Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ASSERT IQ ICM UMRI US

Facility

$19,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270704930
Hospital Revenue Code	278
Min. Negotiated Rate	$553.80
Max. Negotiated Rate	$9,750.00
Rate for Payer: Aetna Commercial	$7,410.00
Rate for Payer: Aetna Medicare Advantage	$5,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,972.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,972.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,972.50
Rate for Payer: Cigna Commercial	$9,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,719.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,925.00
Rate for Payer: UnitedHealthcare Community & State	$616.20
Rate for Payer: Wellpoint Medicaid Managed Care	$553.80

ASSESS CYST CONTRAST INJECT

Facility

$1,706.00

Service Code	HCPCS 49424
Hospital Charge Code	160000219
Hospital Revenue Code	360
Min. Negotiated Rate	$255.90
Max. Negotiated Rate	$255.90
Rate for Payer: Qualcare PPO/HMO/WC	$255.90

ASSESS CYST CONTRAST INJECT

Facility

$1,706.00

Service Code	HCPCS 49424
Hospital Charge Code	160000219
Hospital Revenue Code	360
Min. Negotiated Rate	$48.45
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$648.28
Rate for Payer: Aetna Medicare Advantage	$511.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$435.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$435.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$435.03
Rate for Payer: Cigna Commercial	$853.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$443.56
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.90
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$53.91
Rate for Payer: Wellpoint Medicaid Managed Care	$48.45

ASSESSMENT OF APHASIA PER 60M

Facility

$561.00

Service Code	HCPCS 96105GN
Hospital Charge Code	74204005
Hospital Revenue Code	444
Min. Negotiated Rate	$17.73
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$213.18
Rate for Payer: Aetna Medicare Advantage	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.06
Rate for Payer: Cigna Commercial	$280.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.86
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.15
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$17.73
Rate for Payer: Wellpoint Medicaid Managed Care	$65.00

ASSESSMENT OF APHASIA PER 60M

Facility

$561.00

Service Code	HCPCS 96105GN
Hospital Charge Code	74204005
Hospital Revenue Code	444
Min. Negotiated Rate	$84.15
Max. Negotiated Rate	$84.15
Rate for Payer: Qualcare PPO/HMO/WC	$84.15

ASSY CABLE 23X 52MM

Facility

$1,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270690627
Hospital Revenue Code	278
Min. Negotiated Rate	$241.50
Max. Negotiated Rate	$389.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$322.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.62
Rate for Payer: Qualcare PPO/HMO/WC	$241.50

ASSY CABLE 23X 52MM

Facility

$1,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270690627
Hospital Revenue Code	278
Min. Negotiated Rate	$45.72
Max. Negotiated Rate	$805.00
Rate for Payer: Aetna Commercial	$611.80
Rate for Payer: Aetna Medicare Advantage	$483.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$322.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$410.55
Rate for Payer: Cigna Commercial	$805.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.62
Rate for Payer: Qualcare PPO/HMO/WC	$241.50
Rate for Payer: UnitedHealthcare Community & State	$50.88
Rate for Payer: Wellpoint Medicaid Managed Care	$45.72

ASSY DELTA SHUNT REG LEV 1.5

Facility

$10,828.80

Service Code	HCPCS C1889
Hospital Charge Code	270691051
Hospital Revenue Code	278
Min. Negotiated Rate	$307.54
Max. Negotiated Rate	$5,414.40
Rate for Payer: Aetna Commercial	$4,114.94
Rate for Payer: Aetna Medicare Advantage	$3,248.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,761.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,761.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,165.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,761.34
Rate for Payer: Cigna Commercial	$5,414.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,620.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,624.32
Rate for Payer: UnitedHealthcare Community & State	$342.19
Rate for Payer: Wellpoint Medicaid Managed Care	$307.54

ASSY DELTA SHUNT REG LEV 1.5

Facility

$10,828.80

Service Code	HCPCS C1889
Hospital Charge Code	270691051
Hospital Revenue Code	278
Min. Negotiated Rate	$1,624.32
Max. Negotiated Rate	$2,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,165.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,620.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,624.32

ASSY DELTA SHUNT REG P/L1

Facility

$8,155.20

Service Code	HCPCS C1729
Hospital Charge Code	270647134
Hospital Revenue Code	278
Min. Negotiated Rate	$1,223.28
Max. Negotiated Rate	$1,973.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,631.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,973.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,223.28

ASSY DELTA SHUNT REG P/L1

Facility

$8,155.20

Service Code	HCPCS C1729
Hospital Charge Code	270647134
Hospital Revenue Code	278
Min. Negotiated Rate	$231.61
Max. Negotiated Rate	$4,077.60
Rate for Payer: Aetna Commercial	$3,098.98
Rate for Payer: Aetna Medicare Advantage	$2,446.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,079.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,079.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,631.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,079.58
Rate for Payer: Cigna Commercial	$4,077.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,973.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,223.28
Rate for Payer: UnitedHealthcare Community & State	$257.70
Rate for Payer: Wellpoint Medicaid Managed Care	$231.61

ASSY, HOOK-UP OLYMPUS 2K

Facility

$2,426.50

Hospital Charge Code	270678492
Hospital Revenue Code	272
Min. Negotiated Rate	$363.98
Max. Negotiated Rate	$363.98
Rate for Payer: Qualcare PPO/HMO/WC	$363.98

ASSY, HOOK-UP OLYMPUS 2K

Facility

$2,426.50

Hospital Charge Code	270678492
Hospital Revenue Code	272
Min. Negotiated Rate	$68.91
Max. Negotiated Rate	$1,213.25
Rate for Payer: Aetna Commercial	$922.07
Rate for Payer: Aetna Medicare Advantage	$727.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$618.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$618.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$618.76
Rate for Payer: Cigna Commercial	$1,213.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$630.89
Rate for Payer: Oxford Commercial	$485.30
Rate for Payer: Qualcare PPO/HMO/WC	$363.98
Rate for Payer: UnitedHealthcare Commercial	$485.30
Rate for Payer: UnitedHealthcare Community & State	$76.68
Rate for Payer: Wellpoint Medicaid Managed Care	$68.91

ASTHMA

Facility

$7,788.67

Service Code	APR-DRG 1412
Min. Negotiated Rate	$7,635.95
Max. Negotiated Rate	$7,788.67
Rate for Payer: UnitedHealthcare Community & State	$7,635.95
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,788.67
Rate for Payer: Wellpoint Medicaid Managed Care	$7,635.95

ASTHMA

Facility

$5,318.40

Service Code	APR-DRG 1411
Min. Negotiated Rate	$5,214.12
Max. Negotiated Rate	$5,318.40
Rate for Payer: UnitedHealthcare Community & State	$5,214.12
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,318.40
Rate for Payer: Wellpoint Medicaid Managed Care	$5,214.12

ASTHMA

Facility

$18,036.46

Service Code	APR-DRG 1414
Min. Negotiated Rate	$17,682.80
Max. Negotiated Rate	$18,036.46
Rate for Payer: UnitedHealthcare Community & State	$17,682.80
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$18,036.46
Rate for Payer: Wellpoint Medicaid Managed Care	$17,682.80

ASTHMA

Facility

$9,239.42

Service Code	APR-DRG 1413
Min. Negotiated Rate	$9,058.25
Max. Negotiated Rate	$9,239.42
Rate for Payer: UnitedHealthcare Community & State	$9,058.25
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,239.42
Rate for Payer: Wellpoint Medicaid Managed Care	$9,058.25

ASTRIN GYN FERRIC SUBSULFUTE

Facility

$61.86

Hospital Charge Code	270650773
Hospital Revenue Code	272
Min. Negotiated Rate	$1.76
Max. Negotiated Rate	$30.93
Rate for Payer: Aetna Commercial	$23.51
Rate for Payer: Aetna Medicare Advantage	$18.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.77
Rate for Payer: Cigna Commercial	$30.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.08
Rate for Payer: Oxford Commercial	$12.37
Rate for Payer: Qualcare PPO/HMO/WC	$9.28
Rate for Payer: UnitedHealthcare Commercial	$12.37
Rate for Payer: UnitedHealthcare Community & State	$1.95
Rate for Payer: Wellpoint Medicaid Managed Care	$1.76

ASTRIN GYN FERRIC SUBSULFUTE

Facility

$61.86

Hospital Charge Code	270650773
Hospital Revenue Code	272
Min. Negotiated Rate	$9.28
Max. Negotiated Rate	$9.28
Rate for Payer: Qualcare PPO/HMO/WC	$9.28

AST - SGOT

Facility

$667.59

Service Code	HCPCS 84450
Hospital Charge Code	3002441
Hospital Revenue Code	301
Min. Negotiated Rate	$4.14
Max. Negotiated Rate	$333.80
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	$333.80
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	$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	$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	$18.96

AST - SGOT

Facility

$667.59

Service Code	HCPCS 84450
Hospital Charge Code	3002441
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

ASYMETRIC PATELLAA-29MMX9MM

Facility

$2,678.00

Service Code	HCPCS C1776
Hospital Charge Code	270690854
Hospital Revenue Code	278
Min. Negotiated Rate	$401.70
Max. Negotiated Rate	$648.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$535.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$648.08
Rate for Payer: Qualcare PPO/HMO/WC	$401.70

ASYMETRIC PATELLAA-29MMX9MM

Facility

$2,678.00

Service Code	HCPCS C1776
Hospital Charge Code	270690854
Hospital Revenue Code	278
Min. Negotiated Rate	$76.06
Max. Negotiated Rate	$1,339.00
Rate for Payer: Aetna Commercial	$1,017.64
Rate for Payer: Aetna Medicare Advantage	$803.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$682.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$682.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$535.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$682.89
Rate for Payer: Cigna Commercial	$1,339.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$648.08
Rate for Payer: Qualcare PPO/HMO/WC	$401.70
Rate for Payer: UnitedHealthcare Community & State	$84.62
Rate for Payer: Wellpoint Medicaid Managed Care	$76.06

ATAZANAVIR 100 MG CAP

Facility

$147.27

Service Code	NDC 3363810
Hospital Charge Code	60632255
Hospital Revenue Code	250
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$73.64
Rate for Payer: Aetna Commercial	$55.96
Rate for Payer: Aetna Medicare Advantage	$44.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.55
Rate for Payer: Cigna Commercial	$73.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.29
Rate for Payer: Oxford Commercial	$29.45
Rate for Payer: Qualcare PPO/HMO/WC	$22.09
Rate for Payer: UnitedHealthcare Commercial	$29.45
Rate for Payer: UnitedHealthcare Community & State	$4.65
Rate for Payer: Wellpoint Medicaid Managed Care	$4.18

ATAZANAVIR 100 MG CAP

Facility

$147.27

Service Code	NDC 3363810
Hospital Charge Code	60632255
Hospital Revenue Code	250
Min. Negotiated Rate	$22.09
Max. Negotiated Rate	$22.09
Rate for Payer: Qualcare PPO/HMO/WC	$22.09

Know your out-of-pocket cost for care.

All Charges