Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PANEL MENINGOENCEPHALITIS

Facility

$2,136.90

Service Code	HCPCS 86695
Hospital Charge Code	399900536
Hospital Revenue Code	302
Min. Negotiated Rate	$10.55
Max. Negotiated Rate	$1,068.45
Rate for Payer: Aetna Commercial	$35.88
Rate for Payer: Aetna Medicare Advantage	$42.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.85
Rate for Payer: Cigna Commercial	$1,068.45
Rate for Payer: Cigna Medicare Advantage	$13.19
Rate for Payer: Clover Medicare Advantage	$12.53
Rate for Payer: EmblemHealth Commercial	$39.57
Rate for Payer: Humana Medicare Advantage	$13.59
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$555.59
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$320.54
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.19
Rate for Payer: Wellcare Medicare Advantage	$13.19
Rate for Payer: Wellpoint Medicaid Managed Care	$60.69

PANEL MENINGOENCEPHALITIS

Facility

$2,136.90

Service Code	HCPCS 86695
Hospital Charge Code	399900536
Hospital Revenue Code	302
Min. Negotiated Rate	$320.54
Max. Negotiated Rate	$320.54
Rate for Payer: Qualcare PPO/HMO/WC	$320.54

PAN OPTIC LAMP

Facility

$96.80

Hospital Charge Code	270654005
Hospital Revenue Code	270
Min. Negotiated Rate	$14.52
Max. Negotiated Rate	$14.52
Rate for Payer: Qualcare PPO/HMO/WC	$14.52

PAN OPTIC LAMP

Facility

$96.80

Hospital Charge Code	270654005
Hospital Revenue Code	270
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$48.40
Rate for Payer: Aetna Commercial	$36.78
Rate for Payer: Aetna Medicare Advantage	$29.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.68
Rate for Payer: Cigna Commercial	$48.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.17
Rate for Payer: Oxford Commercial	$19.36
Rate for Payer: Qualcare PPO/HMO/WC	$14.52
Rate for Payer: UnitedHealthcare Commercial	$19.36
Rate for Payer: UnitedHealthcare Community & State	$3.06
Rate for Payer: Wellpoint Medicaid Managed Care	$2.75

PANTALAR ARTHRODESIS

Facility

$57,834.50

Service Code	HCPCS 28705
Hospital Charge Code	1600000886
Hospital Revenue Code	360
Min. Negotiated Rate	$8,675.17
Max. Negotiated Rate	$8,675.17
Rate for Payer: Qualcare PPO/HMO/WC	$8,675.17

PANTALAR ARTHRODESIS

Facility

$57,834.50

Service Code	HCPCS 28705
Hospital Charge Code	1600000886
Hospital Revenue Code	360
Min. Negotiated Rate	$1,642.50
Max. Negotiated Rate	$75,563.15
Rate for Payer: Aetna Commercial	$56,659.34
Rate for Payer: Aetna Medicare Advantage	$67,491.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75,563.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75,563.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,830.64
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	$75,563.15
Rate for Payer: Cigna Commercial	$41,754.94
Rate for Payer: Cigna Medicare Advantage	$20,830.64
Rate for Payer: Clover Medicare Advantage	$19,789.11
Rate for Payer: EmblemHealth Commercial	$62,491.92
Rate for Payer: Humana Medicare Advantage	$21,455.56
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20,830.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15,036.97
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,675.17
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,827.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,830.64
Rate for Payer: Wellcare Medicare Advantage	$20,830.64
Rate for Payer: Wellpoint Medicaid Managed Care	$1,642.50

PANTOPRAZOLE 20 MG ECT

Facility

$4.00

Service Code	NDC 8060601
Hospital Charge Code	60630100
Hospital Revenue Code	250
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

PANTOPRAZOLE 20 MG ECT

Facility

$4.00

Service Code	NDC 8060601
Hospital Charge Code	60630100
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PANTOPRAZOLE 40MG/100ML NACL

Facility

$192.96

Service Code	HCPCS J2470
Hospital Charge Code	60629227
Hospital Revenue Code	636
Min. Negotiated Rate	$28.94
Max. Negotiated Rate	$46.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.70
Rate for Payer: Qualcare PPO/HMO/WC	$28.94

PANTOPRAZOLE 40MG/100ML NACL

Facility

$192.96

Service Code	HCPCS J2470
Hospital Charge Code	60629227
Hospital Revenue Code	636
Min. Negotiated Rate	$5.48
Max. Negotiated Rate	$96.48
Rate for Payer: Aetna Commercial	$73.32
Rate for Payer: Aetna Medicare Advantage	$57.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.20
Rate for Payer: Cigna Commercial	$96.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.70
Rate for Payer: Qualcare PPO/HMO/WC	$28.94
Rate for Payer: UnitedHealthcare Community & State	$6.10
Rate for Payer: Wellpoint Medicaid Managed Care	$5.48

PANTOPTAZOLE 40MG TABLET EC

Facility

$67.13

Service Code	NDC 8060701
Hospital Charge Code	60629236
Hospital Revenue Code	250
Min. Negotiated Rate	$1.91
Max. Negotiated Rate	$33.56
Rate for Payer: Aetna Commercial	$25.51
Rate for Payer: Aetna Medicare Advantage	$20.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.12
Rate for Payer: Cigna Commercial	$33.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.45
Rate for Payer: Oxford Commercial	$13.43
Rate for Payer: Qualcare PPO/HMO/WC	$10.07
Rate for Payer: UnitedHealthcare Commercial	$13.43
Rate for Payer: UnitedHealthcare Community & State	$2.12
Rate for Payer: Wellpoint Medicaid Managed Care	$1.91

PANTOPTAZOLE 40MG TABLET EC

Facility

$67.13

Service Code	NDC 8060701
Hospital Charge Code	60629236
Hospital Revenue Code	250
Min. Negotiated Rate	$10.07
Max. Negotiated Rate	$10.07
Rate for Payer: Qualcare PPO/HMO/WC	$10.07

PAPAVERINE 300MG/10ML INJ

Facility

$1,438.16

Service Code	HCPCS J2440
Hospital Charge Code	60627662
Hospital Revenue Code	636
Min. Negotiated Rate	$215.72
Max. Negotiated Rate	$348.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$348.03
Rate for Payer: Qualcare PPO/HMO/WC	$215.72

PAPAVERINE 300MG/10ML INJ

Facility

$1,438.16

Service Code	HCPCS J2440
Hospital Charge Code	60627662
Hospital Revenue Code	636
Min. Negotiated Rate	$40.84
Max. Negotiated Rate	$719.08
Rate for Payer: Aetna Commercial	$546.50
Rate for Payer: Aetna Medicare Advantage	$431.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$366.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$366.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$366.73
Rate for Payer: Cigna Commercial	$719.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$348.03
Rate for Payer: Qualcare PPO/HMO/WC	$215.72
Rate for Payer: UnitedHealthcare Community & State	$45.45
Rate for Payer: Wellpoint Medicaid Managed Care	$40.84

PAPAVERINE 30MG/ML VIAL

Facility

$287.63

Service Code	HCPCS J2440
Hospital Charge Code	60631898
Hospital Revenue Code	636
Min. Negotiated Rate	$43.14
Max. Negotiated Rate	$69.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.61
Rate for Payer: Qualcare PPO/HMO/WC	$43.14

PAPAVERINE 30MG/ML VIAL

Facility

$287.63

Service Code	HCPCS J2440
Hospital Charge Code	60631898
Hospital Revenue Code	636
Min. Negotiated Rate	$8.17
Max. Negotiated Rate	$143.81
Rate for Payer: Aetna Commercial	$109.30
Rate for Payer: Aetna Medicare Advantage	$86.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.35
Rate for Payer: Cigna Commercial	$143.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.61
Rate for Payer: Qualcare PPO/HMO/WC	$43.14
Rate for Payer: UnitedHealthcare Community & State	$9.09
Rate for Payer: Wellpoint Medicaid Managed Care	$8.17

PAPERED ROUTER 1.7MMx16MM

Facility

$577.55

Hospital Charge Code	270673034
Hospital Revenue Code	272
Min. Negotiated Rate	$16.40
Max. Negotiated Rate	$288.77
Rate for Payer: Aetna Commercial	$219.47
Rate for Payer: Aetna Medicare Advantage	$173.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.28
Rate for Payer: Cigna Commercial	$288.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.16
Rate for Payer: Oxford Commercial	$115.51
Rate for Payer: Qualcare PPO/HMO/WC	$86.63
Rate for Payer: UnitedHealthcare Commercial	$115.51
Rate for Payer: UnitedHealthcare Community & State	$18.25
Rate for Payer: Wellpoint Medicaid Managed Care	$16.40

PAPERED ROUTER 1.7MMx16MM

Facility

$577.55

Hospital Charge Code	270673034
Hospital Revenue Code	272
Min. Negotiated Rate	$86.63
Max. Negotiated Rate	$86.63
Rate for Payer: Qualcare PPO/HMO/WC	$86.63

PAPERED ROUTER 1.7x25MM

Facility

$603.75

Hospital Charge Code	270673204
Hospital Revenue Code	272
Min. Negotiated Rate	$90.56
Max. Negotiated Rate	$90.56
Rate for Payer: Qualcare PPO/HMO/WC	$90.56

PAPERED ROUTER 1.7x25MM

Facility

$603.75

Hospital Charge Code	270673204
Hospital Revenue Code	272
Min. Negotiated Rate	$17.15
Max. Negotiated Rate	$301.88
Rate for Payer: Aetna Commercial	$229.43
Rate for Payer: Aetna Medicare Advantage	$181.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.96
Rate for Payer: Cigna Commercial	$301.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.97
Rate for Payer: Oxford Commercial	$120.75
Rate for Payer: Qualcare PPO/HMO/WC	$90.56
Rate for Payer: UnitedHealthcare Commercial	$120.75
Rate for Payer: UnitedHealthcare Community & State	$19.08
Rate for Payer: Wellpoint Medicaid Managed Care	$17.15

PAP IG, CT-NG, HPV-HR III

Facility

$248.55

Service Code	HCPCS 87624
Hospital Charge Code	3038521C
Hospital Revenue Code	300
Min. Negotiated Rate	$37.28
Max. Negotiated Rate	$37.28
Rate for Payer: Qualcare PPO/HMO/WC	$37.28

PAP IG, CT-NG, HPV-HR III

Facility

$248.55

Service Code	HCPCS 87624
Hospital Charge Code	3038521C
Hospital Revenue Code	300
Min. Negotiated Rate	$7.06
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$95.44
Rate for Payer: Aetna Medicare Advantage	$113.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.29
Rate for Payer: Cigna Commercial	$124.28
Rate for Payer: Cigna Medicare Advantage	$35.09
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.62
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.28
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$28.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Medicare Advantage	$35.09
Rate for Payer: Wellpoint Medicaid Managed Care	$7.06

PAP IMAGE GUIDED, HPV HIGH RIS

Facility

$249.00

Service Code	HCPCS 87624
Hospital Charge Code	3038081A
Hospital Revenue Code	301
Min. Negotiated Rate	$37.35
Max. Negotiated Rate	$37.35
Rate for Payer: Qualcare PPO/HMO/WC	$37.35

PAP IMAGE GUIDED, HPV HIGH RIS

Facility

$249.00

Service Code	HCPCS 87624
Hospital Charge Code	3038081A
Hospital Revenue Code	301
Min. Negotiated Rate	$7.07
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$95.44
Rate for Payer: Aetna Medicare Advantage	$113.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.29
Rate for Payer: Cigna Commercial	$124.50
Rate for Payer: Cigna Medicare Advantage	$35.09
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.74
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.35
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$28.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Medicare Advantage	$35.09
Rate for Payer: Wellpoint Medicaid Managed Care	$7.07

PAP SMEAR

Facility

$147.76

Service Code	HCPCS Q0091
Hospital Charge Code	87502740
Hospital Revenue Code	770
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$124.64
Rate for Payer: Aetna Commercial	$93.46
Rate for Payer: Aetna Medicare Advantage	$111.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$34.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.64
Rate for Payer: Cigna Commercial	$68.87
Rate for Payer: Cigna Medicare Advantage	$34.36
Rate for Payer: Clover Medicare Advantage	$32.64
Rate for Payer: EmblemHealth Commercial	$103.08
Rate for Payer: Humana Medicare Advantage	$35.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$34.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.42
Rate for Payer: Oxford Commercial	$29.55
Rate for Payer: Qualcare PPO/HMO/WC	$22.16
Rate for Payer: UnitedHealthcare Commercial	$29.55
Rate for Payer: UnitedHealthcare Community & State	$4.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$34.36
Rate for Payer: Wellcare Medicare Advantage	$34.36
Rate for Payer: Wellpoint Medicaid Managed Care	$4.20

Know your out-of-pocket cost for care.

All Charges