Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

VACCINE ADMIN PNEUMO

Facility

$20.38

Service Code	HCPCS 90471
Hospital Charge Code	911030
Hospital Revenue Code	771
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$310.30
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$310.30
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.30
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.06
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$0.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$0.58

VACCINE ADMIN PNEUMO

Facility

$41.00

Service Code	HCPCS 90471
Hospital Charge Code	84206165
Hospital Revenue Code	771
Min. Negotiated Rate	$6.15
Max. Negotiated Rate	$6.15
Rate for Payer: Qualcare PPO/HMO/WC	$6.15

VACCINE ADMIN PNEUMO

Facility

$20.38

Service Code	HCPCS 90471
Hospital Charge Code	260121
Hospital Revenue Code	771
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$3.06
Rate for Payer: Qualcare PPO/HMO/WC	$3.06

VACCINE ADMIN PNEUMO

Facility

$20.38

Service Code	HCPCS 90471
Hospital Charge Code	100142
Hospital Revenue Code	771
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$3.06
Rate for Payer: Qualcare PPO/HMO/WC	$3.06

VACCINE ADMIN PNEUMO

Facility

$20.38

Service Code	HCPCS 90471
Hospital Charge Code	83652521
Hospital Revenue Code	771
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$3.06
Rate for Payer: Qualcare PPO/HMO/WC	$3.06

VACCINE ADMIN PNEUMO

Facility

$41.00

Service Code	HCPCS 90471
Hospital Charge Code	84206165
Hospital Revenue Code	771
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$310.30
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$310.30
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.66
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.15
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$1.16

VACCINE ADMIN PNEUMO

Facility

$156.00

Service Code	HCPCS 90471
Hospital Charge Code	3408045
Hospital Revenue Code	771
Min. Negotiated Rate	$4.43
Max. Negotiated Rate	$310.30
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$310.30
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.56
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.40
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$4.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$4.43

VACCINE ADMIN PNEUMO

Facility

$20.38

Service Code	HCPCS 90471
Hospital Charge Code	100142
Hospital Revenue Code	771
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$310.30
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$310.30
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.30
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.06
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$0.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$0.58

VACCUM QUICK CONNECT 18 NPT MA

Facility

$172.50

Hospital Charge Code	270664117
Hospital Revenue Code	270
Min. Negotiated Rate	$25.88
Max. Negotiated Rate	$25.88
Rate for Payer: Qualcare PPO/HMO/WC	$25.88

VACCUM QUICK CONNECT 18 NPT MA

Facility

$172.50

Hospital Charge Code	270664117
Hospital Revenue Code	270
Min. Negotiated Rate	$4.90
Max. Negotiated Rate	$86.25
Rate for Payer: Aetna Commercial	$65.55
Rate for Payer: Aetna Medicare Advantage	$51.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.99
Rate for Payer: Cigna Commercial	$86.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.85
Rate for Payer: Oxford Commercial	$34.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.88
Rate for Payer: UnitedHealthcare Commercial	$34.50
Rate for Payer: UnitedHealthcare Community & State	$5.45
Rate for Payer: Wellpoint Medicaid Managed Care	$4.90

VAC PULSA PLUS FOR SPRING KIT

Facility

$5,735.00

Hospital Charge Code	270654993
Hospital Revenue Code	270
Min. Negotiated Rate	$860.25
Max. Negotiated Rate	$860.25
Rate for Payer: Qualcare PPO/HMO/WC	$860.25

VAC PULSA PLUS FOR SPRING KIT

Facility

$5,735.00

Hospital Charge Code	270654993
Hospital Revenue Code	270
Min. Negotiated Rate	$162.87
Max. Negotiated Rate	$2,867.50
Rate for Payer: Aetna Commercial	$2,179.30
Rate for Payer: Aetna Medicare Advantage	$1,720.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,462.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,462.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,462.42
Rate for Payer: Cigna Commercial	$2,867.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,491.10
Rate for Payer: Oxford Commercial	$1,147.00
Rate for Payer: Qualcare PPO/HMO/WC	$860.25
Rate for Payer: UnitedHealthcare Commercial	$1,147.00
Rate for Payer: UnitedHealthcare Community & State	$181.23
Rate for Payer: Wellpoint Medicaid Managed Care	$162.87

VACURETTE CANNULAS CURVED 12MM

Facility

$225.00

Hospital Charge Code	270655605
Hospital Revenue Code	270
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

VACURETTE CANNULAS CURVED 12MM

Facility

$225.00

Hospital Charge Code	270655605
Hospital Revenue Code	270
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.50
Rate for Payer: Oxford Commercial	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$45.00
Rate for Payer: UnitedHealthcare Community & State	$7.11
Rate for Payer: Wellpoint Medicaid Managed Care	$6.39

VACURETTE CANNULAS F-TIP 8MM

Facility

$221.45

Hospital Charge Code	270655607
Hospital Revenue Code	270
Min. Negotiated Rate	$6.29
Max. Negotiated Rate	$110.72
Rate for Payer: Aetna Commercial	$84.15
Rate for Payer: Aetna Medicare Advantage	$66.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.47
Rate for Payer: Cigna Commercial	$110.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.58
Rate for Payer: Oxford Commercial	$44.29
Rate for Payer: Qualcare PPO/HMO/WC	$33.22
Rate for Payer: UnitedHealthcare Commercial	$44.29
Rate for Payer: UnitedHealthcare Community & State	$7.00
Rate for Payer: Wellpoint Medicaid Managed Care	$6.29

VACURETTE CANNULAS F-TIP 8MM

Facility

$221.45

Hospital Charge Code	270655607
Hospital Revenue Code	270
Min. Negotiated Rate	$33.22
Max. Negotiated Rate	$33.22
Rate for Payer: Qualcare PPO/HMO/WC	$33.22

VACURETTE CRVD TIP 10mm

Facility

$10.42

Hospital Charge Code	270649246
Hospital Revenue Code	272
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$5.21
Rate for Payer: Aetna Commercial	$3.96
Rate for Payer: Aetna Medicare Advantage	$3.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.66
Rate for Payer: Cigna Commercial	$5.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.71
Rate for Payer: Oxford Commercial	$2.08
Rate for Payer: Qualcare PPO/HMO/WC	$1.56
Rate for Payer: UnitedHealthcare Commercial	$2.08
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

VACURETTE CRVD TIP 10mm

Facility

$10.42

Hospital Charge Code	270649246
Hospital Revenue Code	272
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$1.56
Rate for Payer: Qualcare PPO/HMO/WC	$1.56

VACURETTE CRVD TIP 11mm

Facility

$25.00

Hospital Charge Code	270650483
Hospital Revenue Code	272
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

VACURETTE CRVD TIP 11mm

Facility

$25.00

Hospital Charge Code	270650483
Hospital Revenue Code	272
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$12.50
Rate for Payer: Aetna Commercial	$9.50
Rate for Payer: Aetna Medicare Advantage	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.38
Rate for Payer: Cigna Commercial	$12.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.50
Rate for Payer: Oxford Commercial	$5.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$5.00
Rate for Payer: UnitedHealthcare Community & State	$0.79
Rate for Payer: Wellpoint Medicaid Managed Care	$0.71

VACURETTE CRVD TIP 7mm

Facility

$23.08

Hospital Charge Code	270649248
Hospital Revenue Code	272
Min. Negotiated Rate	$0.66
Max. Negotiated Rate	$11.54
Rate for Payer: Aetna Commercial	$8.77
Rate for Payer: Aetna Medicare Advantage	$6.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.89
Rate for Payer: Cigna Commercial	$11.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.00
Rate for Payer: Oxford Commercial	$4.62
Rate for Payer: Qualcare PPO/HMO/WC	$3.46
Rate for Payer: UnitedHealthcare Commercial	$4.62
Rate for Payer: UnitedHealthcare Community & State	$0.73
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

VACURETTE CRVD TIP 7mm

Facility

$23.08

Hospital Charge Code	270649248
Hospital Revenue Code	272
Min. Negotiated Rate	$3.46
Max. Negotiated Rate	$3.46
Rate for Payer: Qualcare PPO/HMO/WC	$3.46

VACURETTE CRVD TIP 8mm

Facility

$21.83

Hospital Charge Code	270649249
Hospital Revenue Code	272
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$10.91
Rate for Payer: Aetna Commercial	$8.30
Rate for Payer: Aetna Medicare Advantage	$6.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.57
Rate for Payer: Cigna Commercial	$10.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.68
Rate for Payer: Oxford Commercial	$4.37
Rate for Payer: Qualcare PPO/HMO/WC	$3.27
Rate for Payer: UnitedHealthcare Commercial	$4.37
Rate for Payer: UnitedHealthcare Community & State	$0.69
Rate for Payer: Wellpoint Medicaid Managed Care	$0.62

VACURETTE CRVD TIP 8mm

Facility

$21.83

Hospital Charge Code	270649249
Hospital Revenue Code	272
Min. Negotiated Rate	$3.27
Max. Negotiated Rate	$3.27
Rate for Payer: Qualcare PPO/HMO/WC	$3.27

VACURETTE CRVD TIP 9mm

Facility

$6.15

Hospital Charge Code	270649250
Hospital Revenue Code	272
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$0.92
Rate for Payer: Qualcare PPO/HMO/WC	$0.92

Know your out-of-pocket cost for care.

All Charges