Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

RETICULOCYTES COUNT

Facility

$667.59

Service Code	HCPCS 85044
Hospital Charge Code	3002359
Hospital Revenue Code	305
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

RETICULOCYTES COUNT

Facility

$667.59

Service Code	HCPCS 85044
Hospital Charge Code	3002359
Hospital Revenue Code	305
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$333.80
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	$333.80
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	$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	$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	$18.96

RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC

Facility

$51,500.53

Service Code	MSDRG 815
Min. Negotiated Rate	$15,681.25
Max. Negotiated Rate	$51,500.53
Rate for Payer: Aetna Commercial	$38,537.78
Rate for Payer: Aetna Medicare Advantage	$51,500.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27,427.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27,427.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16,506.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27,427.95
Rate for Payer: Cigna Commercial	$22,605.10
Rate for Payer: Cigna Medicare Advantage	$16,506.58
Rate for Payer: Clover Medicare Advantage	$15,681.25
Rate for Payer: EmblemHealth Commercial	$49,519.74
Rate for Payer: Humana Medicare Advantage	$17,001.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16,506.58
Rate for Payer: Oxford Commercial	$17,866.68
Rate for Payer: UnitedHealthcare Commercial	$23,915.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$16,506.58
Rate for Payer: Wellcare Medicare Advantage	$16,506.58

RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC

Facility

$86,654.66

Service Code	MSDRG 814
Min. Negotiated Rate	$26,385.23
Max. Negotiated Rate	$86,654.66
Rate for Payer: Aetna Commercial	$63,574.94
Rate for Payer: Aetna Medicare Advantage	$86,654.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59,011.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59,011.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27,773.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59,011.65
Rate for Payer: Cigna Commercial	$47,410.52
Rate for Payer: Cigna Medicare Advantage	$27,773.93
Rate for Payer: Clover Medicare Advantage	$26,385.23
Rate for Payer: EmblemHealth Commercial	$83,321.79
Rate for Payer: Humana Medicare Advantage	$28,607.15
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27,773.93
Rate for Payer: Oxford Commercial	$37,472.45
Rate for Payer: UnitedHealthcare Commercial	$50,158.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$27,773.93
Rate for Payer: Wellcare Medicare Advantage	$27,773.93

RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC

Facility

$39,431.75

Service Code	MSDRG 816
Min. Negotiated Rate	$11,135.84
Max. Negotiated Rate	$39,431.75
Rate for Payer: Aetna Commercial	$29,942.24
Rate for Payer: Aetna Medicare Advantage	$39,431.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19,670.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19,670.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,638.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19,670.55
Rate for Payer: Cigna Commercial	$14,089.18
Rate for Payer: Cigna Medicare Advantage	$12,638.38
Rate for Payer: Clover Medicare Advantage	$12,006.46
Rate for Payer: EmblemHealth Commercial	$37,915.14
Rate for Payer: Humana Medicare Advantage	$13,017.53
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,638.38
Rate for Payer: Oxford Commercial	$11,135.84
Rate for Payer: UnitedHealthcare Commercial	$14,905.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,638.38
Rate for Payer: Wellcare Medicare Advantage	$12,638.38

RETINOL BINDING PROTEIN

Facility

$390.00

Service Code	HCPCS 83883
Hospital Charge Code	39900448
Hospital Revenue Code	301
Min. Negotiated Rate	$10.88
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$36.99
Rate for Payer: Aetna Medicare Advantage	$44.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.33
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$13.60
Rate for Payer: Clover Medicare Advantage	$12.92
Rate for Payer: EmblemHealth Commercial	$40.80
Rate for Payer: Humana Medicare Advantage	$14.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.60
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	$10.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.60
Rate for Payer: Wellcare Medicare Advantage	$13.60
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

RETINOL BINDING PROTEIN

Facility

$390.00

Service Code	HCPCS 83883
Hospital Charge Code	39900448
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

RETRACTA COIL MWCER-35-14-6

Facility

$3,252.45

Hospital Charge Code	270702166
Hospital Revenue Code	278
Min. Negotiated Rate	$92.37
Max. Negotiated Rate	$1,626.22
Rate for Payer: Aetna Commercial	$1,235.93
Rate for Payer: Aetna Medicare Advantage	$975.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$829.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$829.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$829.37
Rate for Payer: Cigna Commercial	$1,626.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$787.09
Rate for Payer: Qualcare PPO/HMO/WC	$487.87
Rate for Payer: UnitedHealthcare Community & State	$102.78
Rate for Payer: Wellpoint Medicaid Managed Care	$92.37

RETRACTA COIL MWCER-35-14-6

Facility

$3,252.45

Hospital Charge Code	270702166
Hospital Revenue Code	278
Min. Negotiated Rate	$487.87
Max. Negotiated Rate	$787.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$787.09
Rate for Payer: Qualcare PPO/HMO/WC	$487.87

RETRACTA COIL MWCER-35-7-10

Facility

$3,252.45

Hospital Charge Code	270702164
Hospital Revenue Code	278
Min. Negotiated Rate	$92.37
Max. Negotiated Rate	$1,626.22
Rate for Payer: Aetna Commercial	$1,235.93
Rate for Payer: Aetna Medicare Advantage	$975.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$829.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$829.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$829.37
Rate for Payer: Cigna Commercial	$1,626.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$787.09
Rate for Payer: Qualcare PPO/HMO/WC	$487.87
Rate for Payer: UnitedHealthcare Community & State	$102.78
Rate for Payer: Wellpoint Medicaid Managed Care	$92.37

RETRACTA COIL MWCER-35-7-10

Facility

$3,252.45

Hospital Charge Code	270702164
Hospital Revenue Code	278
Min. Negotiated Rate	$487.87
Max. Negotiated Rate	$787.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$787.09
Rate for Payer: Qualcare PPO/HMO/WC	$487.87

RETRACTA COIL MWCER-35-7-8

Facility

$3,252.45

Hospital Charge Code	270702163
Hospital Revenue Code	278
Min. Negotiated Rate	$92.37
Max. Negotiated Rate	$1,626.22
Rate for Payer: Aetna Commercial	$1,235.93
Rate for Payer: Aetna Medicare Advantage	$975.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$829.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$829.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$829.37
Rate for Payer: Cigna Commercial	$1,626.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$787.09
Rate for Payer: Qualcare PPO/HMO/WC	$487.87
Rate for Payer: UnitedHealthcare Community & State	$102.78
Rate for Payer: Wellpoint Medicaid Managed Care	$92.37

RETRACTA COIL MWCER-35-7-8

Facility

$3,252.45

Hospital Charge Code	270702163
Hospital Revenue Code	278
Min. Negotiated Rate	$487.87
Max. Negotiated Rate	$787.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$787.09
Rate for Payer: Qualcare PPO/HMO/WC	$487.87

RETRACTA COILS MWCER-35-14-12

Facility

$3,252.45

Hospital Charge Code	270702169
Hospital Revenue Code	278
Min. Negotiated Rate	$92.37
Max. Negotiated Rate	$1,626.22
Rate for Payer: Aetna Commercial	$1,235.93
Rate for Payer: Aetna Medicare Advantage	$975.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$829.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$829.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$829.37
Rate for Payer: Cigna Commercial	$1,626.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$787.09
Rate for Payer: Qualcare PPO/HMO/WC	$487.87
Rate for Payer: UnitedHealthcare Community & State	$102.78
Rate for Payer: Wellpoint Medicaid Managed Care	$92.37

RETRACTA COILS MWCER-35-14-12

Facility

$3,252.45

Hospital Charge Code	270702169
Hospital Revenue Code	278
Min. Negotiated Rate	$487.87
Max. Negotiated Rate	$787.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$787.09
Rate for Payer: Qualcare PPO/HMO/WC	$487.87

RETRACT ALEXIS 2.5 6CM LAP SYS

Facility

$1,000.00

Hospital Charge Code	270683713
Hospital Revenue Code	272
Min. Negotiated Rate	$28.40
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Oxford Commercial	$200.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$200.00
Rate for Payer: UnitedHealthcare Community & State	$31.60
Rate for Payer: Wellpoint Medicaid Managed Care	$28.40

RETRACT ALEXIS 2.5 6CM LAP SYS

Facility

$1,000.00

Hospital Charge Code	270683713
Hospital Revenue Code	272
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

RETRACT ALEXIS 5-9 LAP SYSTEM

Facility

$1,000.00

Hospital Charge Code	270683714
Hospital Revenue Code	272
Min. Negotiated Rate	$28.40
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Oxford Commercial	$200.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$200.00
Rate for Payer: UnitedHealthcare Community & State	$31.60
Rate for Payer: Wellpoint Medicaid Managed Care	$28.40

RETRACT ALEXIS 5-9 LAP SYSTEM

Facility

$1,000.00

Hospital Charge Code	270683714
Hospital Revenue Code	272
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

RETRACTOR ALEXIS 5-9CM

Facility

$375.00

Hospital Charge Code	270687087
Hospital Revenue Code	272
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Oxford Commercial	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Commercial	$75.00
Rate for Payer: UnitedHealthcare Community & State	$11.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.65

RETRACTOR ALEXIS 5-9CM

Facility

$375.00

Hospital Charge Code	270687087
Hospital Revenue Code	272
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

RETRACTOR ALEXIX WOUND MEDIUM

Facility

$270.00

Hospital Charge Code	270688644
Hospital Revenue Code	272
Min. Negotiated Rate	$7.67
Max. Negotiated Rate	$135.00
Rate for Payer: Aetna Commercial	$102.60
Rate for Payer: Aetna Medicare Advantage	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.85
Rate for Payer: Cigna Commercial	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.20
Rate for Payer: Oxford Commercial	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.50
Rate for Payer: UnitedHealthcare Commercial	$54.00
Rate for Payer: UnitedHealthcare Community & State	$8.53
Rate for Payer: Wellpoint Medicaid Managed Care	$7.67

RETRACTOR ALEXIX WOUND MEDIUM

Facility

$270.00

Hospital Charge Code	270688644
Hospital Revenue Code	272
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$40.50
Rate for Payer: Qualcare PPO/HMO/WC	$40.50

RETRACTOR BLADE BLUNT 35MM

Facility

$358.60

Hospital Charge Code	270653461
Hospital Revenue Code	272
Min. Negotiated Rate	$10.18
Max. Negotiated Rate	$179.30
Rate for Payer: Aetna Commercial	$136.27
Rate for Payer: Aetna Medicare Advantage	$107.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.44
Rate for Payer: Cigna Commercial	$179.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.24
Rate for Payer: Oxford Commercial	$71.72
Rate for Payer: Qualcare PPO/HMO/WC	$53.79
Rate for Payer: UnitedHealthcare Commercial	$71.72
Rate for Payer: UnitedHealthcare Community & State	$11.33
Rate for Payer: Wellpoint Medicaid Managed Care	$10.18

RETRACTOR BLADE BLUNT 35MM

Facility

$358.60

Hospital Charge Code	270653461
Hospital Revenue Code	272
Min. Negotiated Rate	$53.79
Max. Negotiated Rate	$53.79
Rate for Payer: Qualcare PPO/HMO/WC	$53.79

Know your out-of-pocket cost for care.

All Charges