Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

MOLECULAR DIAG INTERPRETATION

Facility

$85.00

Hospital Charge Code	38479455
Hospital Revenue Code	301
Min. Negotiated Rate	$2.41
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$32.30
Rate for Payer: Aetna Medicare Advantage	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.68
Rate for Payer: Cigna Commercial	$42.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.10
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.75
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$2.69
Rate for Payer: Wellpoint Medicaid Managed Care	$2.41

MOLECULAR DIAG INTERPRETATION2

Facility

$84.00

Service Code	HCPCS 83912
Hospital Charge Code	38473150
Hospital Revenue Code	301
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.60

MOLECULAR DIAG INTERPRETATION2

Facility

$84.00

Service Code	HCPCS 83912
Hospital Charge Code	38473150
Hospital Revenue Code	301
Min. Negotiated Rate	$2.39
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$31.92
Rate for Payer: Aetna Medicare Advantage	$25.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.42
Rate for Payer: Cigna Commercial	$42.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.84
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.60
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$2.65
Rate for Payer: Wellpoint Medicaid Managed Care	$2.39

MOLECULAR DIAG SEPARATION (1)

Facility

$44.00

Service Code	HCPCS 83894
Hospital Charge Code	38473134
Hospital Revenue Code	301
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

MOLECULAR DIAG SEPARATION (1)

Facility

$44.00

Service Code	HCPCS 83894
Hospital Charge Code	38473134
Hospital Revenue Code	301
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$16.72
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.44
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$1.39
Rate for Payer: Wellpoint Medicaid Managed Care	$1.25

MOLECULAR DIAG SEPARATION (5)

Facility

$44.00

Service Code	HCPCS 83894
Hospital Charge Code	38473146
Hospital Revenue Code	301
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$16.72
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.44
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$1.39
Rate for Payer: Wellpoint Medicaid Managed Care	$1.25

MOLECULAR DIAG SEPARATION (5)

Facility

$44.00

Service Code	HCPCS 83894
Hospital Charge Code	38473146
Hospital Revenue Code	301
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

MOLECULAR DX INTERPRETATION

Facility

$85.00

Service Code	HCPCS 83912
Hospital Charge Code	38479425
Hospital Revenue Code	301
Min. Negotiated Rate	$2.41
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$32.30
Rate for Payer: Aetna Medicare Advantage	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.68
Rate for Payer: Cigna Commercial	$42.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.10
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.75
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$2.69
Rate for Payer: Wellpoint Medicaid Managed Care	$2.41

MOLECULAR DX INTERPRETATION

Facility

$85.00

Service Code	HCPCS 83912
Hospital Charge Code	38479425
Hospital Revenue Code	301
Min. Negotiated Rate	$12.75
Max. Negotiated Rate	$12.75
Rate for Payer: Qualcare PPO/HMO/WC	$12.75

MOLECULAR DX LYSIS PRIOR TO NA

Facility

$94.00

Service Code	HCPCS 83907
Hospital Charge Code	38477114
Hospital Revenue Code	301
Min. Negotiated Rate	$2.67
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$35.72
Rate for Payer: Aetna Medicare Advantage	$28.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.97
Rate for Payer: Cigna Commercial	$47.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.44
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.10
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$2.97
Rate for Payer: Wellpoint Medicaid Managed Care	$2.67

MOLECULAR DX LYSIS PRIOR TO NA

Facility

$94.00

Service Code	HCPCS 83907
Hospital Charge Code	38477114
Hospital Revenue Code	301
Min. Negotiated Rate	$14.10
Max. Negotiated Rate	$14.10
Rate for Payer: Qualcare PPO/HMO/WC	$14.10

MOLECULAR DX;MUTATION SCANNIG

Facility

$118.00

Service Code	HCPCS 83903
Hospital Charge Code	38477139
Hospital Revenue Code	301
Min. Negotiated Rate	$3.35
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$44.84
Rate for Payer: Aetna Medicare Advantage	$35.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.09
Rate for Payer: Cigna Commercial	$59.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.68
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.70
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$3.73
Rate for Payer: Wellpoint Medicaid Managed Care	$3.35

MOLECULAR DX;MUTATION SCANNIG

Facility

$118.00

Service Code	HCPCS 83903
Hospital Charge Code	38477139
Hospital Revenue Code	301
Min. Negotiated Rate	$17.70
Max. Negotiated Rate	$17.70
Rate for Payer: Qualcare PPO/HMO/WC	$17.70

MOLECULAR DX NUCLEIC ACID TRAN

Facility

$28.00

Service Code	HCPCS 83897
Hospital Charge Code	38477024
Hospital Revenue Code	301
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

MOLECULAR DX NUCLEIC ACID TRAN

Facility

$28.00

Service Code	HCPCS 83897
Hospital Charge Code	38477024
Hospital Revenue Code	301
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$10.64
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.28
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$0.88
Rate for Payer: Wellpoint Medicaid Managed Care	$0.80

MOLECULAR DX RNA STABILIZATION

Facility

$94.00

Service Code	HCPCS 83913
Hospital Charge Code	38477115
Hospital Revenue Code	301
Min. Negotiated Rate	$2.67
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$35.72
Rate for Payer: Aetna Medicare Advantage	$28.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.97
Rate for Payer: Cigna Commercial	$47.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.44
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.10
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$2.97
Rate for Payer: Wellpoint Medicaid Managed Care	$2.67

MOLECULAR DX RNA STABILIZATION

Facility

$94.00

Service Code	HCPCS 83913
Hospital Charge Code	38477115
Hospital Revenue Code	301
Min. Negotiated Rate	$14.10
Max. Negotiated Rate	$14.10
Rate for Payer: Qualcare PPO/HMO/WC	$14.10

MOLECULAR ISOLATION (1)

Facility

$478.00

Service Code	HCPCS 83890
Hospital Charge Code	38473131
Hospital Revenue Code	301
Min. Negotiated Rate	$71.70
Max. Negotiated Rate	$71.70
Rate for Payer: Qualcare PPO/HMO/WC	$71.70

MOLECULAR ISOLATION (1)

Facility

$478.00

Service Code	HCPCS 83890
Hospital Charge Code	38473131
Hospital Revenue Code	301
Min. Negotiated Rate	$13.58
Max. Negotiated Rate	$239.00
Rate for Payer: Aetna Commercial	$181.64
Rate for Payer: Aetna Medicare Advantage	$143.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.89
Rate for Payer: Cigna Commercial	$239.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.28
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$71.70
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$15.10
Rate for Payer: Wellpoint Medicaid Managed Care	$13.58

MOLECULAR ISOLATION (2)

Facility

$568.00

Service Code	HCPCS 83890
Hospital Charge Code	38473132
Hospital Revenue Code	301
Min. Negotiated Rate	$85.20
Max. Negotiated Rate	$85.20
Rate for Payer: Qualcare PPO/HMO/WC	$85.20

MOLECULAR ISOLATION (2)

Facility

$568.00

Service Code	HCPCS 83890
Hospital Charge Code	38473132
Hospital Revenue Code	301
Min. Negotiated Rate	$16.13
Max. Negotiated Rate	$284.00
Rate for Payer: Aetna Commercial	$215.84
Rate for Payer: Aetna Medicare Advantage	$170.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.84
Rate for Payer: Cigna Commercial	$284.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.68
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$85.20
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$17.95
Rate for Payer: Wellpoint Medicaid Managed Care	$16.13

MOLEDULAR ISOLATION (3)

Facility

$568.00

Service Code	HCPCS 83890
Hospital Charge Code	38473133
Hospital Revenue Code	301
Min. Negotiated Rate	$85.20
Max. Negotiated Rate	$85.20
Rate for Payer: Qualcare PPO/HMO/WC	$85.20

MOLEDULAR ISOLATION (3)

Facility

$568.00

Service Code	HCPCS 83890
Hospital Charge Code	38473133
Hospital Revenue Code	301
Min. Negotiated Rate	$16.13
Max. Negotiated Rate	$284.00
Rate for Payer: Aetna Commercial	$215.84
Rate for Payer: Aetna Medicare Advantage	$170.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.84
Rate for Payer: Cigna Commercial	$284.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.68
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$85.20
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$17.95
Rate for Payer: Wellpoint Medicaid Managed Care	$16.13

MOMA FLOW REVERSAL DEVICE

Facility

$8,000.00

Hospital Charge Code	270682752N
Hospital Revenue Code	272
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

MOMA FLOW REVERSAL DEVICE

Facility

$8,000.00

Hospital Charge Code	270682752N
Hospital Revenue Code	272
Min. Negotiated Rate	$227.20
Max. Negotiated Rate	$4,000.00
Rate for Payer: Aetna Commercial	$3,040.00
Rate for Payer: Aetna Medicare Advantage	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,040.00
Rate for Payer: Cigna Commercial	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,080.00
Rate for Payer: Oxford Commercial	$1,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00
Rate for Payer: UnitedHealthcare Commercial	$1,600.00
Rate for Payer: UnitedHealthcare Community & State	$252.80
Rate for Payer: Wellpoint Medicaid Managed Care	$227.20

Know your out-of-pocket cost for care.

All Charges