Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BUSPIRONE 7.5MG TABLET

Facility

$10.59

Service Code	NDC 64380078706
Hospital Charge Code	606390258
Hospital Revenue Code	250
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$1.59
Rate for Payer: Qualcare PPO/HMO/WC	$1.59

BUSPIRONE 7.5MG TABLET

Facility

$10.59

Service Code	NDC 64380078706
Hospital Charge Code	606390258
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$5.29
Rate for Payer: Aetna Commercial	$4.02
Rate for Payer: Aetna Medicare Advantage	$3.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.70
Rate for Payer: Cigna Commercial	$5.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.75
Rate for Payer: Oxford Commercial	$2.12
Rate for Payer: Qualcare PPO/HMO/WC	$1.59
Rate for Payer: UnitedHealthcare Commercial	$2.12
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

BUTABARBITAL (BARBITUATE) BLD

Facility

$159.25

Service Code	HCPCS 80345
Hospital Charge Code	3007168
Hospital Revenue Code	301
Min. Negotiated Rate	$4.52
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$60.52
Rate for Payer: Aetna Medicare Advantage	$47.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.61
Rate for Payer: Cigna Commercial	$79.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.41
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.89
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$22.05
Rate for Payer: Wellpoint Medicaid Managed Care	$4.52

BUTABARBITAL (BARBITUATE) BLD

Facility

$159.25

Service Code	HCPCS 80345
Hospital Charge Code	3007168
Hospital Revenue Code	301
Min. Negotiated Rate	$23.89
Max. Negotiated Rate	$23.89
Rate for Payer: Qualcare PPO/HMO/WC	$23.89

BUTFLY BLD COLLECT 21ga 367281

Facility

$3.60

Hospital Charge Code	270639106
Hospital Revenue Code	272
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$1.80
Rate for Payer: Aetna Commercial	$1.37
Rate for Payer: Aetna Medicare Advantage	$1.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.92
Rate for Payer: Cigna Commercial	$1.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.94
Rate for Payer: Oxford Commercial	$0.72
Rate for Payer: Qualcare PPO/HMO/WC	$0.54
Rate for Payer: UnitedHealthcare Commercial	$0.72
Rate for Payer: UnitedHealthcare Community & State	$0.11
Rate for Payer: Wellpoint Medicaid Managed Care	$0.10

BUTFLY BLD COLLECT 21ga 367281

Facility

$3.60

Hospital Charge Code	270639106
Hospital Revenue Code	272
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$0.54
Rate for Payer: Qualcare PPO/HMO/WC	$0.54

BUTTON CERCLAGE HEX T25 3.5MM

Facility

$756.00

Hospital Charge Code	270676918
Hospital Revenue Code	272
Min. Negotiated Rate	$21.47
Max. Negotiated Rate	$378.00
Rate for Payer: Aetna Commercial	$287.28
Rate for Payer: Aetna Medicare Advantage	$226.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.78
Rate for Payer: Cigna Commercial	$378.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.56
Rate for Payer: Oxford Commercial	$151.20
Rate for Payer: Qualcare PPO/HMO/WC	$113.40
Rate for Payer: UnitedHealthcare Commercial	$151.20
Rate for Payer: UnitedHealthcare Community & State	$23.89
Rate for Payer: Wellpoint Medicaid Managed Care	$21.47

BUTTON CERCLAGE HEX T25 3.5MM

Facility

$756.00

Hospital Charge Code	270676918
Hospital Revenue Code	272
Min. Negotiated Rate	$113.40
Max. Negotiated Rate	$113.40
Rate for Payer: Qualcare PPO/HMO/WC	$113.40

BUTTON PROXIMAL TENODESIS

Facility

$2,175.00

Hospital Charge Code	270676803
Hospital Revenue Code	272
Min. Negotiated Rate	$61.77
Max. Negotiated Rate	$1,087.50
Rate for Payer: Aetna Commercial	$826.50
Rate for Payer: Aetna Medicare Advantage	$652.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$554.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$554.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$554.62
Rate for Payer: Cigna Commercial	$1,087.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$565.50
Rate for Payer: Oxford Commercial	$435.00
Rate for Payer: Qualcare PPO/HMO/WC	$326.25
Rate for Payer: UnitedHealthcare Commercial	$435.00
Rate for Payer: UnitedHealthcare Community & State	$68.73
Rate for Payer: Wellpoint Medicaid Managed Care	$61.77

BUTTON PROXIMAL TENODESIS

Facility

$2,175.00

Hospital Charge Code	270676803
Hospital Revenue Code	272
Min. Negotiated Rate	$326.25
Max. Negotiated Rate	$326.25
Rate for Payer: Qualcare PPO/HMO/WC	$326.25

BUTTRESS PLATE (LATERAL)

Facility

$1,522.00

Hospital Charge Code	270335019
Hospital Revenue Code	278
Min. Negotiated Rate	$43.22
Max. Negotiated Rate	$761.00
Rate for Payer: Aetna Commercial	$578.36
Rate for Payer: Aetna Medicare Advantage	$456.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$388.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$388.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$304.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$388.11
Rate for Payer: Cigna Commercial	$761.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$368.32
Rate for Payer: Qualcare PPO/HMO/WC	$228.30
Rate for Payer: UnitedHealthcare Community & State	$48.10
Rate for Payer: Wellpoint Medicaid Managed Care	$43.22

BUTTRESS PLATE (LATERAL)

Facility

$1,522.00

Hospital Charge Code	270335019
Hospital Revenue Code	278
Min. Negotiated Rate	$228.30
Max. Negotiated Rate	$368.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$304.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$368.32
Rate for Payer: Qualcare PPO/HMO/WC	$228.30

BUY ROUND FLUTE 4.0 MM 6

Facility

$1,435.00

Hospital Charge Code	270658117
Hospital Revenue Code	278
Min. Negotiated Rate	$215.25
Max. Negotiated Rate	$347.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$287.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$347.27
Rate for Payer: Qualcare PPO/HMO/WC	$215.25

BUY ROUND FLUTE 4.0 MM 6

Facility

$1,435.00

Hospital Charge Code	270658117
Hospital Revenue Code	278
Min. Negotiated Rate	$40.75
Max. Negotiated Rate	$717.50
Rate for Payer: Aetna Commercial	$545.30
Rate for Payer: Aetna Medicare Advantage	$430.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$365.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$365.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$287.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$365.93
Rate for Payer: Cigna Commercial	$717.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$347.27
Rate for Payer: Qualcare PPO/HMO/WC	$215.25
Rate for Payer: UnitedHealthcare Community & State	$45.35
Rate for Payer: Wellpoint Medicaid Managed Care	$40.75

BX BREAST 1ST LESION STRTCT

Facility

$8,338.90

Service Code	HCPCS 19081
Hospital Charge Code	16000602
Hospital Revenue Code	360
Min. Negotiated Rate	$1,250.84
Max. Negotiated Rate	$1,250.84
Rate for Payer: Qualcare PPO/HMO/WC	$1,250.84

BX BREAST 1ST LESION STRTCT

Facility

$8,338.90

Service Code	HCPCS 19081
Hospital Charge Code	16000602
Hospital Revenue Code	360
Min. Negotiated Rate	$236.82
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,168.11
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,250.84
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$263.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$236.82

BX BREAST 1ST LESION US IMAG

Facility

$8,338.90

Service Code	HCPCS 19083
Hospital Charge Code	16000663
Hospital Revenue Code	360
Min. Negotiated Rate	$236.82
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,168.11
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,250.84
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$263.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$236.82

BX BREAST 1ST LESION US IMAG

Facility

$8,338.90

Service Code	HCPCS 19083
Hospital Charge Code	16000663
Hospital Revenue Code	360
Min. Negotiated Rate	$1,250.84
Max. Negotiated Rate	$1,250.84
Rate for Payer: Qualcare PPO/HMO/WC	$1,250.84

BX BREAST MR GUIDE EA ADD LESN

Facility

$4,789.80

Service Code	HCPCS 19086
Hospital Charge Code	2409030
Hospital Revenue Code	361
Min. Negotiated Rate	$136.03
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,820.12
Rate for Payer: Aetna Medicare Advantage	$1,436.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,221.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,221.40
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	$1,221.40
Rate for Payer: Cigna Commercial	$2,394.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,245.35
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$718.47
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$151.36
Rate for Payer: Wellpoint Medicaid Managed Care	$136.03

BX BREAST MR GUIDE EA ADD LESN

Facility

$4,789.80

Service Code	HCPCS 19086
Hospital Charge Code	2409030
Hospital Revenue Code	361
Min. Negotiated Rate	$718.47
Max. Negotiated Rate	$718.47
Rate for Payer: Qualcare PPO/HMO/WC	$718.47

BX PROSTATE,NEEDLE OR PUNCH

Facility

$10,187.80

Service Code	HCPCS 55700
Hospital Charge Code	1600000847
Hospital Revenue Code	360
Min. Negotiated Rate	$1,528.17
Max. Negotiated Rate	$1,528.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

BX PROSTATE,NEEDLE OR PUNCH

Facility

$10,187.80

Service Code	HCPCS 55700
Hospital Charge Code	1600000847
Hospital Revenue Code	360
Min. Negotiated Rate	$289.33
Max. Negotiated Rate	$5,347.00
Rate for Payer: Aetna Commercial	$3,871.36
Rate for Payer: Aetna Medicare Advantage	$3,056.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,597.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,597.89
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	$2,597.89
Rate for Payer: Cigna Commercial	$5,093.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,648.83
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$321.93
Rate for Payer: Wellpoint Medicaid Managed Care	$289.33

BX-SKIN SQ/MM,EA ADDTL

Facility

$994.50

Service Code	HCPCS 11200
Hospital Charge Code	1600000404
Hospital Revenue Code	360
Min. Negotiated Rate	$28.24
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$648.34
Rate for Payer: Aetna Medicare Advantage	$772.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$864.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$864.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$238.36
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	$864.65
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: Cigna Medicare Advantage	$238.36
Rate for Payer: Clover Medicare Advantage	$226.44
Rate for Payer: EmblemHealth Commercial	$715.08
Rate for Payer: Humana Medicare Advantage	$245.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$238.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.57
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$149.18
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$31.43
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$28.24

BX-SKIN SQ/MM,EA ADDTL

Facility

$994.50

Service Code	HCPCS 11200
Hospital Charge Code	1600000404
Hospital Revenue Code	360
Min. Negotiated Rate	$149.18
Max. Negotiated Rate	$149.18
Rate for Payer: Qualcare PPO/HMO/WC	$149.18

BX SKIN, SQ TISSUE, MUC MEMB

Facility

$1,720.85

Service Code	HCPCS 11100
Hospital Charge Code	2250455
Hospital Revenue Code	361
Min. Negotiated Rate	$54.38
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$653.92
Rate for Payer: Aetna Medicare Advantage	$516.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$438.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$438.82
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	$438.82
Rate for Payer: Cigna Commercial	$860.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$447.42
Rate for Payer: Qualcare PPO/HMO/WC	$258.13
Rate for Payer: UnitedHealthcare Community & State	$54.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1,037.98

Know your out-of-pocket cost for care.

All Charges