Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

MECHANICAL CHEST WALL OSCILL

Facility

$676.95

Service Code	HCPCS 94669
Hospital Charge Code	317094669
Hospital Revenue Code	410
Min. Negotiated Rate	$17.56
Max. Negotiated Rate	$1,440.00
Rate for Payer: Aetna Commercial	$707.61
Rate for Payer: Aetna Medicare Advantage	$842.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$943.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$943.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$943.69
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: Cigna Medicare Advantage	$260.15
Rate for Payer: Clover Medicare Advantage	$247.14
Rate for Payer: EmblemHealth Commercial	$780.45
Rate for Payer: Humana Medicare Advantage	$267.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$260.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.01
Rate for Payer: Oxford Commercial	$1,367.00
Rate for Payer: Qualcare PPO/HMO/WC	$101.54
Rate for Payer: UnitedHealthcare Commercial	$1,440.00
Rate for Payer: UnitedHealthcare Community & State	$21.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$260.15
Rate for Payer: Wellcare Medicare Advantage	$260.15
Rate for Payer: Wellpoint Medicaid Managed Care	$19.23

MECHANICAL CHEST WALL OSCILL

Facility

$676.95

Service Code	HCPCS 94669
Hospital Charge Code	317094669
Hospital Revenue Code	410
Min. Negotiated Rate	$101.54
Max. Negotiated Rate	$101.54
Rate for Payer: Qualcare PPO/HMO/WC	$101.54

MECHANICAL VENTILATOR INITIAL

Facility

$1,411.65

Service Code	HCPCS 94002
Hospital Charge Code	9500422
Hospital Revenue Code	410
Min. Negotiated Rate	$211.75
Max. Negotiated Rate	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$211.75

MECHANICAL VENTILATOR INITIAL

Facility

$1,411.65

Service Code	HCPCS 94002
Hospital Charge Code	9500422
Hospital Revenue Code	410
Min. Negotiated Rate	$40.09
Max. Negotiated Rate	$2,662.40
Rate for Payer: Aetna Commercial	$1,996.34
Rate for Payer: Aetna Medicare Advantage	$2,378.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,662.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,662.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$733.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,662.40
Rate for Payer: Cigna Commercial	$1,471.21
Rate for Payer: Cigna Medicare Advantage	$733.95
Rate for Payer: Clover Medicare Advantage	$697.25
Rate for Payer: EmblemHealth Commercial	$2,201.85
Rate for Payer: Humana Medicare Advantage	$755.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$733.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$367.03
Rate for Payer: Oxford Commercial	$1,367.00
Rate for Payer: Qualcare PPO/HMO/WC	$211.75
Rate for Payer: UnitedHealthcare Commercial	$1,440.00
Rate for Payer: UnitedHealthcare Community & State	$44.61
Rate for Payer: UnitedHealthcare Medicare Advantage	$733.95
Rate for Payer: Wellcare Medicare Advantage	$733.95
Rate for Payer: Wellpoint Medicaid Managed Care	$40.09

MECH VENT EA ADDL DAY

Facility

$689.00

Service Code	HCPCS 94003
Hospital Charge Code	9501148
Hospital Revenue Code	410
Min. Negotiated Rate	$19.57
Max. Negotiated Rate	$2,662.40
Rate for Payer: Aetna Commercial	$1,996.34
Rate for Payer: Aetna Medicare Advantage	$2,378.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,662.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,662.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$733.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,662.40
Rate for Payer: Cigna Commercial	$1,471.21
Rate for Payer: Cigna Medicare Advantage	$733.95
Rate for Payer: Clover Medicare Advantage	$697.25
Rate for Payer: EmblemHealth Commercial	$2,201.85
Rate for Payer: Humana Medicare Advantage	$755.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$733.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$179.14
Rate for Payer: Oxford Commercial	$1,367.00
Rate for Payer: Qualcare PPO/HMO/WC	$103.35
Rate for Payer: UnitedHealthcare Commercial	$1,440.00
Rate for Payer: UnitedHealthcare Community & State	$21.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$733.95
Rate for Payer: Wellcare Medicare Advantage	$733.95
Rate for Payer: Wellpoint Medicaid Managed Care	$19.57

MECH VENT EA ADDL DAY

Facility

$689.00

Service Code	HCPCS 94003
Hospital Charge Code	9501148
Hospital Revenue Code	410
Min. Negotiated Rate	$103.35
Max. Negotiated Rate	$103.35
Rate for Payer: Qualcare PPO/HMO/WC	$103.35

MECLIZINE 12.5MG

Facility

$4.76

Service Code	NDC 49210066
Hospital Charge Code	6022677
Hospital Revenue Code	250
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$0.71
Rate for Payer: Qualcare PPO/HMO/WC	$0.71

MECLIZINE 12.5MG

Facility

$4.76

Service Code	NDC 49210066
Hospital Charge Code	6022677
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.38
Rate for Payer: Aetna Commercial	$1.81
Rate for Payer: Aetna Medicare Advantage	$1.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.21
Rate for Payer: Cigna Commercial	$2.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.24
Rate for Payer: Oxford Commercial	$0.95
Rate for Payer: Qualcare PPO/HMO/WC	$0.71
Rate for Payer: UnitedHealthcare Commercial	$0.95
Rate for Payer: UnitedHealthcare Community & State	$0.15
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

MECLIZINE TAB 25MG

Facility

$4.00

Service Code	NDC 65162044210
Hospital Charge Code	60628143
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

MECLIZINE TAB 25MG

Facility

$4.00

Service Code	NDC 65162044210
Hospital Charge Code	60628143
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

MED CAGE H14 10

Facility

$25,000.00

Service Code	HCPCS C1765
Hospital Charge Code	270703621
Hospital Revenue Code	278
Min. Negotiated Rate	$710.00
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$9,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00
Rate for Payer: UnitedHealthcare Community & State	$790.00
Rate for Payer: Wellpoint Medicaid Managed Care	$710.00

MED CAGE H14 10

Facility

$25,000.00

Service Code	HCPCS C1765
Hospital Charge Code	270703621
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

MEDEKAST KIT W/2 BOOTS 4

Facility

$537.08

Hospital Charge Code	270639682
Hospital Revenue Code	272
Min. Negotiated Rate	$80.56
Max. Negotiated Rate	$80.56
Rate for Payer: Qualcare PPO/HMO/WC	$80.56

MEDEKAST KIT W/2 BOOTS 4

Facility

$537.08

Hospital Charge Code	270639682
Hospital Revenue Code	272
Min. Negotiated Rate	$15.25
Max. Negotiated Rate	$268.54
Rate for Payer: Aetna Commercial	$204.09
Rate for Payer: Aetna Medicare Advantage	$161.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.96
Rate for Payer: Cigna Commercial	$268.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.64
Rate for Payer: Oxford Commercial	$107.42
Rate for Payer: Qualcare PPO/HMO/WC	$80.56
Rate for Payer: UnitedHealthcare Commercial	$107.42
Rate for Payer: UnitedHealthcare Community & State	$16.97
Rate for Payer: Wellpoint Medicaid Managed Care	$15.25

MED E KAST ULTRA TCC2ULTR

Facility

$375.00

Hospital Charge Code	270641932
Hospital Revenue Code	270
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED E KAST ULTRA TCC2ULTR

Facility

$375.00

Hospital Charge Code	270641932
Hospital Revenue Code	270
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) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Oxford Commercial	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Commercial	$75.00
Rate for Payer: UnitedHealthcare Community & State	$11.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.65

MEDIAL DISTAL TIBIAL PLT 6H LT

Facility

$3,833.60

Hospital Charge Code	270663178
Hospital Revenue Code	270
Min. Negotiated Rate	$108.87
Max. Negotiated Rate	$1,916.80
Rate for Payer: Aetna Commercial	$1,456.77
Rate for Payer: Aetna Medicare Advantage	$1,150.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$977.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$977.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$977.57
Rate for Payer: Cigna Commercial	$1,916.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$996.74
Rate for Payer: Oxford Commercial	$766.72
Rate for Payer: Qualcare PPO/HMO/WC	$575.04
Rate for Payer: UnitedHealthcare Commercial	$766.72
Rate for Payer: UnitedHealthcare Community & State	$121.14
Rate for Payer: Wellpoint Medicaid Managed Care	$108.87

MEDIAL DISTAL TIBIAL PLT 6H LT

Facility

$3,833.60

Hospital Charge Code	270663178
Hospital Revenue Code	270
Min. Negotiated Rate	$575.04
Max. Negotiated Rate	$575.04
Rate for Payer: Qualcare PPO/HMO/WC	$575.04

MEDIAL MENISCUS LEFT

Facility

$21,000.00

Service Code	HCPCS C1762
Hospital Charge Code	270675518
Hospital Revenue Code	278
Min. Negotiated Rate	$596.40
Max. Negotiated Rate	$10,500.00
Rate for Payer: Aetna Commercial	$7,980.00
Rate for Payer: Aetna Medicare Advantage	$6,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,355.00
Rate for Payer: Cigna Commercial	$10,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,082.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,150.00
Rate for Payer: UnitedHealthcare Community & State	$663.60
Rate for Payer: Wellpoint Medicaid Managed Care	$596.40

MEDIAL MENISCUS LEFT

Facility

$21,000.00

Service Code	HCPCS C1762
Hospital Charge Code	270675518
Hospital Revenue Code	278
Min. Negotiated Rate	$3,150.00
Max. Negotiated Rate	$5,082.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,082.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,150.00

MEDICAL BACK PROBLEMS WITH MCC

Facility

$72,418.66

Service Code	MSDRG 551
Min. Negotiated Rate	$22,050.55
Max. Negotiated Rate	$72,418.66
Rate for Payer: Aetna Commercial	$53,435.89
Rate for Payer: Aetna Medicare Advantage	$72,418.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47,098.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47,098.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23,211.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47,098.50
Rate for Payer: Cigna Commercial	$37,365.30
Rate for Payer: Cigna Medicare Advantage	$23,211.11
Rate for Payer: Clover Medicare Advantage	$22,050.55
Rate for Payer: EmblemHealth Commercial	$69,633.33
Rate for Payer: Humana Medicare Advantage	$23,907.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$23,211.11
Rate for Payer: Oxford Commercial	$29,532.88
Rate for Payer: UnitedHealthcare Commercial	$39,530.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$23,211.11
Rate for Payer: Wellcare Medicare Advantage	$23,211.11

MEDICAL BACK PROBLEMS WITHOUT MCC

Facility

$49,835.54

Service Code	MSDRG 552
Min. Negotiated Rate	$15,174.28
Max. Negotiated Rate	$49,835.54
Rate for Payer: Aetna Commercial	$37,351.94
Rate for Payer: Aetna Medicare Advantage	$49,835.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26,873.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26,873.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,972.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26,873.85
Rate for Payer: Cigna Commercial	$21,430.26
Rate for Payer: Cigna Medicare Advantage	$15,972.93
Rate for Payer: Clover Medicare Advantage	$15,174.28
Rate for Payer: EmblemHealth Commercial	$47,918.79
Rate for Payer: Humana Medicare Advantage	$16,452.12
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,972.93
Rate for Payer: Oxford Commercial	$16,938.11
Rate for Payer: UnitedHealthcare Commercial	$22,672.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,972.93
Rate for Payer: Wellcare Medicare Advantage	$15,972.93

MEDIHONEY 44ML

Facility

$212.00

Hospital Charge Code	606390572
Hospital Revenue Code	250
Min. Negotiated Rate	$6.02
Max. Negotiated Rate	$106.00
Rate for Payer: Aetna Commercial	$80.56
Rate for Payer: Aetna Medicare Advantage	$63.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.06
Rate for Payer: Cigna Commercial	$106.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.12
Rate for Payer: Oxford Commercial	$42.40
Rate for Payer: Qualcare PPO/HMO/WC	$31.80
Rate for Payer: UnitedHealthcare Commercial	$42.40
Rate for Payer: UnitedHealthcare Community & State	$6.70
Rate for Payer: Wellpoint Medicaid Managed Care	$6.02

MEDIHONEY 44ML

Facility

$212.00

Hospital Charge Code	606390572
Hospital Revenue Code	250
Min. Negotiated Rate	$31.80
Max. Negotiated Rate	$31.80
Rate for Payer: Qualcare PPO/HMO/WC	$31.80

MEDIHONEY GEL TUBE

Facility

$66.06

Service Code	NDC 9958003461
Hospital Charge Code	606390420
Hospital Revenue Code	272
Min. Negotiated Rate	$9.91
Max. Negotiated Rate	$9.91
Rate for Payer: Qualcare PPO/HMO/WC	$9.91

Know your out-of-pocket cost for care.

All Charges