Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

RNA POLYMERASE III ANTIBODY

Facility

$390.00

Service Code	HCPCS 83520
Hospital Charge Code	401183520
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$46.97
Rate for Payer: Aetna Medicare Advantage	$55.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.65
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$17.27
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.27
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	$13.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.27
Rate for Payer: Wellcare Medicare Advantage	$17.27
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

RNL NEUROLYSIS W USE OF OP MIC

Facility

$7,922.15

Service Code	HCPCS 64727
Hospital Charge Code	16000462
Hospital Revenue Code	360
Min. Negotiated Rate	$224.99
Max. Negotiated Rate	$3,961.07
Rate for Payer: Aetna Commercial	$3,010.42
Rate for Payer: Aetna Medicare Advantage	$2,376.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,020.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,020.15
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	$2,020.15
Rate for Payer: Cigna Commercial	$3,961.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,059.76
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,188.32
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$250.34
Rate for Payer: Wellpoint Medicaid Managed Care	$224.99

RNL NEUROLYSIS W USE OF OP MIC

Facility

$7,922.15

Service Code	HCPCS 64727
Hospital Charge Code	16000462
Hospital Revenue Code	360
Min. Negotiated Rate	$1,188.32
Max. Negotiated Rate	$1,188.32
Rate for Payer: Qualcare PPO/HMO/WC	$1,188.32

RNP ANTIBODY

Facility

$390.00

Service Code	HCPCS 86235
Hospital Charge Code	39900449
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

RNP ANTIBODY

Facility

$390.00

Service Code	HCPCS 86235
Hospital Charge Code	39900449
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$48.77
Rate for Payer: Aetna Medicare Advantage	$58.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.04
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$17.93
Rate for Payer: Clover Medicare Advantage	$17.03
Rate for Payer: EmblemHealth Commercial	$53.79
Rate for Payer: Humana Medicare Advantage	$18.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.93
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	$14.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.93
Rate for Payer: Wellcare Medicare Advantage	$17.93
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

ROBOTIC SURG TECH CODE

Facility

$0.01

Hospital Charge Code	73004010
Hospital Revenue Code	360
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
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	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

ROBOTIC SURG TECH CODE

Facility

$0.01

Hospital Charge Code	73004010
Hospital Revenue Code	360
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

ROBOTIC SURG TIME 1ST HOUR

Facility

$50,000.00

Hospital Charge Code	73004001
Hospital Revenue Code	360
Min. Negotiated Rate	$1,420.00
Max. Negotiated Rate	$25,000.00
Rate for Payer: Aetna Commercial	$19,000.00
Rate for Payer: Aetna Medicare Advantage	$15,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,750.00
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	$12,750.00
Rate for Payer: Cigna Commercial	$25,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,500.00
Rate for Payer: UnitedHealthcare Community & State	$1,580.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1,420.00

ROBOTIC SURG TIME 1ST HOUR

Facility

$50,000.00

Hospital Charge Code	73004001
Hospital Revenue Code	360
Min. Negotiated Rate	$7,500.00
Max. Negotiated Rate	$7,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,500.00

ROBOTIC SURG TIME EACH ADDL HR

Facility

$45,000.00

Hospital Charge Code	73004005
Hospital Revenue Code	360
Min. Negotiated Rate	$6,750.00
Max. Negotiated Rate	$6,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,750.00

ROBOTIC SURG TIME EACH ADDL HR

Facility

$45,000.00

Hospital Charge Code	73004005
Hospital Revenue Code	360
Min. Negotiated Rate	$1,278.00
Max. Negotiated Rate	$22,500.00
Rate for Payer: Aetna Commercial	$17,100.00
Rate for Payer: Aetna Medicare Advantage	$13,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,475.00
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	$11,475.00
Rate for Payer: Cigna Commercial	$22,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,700.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,750.00
Rate for Payer: UnitedHealthcare Community & State	$1,422.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1,278.00

ROCALTROL/0.5MCG/CAP

Facility

$18.02

Service Code	NDC 30698014401
Hospital Charge Code	60633839
Hospital Revenue Code	250
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

ROCALTROL/0.5MCG/CAP

Facility

$18.02

Service Code	NDC 30698014401
Hospital Charge Code	60633839
Hospital Revenue Code	250
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$9.01
Rate for Payer: Aetna Commercial	$6.85
Rate for Payer: Aetna Medicare Advantage	$5.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.60
Rate for Payer: Cigna Commercial	$9.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.69
Rate for Payer: Oxford Commercial	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$3.60
Rate for Payer: UnitedHealthcare Community & State	$0.57
Rate for Payer: Wellpoint Medicaid Managed Care	$0.51

ROCURONIUM 50 MG/5ML INJ

Facility

$170.25

Service Code	NDC 52045015
Hospital Charge Code	60627490
Hospital Revenue Code	250
Min. Negotiated Rate	$25.54
Max. Negotiated Rate	$25.54
Rate for Payer: Qualcare PPO/HMO/WC	$25.54

ROCURONIUM 50 MG/5ML INJ

Facility

$170.25

Service Code	NDC 52045015
Hospital Charge Code	60627490
Hospital Revenue Code	250
Min. Negotiated Rate	$4.84
Max. Negotiated Rate	$85.12
Rate for Payer: Aetna Commercial	$64.69
Rate for Payer: Aetna Medicare Advantage	$51.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.41
Rate for Payer: Cigna Commercial	$85.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.27
Rate for Payer: Oxford Commercial	$34.05
Rate for Payer: Qualcare PPO/HMO/WC	$25.54
Rate for Payer: UnitedHealthcare Commercial	$34.05
Rate for Payer: UnitedHealthcare Community & State	$5.38
Rate for Payer: Wellpoint Medicaid Managed Care	$4.84

ROCURONIUM BROMIDE10MG/ML 10ML

Facility

$252.99

Service Code	NDC 781322070
Hospital Charge Code	606390129
Hospital Revenue Code	250
Min. Negotiated Rate	$37.95
Max. Negotiated Rate	$37.95
Rate for Payer: Qualcare PPO/HMO/WC	$37.95

ROCURONIUM BROMIDE10MG/ML 10ML

Facility

$252.99

Service Code	NDC 781322070
Hospital Charge Code	606390129
Hospital Revenue Code	250
Min. Negotiated Rate	$7.18
Max. Negotiated Rate	$126.50
Rate for Payer: Aetna Commercial	$96.14
Rate for Payer: Aetna Medicare Advantage	$75.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.51
Rate for Payer: Cigna Commercial	$126.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.78
Rate for Payer: Oxford Commercial	$50.60
Rate for Payer: Qualcare PPO/HMO/WC	$37.95
Rate for Payer: UnitedHealthcare Commercial	$50.60
Rate for Payer: UnitedHealthcare Community & State	$7.99
Rate for Payer: Wellpoint Medicaid Managed Care	$7.18

ROD

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270681172
Hospital Revenue Code	278
Min. Negotiated Rate	$53.25
Max. Negotiated Rate	$937.50
Rate for Payer: Aetna Commercial	$712.50
Rate for Payer: Aetna Medicare Advantage	$562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.12
Rate for Payer: Cigna Commercial	$937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: Qualcare PPO/HMO/WC	$281.25
Rate for Payer: UnitedHealthcare Community & State	$59.25
Rate for Payer: Wellpoint Medicaid Managed Care	$53.25

ROD

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270681172
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$453.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

ROD

Facility

$1,325.00

Hospital Charge Code	270703489
Hospital Revenue Code	278
Min. Negotiated Rate	$37.63
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$503.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75
Rate for Payer: UnitedHealthcare Community & State	$41.87
Rate for Payer: Wellpoint Medicaid Managed Care	$37.63

ROD

Facility

$1,325.00

Hospital Charge Code	270703489
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

ROD 100MM

Facility

$1,150.00

Service Code	HCPCS C1713
Hospital Charge Code	270704447
Hospital Revenue Code	278
Min. Negotiated Rate	$32.66
Max. Negotiated Rate	$575.00
Rate for Payer: Aetna Commercial	$437.00
Rate for Payer: Aetna Medicare Advantage	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.25
Rate for Payer: Cigna Commercial	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: Qualcare PPO/HMO/WC	$172.50
Rate for Payer: UnitedHealthcare Community & State	$36.34
Rate for Payer: Wellpoint Medicaid Managed Care	$32.66

ROD 100MM

Facility

$1,150.00

Service Code	HCPCS C1713
Hospital Charge Code	270704447
Hospital Revenue Code	278
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$278.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

ROD 120 MM

Facility

$325.00

Service Code	HCPCS C1713
Hospital Charge Code	270684456
Hospital Revenue Code	278
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$78.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.65
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

ROD 120 MM

Facility

$325.00

Service Code	HCPCS C1713
Hospital Charge Code	270684456
Hospital Revenue Code	278
Min. Negotiated Rate	$9.23
Max. Negotiated Rate	$162.50
Rate for Payer: Aetna Commercial	$123.50
Rate for Payer: Aetna Medicare Advantage	$97.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.88
Rate for Payer: Cigna Commercial	$162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.65
Rate for Payer: Qualcare PPO/HMO/WC	$48.75
Rate for Payer: UnitedHealthcare Community & State	$10.27
Rate for Payer: Wellpoint Medicaid Managed Care	$9.23

Know your out-of-pocket cost for care.

All Charges