXTITOPHATSMARKCELER122S

Facility

$412.25

Service Code	HCPCS A4648
Hospital Charge Code	270697948
Hospital Revenue Code	278
Min. Negotiated Rate	$61.84
Max. Negotiated Rate	$99.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.76
Rate for Payer: Qualcare PPO/HMO/WC	$61.84

MARKERBXTITOPHATSMARKCELER122S

Facility

$412.25

Service Code	HCPCS A4648
Hospital Charge Code	270697948
Hospital Revenue Code	278
Min. Negotiated Rate	$11.71
Max. Negotiated Rate	$206.12
Rate for Payer: Aetna Commercial	$156.66
Rate for Payer: Aetna Medicare Advantage	$123.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.12
Rate for Payer: Cigna Commercial	$206.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.76
Rate for Payer: Qualcare PPO/HMO/WC	$61.84
Rate for Payer: UnitedHealthcare Community & State	$13.03
Rate for Payer: Wellpoint Medicaid Managed Care	$11.71

MARKER BX TOPHATSMARKEVIVA2ND

Facility

$359.15

Service Code	HCPCS A4648
Hospital Charge Code	270675353R
Hospital Revenue Code	278
Min. Negotiated Rate	$10.20
Max. Negotiated Rate	$179.57
Rate for Payer: Aetna Commercial	$136.48
Rate for Payer: Aetna Medicare Advantage	$107.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.58
Rate for Payer: Cigna Commercial	$179.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.91
Rate for Payer: Qualcare PPO/HMO/WC	$53.87
Rate for Payer: UnitedHealthcare Community & State	$11.35
Rate for Payer: Wellpoint Medicaid Managed Care	$10.20

MARKER BX TOPHATSMARKEVIVA2ND

Facility

$359.15

Service Code	HCPCS A4648
Hospital Charge Code	270675353R
Hospital Revenue Code	278
Min. Negotiated Rate	$53.87
Max. Negotiated Rate	$86.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.91
Rate for Payer: Qualcare PPO/HMO/WC	$53.87

MARKERBXTRIMARKATECTD-2S-13-XX

Facility

$388.00

Service Code	HCPCS A4648
Hospital Charge Code	270679041R
Hospital Revenue Code	278
Min. Negotiated Rate	$11.02
Max. Negotiated Rate	$194.00
Rate for Payer: Aetna Commercial	$147.44
Rate for Payer: Aetna Medicare Advantage	$116.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.94
Rate for Payer: Cigna Commercial	$194.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.90
Rate for Payer: Qualcare PPO/HMO/WC	$58.20
Rate for Payer: UnitedHealthcare Community & State	$12.26
Rate for Payer: Wellpoint Medicaid Managed Care	$11.02

MARKERBXTRIMARKATECTD-2S-13-XX

Facility

$388.00

Service Code	HCPCS A4648
Hospital Charge Code	270679041R
Hospital Revenue Code	278
Min. Negotiated Rate	$58.20
Max. Negotiated Rate	$93.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.90
Rate for Payer: Qualcare PPO/HMO/WC	$58.20

MARKER BX TRIMARK TI 13CM

Facility

$338.00

Service Code	HCPCS A4648
Hospital Charge Code	270664834R
Hospital Revenue Code	278
Min. Negotiated Rate	$50.70
Max. Negotiated Rate	$81.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.80
Rate for Payer: Qualcare PPO/HMO/WC	$50.70

Know your out-of-pocket cost for care.

All Charges