Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

POD REM/BIVALVIN,FULL LEG

Facility

$458.00

Service Code	HCPCS 29705
Hospital Charge Code	84208200
Hospital Revenue Code	361
Min. Negotiated Rate	$13.01
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$903.80
Rate for Payer: Aetna Medicare Advantage	$1,076.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,205.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,205.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$332.28
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	$1,205.35
Rate for Payer: Cigna Commercial	$666.07
Rate for Payer: Cigna Medicare Advantage	$332.28
Rate for Payer: Clover Medicare Advantage	$315.67
Rate for Payer: EmblemHealth Commercial	$996.84
Rate for Payer: Humana Medicare Advantage	$342.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$332.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.08
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$68.70
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$14.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$332.28
Rate for Payer: Wellcare Medicare Advantage	$332.28
Rate for Payer: Wellpoint Medicaid Managed Care	$13.01

POD REM/BIVALVIN,FULL LEG

Facility

$458.00

Service Code	HCPCS 29705
Hospital Charge Code	84208200
Hospital Revenue Code	361
Min. Negotiated Rate	$68.70
Max. Negotiated Rate	$68.70
Rate for Payer: Qualcare PPO/HMO/WC	$68.70

POD REMOVAL OF CAST

Facility

$458.00

Service Code	HCPCS 29700
Hospital Charge Code	84208195
Hospital Revenue Code	361
Min. Negotiated Rate	$13.01
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$903.80
Rate for Payer: Aetna Medicare Advantage	$1,076.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,205.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,205.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$332.28
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	$1,205.35
Rate for Payer: Cigna Commercial	$666.07
Rate for Payer: Cigna Medicare Advantage	$332.28
Rate for Payer: Clover Medicare Advantage	$315.67
Rate for Payer: EmblemHealth Commercial	$996.84
Rate for Payer: Humana Medicare Advantage	$342.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$332.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.08
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$68.70
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$14.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$332.28
Rate for Payer: Wellcare Medicare Advantage	$332.28
Rate for Payer: Wellpoint Medicaid Managed Care	$13.01

POD REMOVAL OF CAST

Facility

$458.00

Service Code	HCPCS 29700
Hospital Charge Code	84208195
Hospital Revenue Code	361
Min. Negotiated Rate	$68.70
Max. Negotiated Rate	$68.70
Rate for Payer: Qualcare PPO/HMO/WC	$68.70

POD SOFT CAST - UNNA

Facility

$458.00

Service Code	HCPCS 29580
Hospital Charge Code	84208190
Hospital Revenue Code	510
Min. Negotiated Rate	$13.01
Max. Negotiated Rate	$700.29
Rate for Payer: Aetna Commercial	$525.10
Rate for Payer: Aetna Medicare Advantage	$625.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$700.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$700.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$193.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$700.29
Rate for Payer: Cigna Commercial	$386.97
Rate for Payer: Cigna Medicare Advantage	$193.05
Rate for Payer: Clover Medicare Advantage	$183.40
Rate for Payer: EmblemHealth Commercial	$579.15
Rate for Payer: Humana Medicare Advantage	$198.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$193.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.08
Rate for Payer: Qualcare PPO/HMO/WC	$68.70
Rate for Payer: UnitedHealthcare Community & State	$14.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$193.05
Rate for Payer: Wellcare Medicare Advantage	$193.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.01

POD SOFT CAST - UNNA

Facility

$458.00

Service Code	HCPCS 29580
Hospital Charge Code	84208190
Hospital Revenue Code	510
Min. Negotiated Rate	$68.70
Max. Negotiated Rate	$68.70
Rate for Payer: Qualcare PPO/HMO/WC	$68.70

POD STRAPPING FOOT-ANKLE

Facility

$458.00

Service Code	HCPCS 29540
Hospital Charge Code	84208180
Hospital Revenue Code	510
Min. Negotiated Rate	$13.01
Max. Negotiated Rate	$700.29
Rate for Payer: Aetna Commercial	$525.10
Rate for Payer: Aetna Medicare Advantage	$625.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$700.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$700.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$193.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$700.29
Rate for Payer: Cigna Commercial	$386.97
Rate for Payer: Cigna Medicare Advantage	$193.05
Rate for Payer: Clover Medicare Advantage	$183.40
Rate for Payer: EmblemHealth Commercial	$579.15
Rate for Payer: Humana Medicare Advantage	$198.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$193.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.08
Rate for Payer: Qualcare PPO/HMO/WC	$68.70
Rate for Payer: UnitedHealthcare Community & State	$14.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$193.05
Rate for Payer: Wellcare Medicare Advantage	$193.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.01

POD STRAPPING FOOT-ANKLE

Facility

$458.00

Service Code	HCPCS 29540
Hospital Charge Code	84208180
Hospital Revenue Code	510
Min. Negotiated Rate	$68.70
Max. Negotiated Rate	$68.70
Rate for Payer: Qualcare PPO/HMO/WC	$68.70

POD STRAPPING TOE

Facility

$458.00

Service Code	HCPCS 29550
Hospital Charge Code	84208185
Hospital Revenue Code	510
Min. Negotiated Rate	$68.70
Max. Negotiated Rate	$68.70
Rate for Payer: Qualcare PPO/HMO/WC	$68.70

POD STRAPPING TOE

Facility

$458.00

Service Code	HCPCS 29550
Hospital Charge Code	84208185
Hospital Revenue Code	510
Min. Negotiated Rate	$13.01
Max. Negotiated Rate	$254.22
Rate for Payer: Aetna Commercial	$190.62
Rate for Payer: Aetna Medicare Advantage	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$254.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$254.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$70.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$254.22
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: Cigna Medicare Advantage	$70.08
Rate for Payer: Clover Medicare Advantage	$66.58
Rate for Payer: EmblemHealth Commercial	$210.24
Rate for Payer: Humana Medicare Advantage	$72.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$70.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.08
Rate for Payer: Qualcare PPO/HMO/WC	$68.70
Rate for Payer: UnitedHealthcare Community & State	$14.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$70.08
Rate for Payer: Wellcare Medicare Advantage	$70.08
Rate for Payer: Wellpoint Medicaid Managed Care	$13.01

POINTER TRACER AXIEM

Facility

$3,190.00

Hospital Charge Code	270703109
Hospital Revenue Code	278
Min. Negotiated Rate	$478.50
Max. Negotiated Rate	$771.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$638.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$771.98
Rate for Payer: Qualcare PPO/HMO/WC	$478.50

POINTER TRACER AXIEM

Facility

$3,190.00

Hospital Charge Code	270703109
Hospital Revenue Code	278
Min. Negotiated Rate	$90.60
Max. Negotiated Rate	$1,595.00
Rate for Payer: Aetna Commercial	$1,212.20
Rate for Payer: Aetna Medicare Advantage	$957.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$813.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$813.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$638.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$813.45
Rate for Payer: Cigna Commercial	$1,595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$771.98
Rate for Payer: Qualcare PPO/HMO/WC	$478.50
Rate for Payer: UnitedHealthcare Community & State	$100.80
Rate for Payer: Wellpoint Medicaid Managed Care	$90.60

POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC

Facility

$69,016.02

Service Code	MSDRG 917
Min. Negotiated Rate	$21,014.49
Max. Negotiated Rate	$69,016.02
Rate for Payer: Aetna Commercial	$51,012.51
Rate for Payer: Aetna Medicare Advantage	$69,016.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44,328.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44,328.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22,120.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44,328.00
Rate for Payer: Cigna Commercial	$34,964.34
Rate for Payer: Cigna Medicare Advantage	$22,120.52
Rate for Payer: Clover Medicare Advantage	$21,014.49
Rate for Payer: EmblemHealth Commercial	$66,361.56
Rate for Payer: Humana Medicare Advantage	$22,784.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22,120.52
Rate for Payer: Oxford Commercial	$27,635.21
Rate for Payer: UnitedHealthcare Commercial	$36,990.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$22,120.52
Rate for Payer: Wellcare Medicare Advantage	$22,120.52

POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC

Facility

$46,543.44

Service Code	MSDRG 918
Min. Negotiated Rate	$14,171.88
Max. Negotiated Rate	$46,543.44
Rate for Payer: Aetna Commercial	$35,007.29
Rate for Payer: Aetna Medicare Advantage	$46,543.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,826.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,826.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14,917.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,826.30
Rate for Payer: Cigna Commercial	$19,107.33
Rate for Payer: Cigna Medicare Advantage	$14,917.77
Rate for Payer: Clover Medicare Advantage	$14,171.88
Rate for Payer: EmblemHealth Commercial	$44,753.31
Rate for Payer: Humana Medicare Advantage	$15,365.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14,917.77
Rate for Payer: Oxford Commercial	$15,102.10
Rate for Payer: UnitedHealthcare Commercial	$20,214.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$14,917.77
Rate for Payer: Wellcare Medicare Advantage	$14,917.77

POISONING OF MEDICINAL AGENTS

Facility

$19,803.14

Service Code	APR-DRG 8124
Min. Negotiated Rate	$19,414.84
Max. Negotiated Rate	$19,803.14
Rate for Payer: UnitedHealthcare Community & State	$19,414.84
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$19,803.14
Rate for Payer: Wellpoint Medicaid Managed Care	$19,414.84

POISONING OF MEDICINAL AGENTS

Facility

$10,396.66

Service Code	APR-DRG 8123
Min. Negotiated Rate	$10,192.80
Max. Negotiated Rate	$10,396.66
Rate for Payer: UnitedHealthcare Community & State	$10,192.80
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,396.66
Rate for Payer: Wellpoint Medicaid Managed Care	$10,192.80

POISONING OF MEDICINAL AGENTS

Facility

$6,850.54

Service Code	APR-DRG 8122
Min. Negotiated Rate	$6,716.22
Max. Negotiated Rate	$6,850.54
Rate for Payer: UnitedHealthcare Community & State	$6,716.22
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,850.54
Rate for Payer: Wellpoint Medicaid Managed Care	$6,716.22

POISONING OF MEDICINAL AGENTS

Facility

$4,720.09

Service Code	APR-DRG 8121
Min. Negotiated Rate	$4,627.54
Max. Negotiated Rate	$4,720.09
Rate for Payer: UnitedHealthcare Community & State	$4,627.54
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,720.09
Rate for Payer: Wellpoint Medicaid Managed Care	$4,627.54

POLIBAR PS BARIUM SULFATE 750M

Facility

$103.50

Hospital Charge Code	606390571
Hospital Revenue Code	250
Min. Negotiated Rate	$2.94
Max. Negotiated Rate	$51.75
Rate for Payer: Aetna Commercial	$39.33
Rate for Payer: Aetna Medicare Advantage	$31.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.39
Rate for Payer: Cigna Commercial	$51.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.91
Rate for Payer: Oxford Commercial	$20.70
Rate for Payer: Qualcare PPO/HMO/WC	$15.53
Rate for Payer: UnitedHealthcare Commercial	$20.70
Rate for Payer: UnitedHealthcare Community & State	$3.27
Rate for Payer: Wellpoint Medicaid Managed Care	$2.94

POLIBAR PS BARIUM SULFATE 750M

Facility

$103.50

Hospital Charge Code	606390571
Hospital Revenue Code	250
Min. Negotiated Rate	$15.53
Max. Negotiated Rate	$15.53
Rate for Payer: Qualcare PPO/HMO/WC	$15.53

POLIO ANTIBODIES

Facility

$312.00

Service Code	HCPCS 86658
Hospital Charge Code	38472926
Hospital Revenue Code	302
Min. Negotiated Rate	$46.80
Max. Negotiated Rate	$46.80
Rate for Payer: Qualcare PPO/HMO/WC	$46.80

POLIO ANTIBODIES

Facility

$312.00

Service Code	HCPCS 86658
Hospital Charge Code	38472926
Hospital Revenue Code	302
Min. Negotiated Rate	$8.86
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$35.44
Rate for Payer: Aetna Medicare Advantage	$42.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.27
Rate for Payer: Cigna Commercial	$156.00
Rate for Payer: Cigna Medicare Advantage	$13.03
Rate for Payer: Clover Medicare Advantage	$12.38
Rate for Payer: EmblemHealth Commercial	$39.09
Rate for Payer: Humana Medicare Advantage	$13.42
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.12
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.80
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.03
Rate for Payer: Wellcare Medicare Advantage	$13.03
Rate for Payer: Wellpoint Medicaid Managed Care	$8.86

POLIOVIRUS I

Facility

$390.00

Service Code	HCPCS 86382
Hospital Charge Code	39990144A
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$46.00
Rate for Payer: Aetna Medicare Advantage	$54.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.34
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$16.91
Rate for Payer: Clover Medicare Advantage	$16.06
Rate for Payer: EmblemHealth Commercial	$50.73
Rate for Payer: Humana Medicare Advantage	$17.42
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.91
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	$13.53
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.91
Rate for Payer: Wellcare Medicare Advantage	$16.91
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

POLIOVIRUS I

Facility

$390.00

Service Code	HCPCS 86382
Hospital Charge Code	39990144A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

POLIOVIRUS II

Facility

$390.00

Service Code	HCPCS 86382
Hospital Charge Code	39990144B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Know your out-of-pocket cost for care.

All Charges