Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

RUBEOLA IGG

Facility

$465.00

Service Code	HCPCS 86765
Hospital Charge Code	38476037
Hospital Revenue Code	302
Min. Negotiated Rate	$10.30
Max. Negotiated Rate	$232.50
Rate for Payer: Aetna Commercial	$35.03
Rate for Payer: Aetna Medicare Advantage	$41.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.88
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	$46.72
Rate for Payer: Cigna Commercial	$232.50
Rate for Payer: Cigna Medicare Advantage	$12.88
Rate for Payer: Clover Medicare Advantage	$12.24
Rate for Payer: EmblemHealth Commercial	$38.64
Rate for Payer: Humana Medicare Advantage	$13.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.90
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$69.75
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.88
Rate for Payer: Wellcare Medicare Advantage	$12.88
Rate for Payer: Wellpoint Medicaid Managed Care	$13.21

Ruby Coil 36mmx60cm

Facility

$6,450.00

Hospital Charge Code	270687055
Hospital Revenue Code	278
Min. Negotiated Rate	$183.18
Max. Negotiated Rate	$3,225.00
Rate for Payer: Aetna Commercial	$2,451.00
Rate for Payer: Aetna Medicare Advantage	$1,935.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,644.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,644.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,290.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,644.75
Rate for Payer: Cigna Commercial	$3,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.90
Rate for Payer: Qualcare PPO/HMO/WC	$967.50
Rate for Payer: UnitedHealthcare Community & State	$203.82
Rate for Payer: Wellpoint Medicaid Managed Care	$183.18

Ruby Coil 36mmx60cm

Facility

$6,450.00

Hospital Charge Code	270687055
Hospital Revenue Code	278
Min. Negotiated Rate	$967.50
Max. Negotiated Rate	$1,560.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.90
Rate for Payer: Qualcare PPO/HMO/WC	$967.50

Ruby Coil 40mmx60cm

Facility

$6,450.00

Hospital Charge Code	270687054
Hospital Revenue Code	278
Min. Negotiated Rate	$183.18
Max. Negotiated Rate	$3,225.00
Rate for Payer: Aetna Commercial	$2,451.00
Rate for Payer: Aetna Medicare Advantage	$1,935.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,644.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,644.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,290.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,644.75
Rate for Payer: Cigna Commercial	$3,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.90
Rate for Payer: Qualcare PPO/HMO/WC	$967.50
Rate for Payer: UnitedHealthcare Community & State	$203.82
Rate for Payer: Wellpoint Medicaid Managed Care	$183.18

Ruby Coil 40mmx60cm

Facility

$6,450.00

Hospital Charge Code	270687054
Hospital Revenue Code	278
Min. Negotiated Rate	$967.50
Max. Negotiated Rate	$1,560.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.90
Rate for Payer: Qualcare PPO/HMO/WC	$967.50

RUBY COIL SOFT 4MMX15CM

Facility

$4,950.00

Service Code	HCPCS C1884
Hospital Charge Code	270677078
Hospital Revenue Code	278
Min. Negotiated Rate	$140.58
Max. Negotiated Rate	$2,475.00
Rate for Payer: Aetna Commercial	$1,881.00
Rate for Payer: Aetna Medicare Advantage	$1,485.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,262.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,262.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,262.25
Rate for Payer: Cigna Commercial	$2,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,197.90
Rate for Payer: Qualcare PPO/HMO/WC	$742.50
Rate for Payer: UnitedHealthcare Community & State	$156.42
Rate for Payer: Wellpoint Medicaid Managed Care	$140.58

RUBY COIL SOFT 4MMX15CM

Facility

$4,950.00

Service Code	HCPCS C1884
Hospital Charge Code	270677078
Hospital Revenue Code	278
Min. Negotiated Rate	$742.50
Max. Negotiated Rate	$1,197.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$990.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,197.90
Rate for Payer: Qualcare PPO/HMO/WC	$742.50

RUSH MEDULLARY PINS

Facility

$147.00

Hospital Charge Code	270335009
Hospital Revenue Code	278
Min. Negotiated Rate	$4.17
Max. Negotiated Rate	$73.50
Rate for Payer: Aetna Commercial	$55.86
Rate for Payer: Aetna Medicare Advantage	$44.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.48
Rate for Payer: Cigna Commercial	$73.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.57
Rate for Payer: Qualcare PPO/HMO/WC	$22.05
Rate for Payer: UnitedHealthcare Community & State	$4.65
Rate for Payer: Wellpoint Medicaid Managed Care	$4.17

RUSH MEDULLARY PINS

Facility

$147.00

Hospital Charge Code	270335009
Hospital Revenue Code	278
Min. Negotiated Rate	$22.05
Max. Negotiated Rate	$35.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.57
Rate for Payer: Qualcare PPO/HMO/WC	$22.05

RV-RIGHT VENTRICLE

Facility

$2,000.00

Hospital Charge Code	270702378
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

RV-RIGHT VENTRICLE

Facility

$2,000.00

Hospital Charge Code	270702378
Hospital Revenue Code	278
Min. Negotiated Rate	$56.80
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Community & State	$63.20
Rate for Payer: Wellpoint Medicaid Managed Care	$56.80

RW ACCUCHECK

Facility

$390.00

Service Code	HCPCS 82948
Hospital Charge Code	87502315
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

RW ACCUCHECK

Facility

$21.00

Service Code	HCPCS 82948
Hospital Charge Code	84206150
Hospital Revenue Code	301
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$3.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.15

RW ACCUCHECK

Facility

$21.00

Service Code	HCPCS 82948
Hospital Charge Code	84206150
Hospital Revenue Code	301
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$13.71
Rate for Payer: Aetna Medicare Advantage	$16.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.28
Rate for Payer: Cigna Commercial	$10.50
Rate for Payer: Cigna Medicare Advantage	$5.04
Rate for Payer: Clover Medicare Advantage	$4.79
Rate for Payer: EmblemHealth Commercial	$15.12
Rate for Payer: Humana Medicare Advantage	$5.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.46
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.15
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$4.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.04
Rate for Payer: Wellcare Medicare Advantage	$5.04
Rate for Payer: Wellpoint Medicaid Managed Care	$0.60

RW ACCUCHECK

Facility

$390.00

Service Code	HCPCS 82948
Hospital Charge Code	87502315
Hospital Revenue Code	301
Min. Negotiated Rate	$2.48
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$13.71
Rate for Payer: Aetna Medicare Advantage	$16.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.28
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.04
Rate for Payer: Clover Medicare Advantage	$4.79
Rate for Payer: EmblemHealth Commercial	$15.12
Rate for Payer: Humana Medicare Advantage	$5.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.04
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	$4.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.04
Rate for Payer: Wellcare Medicare Advantage	$5.04
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

RW ACTHIB VIAL

Facility

$7.00

Service Code	HCPCS 90648
Hospital Charge Code	84206360
Hospital Revenue Code	636
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$29.70
Rate for Payer: Aetna Commercial	$2.66
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

RW ACTHIB VIAL

Facility

$7.00

Service Code	HCPCS 90648
Hospital Charge Code	84206360
Hospital Revenue Code	636
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

RW ADACEL T DAP PFS

Facility

$2,913.40

Service Code	HCPCS 90715
Hospital Charge Code	84206200
Hospital Revenue Code	636
Min. Negotiated Rate	$82.74
Max. Negotiated Rate	$1,456.70
Rate for Payer: Aetna Commercial	$1,107.09
Rate for Payer: Aetna Medicare Advantage	$874.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$742.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$742.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$742.92
Rate for Payer: Cigna Commercial	$1,456.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$705.04
Rate for Payer: Qualcare PPO/HMO/WC	$437.01
Rate for Payer: UnitedHealthcare Community & State	$92.06
Rate for Payer: Wellpoint Medicaid Managed Care	$82.74

RW ADACEL T DAP PFS

Facility

$2,913.40

Service Code	HCPCS 90715
Hospital Charge Code	84206200
Hospital Revenue Code	636
Min. Negotiated Rate	$437.01
Max. Negotiated Rate	$705.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$705.04
Rate for Payer: Qualcare PPO/HMO/WC	$437.01

RW ALBUTEROL INH. 0.83MG/ML SO

Facility

$19.00

Hospital Charge Code	83652629
Hospital Revenue Code	250
Min. Negotiated Rate	$2.85
Max. Negotiated Rate	$2.85
Rate for Payer: Qualcare PPO/HMO/WC	$2.85

RW ALBUTEROL INH. 0.83MG/ML SO

Facility

$19.00

Hospital Charge Code	83652629
Hospital Revenue Code	250
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$9.50
Rate for Payer: Aetna Commercial	$7.22
Rate for Payer: Aetna Medicare Advantage	$5.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.84
Rate for Payer: Cigna Commercial	$9.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.94
Rate for Payer: Oxford Commercial	$3.80
Rate for Payer: Qualcare PPO/HMO/WC	$2.85
Rate for Payer: UnitedHealthcare Commercial	$3.80
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.54

RW ANAL PAP SMEAR

Facility

$328.27

Service Code	HCPCS 88160
Hospital Charge Code	87592286
Hospital Revenue Code	319
Min. Negotiated Rate	$9.32
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$93.46
Rate for Payer: Aetna Medicare Advantage	$111.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$34.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.64
Rate for Payer: Cigna Commercial	$68.87
Rate for Payer: Cigna Medicare Advantage	$34.36
Rate for Payer: Clover Medicare Advantage	$32.64
Rate for Payer: EmblemHealth Commercial	$103.08
Rate for Payer: Humana Medicare Advantage	$35.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$34.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.35
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.24
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$34.36
Rate for Payer: Wellcare Medicare Advantage	$34.36
Rate for Payer: Wellpoint Medicaid Managed Care	$9.32

RW ANAL PAP SMEAR

Facility

$328.27

Service Code	HCPCS 88160
Hospital Charge Code	87592286
Hospital Revenue Code	319
Min. Negotiated Rate	$49.24
Max. Negotiated Rate	$49.24
Rate for Payer: Qualcare PPO/HMO/WC	$49.24

RW ANAL PAP SMEAR

Facility

$390.00

Service Code	HCPCS 88160
Hospital Charge Code	87502296
Hospital Revenue Code	319
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

RW ANAL PAP SMEAR

Facility

$390.00

Service Code	HCPCS 88160
Hospital Charge Code	87502296
Hospital Revenue Code	319
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$93.46
Rate for Payer: Aetna Medicare Advantage	$111.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$34.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.64
Rate for Payer: Cigna Commercial	$68.87
Rate for Payer: Cigna Medicare Advantage	$34.36
Rate for Payer: Clover Medicare Advantage	$32.64
Rate for Payer: EmblemHealth Commercial	$103.08
Rate for Payer: Humana Medicare Advantage	$35.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$34.36
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	$12.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$34.36
Rate for Payer: Wellcare Medicare Advantage	$34.36
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

Know your out-of-pocket cost for care.

All Charges