Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ASPIRIN 300 MG SUPP

Facility

$9.78

Service Code	NDC 574703412
Hospital Charge Code	60627675
Hospital Revenue Code	250
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$1.47
Rate for Payer: Qualcare PPO/HMO/WC	$1.47

ASPIRIN 325MG BUFFERED TAB

Facility

$4.00

Service Code	NDC 904201559
Hospital Charge Code	606350925
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

ASPIRIN 325MG BUFFERED TAB

Facility

$4.00

Service Code	NDC 904201559
Hospital Charge Code	606350925
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ASPIRIN 325MG TAB

Facility

$2.00

Hospital Charge Code	83652551
Hospital Revenue Code	250
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.00
Rate for Payer: Aetna Commercial	$0.76
Rate for Payer: Aetna Medicare Advantage	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.51
Rate for Payer: Cigna Commercial	$1.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$0.40
Rate for Payer: Qualcare PPO/HMO/WC	$0.30
Rate for Payer: UnitedHealthcare Commercial	$0.40
Rate for Payer: UnitedHealthcare Community & State	$0.06
Rate for Payer: Wellpoint Medicaid Managed Care	$0.06

ASPIRIN 325MG TAB

Facility

$2.00

Hospital Charge Code	83652551
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.30

ASPIRIN 325 MG TABLET

Facility

$4.00

Service Code	NDC 57896090101
Hospital Charge Code	6022156
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ASPIRIN 325 MG TABLET

Facility

$4.00

Service Code	NDC 57896090101
Hospital Charge Code	6022156
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

ASPIRIN 600 MG SUPP

Facility

$10.12

Service Code	NDC 574703612
Hospital Charge Code	60627677
Hospital Revenue Code	250
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$1.52
Rate for Payer: Qualcare PPO/HMO/WC	$1.52

ASPIRIN 600 MG SUPP

Facility

$10.12

Service Code	NDC 574703612
Hospital Charge Code	60627677
Hospital Revenue Code	250
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$5.06
Rate for Payer: Aetna Commercial	$3.85
Rate for Payer: Aetna Medicare Advantage	$3.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.58
Rate for Payer: Cigna Commercial	$5.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.63
Rate for Payer: Oxford Commercial	$2.02
Rate for Payer: Qualcare PPO/HMO/WC	$1.52
Rate for Payer: UnitedHealthcare Commercial	$2.02
Rate for Payer: UnitedHealthcare Community & State	$0.32
Rate for Payer: Wellpoint Medicaid Managed Care	$0.29

ASPIRIN 81 MG CHEW TAB

Facility

$4.00

Service Code	NDC 62107002636
Hospital Charge Code	60627678
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

ASPIRIN 81 MG CHEW TAB

Facility

$4.00

Service Code	NDC 62107002636
Hospital Charge Code	60627678
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ASPIRIN 81 MG TAB

Facility

$4.00

Service Code	NDC 10135017310
Hospital Charge Code	6023238
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

ASPIRIN 81 MG TAB

Facility

$4.00

Service Code	NDC 10135017310
Hospital Charge Code	6023238
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ASSAY DIR MEAS FR ESTRADIOL

Facility

$123.17

Service Code	HCPCS 82681
Hospital Charge Code	401182681
Hospital Revenue Code	300
Min. Negotiated Rate	$18.48
Max. Negotiated Rate	$18.48
Rate for Payer: Qualcare PPO/HMO/WC	$18.48

ASSAY DIR MEAS FR ESTRADIOL

Facility

$123.17

Service Code	HCPCS 82681
Hospital Charge Code	401182681
Hospital Revenue Code	300
Min. Negotiated Rate	$3.50
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$76.00
Rate for Payer: Aetna Medicare Advantage	$90.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.35
Rate for Payer: Cigna Commercial	$61.59
Rate for Payer: Cigna Medicare Advantage	$27.94
Rate for Payer: Clover Medicare Advantage	$26.54
Rate for Payer: EmblemHealth Commercial	$83.82
Rate for Payer: Humana Medicare Advantage	$28.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.02
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.48
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$22.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.94
Rate for Payer: Wellcare Medicare Advantage	$27.94
Rate for Payer: Wellpoint Medicaid Managed Care	$3.50

ASSAY GLUCOSE BLOOD QUANT

Facility

$390.00

Service Code	HCPCS 82947
Hospital Charge Code	401082947
Hospital Revenue Code	301
Min. Negotiated Rate	$3.14
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$10.69
Rate for Payer: Aetna Medicare Advantage	$12.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.26
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$3.93
Rate for Payer: Clover Medicare Advantage	$3.73
Rate for Payer: EmblemHealth Commercial	$11.79
Rate for Payer: Humana Medicare Advantage	$4.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$3.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.93
Rate for Payer: Wellcare Medicare Advantage	$3.93
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

ASSAY GLUCOSE BLOOD QUANT

Facility

$390.00

Service Code	HCPCS 82947
Hospital Charge Code	401082947
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ASSAY HOMOVANILLIC ACID

Facility

$390.00

Service Code	HCPCS 83150
Hospital Charge Code	401083150A
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ASSAY HOMOVANILLIC ACID

Facility

$390.00

Service Code	HCPCS 83150
Hospital Charge Code	401083150A
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$60.96
Rate for Payer: Aetna Medicare Advantage	$72.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.29
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$22.41
Rate for Payer: Clover Medicare Advantage	$21.29
Rate for Payer: EmblemHealth Commercial	$67.23
Rate for Payer: Humana Medicare Advantage	$23.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$17.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.41
Rate for Payer: Wellcare Medicare Advantage	$22.41
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

ASSAY IGA/IGD/IGG/IGM EA

Facility

$115.30

Service Code	HCPCS 82784
Hospital Charge Code	401182784B
Hospital Revenue Code	302
Min. Negotiated Rate	$17.30
Max. Negotiated Rate	$17.30
Rate for Payer: Qualcare PPO/HMO/WC	$17.30

ASSAY IGA/IGD/IGG/IGM EA

Facility

$115.30

Service Code	HCPCS 82784
Hospital Charge Code	401182784B
Hospital Revenue Code	302
Min. Negotiated Rate	$3.27
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$25.30
Rate for Payer: Aetna Medicare Advantage	$30.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.74
Rate for Payer: Cigna Commercial	$57.65
Rate for Payer: Cigna Medicare Advantage	$9.30
Rate for Payer: Clover Medicare Advantage	$8.84
Rate for Payer: EmblemHealth Commercial	$27.90
Rate for Payer: Humana Medicare Advantage	$9.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.98
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.30
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$7.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.30
Rate for Payer: Wellcare Medicare Advantage	$9.30
Rate for Payer: Wellpoint Medicaid Managed Care	$3.27

ASSAY NEPHELOMETRY NOT SPEC

Facility

$390.00

Service Code	HCPCS 83883
Hospital Charge Code	401083883
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ASSAY NEPHELOMETRY NOT SPEC

Facility

$390.00

Service Code	HCPCS 83883
Hospital Charge Code	401083883
Hospital Revenue Code	301
Min. Negotiated Rate	$10.88
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$36.99
Rate for Payer: Aetna Medicare Advantage	$44.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.33
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$13.60
Rate for Payer: Clover Medicare Advantage	$12.92
Rate for Payer: EmblemHealth Commercial	$40.80
Rate for Payer: Humana Medicare Advantage	$14.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.60
Rate for Payer: Wellcare Medicare Advantage	$13.60
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

ASSAY OF ANDROSTENEDIONE

Facility

$390.00

Service Code	HCPCS 82157
Hospital Charge Code	401182157
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ASSAY OF ANDROSTENEDIONE

Facility

$390.00

Service Code	HCPCS 82157
Hospital Charge Code	401182157
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$79.64
Rate for Payer: Aetna Medicare Advantage	$94.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.21
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$29.28
Rate for Payer: Clover Medicare Advantage	$27.82
Rate for Payer: EmblemHealth Commercial	$87.84
Rate for Payer: Humana Medicare Advantage	$30.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$29.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$23.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.28
Rate for Payer: Wellcare Medicare Advantage	$29.28
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

Know your out-of-pocket cost for care.

All Charges