Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

Voice Goal Status CI

Facility

$0.01

Service Code	HCPCS G9172GNCI
Hospital Charge Code	74204085CI
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Voice Goal Status CJ

Facility

$0.01

Service Code	HCPCS G9172GNCJ
Hospital Charge Code	74204085CJ
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Voice Goal Status CJ

Facility

$0.01

Service Code	HCPCS G9172GNCJ
Hospital Charge Code	74204085CJ
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

VOICE GOAL STATUS CK

Facility

$0.01

Service Code	HCPCS G9172GNCK
Hospital Charge Code	74204085CK
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

VOICE GOAL STATUS CK

Facility

$0.01

Service Code	HCPCS G9172GNCK
Hospital Charge Code	74204085CK
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Voice Goal Status CL

Facility

$0.01

Service Code	HCPCS G9172GNCL
Hospital Charge Code	74204085CL
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

Voice Goal Status CL

Facility

$0.01

Service Code	HCPCS G9172GNCL
Hospital Charge Code	74204085CL
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

VOICE GOAL STATUS CM

Facility

$0.01

Service Code	HCPCS G9172GNCM
Hospital Charge Code	74204085CM
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

VOICE GOAL STATUS CM

Facility

$0.01

Service Code	HCPCS G9172GNCM
Hospital Charge Code	74204085CM
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

VOICE GOAL STATUS CN

Facility

$0.01

Service Code	HCPCS G9172GNCN
Hospital Charge Code	74204085CN
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

VOICE GOAL STATUS CN

Facility

$0.01

Service Code	HCPCS G9172GNCN
Hospital Charge Code	74204085CN
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

VOLAR DISTAL RADIUS PLATE 3 HO

Facility

$4,093.75

Service Code	HCPCS C1713
Hospital Charge Code	270704872
Hospital Revenue Code	278
Min. Negotiated Rate	$116.26
Max. Negotiated Rate	$2,046.88
Rate for Payer: Aetna Commercial	$1,555.62
Rate for Payer: Aetna Medicare Advantage	$1,228.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,043.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,043.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$818.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,043.91
Rate for Payer: Cigna Commercial	$2,046.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$990.69
Rate for Payer: Qualcare PPO/HMO/WC	$614.06
Rate for Payer: UnitedHealthcare Community & State	$129.36
Rate for Payer: Wellpoint Medicaid Managed Care	$116.26

VOLAR DISTAL RADIUS PLATE 3 HO

Facility

$4,093.75

Service Code	HCPCS C1713
Hospital Charge Code	270704872
Hospital Revenue Code	278
Min. Negotiated Rate	$614.06
Max. Negotiated Rate	$990.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$818.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$990.69
Rate for Payer: Qualcare PPO/HMO/WC	$614.06

VOLATILES

Facility

$213.65

Service Code	HCPCS 80320
Hospital Charge Code	3035089C
Hospital Revenue Code	301
Min. Negotiated Rate	$32.05
Max. Negotiated Rate	$32.05
Rate for Payer: Qualcare PPO/HMO/WC	$32.05

VOLATILES

Facility

$213.65

Service Code	HCPCS 80320
Hospital Charge Code	3035089C
Hospital Revenue Code	301
Min. Negotiated Rate	$6.07
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$81.19
Rate for Payer: Aetna Medicare Advantage	$64.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.48
Rate for Payer: Cigna Commercial	$106.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.55
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.05
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$16.66
Rate for Payer: Wellpoint Medicaid Managed Care	$6.07

VOLATILES

Facility

$190.45

Service Code	HCPCS 80320
Hospital Charge Code	3035089A
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

VOLATILES

Facility

$190.45

Service Code	HCPCS 80320
Hospital Charge Code	3035089A
Hospital Revenue Code	301
Min. Negotiated Rate	$5.41
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$72.37
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.52
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$16.66
Rate for Payer: Wellpoint Medicaid Managed Care	$5.41

VOLTAGE-GATED CALCIUM CH

Facility

$390.00

Service Code	HCPCS 83519
Hospital Charge Code	39900336
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$50.05
Rate for Payer: Aetna Medicare Advantage	$59.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.75
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$18.40
Rate for Payer: Clover Medicare Advantage	$17.48
Rate for Payer: EmblemHealth Commercial	$55.20
Rate for Payer: Humana Medicare Advantage	$18.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.40
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	$14.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.40
Rate for Payer: Wellcare Medicare Advantage	$18.40
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

VOLTAGE-GATED CALCIUM CH

Facility

$390.00

Service Code	HCPCS 83519
Hospital Charge Code	39900336
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

VOLTAREN/50MG/TAB

Facility

$9.85

Service Code	NDC 51079046601
Hospital Charge Code	60634162
Hospital Revenue Code	250
Min. Negotiated Rate	$1.48
Max. Negotiated Rate	$1.48
Rate for Payer: Qualcare PPO/HMO/WC	$1.48

VOLTAREN/50MG/TAB

Facility

$9.85

Service Code	NDC 51079046601
Hospital Charge Code	60634162
Hospital Revenue Code	250
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$4.92
Rate for Payer: Aetna Commercial	$3.74
Rate for Payer: Aetna Medicare Advantage	$2.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.51
Rate for Payer: Cigna Commercial	$4.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.56
Rate for Payer: Oxford Commercial	$1.97
Rate for Payer: Qualcare PPO/HMO/WC	$1.48
Rate for Payer: UnitedHealthcare Commercial	$1.97
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.28

VOLUMEN ORAL CONTRAST

Facility

$47.50

Service Code	NDC 32909092603
Hospital Charge Code	60635823
Hospital Revenue Code	250
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$7.12
Rate for Payer: Qualcare PPO/HMO/WC	$7.12

VOLUMEN ORAL CONTRAST

Facility

$47.50

Service Code	NDC 32909092603
Hospital Charge Code	60635823
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$23.75
Rate for Payer: Aetna Commercial	$18.05
Rate for Payer: Aetna Medicare Advantage	$14.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.11
Rate for Payer: Cigna Commercial	$23.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.35
Rate for Payer: Oxford Commercial	$9.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.12
Rate for Payer: UnitedHealthcare Commercial	$9.50
Rate for Payer: UnitedHealthcare Community & State	$1.50
Rate for Payer: Wellpoint Medicaid Managed Care	$1.35

VOLUME TIMED MEASUREMENT

Facility

$43.00

Service Code	HCPCS 81050
Hospital Charge Code	38472703
Hospital Revenue Code	307
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

VOLUME TIMED MEASUREMENT

Facility

$43.00

Service Code	HCPCS 81050
Hospital Charge Code	38472703
Hospital Revenue Code	307
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$9.90
Rate for Payer: Aetna Medicare Advantage	$11.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.20
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: Cigna Medicare Advantage	$3.64
Rate for Payer: Clover Medicare Advantage	$3.46
Rate for Payer: EmblemHealth Commercial	$10.92
Rate for Payer: Humana Medicare Advantage	$3.75
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.18
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$2.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.64
Rate for Payer: Wellcare Medicare Advantage	$3.64
Rate for Payer: Wellpoint Medicaid Managed Care	$1.22

Know your out-of-pocket cost for care.

All Charges