Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

STRATTERA 60MG CAP

Facility

$81.14

Service Code	NDC 2323930
Hospital Charge Code	606361021
Hospital Revenue Code	250
Min. Negotiated Rate	$2.30
Max. Negotiated Rate	$40.57
Rate for Payer: Aetna Commercial	$30.83
Rate for Payer: Aetna Medicare Advantage	$24.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.69
Rate for Payer: Cigna Commercial	$40.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.10
Rate for Payer: Oxford Commercial	$16.23
Rate for Payer: Qualcare PPO/HMO/WC	$12.17
Rate for Payer: UnitedHealthcare Commercial	$16.23
Rate for Payer: UnitedHealthcare Community & State	$2.56
Rate for Payer: Wellpoint Medicaid Managed Care	$2.30

STRATTERA 60MG CAP

Facility

$81.14

Service Code	NDC 2323930
Hospital Charge Code	606361021
Hospital Revenue Code	250
Min. Negotiated Rate	$12.17
Max. Negotiated Rate	$12.17
Rate for Payer: Qualcare PPO/HMO/WC	$12.17

STRATUM INSTR KIT 1ST MPJ

Facility

$2,480.00

Service Code	HCPCS C1713
Hospital Charge Code	270694755
Hospital Revenue Code	278
Min. Negotiated Rate	$372.00
Max. Negotiated Rate	$600.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$496.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.16
Rate for Payer: Qualcare PPO/HMO/WC	$372.00

STRATUM INSTR KIT 1ST MPJ

Facility

$2,480.00

Service Code	HCPCS C1713
Hospital Charge Code	270694755
Hospital Revenue Code	278
Min. Negotiated Rate	$70.43
Max. Negotiated Rate	$1,240.00
Rate for Payer: Aetna Commercial	$942.40
Rate for Payer: Aetna Medicare Advantage	$744.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$632.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$632.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$496.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$632.40
Rate for Payer: Cigna Commercial	$1,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.16
Rate for Payer: Qualcare PPO/HMO/WC	$372.00
Rate for Payer: UnitedHealthcare Community & State	$78.37
Rate for Payer: Wellpoint Medicaid Managed Care	$70.43

STRATUM STAND INST KIT RS

Facility

$2,180.00

Service Code	HCPCS C1713
Hospital Charge Code	270692247
Hospital Revenue Code	278
Min. Negotiated Rate	$327.00
Max. Negotiated Rate	$527.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$436.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$527.56
Rate for Payer: Qualcare PPO/HMO/WC	$327.00

STRATUM STAND INST KIT RS

Facility

$2,180.00

Service Code	HCPCS C1713
Hospital Charge Code	270692247
Hospital Revenue Code	278
Min. Negotiated Rate	$61.91
Max. Negotiated Rate	$1,090.00
Rate for Payer: Aetna Commercial	$828.40
Rate for Payer: Aetna Medicare Advantage	$654.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$555.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$555.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$436.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$555.90
Rate for Payer: Cigna Commercial	$1,090.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$527.56
Rate for Payer: Qualcare PPO/HMO/WC	$327.00
Rate for Payer: UnitedHealthcare Community & State	$68.89
Rate for Payer: Wellpoint Medicaid Managed Care	$61.91

STR DIG NRV HND/FT,EA ADDTL NR

Facility

$34,014.10

Service Code	HCPCS 64832
Hospital Charge Code	16000657
Hospital Revenue Code	360
Min. Negotiated Rate	$966.00
Max. Negotiated Rate	$17,007.05
Rate for Payer: Aetna Commercial	$12,925.36
Rate for Payer: Aetna Medicare Advantage	$10,204.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,673.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,673.60
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	$8,673.60
Rate for Payer: Cigna Commercial	$17,007.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,843.67
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,102.11
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$1,074.85
Rate for Payer: Wellpoint Medicaid Managed Care	$966.00

STR DIG NRV HND/FT,EA ADDTL NR

Facility

$34,014.10

Service Code	HCPCS 64832
Hospital Charge Code	16000657
Hospital Revenue Code	360
Min. Negotiated Rate	$5,102.11
Max. Negotiated Rate	$5,102.11
Rate for Payer: Qualcare PPO/HMO/WC	$5,102.11

STREP PNEUMO ANTIBODY I

Facility

$390.00

Service Code	HCPCS 86317
Hospital Charge Code	39990145A
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$40.77
Rate for Payer: Aetna Medicare Advantage	$48.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.38
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$14.99
Rate for Payer: Clover Medicare Advantage	$14.24
Rate for Payer: EmblemHealth Commercial	$44.97
Rate for Payer: Humana Medicare Advantage	$15.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.99
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	$11.99
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.99
Rate for Payer: Wellcare Medicare Advantage	$14.99
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

STREP PNEUMO ANTIBODY I

Facility

$390.00

Service Code	HCPCS 86317
Hospital Charge Code	39990145A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

STREP PNEUMO ANTIBODY II

Facility

$390.00

Service Code	HCPCS 86317
Hospital Charge Code	39990145B
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$40.77
Rate for Payer: Aetna Medicare Advantage	$48.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.38
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$14.99
Rate for Payer: Clover Medicare Advantage	$14.24
Rate for Payer: EmblemHealth Commercial	$44.97
Rate for Payer: Humana Medicare Advantage	$15.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.99
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	$11.99
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.99
Rate for Payer: Wellcare Medicare Advantage	$14.99
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

STREP PNEUMO ANTIBODY II

Facility

$390.00

Service Code	HCPCS 86317
Hospital Charge Code	39990145B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

STREP PNEUMO ANTIBODY III

Facility

$390.00

Service Code	HCPCS 86317
Hospital Charge Code	39990145C
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$40.77
Rate for Payer: Aetna Medicare Advantage	$48.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.38
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$14.99
Rate for Payer: Clover Medicare Advantage	$14.24
Rate for Payer: EmblemHealth Commercial	$44.97
Rate for Payer: Humana Medicare Advantage	$15.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.99
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	$11.99
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.99
Rate for Payer: Wellcare Medicare Advantage	$14.99
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

STREP PNEUMO ANTIBODY III

Facility

$390.00

Service Code	HCPCS 86317
Hospital Charge Code	39990145C
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

STREP PNEUMO ANTIBODY IV

Facility

$390.00

Service Code	HCPCS 86317
Hospital Charge Code	39990145D
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$40.77
Rate for Payer: Aetna Medicare Advantage	$48.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.38
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$14.99
Rate for Payer: Clover Medicare Advantage	$14.24
Rate for Payer: EmblemHealth Commercial	$44.97
Rate for Payer: Humana Medicare Advantage	$15.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.99
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	$11.99
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.99
Rate for Payer: Wellcare Medicare Advantage	$14.99
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

STREP PNEUMO ANTIBODY IV

Facility

$390.00

Service Code	HCPCS 86317
Hospital Charge Code	39990145D
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

STREP PNEUMO ANTIBODY V

Facility

$390.00

Service Code	HCPCS 86317
Hospital Charge Code	39990145E
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

STREP PNEUMO ANTIBODY V

Facility

$390.00

Service Code	HCPCS 86317
Hospital Charge Code	39990145E
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$40.77
Rate for Payer: Aetna Medicare Advantage	$48.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.38
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$14.99
Rate for Payer: Clover Medicare Advantage	$14.24
Rate for Payer: EmblemHealth Commercial	$44.97
Rate for Payer: Humana Medicare Advantage	$15.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.99
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	$11.99
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.99
Rate for Payer: Wellcare Medicare Advantage	$14.99
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

STREP PNEUMO ANTIBODY VI

Facility

$390.00

Service Code	HCPCS 86317
Hospital Charge Code	39990145F
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

STREP PNEUMO ANTIBODY VI

Facility

$390.00

Service Code	HCPCS 86317
Hospital Charge Code	39990145F
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$40.77
Rate for Payer: Aetna Medicare Advantage	$48.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.38
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$14.99
Rate for Payer: Clover Medicare Advantage	$14.24
Rate for Payer: EmblemHealth Commercial	$44.97
Rate for Payer: Humana Medicare Advantage	$15.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.99
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	$11.99
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.99
Rate for Payer: Wellcare Medicare Advantage	$14.99
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

STREP PNEUMO ANTIGEN, URINE

Facility

$728.00

Service Code	HCPCS 87899
Hospital Charge Code	39990239
Hospital Revenue Code	306
Min. Negotiated Rate	$12.86
Max. Negotiated Rate	$364.00
Rate for Payer: Aetna Commercial	$43.71
Rate for Payer: Aetna Medicare Advantage	$52.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.29
Rate for Payer: Cigna Commercial	$364.00
Rate for Payer: Cigna Medicare Advantage	$16.07
Rate for Payer: Clover Medicare Advantage	$15.27
Rate for Payer: EmblemHealth Commercial	$48.21
Rate for Payer: Humana Medicare Advantage	$16.55
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.28
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$109.20
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$12.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.07
Rate for Payer: Wellcare Medicare Advantage	$16.07
Rate for Payer: Wellpoint Medicaid Managed Care	$20.68

STREP PNEUMO ANTIGEN, URINE

Facility

$728.00

Service Code	HCPCS 87899
Hospital Charge Code	39990239
Hospital Revenue Code	306
Min. Negotiated Rate	$109.20
Max. Negotiated Rate	$109.20
Rate for Payer: Qualcare PPO/HMO/WC	$109.20

STREP SCREEN

Facility

$390.00

Service Code	HCPCS 86403
Hospital Charge Code	87502745
Hospital Revenue Code	302
Min. Negotiated Rate	$9.23
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$31.39
Rate for Payer: Aetna Medicare Advantage	$37.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.86
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$11.54
Rate for Payer: Clover Medicare Advantage	$10.96
Rate for Payer: EmblemHealth Commercial	$34.62
Rate for Payer: Humana Medicare Advantage	$11.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.54
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	$9.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.54
Rate for Payer: Wellcare Medicare Advantage	$11.54
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

STREP SCREEN

Facility

$390.00

Service Code	HCPCS 86403
Hospital Charge Code	87502745
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

STREPTOCOCCUS, GROUP A

Facility

$77.00

Service Code	HCPCS 87880
Hospital Charge Code	38472339
Hospital Revenue Code	306
Min. Negotiated Rate	$11.55
Max. Negotiated Rate	$11.55
Rate for Payer: Qualcare PPO/HMO/WC	$11.55

Know your out-of-pocket cost for care.

All Charges