Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

THIN PREP TISSUE WITH HPV

Facility

$241.20

Hospital Charge Code	39900399
Hospital Revenue Code	306
Min. Negotiated Rate	$36.18
Max. Negotiated Rate	$36.18
Rate for Payer: Qualcare PPO/HMO/WC	$36.18

THIN PREP TISSUE WITH HPV

Facility

$241.20

Hospital Charge Code	39900399
Hospital Revenue Code	306
Min. Negotiated Rate	$6.85
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$91.66
Rate for Payer: Aetna Medicare Advantage	$72.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.51
Rate for Payer: Cigna Commercial	$120.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.71
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.18
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$7.62
Rate for Payer: Wellpoint Medicaid Managed Care	$6.85

THIOCYANATE, SERUM

Facility

$259.00

Service Code	HCPCS 84430
Hospital Charge Code	38472034
Hospital Revenue Code	301
Min. Negotiated Rate	$38.85
Max. Negotiated Rate	$38.85
Rate for Payer: Qualcare PPO/HMO/WC	$38.85

THIOCYANATE, SERUM

Facility

$259.00

Service Code	HCPCS 84430
Hospital Charge Code	38472034
Hospital Revenue Code	301
Min. Negotiated Rate	$5.94
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$31.63
Rate for Payer: Aetna Medicare Advantage	$37.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.19
Rate for Payer: Cigna Commercial	$129.50
Rate for Payer: Cigna Medicare Advantage	$11.63
Rate for Payer: Clover Medicare Advantage	$11.05
Rate for Payer: EmblemHealth Commercial	$34.89
Rate for Payer: Humana Medicare Advantage	$11.98
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.34
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.85
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.63
Rate for Payer: Wellcare Medicare Advantage	$11.63
Rate for Payer: Wellpoint Medicaid Managed Care	$7.36

THIOCYANATE,URINE

Facility

$259.00

Service Code	HCPCS 84430
Hospital Charge Code	38472633
Hospital Revenue Code	301
Min. Negotiated Rate	$38.85
Max. Negotiated Rate	$38.85
Rate for Payer: Qualcare PPO/HMO/WC	$38.85

THIOCYANATE,URINE

Facility

$259.00

Service Code	HCPCS 84430
Hospital Charge Code	38472633
Hospital Revenue Code	301
Min. Negotiated Rate	$5.94
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$31.63
Rate for Payer: Aetna Medicare Advantage	$37.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.19
Rate for Payer: Cigna Commercial	$129.50
Rate for Payer: Cigna Medicare Advantage	$11.63
Rate for Payer: Clover Medicare Advantage	$11.05
Rate for Payer: EmblemHealth Commercial	$34.89
Rate for Payer: Humana Medicare Advantage	$11.98
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.34
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.85
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.63
Rate for Payer: Wellcare Medicare Advantage	$11.63
Rate for Payer: Wellpoint Medicaid Managed Care	$7.36

THIOPURINE METABOLITES

Facility

$390.00

Service Code	HCPCS 83789
Hospital Charge Code	397080007
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

THIOPURINE METABOLITES

Facility

$390.00

Service Code	HCPCS 83789
Hospital Charge Code	397080007
Hospital Revenue Code	306
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$65.58
Rate for Payer: Aetna Medicare Advantage	$78.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.46
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$24.11
Rate for Payer: Clover Medicare Advantage	$22.90
Rate for Payer: EmblemHealth Commercial	$72.33
Rate for Payer: Humana Medicare Advantage	$24.83
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24.11
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	$19.29
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.11
Rate for Payer: Wellcare Medicare Advantage	$24.11
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

THIOPURINE METABOLOTES

Facility

$376.33

Hospital Charge Code	397073690
Hospital Revenue Code	306
Min. Negotiated Rate	$10.69
Max. Negotiated Rate	$188.16
Rate for Payer: Aetna Commercial	$143.01
Rate for Payer: Aetna Medicare Advantage	$112.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.96
Rate for Payer: Cigna Commercial	$188.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.85
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.45
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$11.89
Rate for Payer: Wellpoint Medicaid Managed Care	$10.69

THIOPURINE METABOLOTES

Facility

$376.33

Hospital Charge Code	397073690
Hospital Revenue Code	306
Min. Negotiated Rate	$56.45
Max. Negotiated Rate	$56.45
Rate for Payer: Qualcare PPO/HMO/WC	$56.45

THIORIDAZINE HYDROCHLORIDE 10 MG TAB

Facility

$4.02

Service Code	NDC 378061201
Hospital Charge Code	6063943252
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

THIORIDAZINE HYDROCHLORIDE 10 MG TAB

Facility

$4.02

Service Code	NDC 378061201
Hospital Charge Code	6063943252
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.01
Rate for Payer: Aetna Commercial	$1.53
Rate for Payer: Aetna Medicare Advantage	$1.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.03
Rate for Payer: Cigna Commercial	$2.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.05
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

THIORIDAZINE HYDROCHLORIDE 25 MG TAB

Facility

$5.63

Service Code	NDC 378061401
Hospital Charge Code	6063943253
Hospital Revenue Code	250
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$0.84
Rate for Payer: Qualcare PPO/HMO/WC	$0.84

THIORIDAZINE HYDROCHLORIDE 25 MG TAB

Facility

$5.63

Service Code	NDC 378061401
Hospital Charge Code	6063943253
Hospital Revenue Code	250
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$2.81
Rate for Payer: Aetna Commercial	$2.14
Rate for Payer: Aetna Medicare Advantage	$1.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.44
Rate for Payer: Cigna Commercial	$2.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.46
Rate for Payer: Oxford Commercial	$1.13
Rate for Payer: Qualcare PPO/HMO/WC	$0.84
Rate for Payer: UnitedHealthcare Commercial	$1.13
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

THIOTHIXENE 10 MG CAP

Facility

$34.24

Service Code	NDC 51079058920
Hospital Charge Code	6063943254
Hospital Revenue Code	250
Min. Negotiated Rate	$5.14
Max. Negotiated Rate	$5.14
Rate for Payer: Qualcare PPO/HMO/WC	$5.14

THIOTHIXENE 10 MG CAP

Facility

$34.24

Service Code	NDC 51079058920
Hospital Charge Code	6063943254
Hospital Revenue Code	250
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$17.12
Rate for Payer: Aetna Commercial	$13.01
Rate for Payer: Aetna Medicare Advantage	$10.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.73
Rate for Payer: Cigna Commercial	$17.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.90
Rate for Payer: Oxford Commercial	$6.85
Rate for Payer: Qualcare PPO/HMO/WC	$5.14
Rate for Payer: UnitedHealthcare Commercial	$6.85
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$0.97

THIOTHIXENE 1 MG CAP

Facility

$4.00

Service Code	NDC 781222601
Hospital Charge Code	60627826
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

THIOTHIXENE 1 MG CAP

Facility

$4.00

Service Code	NDC 781222601
Hospital Charge Code	60627826
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

THIOTHIXENE 2 MG CAP

Facility

$16.01

Service Code	NDC 51079058720
Hospital Charge Code	60627827
Hospital Revenue Code	250
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$2.40

THIOTHIXENE 2 MG CAP

Facility

$16.01

Service Code	NDC 51079058720
Hospital Charge Code	60627827
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$8.01
Rate for Payer: Aetna Commercial	$6.08
Rate for Payer: Aetna Medicare Advantage	$4.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.08
Rate for Payer: Cigna Commercial	$8.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.16
Rate for Payer: Oxford Commercial	$3.20
Rate for Payer: Qualcare PPO/HMO/WC	$2.40
Rate for Payer: UnitedHealthcare Commercial	$3.20
Rate for Payer: UnitedHealthcare Community & State	$0.51
Rate for Payer: Wellpoint Medicaid Managed Care	$0.45

THIOTHIXENE 5 MG CAP

Facility

$15.95

Service Code	NDC 378300501
Hospital Charge Code	6063943255
Hospital Revenue Code	250
Min. Negotiated Rate	$2.39
Max. Negotiated Rate	$2.39
Rate for Payer: Qualcare PPO/HMO/WC	$2.39

THIOTHIXENE 5 MG CAP

Facility

$15.95

Service Code	NDC 378300501
Hospital Charge Code	6063943255
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$7.97
Rate for Payer: Aetna Commercial	$6.06
Rate for Payer: Aetna Medicare Advantage	$4.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.07
Rate for Payer: Cigna Commercial	$7.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.15
Rate for Payer: Oxford Commercial	$3.19
Rate for Payer: Qualcare PPO/HMO/WC	$2.39
Rate for Payer: UnitedHealthcare Commercial	$3.19
Rate for Payer: UnitedHealthcare Community & State	$0.50
Rate for Payer: Wellpoint Medicaid Managed Care	$0.45

THIOTHIXENE (NAVANE)

Facility

$324.00

Service Code	HCPCS 82542
Hospital Charge Code	38473123
Hospital Revenue Code	301
Min. Negotiated Rate	$9.20
Max. Negotiated Rate	$162.00
Rate for Payer: Aetna Commercial	$65.52
Rate for Payer: Aetna Medicare Advantage	$78.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.39
Rate for Payer: Cigna Commercial	$162.00
Rate for Payer: Cigna Medicare Advantage	$24.09
Rate for Payer: Clover Medicare Advantage	$22.89
Rate for Payer: EmblemHealth Commercial	$72.27
Rate for Payer: Humana Medicare Advantage	$24.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.24
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.60
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$19.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.09
Rate for Payer: Wellcare Medicare Advantage	$24.09
Rate for Payer: Wellpoint Medicaid Managed Care	$9.20

THIOTHIXENE (NAVANE)

Facility

$324.00

Service Code	HCPCS 82542
Hospital Charge Code	38473123
Hospital Revenue Code	301
Min. Negotiated Rate	$48.60
Max. Negotiated Rate	$48.60
Rate for Payer: Qualcare PPO/HMO/WC	$48.60

THNA TI CANNULATED 235 MM

Facility

$9,653.15

Service Code	HCPCS C1713
Hospital Charge Code	270688448
Hospital Revenue Code	278
Min. Negotiated Rate	$1,447.97
Max. Negotiated Rate	$2,336.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,930.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,336.06
Rate for Payer: Qualcare PPO/HMO/WC	$1,447.97

Know your out-of-pocket cost for care.

All Charges