Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC

Facility

$72,061.64

Service Code	MSDRG 070
Min. Negotiated Rate	$21,941.85
Max. Negotiated Rate	$72,061.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,591.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,591.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49,591.95

NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CC/MCC

Facility

$43,355.74

Service Code	MSDRG 072
Min. Negotiated Rate	$13,201.27
Max. Negotiated Rate	$43,355.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21,609.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21,609.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21,609.90

NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION

Facility

$9,018.92

Service Code	APR-DRG 0461
Min. Negotiated Rate	$8,842.08
Max. Negotiated Rate	$9,018.92
Rate for Payer: UnitedHealthcare Community & State	$8,842.08
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,018.92
Rate for Payer: Wellpoint Medicaid Managed Care	$8,842.08

NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION

Facility

$26,523.16

Service Code	APR-DRG 0464
Min. Negotiated Rate	$26,003.10
Max. Negotiated Rate	$26,523.16
Rate for Payer: UnitedHealthcare Community & State	$26,003.10
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$26,523.16
Rate for Payer: Wellpoint Medicaid Managed Care	$26,003.10

NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION

Facility

$13,586.00

Service Code	APR-DRG 0463
Min. Negotiated Rate	$13,319.61
Max. Negotiated Rate	$13,586.00
Rate for Payer: UnitedHealthcare Community & State	$13,319.61
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,586.00
Rate for Payer: Wellpoint Medicaid Managed Care	$13,319.61

NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION

Facility

$10,802.49

Service Code	APR-DRG 0462
Min. Negotiated Rate	$10,590.68
Max. Negotiated Rate	$10,802.49
Rate for Payer: UnitedHealthcare Community & State	$10,590.68
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,802.49
Rate for Payer: Wellpoint Medicaid Managed Care	$10,590.68

NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC

Facility

$65,866.13

Service Code	MSDRG 067
Min. Negotiated Rate	$20,055.39
Max. Negotiated Rate	$65,866.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39,341.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39,341.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39,341.10

NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC

Facility

$46,774.07

Service Code	MSDRG 068
Min. Negotiated Rate	$14,242.11
Max. Negotiated Rate	$46,774.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24,103.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24,103.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24,103.35

NONTRAUMATIC STUPOR AND COMA WITH MCC

Facility

$76,648.98

Service Code	MSDRG 080
Min. Negotiated Rate	$23,338.63
Max. Negotiated Rate	$76,648.98
Rate for Payer: Aetna Medicare Advantage	$76,648.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61,228.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61,228.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24,566.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61,228.05
Rate for Payer: Cigna Commercial	$40,350.33
Rate for Payer: Cigna Medicare Advantage	$24,566.98
Rate for Payer: Clover Medicare Advantage	$23,338.63
Rate for Payer: EmblemHealth Commercial	$73,700.94
Rate for Payer: Humana Medicare Advantage	$25,303.99
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24,566.98
Rate for Payer: Oxford Commercial	$31,892.20
Rate for Payer: UnitedHealthcare Commercial	$42,688.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$24,566.98
Rate for Payer: Wellcare Medicare Advantage	$24,566.98

NONTRAUMATIC STUPOR AND COMA WITHOUT MCC

Facility

$47,759.81

Service Code	MSDRG 081
Min. Negotiated Rate	$14,542.25
Max. Negotiated Rate	$47,759.81
Rate for Payer: Aetna Medicare Advantage	$47,759.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,211.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,211.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,307.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25,211.55
Rate for Payer: Cigna Commercial	$19,965.61
Rate for Payer: Cigna Medicare Advantage	$15,307.63
Rate for Payer: Clover Medicare Advantage	$14,542.25
Rate for Payer: EmblemHealth Commercial	$45,922.89
Rate for Payer: Humana Medicare Advantage	$15,766.86
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,307.63
Rate for Payer: Oxford Commercial	$15,780.47
Rate for Payer: UnitedHealthcare Commercial	$21,122.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,307.63
Rate for Payer: Wellcare Medicare Advantage	$15,307.63

NOREPINEPBITART NS 16MG/250ML

Facility

$201.00

Service Code	NDC 70092146805
Hospital Charge Code	606390482
Hospital Revenue Code	250
Min. Negotiated Rate	$5.71
Max. Negotiated Rate	$100.50
Rate for Payer: Aetna Commercial	$76.38
Rate for Payer: Aetna Medicare Advantage	$60.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.26
Rate for Payer: Cigna Commercial	$100.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.26
Rate for Payer: Oxford Commercial	$40.20
Rate for Payer: Qualcare PPO/HMO/WC	$30.15
Rate for Payer: UnitedHealthcare Commercial	$40.20
Rate for Payer: UnitedHealthcare Community & State	$6.35
Rate for Payer: Wellpoint Medicaid Managed Care	$5.71

NOREPINEPBITART NS 16MG/250ML

Facility

$201.00

Service Code	NDC 70092146805
Hospital Charge Code	606390482
Hospital Revenue Code	250
Min. Negotiated Rate	$30.15
Max. Negotiated Rate	$30.15
Rate for Payer: Qualcare PPO/HMO/WC	$30.15

NOREPINEPHRINE 4MG/250ML NS

Facility

$53.60

Service Code	NDC 75901120204
Hospital Charge Code	606390109
Hospital Revenue Code	250
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$26.80
Rate for Payer: Aetna Commercial	$20.37
Rate for Payer: Aetna Medicare Advantage	$16.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.67
Rate for Payer: Cigna Commercial	$26.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.94
Rate for Payer: Oxford Commercial	$10.72
Rate for Payer: Qualcare PPO/HMO/WC	$8.04
Rate for Payer: UnitedHealthcare Commercial	$10.72
Rate for Payer: UnitedHealthcare Community & State	$1.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1.52

NOREPINEPHRINE 4MG/250ML NS

Facility

$53.60

Service Code	NDC 75901120204
Hospital Charge Code	606390109
Hospital Revenue Code	250
Min. Negotiated Rate	$8.04
Max. Negotiated Rate	$8.04
Rate for Payer: Qualcare PPO/HMO/WC	$8.04

NOREPINEPHRINE 4 MG / 4 ML INJ

Facility

$70.35

Service Code	NDC 36000016210
Hospital Charge Code	60627463
Hospital Revenue Code	250
Min. Negotiated Rate	$10.55
Max. Negotiated Rate	$10.55
Rate for Payer: Qualcare PPO/HMO/WC	$10.55

NOREPINEPHRINE 4 MG / 4 ML INJ

Facility

$70.35

Service Code	NDC 36000016210
Hospital Charge Code	60627463
Hospital Revenue Code	250
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$35.17
Rate for Payer: Aetna Commercial	$26.73
Rate for Payer: Aetna Medicare Advantage	$21.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.94
Rate for Payer: Cigna Commercial	$35.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.29
Rate for Payer: Oxford Commercial	$14.07
Rate for Payer: Qualcare PPO/HMO/WC	$10.55
Rate for Payer: UnitedHealthcare Commercial	$14.07
Rate for Payer: UnitedHealthcare Community & State	$2.22
Rate for Payer: Wellpoint Medicaid Managed Care	$2.00

NOREPINEPHRINE PLASMA

Facility

$123.15

Service Code	HCPCS 82542
Hospital Charge Code	39708033
Hospital Revenue Code	301
Min. Negotiated Rate	$3.50
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$65.52
Rate for Payer: Aetna Medicare Advantage	$78.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.39
Rate for Payer: Cigna Commercial	$61.58
Rate for Payer: Cigna Medicare Advantage	$24.09
Rate for Payer: Clover Medicare Advantage	$22.89
Rate for Payer: EmblemHealth Commercial	$72.27
Rate for Payer: Humana Medicare Advantage	$24.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24.09
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	$18.47
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$19.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.09
Rate for Payer: Wellcare Medicare Advantage	$24.09
Rate for Payer: Wellpoint Medicaid Managed Care	$3.50

NOREPINEPHRINE PLASMA

Facility

$123.15

Service Code	HCPCS 82542
Hospital Charge Code	39708033
Hospital Revenue Code	301
Min. Negotiated Rate	$18.47
Max. Negotiated Rate	$18.47
Rate for Payer: Qualcare PPO/HMO/WC	$18.47

NOREPINEPHRN BITAR 8MG/NS250ML

Facility

$150.75

Service Code	NDC 69374050425
Hospital Charge Code	606390290
Hospital Revenue Code	250
Min. Negotiated Rate	$22.61
Max. Negotiated Rate	$22.61
Rate for Payer: Qualcare PPO/HMO/WC	$22.61

NOREPINEPHRN BITAR 8MG/NS250ML

Facility

$150.75

Service Code	NDC 69374050425
Hospital Charge Code	606390290
Hospital Revenue Code	250
Min. Negotiated Rate	$4.28
Max. Negotiated Rate	$75.38
Rate for Payer: Aetna Commercial	$57.28
Rate for Payer: Aetna Medicare Advantage	$45.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.44
Rate for Payer: Cigna Commercial	$75.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.20
Rate for Payer: Oxford Commercial	$30.15
Rate for Payer: Qualcare PPO/HMO/WC	$22.61
Rate for Payer: UnitedHealthcare Commercial	$30.15
Rate for Payer: UnitedHealthcare Community & State	$4.76
Rate for Payer: Wellpoint Medicaid Managed Care	$4.28

NORMAL NEWBORN

Facility

$25,777.10

Service Code	MSDRG 795
Min. Negotiated Rate	$3,897.00
Max. Negotiated Rate	$25,777.10
Rate for Payer: Aetna Commercial	$20,217.23
Rate for Payer: Aetna Medicare Advantage	$25,777.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,261.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,541.00
Rate for Payer: Cigna Commercial	$4,454.14
Rate for Payer: Cigna Medicare Advantage	$8,261.89
Rate for Payer: Clover Medicare Advantage	$7,848.80
Rate for Payer: EmblemHealth Commercial	$24,785.67
Rate for Payer: Humana Medicare Advantage	$8,509.75
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,261.89
Rate for Payer: Oxford Commercial	$3,897.00
Rate for Payer: UnitedHealthcare Commercial	$4,425.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,261.89
Rate for Payer: Wellcare Medicare Advantage	$8,261.89

NORMAL SALINE FLUSH 2.5ML

Facility

$4.00

Service Code	NDC 63807010030
Hospital Charge Code	6063943150
Hospital Revenue Code	258
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

NORMAL SALINE FLUSH 2.5ML

Facility

$4.00

Service Code	NDC 63807010030
Hospital Charge Code	6063943150
Hospital Revenue Code	258
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

NORMEPERIDINE RANDOM URINE

Facility

$588.25

Service Code	HCPCS 80349
Hospital Charge Code	39708047
Hospital Revenue Code	306
Min. Negotiated Rate	$88.24
Max. Negotiated Rate	$88.24
Rate for Payer: Qualcare PPO/HMO/WC	$88.24

NORMEPERIDINE RANDOM URINE

Facility

$588.25

Service Code	HCPCS 80349
Hospital Charge Code	39708047
Hospital Revenue Code	306
Min. Negotiated Rate	$16.71
Max. Negotiated Rate	$294.12
Rate for Payer: Aetna Commercial	$223.53
Rate for Payer: Aetna Medicare Advantage	$176.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$150.00
Rate for Payer: Cigna Commercial	$294.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.94
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$88.24
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$22.05
Rate for Payer: Wellpoint Medicaid Managed Care	$16.71

Know your out-of-pocket cost for care.

All Charges