Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES

Facility

$15,057.79

Service Code	APR-DRG 0432
Min. Negotiated Rate	$14,762.54
Max. Negotiated Rate	$15,057.79
Rate for Payer: UnitedHealthcare Community & State	$14,762.54
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$15,057.79
Rate for Payer: Wellpoint Medicaid Managed Care	$14,762.54

MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES

Facility

$22,290.37

Service Code	APR-DRG 0433
Min. Negotiated Rate	$21,853.30
Max. Negotiated Rate	$22,290.37
Rate for Payer: UnitedHealthcare Community & State	$21,853.30
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$22,290.37
Rate for Payer: Wellpoint Medicaid Managed Care	$21,853.30

MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES

Facility

$43,412.21

Service Code	APR-DRG 0434
Min. Negotiated Rate	$42,560.99
Max. Negotiated Rate	$43,412.21
Rate for Payer: UnitedHealthcare Community & State	$42,560.99
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$43,412.21
Rate for Payer: Wellpoint Medicaid Managed Care	$42,560.99

MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE

Facility

$12,466.68

Service Code	APR-DRG 9302
Min. Negotiated Rate	$12,222.24
Max. Negotiated Rate	$12,466.68
Rate for Payer: UnitedHealthcare Community & State	$12,222.24
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,466.68
Rate for Payer: Wellpoint Medicaid Managed Care	$12,222.24

MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE

Facility

$10,594.67

Service Code	APR-DRG 9301
Min. Negotiated Rate	$10,386.93
Max. Negotiated Rate	$10,594.67
Rate for Payer: UnitedHealthcare Community & State	$10,386.93
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,594.67
Rate for Payer: Wellpoint Medicaid Managed Care	$10,386.93

MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE

Facility

$39,203.29

Service Code	APR-DRG 9304
Min. Negotiated Rate	$38,434.60
Max. Negotiated Rate	$39,203.29
Rate for Payer: UnitedHealthcare Community & State	$38,434.60
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$39,203.29
Rate for Payer: Wellpoint Medicaid Managed Care	$38,434.60

MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE

Facility

$19,884.60

Service Code	APR-DRG 9303
Min. Negotiated Rate	$19,494.71
Max. Negotiated Rate	$19,884.60
Rate for Payer: UnitedHealthcare Community & State	$19,494.71
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$19,884.60
Rate for Payer: Wellpoint Medicaid Managed Care	$19,494.71

MULTIPLE VITAMINS INJ 10 ML

Facility

$59.09

Service Code	NDC 54643564901
Hospital Charge Code	6012876
Hospital Revenue Code	250
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$29.55
Rate for Payer: Aetna Commercial	$22.45
Rate for Payer: Aetna Medicare Advantage	$17.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.07
Rate for Payer: Cigna Commercial	$29.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.36
Rate for Payer: Oxford Commercial	$11.82
Rate for Payer: Qualcare PPO/HMO/WC	$8.86
Rate for Payer: UnitedHealthcare Commercial	$11.82
Rate for Payer: UnitedHealthcare Community & State	$1.87
Rate for Payer: Wellpoint Medicaid Managed Care	$1.68

MULTIPLE VITAMINS INJ 10 ML

Facility

$59.09

Service Code	NDC 54643564901
Hospital Charge Code	6012876
Hospital Revenue Code	250
Min. Negotiated Rate	$8.86
Max. Negotiated Rate	$8.86
Rate for Payer: Qualcare PPO/HMO/WC	$8.86

MULTIPLE VITAMINS LIQ

Facility

$241.20

Service Code	NDC 54838000870
Hospital Charge Code	60628501
Hospital Revenue Code	250
Min. Negotiated Rate	$6.85
Max. Negotiated Rate	$120.60
Rate for Payer: Aetna Commercial	$91.66
Rate for Payer: Aetna Medicare Advantage	$72.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.51
Rate for Payer: Cigna Commercial	$120.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.71
Rate for Payer: Oxford Commercial	$48.24
Rate for Payer: Qualcare PPO/HMO/WC	$36.18
Rate for Payer: UnitedHealthcare Commercial	$48.24
Rate for Payer: UnitedHealthcare Community & State	$7.62
Rate for Payer: Wellpoint Medicaid Managed Care	$6.85

MULTIPLE VITAMINS LIQ

Facility

$241.20

Service Code	NDC 54838000870
Hospital Charge Code	60628501
Hospital Revenue Code	250
Min. Negotiated Rate	$36.18
Max. Negotiated Rate	$36.18
Rate for Payer: Qualcare PPO/HMO/WC	$36.18

MULTIPODUS BOOT L

Facility

$530.95

Hospital Charge Code	270665976
Hospital Revenue Code	270
Min. Negotiated Rate	$15.08
Max. Negotiated Rate	$265.48
Rate for Payer: Aetna Commercial	$201.76
Rate for Payer: Aetna Medicare Advantage	$159.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.39
Rate for Payer: Cigna Commercial	$265.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.05
Rate for Payer: Oxford Commercial	$106.19
Rate for Payer: Qualcare PPO/HMO/WC	$79.64
Rate for Payer: UnitedHealthcare Commercial	$106.19
Rate for Payer: UnitedHealthcare Community & State	$16.78
Rate for Payer: Wellpoint Medicaid Managed Care	$15.08

MULTIPODUS BOOT L

Facility

$530.95

Hospital Charge Code	270665976
Hospital Revenue Code	270
Min. Negotiated Rate	$79.64
Max. Negotiated Rate	$79.64
Rate for Payer: Qualcare PPO/HMO/WC	$79.64

MULTIPODUS BOOT MED.

Facility

$598.80

Hospital Charge Code	270669589
Hospital Revenue Code	274
Min. Negotiated Rate	$89.82
Max. Negotiated Rate	$144.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.91
Rate for Payer: Qualcare PPO/HMO/WC	$89.82

MULTIPODUS BOOT MED.

Facility

$598.80

Hospital Charge Code	270669589
Hospital Revenue Code	274
Min. Negotiated Rate	$17.01
Max. Negotiated Rate	$299.40
Rate for Payer: Aetna Commercial	$227.54
Rate for Payer: Aetna Medicare Advantage	$179.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$152.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$152.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$152.69
Rate for Payer: Cigna Commercial	$299.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.91
Rate for Payer: Qualcare PPO/HMO/WC	$89.82
Rate for Payer: UnitedHealthcare Community & State	$18.92
Rate for Payer: Wellpoint Medicaid Managed Care	$17.01

MULTIVITAMIN AND IRON DROPS

Facility

$4.00

Service Code	NDC 536853080
Hospital Charge Code	6063943217
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

MULTIVITAMIN AND IRON DROPS

Facility

$4.00

Service Code	NDC 536853080
Hospital Charge Code	6063943217
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

MULTIVITAMIN WITH MINERALS TAB

Facility

$4.00

Service Code	NDC 904549261
Hospital Charge Code	60628509
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

MULTIVITAMIN WITH MINERALS TAB

Facility

$4.00

Service Code	NDC 904549261
Hospital Charge Code	60628509
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

MUMPS AB (IGG)

Facility

$667.59

Service Code	HCPCS 86735
Hospital Charge Code	39900249
Hospital Revenue Code	302
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

MUMPS AB (IGG)

Facility

$667.59

Service Code	HCPCS 86735
Hospital Charge Code	39900249
Hospital Revenue Code	302
Min. Negotiated Rate	$10.44
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$35.50
Rate for Payer: Aetna Medicare Advantage	$42.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.34
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$13.05
Rate for Payer: Clover Medicare Advantage	$12.40
Rate for Payer: EmblemHealth Commercial	$39.15
Rate for Payer: Humana Medicare Advantage	$13.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.05
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	$10.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.05
Rate for Payer: Wellcare Medicare Advantage	$13.05
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

MUMPS ANTIBODY

Facility

$602.00

Service Code	HCPCS 86735
Hospital Charge Code	38479107
Hospital Revenue Code	302
Min. Negotiated Rate	$90.30
Max. Negotiated Rate	$90.30
Rate for Payer: Qualcare PPO/HMO/WC	$90.30

MUMPS ANTIBODY

Facility

$602.00

Service Code	HCPCS 86735
Hospital Charge Code	38479107
Hospital Revenue Code	302
Min. Negotiated Rate	$10.44
Max. Negotiated Rate	$301.00
Rate for Payer: Aetna Commercial	$35.50
Rate for Payer: Aetna Medicare Advantage	$42.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.34
Rate for Payer: Cigna Commercial	$301.00
Rate for Payer: Cigna Medicare Advantage	$13.05
Rate for Payer: Clover Medicare Advantage	$12.40
Rate for Payer: EmblemHealth Commercial	$39.15
Rate for Payer: Humana Medicare Advantage	$13.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.52
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.30
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.05
Rate for Payer: Wellcare Medicare Advantage	$13.05
Rate for Payer: Wellpoint Medicaid Managed Care	$17.10

MUMPS IGM

Facility

$667.59

Service Code	HCPCS 86735
Hospital Charge Code	39900384
Hospital Revenue Code	302
Min. Negotiated Rate	$10.44
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$35.50
Rate for Payer: Aetna Medicare Advantage	$42.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.34
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$13.05
Rate for Payer: Clover Medicare Advantage	$12.40
Rate for Payer: EmblemHealth Commercial	$39.15
Rate for Payer: Humana Medicare Advantage	$13.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.05
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	$10.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.05
Rate for Payer: Wellcare Medicare Advantage	$13.05
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

MUMPS IGM

Facility

$667.59

Service Code	HCPCS 86735
Hospital Charge Code	39900384
Hospital Revenue Code	302
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

Know your out-of-pocket cost for care.

All Charges