Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

NPWT < 50 SQ CM WO DME

Facility

$867.53

Service Code	HCPCS 97607
Hospital Charge Code	9808331
Hospital Revenue Code	361
Min. Negotiated Rate	$130.13
Max. Negotiated Rate	$130.13
Rate for Payer: Qualcare PPO/HMO/WC	$130.13

NPWT < 50 SQ CM WO DME

Facility

$867.53

Service Code	HCPCS 97607
Hospital Charge Code	9808331
Hospital Revenue Code	361
Min. Negotiated Rate	$24.64
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
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	$1,751.90
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.56
Rate for Payer: Qualcare PPO/HMO/WC	$130.13
Rate for Payer: UnitedHealthcare Community & State	$27.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$24.64

NPWT > 50 SQ CM WO DME

Facility

$867.53

Service Code	HCPCS 97608
Hospital Charge Code	9808332
Hospital Revenue Code	361
Min. Negotiated Rate	$130.13
Max. Negotiated Rate	$130.13
Rate for Payer: Qualcare PPO/HMO/WC	$130.13

NPWT > 50 SQ CM WO DME

Facility

$867.53

Service Code	HCPCS 97608
Hospital Charge Code	9808332
Hospital Revenue Code	361
Min. Negotiated Rate	$24.64
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
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	$1,751.90
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.56
Rate for Payer: Qualcare PPO/HMO/WC	$130.13
Rate for Payer: UnitedHealthcare Community & State	$27.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$24.64

NPWT TWO DRESSING KIT 10X20CM

Facility

$572.00

Hospital Charge Code	270693967
Hospital Revenue Code	270
Min. Negotiated Rate	$16.24
Max. Negotiated Rate	$286.00
Rate for Payer: Aetna Commercial	$217.36
Rate for Payer: Aetna Medicare Advantage	$171.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.86
Rate for Payer: Cigna Commercial	$286.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.72
Rate for Payer: Oxford Commercial	$114.40
Rate for Payer: Qualcare PPO/HMO/WC	$85.80
Rate for Payer: UnitedHealthcare Commercial	$114.40
Rate for Payer: UnitedHealthcare Community & State	$18.08
Rate for Payer: Wellpoint Medicaid Managed Care	$16.24

NPWT TWO DRESSING KIT 10X20CM

Facility

$572.00

Hospital Charge Code	270693967
Hospital Revenue Code	270
Min. Negotiated Rate	$85.80
Max. Negotiated Rate	$85.80
Rate for Payer: Qualcare PPO/HMO/WC	$85.80

NPWT TWO DRESSING KIT 10X40CM

Facility

$572.83

Hospital Charge Code	270693968
Hospital Revenue Code	270
Min. Negotiated Rate	$16.27
Max. Negotiated Rate	$286.42
Rate for Payer: Aetna Commercial	$217.68
Rate for Payer: Aetna Medicare Advantage	$171.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.07
Rate for Payer: Cigna Commercial	$286.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.94
Rate for Payer: Oxford Commercial	$114.57
Rate for Payer: Qualcare PPO/HMO/WC	$85.92
Rate for Payer: UnitedHealthcare Commercial	$114.57
Rate for Payer: UnitedHealthcare Community & State	$18.10
Rate for Payer: Wellpoint Medicaid Managed Care	$16.27

NPWT TWO DRESSING KIT 10X40CM

Facility

$572.83

Hospital Charge Code	270693968
Hospital Revenue Code	270
Min. Negotiated Rate	$85.92
Max. Negotiated Rate	$85.92
Rate for Payer: Qualcare PPO/HMO/WC	$85.92

NSL/SINS NDSC TOTAL

Facility

$31,659.60

Service Code	HCPCS 31253
Hospital Charge Code	1600000467
Hospital Revenue Code	360
Min. Negotiated Rate	$4,748.94
Max. Negotiated Rate	$4,748.94
Rate for Payer: Qualcare PPO/HMO/WC	$4,748.94

NSL/SINS NDSC TOTAL

Facility

$31,659.60

Service Code	HCPCS 31253
Hospital Charge Code	1600000467
Hospital Revenue Code	360
Min. Negotiated Rate	$899.13
Max. Negotiated Rate	$30,414.59
Rate for Payer: Aetna Commercial	$22,805.70
Rate for Payer: Aetna Medicare Advantage	$27,165.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30,414.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30,414.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,384.45
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	$30,414.59
Rate for Payer: Cigna Commercial	$16,806.60
Rate for Payer: Cigna Medicare Advantage	$8,384.45
Rate for Payer: Clover Medicare Advantage	$7,965.23
Rate for Payer: EmblemHealth Commercial	$25,153.35
Rate for Payer: Humana Medicare Advantage	$8,635.98
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,384.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,231.50
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,748.94
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$1,000.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,384.45
Rate for Payer: Wellcare Medicare Advantage	$8,384.45
Rate for Payer: Wellpoint Medicaid Managed Care	$899.13

NSL/SINS NDSC TOT W/SPHENDT

Facility

$31,659.60

Service Code	HCPCS 31257
Hospital Charge Code	1600000466
Hospital Revenue Code	360
Min. Negotiated Rate	$899.13
Max. Negotiated Rate	$30,414.59
Rate for Payer: Aetna Commercial	$22,805.70
Rate for Payer: Aetna Medicare Advantage	$27,165.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30,414.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30,414.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,384.45
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	$30,414.59
Rate for Payer: Cigna Commercial	$16,806.60
Rate for Payer: Cigna Medicare Advantage	$8,384.45
Rate for Payer: Clover Medicare Advantage	$7,965.23
Rate for Payer: EmblemHealth Commercial	$25,153.35
Rate for Payer: Humana Medicare Advantage	$8,635.98
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,384.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,231.50
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,748.94
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$1,000.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,384.45
Rate for Payer: Wellcare Medicare Advantage	$8,384.45
Rate for Payer: Wellpoint Medicaid Managed Care	$899.13

NSL/SINS NDSC TOT W/SPHENDT

Facility

$31,659.60

Service Code	HCPCS 31257
Hospital Charge Code	1600000466
Hospital Revenue Code	360
Min. Negotiated Rate	$4,748.94
Max. Negotiated Rate	$4,748.94
Rate for Payer: Qualcare PPO/HMO/WC	$4,748.94

NUBBINS

Facility

$175.00

Hospital Charge Code	270656535
Hospital Revenue Code	271
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

NUBBINS

Facility

$175.00

Hospital Charge Code	270656535
Hospital Revenue Code	271
Min. Negotiated Rate	$4.97
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.50
Rate for Payer: Oxford Commercial	$35.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$35.00
Rate for Payer: UnitedHealthcare Community & State	$5.53
Rate for Payer: Wellpoint Medicaid Managed Care	$4.97

NUCLEAR ANTIGEN AB

Facility

$667.59

Service Code	HCPCS 86235
Hospital Charge Code	39708042D
Hospital Revenue Code	306
Min. Negotiated Rate	$14.34
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$48.77
Rate for Payer: Aetna Medicare Advantage	$58.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.04
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$17.93
Rate for Payer: Clover Medicare Advantage	$17.03
Rate for Payer: EmblemHealth Commercial	$53.79
Rate for Payer: Humana Medicare Advantage	$18.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.93
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	$14.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.93
Rate for Payer: Wellcare Medicare Advantage	$17.93
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

NUCLEAR ANTIGEN AB

Facility

$667.59

Service Code	HCPCS 86235
Hospital Charge Code	39708042D
Hospital Revenue Code	306
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

NUCLEAR ANTIGEN ANTIBDY EA(X5)

Facility

$610.06

Service Code	HCPCS 86235
Hospital Charge Code	40119477B
Hospital Revenue Code	302
Min. Negotiated Rate	$14.34
Max. Negotiated Rate	$305.03
Rate for Payer: Aetna Commercial	$48.77
Rate for Payer: Aetna Medicare Advantage	$58.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.04
Rate for Payer: Cigna Commercial	$305.03
Rate for Payer: Cigna Medicare Advantage	$17.93
Rate for Payer: Clover Medicare Advantage	$17.03
Rate for Payer: EmblemHealth Commercial	$53.79
Rate for Payer: Humana Medicare Advantage	$18.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.62
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.51
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.93
Rate for Payer: Wellcare Medicare Advantage	$17.93
Rate for Payer: Wellpoint Medicaid Managed Care	$17.33

NUCLEAR ANTIGEN ANTIBDY EA(X5)

Facility

$610.06

Service Code	HCPCS 86235
Hospital Charge Code	40119477B
Hospital Revenue Code	302
Min. Negotiated Rate	$91.51
Max. Negotiated Rate	$91.51
Rate for Payer: Qualcare PPO/HMO/WC	$91.51

NUCLEAR ANTIGEN ANTIBODY

Facility

$448.25

Service Code	HCPCS 86235
Hospital Charge Code	401386235C
Hospital Revenue Code	302
Min. Negotiated Rate	$67.24
Max. Negotiated Rate	$67.24
Rate for Payer: Qualcare PPO/HMO/WC	$67.24

NUCLEAR ANTIGEN ANTIBODY

Facility

$448.25

Service Code	HCPCS 86235
Hospital Charge Code	401386235C
Hospital Revenue Code	302
Min. Negotiated Rate	$12.73
Max. Negotiated Rate	$224.12
Rate for Payer: Aetna Commercial	$48.77
Rate for Payer: Aetna Medicare Advantage	$58.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.04
Rate for Payer: Cigna Commercial	$224.12
Rate for Payer: Cigna Medicare Advantage	$17.93
Rate for Payer: Clover Medicare Advantage	$17.03
Rate for Payer: EmblemHealth Commercial	$53.79
Rate for Payer: Humana Medicare Advantage	$18.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.55
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.24
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.93
Rate for Payer: Wellcare Medicare Advantage	$17.93
Rate for Payer: Wellpoint Medicaid Managed Care	$12.73

NUCLEAR MEDICINE TREATMENT

Facility

$6,315.40

Service Code	HCPCS 78452
Hospital Charge Code	36540017
Hospital Revenue Code	341
Min. Negotiated Rate	$947.31
Max. Negotiated Rate	$947.31
Rate for Payer: Qualcare PPO/HMO/WC	$947.31

NUCLEAR MEDICINE TREATMENT

Facility

$6,315.40

Service Code	HCPCS 78452
Hospital Charge Code	36540017
Hospital Revenue Code	341
Min. Negotiated Rate	$179.36
Max. Negotiated Rate	$5,579.39
Rate for Payer: Aetna Commercial	$4,183.58
Rate for Payer: Aetna Medicare Advantage	$4,983.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,579.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,579.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,538.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$277.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,579.39
Rate for Payer: Cigna Commercial	$3,083.08
Rate for Payer: Cigna Medicare Advantage	$1,076.66
Rate for Payer: Clover Medicare Advantage	$1,461.18
Rate for Payer: EmblemHealth Commercial	$4,614.24
Rate for Payer: Humana Medicare Advantage	$1,584.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,538.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,642.00
Rate for Payer: Oxford Commercial	$4,820.00
Rate for Payer: Qualcare PPO/HMO/WC	$947.31
Rate for Payer: UnitedHealthcare Commercial	$4,748.00
Rate for Payer: UnitedHealthcare Community & State	$199.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,538.08
Rate for Payer: Wellcare Medicare Advantage	$1,538.08
Rate for Payer: Wellpoint Medicaid Managed Care	$179.36

NUCLEAR MOLECULAR DX ENZY DIG1

Facility

$44.00

Service Code	HCPCS 83892
Hospital Charge Code	38476241
Hospital Revenue Code	301
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

NUCLEAR MOLECULAR DX ENZY DIG1

Facility

$44.00

Service Code	HCPCS 83892
Hospital Charge Code	38476241
Hospital Revenue Code	301
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$16.72
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.44
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$1.39
Rate for Payer: Wellpoint Medicaid Managed Care	$1.25

NUCLEAR MOLECULAR DX ENZY DIG2

Facility

$44.00

Service Code	HCPCS 83892
Hospital Charge Code	38476792
Hospital Revenue Code	301
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$16.72
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.44
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$1.39
Rate for Payer: Wellpoint Medicaid Managed Care	$1.25

Know your out-of-pocket cost for care.

All Charges