Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

RADIO FREQUENCY-ELECTCAUT RENT

Facility

$1,445.00

Hospital Charge Code	270339084
Hospital Revenue Code	272
Min. Negotiated Rate	$216.75
Max. Negotiated Rate	$216.75
Rate for Payer: Qualcare PPO/HMO/WC	$216.75

RADIO FREQUENCY-ELECTCAUT RENT

Facility

$1,445.00

Hospital Charge Code	270339084
Hospital Revenue Code	272
Min. Negotiated Rate	$41.04
Max. Negotiated Rate	$722.50
Rate for Payer: Aetna Commercial	$549.10
Rate for Payer: Aetna Medicare Advantage	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$368.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$368.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$368.48
Rate for Payer: Cigna Commercial	$722.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.70
Rate for Payer: Oxford Commercial	$289.00
Rate for Payer: Qualcare PPO/HMO/WC	$216.75
Rate for Payer: UnitedHealthcare Commercial	$289.00
Rate for Payer: UnitedHealthcare Community & State	$45.66
Rate for Payer: Wellpoint Medicaid Managed Care	$41.04

RADIOFREQUENCY GROUNDING PODS

Facility

$69.75

Hospital Charge Code	270663641
Hospital Revenue Code	270
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$34.88
Rate for Payer: Aetna Commercial	$26.50
Rate for Payer: Aetna Medicare Advantage	$20.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.79
Rate for Payer: Cigna Commercial	$34.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.14
Rate for Payer: Oxford Commercial	$13.95
Rate for Payer: Qualcare PPO/HMO/WC	$10.46
Rate for Payer: UnitedHealthcare Commercial	$13.95
Rate for Payer: UnitedHealthcare Community & State	$2.20
Rate for Payer: Wellpoint Medicaid Managed Care	$1.98

RADIOFREQUENCY GROUNDING PODS

Facility

$69.75

Hospital Charge Code	270663641
Hospital Revenue Code	270
Min. Negotiated Rate	$10.46
Max. Negotiated Rate	$10.46
Rate for Payer: Qualcare PPO/HMO/WC	$10.46

RADIOLOGY PORT FILMS

Facility

$271.00

Service Code	HCPCS 77417
Hospital Charge Code	85000745
Hospital Revenue Code	333
Min. Negotiated Rate	$7.70
Max. Negotiated Rate	$6,851.00
Rate for Payer: Aetna Commercial	$102.98
Rate for Payer: Aetna Medicare Advantage	$81.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.11
Rate for Payer: Cigna Commercial	$135.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.46
Rate for Payer: Oxford Commercial	$6,034.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.65
Rate for Payer: UnitedHealthcare Commercial	$6,851.00
Rate for Payer: UnitedHealthcare Community & State	$8.56
Rate for Payer: Wellpoint Medicaid Managed Care	$7.70

RADIOLOGY PORT FILMS

Facility

$271.00

Service Code	HCPCS 77417
Hospital Charge Code	85000745
Hospital Revenue Code	333
Min. Negotiated Rate	$40.65
Max. Negotiated Rate	$40.65
Rate for Payer: Qualcare PPO/HMO/WC	$40.65

RADIOPAQUE UMB TAPE WHIT 2 24

Facility

$12.29

Hospital Charge Code	270680989
Hospital Revenue Code	272
Min. Negotiated Rate	$1.84
Max. Negotiated Rate	$1.84
Rate for Payer: Qualcare PPO/HMO/WC	$1.84

RADIOPAQUE UMB TAPE WHIT 2 24

Facility

$12.29

Hospital Charge Code	270680989
Hospital Revenue Code	272
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$6.14
Rate for Payer: Aetna Commercial	$4.67
Rate for Payer: Aetna Medicare Advantage	$3.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.13
Rate for Payer: Cigna Commercial	$6.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.20
Rate for Payer: Oxford Commercial	$2.46
Rate for Payer: Qualcare PPO/HMO/WC	$1.84
Rate for Payer: UnitedHealthcare Commercial	$2.46
Rate for Payer: UnitedHealthcare Community & State	$0.39
Rate for Payer: Wellpoint Medicaid Managed Care	$0.35

RADIOTHERAPY

Facility

$26,549.80

Service Code	APR-DRG 6923
Min. Negotiated Rate	$26,029.22
Max. Negotiated Rate	$26,549.80
Rate for Payer: UnitedHealthcare Community & State	$26,029.22
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$26,549.80
Rate for Payer: Wellpoint Medicaid Managed Care	$26,029.22

RADIOTHERAPY

Facility

$8,458.60

Service Code	APR-DRG 6921
Min. Negotiated Rate	$8,292.75
Max. Negotiated Rate	$8,458.60
Rate for Payer: UnitedHealthcare Community & State	$8,292.75
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,458.60
Rate for Payer: Wellpoint Medicaid Managed Care	$8,292.75

RADIOTHERAPY

Facility

$105,067.37

Service Code	MSDRG 849
Min. Negotiated Rate	$31,991.67
Max. Negotiated Rate	$105,067.37
Rate for Payer: Aetna Commercial	$76,688.69
Rate for Payer: Aetna Medicare Advantage	$105,067.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74,526.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74,526.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$33,675.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74,526.45
Rate for Payer: Cigna Commercial	$60,402.88
Rate for Payer: Cigna Medicare Advantage	$33,675.44
Rate for Payer: Clover Medicare Advantage	$31,991.67
Rate for Payer: EmblemHealth Commercial	$101,026.32
Rate for Payer: Humana Medicare Advantage	$34,685.70
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$33,675.44
Rate for Payer: Oxford Commercial	$47,741.39
Rate for Payer: UnitedHealthcare Commercial	$63,903.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$33,675.44
Rate for Payer: Wellcare Medicare Advantage	$33,675.44

RADIOTHERAPY

Facility

$16,219.17

Service Code	APR-DRG 6922
Min. Negotiated Rate	$15,901.15
Max. Negotiated Rate	$16,219.17
Rate for Payer: UnitedHealthcare Community & State	$15,901.15
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$16,219.17
Rate for Payer: Wellpoint Medicaid Managed Care	$15,901.15

RADIOTHERAPY

Facility

$43,187.57

Service Code	APR-DRG 6924
Min. Negotiated Rate	$42,340.75
Max. Negotiated Rate	$43,187.57
Rate for Payer: UnitedHealthcare Community & State	$42,340.75
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$43,187.57
Rate for Payer: Wellpoint Medicaid Managed Care	$42,340.75

RAD JAW 4LC W/O NDL240cm133240

Facility

$46.25

Hospital Charge Code	270638688
Hospital Revenue Code	272
Min. Negotiated Rate	$6.94
Max. Negotiated Rate	$6.94
Rate for Payer: Qualcare PPO/HMO/WC	$6.94

RAD JAW 4LC W/O NDL240cm133240

Facility

$46.25

Hospital Charge Code	270638688
Hospital Revenue Code	272
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$23.12
Rate for Payer: Aetna Commercial	$17.57
Rate for Payer: Aetna Medicare Advantage	$13.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.79
Rate for Payer: Cigna Commercial	$23.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.03
Rate for Payer: Oxford Commercial	$9.25
Rate for Payer: Qualcare PPO/HMO/WC	$6.94
Rate for Payer: UnitedHealthcare Commercial	$9.25
Rate for Payer: UnitedHealthcare Community & State	$1.46
Rate for Payer: Wellpoint Medicaid Managed Care	$1.31

RAFN NAIL 11 MM 300

Facility

$7,658.65

Service Code	HCPCS C1713
Hospital Charge Code	270687791
Hospital Revenue Code	278
Min. Negotiated Rate	$1,148.80
Max. Negotiated Rate	$1,853.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,531.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,853.39
Rate for Payer: Qualcare PPO/HMO/WC	$1,148.80

RAFN NAIL 11 MM 300

Facility

$7,658.65

Service Code	HCPCS C1713
Hospital Charge Code	270687791
Hospital Revenue Code	278
Min. Negotiated Rate	$217.51
Max. Negotiated Rate	$3,829.32
Rate for Payer: Aetna Commercial	$2,910.29
Rate for Payer: Aetna Medicare Advantage	$2,297.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,952.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,952.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,531.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,952.96
Rate for Payer: Cigna Commercial	$3,829.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,853.39
Rate for Payer: Qualcare PPO/HMO/WC	$1,148.80
Rate for Payer: UnitedHealthcare Community & State	$242.01
Rate for Payer: Wellpoint Medicaid Managed Care	$217.51

RALLY MV AB BONE CEMENT 40 GRA

Facility

$2,334.50

Service Code	HCPCS C1713
Hospital Charge Code	270686906
Hospital Revenue Code	278
Min. Negotiated Rate	$66.30
Max. Negotiated Rate	$1,167.25
Rate for Payer: Aetna Commercial	$887.11
Rate for Payer: Aetna Medicare Advantage	$700.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$595.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$595.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$466.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$595.30
Rate for Payer: Cigna Commercial	$1,167.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$564.95
Rate for Payer: Qualcare PPO/HMO/WC	$350.18
Rate for Payer: UnitedHealthcare Community & State	$73.77
Rate for Payer: Wellpoint Medicaid Managed Care	$66.30

RALLY MV AB BONE CEMENT 40 GRA

Facility

$2,334.50

Service Code	HCPCS C1713
Hospital Charge Code	270686906
Hospital Revenue Code	278
Min. Negotiated Rate	$350.18
Max. Negotiated Rate	$564.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$466.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$564.95
Rate for Payer: Qualcare PPO/HMO/WC	$350.18

RALOXIFENE 60 MG TAB

Facility

$53.06

Service Code	NDC 2418430
Hospital Charge Code	60629016
Hospital Revenue Code	250
Min. Negotiated Rate	$1.51
Max. Negotiated Rate	$26.53
Rate for Payer: Aetna Commercial	$20.16
Rate for Payer: Aetna Medicare Advantage	$15.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.53
Rate for Payer: Cigna Commercial	$26.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.80
Rate for Payer: Oxford Commercial	$10.61
Rate for Payer: Qualcare PPO/HMO/WC	$7.96
Rate for Payer: UnitedHealthcare Commercial	$10.61
Rate for Payer: UnitedHealthcare Community & State	$1.68
Rate for Payer: Wellpoint Medicaid Managed Care	$1.51

RALOXIFENE 60 MG TAB

Facility

$53.06

Service Code	NDC 2418430
Hospital Charge Code	60629016
Hospital Revenue Code	250
Min. Negotiated Rate	$7.96
Max. Negotiated Rate	$7.96
Rate for Payer: Qualcare PPO/HMO/WC	$7.96

RALOXIFENE 60MG TAB

Facility

$47.77

Service Code	NDC 69097082502
Hospital Charge Code	6063943401
Hospital Revenue Code	250
Min. Negotiated Rate	$7.17
Max. Negotiated Rate	$7.17
Rate for Payer: Qualcare PPO/HMO/WC	$7.17

RALOXIFENE 60MG TAB

Facility

$47.77

Service Code	NDC 69097082502
Hospital Charge Code	6063943401
Hospital Revenue Code	250
Min. Negotiated Rate	$1.36
Max. Negotiated Rate	$23.89
Rate for Payer: Aetna Commercial	$18.15
Rate for Payer: Aetna Medicare Advantage	$14.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.18
Rate for Payer: Cigna Commercial	$23.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.42
Rate for Payer: Oxford Commercial	$9.55
Rate for Payer: Qualcare PPO/HMO/WC	$7.17
Rate for Payer: UnitedHealthcare Commercial	$9.55
Rate for Payer: UnitedHealthcare Community & State	$1.51
Rate for Payer: Wellpoint Medicaid Managed Care	$1.36

RALTEGRAVIR 100MG CHEWABLE

Facility

$40.33

Service Code	NDC 6047761
Hospital Charge Code	6000428
Hospital Revenue Code	250
Min. Negotiated Rate	$1.15
Max. Negotiated Rate	$20.16
Rate for Payer: Aetna Commercial	$15.33
Rate for Payer: Aetna Medicare Advantage	$12.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.28
Rate for Payer: Cigna Commercial	$20.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.49
Rate for Payer: Oxford Commercial	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$6.05
Rate for Payer: UnitedHealthcare Commercial	$8.07
Rate for Payer: UnitedHealthcare Community & State	$1.27
Rate for Payer: Wellpoint Medicaid Managed Care	$1.15

RALTEGRAVIR 100MG CHEWABLE

Facility

$40.33

Service Code	NDC 6047761
Hospital Charge Code	6000428
Hospital Revenue Code	250
Min. Negotiated Rate	$6.05
Max. Negotiated Rate	$6.05
Rate for Payer: Qualcare PPO/HMO/WC	$6.05

Know your out-of-pocket cost for care.

All Charges