Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

WEST NILE IGG/IGM III

Facility

$390.00

Service Code	HCPCS 86789
Hospital Charge Code	39990107B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

WEST NILE IGG/IGM III

Facility

$390.00

Service Code	HCPCS 86789
Hospital Charge Code	39990107B
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$39.14
Rate for Payer: Aetna Medicare Advantage	$46.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.20
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$14.39
Rate for Payer: Clover Medicare Advantage	$13.67
Rate for Payer: EmblemHealth Commercial	$43.17
Rate for Payer: Humana Medicare Advantage	$14.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.39
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	$11.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.39
Rate for Payer: Wellcare Medicare Advantage	$14.39
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

WEST NILE,RNA, RT-PCR (CSF)

Facility

$390.00

Service Code	HCPCS 87798
Hospital Charge Code	3990521
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

WEST NILE,RNA, RT-PCR (CSF)

Facility

$390.00

Service Code	HCPCS 87798
Hospital Charge Code	3990521
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

WEST NILE VIRUS, ANTIBODY

Facility

$101.00

Service Code	HCPCS 86789
Hospital Charge Code	38472343
Hospital Revenue Code	302
Min. Negotiated Rate	$15.15
Max. Negotiated Rate	$15.15
Rate for Payer: Qualcare PPO/HMO/WC	$15.15

WEST NILE VIRUS, ANTIBODY

Facility

$101.00

Service Code	HCPCS 86789
Hospital Charge Code	38472343
Hospital Revenue Code	302
Min. Negotiated Rate	$2.87
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$39.14
Rate for Payer: Aetna Medicare Advantage	$46.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.20
Rate for Payer: Cigna Commercial	$50.50
Rate for Payer: Cigna Medicare Advantage	$14.39
Rate for Payer: Clover Medicare Advantage	$13.67
Rate for Payer: EmblemHealth Commercial	$43.17
Rate for Payer: Humana Medicare Advantage	$14.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.26
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.15
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$11.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.39
Rate for Payer: Wellcare Medicare Advantage	$14.39
Rate for Payer: Wellpoint Medicaid Managed Care	$2.87

WEST NILE VIRUS,IGM-ANTIBODY

Facility

$119.00

Service Code	HCPCS 86788
Hospital Charge Code	38472342
Hospital Revenue Code	302
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$45.83
Rate for Payer: Aetna Medicare Advantage	$54.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.12
Rate for Payer: Cigna Commercial	$59.50
Rate for Payer: Cigna Medicare Advantage	$16.85
Rate for Payer: Clover Medicare Advantage	$16.01
Rate for Payer: EmblemHealth Commercial	$50.55
Rate for Payer: Humana Medicare Advantage	$17.36
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.94
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.85
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.85
Rate for Payer: Wellcare Medicare Advantage	$16.85
Rate for Payer: Wellpoint Medicaid Managed Care	$3.38

WEST NILE VIRUS,IGM-ANTIBODY

Facility

$119.00

Service Code	HCPCS 86788
Hospital Charge Code	38472342
Hospital Revenue Code	302
Min. Negotiated Rate	$17.85
Max. Negotiated Rate	$17.85
Rate for Payer: Qualcare PPO/HMO/WC	$17.85

WETFIELD FORCEP

Facility

$1,280.00

Hospital Charge Code	270658118
Hospital Revenue Code	272
Min. Negotiated Rate	$36.35
Max. Negotiated Rate	$640.00
Rate for Payer: Aetna Commercial	$486.40
Rate for Payer: Aetna Medicare Advantage	$384.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$326.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$326.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$326.40
Rate for Payer: Cigna Commercial	$640.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.80
Rate for Payer: Oxford Commercial	$256.00
Rate for Payer: Qualcare PPO/HMO/WC	$192.00
Rate for Payer: UnitedHealthcare Commercial	$256.00
Rate for Payer: UnitedHealthcare Community & State	$40.45
Rate for Payer: Wellpoint Medicaid Managed Care	$36.35

WETFIELD FORCEP

Facility

$1,280.00

Hospital Charge Code	270658118
Hospital Revenue Code	272
Min. Negotiated Rate	$192.00
Max. Negotiated Rate	$192.00
Rate for Payer: Qualcare PPO/HMO/WC	$192.00

WET MOUNT/KOH

Facility

$390.00

Service Code	HCPCS 87210
Hospital Charge Code	87502755
Hospital Revenue Code	309
Min. Negotiated Rate	$3.96
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$15.83
Rate for Payer: Aetna Medicare Advantage	$18.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.11
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.82
Rate for Payer: Clover Medicare Advantage	$5.53
Rate for Payer: EmblemHealth Commercial	$17.46
Rate for Payer: Humana Medicare Advantage	$5.99
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.82
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	$4.66
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.82
Rate for Payer: Wellcare Medicare Advantage	$5.82
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

WET MOUNT/KOH

Facility

$390.00

Service Code	HCPCS 87210
Hospital Charge Code	87502755
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

WEZLANA 90MG /ML INJ

Facility

$36,376.71

Service Code	NDC 84612088901
Hospital Charge Code	6064943029
Hospital Revenue Code	250
Min. Negotiated Rate	$5,456.51
Max. Negotiated Rate	$5,456.51
Rate for Payer: Qualcare PPO/HMO/WC	$5,456.51

WEZLANA 90MG /ML INJ

Facility

$36,376.71

Service Code	NDC 84612088901
Hospital Charge Code	6064943029
Hospital Revenue Code	250
Min. Negotiated Rate	$1,033.10
Max. Negotiated Rate	$18,188.35
Rate for Payer: Aetna Commercial	$13,823.15
Rate for Payer: Aetna Medicare Advantage	$10,913.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,276.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,276.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,276.06
Rate for Payer: Cigna Commercial	$18,188.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,457.94
Rate for Payer: Oxford Commercial	$7,275.34
Rate for Payer: Qualcare PPO/HMO/WC	$5,456.51
Rate for Payer: UnitedHealthcare Commercial	$7,275.34
Rate for Payer: UnitedHealthcare Community & State	$1,149.50
Rate for Payer: Wellpoint Medicaid Managed Care	$1,033.10

WHEELCHAIR MANAGMNT PROP TRAIN

Facility

$164.50

Service Code	HCPCS 97542GP
Hospital Charge Code	9107010
Hospital Revenue Code	420
Min. Negotiated Rate	$4.67
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$62.51
Rate for Payer: Aetna Medicare Advantage	$49.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.95
Rate for Payer: Cigna Commercial	$82.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.77
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.68
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$5.20
Rate for Payer: Wellpoint Medicaid Managed Care	$4.67

WHEELCHAIR MANAGMNT PROP TRAIN

Facility

$164.50

Service Code	HCPCS 97542GP
Hospital Charge Code	9107010
Hospital Revenue Code	420
Min. Negotiated Rate	$24.68
Max. Negotiated Rate	$24.68
Rate for Payer: Qualcare PPO/HMO/WC	$24.68

WHEELCHAIR MANGMNT PROP TRAIN

Facility

$164.50

Service Code	HCPCS 97542GO
Hospital Charge Code	1008340
Hospital Revenue Code	430
Min. Negotiated Rate	$24.68
Max. Negotiated Rate	$24.68
Rate for Payer: Qualcare PPO/HMO/WC	$24.68

WHEELCHAIR MANGMNT PROP TRAIN

Facility

$164.50

Service Code	HCPCS 97542GO
Hospital Charge Code	1008340
Hospital Revenue Code	430
Min. Negotiated Rate	$4.67
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$62.51
Rate for Payer: Aetna Medicare Advantage	$49.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.95
Rate for Payer: Cigna Commercial	$82.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.77
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.68
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$5.20
Rate for Payer: Wellpoint Medicaid Managed Care	$4.67

WHEELCHAIR MANGMNT PROP TRAN

Facility

$164.50

Hospital Charge Code	1008345
Hospital Revenue Code	420
Min. Negotiated Rate	$24.68
Max. Negotiated Rate	$24.68
Rate for Payer: Qualcare PPO/HMO/WC	$24.68

WHEELCHAIR MANGMNT PROP TRAN

Facility

$164.50

Hospital Charge Code	1008345
Hospital Revenue Code	420
Min. Negotiated Rate	$4.67
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$62.51
Rate for Payer: Aetna Medicare Advantage	$49.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.95
Rate for Payer: Cigna Commercial	$82.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.77
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.68
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$5.20
Rate for Payer: Wellpoint Medicaid Managed Care	$4.67

WHEELCHAIR MNG EA 15 MIN CQ

Facility

$164.50

Service Code	HCPCS 97542GP
Hospital Charge Code	409197542Q
Hospital Revenue Code	420
Min. Negotiated Rate	$4.67
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$62.51
Rate for Payer: Aetna Medicare Advantage	$49.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.95
Rate for Payer: Cigna Commercial	$82.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.77
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.68
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$5.20
Rate for Payer: Wellpoint Medicaid Managed Care	$4.67

WHEELCHAIR MNG EA 15 MIN CQ

Facility

$164.50

Service Code	HCPCS 97542GP
Hospital Charge Code	409197542Q
Hospital Revenue Code	420
Min. Negotiated Rate	$24.68
Max. Negotiated Rate	$24.68
Rate for Payer: Qualcare PPO/HMO/WC	$24.68

WHIP SUTURE LASSO QUICK

Facility

$375.00

Hospital Charge Code	270678723
Hospital Revenue Code	272
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Oxford Commercial	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Commercial	$75.00
Rate for Payer: UnitedHealthcare Community & State	$11.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.65

WHIP SUTURE LASSO QUICK

Facility

$375.00

Hospital Charge Code	270678723
Hospital Revenue Code	272
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

WHIRLPOOL CQ

Facility

$185.00

Service Code	HCPCS 97022GP
Hospital Charge Code	904197022Q
Hospital Revenue Code	420
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$70.30
Rate for Payer: Aetna Medicare Advantage	$55.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.17
Rate for Payer: Cigna Commercial	$92.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.10
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.75
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$5.85
Rate for Payer: Wellpoint Medicaid Managed Care	$5.25

Know your out-of-pocket cost for care.

All Charges