Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLAIN WASHER 3 PK

Facility

$440.00

Hospital Charge Code	270684106
Hospital Revenue Code	272
Min. Negotiated Rate	$12.50
Max. Negotiated Rate	$220.00
Rate for Payer: Aetna Commercial	$167.20
Rate for Payer: Aetna Medicare Advantage	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.20
Rate for Payer: Cigna Commercial	$220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.40
Rate for Payer: Oxford Commercial	$88.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.00
Rate for Payer: UnitedHealthcare Commercial	$88.00
Rate for Payer: UnitedHealthcare Community & State	$13.90
Rate for Payer: Wellpoint Medicaid Managed Care	$12.50

PLAIN WASHER 3 PK

Facility

$440.00

Hospital Charge Code	270684106
Hospital Revenue Code	272
Min. Negotiated Rate	$66.00
Max. Negotiated Rate	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.00

PLANTAR LAPIDUS PLATE LEFT

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270677079
Hospital Revenue Code	278
Min. Negotiated Rate	$212.29
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,840.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Community & State	$236.21
Rate for Payer: Wellpoint Medicaid Managed Care	$212.29

PLANTAR LAPIDUS PLATE LEFT

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270677079
Hospital Revenue Code	278
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,808.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

PLASMABLADE

Facility

$3,505.00

Hospital Charge Code	270702692
Hospital Revenue Code	270
Min. Negotiated Rate	$525.75
Max. Negotiated Rate	$525.75
Rate for Payer: Qualcare PPO/HMO/WC	$525.75

PLASMABLADE

Facility

$3,505.00

Hospital Charge Code	270702692
Hospital Revenue Code	270
Min. Negotiated Rate	$99.54
Max. Negotiated Rate	$1,752.50
Rate for Payer: Aetna Commercial	$1,331.90
Rate for Payer: Aetna Medicare Advantage	$1,051.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$893.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$893.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$893.77
Rate for Payer: Cigna Commercial	$1,752.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$911.30
Rate for Payer: Oxford Commercial	$701.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.75
Rate for Payer: UnitedHealthcare Commercial	$701.00
Rate for Payer: UnitedHealthcare Community & State	$110.76
Rate for Payer: Wellpoint Medicaid Managed Care	$99.54

PLASMA HEMOGLOBIN

Facility

$51.00

Service Code	HCPCS 83051
Hospital Charge Code	38478084
Hospital Revenue Code	301
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$19.88
Rate for Payer: Aetna Medicare Advantage	$23.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.52
Rate for Payer: Cigna Commercial	$25.50
Rate for Payer: Cigna Medicare Advantage	$7.31
Rate for Payer: Clover Medicare Advantage	$6.94
Rate for Payer: EmblemHealth Commercial	$21.93
Rate for Payer: Humana Medicare Advantage	$7.53
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.26
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.65
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$5.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.31
Rate for Payer: Wellcare Medicare Advantage	$7.31
Rate for Payer: Wellpoint Medicaid Managed Care	$1.45

PLASMA HEMOGLOBIN

Facility

$51.00

Service Code	HCPCS 83051
Hospital Charge Code	38478084
Hospital Revenue Code	301
Min. Negotiated Rate	$7.65
Max. Negotiated Rate	$7.65
Rate for Payer: Qualcare PPO/HMO/WC	$7.65

PLASMA PLATELET RICH PRP

Facility

$2,500.00

Hospital Charge Code	270646448
Hospital Revenue Code	272
Min. Negotiated Rate	$71.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$650.00
Rate for Payer: Oxford Commercial	$500.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Commercial	$500.00
Rate for Payer: UnitedHealthcare Community & State	$79.00
Rate for Payer: Wellpoint Medicaid Managed Care	$71.00

PLASMA PLATELET RICH PRP

Facility

$2,500.00

Hospital Charge Code	270646448
Hospital Revenue Code	272
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

PLASMA RENIN ACTIVITY

Facility

$667.59

Service Code	HCPCS 84244
Hospital Charge Code	39900128
Hospital Revenue Code	301
Min. Negotiated Rate	$17.59
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$59.81
Rate for Payer: Aetna Medicare Advantage	$71.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.77
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$21.99
Rate for Payer: Clover Medicare Advantage	$20.89
Rate for Payer: EmblemHealth Commercial	$65.97
Rate for Payer: Humana Medicare Advantage	$22.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.99
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	$17.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.99
Rate for Payer: Wellcare Medicare Advantage	$21.99
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

PLASMA RENIN ACTIVITY

Facility

$667.59

Service Code	HCPCS 84244
Hospital Charge Code	39900128
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

PLASMA STEM STRAIGHT 13x167MM

Facility

$28,420.00

Service Code	HCPCS C1776
Hospital Charge Code	270676119
Hospital Revenue Code	278
Min. Negotiated Rate	$807.13
Max. Negotiated Rate	$14,210.00
Rate for Payer: Aetna Commercial	$10,799.60
Rate for Payer: Aetna Medicare Advantage	$8,526.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,247.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,247.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,684.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,247.10
Rate for Payer: Cigna Commercial	$14,210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,877.64
Rate for Payer: Qualcare PPO/HMO/WC	$4,263.00
Rate for Payer: UnitedHealthcare Community & State	$898.07
Rate for Payer: Wellpoint Medicaid Managed Care	$807.13

PLASMA STEM STRAIGHT 13x167MM

Facility

$28,420.00

Service Code	HCPCS C1776
Hospital Charge Code	270676119
Hospital Revenue Code	278
Min. Negotiated Rate	$4,263.00
Max. Negotiated Rate	$6,877.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,684.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,877.64
Rate for Payer: Qualcare PPO/HMO/WC	$4,263.00

PLASMAX 800-0517

Facility

$4,505.00

Service Code	HCPCS C1713
Hospital Charge Code	270640107
Hospital Revenue Code	272
Min. Negotiated Rate	$127.94
Max. Negotiated Rate	$2,252.50
Rate for Payer: Aetna Commercial	$1,711.90
Rate for Payer: Aetna Medicare Advantage	$1,351.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,148.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,148.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,148.78
Rate for Payer: Cigna Commercial	$2,252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,171.30
Rate for Payer: Oxford Commercial	$901.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.75
Rate for Payer: UnitedHealthcare Commercial	$901.00
Rate for Payer: UnitedHealthcare Community & State	$142.36
Rate for Payer: Wellpoint Medicaid Managed Care	$127.94

PLASMAX 800-0517

Facility

$4,505.00

Service Code	HCPCS C1713
Hospital Charge Code	270640107
Hospital Revenue Code	272
Min. Negotiated Rate	$675.75
Max. Negotiated Rate	$675.75
Rate for Payer: Qualcare PPO/HMO/WC	$675.75

PLASMINOGEN ACTIVATOR INH

Facility

$390.00

Service Code	HCPCS 85415
Hospital Charge Code	39900173
Hospital Revenue Code	305
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$46.76
Rate for Payer: Aetna Medicare Advantage	$55.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.36
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$17.19
Rate for Payer: Clover Medicare Advantage	$16.33
Rate for Payer: EmblemHealth Commercial	$51.57
Rate for Payer: Humana Medicare Advantage	$17.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.19
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	$13.75
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.19
Rate for Payer: Wellcare Medicare Advantage	$17.19
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

PLASMINOGEN ACTIVATOR INH

Facility

$390.00

Service Code	HCPCS 85415
Hospital Charge Code	39900173
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PLASMINOGEN ACTIVITY

Facility

$390.00

Service Code	HCPCS 85420
Hospital Charge Code	39900352
Hospital Revenue Code	305
Min. Negotiated Rate	$5.22
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$17.76
Rate for Payer: Aetna Medicare Advantage	$21.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.53
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	$23.69
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$6.53
Rate for Payer: Clover Medicare Advantage	$6.20
Rate for Payer: EmblemHealth Commercial	$19.59
Rate for Payer: Humana Medicare Advantage	$6.73
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.53
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	$5.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.53
Rate for Payer: Wellcare Medicare Advantage	$6.53
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

PLASMINOGEN ACTIVITY

Facility

$390.00

Service Code	HCPCS 85420
Hospital Charge Code	39900352
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PLASMINOGEN AG ( PLASMA)

Facility

$50.90

Service Code	HCPCS 85421
Hospital Charge Code	401185421
Hospital Revenue Code	306
Min. Negotiated Rate	$7.63
Max. Negotiated Rate	$7.63
Rate for Payer: Qualcare PPO/HMO/WC	$7.63

PLASMINOGEN AG ( PLASMA)

Facility

$50.90

Service Code	HCPCS 85421
Hospital Charge Code	401185421
Hospital Revenue Code	306
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$27.69
Rate for Payer: Aetna Medicare Advantage	$32.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.93
Rate for Payer: Cigna Commercial	$25.45
Rate for Payer: Cigna Medicare Advantage	$10.18
Rate for Payer: Clover Medicare Advantage	$9.67
Rate for Payer: EmblemHealth Commercial	$30.54
Rate for Payer: Humana Medicare Advantage	$10.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.23
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.63
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$8.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.18
Rate for Payer: Wellcare Medicare Advantage	$10.18
Rate for Payer: Wellpoint Medicaid Managed Care	$1.45

PLASMINOGEN,FUNCTIONAL

Facility

$44.90

Service Code	HCPCS 85420
Hospital Charge Code	39900174
Hospital Revenue Code	305
Min. Negotiated Rate	$6.74
Max. Negotiated Rate	$6.74
Rate for Payer: Qualcare PPO/HMO/WC	$6.74

PLASMINOGEN,FUNCTIONAL

Facility

$44.90

Service Code	HCPCS 85420
Hospital Charge Code	39900174
Hospital Revenue Code	305
Min. Negotiated Rate	$1.28
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$17.76
Rate for Payer: Aetna Medicare Advantage	$21.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.53
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	$23.69
Rate for Payer: Cigna Commercial	$22.45
Rate for Payer: Cigna Medicare Advantage	$6.53
Rate for Payer: Clover Medicare Advantage	$6.20
Rate for Payer: EmblemHealth Commercial	$19.59
Rate for Payer: Humana Medicare Advantage	$6.73
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.67
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.74
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$5.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.53
Rate for Payer: Wellcare Medicare Advantage	$6.53
Rate for Payer: Wellpoint Medicaid Managed Care	$1.28

PLASMINOGEN,FUNCTIONAL

Facility

$48.00

Service Code	HCPCS 85420
Hospital Charge Code	38473151
Hospital Revenue Code	305
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$7.20

Know your out-of-pocket cost for care.

All Charges