Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION

Facility

$955.02

Service Code	APR-DRG 5894
Min. Negotiated Rate	$936.29
Max. Negotiated Rate	$955.02
Rate for Payer: UnitedHealthcare Community & State	$936.29
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$955.02
Rate for Payer: Wellpoint Medicaid Managed Care	$936.29

NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION

Facility

$52,910.05

Service Code	APR-DRG 5893
Min. Negotiated Rate	$51,872.60
Max. Negotiated Rate	$52,910.05
Rate for Payer: UnitedHealthcare Community & State	$51,872.60
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$52,910.05
Rate for Payer: Wellpoint Medicaid Managed Care	$51,872.60

NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION

Facility

$63,006.13

Service Code	APR-DRG 5892
Min. Negotiated Rate	$61,770.72
Max. Negotiated Rate	$63,006.13
Rate for Payer: UnitedHealthcare Community & State	$61,770.72
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$63,006.13
Rate for Payer: Wellpoint Medicaid Managed Care	$61,770.72

NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION

Facility

$86,512.71

Service Code	APR-DRG 5891
Min. Negotiated Rate	$84,816.38
Max. Negotiated Rate	$86,512.71
Rate for Payer: UnitedHealthcare Community & State	$84,816.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$86,512.71
Rate for Payer: Wellpoint Medicaid Managed Care	$84,816.38

NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE

Facility

$161,001.03

Service Code	APR-DRG 5933
Min. Negotiated Rate	$157,844.15
Max. Negotiated Rate	$161,001.03
Rate for Payer: UnitedHealthcare Community & State	$157,844.15
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$161,001.03
Rate for Payer: Wellpoint Medicaid Managed Care	$157,844.15

NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE

Facility

$239,028.49

Service Code	APR-DRG 5934
Min. Negotiated Rate	$234,341.66
Max. Negotiated Rate	$239,028.49
Rate for Payer: UnitedHealthcare Community & State	$234,341.66
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$239,028.49
Rate for Payer: Wellpoint Medicaid Managed Care	$234,341.66

NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE

Facility

$125,182.33

Service Code	APR-DRG 5932
Min. Negotiated Rate	$122,727.77
Max. Negotiated Rate	$125,182.33
Rate for Payer: UnitedHealthcare Community & State	$122,727.77
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$125,182.33
Rate for Payer: Wellpoint Medicaid Managed Care	$122,727.77

NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE

Facility

$2,432.40

Service Code	APR-DRG 5931
Min. Negotiated Rate	$2,384.71
Max. Negotiated Rate	$2,432.40
Rate for Payer: UnitedHealthcare Community & State	$2,384.71
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$2,432.40
Rate for Payer: Wellpoint Medicaid Managed Care	$2,384.71

NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY

Facility

$76,402.59

Service Code	MSDRG 789
Min. Negotiated Rate	$4,678.00
Max. Negotiated Rate	$76,402.59
Rate for Payer: Aetna Commercial	$56,273.29
Rate for Payer: Aetna Medicare Advantage	$76,402.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50,423.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50,423.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24,488.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50,423.10
Rate for Payer: Cigna Commercial	$40,176.44
Rate for Payer: Cigna Medicare Advantage	$24,488.01
Rate for Payer: Clover Medicare Advantage	$23,263.61
Rate for Payer: EmblemHealth Commercial	$73,464.03
Rate for Payer: Humana Medicare Advantage	$25,222.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24,488.01
Rate for Payer: Oxford Commercial	$4,678.00
Rate for Payer: UnitedHealthcare Commercial	$5,309.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$24,488.01
Rate for Payer: Wellcare Medicare Advantage	$24,488.01

NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE

Facility

$2,150.10

Service Code	APR-DRG 5812
Min. Negotiated Rate	$2,107.94
Max. Negotiated Rate	$2,150.10
Rate for Payer: UnitedHealthcare Community & State	$2,107.94
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$2,150.10
Rate for Payer: Wellpoint Medicaid Managed Care	$2,107.94

NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE

Facility

$1,432.48

Service Code	APR-DRG 5811
Min. Negotiated Rate	$1,404.39
Max. Negotiated Rate	$1,432.48
Rate for Payer: UnitedHealthcare Community & State	$1,404.39
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,432.48
Rate for Payer: Wellpoint Medicaid Managed Care	$1,404.39

NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE

Facility

$5,432.11

Service Code	APR-DRG 5814
Min. Negotiated Rate	$5,325.60
Max. Negotiated Rate	$5,432.11
Rate for Payer: UnitedHealthcare Community & State	$5,325.60
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,432.11
Rate for Payer: Wellpoint Medicaid Managed Care	$5,325.60

NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE

Facility

$3,245.54

Service Code	APR-DRG 5813
Min. Negotiated Rate	$3,181.90
Max. Negotiated Rate	$3,245.54
Rate for Payer: UnitedHealthcare Community & State	$3,181.90
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$3,245.54
Rate for Payer: Wellpoint Medicaid Managed Care	$3,181.90

NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE

Facility

$4,092.37

Service Code	APR-DRG 5801
Min. Negotiated Rate	$4,012.13
Max. Negotiated Rate	$4,092.37
Rate for Payer: UnitedHealthcare Community & State	$4,012.13
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,092.37
Rate for Payer: Wellpoint Medicaid Managed Care	$4,012.13

NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE

Facility

$5,665.28

Service Code	APR-DRG 5802
Min. Negotiated Rate	$5,554.20
Max. Negotiated Rate	$5,665.28
Rate for Payer: UnitedHealthcare Community & State	$5,554.20
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,665.28
Rate for Payer: Wellpoint Medicaid Managed Care	$5,554.20

NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE

Facility

$14,476.37

Service Code	APR-DRG 5804
Min. Negotiated Rate	$14,192.52
Max. Negotiated Rate	$14,476.37
Rate for Payer: UnitedHealthcare Community & State	$14,192.52
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$14,476.37
Rate for Payer: Wellpoint Medicaid Managed Care	$14,192.52

NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE

Facility

$8,267.59

Service Code	APR-DRG 5803
Min. Negotiated Rate	$8,105.48
Max. Negotiated Rate	$8,267.59
Rate for Payer: UnitedHealthcare Community & State	$8,105.48
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,267.59
Rate for Payer: Wellpoint Medicaid Managed Care	$8,105.48

NEONATE WITH ECMO

Facility

$424,538.79

Service Code	APR-DRG 5833
Min. Negotiated Rate	$416,214.50
Max. Negotiated Rate	$424,538.79
Rate for Payer: UnitedHealthcare Community & State	$416,214.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$424,538.79
Rate for Payer: Wellpoint Medicaid Managed Care	$416,214.50

NEONATE WITH ECMO

Facility

$487,487.43

Service Code	APR-DRG 5834
Min. Negotiated Rate	$477,928.85
Max. Negotiated Rate	$487,487.43
Rate for Payer: UnitedHealthcare Community & State	$477,928.85
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$487,487.43
Rate for Payer: Wellpoint Medicaid Managed Care	$477,928.85

NEONATE WITH ECMO

Facility

$266,408.32

Service Code	APR-DRG 5832
Min. Negotiated Rate	$261,184.63
Max. Negotiated Rate	$266,408.32
Rate for Payer: UnitedHealthcare Community & State	$261,184.63
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$266,408.32
Rate for Payer: Wellpoint Medicaid Managed Care	$261,184.63

NEONATE WITH ECMO

Facility

$215,741.04

Service Code	APR-DRG 5831
Min. Negotiated Rate	$211,510.82
Max. Negotiated Rate	$215,741.04
Rate for Payer: UnitedHealthcare Community & State	$211,510.82
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$215,741.04
Rate for Payer: Wellpoint Medicaid Managed Care	$211,510.82

NEONATE WITH OTHER SIGNIFICANT PROBLEMS

Facility

$66,093.55

Service Code	MSDRG 794
Min. Negotiated Rate	$4,678.00
Max. Negotiated Rate	$66,093.55
Rate for Payer: Aetna Commercial	$48,931.09
Rate for Payer: Aetna Medicare Advantage	$66,093.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41,280.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41,280.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,183.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41,280.45
Rate for Payer: Cigna Commercial	$32,902.24
Rate for Payer: Cigna Medicare Advantage	$21,183.83
Rate for Payer: Clover Medicare Advantage	$20,124.64
Rate for Payer: EmblemHealth Commercial	$63,551.49
Rate for Payer: Humana Medicare Advantage	$21,819.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21,183.83
Rate for Payer: Oxford Commercial	$4,678.00
Rate for Payer: UnitedHealthcare Commercial	$5,309.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$21,183.83
Rate for Payer: Wellcare Medicare Advantage	$21,183.83

NEO/POLY/BACI OINT

Facility

$28.48

Service Code	NDC 45802014301
Hospital Charge Code	6063943347
Hospital Revenue Code	250
Min. Negotiated Rate	$4.27
Max. Negotiated Rate	$4.27
Rate for Payer: Qualcare PPO/HMO/WC	$4.27

NEO/POLY/BACI OINT

Facility

$28.48

Service Code	NDC 45802014301
Hospital Charge Code	6063943347
Hospital Revenue Code	250
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$14.24
Rate for Payer: Aetna Commercial	$10.82
Rate for Payer: Aetna Medicare Advantage	$8.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.26
Rate for Payer: Cigna Commercial	$14.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.40
Rate for Payer: Oxford Commercial	$5.70
Rate for Payer: Qualcare PPO/HMO/WC	$4.27
Rate for Payer: UnitedHealthcare Commercial	$5.70
Rate for Payer: UnitedHealthcare Community & State	$0.90
Rate for Payer: Wellpoint Medicaid Managed Care	$0.81

NEOSPORIN G.U. IRRIGANT

Facility

$860.95

Service Code	NDC 61570004710
Hospital Charge Code	60633525
Hospital Revenue Code	250
Min. Negotiated Rate	$24.45
Max. Negotiated Rate	$430.48
Rate for Payer: Aetna Commercial	$327.16
Rate for Payer: Aetna Medicare Advantage	$258.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.54
Rate for Payer: Cigna Commercial	$430.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.85
Rate for Payer: Oxford Commercial	$172.19
Rate for Payer: Qualcare PPO/HMO/WC	$129.14
Rate for Payer: UnitedHealthcare Commercial	$172.19
Rate for Payer: UnitedHealthcare Community & State	$27.21
Rate for Payer: Wellpoint Medicaid Managed Care	$24.45

Know your out-of-pocket cost for care.

All Charges