Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

VARIBAR NECTAR BARIUM SULFATE

Facility

$127.30

Service Code	NDC 32909011600
Hospital Charge Code	606390510
Hospital Revenue Code	250
Min. Negotiated Rate	$19.09
Max. Negotiated Rate	$19.09
Rate for Payer: Qualcare PPO/HMO/WC	$19.09

VARIBAR NECTAR BARIUM SULFATE

Facility

$127.30

Service Code	NDC 32909011600
Hospital Charge Code	606390510
Hospital Revenue Code	250
Min. Negotiated Rate	$3.62
Max. Negotiated Rate	$63.65
Rate for Payer: Aetna Commercial	$48.37
Rate for Payer: Aetna Medicare Advantage	$38.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.46
Rate for Payer: Cigna Commercial	$63.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.10
Rate for Payer: Oxford Commercial	$25.46
Rate for Payer: Qualcare PPO/HMO/WC	$19.09
Rate for Payer: UnitedHealthcare Commercial	$25.46
Rate for Payer: UnitedHealthcare Community & State	$4.02
Rate for Payer: Wellpoint Medicaid Managed Care	$3.62

VARIBAR THIN LIQ BARIUM SULFAT

Facility

$46.30

Service Code	NDC 32909010510
Hospital Charge Code	606390511
Hospital Revenue Code	250
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$23.15
Rate for Payer: Aetna Commercial	$17.59
Rate for Payer: Aetna Medicare Advantage	$13.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.81
Rate for Payer: Cigna Commercial	$23.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.04
Rate for Payer: Oxford Commercial	$9.26
Rate for Payer: Qualcare PPO/HMO/WC	$6.95
Rate for Payer: UnitedHealthcare Commercial	$9.26
Rate for Payer: UnitedHealthcare Community & State	$1.46
Rate for Payer: Wellpoint Medicaid Managed Care	$1.31

VARIBAR THIN LIQ BARIUM SULFAT

Facility

$46.30

Service Code	NDC 32909010510
Hospital Charge Code	606390511
Hospital Revenue Code	250
Min. Negotiated Rate	$6.95
Max. Negotiated Rate	$6.95
Rate for Payer: Qualcare PPO/HMO/WC	$6.95

VARICELLA VIRUS VACCINE - INJ

Facility

$848.02

Service Code	HCPCS 90716
Hospital Charge Code	60628312
Hospital Revenue Code	636
Min. Negotiated Rate	$24.08
Max. Negotiated Rate	$424.01
Rate for Payer: Aetna Commercial	$322.25
Rate for Payer: Aetna Medicare Advantage	$254.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.25
Rate for Payer: Cigna Commercial	$424.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.22
Rate for Payer: Qualcare PPO/HMO/WC	$127.20
Rate for Payer: UnitedHealthcare Community & State	$26.80
Rate for Payer: Wellpoint Medicaid Managed Care	$24.08

VARICELLA VIRUS VACCINE - INJ

Facility

$848.02

Service Code	HCPCS 90716
Hospital Charge Code	60628312
Hospital Revenue Code	636
Min. Negotiated Rate	$127.20
Max. Negotiated Rate	$205.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.22
Rate for Payer: Qualcare PPO/HMO/WC	$127.20

VARICELLA ZOSTER ANTIBODIE,IGG

Facility

$424.00

Service Code	HCPCS 86787
Hospital Charge Code	38476146
Hospital Revenue Code	302
Min. Negotiated Rate	$63.60
Max. Negotiated Rate	$63.60
Rate for Payer: Qualcare PPO/HMO/WC	$63.60

VARICELLA ZOSTER ANTIBODIE,IGG

Facility

$424.00

Service Code	HCPCS 86787
Hospital Charge Code	38476146
Hospital Revenue Code	302
Min. Negotiated Rate	$10.30
Max. Negotiated Rate	$212.00
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	$20.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.72
Rate for Payer: Cigna Commercial	$212.00
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	$110.24
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.60
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	$12.04

VARICELLA ZOSTER ANTIBODIE,IGM

Facility

$424.00

Service Code	HCPCS 86787
Hospital Charge Code	38476149
Hospital Revenue Code	302
Min. Negotiated Rate	$10.30
Max. Negotiated Rate	$212.00
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	$20.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.72
Rate for Payer: Cigna Commercial	$212.00
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	$110.24
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.60
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	$12.04

VARICELLA ZOSTER ANTIBODIE,IGM

Facility

$424.00

Service Code	HCPCS 86787
Hospital Charge Code	38476149
Hospital Revenue Code	302
Min. Negotiated Rate	$63.60
Max. Negotiated Rate	$63.60
Rate for Payer: Qualcare PPO/HMO/WC	$63.60

VARICELLA ZOSTER VIR,PCR

Facility

$390.00

Service Code	HCPCS 87798
Hospital Charge Code	39900305
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

VARICELLA ZOSTER VIR,PCR

Facility

$390.00

Service Code	HCPCS 87798
Hospital Charge Code	39900305
Hospital Revenue Code	306
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$95.44
Rate for Payer: Aetna Medicare Advantage	$113.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.29
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$35.09
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35.09
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	$28.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Medicare Advantage	$35.09
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

VARILIFT LX 11MMX24MM

Facility

$25,000.00

Service Code	HCPCS L8699
Hospital Charge Code	270692844
Hospital Revenue Code	278
Min. Negotiated Rate	$710.00
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$9,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00
Rate for Payer: UnitedHealthcare Community & State	$790.00
Rate for Payer: Wellpoint Medicaid Managed Care	$710.00

VARILIFT LX 11MMX24MM

Facility

$25,000.00

Service Code	HCPCS L8699
Hospital Charge Code	270692844
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

VARILIFT LX 11MMX28MM

Facility

$25,000.00

Service Code	HCPCS L8699
Hospital Charge Code	270692843
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

VARILIFT LX 11MMX28MM

Facility

$25,000.00

Service Code	HCPCS L8699
Hospital Charge Code	270692843
Hospital Revenue Code	278
Min. Negotiated Rate	$710.00
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$9,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00
Rate for Payer: UnitedHealthcare Community & State	$790.00
Rate for Payer: Wellpoint Medicaid Managed Care	$710.00

VARILIFT LX HT 10MM 28MM LONG

Facility

$25,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692794
Hospital Revenue Code	278
Min. Negotiated Rate	$710.00
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$9,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00
Rate for Payer: UnitedHealthcare Community & State	$790.00
Rate for Payer: Wellpoint Medicaid Managed Care	$710.00

VARILIFT LX HT 10MM 28MM LONG

Facility

$25,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692794
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

VARISYNC ALIF 28X40X14MM 15DEG

Facility

$32,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705504
Hospital Revenue Code	278
Min. Negotiated Rate	$923.00
Max. Negotiated Rate	$16,250.00
Rate for Payer: Aetna Commercial	$12,350.00
Rate for Payer: Aetna Medicare Advantage	$9,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,287.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,287.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,287.50
Rate for Payer: Cigna Commercial	$16,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,865.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,875.00
Rate for Payer: UnitedHealthcare Community & State	$1,027.00
Rate for Payer: Wellpoint Medicaid Managed Care	$923.00

VARISYNC ALIF 28X40X14MM 15DEG

Facility

$32,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705504
Hospital Revenue Code	278
Min. Negotiated Rate	$4,875.00
Max. Negotiated Rate	$7,865.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,865.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,875.00

VARISYNC ALIF F3D-Z. CAGE 24X3

Facility

$35,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704099
Hospital Revenue Code	278
Min. Negotiated Rate	$5,250.00
Max. Negotiated Rate	$8,470.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,470.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,250.00

VARISYNC ALIF F3D-Z. CAGE 24X3

Facility

$35,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704099
Hospital Revenue Code	278
Min. Negotiated Rate	$994.00
Max. Negotiated Rate	$17,500.00
Rate for Payer: Aetna Commercial	$13,300.00
Rate for Payer: Aetna Medicare Advantage	$10,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,925.00
Rate for Payer: Cigna Commercial	$17,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,470.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,250.00
Rate for Payer: UnitedHealthcare Community & State	$1,106.00
Rate for Payer: Wellpoint Medicaid Managed Care	$994.00

VARITHENA 180MG/18ML INJ FOAM

Facility

$23,416.50

Service Code	NDC 60635011801
Hospital Charge Code	6063943398
Hospital Revenue Code	250
Min. Negotiated Rate	$665.03
Max. Negotiated Rate	$11,708.25
Rate for Payer: Aetna Commercial	$8,898.27
Rate for Payer: Aetna Medicare Advantage	$7,024.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,971.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,971.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,971.21
Rate for Payer: Cigna Commercial	$11,708.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,088.29
Rate for Payer: Oxford Commercial	$4,683.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,512.47
Rate for Payer: UnitedHealthcare Commercial	$4,683.30
Rate for Payer: UnitedHealthcare Community & State	$739.96
Rate for Payer: Wellpoint Medicaid Managed Care	$665.03

VARITHENA 180MG/18ML INJ FOAM

Facility

$23,416.50

Service Code	NDC 60635011801
Hospital Charge Code	6063943398
Hospital Revenue Code	250
Min. Negotiated Rate	$3,512.47
Max. Negotiated Rate	$3,512.47
Rate for Payer: Qualcare PPO/HMO/WC	$3,512.47

VAS ACCUCHECK

Facility

$56.00

Service Code	HCPCS 82948
Hospital Charge Code	7411762
Hospital Revenue Code	301
Min. Negotiated Rate	$1.59
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	$28.00
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	$14.56
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.40
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	$1.59

Know your out-of-pocket cost for care.

All Charges