Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CAUTERY HOT TEMP FINE TIP

Facility

$43.95

Hospital Charge Code	270651811
Hospital Revenue Code	272
Min. Negotiated Rate	$6.59
Max. Negotiated Rate	$6.59
Rate for Payer: Qualcare PPO/HMO/WC	$6.59

CAUTERY HOT TEMP FINE TIP

Facility

$43.95

Hospital Charge Code	270651811
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$21.98
Rate for Payer: Aetna Commercial	$16.70
Rate for Payer: Aetna Medicare Advantage	$13.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.21
Rate for Payer: Cigna Commercial	$21.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.43
Rate for Payer: Oxford Commercial	$8.79
Rate for Payer: Qualcare PPO/HMO/WC	$6.59
Rate for Payer: UnitedHealthcare Commercial	$8.79
Rate for Payer: UnitedHealthcare Community & State	$1.39
Rate for Payer: Wellpoint Medicaid Managed Care	$1.25

CAVILON BARRIER CREAM 1.3% 1OZ

Facility

$12.86

Service Code	NDC 17518003003
Hospital Charge Code	606390442
Hospital Revenue Code	271
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$6.43
Rate for Payer: Aetna Commercial	$4.89
Rate for Payer: Aetna Medicare Advantage	$3.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.28
Rate for Payer: Cigna Commercial	$6.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.34
Rate for Payer: Oxford Commercial	$2.57
Rate for Payer: Qualcare PPO/HMO/WC	$1.93
Rate for Payer: UnitedHealthcare Commercial	$2.57
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

CAVILON BARRIER CREAM 1.3% 1OZ

Facility

$12.86

Service Code	NDC 17518003003
Hospital Charge Code	606390442
Hospital Revenue Code	271
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$1.93
Rate for Payer: Qualcare PPO/HMO/WC	$1.93

CAVUX FAC FIX SY 4MM

Facility

$14,000.00

Hospital Charge Code	270702429
Hospital Revenue Code	278
Min. Negotiated Rate	$397.60
Max. Negotiated Rate	$7,000.00
Rate for Payer: Aetna Commercial	$5,320.00
Rate for Payer: Aetna Medicare Advantage	$4,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,570.00
Rate for Payer: Cigna Commercial	$7,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,388.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,100.00
Rate for Payer: UnitedHealthcare Community & State	$442.40
Rate for Payer: Wellpoint Medicaid Managed Care	$397.60

CAVUX FAC FIX SY 4MM

Facility

$14,000.00

Hospital Charge Code	270702429
Hospital Revenue Code	278
Min. Negotiated Rate	$2,100.00
Max. Negotiated Rate	$3,388.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,388.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,100.00

CBC (NO DIFF)

Facility

$667.59

Service Code	HCPCS 85027
Hospital Charge Code	3005403
Hospital Revenue Code	305
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$333.80
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	$7.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.47
Rate for Payer: Cigna Commercial	$333.80
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	$173.57
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
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	$18.96

CBC (NO DIFF)

Facility

$667.59

Service Code	HCPCS 85027
Hospital Charge Code	3005403
Hospital Revenue Code	305
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

CBC PATHOLOGIST REVIEW

Facility

$113.65

Service Code	HCPCS 85060
Hospital Charge Code	3007978
Hospital Revenue Code	305
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$43.19
Rate for Payer: Aetna Medicare Advantage	$34.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.98
Rate for Payer: Cigna Commercial	$56.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.55
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.05
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$18.52
Rate for Payer: Wellpoint Medicaid Managed Care	$3.23

CBC PATHOLOGIST REVIEW

Facility

$113.65

Service Code	HCPCS 85060
Hospital Charge Code	3007978
Hospital Revenue Code	305
Min. Negotiated Rate	$17.05
Max. Negotiated Rate	$17.05
Rate for Payer: Qualcare PPO/HMO/WC	$17.05

CBC W/AUTO DIFFERNTIAL

Facility

$449.40

Service Code	HCPCS 85025
Hospital Charge Code	38473003
Hospital Revenue Code	305
Min. Negotiated Rate	$67.41
Max. Negotiated Rate	$67.41
Rate for Payer: Qualcare PPO/HMO/WC	$67.41

CBC W/AUTO DIFFERNTIAL

Facility

$449.40

Service Code	HCPCS 85025
Hospital Charge Code	38473003
Hospital Revenue Code	305
Min. Negotiated Rate	$6.22
Max. Negotiated Rate	$224.70
Rate for Payer: Aetna Commercial	$21.13
Rate for Payer: Aetna Medicare Advantage	$25.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.19
Rate for Payer: Cigna Commercial	$224.70
Rate for Payer: Cigna Medicare Advantage	$7.77
Rate for Payer: Clover Medicare Advantage	$7.38
Rate for Payer: EmblemHealth Commercial	$23.31
Rate for Payer: Humana Medicare Advantage	$8.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.84
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.41
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$6.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.77
Rate for Payer: Wellcare Medicare Advantage	$7.77
Rate for Payer: Wellpoint Medicaid Managed Care	$12.76

CBC W/O DIFFERENTIAL

Facility

$183.00

Service Code	HCPCS 85027
Hospital Charge Code	38474116
Hospital Revenue Code	305
Min. Negotiated Rate	$27.45
Max. Negotiated Rate	$27.45
Rate for Payer: Qualcare PPO/HMO/WC	$27.45

CBC W/O DIFFERENTIAL

Facility

$183.00

Service Code	HCPCS 85027
Hospital Charge Code	38474116
Hospital Revenue Code	305
Min. Negotiated Rate	$5.18
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	$7.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.47
Rate for Payer: Cigna Commercial	$91.50
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	$47.58
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.45
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	$5.20

CCIIV4 VAC NO PRSV 0.5 ML IM

Facility

$72.45

Service Code	HCPCS 90674
Hospital Charge Code	412390674
Hospital Revenue Code	636
Min. Negotiated Rate	$10.87
Max. Negotiated Rate	$17.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.53
Rate for Payer: Qualcare PPO/HMO/WC	$10.87

CCIIV4 VAC NO PRSV 0.5 ML IM

Facility

$72.45

Service Code	HCPCS 90674
Hospital Charge Code	412390674
Hospital Revenue Code	636
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$36.23
Rate for Payer: Aetna Commercial	$27.53
Rate for Payer: Aetna Medicare Advantage	$21.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.47
Rate for Payer: Cigna Commercial	$36.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.53
Rate for Payer: Qualcare PPO/HMO/WC	$10.87
Rate for Payer: UnitedHealthcare Community & State	$2.29
Rate for Payer: Wellpoint Medicaid Managed Care	$2.06

CCP IGG

Facility

$390.00

Service Code	HCPCS 86200
Hospital Charge Code	39900361
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CCP IGG

Facility

$390.00

Service Code	HCPCS 86200
Hospital Charge Code	39900361
Hospital Revenue Code	302
Min. Negotiated Rate	$10.36
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$35.22
Rate for Payer: Aetna Medicare Advantage	$41.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.98
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.95
Rate for Payer: Clover Medicare Advantage	$12.30
Rate for Payer: EmblemHealth Commercial	$38.85
Rate for Payer: Humana Medicare Advantage	$13.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.95
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	$10.36
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.95
Rate for Payer: Wellcare Medicare Advantage	$12.95
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

CDIFF CULT REFL TOXIN B RT PCR

Facility

$109.12

Service Code	HCPCS 87081
Hospital Charge Code	4013870813
Hospital Revenue Code	309
Min. Negotiated Rate	$16.37
Max. Negotiated Rate	$16.37
Rate for Payer: Qualcare PPO/HMO/WC	$16.37

CDIFF CULT REFL TOXIN B RT PCR

Facility

$109.12

Service Code	HCPCS 87081
Hospital Charge Code	4013870813
Hospital Revenue Code	309
Min. Negotiated Rate	$3.10
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$18.03
Rate for Payer: Aetna Medicare Advantage	$21.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.05
Rate for Payer: Cigna Commercial	$54.56
Rate for Payer: Cigna Medicare Advantage	$6.63
Rate for Payer: Clover Medicare Advantage	$6.30
Rate for Payer: EmblemHealth Commercial	$19.89
Rate for Payer: Humana Medicare Advantage	$6.83
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.37
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.37
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$5.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.63
Rate for Payer: Wellcare Medicare Advantage	$6.63
Rate for Payer: Wellpoint Medicaid Managed Care	$3.10

C DIFFICILE TOX A & B

Facility

$390.00

Service Code	HCPCS 87324
Hospital Charge Code	3000944
Hospital Revenue Code	300
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

C DIFFICILE TOX A & B

Facility

$390.00

Service Code	HCPCS 87324
Hospital Charge Code	3000944
Hospital Revenue Code	300
Min. Negotiated Rate	$9.58
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$32.59
Rate for Payer: Aetna Medicare Advantage	$38.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.46
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$11.98
Rate for Payer: Clover Medicare Advantage	$11.38
Rate for Payer: EmblemHealth Commercial	$35.94
Rate for Payer: Humana Medicare Advantage	$12.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.98
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	$9.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.98
Rate for Payer: Wellcare Medicare Advantage	$11.98
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

CDX2 IHC

Facility

$1,082.30

Service Code	HCPCS 88342
Hospital Charge Code	4016883420
Hospital Revenue Code	310
Min. Negotiated Rate	$162.34
Max. Negotiated Rate	$162.34
Rate for Payer: Qualcare PPO/HMO/WC	$162.34

CDX2 IHC

Facility

$1,082.30

Service Code	HCPCS 88342
Hospital Charge Code	4016883420
Hospital Revenue Code	310
Min. Negotiated Rate	$30.74
Max. Negotiated Rate	$734.21
Rate for Payer: Aetna Commercial	$550.53
Rate for Payer: Aetna Medicare Advantage	$655.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$734.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$734.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$202.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$734.21
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$202.40
Rate for Payer: Clover Medicare Advantage	$192.28
Rate for Payer: EmblemHealth Commercial	$607.20
Rate for Payer: Humana Medicare Advantage	$208.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$202.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$281.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$162.34
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$86.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$202.40
Rate for Payer: Wellcare Medicare Advantage	$202.40
Rate for Payer: Wellpoint Medicaid Managed Care	$30.74

CEA, CARCINOEMBRYONIC AG

Facility

$667.59

Service Code	HCPCS 82378
Hospital Charge Code	3000668
Hospital Revenue Code	301
Min. Negotiated Rate	$15.17
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$51.57
Rate for Payer: Aetna Medicare Advantage	$61.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.78
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$18.96
Rate for Payer: Clover Medicare Advantage	$18.01
Rate for Payer: EmblemHealth Commercial	$56.88
Rate for Payer: Humana Medicare Advantage	$19.53
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.57
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$15.17
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.96
Rate for Payer: Wellcare Medicare Advantage	$18.96
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

Know your out-of-pocket cost for care.

All Charges