Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BLOCK TIB FULL AUG TIB 67MM

Facility

$5,550.00

Service Code	HCPCS C1776
Hospital Charge Code	270694499
Hospital Revenue Code	278
Min. Negotiated Rate	$157.62
Max. Negotiated Rate	$2,775.00
Rate for Payer: Aetna Commercial	$2,109.00
Rate for Payer: Aetna Medicare Advantage	$1,665.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,415.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,415.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,415.25
Rate for Payer: Cigna Commercial	$2,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,343.10
Rate for Payer: Qualcare PPO/HMO/WC	$832.50
Rate for Payer: UnitedHealthcare Community & State	$175.38
Rate for Payer: Wellpoint Medicaid Managed Care	$157.62

BLOCK TIB FULL AUG TIB 67MM

Facility

$5,550.00

Service Code	HCPCS C1776
Hospital Charge Code	270694499
Hospital Revenue Code	278
Min. Negotiated Rate	$832.50
Max. Negotiated Rate	$1,343.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,343.10
Rate for Payer: Qualcare PPO/HMO/WC	$832.50

BLOCK TRI-CORTICAL 3.0-3.9CM

Facility

$4,125.00

Hospital Charge Code	270677704
Hospital Revenue Code	272
Min. Negotiated Rate	$618.75
Max. Negotiated Rate	$618.75
Rate for Payer: Qualcare PPO/HMO/WC	$618.75

BLOCK TRI-CORTICAL 3.0-3.9CM

Facility

$4,125.00

Hospital Charge Code	270677704
Hospital Revenue Code	272
Min. Negotiated Rate	$117.15
Max. Negotiated Rate	$2,062.50
Rate for Payer: Aetna Commercial	$1,567.50
Rate for Payer: Aetna Medicare Advantage	$1,237.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,051.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,051.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,051.88
Rate for Payer: Cigna Commercial	$2,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,072.50
Rate for Payer: Oxford Commercial	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$618.75
Rate for Payer: UnitedHealthcare Commercial	$825.00
Rate for Payer: UnitedHealthcare Community & State	$130.35
Rate for Payer: Wellpoint Medicaid Managed Care	$117.15

BLOOD ADMIN/TRANSF (NSG DEPT)

Facility

$1,403.75

Service Code	HCPCS 36430
Hospital Charge Code	38471065
Hospital Revenue Code	391
Min. Negotiated Rate	$210.56
Max. Negotiated Rate	$210.56
Rate for Payer: Qualcare PPO/HMO/WC	$210.56

BLOOD ADMIN/TRANSF (NSG DEPT)

Facility

$1,403.75

Service Code	HCPCS 36430
Hospital Charge Code	38471065
Hospital Revenue Code	391
Min. Negotiated Rate	$39.87
Max. Negotiated Rate	$1,901.28
Rate for Payer: Aetna Commercial	$1,425.63
Rate for Payer: Aetna Medicare Advantage	$1,698.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,901.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,901.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$524.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,901.28
Rate for Payer: Cigna Commercial	$1,050.61
Rate for Payer: Cigna Medicare Advantage	$524.13
Rate for Payer: Clover Medicare Advantage	$497.92
Rate for Payer: EmblemHealth Commercial	$1,572.39
Rate for Payer: Humana Medicare Advantage	$539.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$524.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.98
Rate for Payer: Oxford Commercial	$1,028.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.56
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$44.36
Rate for Payer: UnitedHealthcare Medicare Advantage	$524.13
Rate for Payer: Wellcare Medicare Advantage	$524.13
Rate for Payer: Wellpoint Medicaid Managed Care	$39.87

BLOOD/CLOT PATCH, LUMB EPI INJ

Facility

$3,450.90

Hospital Charge Code	93082086
Hospital Revenue Code	361
Min. Negotiated Rate	$98.01
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,311.34
Rate for Payer: Aetna Medicare Advantage	$1,035.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$879.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$879.98
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	$879.98
Rate for Payer: Cigna Commercial	$1,725.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$897.23
Rate for Payer: Qualcare PPO/HMO/WC	$517.63
Rate for Payer: UnitedHealthcare Community & State	$109.05
Rate for Payer: Wellpoint Medicaid Managed Care	$98.01

BLOOD/CLOT PATCH, LUMB EPI INJ

Facility

$3,450.90

Hospital Charge Code	93082086
Hospital Revenue Code	361
Min. Negotiated Rate	$517.63
Max. Negotiated Rate	$517.63
Rate for Payer: Qualcare PPO/HMO/WC	$517.63

BLOOD/CLOT PATCH, LUMB EPI INJ

Facility

$3,103.00

Service Code	HCPCS 62273
Hospital Charge Code	84506010
Hospital Revenue Code	361
Min. Negotiated Rate	$88.13
Max. Negotiated Rate	$3,629.00
Rate for Payer: Aetna Commercial	$2,281.02
Rate for Payer: Aetna Medicare Advantage	$2,717.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,042.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,042.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$838.61
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	$3,042.06
Rate for Payer: Cigna Commercial	$1,680.99
Rate for Payer: Cigna Medicare Advantage	$838.61
Rate for Payer: Clover Medicare Advantage	$796.68
Rate for Payer: EmblemHealth Commercial	$2,515.83
Rate for Payer: Humana Medicare Advantage	$863.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$838.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$806.78
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$465.45
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$98.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$838.61
Rate for Payer: Wellcare Medicare Advantage	$838.61
Rate for Payer: Wellpoint Medicaid Managed Care	$88.13

BLOOD/CLOT PATCH, LUMB EPI INJ

Facility

$3,103.00

Service Code	HCPCS 62273
Hospital Charge Code	84506010
Hospital Revenue Code	361
Min. Negotiated Rate	$465.45
Max. Negotiated Rate	$465.45
Rate for Payer: Qualcare PPO/HMO/WC	$465.45

BLOOD COLLECTION 25 SAFTY LOC

Facility

$4.20

Hospital Charge Code	270651617
Hospital Revenue Code	272
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$0.63
Rate for Payer: Qualcare PPO/HMO/WC	$0.63

BLOOD COLLECTION 25 SAFTY LOC

Facility

$4.20

Hospital Charge Code	270651617
Hospital Revenue Code	272
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.10
Rate for Payer: Aetna Commercial	$1.60
Rate for Payer: Aetna Medicare Advantage	$1.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.07
Rate for Payer: Cigna Commercial	$2.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.09
Rate for Payer: Oxford Commercial	$0.84
Rate for Payer: Qualcare PPO/HMO/WC	$0.63
Rate for Payer: UnitedHealthcare Commercial	$0.84
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.12

BLOOD COLLECTION SET MALE ADPT

Facility

$4.53

Hospital Charge Code	270650195
Hospital Revenue Code	270
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$0.68
Rate for Payer: Qualcare PPO/HMO/WC	$0.68

BLOOD COLLECTION SET MALE ADPT

Facility

$4.53

Hospital Charge Code	270650195
Hospital Revenue Code	270
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$2.27
Rate for Payer: Aetna Commercial	$1.72
Rate for Payer: Aetna Medicare Advantage	$1.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.16
Rate for Payer: Cigna Commercial	$2.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.18
Rate for Payer: Oxford Commercial	$0.91
Rate for Payer: Qualcare PPO/HMO/WC	$0.68
Rate for Payer: UnitedHealthcare Commercial	$0.91
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

BLOOD CONSERVATION SYSTEM

Facility

$835.63

Hospital Charge Code	270655822
Hospital Revenue Code	272
Min. Negotiated Rate	$23.73
Max. Negotiated Rate	$417.81
Rate for Payer: Aetna Commercial	$317.54
Rate for Payer: Aetna Medicare Advantage	$250.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$213.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$213.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$213.09
Rate for Payer: Cigna Commercial	$417.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.26
Rate for Payer: Oxford Commercial	$167.13
Rate for Payer: Qualcare PPO/HMO/WC	$125.34
Rate for Payer: UnitedHealthcare Commercial	$167.13
Rate for Payer: UnitedHealthcare Community & State	$26.41
Rate for Payer: Wellpoint Medicaid Managed Care	$23.73

BLOOD CONSERVATION SYSTEM

Facility

$835.63

Hospital Charge Code	270655822
Hospital Revenue Code	272
Min. Negotiated Rate	$125.34
Max. Negotiated Rate	$125.34
Rate for Payer: Qualcare PPO/HMO/WC	$125.34

BLOOD COUNT;AUTO DIFF.WBC COUN

Facility

$37.00

Service Code	HCPCS 85004
Hospital Charge Code	38477219
Hospital Revenue Code	301
Min. Negotiated Rate	$5.55
Max. Negotiated Rate	$5.55
Rate for Payer: Qualcare PPO/HMO/WC	$5.55

BLOOD COUNT;AUTO DIFF.WBC COUN

Facility

$37.00

Service Code	HCPCS 85004
Hospital Charge Code	38477219
Hospital Revenue Code	301
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$17.60
Rate for Payer: Aetna Medicare Advantage	$20.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.47
Rate for Payer: Cigna Commercial	$18.50
Rate for Payer: Cigna Medicare Advantage	$6.47
Rate for Payer: Clover Medicare Advantage	$6.15
Rate for Payer: EmblemHealth Commercial	$19.41
Rate for Payer: Humana Medicare Advantage	$6.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.62
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.55
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$5.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.47
Rate for Payer: Wellcare Medicare Advantage	$6.47
Rate for Payer: Wellpoint Medicaid Managed Care	$1.05

BLOOD COUNT;HEMOGLOBIN (HGB)

Facility

$25.00

Service Code	HCPCS 85018
Hospital Charge Code	38474120
Hospital Revenue Code	305
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$6.45
Rate for Payer: Aetna Medicare Advantage	$7.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.37
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	$8.60
Rate for Payer: Cigna Commercial	$12.50
Rate for Payer: Cigna Medicare Advantage	$2.37
Rate for Payer: Clover Medicare Advantage	$2.25
Rate for Payer: EmblemHealth Commercial	$7.11
Rate for Payer: Humana Medicare Advantage	$2.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.50
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$1.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.37
Rate for Payer: Wellcare Medicare Advantage	$2.37
Rate for Payer: Wellpoint Medicaid Managed Care	$0.71

BLOOD COUNT;HEMOGLOBIN (HGB)

Facility

$25.00

Service Code	HCPCS 85018
Hospital Charge Code	38474120
Hospital Revenue Code	305
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

BLOOD COUNT,MANUAL CELL CT

Facility

$49.00

Service Code	HCPCS 85032
Hospital Charge Code	38474121
Hospital Revenue Code	301
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$11.72
Rate for Payer: Aetna Medicare Advantage	$13.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.63
Rate for Payer: Cigna Commercial	$24.50
Rate for Payer: Cigna Medicare Advantage	$4.31
Rate for Payer: Clover Medicare Advantage	$4.09
Rate for Payer: EmblemHealth Commercial	$12.93
Rate for Payer: Humana Medicare Advantage	$4.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.74
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.35
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$3.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.31
Rate for Payer: Wellcare Medicare Advantage	$4.31
Rate for Payer: Wellpoint Medicaid Managed Care	$1.39

BLOOD COUNT,MANUAL CELL CT

Facility

$49.00

Service Code	HCPCS 85032
Hospital Charge Code	38474121
Hospital Revenue Code	301
Min. Negotiated Rate	$7.35
Max. Negotiated Rate	$7.35
Rate for Payer: Qualcare PPO/HMO/WC	$7.35

BLOOD COUNT,RETC,AUTO

Facility

$29.00

Service Code	HCPCS 85045
Hospital Charge Code	38474122
Hospital Revenue Code	301
Min. Negotiated Rate	$4.35
Max. Negotiated Rate	$4.35
Rate for Payer: Qualcare PPO/HMO/WC	$4.35

BLOOD COUNT,RETC,AUTO

Facility

$29.00

Service Code	HCPCS 85045
Hospital Charge Code	38474122
Hospital Revenue Code	301
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$10.85
Rate for Payer: Aetna Medicare Advantage	$12.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.47
Rate for Payer: Cigna Commercial	$14.50
Rate for Payer: Cigna Medicare Advantage	$3.99
Rate for Payer: Clover Medicare Advantage	$3.79
Rate for Payer: EmblemHealth Commercial	$11.97
Rate for Payer: Humana Medicare Advantage	$4.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.54
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.35
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$3.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.99
Rate for Payer: Wellcare Medicare Advantage	$3.99
Rate for Payer: Wellpoint Medicaid Managed Care	$0.82

BLOOD CULTURE

Facility

$389.20

Service Code	HCPCS 87040
Hospital Charge Code	38475017
Hospital Revenue Code	306
Min. Negotiated Rate	$58.38
Max. Negotiated Rate	$58.38
Rate for Payer: Qualcare PPO/HMO/WC	$58.38

Know your out-of-pocket cost for care.

All Charges