Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

VINYL CONNECTING TUBE 30CM

Facility

$12.52

Hospital Charge Code	270653764N
Hospital Revenue Code	272
Min. Negotiated Rate	$1.88
Max. Negotiated Rate	$1.88
Rate for Payer: Qualcare PPO/HMO/WC	$1.88

VIPER WIRE ADVANCE GUIDE FIRM

Facility

$850.00

Service Code	HCPCS C1769
Hospital Charge Code	270644368
Hospital Revenue Code	278
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$205.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

VIPER WIRE ADVANCE GUIDE FIRM

Facility

$950.00

Service Code	HCPCS C1769
Hospital Charge Code	270644368N
Hospital Revenue Code	278
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$229.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$142.50

VIPER WIRE ADVANCE GUIDE FIRM

Facility

$850.00

Service Code	HCPCS C1769
Hospital Charge Code	270644368S
Hospital Revenue Code	278
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$205.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

VIPER WIRE ADVANCE GUIDE FIRM

Facility

$850.00

Service Code	HCPCS C1769
Hospital Charge Code	270644368S
Hospital Revenue Code	278
Min. Negotiated Rate	$24.14
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$323.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Community & State	$26.86
Rate for Payer: Wellpoint Medicaid Managed Care	$24.14

VIPER WIRE ADVANCE GUIDE FIRM

Facility

$950.00

Service Code	HCPCS C1769
Hospital Charge Code	270644368N
Hospital Revenue Code	278
Min. Negotiated Rate	$26.98
Max. Negotiated Rate	$475.00
Rate for Payer: Aetna Commercial	$361.00
Rate for Payer: Aetna Medicare Advantage	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.25
Rate for Payer: Cigna Commercial	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$142.50
Rate for Payer: UnitedHealthcare Community & State	$30.02
Rate for Payer: Wellpoint Medicaid Managed Care	$26.98

VIPER WIRE ADVANCE GUIDE FIRM

Facility

$850.00

Service Code	HCPCS C1769
Hospital Charge Code	270644368
Hospital Revenue Code	278
Min. Negotiated Rate	$24.14
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$323.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Community & State	$26.86
Rate for Payer: Wellpoint Medicaid Managed Care	$24.14

VIRACEPT 625MG TAB

Facility

$65.26

Service Code	NDC 63010002770
Hospital Charge Code	60635517
Hospital Revenue Code	250
Min. Negotiated Rate	$9.79
Max. Negotiated Rate	$9.79
Rate for Payer: Qualcare PPO/HMO/WC	$9.79

VIRACEPT 625MG TAB

Facility

$65.26

Service Code	NDC 63010002770
Hospital Charge Code	60635517
Hospital Revenue Code	250
Min. Negotiated Rate	$1.85
Max. Negotiated Rate	$32.63
Rate for Payer: Aetna Commercial	$24.80
Rate for Payer: Aetna Medicare Advantage	$19.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.64
Rate for Payer: Cigna Commercial	$32.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.97
Rate for Payer: Oxford Commercial	$13.05
Rate for Payer: Qualcare PPO/HMO/WC	$9.79
Rate for Payer: UnitedHealthcare Commercial	$13.05
Rate for Payer: UnitedHealthcare Community & State	$2.06
Rate for Payer: Wellpoint Medicaid Managed Care	$1.85

VIRAL CULTURE

Facility

$489.00

Service Code	HCPCS 87250
Hospital Charge Code	38475053
Hospital Revenue Code	309
Min. Negotiated Rate	$73.35
Max. Negotiated Rate	$73.35
Rate for Payer: Qualcare PPO/HMO/WC	$73.35

VIRAL CULTURE

Facility

$489.00

Service Code	HCPCS 87250
Hospital Charge Code	38475053
Hospital Revenue Code	309
Min. Negotiated Rate	$13.89
Max. Negotiated Rate	$244.50
Rate for Payer: Aetna Commercial	$53.20
Rate for Payer: Aetna Medicare Advantage	$63.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.95
Rate for Payer: Cigna Commercial	$244.50
Rate for Payer: Cigna Medicare Advantage	$19.56
Rate for Payer: Clover Medicare Advantage	$18.58
Rate for Payer: EmblemHealth Commercial	$58.68
Rate for Payer: Humana Medicare Advantage	$20.15
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.14
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$73.35
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$15.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.56
Rate for Payer: Wellcare Medicare Advantage	$19.56
Rate for Payer: Wellpoint Medicaid Managed Care	$13.89

VIRAL ILLNESS

Facility

$5,052.99

Service Code	APR-DRG 7231
Min. Negotiated Rate	$4,953.91
Max. Negotiated Rate	$5,052.99
Rate for Payer: UnitedHealthcare Community & State	$4,953.91
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,052.99
Rate for Payer: Wellpoint Medicaid Managed Care	$4,953.91

VIRAL ILLNESS

Facility

$10,757.58

Service Code	APR-DRG 7233
Min. Negotiated Rate	$10,546.65
Max. Negotiated Rate	$10,757.58
Rate for Payer: UnitedHealthcare Community & State	$10,546.65
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,757.58
Rate for Payer: Wellpoint Medicaid Managed Care	$10,546.65

VIRAL ILLNESS

Facility

$7,033.11

Service Code	APR-DRG 7232
Min. Negotiated Rate	$6,895.21
Max. Negotiated Rate	$7,033.11
Rate for Payer: UnitedHealthcare Community & State	$6,895.21
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,033.11
Rate for Payer: Wellpoint Medicaid Managed Care	$6,895.21

VIRAL ILLNESS

Facility

$22,415.36

Service Code	APR-DRG 7234
Min. Negotiated Rate	$21,975.84
Max. Negotiated Rate	$22,415.36
Rate for Payer: UnitedHealthcare Community & State	$21,975.84
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$22,415.36
Rate for Payer: Wellpoint Medicaid Managed Care	$21,975.84

VIRAL ILLNESS WITH MCC

Facility

$66,801.23

Service Code	MSDRG 865
Min. Negotiated Rate	$20,340.12
Max. Negotiated Rate	$66,801.23
Rate for Payer: Aetna Commercial	$49,435.09
Rate for Payer: Aetna Medicare Advantage	$66,801.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45,436.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45,436.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,410.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45,436.20
Rate for Payer: Cigna Commercial	$33,401.60
Rate for Payer: Cigna Medicare Advantage	$21,410.65
Rate for Payer: Clover Medicare Advantage	$20,340.12
Rate for Payer: EmblemHealth Commercial	$64,231.95
Rate for Payer: Humana Medicare Advantage	$22,052.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21,410.65
Rate for Payer: Oxford Commercial	$26,400.05
Rate for Payer: UnitedHealthcare Commercial	$35,337.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$21,410.65
Rate for Payer: Wellcare Medicare Advantage	$21,410.65

VIRAL ILLNESS WITHOUT MCC

Facility

$46,938.43

Service Code	MSDRG 866
Min. Negotiated Rate	$6,546.00
Max. Negotiated Rate	$46,938.43
Rate for Payer: Aetna Commercial	$35,288.59
Rate for Payer: Aetna Medicare Advantage	$46,938.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,488.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,488.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,044.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,546.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25,488.60
Rate for Payer: Cigna Commercial	$19,385.99
Rate for Payer: Cigna Medicare Advantage	$15,044.37
Rate for Payer: Clover Medicare Advantage	$14,292.15
Rate for Payer: EmblemHealth Commercial	$45,133.11
Rate for Payer: Humana Medicare Advantage	$15,495.70
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,044.37
Rate for Payer: Oxford Commercial	$15,322.35
Rate for Payer: UnitedHealthcare Commercial	$20,509.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,044.37
Rate for Payer: Wellcare Medicare Advantage	$15,044.37

VIRAL MENINGITIS

Facility

$30,566.33

Service Code	APR-DRG 0514
Min. Negotiated Rate	$29,966.99
Max. Negotiated Rate	$30,566.33
Rate for Payer: UnitedHealthcare Community & State	$29,966.99
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$30,566.33
Rate for Payer: Wellpoint Medicaid Managed Care	$29,966.99

VIRAL MENINGITIS

Facility

$6,658.14

Service Code	APR-DRG 0511
Min. Negotiated Rate	$6,527.59
Max. Negotiated Rate	$6,658.14
Rate for Payer: UnitedHealthcare Community & State	$6,527.59
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,658.14
Rate for Payer: Wellpoint Medicaid Managed Care	$6,527.59

VIRAL MENINGITIS

Facility

$9,888.25

Service Code	APR-DRG 0512
Min. Negotiated Rate	$9,694.36
Max. Negotiated Rate	$9,888.25
Rate for Payer: UnitedHealthcare Community & State	$9,694.36
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,888.25
Rate for Payer: Wellpoint Medicaid Managed Care	$9,694.36

VIRAL MENINGITIS

Facility

$16,717.76

Service Code	APR-DRG 0513
Min. Negotiated Rate	$16,389.96
Max. Negotiated Rate	$16,717.76
Rate for Payer: UnitedHealthcare Community & State	$16,389.96
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$16,717.76
Rate for Payer: Wellpoint Medicaid Managed Care	$16,389.96

VIRAL MENINGITIS WITH CC/MCC

Facility

$80,045.28

Service Code	MSDRG 075
Min. Negotiated Rate	$24,372.76
Max. Negotiated Rate	$80,045.28
Rate for Payer: Aetna Medicare Advantage	$80,045.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52,916.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52,916.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25,655.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52,916.55
Rate for Payer: Cigna Commercial	$42,746.83
Rate for Payer: Cigna Medicare Advantage	$25,655.54
Rate for Payer: Clover Medicare Advantage	$24,372.76
Rate for Payer: EmblemHealth Commercial	$76,966.62
Rate for Payer: Humana Medicare Advantage	$26,425.21
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$25,655.54
Rate for Payer: Oxford Commercial	$33,786.35
Rate for Payer: UnitedHealthcare Commercial	$45,224.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$25,655.54
Rate for Payer: Wellcare Medicare Advantage	$25,655.54

VIRAL MENINGITIS WITHOUT CC/MCC

Facility

$45,535.68

Service Code	MSDRG 076
Min. Negotiated Rate	$13,193.86
Max. Negotiated Rate	$45,535.68
Rate for Payer: Aetna Medicare Advantage	$45,535.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,488.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,488.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14,594.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25,488.60
Rate for Payer: Cigna Commercial	$16,693.00
Rate for Payer: Cigna Medicare Advantage	$14,594.77
Rate for Payer: Clover Medicare Advantage	$13,865.03
Rate for Payer: EmblemHealth Commercial	$43,784.31
Rate for Payer: Humana Medicare Advantage	$15,032.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14,594.77
Rate for Payer: Oxford Commercial	$13,193.86
Rate for Payer: UnitedHealthcare Commercial	$17,660.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$14,594.77
Rate for Payer: Wellcare Medicare Advantage	$14,594.77

VIRAMUNE 200MG TAB

Facility

$72.63

Service Code	NDC 51991033106
Hospital Charge Code	60635185
Hospital Revenue Code	250
Min. Negotiated Rate	$10.89
Max. Negotiated Rate	$10.89
Rate for Payer: Qualcare PPO/HMO/WC	$10.89

VIRAMUNE 200MG TAB

Facility

$72.63

Service Code	NDC 51991033106
Hospital Charge Code	60635185
Hospital Revenue Code	250
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$36.31
Rate for Payer: Aetna Commercial	$27.60
Rate for Payer: Aetna Medicare Advantage	$21.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.52
Rate for Payer: Cigna Commercial	$36.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.88
Rate for Payer: Oxford Commercial	$14.53
Rate for Payer: Qualcare PPO/HMO/WC	$10.89
Rate for Payer: UnitedHealthcare Commercial	$14.53
Rate for Payer: UnitedHealthcare Community & State	$2.30
Rate for Payer: Wellpoint Medicaid Managed Care	$2.06

Know your out-of-pocket cost for care.

All Charges