Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ORBIT AND EYE PROCEDURES

Facility

$12,607.11

Service Code	APR-DRG 0731
Min. Negotiated Rate	$12,359.91
Max. Negotiated Rate	$12,607.11
Rate for Payer: UnitedHealthcare Community & State	$12,359.91
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,607.11
Rate for Payer: Wellpoint Medicaid Managed Care	$12,359.91

ORBIT AND EYE PROCEDURES

Facility

$15,502.94

Service Code	APR-DRG 0732
Min. Negotiated Rate	$15,198.96
Max. Negotiated Rate	$15,502.94
Rate for Payer: UnitedHealthcare Community & State	$15,198.96
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$15,502.94
Rate for Payer: Wellpoint Medicaid Managed Care	$15,198.96

ORBITS COMP MIN 4VW-BI

Facility

$5,100.00

Service Code	HCPCS 7020050
Hospital Charge Code	94061205
Hospital Revenue Code	320
Min. Negotiated Rate	$144.84
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.00
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$161.16
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

ORBITS COMP MIN 4VW-BI

Facility

$5,100.00

Service Code	HCPCS 7020050
Hospital Charge Code	94061205
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

ORBITS COMP MIN 4VW-LT

Facility

$5,100.00

Service Code	HCPCS 70200LT
Hospital Charge Code	94061261
Hospital Revenue Code	320
Min. Negotiated Rate	$144.84
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.00
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$161.16
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

ORBITS COMP MIN 4VW-LT

Facility

$5,100.00

Service Code	HCPCS 70200LT
Hospital Charge Code	94061261
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

ORCHIECTOMY SIMPLE BL

Facility

$25,837.00

Service Code	HCPCS 54520
Hospital Charge Code	1600000692
Hospital Revenue Code	360
Min. Negotiated Rate	$733.77
Max. Negotiated Rate	$15,191.14
Rate for Payer: Aetna Commercial	$11,390.73
Rate for Payer: Aetna Medicare Advantage	$13,568.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,191.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,191.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,187.77
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	$15,191.14
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: Cigna Medicare Advantage	$4,187.77
Rate for Payer: Clover Medicare Advantage	$3,978.38
Rate for Payer: EmblemHealth Commercial	$12,563.31
Rate for Payer: Humana Medicare Advantage	$4,313.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,187.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,717.62
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,875.55
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$816.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,187.77
Rate for Payer: Wellcare Medicare Advantage	$4,187.77
Rate for Payer: Wellpoint Medicaid Managed Care	$733.77

ORCHIECTOMY SIMPLE BL

Facility

$25,837.00

Service Code	HCPCS 54520
Hospital Charge Code	1600000692
Hospital Revenue Code	360
Min. Negotiated Rate	$3,875.55
Max. Negotiated Rate	$3,875.55
Rate for Payer: Qualcare PPO/HMO/WC	$3,875.55

ORCHIOPEXY INGUINAL APPROACH

Facility

$30,877.00

Service Code	HCPCS 54640
Hospital Charge Code	16001002
Hospital Revenue Code	360
Min. Negotiated Rate	$876.91
Max. Negotiated Rate	$15,429.97
Rate for Payer: Aetna Commercial	$11,569.82
Rate for Payer: Aetna Medicare Advantage	$13,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,429.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,429.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,253.61
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	$15,429.97
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: Cigna Medicare Advantage	$4,253.61
Rate for Payer: Clover Medicare Advantage	$4,040.93
Rate for Payer: EmblemHealth Commercial	$12,760.83
Rate for Payer: Humana Medicare Advantage	$4,381.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,253.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,028.02
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,631.55
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$975.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,253.61
Rate for Payer: Wellcare Medicare Advantage	$4,253.61
Rate for Payer: Wellpoint Medicaid Managed Care	$876.91

ORCHIOPEXY INGUINAL APPROACH

Facility

$30,877.00

Service Code	HCPCS 54640
Hospital Charge Code	16001002
Hospital Revenue Code	360
Min. Negotiated Rate	$4,631.55
Max. Negotiated Rate	$4,631.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,631.55

Orencia(Abatacept) 250mg iv

Facility

$805.25

Hospital Charge Code	6063943273
Hospital Revenue Code	636
Min. Negotiated Rate	$120.79
Max. Negotiated Rate	$194.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.87
Rate for Payer: Qualcare PPO/HMO/WC	$120.79

Orencia(Abatacept) 250mg iv

Facility

$805.25

Hospital Charge Code	6063943273
Hospital Revenue Code	636
Min. Negotiated Rate	$22.87
Max. Negotiated Rate	$402.62
Rate for Payer: Aetna Commercial	$306.00
Rate for Payer: Aetna Medicare Advantage	$241.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$205.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$205.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$205.34
Rate for Payer: Cigna Commercial	$402.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.87
Rate for Payer: Qualcare PPO/HMO/WC	$120.79
Rate for Payer: UnitedHealthcare Community & State	$25.45
Rate for Payer: Wellpoint Medicaid Managed Care	$22.87

ORGANIC ACID FULL QUANT A

Facility

$390.00

Service Code	HCPCS 82570
Hospital Charge Code	39708015A
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ORGANIC ACID FULL QUANT A

Facility

$390.00

Service Code	HCPCS 82570
Hospital Charge Code	39708015A
Hospital Revenue Code	301
Min. Negotiated Rate	$4.14
Max. Negotiated Rate	$195.00
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	$195.00
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	$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	$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	$11.08

ORGANIC ACID FULL QUANT B

Facility

$390.00

Service Code	HCPCS 83918
Hospital Charge Code	39708015B
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$64.19
Rate for Payer: Aetna Medicare Advantage	$76.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.61
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$23.60
Rate for Payer: Clover Medicare Advantage	$22.42
Rate for Payer: EmblemHealth Commercial	$70.80
Rate for Payer: Humana Medicare Advantage	$24.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$23.60
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	$18.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$23.60
Rate for Payer: Wellcare Medicare Advantage	$23.60
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

ORGANIC ACID FULL QUANT B

Facility

$390.00

Service Code	HCPCS 83918
Hospital Charge Code	39708015B
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ORGANIC ACID QUAL EA SPEC

Facility

$390.00

Service Code	HCPCS 83919
Hospital Charge Code	39708052A
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ORGANIC ACID QUAL EA SPEC

Facility

$390.00

Service Code	HCPCS 83919
Hospital Charge Code	39708052A
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$44.74
Rate for Payer: Aetna Medicare Advantage	$53.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.67
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$16.45
Rate for Payer: Clover Medicare Advantage	$15.63
Rate for Payer: EmblemHealth Commercial	$49.35
Rate for Payer: Humana Medicare Advantage	$16.94
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.45
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	$13.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.45
Rate for Payer: Wellcare Medicare Advantage	$16.45
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

ORGANIC ACID SINGLE QUANT

Facility

$116.00

Service Code	HCPCS 83921
Hospital Charge Code	38477138
Hospital Revenue Code	301
Min. Negotiated Rate	$3.29
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$57.69
Rate for Payer: Aetna Medicare Advantage	$68.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.94
Rate for Payer: Cigna Commercial	$58.00
Rate for Payer: Cigna Medicare Advantage	$21.21
Rate for Payer: Clover Medicare Advantage	$20.15
Rate for Payer: EmblemHealth Commercial	$63.63
Rate for Payer: Humana Medicare Advantage	$21.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.16
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.40
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$16.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.21
Rate for Payer: Wellcare Medicare Advantage	$21.21
Rate for Payer: Wellpoint Medicaid Managed Care	$3.29

ORGANIC ACID SINGLE QUANT

Facility

$116.00

Service Code	HCPCS 83921
Hospital Charge Code	38477138
Hospital Revenue Code	301
Min. Negotiated Rate	$17.40
Max. Negotiated Rate	$17.40
Rate for Payer: Qualcare PPO/HMO/WC	$17.40

ORGANIC ACIDS QUAL

Facility

$333.00

Service Code	HCPCS 83918
Hospital Charge Code	38472928
Hospital Revenue Code	301
Min. Negotiated Rate	$49.95
Max. Negotiated Rate	$49.95
Rate for Payer: Qualcare PPO/HMO/WC	$49.95

ORGANIC ACIDS QUAL

Facility

$333.00

Service Code	HCPCS 83918
Hospital Charge Code	38472928
Hospital Revenue Code	301
Min. Negotiated Rate	$9.46
Max. Negotiated Rate	$166.50
Rate for Payer: Aetna Commercial	$64.19
Rate for Payer: Aetna Medicare Advantage	$76.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.61
Rate for Payer: Cigna Commercial	$166.50
Rate for Payer: Cigna Medicare Advantage	$23.60
Rate for Payer: Clover Medicare Advantage	$22.42
Rate for Payer: EmblemHealth Commercial	$70.80
Rate for Payer: Humana Medicare Advantage	$24.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$23.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.58
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.95
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$18.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$23.60
Rate for Payer: Wellcare Medicare Advantage	$23.60
Rate for Payer: Wellpoint Medicaid Managed Care	$9.46

ORGANIC ACIDS QUAL,EACH

Facility

$116.00

Service Code	HCPCS 83919
Hospital Charge Code	38477137
Hospital Revenue Code	301
Min. Negotiated Rate	$17.40
Max. Negotiated Rate	$17.40
Rate for Payer: Qualcare PPO/HMO/WC	$17.40

ORGANIC ACIDS QUAL,EACH

Facility

$116.00

Service Code	HCPCS 83919
Hospital Charge Code	38477137
Hospital Revenue Code	301
Min. Negotiated Rate	$3.29
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$44.74
Rate for Payer: Aetna Medicare Advantage	$53.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.67
Rate for Payer: Cigna Commercial	$58.00
Rate for Payer: Cigna Medicare Advantage	$16.45
Rate for Payer: Clover Medicare Advantage	$15.63
Rate for Payer: EmblemHealth Commercial	$49.35
Rate for Payer: Humana Medicare Advantage	$16.94
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.16
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.40
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.45
Rate for Payer: Wellcare Medicare Advantage	$16.45
Rate for Payer: Wellpoint Medicaid Managed Care	$3.29

ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY

Facility

$70,295.53

Service Code	MSDRG 884
Min. Negotiated Rate	$7,161.00
Max. Negotiated Rate	$70,295.53
Rate for Payer: Aetna Commercial	$51,923.77
Rate for Payer: Aetna Medicare Advantage	$70,295.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48,760.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,756.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,161.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48,760.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22,530.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48,760.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,756.00
Rate for Payer: Cigna Commercial	$35,867.21
Rate for Payer: Cigna Medicare Advantage	$22,530.62
Rate for Payer: Clover Medicare Advantage	$21,404.09
Rate for Payer: EmblemHealth Commercial	$67,591.86
Rate for Payer: Humana Medicare Advantage	$23,206.54
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22,530.62
Rate for Payer: Oxford Commercial	$28,348.82
Rate for Payer: UnitedHealthcare Commercial	$37,945.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$22,530.62
Rate for Payer: Wellcare Medicare Advantage	$22,530.62

Know your out-of-pocket cost for care.

All Charges