Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

MICROPUNCTURE SET 5FR SS

Facility

$87.55

Hospital Charge Code	270654224N
Hospital Revenue Code	272
Min. Negotiated Rate	$2.49
Max. Negotiated Rate	$43.77
Rate for Payer: Aetna Commercial	$33.27
Rate for Payer: Aetna Medicare Advantage	$26.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.33
Rate for Payer: Cigna Commercial	$43.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.76
Rate for Payer: Oxford Commercial	$17.51
Rate for Payer: Qualcare PPO/HMO/WC	$13.13
Rate for Payer: UnitedHealthcare Commercial	$17.51
Rate for Payer: UnitedHealthcare Community & State	$2.77
Rate for Payer: Wellpoint Medicaid Managed Care	$2.49

MICROPUNCTURE SET 5FR SS

Facility

$87.55

Hospital Charge Code	270654224N
Hospital Revenue Code	272
Min. Negotiated Rate	$13.13
Max. Negotiated Rate	$13.13
Rate for Payer: Qualcare PPO/HMO/WC	$13.13

MICROPUNCTURE SHEATH 5FRX10CM

Facility

$3,550.00

Hospital Charge Code	270665132
Hospital Revenue Code	279
Min. Negotiated Rate	$532.50
Max. Negotiated Rate	$532.50
Rate for Payer: Qualcare PPO/HMO/WC	$532.50

MICROPUNCTURE SHEATH 5FRX10CM

Facility

$3,550.00

Hospital Charge Code	270665132
Hospital Revenue Code	279
Min. Negotiated Rate	$100.82
Max. Negotiated Rate	$1,775.00
Rate for Payer: Aetna Commercial	$1,349.00
Rate for Payer: Aetna Medicare Advantage	$1,065.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$905.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$905.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$905.25
Rate for Payer: Cigna Commercial	$1,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$923.00
Rate for Payer: Oxford Commercial	$710.00
Rate for Payer: Qualcare PPO/HMO/WC	$532.50
Rate for Payer: UnitedHealthcare Commercial	$710.00
Rate for Payer: UnitedHealthcare Community & State	$112.18
Rate for Payer: Wellpoint Medicaid Managed Care	$100.82

MICRO SAGITTAL BLADE

Facility

$30.80

Hospital Charge Code	270654639
Hospital Revenue Code	270
Min. Negotiated Rate	$4.62
Max. Negotiated Rate	$4.62
Rate for Payer: Qualcare PPO/HMO/WC	$4.62

MICRO SAGITTAL BLADE

Facility

$30.80

Hospital Charge Code	270654639
Hospital Revenue Code	270
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$15.40
Rate for Payer: Aetna Commercial	$11.70
Rate for Payer: Aetna Medicare Advantage	$9.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.85
Rate for Payer: Cigna Commercial	$15.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.01
Rate for Payer: Oxford Commercial	$6.16
Rate for Payer: Qualcare PPO/HMO/WC	$4.62
Rate for Payer: UnitedHealthcare Commercial	$6.16
Rate for Payer: UnitedHealthcare Community & State	$0.97
Rate for Payer: Wellpoint Medicaid Managed Care	$0.87

MICROSCOPIC EXAM, URINE

Facility

$390.00

Service Code	HCPCS 81015
Hospital Charge Code	3032711
Hospital Revenue Code	307
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

MICROSCOPIC EXAM, URINE

Facility

$390.00

Service Code	HCPCS 81015
Hospital Charge Code	3032711
Hospital Revenue Code	307
Min. Negotiated Rate	$0.66
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$8.30
Rate for Payer: Aetna Medicare Advantage	$9.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.06
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$3.05
Rate for Payer: Clover Medicare Advantage	$2.90
Rate for Payer: EmblemHealth Commercial	$9.15
Rate for Payer: Humana Medicare Advantage	$3.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.05
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	$2.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.05
Rate for Payer: Wellcare Medicare Advantage	$3.05
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

MICROSCOPIC NEURO LASER

Facility

$258.00

Hospital Charge Code	270335115
Hospital Revenue Code	272
Min. Negotiated Rate	$38.70
Max. Negotiated Rate	$38.70
Rate for Payer: Qualcare PPO/HMO/WC	$38.70

MICROSCOPIC NEURO LASER

Facility

$258.00

Hospital Charge Code	270335115
Hospital Revenue Code	272
Min. Negotiated Rate	$7.33
Max. Negotiated Rate	$129.00
Rate for Payer: Aetna Commercial	$98.04
Rate for Payer: Aetna Medicare Advantage	$77.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.79
Rate for Payer: Cigna Commercial	$129.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.08
Rate for Payer: Oxford Commercial	$51.60
Rate for Payer: Qualcare PPO/HMO/WC	$38.70
Rate for Payer: UnitedHealthcare Commercial	$51.60
Rate for Payer: UnitedHealthcare Community & State	$8.15
Rate for Payer: Wellpoint Medicaid Managed Care	$7.33

MICROSOMAL AB

Facility

$667.59

Service Code	HCPCS 86376
Hospital Charge Code	39708042E
Hospital Revenue Code	306
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

MICROSOMAL AB

Facility

$667.59

Service Code	HCPCS 86376
Hospital Charge Code	39708042E
Hospital Revenue Code	306
Min. Negotiated Rate	$10.89
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$39.58
Rate for Payer: Aetna Medicare Advantage	$47.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.78
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$14.55
Rate for Payer: Clover Medicare Advantage	$13.82
Rate for Payer: EmblemHealth Commercial	$43.65
Rate for Payer: Humana Medicare Advantage	$14.99
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.57
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$11.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.55
Rate for Payer: Wellcare Medicare Advantage	$14.55
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

MICROSOMAL ANTIBODY EACH

Facility

$72.75

Service Code	HCPCS 86376
Hospital Charge Code	401386376C
Hospital Revenue Code	302
Min. Negotiated Rate	$10.91
Max. Negotiated Rate	$10.91
Rate for Payer: Qualcare PPO/HMO/WC	$10.91

MICROSOMAL ANTIBODY EACH

Facility

$72.75

Service Code	HCPCS 86376
Hospital Charge Code	401386376C
Hospital Revenue Code	302
Min. Negotiated Rate	$2.07
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$39.58
Rate for Payer: Aetna Medicare Advantage	$47.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.78
Rate for Payer: Cigna Commercial	$36.38
Rate for Payer: Cigna Medicare Advantage	$14.55
Rate for Payer: Clover Medicare Advantage	$13.82
Rate for Payer: EmblemHealth Commercial	$43.65
Rate for Payer: Humana Medicare Advantage	$14.99
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.91
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.91
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$11.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.55
Rate for Payer: Wellcare Medicare Advantage	$14.55
Rate for Payer: Wellpoint Medicaid Managed Care	$2.07

MICROSPORIDIA ID

Facility

$390.00

Service Code	HCPCS 87207
Hospital Charge Code	39900494
Hospital Revenue Code	309
Min. Negotiated Rate	$4.79
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$16.29
Rate for Payer: Aetna Medicare Advantage	$19.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.99
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	$21.73
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.99
Rate for Payer: Clover Medicare Advantage	$5.69
Rate for Payer: EmblemHealth Commercial	$17.97
Rate for Payer: Humana Medicare Advantage	$6.17
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.99
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	$4.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.99
Rate for Payer: Wellcare Medicare Advantage	$5.99
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

MICROSPORIDIA ID

Facility

$390.00

Service Code	HCPCS 87207
Hospital Charge Code	39900494
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

MICROSTENT HYDRUS I STENT

Facility

$9,500.00

Service Code	HCPCS C1783
Hospital Charge Code	270690093
Hospital Revenue Code	278
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$2,299.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,299.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

MICROSTENT HYDRUS I STENT

Facility

$9,500.00

Service Code	HCPCS C1783
Hospital Charge Code	270690093
Hospital Revenue Code	278
Min. Negotiated Rate	$269.80
Max. Negotiated Rate	$4,750.00
Rate for Payer: Aetna Commercial	$3,610.00
Rate for Payer: Aetna Medicare Advantage	$2,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,422.50
Rate for Payer: Cigna Commercial	$4,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,299.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Community & State	$300.20
Rate for Payer: Wellpoint Medicaid Managed Care	$269.80

MICRO-STICK 5F REGULAR

Facility

$105.00

Hospital Charge Code	270681204
Hospital Revenue Code	272
Min. Negotiated Rate	$15.75
Max. Negotiated Rate	$15.75
Rate for Payer: Qualcare PPO/HMO/WC	$15.75

MICRO-STICK 5F REGULAR

Facility

$105.00

Hospital Charge Code	270681204
Hospital Revenue Code	272
Min. Negotiated Rate	$2.98
Max. Negotiated Rate	$52.50
Rate for Payer: Aetna Commercial	$39.90
Rate for Payer: Aetna Medicare Advantage	$31.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.77
Rate for Payer: Cigna Commercial	$52.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.30
Rate for Payer: Oxford Commercial	$21.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.75
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Community & State	$3.32
Rate for Payer: Wellpoint Medicaid Managed Care	$2.98

MICROSURGERY ADD-ON

Facility

$6,832.37

Service Code	HCPCS 14061
Hospital Charge Code	16000596
Hospital Revenue Code	360
Min. Negotiated Rate	$194.04
Max. Negotiated Rate	$8,891.84
Rate for Payer: Aetna Commercial	$6,667.35
Rate for Payer: Aetna Medicare Advantage	$7,941.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,891.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,891.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,451.23
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	$8,891.84
Rate for Payer: Cigna Commercial	$4,913.48
Rate for Payer: Cigna Medicare Advantage	$2,451.23
Rate for Payer: Clover Medicare Advantage	$2,328.67
Rate for Payer: EmblemHealth Commercial	$7,353.69
Rate for Payer: Humana Medicare Advantage	$2,524.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,451.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,776.42
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,024.86
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$215.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,451.23
Rate for Payer: Wellcare Medicare Advantage	$2,451.23
Rate for Payer: Wellpoint Medicaid Managed Care	$194.04

MICROSURGERY ADD-ON

Facility

$6,832.37

Service Code	HCPCS 14061
Hospital Charge Code	16000596
Hospital Revenue Code	360
Min. Negotiated Rate	$1,024.86
Max. Negotiated Rate	$1,024.86
Rate for Payer: Qualcare PPO/HMO/WC	$1,024.86

MICRO TIP TX1

Facility

$3,825.00

Hospital Charge Code	270663886
Hospital Revenue Code	272
Min. Negotiated Rate	$573.75
Max. Negotiated Rate	$573.75
Rate for Payer: Qualcare PPO/HMO/WC	$573.75

MICRO TIP TX1

Facility

$3,825.00

Hospital Charge Code	270663886
Hospital Revenue Code	272
Min. Negotiated Rate	$108.63
Max. Negotiated Rate	$1,912.50
Rate for Payer: Aetna Commercial	$1,453.50
Rate for Payer: Aetna Medicare Advantage	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$975.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$975.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$975.38
Rate for Payer: Cigna Commercial	$1,912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$994.50
Rate for Payer: Oxford Commercial	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$573.75
Rate for Payer: UnitedHealthcare Commercial	$765.00
Rate for Payer: UnitedHealthcare Community & State	$120.87
Rate for Payer: Wellpoint Medicaid Managed Care	$108.63

MIDAZOLAM 100MG/100ML NACL

Facility

$225.12

Service Code	HCPCS J2250
Hospital Charge Code	60630239
Hospital Revenue Code	636
Min. Negotiated Rate	$33.77
Max. Negotiated Rate	$54.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.48
Rate for Payer: Qualcare PPO/HMO/WC	$33.77

Know your out-of-pocket cost for care.

All Charges