Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

MINOR SKIN DISORDERS WITHOUT MCC

Facility

$48,101.07

Service Code	MSDRG 607
Min. Negotiated Rate	$14,646.16
Max. Negotiated Rate	$48,101.07
Rate for Payer: Aetna Commercial	$36,116.64
Rate for Payer: Aetna Medicare Advantage	$48,101.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24,657.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24,657.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,417.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24,657.45
Rate for Payer: Cigna Commercial	$20,206.38
Rate for Payer: Cigna Medicare Advantage	$15,417.01
Rate for Payer: Clover Medicare Advantage	$14,646.16
Rate for Payer: EmblemHealth Commercial	$46,251.03
Rate for Payer: Humana Medicare Advantage	$15,879.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,417.01
Rate for Payer: Oxford Commercial	$15,970.77
Rate for Payer: UnitedHealthcare Commercial	$21,377.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,417.01
Rate for Payer: Wellcare Medicare Advantage	$15,417.01

MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC

Facility

$67,003.44

Service Code	MSDRG 345
Min. Negotiated Rate	$20,401.69
Max. Negotiated Rate	$67,003.44
Rate for Payer: Aetna Commercial	$49,579.11
Rate for Payer: Aetna Medicare Advantage	$67,003.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42,665.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42,665.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,475.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42,665.70
Rate for Payer: Cigna Commercial	$33,544.28
Rate for Payer: Cigna Medicare Advantage	$21,475.46
Rate for Payer: Clover Medicare Advantage	$20,401.69
Rate for Payer: EmblemHealth Commercial	$64,426.38
Rate for Payer: Humana Medicare Advantage	$22,119.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21,475.46
Rate for Payer: Oxford Commercial	$26,512.81
Rate for Payer: UnitedHealthcare Commercial	$35,488.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$21,475.46
Rate for Payer: Wellcare Medicare Advantage	$21,475.46

MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC

Facility

$101,064.51

Service Code	MSDRG 344
Min. Negotiated Rate	$30,772.85
Max. Negotiated Rate	$101,064.51
Rate for Payer: Aetna Commercial	$73,837.79
Rate for Payer: Aetna Medicare Advantage	$101,064.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75,911.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75,911.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$32,392.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75,911.70
Rate for Payer: Cigna Commercial	$57,578.36
Rate for Payer: Cigna Medicare Advantage	$32,392.47
Rate for Payer: Clover Medicare Advantage	$30,772.85
Rate for Payer: EmblemHealth Commercial	$97,177.41
Rate for Payer: Humana Medicare Advantage	$33,364.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$32,392.47
Rate for Payer: Oxford Commercial	$45,508.94
Rate for Payer: UnitedHealthcare Commercial	$60,915.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$32,392.47
Rate for Payer: Wellcare Medicare Advantage	$32,392.47

MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC

Facility

$56,940.97

Service Code	MSDRG 346
Min. Negotiated Rate	$17,337.79
Max. Negotiated Rate	$56,940.97
Rate for Payer: Aetna Commercial	$42,412.51
Rate for Payer: Aetna Medicare Advantage	$56,940.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35,739.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35,739.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18,250.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35,739.45
Rate for Payer: Cigna Commercial	$26,443.96
Rate for Payer: Cigna Medicare Advantage	$18,250.31
Rate for Payer: Clover Medicare Advantage	$17,337.79
Rate for Payer: EmblemHealth Commercial	$54,750.93
Rate for Payer: Humana Medicare Advantage	$18,797.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18,250.31
Rate for Payer: Oxford Commercial	$20,900.84
Rate for Payer: UnitedHealthcare Commercial	$27,976.53
Rate for Payer: UnitedHealthcare Medicare Advantage	$18,250.31
Rate for Payer: Wellcare Medicare Advantage	$18,250.31

MINOXIDIL 2.5 MG TAB

Facility

$4.00

Service Code	NDC 591564201
Hospital Charge Code	60627640
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

MINOXIDIL 2.5 MG TAB

Facility

$4.00

Service Code	NDC 591564201
Hospital Charge Code	60627640
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

MIO MEDICAL DEVICE ORGANIZER

Facility

$86.67

Hospital Charge Code	270658155
Hospital Revenue Code	270
Min. Negotiated Rate	$13.00
Max. Negotiated Rate	$13.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.00

MIO MEDICAL DEVICE ORGANIZER

Facility

$86.67

Hospital Charge Code	270658155
Hospital Revenue Code	270
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$43.34
Rate for Payer: Aetna Commercial	$32.93
Rate for Payer: Aetna Medicare Advantage	$26.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.10
Rate for Payer: Cigna Commercial	$43.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.53
Rate for Payer: Oxford Commercial	$17.33
Rate for Payer: Qualcare PPO/HMO/WC	$13.00
Rate for Payer: UnitedHealthcare Commercial	$17.33
Rate for Payer: UnitedHealthcare Community & State	$2.74
Rate for Payer: Wellpoint Medicaid Managed Care	$2.46

MIOSTAT 0.01% SDV

Facility

$236.91

Service Code	NDC 65002315
Hospital Charge Code	606390042
Hospital Revenue Code	250
Min. Negotiated Rate	$6.73
Max. Negotiated Rate	$118.45
Rate for Payer: Aetna Commercial	$90.03
Rate for Payer: Aetna Medicare Advantage	$71.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.41
Rate for Payer: Cigna Commercial	$118.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.60
Rate for Payer: Oxford Commercial	$47.38
Rate for Payer: Qualcare PPO/HMO/WC	$35.54
Rate for Payer: UnitedHealthcare Commercial	$47.38
Rate for Payer: UnitedHealthcare Community & State	$7.49
Rate for Payer: Wellpoint Medicaid Managed Care	$6.73

MIOSTAT 0.01% SDV

Facility

$236.91

Service Code	NDC 65002315
Hospital Charge Code	606390042
Hospital Revenue Code	250
Min. Negotiated Rate	$35.54
Max. Negotiated Rate	$35.54
Rate for Payer: Qualcare PPO/HMO/WC	$35.54

MIRACLE MOUTHWASH

Facility

$294.80

Service Code	NDC 10223030101
Hospital Charge Code	60635521
Hospital Revenue Code	250
Min. Negotiated Rate	$8.37
Max. Negotiated Rate	$147.40
Rate for Payer: Aetna Commercial	$112.02
Rate for Payer: Aetna Medicare Advantage	$88.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.17
Rate for Payer: Cigna Commercial	$147.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.65
Rate for Payer: Oxford Commercial	$58.96
Rate for Payer: Qualcare PPO/HMO/WC	$44.22
Rate for Payer: UnitedHealthcare Commercial	$58.96
Rate for Payer: UnitedHealthcare Community & State	$9.32
Rate for Payer: Wellpoint Medicaid Managed Care	$8.37

MIRACLE MOUTHWASH

Facility

$294.80

Service Code	NDC 10223030101
Hospital Charge Code	60635521
Hospital Revenue Code	250
Min. Negotiated Rate	$44.22
Max. Negotiated Rate	$44.22
Rate for Payer: Qualcare PPO/HMO/WC	$44.22

MIRAPEX 1MG TAB

Facility

$19.77

Service Code	NDC 13668009490
Hospital Charge Code	60635193
Hospital Revenue Code	250
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$9.88
Rate for Payer: Aetna Commercial	$7.51
Rate for Payer: Aetna Medicare Advantage	$5.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.04
Rate for Payer: Cigna Commercial	$9.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.14
Rate for Payer: Oxford Commercial	$3.95
Rate for Payer: Qualcare PPO/HMO/WC	$2.97
Rate for Payer: UnitedHealthcare Commercial	$3.95
Rate for Payer: UnitedHealthcare Community & State	$0.62
Rate for Payer: Wellpoint Medicaid Managed Care	$0.56

MIRAPEX 1MG TAB

Facility

$19.77

Service Code	NDC 13668009490
Hospital Charge Code	60635193
Hospital Revenue Code	250
Min. Negotiated Rate	$2.97
Max. Negotiated Rate	$2.97
Rate for Payer: Qualcare PPO/HMO/WC	$2.97

MIRCO CLIPS SUERFINE TITANIUM

Facility

$54.17

Hospital Charge Code	270663933
Hospital Revenue Code	270
Min. Negotiated Rate	$8.13
Max. Negotiated Rate	$8.13
Rate for Payer: Qualcare PPO/HMO/WC	$8.13

MIRCO CLIPS SUERFINE TITANIUM

Facility

$54.17

Hospital Charge Code	270663933
Hospital Revenue Code	270
Min. Negotiated Rate	$1.54
Max. Negotiated Rate	$27.09
Rate for Payer: Aetna Commercial	$20.58
Rate for Payer: Aetna Medicare Advantage	$16.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.81
Rate for Payer: Cigna Commercial	$27.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.08
Rate for Payer: Oxford Commercial	$10.83
Rate for Payer: Qualcare PPO/HMO/WC	$8.13
Rate for Payer: UnitedHealthcare Commercial	$10.83
Rate for Payer: UnitedHealthcare Community & State	$1.71
Rate for Payer: Wellpoint Medicaid Managed Care	$1.54

MIRENA IUD

Facility

$1,471.50

Service Code	HCPCS J7298
Hospital Charge Code	270677501
Hospital Revenue Code	636
Min. Negotiated Rate	$41.79
Max. Negotiated Rate	$735.75
Rate for Payer: Aetna Commercial	$559.17
Rate for Payer: Aetna Medicare Advantage	$441.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$375.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$375.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$375.23
Rate for Payer: Cigna Commercial	$735.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.10
Rate for Payer: Qualcare PPO/HMO/WC	$220.72
Rate for Payer: UnitedHealthcare Community & State	$46.50
Rate for Payer: Wellpoint Medicaid Managed Care	$41.79

MIRENA IUD

Facility

$1,471.50

Service Code	HCPCS J7298
Hospital Charge Code	87502785
Hospital Revenue Code	278
Min. Negotiated Rate	$220.72
Max. Negotiated Rate	$356.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$294.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.10
Rate for Payer: Qualcare PPO/HMO/WC	$220.72

MIRENA IUD

Facility

$1,471.50

Service Code	HCPCS J7298
Hospital Charge Code	87502785
Hospital Revenue Code	278
Min. Negotiated Rate	$41.79
Max. Negotiated Rate	$735.75
Rate for Payer: Aetna Commercial	$559.17
Rate for Payer: Aetna Medicare Advantage	$441.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$375.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$375.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$294.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$375.23
Rate for Payer: Cigna Commercial	$735.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.10
Rate for Payer: Qualcare PPO/HMO/WC	$220.72
Rate for Payer: UnitedHealthcare Community & State	$46.50
Rate for Payer: Wellpoint Medicaid Managed Care	$41.79

MIRENA IUD

Facility

$1,471.50

Service Code	HCPCS J7298
Hospital Charge Code	270677501
Hospital Revenue Code	636
Min. Negotiated Rate	$220.72
Max. Negotiated Rate	$356.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.10
Rate for Payer: Qualcare PPO/HMO/WC	$220.72

MIRTAZAPINE 15 MG TAB

Facility

$18.22

Service Code	NDC 51079008620
Hospital Charge Code	60628850
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$9.11
Rate for Payer: Aetna Commercial	$6.92
Rate for Payer: Aetna Medicare Advantage	$5.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.65
Rate for Payer: Cigna Commercial	$9.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.74
Rate for Payer: Oxford Commercial	$3.64
Rate for Payer: Qualcare PPO/HMO/WC	$2.73
Rate for Payer: UnitedHealthcare Commercial	$3.64
Rate for Payer: UnitedHealthcare Community & State	$0.58
Rate for Payer: Wellpoint Medicaid Managed Care	$0.52

MIRTAZAPINE 15 MG TAB

Facility

$18.22

Service Code	NDC 51079008620
Hospital Charge Code	60628850
Hospital Revenue Code	250
Min. Negotiated Rate	$2.73
Max. Negotiated Rate	$2.73
Rate for Payer: Qualcare PPO/HMO/WC	$2.73

MIRTAZAPINE 30 MG ODT

Facility

$17.96

Service Code	NDC 66993071130
Hospital Charge Code	6063943266
Hospital Revenue Code	250
Min. Negotiated Rate	$2.69
Max. Negotiated Rate	$2.69
Rate for Payer: Qualcare PPO/HMO/WC	$2.69

MIRTAZAPINE 30 MG ODT

Facility

$17.96

Service Code	NDC 66993071130
Hospital Charge Code	6063943266
Hospital Revenue Code	250
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$8.98
Rate for Payer: Aetna Commercial	$6.82
Rate for Payer: Aetna Medicare Advantage	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.58
Rate for Payer: Cigna Commercial	$8.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.67
Rate for Payer: Oxford Commercial	$3.59
Rate for Payer: Qualcare PPO/HMO/WC	$2.69
Rate for Payer: UnitedHealthcare Commercial	$3.59
Rate for Payer: UnitedHealthcare Community & State	$0.57
Rate for Payer: Wellpoint Medicaid Managed Care	$0.51

MIRTAZAPINE 30 MG TAB

Facility

$18.76

Service Code	NDC 51079008720
Hospital Charge Code	60628851
Hospital Revenue Code	250
Min. Negotiated Rate	$2.81
Max. Negotiated Rate	$2.81
Rate for Payer: Qualcare PPO/HMO/WC	$2.81

Know your out-of-pocket cost for care.

All Charges