Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ORGANIC MENTAL HEALTH CONDITIONS AND DISTURBANCES

Facility

$6,409.62

Service Code	APR-DRG 7571
Min. Negotiated Rate	$6,283.94
Max. Negotiated Rate	$6,409.62
Rate for Payer: UnitedHealthcare Community & State	$6,283.94
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,409.62
Rate for Payer: Wellpoint Medicaid Managed Care	$6,283.94

ORGANIC MENTAL HEALTH CONDITIONS AND DISTURBANCES

Facility

$27,004.86

Service Code	APR-DRG 7574
Min. Negotiated Rate	$26,475.35
Max. Negotiated Rate	$27,004.86
Rate for Payer: UnitedHealthcare Community & State	$26,475.35
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27,004.86
Rate for Payer: Wellpoint Medicaid Managed Care	$26,475.35

ORGANIC MENTAL HEALTH CONDITIONS AND DISTURBANCES

Facility

$13,557.90

Service Code	APR-DRG 7573
Min. Negotiated Rate	$13,292.06
Max. Negotiated Rate	$13,557.90
Rate for Payer: UnitedHealthcare Community & State	$13,292.06
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,557.90
Rate for Payer: Wellpoint Medicaid Managed Care	$13,292.06

ORGANIC MENTAL HEALTH CONDITIONS AND DISTURBANCES

Facility

$8,461.37

Service Code	APR-DRG 7572
Min. Negotiated Rate	$8,295.46
Max. Negotiated Rate	$8,461.37
Rate for Payer: UnitedHealthcare Community & State	$8,295.46
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,461.37
Rate for Payer: Wellpoint Medicaid Managed Care	$8,295.46

ORGANISM IDENTIFICATION

Facility

$389.24

Service Code	HCPCS 87077
Hospital Charge Code	3030154
Hospital Revenue Code	309
Min. Negotiated Rate	$6.46
Max. Negotiated Rate	$194.62
Rate for Payer: Aetna Commercial	$21.98
Rate for Payer: Aetna Medicare Advantage	$26.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.31
Rate for Payer: Cigna Commercial	$194.62
Rate for Payer: Cigna Medicare Advantage	$8.08
Rate for Payer: Clover Medicare Advantage	$7.68
Rate for Payer: EmblemHealth Commercial	$24.24
Rate for Payer: Humana Medicare Advantage	$8.32
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.20
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.39
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$6.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.08
Rate for Payer: Wellcare Medicare Advantage	$8.08
Rate for Payer: Wellpoint Medicaid Managed Care	$11.05

ORGANISM IDENTIFICATION

Facility

$389.24

Service Code	HCPCS 87077
Hospital Charge Code	3030154
Hospital Revenue Code	309
Min. Negotiated Rate	$58.39
Max. Negotiated Rate	$58.39
Rate for Payer: Qualcare PPO/HMO/WC	$58.39

Organism Identification, Yeast

Facility

$70.95

Service Code	HCPCS 87106
Hospital Charge Code	399888014
Hospital Revenue Code	309
Min. Negotiated Rate	$2.01
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$28.07
Rate for Payer: Aetna Medicare Advantage	$33.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.44
Rate for Payer: Cigna Commercial	$35.48
Rate for Payer: Cigna Medicare Advantage	$10.32
Rate for Payer: Clover Medicare Advantage	$9.80
Rate for Payer: EmblemHealth Commercial	$30.96
Rate for Payer: Humana Medicare Advantage	$10.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.45
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.64
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$8.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.32
Rate for Payer: Wellcare Medicare Advantage	$10.32
Rate for Payer: Wellpoint Medicaid Managed Care	$2.01

Organism Identification, Yeast

Facility

$70.95

Service Code	HCPCS 87106
Hospital Charge Code	399888014
Hospital Revenue Code	309
Min. Negotiated Rate	$10.64
Max. Negotiated Rate	$10.64
Rate for Payer: Qualcare PPO/HMO/WC	$10.64

ORGANISM SENSITIVITY

Facility

$390.00

Service Code	HCPCS 87186
Hospital Charge Code	3030153
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ORGANISM SENSITIVITY

Facility

$390.00

Service Code	HCPCS 87186
Hospital Charge Code	3030153
Hospital Revenue Code	309
Min. Negotiated Rate	$6.92
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$23.53
Rate for Payer: Aetna Medicare Advantage	$28.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.38
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$8.65
Rate for Payer: Clover Medicare Advantage	$8.22
Rate for Payer: EmblemHealth Commercial	$25.95
Rate for Payer: Humana Medicare Advantage	$8.91
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.65
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	$6.92
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.65
Rate for Payer: Wellcare Medicare Advantage	$8.65
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

O.R.I.F. HUMERUS-ADDITIONAL

Facility

$17,500.00

Hospital Charge Code	270335976
Hospital Revenue Code	278
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$4,235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

O.R.I.F. HUMERUS-ADDITIONAL

Facility

$17,500.00

Hospital Charge Code	270335976
Hospital Revenue Code	278
Min. Negotiated Rate	$497.00
Max. Negotiated Rate	$8,750.00
Rate for Payer: Aetna Commercial	$6,650.00
Rate for Payer: Aetna Medicare Advantage	$5,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,462.50
Rate for Payer: Cigna Commercial	$8,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00
Rate for Payer: UnitedHealthcare Community & State	$553.00
Rate for Payer: Wellpoint Medicaid Managed Care	$497.00

O.R.I.F.HUMERUS FRCTRE(IMPLNT)

Facility

$5,333.00

Hospital Charge Code	270335444
Hospital Revenue Code	278
Min. Negotiated Rate	$799.95
Max. Negotiated Rate	$1,290.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,066.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,290.59
Rate for Payer: Qualcare PPO/HMO/WC	$799.95

O.R.I.F.HUMERUS FRCTRE(IMPLNT)

Facility

$5,333.00

Hospital Charge Code	270335444
Hospital Revenue Code	278
Min. Negotiated Rate	$151.46
Max. Negotiated Rate	$2,666.50
Rate for Payer: Aetna Commercial	$2,026.54
Rate for Payer: Aetna Medicare Advantage	$1,599.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,359.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,359.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,066.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,359.91
Rate for Payer: Cigna Commercial	$2,666.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,290.59
Rate for Payer: Qualcare PPO/HMO/WC	$799.95
Rate for Payer: UnitedHealthcare Community & State	$168.52
Rate for Payer: Wellpoint Medicaid Managed Care	$151.46

ORIF RADIOUS-ACUMED

Facility

$15,021.00

Hospital Charge Code	270339016
Hospital Revenue Code	278
Min. Negotiated Rate	$426.60
Max. Negotiated Rate	$7,510.50
Rate for Payer: Aetna Commercial	$5,707.98
Rate for Payer: Aetna Medicare Advantage	$4,506.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,830.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,830.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,004.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,830.36
Rate for Payer: Cigna Commercial	$7,510.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,635.08
Rate for Payer: Qualcare PPO/HMO/WC	$2,253.15
Rate for Payer: UnitedHealthcare Community & State	$474.66
Rate for Payer: Wellpoint Medicaid Managed Care	$426.60

ORIF RADIOUS-ACUMED

Facility

$15,021.00

Hospital Charge Code	270339016
Hospital Revenue Code	278
Min. Negotiated Rate	$2,253.15
Max. Negotiated Rate	$3,635.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,004.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,635.08
Rate for Payer: Qualcare PPO/HMO/WC	$2,253.15

ORIF TIB-FIB

Facility

$10,248.00

Hospital Charge Code	270339083
Hospital Revenue Code	278
Min. Negotiated Rate	$291.04
Max. Negotiated Rate	$5,124.00
Rate for Payer: Aetna Commercial	$3,894.24
Rate for Payer: Aetna Medicare Advantage	$3,074.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,613.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,613.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,049.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,613.24
Rate for Payer: Cigna Commercial	$5,124.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.02
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.20
Rate for Payer: UnitedHealthcare Community & State	$323.84
Rate for Payer: Wellpoint Medicaid Managed Care	$291.04

ORIF TIB-FIB

Facility

$10,248.00

Hospital Charge Code	270339083
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.20
Max. Negotiated Rate	$2,480.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,049.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.02
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.20

O.R.I.F ULNAR

Facility

$2,106.00

Hospital Charge Code	270335600
Hospital Revenue Code	278
Min. Negotiated Rate	$59.81
Max. Negotiated Rate	$1,053.00
Rate for Payer: Aetna Commercial	$800.28
Rate for Payer: Aetna Medicare Advantage	$631.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$537.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$537.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$421.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$537.03
Rate for Payer: Cigna Commercial	$1,053.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$509.65
Rate for Payer: Qualcare PPO/HMO/WC	$315.90
Rate for Payer: UnitedHealthcare Community & State	$66.55
Rate for Payer: Wellpoint Medicaid Managed Care	$59.81

O.R.I.F ULNAR

Facility

$2,106.00

Hospital Charge Code	270335600
Hospital Revenue Code	278
Min. Negotiated Rate	$315.90
Max. Negotiated Rate	$509.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$421.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$509.65
Rate for Payer: Qualcare PPO/HMO/WC	$315.90

ORIF WRIST-SYNTHES

Facility

$16,768.00

Hospital Charge Code	270339017
Hospital Revenue Code	278
Min. Negotiated Rate	$2,515.20
Max. Negotiated Rate	$4,057.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,353.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,057.86
Rate for Payer: Qualcare PPO/HMO/WC	$2,515.20

ORIF WRIST-SYNTHES

Facility

$16,768.00

Hospital Charge Code	270339017
Hospital Revenue Code	278
Min. Negotiated Rate	$476.21
Max. Negotiated Rate	$8,384.00
Rate for Payer: Aetna Commercial	$6,371.84
Rate for Payer: Aetna Medicare Advantage	$5,030.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,275.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,275.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,353.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,275.84
Rate for Payer: Cigna Commercial	$8,384.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,057.86
Rate for Payer: Qualcare PPO/HMO/WC	$2,515.20
Rate for Payer: UnitedHealthcare Community & State	$529.87
Rate for Payer: Wellpoint Medicaid Managed Care	$476.21

ORIOS XT 10CC

Facility

$18,550.00

Service Code	HCPCS C1765
Hospital Charge Code	270704862
Hospital Revenue Code	278
Min. Negotiated Rate	$526.82
Max. Negotiated Rate	$9,275.00
Rate for Payer: Aetna Commercial	$7,049.00
Rate for Payer: Aetna Medicare Advantage	$5,565.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,730.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,730.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,730.25
Rate for Payer: Cigna Commercial	$9,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,489.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,782.50
Rate for Payer: UnitedHealthcare Community & State	$586.18
Rate for Payer: Wellpoint Medicaid Managed Care	$526.82

ORIOS XT 10CC

Facility

$18,550.00

Service Code	HCPCS C1765
Hospital Charge Code	270704862
Hospital Revenue Code	278
Min. Negotiated Rate	$2,782.50
Max. Negotiated Rate	$4,489.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,710.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,489.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,782.50

ORIOS XT 5CC

Facility

$4,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270704165
Hospital Revenue Code	278
Min. Negotiated Rate	$660.00
Max. Negotiated Rate	$1,064.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$880.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,064.80
Rate for Payer: Qualcare PPO/HMO/WC	$660.00

Know your out-of-pocket cost for care.

All Charges