Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

RBC BUFFY COAT REMOVED, 1 UNIT

Facility

$1,157.00

Hospital Charge Code	38471040
Hospital Revenue Code	390
Min. Negotiated Rate	$32.86
Max. Negotiated Rate	$1,167.00
Rate for Payer: Aetna Commercial	$439.66
Rate for Payer: Aetna Medicare Advantage	$347.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$295.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$295.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$295.04
Rate for Payer: Cigna Commercial	$578.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.82
Rate for Payer: Oxford Commercial	$1,028.00
Rate for Payer: Qualcare PPO/HMO/WC	$173.55
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$36.56
Rate for Payer: Wellpoint Medicaid Managed Care	$32.86

RBC COUNT

Facility

$142.00

Service Code	HCPCS 85041
Hospital Charge Code	38473013
Hospital Revenue Code	301
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$21.30
Rate for Payer: Qualcare PPO/HMO/WC	$21.30

RBC COUNT

Facility

$142.00

Service Code	HCPCS 85041
Hospital Charge Code	38473013
Hospital Revenue Code	301
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$8.21
Rate for Payer: Aetna Medicare Advantage	$9.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.02
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	$10.96
Rate for Payer: Cigna Commercial	$71.00
Rate for Payer: Cigna Medicare Advantage	$3.02
Rate for Payer: Clover Medicare Advantage	$2.87
Rate for Payer: EmblemHealth Commercial	$9.06
Rate for Payer: Humana Medicare Advantage	$3.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.92
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.30
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$2.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.02
Rate for Payer: Wellcare Medicare Advantage	$3.02
Rate for Payer: Wellpoint Medicaid Managed Care	$4.03

RBC DEGLYCEROLIZED

Facility

$2,959.25

Service Code	HCPCS P9039
Hospital Charge Code	3101517
Hospital Revenue Code	390
Min. Negotiated Rate	$84.04
Max. Negotiated Rate	$1,320.30
Rate for Payer: Aetna Commercial	$990.00
Rate for Payer: Aetna Medicare Advantage	$1,179.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,320.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,320.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$363.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,320.30
Rate for Payer: Cigna Commercial	$729.59
Rate for Payer: Cigna Medicare Advantage	$363.97
Rate for Payer: Clover Medicare Advantage	$345.77
Rate for Payer: EmblemHealth Commercial	$1,091.91
Rate for Payer: Humana Medicare Advantage	$374.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$363.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$769.40
Rate for Payer: Oxford Commercial	$1,028.00
Rate for Payer: Qualcare PPO/HMO/WC	$443.89
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$93.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$363.97
Rate for Payer: Wellcare Medicare Advantage	$363.97
Rate for Payer: Wellpoint Medicaid Managed Care	$84.04

RBC DEGLYCEROLIZED

Facility

$2,959.25

Service Code	HCPCS P9039
Hospital Charge Code	3101517
Hospital Revenue Code	390
Min. Negotiated Rate	$443.89
Max. Negotiated Rate	$443.89
Rate for Payer: Qualcare PPO/HMO/WC	$443.89

RBC FRAGILITY INCUBATED

Facility

$91.15

Hospital Charge Code	39708009
Hospital Revenue Code	305
Min. Negotiated Rate	$2.59
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$34.64
Rate for Payer: Aetna Medicare Advantage	$27.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.24
Rate for Payer: Cigna Commercial	$45.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.70
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.67
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$2.88
Rate for Payer: Wellpoint Medicaid Managed Care	$2.59

RBC FRAGILITY INCUBATED

Facility

$91.15

Hospital Charge Code	39708009
Hospital Revenue Code	305
Min. Negotiated Rate	$13.67
Max. Negotiated Rate	$13.67
Rate for Payer: Qualcare PPO/HMO/WC	$13.67

RBC FRAGILITY INCUBATED

Facility

$390.00

Service Code	HCPCS 85557
Hospital Charge Code	3035139
Hospital Revenue Code	305
Min. Negotiated Rate	$7.92
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$36.34
Rate for Payer: Aetna Medicare Advantage	$43.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.46
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$13.36
Rate for Payer: Clover Medicare Advantage	$12.69
Rate for Payer: EmblemHealth Commercial	$40.08
Rate for Payer: Humana Medicare Advantage	$13.76
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.36
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	$10.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.36
Rate for Payer: Wellcare Medicare Advantage	$13.36
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

RBC FRAGILITY INCUBATED

Facility

$390.00

Service Code	HCPCS 85557
Hospital Charge Code	3035139
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

RBC FRAGILITY-INCUBATED

Facility

$91.85

Service Code	HCPCS 85557
Hospital Charge Code	39900177
Hospital Revenue Code	305
Min. Negotiated Rate	$2.61
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$36.34
Rate for Payer: Aetna Medicare Advantage	$43.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.46
Rate for Payer: Cigna Commercial	$45.92
Rate for Payer: Cigna Medicare Advantage	$13.36
Rate for Payer: Clover Medicare Advantage	$12.69
Rate for Payer: EmblemHealth Commercial	$40.08
Rate for Payer: Humana Medicare Advantage	$13.76
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.88
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.78
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.36
Rate for Payer: Wellcare Medicare Advantage	$13.36
Rate for Payer: Wellpoint Medicaid Managed Care	$2.61

RBC FRAGILITY-INCUBATED

Facility

$91.85

Service Code	HCPCS 85557
Hospital Charge Code	39900177
Hospital Revenue Code	305
Min. Negotiated Rate	$13.78
Max. Negotiated Rate	$13.78
Rate for Payer: Qualcare PPO/HMO/WC	$13.78

RBC LEUKO IRRAD CMV NEG

Facility

$1,696.00

Hospital Charge Code	38471215
Hospital Revenue Code	390
Min. Negotiated Rate	$48.17
Max. Negotiated Rate	$1,167.00
Rate for Payer: Aetna Commercial	$644.48
Rate for Payer: Aetna Medicare Advantage	$508.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$432.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$432.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$432.48
Rate for Payer: Cigna Commercial	$848.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$440.96
Rate for Payer: Oxford Commercial	$1,028.00
Rate for Payer: Qualcare PPO/HMO/WC	$254.40
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$53.59
Rate for Payer: Wellpoint Medicaid Managed Care	$48.17

RBC LEUKO IRRAD CMV NEG

Facility

$1,696.00

Hospital Charge Code	38471215
Hospital Revenue Code	390
Min. Negotiated Rate	$254.40
Max. Negotiated Rate	$254.40
Rate for Payer: Qualcare PPO/HMO/WC	$254.40

RBC MAGNESIUM

Facility

$390.00

Service Code	HCPCS 83735
Hospital Charge Code	39900443
Hospital Revenue Code	301
Min. Negotiated Rate	$5.36
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$18.22
Rate for Payer: Aetna Medicare Advantage	$21.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.30
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$6.70
Rate for Payer: Clover Medicare Advantage	$6.37
Rate for Payer: EmblemHealth Commercial	$20.10
Rate for Payer: Humana Medicare Advantage	$6.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.70
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	$5.36
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.70
Rate for Payer: Wellcare Medicare Advantage	$6.70
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

RBC MAGNESIUM

Facility

$390.00

Service Code	HCPCS 83735
Hospital Charge Code	39900443
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

R&B INTERMEDIATE NRS LEVEL 2

Facility

$18,000.00

Hospital Charge Code	100815
Hospital Revenue Code	172
Min. Negotiated Rate	$2,435.00
Max. Negotiated Rate	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,435.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,700.00

R&B REHAB MED - PRIVATE

Facility

$18,000.00

Hospital Charge Code	100818
Hospital Revenue Code	118
Min. Negotiated Rate	$1,000.00
Max. Negotiated Rate	$6,764.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,764.00
Rate for Payer: Oxford Commercial	$3,586.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,700.00
Rate for Payer: UnitedHealthcare Commercial	$4,070.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1,000.00

RC IMPL NS ELECTRODES,PEPH NV

Facility

$73,873.00

Service Code	HCPCS 64555
Hospital Charge Code	1600000528
Hospital Revenue Code	360
Min. Negotiated Rate	$11,080.95
Max. Negotiated Rate	$11,080.95
Rate for Payer: Qualcare PPO/HMO/WC	$11,080.95

RC IMPL NS ELECTRODES,PEPH NV

Facility

$73,873.00

Service Code	HCPCS 64555
Hospital Charge Code	1600000528
Hospital Revenue Code	360
Min. Negotiated Rate	$2,097.99
Max. Negotiated Rate	$27,464.85
Rate for Payer: Aetna Commercial	$20,593.91
Rate for Payer: Aetna Medicare Advantage	$24,530.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27,464.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27,464.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,571.29
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	$27,464.85
Rate for Payer: Cigna Commercial	$15,176.62
Rate for Payer: Cigna Medicare Advantage	$7,571.29
Rate for Payer: Clover Medicare Advantage	$7,192.73
Rate for Payer: EmblemHealth Commercial	$22,713.87
Rate for Payer: Humana Medicare Advantage	$7,798.43
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,571.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19,206.98
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$11,080.95
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$2,334.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,571.29
Rate for Payer: Wellcare Medicare Advantage	$7,571.29
Rate for Payer: Wellpoint Medicaid Managed Care	$2,097.99

REACH POROUS FEMORAL 13x200mm

Facility

$53,725.00

Service Code	HCPCS C1776
Hospital Charge Code	270615806
Hospital Revenue Code	278
Min. Negotiated Rate	$8,058.75
Max. Negotiated Rate	$13,001.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,745.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,001.45
Rate for Payer: Qualcare PPO/HMO/WC	$8,058.75

REACH POROUS FEMORAL 13x200mm

Facility

$53,725.00

Service Code	HCPCS C1776
Hospital Charge Code	270615806
Hospital Revenue Code	278
Min. Negotiated Rate	$1,525.79
Max. Negotiated Rate	$26,862.50
Rate for Payer: Aetna Commercial	$20,415.50
Rate for Payer: Aetna Medicare Advantage	$16,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,699.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,699.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,745.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,699.88
Rate for Payer: Cigna Commercial	$26,862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,001.45
Rate for Payer: Qualcare PPO/HMO/WC	$8,058.75
Rate for Payer: UnitedHealthcare Community & State	$1,697.71
Rate for Payer: Wellpoint Medicaid Managed Care	$1,525.79

READICAT 2 BARIUM SULFATE

Facility

$728.09

Service Code	NDC 32909071503
Hospital Charge Code	60635890
Hospital Revenue Code	272
Min. Negotiated Rate	$20.68
Max. Negotiated Rate	$364.05
Rate for Payer: Aetna Commercial	$276.67
Rate for Payer: Aetna Medicare Advantage	$218.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$185.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$185.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$185.66
Rate for Payer: Cigna Commercial	$364.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.30
Rate for Payer: Oxford Commercial	$145.62
Rate for Payer: Qualcare PPO/HMO/WC	$109.21
Rate for Payer: UnitedHealthcare Commercial	$145.62
Rate for Payer: UnitedHealthcare Community & State	$23.01
Rate for Payer: Wellpoint Medicaid Managed Care	$20.68

READICAT 2 BARIUM SULFATE

Facility

$728.09

Service Code	NDC 32909071503
Hospital Charge Code	60635890
Hospital Revenue Code	272
Min. Negotiated Rate	$109.21
Max. Negotiated Rate	$109.21
Rate for Payer: Qualcare PPO/HMO/WC	$109.21

READIGRAFT CANC 5 1-8MM

Facility

$720.00

Hospital Charge Code	270676690
Hospital Revenue Code	278
Min. Negotiated Rate	$20.45
Max. Negotiated Rate	$360.00
Rate for Payer: Aetna Commercial	$273.60
Rate for Payer: Aetna Medicare Advantage	$216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.60
Rate for Payer: Cigna Commercial	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: Qualcare PPO/HMO/WC	$108.00
Rate for Payer: UnitedHealthcare Community & State	$22.75
Rate for Payer: Wellpoint Medicaid Managed Care	$20.45

READIGRAFT CANC 5 1-8MM

Facility

$720.00

Hospital Charge Code	270676690
Hospital Revenue Code	278
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$174.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

Know your out-of-pocket cost for care.

All Charges