Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CELEBREX 100 MG U/D CAP

Facility

$37.65

Service Code	NDC 58151008301
Hospital Charge Code	60635325
Hospital Revenue Code	250
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$18.82
Rate for Payer: Aetna Commercial	$14.31
Rate for Payer: Aetna Medicare Advantage	$11.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.60
Rate for Payer: Cigna Commercial	$18.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.79
Rate for Payer: Oxford Commercial	$7.53
Rate for Payer: Qualcare PPO/HMO/WC	$5.65
Rate for Payer: UnitedHealthcare Commercial	$7.53
Rate for Payer: UnitedHealthcare Community & State	$1.19
Rate for Payer: Wellpoint Medicaid Managed Care	$1.07

CELEBREX 200 MG U/D CAP

Facility

$61.77

Service Code	NDC 58151008401
Hospital Charge Code	60635326
Hospital Revenue Code	250
Min. Negotiated Rate	$9.27
Max. Negotiated Rate	$9.27
Rate for Payer: Qualcare PPO/HMO/WC	$9.27

CELEBREX 200 MG U/D CAP

Facility

$61.77

Service Code	NDC 58151008401
Hospital Charge Code	60635326
Hospital Revenue Code	250
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$30.89
Rate for Payer: Aetna Commercial	$23.47
Rate for Payer: Aetna Medicare Advantage	$18.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.75
Rate for Payer: Cigna Commercial	$30.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.06
Rate for Payer: Oxford Commercial	$12.35
Rate for Payer: Qualcare PPO/HMO/WC	$9.27
Rate for Payer: UnitedHealthcare Commercial	$12.35
Rate for Payer: UnitedHealthcare Community & State	$1.95
Rate for Payer: Wellpoint Medicaid Managed Care	$1.75

CELEBRITY ENDO CYTO BRUSH

Facility

$56.00

Hospital Charge Code	270656979
Hospital Revenue Code	272
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.40

CELEBRITY ENDO CYTO BRUSH

Facility

$56.00

Hospital Charge Code	270656979
Hospital Revenue Code	272
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$28.00
Rate for Payer: Aetna Commercial	$21.28
Rate for Payer: Aetna Medicare Advantage	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.28
Rate for Payer: Cigna Commercial	$28.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.56
Rate for Payer: Oxford Commercial	$11.20
Rate for Payer: Qualcare PPO/HMO/WC	$8.40
Rate for Payer: UnitedHealthcare Commercial	$11.20
Rate for Payer: UnitedHealthcare Community & State	$1.77
Rate for Payer: Wellpoint Medicaid Managed Care	$1.59

CELIAC DISEASE COMP PANEL I

Facility

$667.59

Service Code	HCPCS 83516
Hospital Charge Code	39990072A
Hospital Revenue Code	301
Min. Negotiated Rate	$9.22
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$31.36
Rate for Payer: Aetna Medicare Advantage	$37.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.83
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$11.53
Rate for Payer: Clover Medicare Advantage	$10.95
Rate for Payer: EmblemHealth Commercial	$34.59
Rate for Payer: Humana Medicare Advantage	$11.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.53
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	$9.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.53
Rate for Payer: Wellcare Medicare Advantage	$11.53
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

CELIAC DISEASE COMP PANEL I

Facility

$667.59

Service Code	HCPCS 83516
Hospital Charge Code	39990072A
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

CELIAC DISEASE COMP PANEL II

Facility

$667.59

Service Code	HCPCS 82784
Hospital Charge Code	39990072B
Hospital Revenue Code	301
Min. Negotiated Rate	$7.44
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$25.30
Rate for Payer: Aetna Medicare Advantage	$30.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.74
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$9.30
Rate for Payer: Clover Medicare Advantage	$8.84
Rate for Payer: EmblemHealth Commercial	$27.90
Rate for Payer: Humana Medicare Advantage	$9.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.30
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	$7.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.30
Rate for Payer: Wellcare Medicare Advantage	$9.30
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

CELIAC DISEASE COMP PANEL II

Facility

$667.59

Service Code	HCPCS 82784
Hospital Charge Code	39990072B
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

CELIAC PLEXUS BLOC (ANALGESIC)

Facility

$3,103.00

Service Code	HCPCS 64530
Hospital Charge Code	84506050
Hospital Revenue Code	361
Min. Negotiated Rate	$465.45
Max. Negotiated Rate	$465.45
Rate for Payer: Qualcare PPO/HMO/WC	$465.45

CELIAC PLEXUS BLOC (ANALGESIC)

Facility

$3,103.00

Service Code	HCPCS 64530
Hospital Charge Code	84506050
Hospital Revenue Code	361
Min. Negotiated Rate	$88.13
Max. Negotiated Rate	$3,811.70
Rate for Payer: Aetna Commercial	$2,858.12
Rate for Payer: Aetna Medicare Advantage	$3,404.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,811.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,811.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,050.78
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	$3,811.70
Rate for Payer: Cigna Commercial	$2,106.27
Rate for Payer: Cigna Medicare Advantage	$1,050.78
Rate for Payer: Clover Medicare Advantage	$998.24
Rate for Payer: EmblemHealth Commercial	$3,152.34
Rate for Payer: Humana Medicare Advantage	$1,082.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,050.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$806.78
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$465.45
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$98.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,050.78
Rate for Payer: Wellcare Medicare Advantage	$1,050.78
Rate for Payer: Wellpoint Medicaid Managed Care	$88.13

CELL ASSURITY PACEMAKER

Facility

$32,000.00

Service Code	HCPCS C1785
Hospital Charge Code	270676936
Hospital Revenue Code	275
Min. Negotiated Rate	$4,800.00
Max. Negotiated Rate	$7,744.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,744.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,800.00

CELL ASSURITY PACEMAKER

Facility

$32,000.00

Service Code	HCPCS C1785
Hospital Charge Code	270676936
Hospital Revenue Code	275
Min. Negotiated Rate	$908.80
Max. Negotiated Rate	$16,000.00
Rate for Payer: Aetna Commercial	$12,160.00
Rate for Payer: Aetna Medicare Advantage	$9,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,160.00
Rate for Payer: Cigna Commercial	$16,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,744.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,800.00
Rate for Payer: UnitedHealthcare Community & State	$1,011.20
Rate for Payer: Wellpoint Medicaid Managed Care	$908.80

CELLCEPT 500MG TAB

Facility

$114.84

Service Code	HCPCS J7517
Hospital Charge Code	60635225
Hospital Revenue Code	636
Min. Negotiated Rate	$17.23
Max. Negotiated Rate	$27.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.79
Rate for Payer: Qualcare PPO/HMO/WC	$17.23

CELLCEPT 500MG TAB

Facility

$114.84

Service Code	HCPCS J7517
Hospital Charge Code	60635225
Hospital Revenue Code	636
Min. Negotiated Rate	$3.26
Max. Negotiated Rate	$57.42
Rate for Payer: Aetna Commercial	$43.64
Rate for Payer: Aetna Medicare Advantage	$34.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.28
Rate for Payer: Cigna Commercial	$57.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.79
Rate for Payer: Qualcare PPO/HMO/WC	$17.23
Rate for Payer: UnitedHealthcare Community & State	$3.63
Rate for Payer: Wellpoint Medicaid Managed Care	$3.26

CELL COUNT (CSF)

Facility

$390.00

Service Code	HCPCS 89050
Hospital Charge Code	3000676
Hospital Revenue Code	300
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CELL COUNT (CSF)

Facility

$390.00

Service Code	HCPCS 89050
Hospital Charge Code	3000676
Hospital Revenue Code	300
Min. Negotiated Rate	$3.78
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$12.84
Rate for Payer: Aetna Medicare Advantage	$15.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.12
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$4.72
Rate for Payer: Clover Medicare Advantage	$4.48
Rate for Payer: EmblemHealth Commercial	$14.16
Rate for Payer: Humana Medicare Advantage	$4.86
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.72
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	$3.78
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.72
Rate for Payer: Wellcare Medicare Advantage	$4.72
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

CELL COUNT/DIFF PERITONEAL FLD

Facility

$667.59

Service Code	HCPCS 89051
Hospital Charge Code	3008705
Hospital Revenue Code	309
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

CELL COUNT/DIFF PERITONEAL FLD

Facility

$667.59

Service Code	HCPCS 89051
Hospital Charge Code	3008705
Hospital Revenue Code	309
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$15.23
Rate for Payer: Aetna Medicare Advantage	$18.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.31
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$5.60
Rate for Payer: Clover Medicare Advantage	$5.32
Rate for Payer: EmblemHealth Commercial	$16.80
Rate for Payer: Humana Medicare Advantage	$5.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.60
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	$4.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.60
Rate for Payer: Wellcare Medicare Advantage	$5.60
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

CELL COUNT FLUID

Facility

$307.00

Service Code	HCPCS 89050
Hospital Charge Code	38472208
Hospital Revenue Code	309
Min. Negotiated Rate	$3.78
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$12.84
Rate for Payer: Aetna Medicare Advantage	$15.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.12
Rate for Payer: Cigna Commercial	$153.50
Rate for Payer: Cigna Medicare Advantage	$4.72
Rate for Payer: Clover Medicare Advantage	$4.48
Rate for Payer: EmblemHealth Commercial	$14.16
Rate for Payer: Humana Medicare Advantage	$4.86
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.82
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.05
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$3.78
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.72
Rate for Payer: Wellcare Medicare Advantage	$4.72
Rate for Payer: Wellpoint Medicaid Managed Care	$8.72

CELL COUNT FLUID

Facility

$307.00

Service Code	HCPCS 89050
Hospital Charge Code	38472208
Hospital Revenue Code	309
Min. Negotiated Rate	$46.05
Max. Negotiated Rate	$46.05
Rate for Payer: Qualcare PPO/HMO/WC	$46.05

CELL COUNT W/DIFF,FLUID

Facility

$183.00

Service Code	HCPCS 89051
Hospital Charge Code	38473027
Hospital Revenue Code	309
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$15.23
Rate for Payer: Aetna Medicare Advantage	$18.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.31
Rate for Payer: Cigna Commercial	$91.50
Rate for Payer: Cigna Medicare Advantage	$5.60
Rate for Payer: Clover Medicare Advantage	$5.32
Rate for Payer: EmblemHealth Commercial	$16.80
Rate for Payer: Humana Medicare Advantage	$5.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.60
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	$4.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.60
Rate for Payer: Wellcare Medicare Advantage	$5.60
Rate for Payer: Wellpoint Medicaid Managed Care	$5.20

CELL COUNT W/DIFF,FLUID

Facility

$183.00

Service Code	HCPCS 89051
Hospital Charge Code	38473027
Hospital Revenue Code	309
Min. Negotiated Rate	$27.45
Max. Negotiated Rate	$27.45
Rate for Payer: Qualcare PPO/HMO/WC	$27.45

CELLERATE WND FILL POWDER 5GM

Facility

$13,751.25

Service Code	HCPCS A6010
Hospital Charge Code	270695988
Hospital Revenue Code	272
Min. Negotiated Rate	$390.54
Max. Negotiated Rate	$6,875.62
Rate for Payer: Aetna Commercial	$5,225.48
Rate for Payer: Aetna Medicare Advantage	$4,125.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,506.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,506.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,506.57
Rate for Payer: Cigna Commercial	$6,875.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,575.32
Rate for Payer: Oxford Commercial	$2,750.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.69
Rate for Payer: UnitedHealthcare Commercial	$2,750.25
Rate for Payer: UnitedHealthcare Community & State	$434.54
Rate for Payer: Wellpoint Medicaid Managed Care	$390.54

CELLERATE WND FILL POWDER 5GM

Facility

$13,751.25

Service Code	HCPCS A6010
Hospital Charge Code	270695988
Hospital Revenue Code	272
Min. Negotiated Rate	$2,062.69
Max. Negotiated Rate	$2,062.69
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.69

Know your out-of-pocket cost for care.

All Charges