Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TERCONAZOLE 0.8% VAG CRM 20GM

Facility

$436.17

Service Code	NDC 50458053601
Hospital Charge Code	606361042
Hospital Revenue Code	250
Min. Negotiated Rate	$12.39
Max. Negotiated Rate	$218.09
Rate for Payer: Aetna Commercial	$165.74
Rate for Payer: Aetna Medicare Advantage	$130.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.22
Rate for Payer: Cigna Commercial	$218.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.40
Rate for Payer: Oxford Commercial	$87.23
Rate for Payer: Qualcare PPO/HMO/WC	$65.43
Rate for Payer: UnitedHealthcare Commercial	$87.23
Rate for Payer: UnitedHealthcare Community & State	$13.78
Rate for Payer: Wellpoint Medicaid Managed Care	$12.39

TERM.DEOXYNUCLEOTIDYL TRANSFER

Facility

$217.00

Service Code	HCPCS 88346
Hospital Charge Code	38476180
Hospital Revenue Code	312
Min. Negotiated Rate	$32.55
Max. Negotiated Rate	$32.55
Rate for Payer: Qualcare PPO/HMO/WC	$32.55

TERM.DEOXYNUCLEOTIDYL TRANSFER

Facility

$217.00

Service Code	HCPCS 88346
Hospital Charge Code	38476180
Hospital Revenue Code	312
Min. Negotiated Rate	$6.16
Max. Negotiated Rate	$734.21
Rate for Payer: Aetna Commercial	$550.53
Rate for Payer: Aetna Medicare Advantage	$655.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$734.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$734.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$202.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$734.21
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$202.40
Rate for Payer: Clover Medicare Advantage	$192.28
Rate for Payer: EmblemHealth Commercial	$607.20
Rate for Payer: Humana Medicare Advantage	$208.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$202.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.42
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.55
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$122.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$202.40
Rate for Payer: Wellcare Medicare Advantage	$202.40
Rate for Payer: Wellpoint Medicaid Managed Care	$6.16

TERUMOBCT/PRP

Facility

$3,050.00

Hospital Charge Code	270681065
Hospital Revenue Code	272
Min. Negotiated Rate	$457.50
Max. Negotiated Rate	$457.50
Rate for Payer: Qualcare PPO/HMO/WC	$457.50

TERUMOBCT/PRP

Facility

$3,050.00

Hospital Charge Code	270681065
Hospital Revenue Code	272
Min. Negotiated Rate	$86.62
Max. Negotiated Rate	$1,525.00
Rate for Payer: Aetna Commercial	$1,159.00
Rate for Payer: Aetna Medicare Advantage	$915.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$777.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$777.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$777.75
Rate for Payer: Cigna Commercial	$1,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$793.00
Rate for Payer: Oxford Commercial	$610.00
Rate for Payer: Qualcare PPO/HMO/WC	$457.50
Rate for Payer: UnitedHealthcare Commercial	$610.00
Rate for Payer: UnitedHealthcare Community & State	$96.38
Rate for Payer: Wellpoint Medicaid Managed Care	$86.62

TERUMOBCT/PRP 120 ML

Facility

$11,475.00

Hospital Charge Code	270676585
Hospital Revenue Code	272
Min. Negotiated Rate	$1,721.25
Max. Negotiated Rate	$1,721.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,721.25

TERUMOBCT/PRP 120 ML

Facility

$11,475.00

Hospital Charge Code	270676585
Hospital Revenue Code	272
Min. Negotiated Rate	$325.89
Max. Negotiated Rate	$5,737.50
Rate for Payer: Aetna Commercial	$4,360.50
Rate for Payer: Aetna Medicare Advantage	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,926.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,926.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,926.12
Rate for Payer: Cigna Commercial	$5,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,983.50
Rate for Payer: Oxford Commercial	$2,295.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,721.25
Rate for Payer: UnitedHealthcare Commercial	$2,295.00
Rate for Payer: UnitedHealthcare Community & State	$362.61
Rate for Payer: Wellpoint Medicaid Managed Care	$325.89

TERUMO CENTRIFUGAL HEAD

Facility

$1,115.50

Hospital Charge Code	2703110C
Hospital Revenue Code	272
Min. Negotiated Rate	$167.32
Max. Negotiated Rate	$167.32
Rate for Payer: Qualcare PPO/HMO/WC	$167.32

TERUMO CENTRIFUGAL HEAD

Facility

$1,115.50

Hospital Charge Code	2703110C
Hospital Revenue Code	272
Min. Negotiated Rate	$31.68
Max. Negotiated Rate	$557.75
Rate for Payer: Aetna Commercial	$423.89
Rate for Payer: Aetna Medicare Advantage	$334.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$284.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$284.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$284.45
Rate for Payer: Cigna Commercial	$557.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.03
Rate for Payer: Oxford Commercial	$223.10
Rate for Payer: Qualcare PPO/HMO/WC	$167.32
Rate for Payer: UnitedHealthcare Commercial	$223.10
Rate for Payer: UnitedHealthcare Community & State	$35.25
Rate for Payer: Wellpoint Medicaid Managed Care	$31.68

TERUMO TORQUE DEVICE

Facility

$199.50

Hospital Charge Code	270662664
Hospital Revenue Code	270
Min. Negotiated Rate	$29.93
Max. Negotiated Rate	$29.93
Rate for Payer: Qualcare PPO/HMO/WC	$29.93

TERUMO TORQUE DEVICE

Facility

$199.50

Hospital Charge Code	270662664
Hospital Revenue Code	270
Min. Negotiated Rate	$5.67
Max. Negotiated Rate	$99.75
Rate for Payer: Aetna Commercial	$75.81
Rate for Payer: Aetna Medicare Advantage	$59.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.87
Rate for Payer: Cigna Commercial	$99.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.87
Rate for Payer: Oxford Commercial	$39.90
Rate for Payer: Qualcare PPO/HMO/WC	$29.93
Rate for Payer: UnitedHealthcare Commercial	$39.90
Rate for Payer: UnitedHealthcare Community & State	$6.30
Rate for Payer: Wellpoint Medicaid Managed Care	$5.67

TESTER LEAKAGE GASTROSCOPE MU1

Facility

$1,120.00

Hospital Charge Code	270617457
Hospital Revenue Code	270
Min. Negotiated Rate	$31.81
Max. Negotiated Rate	$560.00
Rate for Payer: Aetna Commercial	$425.60
Rate for Payer: Aetna Medicare Advantage	$336.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$285.60
Rate for Payer: Cigna Commercial	$560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.20
Rate for Payer: Oxford Commercial	$224.00
Rate for Payer: Qualcare PPO/HMO/WC	$168.00
Rate for Payer: UnitedHealthcare Commercial	$224.00
Rate for Payer: UnitedHealthcare Community & State	$35.39
Rate for Payer: Wellpoint Medicaid Managed Care	$31.81

TESTER LEAKAGE GASTROSCOPE MU1

Facility

$1,120.00

Hospital Charge Code	270617457
Hospital Revenue Code	270
Min. Negotiated Rate	$168.00
Max. Negotiated Rate	$168.00
Rate for Payer: Qualcare PPO/HMO/WC	$168.00

TESTES PROCEDURES WITH CC/MCC

Facility

$85,299.33

Service Code	MSDRG 711
Min. Negotiated Rate	$25,972.55
Max. Negotiated Rate	$85,299.33
Rate for Payer: Aetna Commercial	$62,609.65
Rate for Payer: Aetna Medicare Advantage	$85,299.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58,734.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58,734.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27,339.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58,734.60
Rate for Payer: Cigna Commercial	$46,454.15
Rate for Payer: Cigna Medicare Advantage	$27,339.53
Rate for Payer: Clover Medicare Advantage	$25,972.55
Rate for Payer: EmblemHealth Commercial	$82,018.59
Rate for Payer: Humana Medicare Advantage	$28,159.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27,339.53
Rate for Payer: Oxford Commercial	$36,716.56
Rate for Payer: UnitedHealthcare Commercial	$49,146.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$27,339.53
Rate for Payer: Wellcare Medicare Advantage	$27,339.53

TESTES PROCEDURES WITHOUT CC/MCC

Facility

$54,208.10

Service Code	MSDRG 712
Min. Negotiated Rate	$16,505.67
Max. Negotiated Rate	$54,208.10
Rate for Payer: Aetna Commercial	$40,466.11
Rate for Payer: Aetna Medicare Advantage	$54,208.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32,968.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32,968.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17,374.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32,968.95
Rate for Payer: Cigna Commercial	$24,515.61
Rate for Payer: Cigna Medicare Advantage	$17,374.39
Rate for Payer: Clover Medicare Advantage	$16,505.67
Rate for Payer: EmblemHealth Commercial	$52,123.17
Rate for Payer: Humana Medicare Advantage	$17,895.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17,374.39
Rate for Payer: Oxford Commercial	$19,376.71
Rate for Payer: UnitedHealthcare Commercial	$25,936.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$17,374.39
Rate for Payer: Wellcare Medicare Advantage	$17,374.39

TESTICULAR

Facility

$6,700.00

Service Code	HCPCS 76870
Hospital Charge Code	2301057
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

TESTICULAR

Facility

$6,700.00

Service Code	HCPCS 76870
Hospital Charge Code	94061181
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

TESTICULAR

Facility

$6,700.00

Service Code	HCPCS 76870
Hospital Charge Code	94061181
Hospital Revenue Code	402
Min. Negotiated Rate	$85.31
Max. Negotiated Rate	$2,904.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$450.54
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$124.20
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,742.00
Rate for Payer: Oxford Commercial	$2,697.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$2,904.00
Rate for Payer: UnitedHealthcare Community & State	$211.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.88
Rate for Payer: Wellpoint Medicaid Managed Care	$190.28

TESTICULAR

Facility

$6,700.00

Service Code	HCPCS 76870
Hospital Charge Code	2301057
Hospital Revenue Code	402
Min. Negotiated Rate	$85.31
Max. Negotiated Rate	$2,904.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$450.54
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$124.20
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,742.00
Rate for Payer: Oxford Commercial	$2,697.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$2,904.00
Rate for Payer: UnitedHealthcare Community & State	$211.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.88
Rate for Payer: Wellpoint Medicaid Managed Care	$190.28

TESTOSTERONE, FREE

Facility

$455.00

Service Code	HCPCS 84402
Hospital Charge Code	38472045
Hospital Revenue Code	301
Min. Negotiated Rate	$12.92
Max. Negotiated Rate	$227.50
Rate for Payer: Aetna Commercial	$69.28
Rate for Payer: Aetna Medicare Advantage	$82.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.39
Rate for Payer: Cigna Commercial	$227.50
Rate for Payer: Cigna Medicare Advantage	$25.47
Rate for Payer: Clover Medicare Advantage	$24.20
Rate for Payer: EmblemHealth Commercial	$76.41
Rate for Payer: Humana Medicare Advantage	$26.23
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$25.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.30
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$68.25
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$20.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$25.47
Rate for Payer: Wellcare Medicare Advantage	$25.47
Rate for Payer: Wellpoint Medicaid Managed Care	$12.92

TESTOSTERONE, FREE

Facility

$455.00

Service Code	HCPCS 84402
Hospital Charge Code	38472045
Hospital Revenue Code	301
Min. Negotiated Rate	$68.25
Max. Negotiated Rate	$68.25
Rate for Payer: Qualcare PPO/HMO/WC	$68.25

TESTOSTERONE,SERUM TOTAL

Facility

$976.00

Service Code	HCPCS 84403
Hospital Charge Code	38479469
Hospital Revenue Code	301
Min. Negotiated Rate	$146.40
Max. Negotiated Rate	$146.40
Rate for Payer: Qualcare PPO/HMO/WC	$146.40

TESTOSTERONE,SERUM TOTAL

Facility

$976.00

Service Code	HCPCS 84403
Hospital Charge Code	38479469
Hospital Revenue Code	301
Min. Negotiated Rate	$20.65
Max. Negotiated Rate	$488.00
Rate for Payer: Aetna Commercial	$70.20
Rate for Payer: Aetna Medicare Advantage	$83.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.63
Rate for Payer: Cigna Commercial	$488.00
Rate for Payer: Cigna Medicare Advantage	$25.81
Rate for Payer: Clover Medicare Advantage	$24.52
Rate for Payer: EmblemHealth Commercial	$77.43
Rate for Payer: Humana Medicare Advantage	$26.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$25.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$253.76
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.40
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$20.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$25.81
Rate for Payer: Wellcare Medicare Advantage	$25.81
Rate for Payer: Wellpoint Medicaid Managed Care	$27.72

TESTOSTERONE,SERUM-TOTAL

Facility

$976.00

Service Code	HCPCS 84403
Hospital Charge Code	38472635
Hospital Revenue Code	301
Min. Negotiated Rate	$146.40
Max. Negotiated Rate	$146.40
Rate for Payer: Qualcare PPO/HMO/WC	$146.40

TESTOSTERONE,SERUM-TOTAL

Facility

$976.00

Service Code	HCPCS 84403
Hospital Charge Code	38472635
Hospital Revenue Code	301
Min. Negotiated Rate	$20.65
Max. Negotiated Rate	$488.00
Rate for Payer: Aetna Commercial	$70.20
Rate for Payer: Aetna Medicare Advantage	$83.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.63
Rate for Payer: Cigna Commercial	$488.00
Rate for Payer: Cigna Medicare Advantage	$25.81
Rate for Payer: Clover Medicare Advantage	$24.52
Rate for Payer: EmblemHealth Commercial	$77.43
Rate for Payer: Humana Medicare Advantage	$26.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$25.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$253.76
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.40
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$20.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$25.81
Rate for Payer: Wellcare Medicare Advantage	$25.81
Rate for Payer: Wellpoint Medicaid Managed Care	$27.72

Know your out-of-pocket cost for care.

All Charges