Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

MOMA FLOW REVERSAL DEVICE

Facility

$8,000.00

Hospital Charge Code	270682752
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

MOMA FLOW REVERSAL DEVICE

Facility

$8,000.00

Hospital Charge Code	270682752
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

MOMETASONE 220MCG/INH AER

Facility

$375.33

Service Code	NDC 85134101
Hospital Charge Code	60629954
Hospital Revenue Code	250
Min. Negotiated Rate	$56.30
Max. Negotiated Rate	$56.30
Rate for Payer: Qualcare PPO/HMO/WC	$56.30

MOMETASONE 220MCG/INH AER

Facility

$375.33

Service Code	NDC 85134101
Hospital Charge Code	60629954
Hospital Revenue Code	250
Min. Negotiated Rate	$10.66
Max. Negotiated Rate	$187.66
Rate for Payer: Aetna Commercial	$142.63
Rate for Payer: Aetna Medicare Advantage	$112.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.71
Rate for Payer: Cigna Commercial	$187.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.59
Rate for Payer: Oxford Commercial	$75.07
Rate for Payer: Qualcare PPO/HMO/WC	$56.30
Rate for Payer: UnitedHealthcare Commercial	$75.07
Rate for Payer: UnitedHealthcare Community & State	$11.86
Rate for Payer: Wellpoint Medicaid Managed Care	$10.66

MOMETASONE FUROATE 110MCG

Facility

$1,159.10

Service Code	NDC 85146107
Hospital Charge Code	60635779
Hospital Revenue Code	250
Min. Negotiated Rate	$32.92
Max. Negotiated Rate	$579.55
Rate for Payer: Aetna Commercial	$440.46
Rate for Payer: Aetna Medicare Advantage	$347.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$295.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$295.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$295.57
Rate for Payer: Cigna Commercial	$579.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.37
Rate for Payer: Oxford Commercial	$231.82
Rate for Payer: Qualcare PPO/HMO/WC	$173.87
Rate for Payer: UnitedHealthcare Commercial	$231.82
Rate for Payer: UnitedHealthcare Community & State	$36.63
Rate for Payer: Wellpoint Medicaid Managed Care	$32.92

MOMETASONE FUROATE 110MCG

Facility

$1,159.10

Service Code	NDC 85146107
Hospital Charge Code	60635779
Hospital Revenue Code	250
Min. Negotiated Rate	$173.87
Max. Negotiated Rate	$173.87
Rate for Payer: Qualcare PPO/HMO/WC	$173.87

MONISTAT 3/200MG/EACH

Facility

$127.97

Service Code	NDC 472173803
Hospital Charge Code	60633443
Hospital Revenue Code	250
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

MONISTAT 3/200MG/EACH

Facility

$127.97

Service Code	NDC 472173803
Hospital Charge Code	60633443
Hospital Revenue Code	250
Min. Negotiated Rate	$3.63
Max. Negotiated Rate	$63.98
Rate for Payer: Aetna Commercial	$48.63
Rate for Payer: Aetna Medicare Advantage	$38.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.63
Rate for Payer: Cigna Commercial	$63.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.27
Rate for Payer: Oxford Commercial	$25.59
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$25.59
Rate for Payer: UnitedHealthcare Community & State	$4.04
Rate for Payer: Wellpoint Medicaid Managed Care	$3.63

MONITOR BELT DISPOSABLE

Facility

$14.10

Hospital Charge Code	270664965
Hospital Revenue Code	270
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$7.05
Rate for Payer: Aetna Commercial	$5.36
Rate for Payer: Aetna Medicare Advantage	$4.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.60
Rate for Payer: Cigna Commercial	$7.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.67
Rate for Payer: Oxford Commercial	$2.82
Rate for Payer: Qualcare PPO/HMO/WC	$2.12
Rate for Payer: UnitedHealthcare Commercial	$2.82
Rate for Payer: UnitedHealthcare Community & State	$0.45
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

MONITOR BELT DISPOSABLE

Facility

$14.10

Hospital Charge Code	270664965
Hospital Revenue Code	270
Min. Negotiated Rate	$2.12
Max. Negotiated Rate	$2.12
Rate for Payer: Qualcare PPO/HMO/WC	$2.12

MONITOR CARDIAC AF REVEAL LINQ

Facility

$24,975.00

Service Code	HCPCS C1764
Hospital Charge Code	270698999S
Hospital Revenue Code	278
Min. Negotiated Rate	$3,746.25
Max. Negotiated Rate	$6,043.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,043.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,746.25

MONITOR CARDIAC AF REVEAL LINQ

Facility

$24,975.00

Service Code	HCPCS C1764
Hospital Charge Code	270698999S
Hospital Revenue Code	278
Min. Negotiated Rate	$709.29
Max. Negotiated Rate	$12,487.50
Rate for Payer: Aetna Commercial	$9,490.50
Rate for Payer: Aetna Medicare Advantage	$7,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,368.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,368.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,368.62
Rate for Payer: Cigna Commercial	$12,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,043.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,746.25
Rate for Payer: UnitedHealthcare Community & State	$789.21
Rate for Payer: Wellpoint Medicaid Managed Care	$709.29

MONITOR CO2 LNG TERM ORAL/NASL

Facility

$87.04

Hospital Charge Code	270652786
Hospital Revenue Code	270
Min. Negotiated Rate	$13.06
Max. Negotiated Rate	$13.06
Rate for Payer: Qualcare PPO/HMO/WC	$13.06

MONITOR CO2 LNG TERM ORAL/NASL

Facility

$87.04

Hospital Charge Code	270652786
Hospital Revenue Code	270
Min. Negotiated Rate	$2.47
Max. Negotiated Rate	$43.52
Rate for Payer: Aetna Commercial	$33.08
Rate for Payer: Aetna Medicare Advantage	$26.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.20
Rate for Payer: Cigna Commercial	$43.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.63
Rate for Payer: Oxford Commercial	$17.41
Rate for Payer: Qualcare PPO/HMO/WC	$13.06
Rate for Payer: UnitedHealthcare Commercial	$17.41
Rate for Payer: UnitedHealthcare Community & State	$2.75
Rate for Payer: Wellpoint Medicaid Managed Care	$2.47

MONITOR NEURO IN OR/15 MIN

Facility

$1,000.00

Service Code	HCPCS 95940
Hospital Charge Code	1610001
Hospital Revenue Code	920
Min. Negotiated Rate	$28.40
Max. Negotiated Rate	$2,301.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Oxford Commercial	$2,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$2,301.00
Rate for Payer: UnitedHealthcare Community & State	$31.60
Rate for Payer: Wellpoint Medicaid Managed Care	$28.40

MONITOR NEURO IN OR/15 MIN

Facility

$1,000.00

Service Code	HCPCS 95940
Hospital Charge Code	1610001
Hospital Revenue Code	920
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

MONITOR NEURO REMOTE PER HR

Facility

$1,250.00

Service Code	HCPCS 95941
Hospital Charge Code	1610002
Hospital Revenue Code	920
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

MONITOR NEURO REMOTE PER HR

Facility

$1,250.00

Service Code	HCPCS 95941
Hospital Charge Code	1610002
Hospital Revenue Code	920
Min. Negotiated Rate	$35.50
Max. Negotiated Rate	$2,301.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$325.00
Rate for Payer: Oxford Commercial	$2,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Commercial	$2,301.00
Rate for Payer: UnitedHealthcare Community & State	$39.50
Rate for Payer: Wellpoint Medicaid Managed Care	$35.50

MONOCRYL 3-0 SPIRAL SH

Facility

$123.17

Service Code	HCPCS A4649
Hospital Charge Code	270691628
Hospital Revenue Code	272
Min. Negotiated Rate	$18.48
Max. Negotiated Rate	$18.48
Rate for Payer: Qualcare PPO/HMO/WC	$18.48

MONOCRYL 3-0 SPIRAL SH

Facility

$123.17

Service Code	HCPCS A4649
Hospital Charge Code	270691628
Hospital Revenue Code	272
Min. Negotiated Rate	$3.50
Max. Negotiated Rate	$61.59
Rate for Payer: Aetna Commercial	$46.80
Rate for Payer: Aetna Medicare Advantage	$36.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.41
Rate for Payer: Cigna Commercial	$61.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.02
Rate for Payer: Oxford Commercial	$24.63
Rate for Payer: Qualcare PPO/HMO/WC	$18.48
Rate for Payer: UnitedHealthcare Commercial	$24.63
Rate for Payer: UnitedHealthcare Community & State	$3.89
Rate for Payer: Wellpoint Medicaid Managed Care	$3.50

MONO SCREEN,LA

Facility

$35.55

Service Code	HCPCS 86308
Hospital Charge Code	39900209
Hospital Revenue Code	302
Min. Negotiated Rate	$1.01
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$14.09
Rate for Payer: Aetna Medicare Advantage	$16.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.18
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	$18.79
Rate for Payer: Cigna Commercial	$17.77
Rate for Payer: Cigna Medicare Advantage	$5.18
Rate for Payer: Clover Medicare Advantage	$4.92
Rate for Payer: EmblemHealth Commercial	$15.54
Rate for Payer: Humana Medicare Advantage	$5.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.24
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.33
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$4.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.18
Rate for Payer: Wellcare Medicare Advantage	$5.18
Rate for Payer: Wellpoint Medicaid Managed Care	$1.01

MONO SCREEN,LA

Facility

$35.55

Service Code	HCPCS 86308
Hospital Charge Code	39900209
Hospital Revenue Code	302
Min. Negotiated Rate	$5.33
Max. Negotiated Rate	$5.33
Rate for Payer: Qualcare PPO/HMO/WC	$5.33

MONOTUBETRIAX STERILE WRIS.KIT

Facility

$1,340.00

Hospital Charge Code	270656538
Hospital Revenue Code	272
Min. Negotiated Rate	$201.00
Max. Negotiated Rate	$201.00
Rate for Payer: Qualcare PPO/HMO/WC	$201.00

MONOTUBETRIAX STERILE WRIS.KIT

Facility

$1,340.00

Hospital Charge Code	270656538
Hospital Revenue Code	272
Min. Negotiated Rate	$38.06
Max. Negotiated Rate	$670.00
Rate for Payer: Aetna Commercial	$509.20
Rate for Payer: Aetna Medicare Advantage	$402.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$341.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$341.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$341.70
Rate for Payer: Cigna Commercial	$670.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$348.40
Rate for Payer: Oxford Commercial	$268.00
Rate for Payer: Qualcare PPO/HMO/WC	$201.00
Rate for Payer: UnitedHealthcare Commercial	$268.00
Rate for Payer: UnitedHealthcare Community & State	$42.34
Rate for Payer: Wellpoint Medicaid Managed Care	$38.06

MONOTUBE TRIAX-STERILEWRISTKIT

Facility

$11,075.00

Hospital Charge Code	270663134
Hospital Revenue Code	270
Min. Negotiated Rate	$1,661.25
Max. Negotiated Rate	$1,661.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,661.25

Know your out-of-pocket cost for care.

All Charges