Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

RISPERIDONE CONSTA 37.5MG/2 ML

Facility

$4,117.22

Service Code	HCPCS J2794
Hospital Charge Code	60630030
Hospital Revenue Code	636
Min. Negotiated Rate	$617.58
Max. Negotiated Rate	$996.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$996.37
Rate for Payer: Qualcare PPO/HMO/WC	$617.58

RISTOCETIN COFACTOR

Facility

$172.00

Service Code	HCPCS 85245
Hospital Charge Code	38479464
Hospital Revenue Code	305
Min. Negotiated Rate	$25.80
Max. Negotiated Rate	$25.80
Rate for Payer: Qualcare PPO/HMO/WC	$25.80

RISTOCETIN COFACTOR

Facility

$172.00

Service Code	HCPCS 85245
Hospital Charge Code	38479464
Hospital Revenue Code	305
Min. Negotiated Rate	$4.88
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$62.40
Rate for Payer: Aetna Medicare Advantage	$74.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.94
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	$83.21
Rate for Payer: Cigna Commercial	$86.00
Rate for Payer: Cigna Medicare Advantage	$22.94
Rate for Payer: Clover Medicare Advantage	$21.79
Rate for Payer: EmblemHealth Commercial	$68.82
Rate for Payer: Humana Medicare Advantage	$23.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.72
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.80
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$18.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.94
Rate for Payer: Wellcare Medicare Advantage	$22.94
Rate for Payer: Wellpoint Medicaid Managed Care	$4.88

RISTOCETIN COFACTOR

Facility

$172.00

Service Code	HCPCS 85245
Hospital Charge Code	38473005
Hospital Revenue Code	305
Min. Negotiated Rate	$4.88
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$62.40
Rate for Payer: Aetna Medicare Advantage	$74.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.94
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	$83.21
Rate for Payer: Cigna Commercial	$86.00
Rate for Payer: Cigna Medicare Advantage	$22.94
Rate for Payer: Clover Medicare Advantage	$21.79
Rate for Payer: EmblemHealth Commercial	$68.82
Rate for Payer: Humana Medicare Advantage	$23.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.72
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.80
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$18.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.94
Rate for Payer: Wellcare Medicare Advantage	$22.94
Rate for Payer: Wellpoint Medicaid Managed Care	$4.88

RISTOCETIN COFACTOR

Facility

$172.00

Service Code	HCPCS 85245
Hospital Charge Code	38473005
Hospital Revenue Code	305
Min. Negotiated Rate	$25.80
Max. Negotiated Rate	$25.80
Rate for Payer: Qualcare PPO/HMO/WC	$25.80

RITONAVIR 100 MG TAB

Facility

$68.94

Service Code	NDC 74234030
Hospital Charge Code	606350993
Hospital Revenue Code	250
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$10.34
Rate for Payer: Qualcare PPO/HMO/WC	$10.34

RITONAVIR 100 MG TAB

Facility

$68.94

Service Code	NDC 74234030
Hospital Charge Code	606350993
Hospital Revenue Code	250
Min. Negotiated Rate	$1.96
Max. Negotiated Rate	$34.47
Rate for Payer: Aetna Commercial	$26.20
Rate for Payer: Aetna Medicare Advantage	$20.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.58
Rate for Payer: Cigna Commercial	$34.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.92
Rate for Payer: Oxford Commercial	$13.79
Rate for Payer: Qualcare PPO/HMO/WC	$10.34
Rate for Payer: UnitedHealthcare Commercial	$13.79
Rate for Payer: UnitedHealthcare Community & State	$2.18
Rate for Payer: Wellpoint Medicaid Managed Care	$1.96

RITUXAN SENSITIVITY (CD20

Facility

$184.00

Service Code	HCPCS 86356
Hospital Charge Code	39900220
Hospital Revenue Code	302
Min. Negotiated Rate	$27.60
Max. Negotiated Rate	$27.60
Rate for Payer: Qualcare PPO/HMO/WC	$27.60

RITUXAN SENSITIVITY (CD20

Facility

$184.00

Service Code	HCPCS 86356
Hospital Charge Code	39900220
Hospital Revenue Code	302
Min. Negotiated Rate	$5.23
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$72.84
Rate for Payer: Aetna Medicare Advantage	$86.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.14
Rate for Payer: Cigna Commercial	$92.00
Rate for Payer: Cigna Medicare Advantage	$26.78
Rate for Payer: Clover Medicare Advantage	$25.44
Rate for Payer: EmblemHealth Commercial	$80.34
Rate for Payer: Humana Medicare Advantage	$27.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.84
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.60
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$21.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.78
Rate for Payer: Wellcare Medicare Advantage	$26.78
Rate for Payer: Wellpoint Medicaid Managed Care	$5.23

RITUXIMAB 100MG/10 ML INJ.

Facility

$5,186.27

Service Code	HCPCS J9312
Hospital Charge Code	60628699
Hospital Revenue Code	636
Min. Negotiated Rate	$777.94
Max. Negotiated Rate	$1,255.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,255.08
Rate for Payer: Qualcare PPO/HMO/WC	$777.94

RITUXIMAB 100MG/10 ML INJ.

Facility

$5,186.27

Service Code	HCPCS J9312
Hospital Charge Code	60628699
Hospital Revenue Code	636
Min. Negotiated Rate	$70.45
Max. Negotiated Rate	$1,255.08
Rate for Payer: Aetna Commercial	$201.72
Rate for Payer: Aetna Medicare Advantage	$240.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$269.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$269.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$74.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$78.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$269.02
Rate for Payer: Cigna Medicare Advantage	$74.16
Rate for Payer: Clover Medicare Advantage	$70.45
Rate for Payer: EmblemHealth Commercial	$222.48
Rate for Payer: Humana Medicare Advantage	$76.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$74.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,255.08
Rate for Payer: Qualcare PPO/HMO/WC	$777.94
Rate for Payer: UnitedHealthcare Community & State	$163.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$74.16
Rate for Payer: Wellcare Medicare Advantage	$74.16
Rate for Payer: Wellpoint Medicaid Managed Care	$147.29

RITUXIMAB-ABBS 100MG/10ML

Facility

$679.85

Service Code	HCPCS Q5115
Hospital Charge Code	606390348
Hospital Revenue Code	636
Min. Negotiated Rate	$19.31
Max. Negotiated Rate	$164.52
Rate for Payer: Aetna Commercial	$85.08
Rate for Payer: Aetna Medicare Advantage	$101.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$31.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.47
Rate for Payer: Cigna Medicare Advantage	$31.28
Rate for Payer: Clover Medicare Advantage	$29.72
Rate for Payer: EmblemHealth Commercial	$93.84
Rate for Payer: Humana Medicare Advantage	$32.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$31.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.52
Rate for Payer: Qualcare PPO/HMO/WC	$101.98
Rate for Payer: UnitedHealthcare Community & State	$21.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$31.28
Rate for Payer: Wellcare Medicare Advantage	$31.28
Rate for Payer: Wellpoint Medicaid Managed Care	$19.31

RITUXIMAB-ABBS 100MG/10ML

Facility

$679.85

Service Code	HCPCS Q5115
Hospital Charge Code	606390348
Hospital Revenue Code	636
Min. Negotiated Rate	$101.98
Max. Negotiated Rate	$164.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.52
Rate for Payer: Qualcare PPO/HMO/WC	$101.98

RITUXIMAB PVVR 10MG/ML

Facility

$3,015.00

Service Code	HCPCS Q5119
Hospital Charge Code	6064943021
Hospital Revenue Code	636
Min. Negotiated Rate	$452.25
Max. Negotiated Rate	$729.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$729.63
Rate for Payer: Qualcare PPO/HMO/WC	$452.25

RITUXIMAB PVVR 10MG/ML

Facility

$3,015.00

Service Code	HCPCS Q5119
Hospital Charge Code	6064943021
Hospital Revenue Code	636
Min. Negotiated Rate	$13.01
Max. Negotiated Rate	$729.63
Rate for Payer: Aetna Commercial	$37.24
Rate for Payer: Aetna Medicare Advantage	$44.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.66
Rate for Payer: Cigna Medicare Advantage	$13.69
Rate for Payer: Clover Medicare Advantage	$13.01
Rate for Payer: EmblemHealth Commercial	$41.07
Rate for Payer: Humana Medicare Advantage	$14.10
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$729.63
Rate for Payer: Qualcare PPO/HMO/WC	$452.25
Rate for Payer: UnitedHealthcare Community & State	$95.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.69
Rate for Payer: Wellcare Medicare Advantage	$13.69
Rate for Payer: Wellpoint Medicaid Managed Care	$85.63

RIV4 VACC RECOMBINANT DNA IM

Facility

$222.65

Service Code	HCPCS 90682
Hospital Charge Code	412390682
Hospital Revenue Code	636
Min. Negotiated Rate	$33.40
Max. Negotiated Rate	$53.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.88
Rate for Payer: Qualcare PPO/HMO/WC	$33.40

RIV4 VACC RECOMBINANT DNA IM

Facility

$222.65

Service Code	HCPCS 90682
Hospital Charge Code	412390682
Hospital Revenue Code	636
Min. Negotiated Rate	$6.32
Max. Negotiated Rate	$111.33
Rate for Payer: Aetna Commercial	$84.61
Rate for Payer: Aetna Medicare Advantage	$66.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.78
Rate for Payer: Cigna Commercial	$111.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.88
Rate for Payer: Qualcare PPO/HMO/WC	$33.40
Rate for Payer: UnitedHealthcare Community & State	$7.04
Rate for Payer: Wellpoint Medicaid Managed Care	$6.32

RIVAROXABAN 2.5MG TAB

Facility

$35.58

Service Code	NDC 50458057710
Hospital Charge Code	606390289
Hospital Revenue Code	250
Min. Negotiated Rate	$1.01
Max. Negotiated Rate	$17.79
Rate for Payer: Aetna Commercial	$13.52
Rate for Payer: Aetna Medicare Advantage	$10.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.07
Rate for Payer: Cigna Commercial	$17.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.25
Rate for Payer: Oxford Commercial	$7.12
Rate for Payer: Qualcare PPO/HMO/WC	$5.34
Rate for Payer: UnitedHealthcare Commercial	$7.12
Rate for Payer: UnitedHealthcare Community & State	$1.12
Rate for Payer: Wellpoint Medicaid Managed Care	$1.01

RIVAROXABAN 2.5MG TAB

Facility

$35.58

Service Code	NDC 50458057710
Hospital Charge Code	606390289
Hospital Revenue Code	250
Min. Negotiated Rate	$5.34
Max. Negotiated Rate	$5.34
Rate for Payer: Qualcare PPO/HMO/WC	$5.34

RIVASTIGMINE 1.5 MG CAP

Facility

$28.41

Service Code	NDC 781261460
Hospital Charge Code	60629076
Hospital Revenue Code	250
Min. Negotiated Rate	$4.26
Max. Negotiated Rate	$4.26
Rate for Payer: Qualcare PPO/HMO/WC	$4.26

RIVASTIGMINE 1.5 MG CAP

Facility

$28.41

Service Code	NDC 781261460
Hospital Charge Code	60629076
Hospital Revenue Code	250
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$14.21
Rate for Payer: Aetna Commercial	$10.80
Rate for Payer: Aetna Medicare Advantage	$8.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.24
Rate for Payer: Cigna Commercial	$14.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.39
Rate for Payer: Oxford Commercial	$5.68
Rate for Payer: Qualcare PPO/HMO/WC	$4.26
Rate for Payer: UnitedHealthcare Commercial	$5.68
Rate for Payer: UnitedHealthcare Community & State	$0.90
Rate for Payer: Wellpoint Medicaid Managed Care	$0.81

RIVASTIGMINE 3 MG CAP

Facility

$28.41

Service Code	NDC 781261560
Hospital Charge Code	60629182
Hospital Revenue Code	250
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$14.21
Rate for Payer: Aetna Commercial	$10.80
Rate for Payer: Aetna Medicare Advantage	$8.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.24
Rate for Payer: Cigna Commercial	$14.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.39
Rate for Payer: Oxford Commercial	$5.68
Rate for Payer: Qualcare PPO/HMO/WC	$4.26
Rate for Payer: UnitedHealthcare Commercial	$5.68
Rate for Payer: UnitedHealthcare Community & State	$0.90
Rate for Payer: Wellpoint Medicaid Managed Care	$0.81

RIVASTIGMINE 3 MG CAP

Facility

$28.41

Service Code	NDC 781261560
Hospital Charge Code	60629182
Hospital Revenue Code	250
Min. Negotiated Rate	$4.26
Max. Negotiated Rate	$4.26
Rate for Payer: Qualcare PPO/HMO/WC	$4.26

RIVASTIGMINE 4.6 MG PATCH

Facility

$100.70

Service Code	NDC 78050115
Hospital Charge Code	60630006
Hospital Revenue Code	250
Min. Negotiated Rate	$15.11
Max. Negotiated Rate	$15.11
Rate for Payer: Qualcare PPO/HMO/WC	$15.11

RIVASTIGMINE 4.6 MG PATCH

Facility

$100.70

Service Code	NDC 78050115
Hospital Charge Code	60630006
Hospital Revenue Code	250
Min. Negotiated Rate	$2.86
Max. Negotiated Rate	$50.35
Rate for Payer: Aetna Commercial	$38.27
Rate for Payer: Aetna Medicare Advantage	$30.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.68
Rate for Payer: Cigna Commercial	$50.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.18
Rate for Payer: Oxford Commercial	$20.14
Rate for Payer: Qualcare PPO/HMO/WC	$15.11
Rate for Payer: UnitedHealthcare Commercial	$20.14
Rate for Payer: UnitedHealthcare Community & State	$3.18
Rate for Payer: Wellpoint Medicaid Managed Care	$2.86

Know your out-of-pocket cost for care.

All Charges