Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATELET AB (IGG),DIRECT

Facility

$390.00

Service Code	HCPCS 86023
Hospital Charge Code	39900190
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PLATELET AB (IGG),DIRECT

Facility

$390.00

Service Code	HCPCS 86023
Hospital Charge Code	39900190
Hospital Revenue Code	302
Min. Negotiated Rate	$9.97
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$33.89
Rate for Payer: Aetna Medicare Advantage	$40.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.20
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.46
Rate for Payer: Clover Medicare Advantage	$11.84
Rate for Payer: EmblemHealth Commercial	$37.38
Rate for Payer: Humana Medicare Advantage	$12.83
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.46
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	$9.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.46
Rate for Payer: Wellcare Medicare Advantage	$12.46
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

PLATELET AGGREGATION(IN VITRO)

Facility

$390.00

Service Code	HCPCS 85576
Hospital Charge Code	5100825
Hospital Revenue Code	300
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$67.76
Rate for Payer: Aetna Medicare Advantage	$80.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$90.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$90.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.91
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	$90.36
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$24.91
Rate for Payer: Clover Medicare Advantage	$23.66
Rate for Payer: EmblemHealth Commercial	$74.73
Rate for Payer: Humana Medicare Advantage	$25.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24.91
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	$19.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.91
Rate for Payer: Wellcare Medicare Advantage	$24.91
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

PLATELET AGGREGATION(IN VITRO)

Facility

$390.00

Service Code	HCPCS 85576
Hospital Charge Code	5100825
Hospital Revenue Code	300
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PLATELET ANTIBODIES

Facility

$194.00

Service Code	HCPCS 86022
Hospital Charge Code	38477010
Hospital Revenue Code	300
Min. Negotiated Rate	$29.10
Max. Negotiated Rate	$29.10
Rate for Payer: Qualcare PPO/HMO/WC	$29.10

PLATELET ANTIBODIES

Facility

$194.00

Service Code	HCPCS 86022
Hospital Charge Code	38477010
Hospital Revenue Code	300
Min. Negotiated Rate	$5.51
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$49.97
Rate for Payer: Aetna Medicare Advantage	$59.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.64
Rate for Payer: Cigna Commercial	$97.00
Rate for Payer: Cigna Medicare Advantage	$18.37
Rate for Payer: Clover Medicare Advantage	$17.45
Rate for Payer: EmblemHealth Commercial	$55.11
Rate for Payer: Humana Medicare Advantage	$18.92
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.44
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.10
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.37
Rate for Payer: Wellcare Medicare Advantage	$18.37
Rate for Payer: Wellpoint Medicaid Managed Care	$5.51

PLATELET BOUND ANTIBODY IGG

Facility

$471.00

Service Code	HCPCS 86022
Hospital Charge Code	38476026
Hospital Revenue Code	302
Min. Negotiated Rate	$70.65
Max. Negotiated Rate	$70.65
Rate for Payer: Qualcare PPO/HMO/WC	$70.65

PLATELET BOUND ANTIBODY IGG

Facility

$471.00

Service Code	HCPCS 86022
Hospital Charge Code	38476026
Hospital Revenue Code	302
Min. Negotiated Rate	$13.38
Max. Negotiated Rate	$235.50
Rate for Payer: Aetna Commercial	$49.97
Rate for Payer: Aetna Medicare Advantage	$59.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.64
Rate for Payer: Cigna Commercial	$235.50
Rate for Payer: Cigna Medicare Advantage	$18.37
Rate for Payer: Clover Medicare Advantage	$17.45
Rate for Payer: EmblemHealth Commercial	$55.11
Rate for Payer: Humana Medicare Advantage	$18.92
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.46
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$70.65
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.37
Rate for Payer: Wellcare Medicare Advantage	$18.37
Rate for Payer: Wellpoint Medicaid Managed Care	$13.38

PLATELET CONCENTRATE SYS 30ML

Facility

$3,625.00

Hospital Charge Code	270670801
Hospital Revenue Code	272
Min. Negotiated Rate	$102.95
Max. Negotiated Rate	$1,812.50
Rate for Payer: Aetna Commercial	$1,377.50
Rate for Payer: Aetna Medicare Advantage	$1,087.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$924.38
Rate for Payer: Cigna Commercial	$1,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$942.50
Rate for Payer: Oxford Commercial	$725.00
Rate for Payer: Qualcare PPO/HMO/WC	$543.75
Rate for Payer: UnitedHealthcare Commercial	$725.00
Rate for Payer: UnitedHealthcare Community & State	$114.55
Rate for Payer: Wellpoint Medicaid Managed Care	$102.95

PLATELET CONCENTRATE SYS 30ML

Facility

$3,625.00

Hospital Charge Code	270670801
Hospital Revenue Code	272
Min. Negotiated Rate	$543.75
Max. Negotiated Rate	$543.75
Rate for Payer: Qualcare PPO/HMO/WC	$543.75

PLATELET CONCENTRATION SYSTEM

Facility

$10,750.00

Hospital Charge Code	270670760
Hospital Revenue Code	272
Min. Negotiated Rate	$305.30
Max. Negotiated Rate	$5,375.00
Rate for Payer: Aetna Commercial	$4,085.00
Rate for Payer: Aetna Medicare Advantage	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,741.25
Rate for Payer: Cigna Commercial	$5,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,795.00
Rate for Payer: Oxford Commercial	$2,150.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50
Rate for Payer: UnitedHealthcare Commercial	$2,150.00
Rate for Payer: UnitedHealthcare Community & State	$339.70
Rate for Payer: Wellpoint Medicaid Managed Care	$305.30

PLATELET CONCENTRATION SYSTEM

Facility

$10,750.00

Hospital Charge Code	270670760
Hospital Revenue Code	272
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$1,612.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

PLATELET COUNT

Facility

$390.00

Service Code	HCPCS 85049
Hospital Charge Code	3002128
Hospital Revenue Code	301
Min. Negotiated Rate	$3.58
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$12.19
Rate for Payer: Aetna Medicare Advantage	$14.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.25
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$4.48
Rate for Payer: Clover Medicare Advantage	$4.26
Rate for Payer: EmblemHealth Commercial	$13.44
Rate for Payer: Humana Medicare Advantage	$4.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.48
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	$3.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.48
Rate for Payer: Wellcare Medicare Advantage	$4.48
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

PLATELET COUNT

Facility

$390.00

Service Code	HCPCS 85049
Hospital Charge Code	3002128
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PLATELET COUNT

Facility

$104.00

Service Code	HCPCS 85032
Hospital Charge Code	38473016
Hospital Revenue Code	309
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$11.72
Rate for Payer: Aetna Medicare Advantage	$13.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.31
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	$15.63
Rate for Payer: Cigna Commercial	$52.00
Rate for Payer: Cigna Medicare Advantage	$4.31
Rate for Payer: Clover Medicare Advantage	$4.09
Rate for Payer: EmblemHealth Commercial	$12.93
Rate for Payer: Humana Medicare Advantage	$4.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.04
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.60
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$3.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.31
Rate for Payer: Wellcare Medicare Advantage	$4.31
Rate for Payer: Wellpoint Medicaid Managed Care	$2.95

PLATELET COUNT

Facility

$135.00

Service Code	HCPCS 85032
Hospital Charge Code	38479050
Hospital Revenue Code	309
Min. Negotiated Rate	$20.25
Max. Negotiated Rate	$20.25
Rate for Payer: Qualcare PPO/HMO/WC	$20.25

PLATELET COUNT

Facility

$104.00

Service Code	HCPCS 85032
Hospital Charge Code	38473016
Hospital Revenue Code	309
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$15.60
Rate for Payer: Qualcare PPO/HMO/WC	$15.60

PLATELET COUNT

Facility

$135.00

Service Code	HCPCS 85032
Hospital Charge Code	38479050
Hospital Revenue Code	309
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$11.72
Rate for Payer: Aetna Medicare Advantage	$13.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.31
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	$15.63
Rate for Payer: Cigna Commercial	$67.50
Rate for Payer: Cigna Medicare Advantage	$4.31
Rate for Payer: Clover Medicare Advantage	$4.09
Rate for Payer: EmblemHealth Commercial	$12.93
Rate for Payer: Humana Medicare Advantage	$4.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.10
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.25
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$3.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.31
Rate for Payer: Wellcare Medicare Advantage	$4.31
Rate for Payer: Wellpoint Medicaid Managed Care	$3.83

PLATELET NEUTRALIZATION

Facility

$127.00

Service Code	HCPCS 85597
Hospital Charge Code	38477147
Hospital Revenue Code	305
Min. Negotiated Rate	$3.61
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$48.91
Rate for Payer: Aetna Medicare Advantage	$58.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.22
Rate for Payer: Cigna Commercial	$63.50
Rate for Payer: Cigna Medicare Advantage	$17.98
Rate for Payer: Clover Medicare Advantage	$17.08
Rate for Payer: EmblemHealth Commercial	$53.94
Rate for Payer: Humana Medicare Advantage	$18.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.02
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.05
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.98
Rate for Payer: Wellcare Medicare Advantage	$17.98
Rate for Payer: Wellpoint Medicaid Managed Care	$3.61

PLATELET NEUTRALIZATION

Facility

$127.00

Service Code	HCPCS 85597
Hospital Charge Code	38477147
Hospital Revenue Code	305
Min. Negotiated Rate	$19.05
Max. Negotiated Rate	$19.05
Rate for Payer: Qualcare PPO/HMO/WC	$19.05

PLATELET, PHERESIS, EACH UNIT

Facility

$2,722.00

Hospital Charge Code	38471090
Hospital Revenue Code	390
Min. Negotiated Rate	$408.30
Max. Negotiated Rate	$408.30
Rate for Payer: Qualcare PPO/HMO/WC	$408.30

PLATELET, PHERESIS, EACH UNIT

Facility

$2,722.00

Hospital Charge Code	38471090
Hospital Revenue Code	390
Min. Negotiated Rate	$77.30
Max. Negotiated Rate	$1,361.00
Rate for Payer: Aetna Commercial	$1,034.36
Rate for Payer: Aetna Medicare Advantage	$816.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$694.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$694.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$694.11
Rate for Payer: Cigna Commercial	$1,361.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$707.72
Rate for Payer: Oxford Commercial	$1,028.00
Rate for Payer: Qualcare PPO/HMO/WC	$408.30
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$86.02
Rate for Payer: Wellpoint Medicaid Managed Care	$77.30

PLATELET PHERESIS HLA, L/R

Facility

$2,519.00

Service Code	HCPCS P9052
Hospital Charge Code	38471095
Hospital Revenue Code	390
Min. Negotiated Rate	$71.54
Max. Negotiated Rate	$2,986.74
Rate for Payer: Aetna Commercial	$2,239.54
Rate for Payer: Aetna Medicare Advantage	$2,667.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,986.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,986.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$823.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,986.74
Rate for Payer: Cigna Commercial	$1,650.43
Rate for Payer: Cigna Medicare Advantage	$823.36
Rate for Payer: Clover Medicare Advantage	$782.19
Rate for Payer: EmblemHealth Commercial	$2,470.08
Rate for Payer: Humana Medicare Advantage	$848.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$823.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$654.94
Rate for Payer: Oxford Commercial	$1,028.00
Rate for Payer: Qualcare PPO/HMO/WC	$377.85
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$79.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$823.36
Rate for Payer: Wellcare Medicare Advantage	$823.36
Rate for Payer: Wellpoint Medicaid Managed Care	$71.54

PLATELET PHERESIS HLA, L/R

Facility

$2,519.00

Service Code	HCPCS P9052
Hospital Charge Code	38471095
Hospital Revenue Code	390
Min. Negotiated Rate	$377.85
Max. Negotiated Rate	$377.85
Rate for Payer: Qualcare PPO/HMO/WC	$377.85

PLATELET PHERESIS IRRADIATED

Facility

$2,688.00

Hospital Charge Code	38471097
Hospital Revenue Code	390
Min. Negotiated Rate	$403.20
Max. Negotiated Rate	$403.20
Rate for Payer: Qualcare PPO/HMO/WC	$403.20

Know your out-of-pocket cost for care.

All Charges