Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

5CC BONE FIBER

Facility

$3,395.00

Service Code	HCPCS C1765
Hospital Charge Code	270703923
Hospital Revenue Code	278
Min. Negotiated Rate	$96.42
Max. Negotiated Rate	$1,697.50
Rate for Payer: Aetna Commercial	$1,290.10
Rate for Payer: Aetna Medicare Advantage	$1,018.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$865.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$865.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$679.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$865.73
Rate for Payer: Cigna Commercial	$1,697.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$821.59
Rate for Payer: Qualcare PPO/HMO/WC	$509.25
Rate for Payer: UnitedHealthcare Community & State	$107.28
Rate for Payer: Wellpoint Medicaid Managed Care	$96.42

5%DEXT0.225%SODIUM CHLOR 1000ML

Facility

$42.21

Service Code	NDC 409792409
Hospital Charge Code	606350934
Hospital Revenue Code	258
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$21.11
Rate for Payer: Aetna Commercial	$16.04
Rate for Payer: Aetna Medicare Advantage	$12.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.76
Rate for Payer: Cigna Commercial	$21.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.97
Rate for Payer: Oxford Commercial	$8.44
Rate for Payer: Qualcare PPO/HMO/WC	$6.33
Rate for Payer: UnitedHealthcare Commercial	$8.44
Rate for Payer: UnitedHealthcare Community & State	$1.33
Rate for Payer: Wellpoint Medicaid Managed Care	$1.20

5%DEXT0.225%SODIUM CHLOR 1000ML

Facility

$42.21

Service Code	NDC 409792409
Hospital Charge Code	606350934
Hospital Revenue Code	258
Min. Negotiated Rate	$6.33
Max. Negotiated Rate	$6.33
Rate for Payer: Qualcare PPO/HMO/WC	$6.33

5FR JL 6.0

Facility

$40.00

Hospital Charge Code	270658158
Hospital Revenue Code	270
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

5FR JL 6.0

Facility

$40.00

Hospital Charge Code	270658158
Hospital Revenue Code	270
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$20.00
Rate for Payer: Aetna Commercial	$15.20
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.40
Rate for Payer: Oxford Commercial	$8.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$8.00
Rate for Payer: UnitedHealthcare Community & State	$1.26
Rate for Payer: Wellpoint Medicaid Managed Care	$1.14

5-HIAA,24HR URINE

Facility

$390.00

Service Code	HCPCS 83497
Hospital Charge Code	39900094
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

5-HIAA,24HR URINE

Facility

$390.00

Service Code	HCPCS 83497
Hospital Charge Code	39900094
Hospital Revenue Code	301
Min. Negotiated Rate	$9.90
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	$9.90
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

5 - HYDROXYINDOLEACETIC ACID 5

Facility

$257.00

Service Code	HCPCS 83497
Hospital Charge Code	38472479
Hospital Revenue Code	301
Min. Negotiated Rate	$7.30
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	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.79
Rate for Payer: Cigna Commercial	$128.50
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	$66.82
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.55
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	$7.30

5 - HYDROXYINDOLEACETIC ACID 5

Facility

$257.00

Service Code	HCPCS 83497
Hospital Charge Code	38472479
Hospital Revenue Code	301
Min. Negotiated Rate	$38.55
Max. Negotiated Rate	$38.55
Rate for Payer: Qualcare PPO/HMO/WC	$38.55

5MM ALLEN WRENCH

Facility

$57.55

Hospital Charge Code	270656630
Hospital Revenue Code	278
Min. Negotiated Rate	$8.63
Max. Negotiated Rate	$13.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.93
Rate for Payer: Qualcare PPO/HMO/WC	$8.63

5MM ALLEN WRENCH

Facility

$57.55

Hospital Charge Code	270656630
Hospital Revenue Code	278
Min. Negotiated Rate	$1.63
Max. Negotiated Rate	$28.77
Rate for Payer: Aetna Commercial	$21.87
Rate for Payer: Aetna Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.68
Rate for Payer: Cigna Commercial	$28.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.93
Rate for Payer: Qualcare PPO/HMO/WC	$8.63
Rate for Payer: UnitedHealthcare Community & State	$1.82
Rate for Payer: Wellpoint Medicaid Managed Care	$1.63

5MM CAGE

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270679110
Hospital Revenue Code	278
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$1,573.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00

5MM CAGE

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270679110
Hospital Revenue Code	278
Min. Negotiated Rate	$184.60
Max. Negotiated Rate	$3,250.00
Rate for Payer: Aetna Commercial	$2,470.00
Rate for Payer: Aetna Medicare Advantage	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,657.50
Rate for Payer: Cigna Commercial	$3,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00
Rate for Payer: UnitedHealthcare Community & State	$205.40
Rate for Payer: Wellpoint Medicaid Managed Care	$184.60

5MM LARGE CAGE

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270685693
Hospital Revenue Code	278
Min. Negotiated Rate	$184.60
Max. Negotiated Rate	$3,250.00
Rate for Payer: Aetna Commercial	$2,470.00
Rate for Payer: Aetna Medicare Advantage	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,657.50
Rate for Payer: Cigna Commercial	$3,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00
Rate for Payer: UnitedHealthcare Community & State	$205.40
Rate for Payer: Wellpoint Medicaid Managed Care	$184.60

5MM LARGE CAGE

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270685693
Hospital Revenue Code	278
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$1,573.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00

5MM SCREW

Facility

$780.00

Hospital Charge Code	270339471
Hospital Revenue Code	278
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$188.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: Qualcare PPO/HMO/WC	$117.00

5MM SCREW

Facility

$780.00

Hospital Charge Code	270339471
Hospital Revenue Code	278
Min. Negotiated Rate	$22.15
Max. Negotiated Rate	$390.00
Rate for Payer: Aetna Commercial	$296.40
Rate for Payer: Aetna Medicare Advantage	$234.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.90
Rate for Payer: Cigna Commercial	$390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: Qualcare PPO/HMO/WC	$117.00
Rate for Payer: UnitedHealthcare Community & State	$24.65
Rate for Payer: Wellpoint Medicaid Managed Care	$22.15

5MM SINGLE-SITE WRISTED NEEDLE

Facility

$6,250.00

Hospital Charge Code	270673361
Hospital Revenue Code	272
Min. Negotiated Rate	$177.50
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,625.00
Rate for Payer: Oxford Commercial	$1,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Commercial	$1,250.00
Rate for Payer: UnitedHealthcare Community & State	$197.50
Rate for Payer: Wellpoint Medicaid Managed Care	$177.50

5MM SINGLE-SITE WRISTED NEEDLE

Facility

$6,250.00

Hospital Charge Code	270673361
Hospital Revenue Code	272
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$937.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

5MM TRANSHING PIN

Facility

$660.00

Hospital Charge Code	270339497
Hospital Revenue Code	272
Min. Negotiated Rate	$18.74
Max. Negotiated Rate	$330.00
Rate for Payer: Aetna Commercial	$250.80
Rate for Payer: Aetna Medicare Advantage	$198.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.30
Rate for Payer: Cigna Commercial	$330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.60
Rate for Payer: Oxford Commercial	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$99.00
Rate for Payer: UnitedHealthcare Commercial	$132.00
Rate for Payer: UnitedHealthcare Community & State	$20.86
Rate for Payer: Wellpoint Medicaid Managed Care	$18.74

5MM TRANSHING PIN

Facility

$660.00

Hospital Charge Code	270339497
Hospital Revenue Code	272
Min. Negotiated Rate	$99.00
Max. Negotiated Rate	$99.00
Rate for Payer: Qualcare PPO/HMO/WC	$99.00

5'NUCLEOTIDASE

Facility

$390.00

Service Code	HCPCS 83915
Hospital Charge Code	39900112
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

5'NUCLEOTIDASE

Facility

$390.00

Service Code	HCPCS 83915
Hospital Charge Code	39900112
Hospital Revenue Code	301
Min. Negotiated Rate	$8.92
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$30.33
Rate for Payer: Aetna Medicare Advantage	$36.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.45
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$11.15
Rate for Payer: Clover Medicare Advantage	$10.59
Rate for Payer: EmblemHealth Commercial	$33.45
Rate for Payer: Humana Medicare Advantage	$11.48
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.15
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	$8.92
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.15
Rate for Payer: Wellcare Medicare Advantage	$11.15
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

5' NUCLEOTIDASE

Facility

$176.00

Service Code	HCPCS 83915
Hospital Charge Code	38472518
Hospital Revenue Code	301
Min. Negotiated Rate	$5.00
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$30.33
Rate for Payer: Aetna Medicare Advantage	$36.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.45
Rate for Payer: Cigna Commercial	$88.00
Rate for Payer: Cigna Medicare Advantage	$11.15
Rate for Payer: Clover Medicare Advantage	$10.59
Rate for Payer: EmblemHealth Commercial	$33.45
Rate for Payer: Humana Medicare Advantage	$11.48
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.76
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.40
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$8.92
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.15
Rate for Payer: Wellcare Medicare Advantage	$11.15
Rate for Payer: Wellpoint Medicaid Managed Care	$5.00

5' NUCLEOTIDASE

Facility

$176.00

Service Code	HCPCS 83915
Hospital Charge Code	38472518
Hospital Revenue Code	301
Min. Negotiated Rate	$26.40
Max. Negotiated Rate	$26.40
Rate for Payer: Qualcare PPO/HMO/WC	$26.40

Know your out-of-pocket cost for care.

All Charges