Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BROMOCRIPTINE 2.5 MG TAB

Facility

$44.69

Service Code	NDC 30698020230
Hospital Charge Code	6009278
Hospital Revenue Code	251
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$22.34
Rate for Payer: Aetna Commercial	$16.98
Rate for Payer: Aetna Medicare Advantage	$13.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.40
Rate for Payer: Cigna Commercial	$22.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.62
Rate for Payer: Oxford Commercial	$8.94
Rate for Payer: Qualcare PPO/HMO/WC	$6.70
Rate for Payer: UnitedHealthcare Commercial	$8.94
Rate for Payer: UnitedHealthcare Community & State	$1.41
Rate for Payer: Wellpoint Medicaid Managed Care	$1.27

BROMOCRIPTINE 2.5 MG TAB

Facility

$44.69

Service Code	NDC 30698020230
Hospital Charge Code	6009278
Hospital Revenue Code	251
Min. Negotiated Rate	$6.70
Max. Negotiated Rate	$6.70
Rate for Payer: Qualcare PPO/HMO/WC	$6.70

BRONCH EMBUS SAMPLING 3/> NODE

Facility

$21,709.85

Service Code	HCPCS 31653
Hospital Charge Code	1600000448
Hospital Revenue Code	360
Min. Negotiated Rate	$616.56
Max. Negotiated Rate	$16,067.54
Rate for Payer: Aetna Commercial	$12,047.89
Rate for Payer: Aetna Medicare Advantage	$14,351.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,067.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,067.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,429.37
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	$16,067.54
Rate for Payer: Cigna Commercial	$8,878.66
Rate for Payer: Cigna Medicare Advantage	$4,429.37
Rate for Payer: Clover Medicare Advantage	$4,207.90
Rate for Payer: EmblemHealth Commercial	$13,288.11
Rate for Payer: Humana Medicare Advantage	$4,562.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,429.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,644.56
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,256.48
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$686.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,429.37
Rate for Payer: Wellcare Medicare Advantage	$4,429.37
Rate for Payer: Wellpoint Medicaid Managed Care	$616.56

BRONCH EMBUS SAMPLING 3/> NODE

Facility

$21,709.85

Service Code	HCPCS 31653
Hospital Charge Code	1600000448
Hospital Revenue Code	360
Min. Negotiated Rate	$3,256.48
Max. Negotiated Rate	$3,256.48
Rate for Payer: Qualcare PPO/HMO/WC	$3,256.48

BRONCHIOLITIS AND RSV PNEUMONIA

Facility

$21,656.97

Service Code	APR-DRG 1384
Min. Negotiated Rate	$21,232.32
Max. Negotiated Rate	$21,656.97
Rate for Payer: UnitedHealthcare Community & State	$21,232.32
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$21,656.97
Rate for Payer: Wellpoint Medicaid Managed Care	$21,232.32

BRONCHIOLITIS AND RSV PNEUMONIA

Facility

$5,724.24

Service Code	APR-DRG 1382
Min. Negotiated Rate	$5,612.00
Max. Negotiated Rate	$5,724.24
Rate for Payer: UnitedHealthcare Community & State	$5,612.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,724.24
Rate for Payer: Wellpoint Medicaid Managed Care	$5,612.00

BRONCHIOLITIS AND RSV PNEUMONIA

Facility

$9,149.51

Service Code	APR-DRG 1383
Min. Negotiated Rate	$8,970.11
Max. Negotiated Rate	$9,149.51
Rate for Payer: UnitedHealthcare Community & State	$8,970.11
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,149.51
Rate for Payer: Wellpoint Medicaid Managed Care	$8,970.11

BRONCHIOLITIS AND RSV PNEUMONIA

Facility

$3,930.84

Service Code	APR-DRG 1381
Min. Negotiated Rate	$3,853.76
Max. Negotiated Rate	$3,930.84
Rate for Payer: UnitedHealthcare Community & State	$3,853.76
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$3,930.84
Rate for Payer: Wellpoint Medicaid Managed Care	$3,853.76

BRONCHITIS AND ASTHMA WITH CC/MCC

Facility

$50,148.32

Service Code	MSDRG 202
Min. Negotiated Rate	$15,269.52
Max. Negotiated Rate	$50,148.32
Rate for Payer: Aetna Commercial	$37,574.74
Rate for Payer: Aetna Medicare Advantage	$50,148.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26,596.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26,596.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16,073.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26,596.80
Rate for Payer: Cigna Commercial	$21,650.96
Rate for Payer: Cigna Medicare Advantage	$16,073.18
Rate for Payer: Clover Medicare Advantage	$15,269.52
Rate for Payer: EmblemHealth Commercial	$48,219.54
Rate for Payer: Humana Medicare Advantage	$16,555.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16,073.18
Rate for Payer: Oxford Commercial	$17,112.54
Rate for Payer: UnitedHealthcare Commercial	$22,905.75
Rate for Payer: UnitedHealthcare Medicare Advantage	$16,073.18
Rate for Payer: Wellcare Medicare Advantage	$16,073.18

BRONCHITIS AND ASTHMA WITHOUT CC/MCC

Facility

$40,632.32

Service Code	MSDRG 203
Min. Negotiated Rate	$11,805.40
Max. Negotiated Rate	$40,632.32
Rate for Payer: Aetna Commercial	$30,797.30
Rate for Payer: Aetna Medicare Advantage	$40,632.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19,116.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19,116.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,023.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19,116.45
Rate for Payer: Cigna Commercial	$14,936.31
Rate for Payer: Cigna Medicare Advantage	$13,023.18
Rate for Payer: Clover Medicare Advantage	$12,372.02
Rate for Payer: EmblemHealth Commercial	$39,069.54
Rate for Payer: Humana Medicare Advantage	$13,413.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,023.18
Rate for Payer: Oxford Commercial	$11,805.40
Rate for Payer: UnitedHealthcare Commercial	$15,801.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,023.18
Rate for Payer: Wellcare Medicare Advantage	$13,023.18

BRONCHO CYTOLOGY BRUSH

Facility

$307.00

Hospital Charge Code	270331590
Hospital Revenue Code	272
Min. Negotiated Rate	$46.05
Max. Negotiated Rate	$46.05
Rate for Payer: Qualcare PPO/HMO/WC	$46.05

BRONCHO CYTOLOGY BRUSH

Facility

$307.00

Hospital Charge Code	270331590
Hospital Revenue Code	272
Min. Negotiated Rate	$8.72
Max. Negotiated Rate	$153.50
Rate for Payer: Aetna Commercial	$116.66
Rate for Payer: Aetna Medicare Advantage	$92.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.28
Rate for Payer: Cigna Commercial	$153.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.82
Rate for Payer: Oxford Commercial	$61.40
Rate for Payer: Qualcare PPO/HMO/WC	$46.05
Rate for Payer: UnitedHealthcare Commercial	$61.40
Rate for Payer: UnitedHealthcare Community & State	$9.70
Rate for Payer: Wellpoint Medicaid Managed Care	$8.72

BRONCHOSCOPE ASCOPE 4 LARGE

Facility

$7,850.00

Hospital Charge Code	270686017
Hospital Revenue Code	272
Min. Negotiated Rate	$1,177.50
Max. Negotiated Rate	$1,177.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,177.50

BRONCHOSCOPE ASCOPE 4 LARGE

Facility

$7,850.00

Hospital Charge Code	270686017
Hospital Revenue Code	272
Min. Negotiated Rate	$222.94
Max. Negotiated Rate	$3,925.00
Rate for Payer: Aetna Commercial	$2,983.00
Rate for Payer: Aetna Medicare Advantage	$2,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,001.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,001.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,001.75
Rate for Payer: Cigna Commercial	$3,925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,041.00
Rate for Payer: Oxford Commercial	$1,570.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,177.50
Rate for Payer: UnitedHealthcare Commercial	$1,570.00
Rate for Payer: UnitedHealthcare Community & State	$248.06
Rate for Payer: Wellpoint Medicaid Managed Care	$222.94

BRONCHOSCOPE ASCOPE 4 REGULAR

Facility

$6,825.00

Hospital Charge Code	270686016
Hospital Revenue Code	272
Min. Negotiated Rate	$193.83
Max. Negotiated Rate	$3,412.50
Rate for Payer: Aetna Commercial	$2,593.50
Rate for Payer: Aetna Medicare Advantage	$2,047.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,740.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,740.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,740.38
Rate for Payer: Cigna Commercial	$3,412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,774.50
Rate for Payer: Oxford Commercial	$1,365.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.75
Rate for Payer: UnitedHealthcare Commercial	$1,365.00
Rate for Payer: UnitedHealthcare Community & State	$215.67
Rate for Payer: Wellpoint Medicaid Managed Care	$193.83

BRONCHOSCOPE ASCOPE 4 REGULAR

Facility

$6,825.00

Hospital Charge Code	270686016
Hospital Revenue Code	272
Min. Negotiated Rate	$1,023.75
Max. Negotiated Rate	$1,023.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.75

BRONCHOSCOPE ASCOPE 4 SLIM

Facility

$6,825.00

Hospital Charge Code	270686015
Hospital Revenue Code	272
Min. Negotiated Rate	$193.83
Max. Negotiated Rate	$3,412.50
Rate for Payer: Aetna Commercial	$2,593.50
Rate for Payer: Aetna Medicare Advantage	$2,047.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,740.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,740.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,740.38
Rate for Payer: Cigna Commercial	$3,412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,774.50
Rate for Payer: Oxford Commercial	$1,365.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.75
Rate for Payer: UnitedHealthcare Commercial	$1,365.00
Rate for Payer: UnitedHealthcare Community & State	$215.67
Rate for Payer: Wellpoint Medicaid Managed Care	$193.83

BRONCHOSCOPE ASCOPE 4 SLIM

Facility

$6,825.00

Hospital Charge Code	270686015
Hospital Revenue Code	272
Min. Negotiated Rate	$1,023.75
Max. Negotiated Rate	$1,023.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.75

BRONCHOSCOPY

Facility

$5,294.80

Service Code	HCPCS 31622
Hospital Charge Code	1600000370
Hospital Revenue Code	360
Min. Negotiated Rate	$794.22
Max. Negotiated Rate	$794.22
Rate for Payer: Qualcare PPO/HMO/WC	$794.22

BRONCHOSCOPY

Facility

$99,458.44

Service Code	HCPCS 31622
Hospital Charge Code	1600000275
Hospital Revenue Code	360
Min. Negotiated Rate	$14,918.77
Max. Negotiated Rate	$14,918.77
Rate for Payer: Qualcare PPO/HMO/WC	$14,918.77

BRONCHOSCOPY

Facility

$99,458.44

Service Code	HCPCS 31622
Hospital Charge Code	1600000275
Hospital Revenue Code	360
Min. Negotiated Rate	$504.20
Max. Negotiated Rate	$25,859.19
Rate for Payer: Aetna Commercial	$5,751.63
Rate for Payer: Aetna Medicare Advantage	$6,851.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,670.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,670.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,114.57
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	$7,670.60
Rate for Payer: Cigna Commercial	$4,238.63
Rate for Payer: Cigna Medicare Advantage	$2,114.57
Rate for Payer: Clover Medicare Advantage	$2,008.84
Rate for Payer: EmblemHealth Commercial	$6,343.71
Rate for Payer: Humana Medicare Advantage	$2,178.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,114.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25,859.19
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$14,918.77
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$3,142.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,114.57
Rate for Payer: Wellcare Medicare Advantage	$2,114.57
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$514.28
Rate for Payer: Wellpoint Medicaid Managed Care	$504.20

BRONCHOSCOPY

Facility

$5,294.80

Service Code	HCPCS 31622
Hospital Charge Code	1600000370
Hospital Revenue Code	360
Min. Negotiated Rate	$167.32
Max. Negotiated Rate	$7,670.60
Rate for Payer: Aetna Commercial	$5,751.63
Rate for Payer: Aetna Medicare Advantage	$6,851.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,670.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,670.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,114.57
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	$7,670.60
Rate for Payer: Cigna Commercial	$4,238.63
Rate for Payer: Cigna Medicare Advantage	$2,114.57
Rate for Payer: Clover Medicare Advantage	$2,008.84
Rate for Payer: EmblemHealth Commercial	$6,343.71
Rate for Payer: Humana Medicare Advantage	$2,178.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,114.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,376.65
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$794.22
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$167.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,114.57
Rate for Payer: Wellcare Medicare Advantage	$2,114.57
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$514.28
Rate for Payer: Wellpoint Medicaid Managed Care	$504.20

BRONCHOSCOPY/LUNG BX EACH

Facility

$11,302.80

Service Code	HCPCS 31628
Hospital Charge Code	1600000487
Hospital Revenue Code	360
Min. Negotiated Rate	$1,695.42
Max. Negotiated Rate	$1,695.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,695.42

BRONCHOSCOPY/LUNG BX EACH

Facility

$11,302.80

Service Code	HCPCS 31628
Hospital Charge Code	1600000487
Hospital Revenue Code	360
Min. Negotiated Rate	$321.00
Max. Negotiated Rate	$16,067.54
Rate for Payer: Aetna Commercial	$12,047.89
Rate for Payer: Aetna Medicare Advantage	$14,351.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,067.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,067.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,429.37
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	$16,067.54
Rate for Payer: Cigna Commercial	$8,878.66
Rate for Payer: Cigna Medicare Advantage	$4,429.37
Rate for Payer: Clover Medicare Advantage	$4,207.90
Rate for Payer: EmblemHealth Commercial	$13,288.11
Rate for Payer: Humana Medicare Advantage	$4,562.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,429.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,938.73
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,695.42
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$357.17
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,429.37
Rate for Payer: Wellcare Medicare Advantage	$4,429.37
Rate for Payer: Wellpoint Medicaid Managed Care	$321.00

BRONCHOSCOPY W/BAL

Facility

$6,293.60

Service Code	HCPCS 31624
Hospital Charge Code	1600000354
Hospital Revenue Code	360
Min. Negotiated Rate	$944.04
Max. Negotiated Rate	$944.04
Rate for Payer: Qualcare PPO/HMO/WC	$944.04

Know your out-of-pocket cost for care.

All Charges