Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BLANKET HYPOTHERMIA DISPOSABLE

Facility

$204.00

Hospital Charge Code	270331148
Hospital Revenue Code	272
Min. Negotiated Rate	$30.60
Max. Negotiated Rate	$30.60
Rate for Payer: Qualcare PPO/HMO/WC	$30.60

BLANKET HYPOTHERMIA DISPOSABLE

Facility

$204.00

Hospital Charge Code	270331148
Hospital Revenue Code	272
Min. Negotiated Rate	$5.79
Max. Negotiated Rate	$102.00
Rate for Payer: Aetna Commercial	$77.52
Rate for Payer: Aetna Medicare Advantage	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.02
Rate for Payer: Cigna Commercial	$102.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.04
Rate for Payer: Oxford Commercial	$40.80
Rate for Payer: Qualcare PPO/HMO/WC	$30.60
Rate for Payer: UnitedHealthcare Commercial	$40.80
Rate for Payer: UnitedHealthcare Community & State	$6.45
Rate for Payer: Wellpoint Medicaid Managed Care	$5.79

BLANKET VEST SMALL/MED

Facility

$271.35

Hospital Charge Code	270649706
Hospital Revenue Code	272
Min. Negotiated Rate	$7.71
Max. Negotiated Rate	$135.68
Rate for Payer: Aetna Commercial	$103.11
Rate for Payer: Aetna Medicare Advantage	$81.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.19
Rate for Payer: Cigna Commercial	$135.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.55
Rate for Payer: Oxford Commercial	$54.27
Rate for Payer: Qualcare PPO/HMO/WC	$40.70
Rate for Payer: UnitedHealthcare Commercial	$54.27
Rate for Payer: UnitedHealthcare Community & State	$8.57
Rate for Payer: Wellpoint Medicaid Managed Care	$7.71

BLANKET VEST SMALL/MED

Facility

$271.35

Hospital Charge Code	270649706
Hospital Revenue Code	272
Min. Negotiated Rate	$40.70
Max. Negotiated Rate	$40.70
Rate for Payer: Qualcare PPO/HMO/WC	$40.70

BLANKET WARMING LOW BODY BH525

Facility

$26.75

Hospital Charge Code	270600855
Hospital Revenue Code	272
Min. Negotiated Rate	$0.76
Max. Negotiated Rate	$13.38
Rate for Payer: Aetna Commercial	$10.16
Rate for Payer: Aetna Medicare Advantage	$8.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.82
Rate for Payer: Cigna Commercial	$13.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.96
Rate for Payer: Oxford Commercial	$5.35
Rate for Payer: Qualcare PPO/HMO/WC	$4.01
Rate for Payer: UnitedHealthcare Commercial	$5.35
Rate for Payer: UnitedHealthcare Community & State	$0.85
Rate for Payer: Wellpoint Medicaid Managed Care	$0.76

BLANKET WARMING LOW BODY BH525

Facility

$26.75

Hospital Charge Code	270600855
Hospital Revenue Code	272
Min. Negotiated Rate	$4.01
Max. Negotiated Rate	$4.01
Rate for Payer: Qualcare PPO/HMO/WC	$4.01

BLASTOMYCES AB IMMUNODIFFUSION

Facility

$390.00

Service Code	HCPCS 86612
Hospital Charge Code	3847979
Hospital Revenue Code	302
Min. Negotiated Rate	$10.32
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$35.09
Rate for Payer: Aetna Medicare Advantage	$41.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.79
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.90
Rate for Payer: Clover Medicare Advantage	$12.26
Rate for Payer: EmblemHealth Commercial	$38.70
Rate for Payer: Humana Medicare Advantage	$13.29
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.90
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	$10.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.90
Rate for Payer: Wellcare Medicare Advantage	$12.90
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

BLASTOMYCES AB IMMUNODIFFUSION

Facility

$390.00

Service Code	HCPCS 86612
Hospital Charge Code	3847979
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

BLASTOMYCES ANTIBODY

Facility

$148.00

Service Code	HCPCS 86612
Hospital Charge Code	38473069
Hospital Revenue Code	302
Min. Negotiated Rate	$22.20
Max. Negotiated Rate	$22.20
Rate for Payer: Qualcare PPO/HMO/WC	$22.20

BLASTOMYCES ANTIBODY

Facility

$148.00

Service Code	HCPCS 86612
Hospital Charge Code	38473069
Hospital Revenue Code	302
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$35.09
Rate for Payer: Aetna Medicare Advantage	$41.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.79
Rate for Payer: Cigna Commercial	$74.00
Rate for Payer: Cigna Medicare Advantage	$12.90
Rate for Payer: Clover Medicare Advantage	$12.26
Rate for Payer: EmblemHealth Commercial	$38.70
Rate for Payer: Humana Medicare Advantage	$13.29
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.48
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.20
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.90
Rate for Payer: Wellcare Medicare Advantage	$12.90
Rate for Payer: Wellpoint Medicaid Managed Care	$4.20

BLD CT PLATELET AUTO

Facility

$390.00

Service Code	HCPCS 85049
Hospital Charge Code	401185049
Hospital Revenue Code	300
Min. Negotiated Rate	$3.58
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$12.19
Rate for Payer: Aetna Medicare Advantage	$14.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.25
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$4.48
Rate for Payer: Clover Medicare Advantage	$4.26
Rate for Payer: EmblemHealth Commercial	$13.44
Rate for Payer: Humana Medicare Advantage	$4.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.48
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	$3.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.48
Rate for Payer: Wellcare Medicare Advantage	$4.48
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

BLD CT PLATELET AUTO

Facility

$390.00

Service Code	HCPCS 85049
Hospital Charge Code	401185049
Hospital Revenue Code	300
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

BLD TYPE: RH PHENOTYPING

Facility

$159.00

Service Code	HCPCS 86906
Hospital Charge Code	38471074
Hospital Revenue Code	309
Min. Negotiated Rate	$23.85
Max. Negotiated Rate	$23.85
Rate for Payer: Qualcare PPO/HMO/WC	$23.85

BLD TYPE: RH PHENOTYPING

Facility

$159.00

Service Code	HCPCS 86906
Hospital Charge Code	38471074
Hospital Revenue Code	309
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$21.08
Rate for Payer: Aetna Medicare Advantage	$25.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.11
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: Cigna Medicare Advantage	$7.75
Rate for Payer: Clover Medicare Advantage	$7.36
Rate for Payer: EmblemHealth Commercial	$23.25
Rate for Payer: Humana Medicare Advantage	$7.98
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.34
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.85
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$6.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.75
Rate for Payer: Wellcare Medicare Advantage	$7.75
Rate for Payer: Wellpoint Medicaid Managed Care	$4.52

BLEEDING TIME

Facility

$194.00

Service Code	HCPCS 85002
Hospital Charge Code	38478023
Hospital Revenue Code	301
Min. Negotiated Rate	$29.10
Max. Negotiated Rate	$29.10
Rate for Payer: Qualcare PPO/HMO/WC	$29.10

BLEEDING TIME

Facility

$194.00

Service Code	HCPCS 85002
Hospital Charge Code	38478023
Hospital Revenue Code	301
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$13.11
Rate for Payer: Aetna Medicare Advantage	$15.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.48
Rate for Payer: Cigna Commercial	$97.00
Rate for Payer: Cigna Medicare Advantage	$4.82
Rate for Payer: Clover Medicare Advantage	$4.58
Rate for Payer: EmblemHealth Commercial	$14.46
Rate for Payer: Humana Medicare Advantage	$4.96
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.44
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.10
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$3.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.82
Rate for Payer: Wellcare Medicare Advantage	$4.82
Rate for Payer: Wellpoint Medicaid Managed Care	$5.51

BLEOMYCIN 15 UNITS INJ

Facility

$459.89

Service Code	HCPCS J9040
Hospital Charge Code	6000715
Hospital Revenue Code	636
Min. Negotiated Rate	$68.98
Max. Negotiated Rate	$111.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.29
Rate for Payer: Qualcare PPO/HMO/WC	$68.98

BLEOMYCIN 15 UNITS INJ

Facility

$459.89

Service Code	HCPCS J9040
Hospital Charge Code	6000715
Hospital Revenue Code	636
Min. Negotiated Rate	$13.06
Max. Negotiated Rate	$229.94
Rate for Payer: Aetna Commercial	$174.76
Rate for Payer: Aetna Medicare Advantage	$137.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$117.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$117.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$117.27
Rate for Payer: Cigna Commercial	$229.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.29
Rate for Payer: Qualcare PPO/HMO/WC	$68.98
Rate for Payer: UnitedHealthcare Community & State	$14.53
Rate for Payer: Wellpoint Medicaid Managed Care	$13.06

BLEPH-10 10% OPHTH/5ML

Facility

$772.78

Service Code	NDC 11980001105
Hospital Charge Code	60632573
Hospital Revenue Code	250
Min. Negotiated Rate	$115.92
Max. Negotiated Rate	$115.92
Rate for Payer: Qualcare PPO/HMO/WC	$115.92

BLEPH-10 10% OPHTH/5ML

Facility

$772.78

Service Code	NDC 11980001105
Hospital Charge Code	60632573
Hospital Revenue Code	250
Min. Negotiated Rate	$21.95
Max. Negotiated Rate	$386.39
Rate for Payer: Aetna Commercial	$293.66
Rate for Payer: Aetna Medicare Advantage	$231.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.06
Rate for Payer: Cigna Commercial	$386.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.92
Rate for Payer: Oxford Commercial	$154.56
Rate for Payer: Qualcare PPO/HMO/WC	$115.92
Rate for Payer: UnitedHealthcare Commercial	$154.56
Rate for Payer: UnitedHealthcare Community & State	$24.42
Rate for Payer: Wellpoint Medicaid Managed Care	$21.95

BLEPHAMIDE LIQUIFILM 0.2%

Facility

$157.45

Service Code	NDC 11980002210
Hospital Charge Code	60632574
Hospital Revenue Code	250
Min. Negotiated Rate	$4.47
Max. Negotiated Rate	$78.72
Rate for Payer: Aetna Commercial	$59.83
Rate for Payer: Aetna Medicare Advantage	$47.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.15
Rate for Payer: Cigna Commercial	$78.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.94
Rate for Payer: Oxford Commercial	$31.49
Rate for Payer: Qualcare PPO/HMO/WC	$23.62
Rate for Payer: UnitedHealthcare Commercial	$31.49
Rate for Payer: UnitedHealthcare Community & State	$4.98
Rate for Payer: Wellpoint Medicaid Managed Care	$4.47

BLEPHAMIDE LIQUIFILM 0.2%

Facility

$157.45

Service Code	NDC 11980002210
Hospital Charge Code	60632574
Hospital Revenue Code	250
Min. Negotiated Rate	$23.62
Max. Negotiated Rate	$23.62
Rate for Payer: Qualcare PPO/HMO/WC	$23.62

BLEPHAROPLASTY L EYELID,

Facility

$16,286.20

Service Code	HCPCS 15820
Hospital Charge Code	16000786
Hospital Revenue Code	360
Min. Negotiated Rate	$462.53
Max. Negotiated Rate	$8,891.84
Rate for Payer: Aetna Commercial	$6,667.35
Rate for Payer: Aetna Medicare Advantage	$7,941.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,891.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,891.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,451.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,891.84
Rate for Payer: Cigna Commercial	$4,913.48
Rate for Payer: Cigna Medicare Advantage	$2,451.23
Rate for Payer: Clover Medicare Advantage	$2,328.67
Rate for Payer: EmblemHealth Commercial	$7,353.69
Rate for Payer: Humana Medicare Advantage	$2,524.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,451.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,234.41
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,442.93
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$514.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,451.23
Rate for Payer: Wellcare Medicare Advantage	$2,451.23
Rate for Payer: Wellpoint Medicaid Managed Care	$462.53

BLEPHAROPLASTY L EYELID,

Facility

$16,286.20

Service Code	HCPCS 15820
Hospital Charge Code	16000786
Hospital Revenue Code	360
Min. Negotiated Rate	$2,442.93
Max. Negotiated Rate	$2,442.93
Rate for Payer: Qualcare PPO/HMO/WC	$2,442.93

BLLN SPRNT RX0x6MM SPL20006X

Facility

$625.00

Service Code	HCPCS C1725
Hospital Charge Code	270650726C
Hospital Revenue Code	278
Min. Negotiated Rate	$17.75
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Community & State	$19.75
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

Know your out-of-pocket cost for care.

All Charges