Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BOTULINUM TOXIN TYPE A 100U

Facility

$4,832.04

Service Code	HCPCS J0585
Hospital Charge Code	606390191
Hospital Revenue Code	636
Min. Negotiated Rate	$6.18
Max. Negotiated Rate	$1,169.35
Rate for Payer: Aetna Commercial	$17.71
Rate for Payer: Aetna Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.62
Rate for Payer: Cigna Medicare Advantage	$6.51
Rate for Payer: Clover Medicare Advantage	$6.18
Rate for Payer: EmblemHealth Commercial	$19.53
Rate for Payer: Humana Medicare Advantage	$6.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,169.35
Rate for Payer: Qualcare PPO/HMO/WC	$724.81
Rate for Payer: UnitedHealthcare Community & State	$152.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.51
Rate for Payer: Wellcare Medicare Advantage	$6.51
Rate for Payer: Wellpoint Medicaid Managed Care	$137.23

BOTULINUM TOXIN TYPE A 100U

Facility

$4,832.04

Service Code	HCPCS J0585
Hospital Charge Code	606390191
Hospital Revenue Code	636
Min. Negotiated Rate	$724.81
Max. Negotiated Rate	$1,169.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,169.35
Rate for Payer: Qualcare PPO/HMO/WC	$724.81

BOUGIE M-FLEX BLUE 52FR

Facility

$1,445.00

Hospital Charge Code	270683619
Hospital Revenue Code	272
Min. Negotiated Rate	$216.75
Max. Negotiated Rate	$216.75
Rate for Payer: Qualcare PPO/HMO/WC	$216.75

BOUGIE M-FLEX BLUE 52FR

Facility

$1,445.00

Hospital Charge Code	270683619
Hospital Revenue Code	272
Min. Negotiated Rate	$41.04
Max. Negotiated Rate	$722.50
Rate for Payer: Aetna Commercial	$549.10
Rate for Payer: Aetna Medicare Advantage	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$368.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$368.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$368.48
Rate for Payer: Cigna Commercial	$722.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.70
Rate for Payer: Oxford Commercial	$289.00
Rate for Payer: Qualcare PPO/HMO/WC	$216.75
Rate for Payer: UnitedHealthcare Commercial	$289.00
Rate for Payer: UnitedHealthcare Community & State	$45.66
Rate for Payer: Wellpoint Medicaid Managed Care	$41.04

BOUGIE M-FLEX BLUE 54FR

Facility

$1,445.00

Hospital Charge Code	270683621
Hospital Revenue Code	272
Min. Negotiated Rate	$41.04
Max. Negotiated Rate	$722.50
Rate for Payer: Aetna Commercial	$549.10
Rate for Payer: Aetna Medicare Advantage	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$368.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$368.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$368.48
Rate for Payer: Cigna Commercial	$722.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.70
Rate for Payer: Oxford Commercial	$289.00
Rate for Payer: Qualcare PPO/HMO/WC	$216.75
Rate for Payer: UnitedHealthcare Commercial	$289.00
Rate for Payer: UnitedHealthcare Community & State	$45.66
Rate for Payer: Wellpoint Medicaid Managed Care	$41.04

BOUGIE M-FLEX BLUE 54FR

Facility

$1,445.00

Hospital Charge Code	270683621
Hospital Revenue Code	272
Min. Negotiated Rate	$216.75
Max. Negotiated Rate	$216.75
Rate for Payer: Qualcare PPO/HMO/WC	$216.75

BOUGIE M-FLEX BLUE 54FR

Facility

$1,445.00

Hospital Charge Code	270683620
Hospital Revenue Code	272
Min. Negotiated Rate	$41.04
Max. Negotiated Rate	$722.50
Rate for Payer: Aetna Commercial	$549.10
Rate for Payer: Aetna Medicare Advantage	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$368.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$368.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$368.48
Rate for Payer: Cigna Commercial	$722.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.70
Rate for Payer: Oxford Commercial	$289.00
Rate for Payer: Qualcare PPO/HMO/WC	$216.75
Rate for Payer: UnitedHealthcare Commercial	$289.00
Rate for Payer: UnitedHealthcare Community & State	$45.66
Rate for Payer: Wellpoint Medicaid Managed Care	$41.04

BOUGIE M-FLEX BLUE 54FR

Facility

$1,445.00

Hospital Charge Code	270683620
Hospital Revenue Code	272
Min. Negotiated Rate	$216.75
Max. Negotiated Rate	$216.75
Rate for Payer: Qualcare PPO/HMO/WC	$216.75

BOURDEAUXS BUTT PASTE

Facility

$15.08

Service Code	NDC 62103033300
Hospital Charge Code	606380038
Hospital Revenue Code	250
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$7.54
Rate for Payer: Aetna Commercial	$5.73
Rate for Payer: Aetna Medicare Advantage	$4.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.85
Rate for Payer: Cigna Commercial	$7.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.92
Rate for Payer: Oxford Commercial	$3.02
Rate for Payer: Qualcare PPO/HMO/WC	$2.26
Rate for Payer: UnitedHealthcare Commercial	$3.02
Rate for Payer: UnitedHealthcare Community & State	$0.48
Rate for Payer: Wellpoint Medicaid Managed Care	$0.43

BOURDEAUXS BUTT PASTE

Facility

$15.08

Service Code	NDC 62103033300
Hospital Charge Code	606380038
Hospital Revenue Code	250
Min. Negotiated Rate	$2.26
Max. Negotiated Rate	$2.26
Rate for Payer: Qualcare PPO/HMO/WC	$2.26

BOWER PEG KIT 20FR

Facility

$744.00

Hospital Charge Code	270332542
Hospital Revenue Code	272
Min. Negotiated Rate	$111.60
Max. Negotiated Rate	$111.60
Rate for Payer: Qualcare PPO/HMO/WC	$111.60

BOWER PEG KIT 20FR

Facility

$744.00

Hospital Charge Code	270332542
Hospital Revenue Code	272
Min. Negotiated Rate	$21.13
Max. Negotiated Rate	$372.00
Rate for Payer: Aetna Commercial	$282.72
Rate for Payer: Aetna Medicare Advantage	$223.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.72
Rate for Payer: Cigna Commercial	$372.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.44
Rate for Payer: Oxford Commercial	$148.80
Rate for Payer: Qualcare PPO/HMO/WC	$111.60
Rate for Payer: UnitedHealthcare Commercial	$148.80
Rate for Payer: UnitedHealthcare Community & State	$23.51
Rate for Payer: Wellpoint Medicaid Managed Care	$21.13

BOWL MIXING ADVANCED CEMENT

Facility

$419.75

Hospital Charge Code	270651658
Hospital Revenue Code	272
Min. Negotiated Rate	$11.92
Max. Negotiated Rate	$209.88
Rate for Payer: Aetna Commercial	$159.50
Rate for Payer: Aetna Medicare Advantage	$125.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.04
Rate for Payer: Cigna Commercial	$209.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.14
Rate for Payer: Oxford Commercial	$83.95
Rate for Payer: Qualcare PPO/HMO/WC	$62.96
Rate for Payer: UnitedHealthcare Commercial	$83.95
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: Wellpoint Medicaid Managed Care	$11.92

BOWL MIXING ADVANCED CEMENT

Facility

$419.75

Hospital Charge Code	270651658
Hospital Revenue Code	272
Min. Negotiated Rate	$62.96
Max. Negotiated Rate	$62.96
Rate for Payer: Qualcare PPO/HMO/WC	$62.96

BOWL ZIM MIX QUIKVAC 50490110

Facility

$337.26

Hospital Charge Code	270616932
Hospital Revenue Code	272
Min. Negotiated Rate	$50.59
Max. Negotiated Rate	$50.59
Rate for Payer: Qualcare PPO/HMO/WC	$50.59

BOWL ZIM MIX QUIKVAC 50490110

Facility

$337.26

Hospital Charge Code	270616932
Hospital Revenue Code	272
Min. Negotiated Rate	$9.58
Max. Negotiated Rate	$168.63
Rate for Payer: Aetna Commercial	$128.16
Rate for Payer: Aetna Medicare Advantage	$101.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.00
Rate for Payer: Cigna Commercial	$168.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.69
Rate for Payer: Oxford Commercial	$67.45
Rate for Payer: Qualcare PPO/HMO/WC	$50.59
Rate for Payer: UnitedHealthcare Commercial	$67.45
Rate for Payer: UnitedHealthcare Community & State	$10.66
Rate for Payer: Wellpoint Medicaid Managed Care	$9.58

BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD

Facility

$4,854.91

Service Code	APR-DRG 1321
Min. Negotiated Rate	$4,759.72
Max. Negotiated Rate	$4,854.91
Rate for Payer: UnitedHealthcare Community & State	$4,759.72
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,854.91
Rate for Payer: Wellpoint Medicaid Managed Care	$4,759.72

BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD

Facility

$12,229.37

Service Code	APR-DRG 1323
Min. Negotiated Rate	$11,989.58
Max. Negotiated Rate	$12,229.37
Rate for Payer: UnitedHealthcare Community & State	$11,989.58
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,229.37
Rate for Payer: Wellpoint Medicaid Managed Care	$11,989.58

BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD

Facility

$6,565.47

Service Code	APR-DRG 1322
Min. Negotiated Rate	$6,436.74
Max. Negotiated Rate	$6,565.47
Rate for Payer: UnitedHealthcare Community & State	$6,436.74
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,565.47
Rate for Payer: Wellpoint Medicaid Managed Care	$6,436.74

BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD

Facility

$18,384.79

Service Code	APR-DRG 1324
Min. Negotiated Rate	$18,024.30
Max. Negotiated Rate	$18,384.79
Rate for Payer: UnitedHealthcare Community & State	$18,024.30
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$18,384.79
Rate for Payer: Wellpoint Medicaid Managed Care	$18,024.30

BPERTAB I

Facility

$90.65

Service Code	HCPCS 8661591
Hospital Charge Code	39990084A
Hospital Revenue Code	302
Min. Negotiated Rate	$13.60
Max. Negotiated Rate	$13.60
Rate for Payer: Qualcare PPO/HMO/WC	$13.60

BPERTAB I

Facility

$90.65

Service Code	HCPCS 8661591
Hospital Charge Code	39990084A
Hospital Revenue Code	302
Min. Negotiated Rate	$2.57
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$34.45
Rate for Payer: Aetna Medicare Advantage	$27.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.12
Rate for Payer: Cigna Commercial	$45.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.57
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.60
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$2.86
Rate for Payer: Wellpoint Medicaid Managed Care	$2.57

BPERTAB II

Facility

$90.65

Service Code	HCPCS 8661591
Hospital Charge Code	39990084B
Hospital Revenue Code	302
Min. Negotiated Rate	$13.60
Max. Negotiated Rate	$13.60
Rate for Payer: Qualcare PPO/HMO/WC	$13.60

BPERTAB II

Facility

$90.65

Service Code	HCPCS 8661591
Hospital Charge Code	39990084B
Hospital Revenue Code	302
Min. Negotiated Rate	$2.57
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$34.45
Rate for Payer: Aetna Medicare Advantage	$27.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.12
Rate for Payer: Cigna Commercial	$45.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.57
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.60
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$2.86
Rate for Payer: Wellpoint Medicaid Managed Care	$2.57

BPERTAB III

Facility

$90.65

Service Code	HCPCS 8661591
Hospital Charge Code	39990084C
Hospital Revenue Code	302
Min. Negotiated Rate	$13.60
Max. Negotiated Rate	$13.60
Rate for Payer: Qualcare PPO/HMO/WC	$13.60

Know your out-of-pocket cost for care.

All Charges