Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CFH PAP SMEAR

Facility

$35.00

Service Code	HCPCS 88142
Hospital Charge Code	83652289
Hospital Revenue Code	311
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$55.11
Rate for Payer: Aetna Medicare Advantage	$65.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.49
Rate for Payer: Cigna Commercial	$17.50
Rate for Payer: Cigna Medicare Advantage	$20.26
Rate for Payer: Clover Medicare Advantage	$19.25
Rate for Payer: EmblemHealth Commercial	$60.78
Rate for Payer: Humana Medicare Advantage	$20.87
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.10
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.25
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$16.21
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.26
Rate for Payer: Wellcare Medicare Advantage	$20.26
Rate for Payer: Wellpoint Medicaid Managed Care	$0.99

CFH PAP SMEAR

Facility

$35.00

Service Code	HCPCS 88142
Hospital Charge Code	83652289
Hospital Revenue Code	311
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$5.25
Rate for Payer: Qualcare PPO/HMO/WC	$5.25

CFH PARAGARD IUD

Facility

$174.00

Service Code	HCPCS J7300
Hospital Charge Code	83652645
Hospital Revenue Code	636
Min. Negotiated Rate	$4.94
Max. Negotiated Rate	$87.00
Rate for Payer: Aetna Commercial	$66.12
Rate for Payer: Aetna Medicare Advantage	$52.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.37
Rate for Payer: Cigna Commercial	$87.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.11
Rate for Payer: Qualcare PPO/HMO/WC	$26.10
Rate for Payer: UnitedHealthcare Community & State	$5.50
Rate for Payer: Wellpoint Medicaid Managed Care	$4.94

CFH PARAGARD IUD

Facility

$174.00

Service Code	HCPCS J7300
Hospital Charge Code	83652645
Hospital Revenue Code	636
Min. Negotiated Rate	$26.10
Max. Negotiated Rate	$42.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.11
Rate for Payer: Qualcare PPO/HMO/WC	$26.10

CFH PED PREV EST PT 1 TO 4 YRS

Facility

$175.00

Service Code	HCPCS 99392
Hospital Charge Code	83652485
Hospital Revenue Code	515
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

CFH PED PREV EST PT 1 TO 4 YRS

Facility

$175.00

Service Code	HCPCS 99392
Hospital Charge Code	83652485
Hospital Revenue Code	515
Min. Negotiated Rate	$4.97
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Community & State	$5.53
Rate for Payer: Wellpoint Medicaid Managed Care	$4.97

CFH PED PREV EST PT<1 YEAR OLD

Facility

$175.00

Service Code	HCPCS 99391
Hospital Charge Code	83652483
Hospital Revenue Code	515
Min. Negotiated Rate	$4.97
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Community & State	$5.53
Rate for Payer: Wellpoint Medicaid Managed Care	$4.97

CFH PED PREV EST PT<1 YEAR OLD

Facility

$175.00

Service Code	HCPCS 99391
Hospital Charge Code	83652483
Hospital Revenue Code	515
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

CFH PROFEE: HSP DISCH<=30 MN

Professional

Both

$145.00

Service Code	HCPCS 99238
Hospital Charge Code	83652431
Hospital Revenue Code	960
Min. Negotiated Rate	$22.96
Max. Negotiated Rate	$158.30
Rate for Payer: Aetna Commercial	$77.88
Rate for Payer: Aetna Medicare Advantage	$85.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.96
Rate for Payer: Cigna Commercial	$154.08
Rate for Payer: Cigna Medicare Advantage	$154.08
Rate for Payer: Clover Medicare Advantage	$84.24
Rate for Payer: EmblemHealth Commercial	$85.04
Rate for Payer: Fidelis All Plans	$50.72
Rate for Payer: Healthfirst NY All Plans	$27.01
Rate for Payer: Humana Medicare Advantage	$82.80
Rate for Payer: Marpai Administrators LLC Commercial	$84.42
Rate for Payer: MetroPlus Health All Plans	$27.01
Rate for Payer: Molina Healthcare All Plans	$27.01
Rate for Payer: Oscar Health Commercial	$158.30
Rate for Payer: Tricare Tricare	$77.36
Rate for Payer: UnitedHealthcare Commercial	$80.41
Rate for Payer: UnitedHealthcare Community & State	$80.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$80.41
Rate for Payer: Wellpoint Medicaid Managed Care	$78.17

CFH PROFEE: HSP DISCH>30 MN

Professional

Both

$174.00

Service Code	HCPCS 99239
Hospital Charge Code	83652433
Hospital Revenue Code	960
Min. Negotiated Rate	$38.71
Max. Negotiated Rate	$233.14
Rate for Payer: Aetna Commercial	$132.85
Rate for Payer: Aetna Medicare Advantage	$86.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$58.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.07
Rate for Payer: Cigna Commercial	$207.97
Rate for Payer: Cigna Medicare Advantage	$207.97
Rate for Payer: Clover Medicare Advantage	$114.39
Rate for Payer: Elderplan Medicare Advantage	$115.54
Rate for Payer: EmblemHealth Commercial	$59.29
Rate for Payer: Fidelis All Plans	$76.35
Rate for Payer: Healthfirst NY All Plans	$38.71
Rate for Payer: Humana Medicare Advantage	$107.77
Rate for Payer: Local 1199 Commercial	$86.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.98
Rate for Payer: Marpai Administrators LLC Commercial	$123.04
Rate for Payer: MetroPlus Health All Plans	$38.71
Rate for Payer: Molina Healthcare All Plans	$38.71
Rate for Payer: Oscar Health Commercial	$233.14
Rate for Payer: UnitedHealthcare Commercial	$83.56
Rate for Payer: UnitedHealthcare Community & State	$83.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$83.56
Rate for Payer: Wellpoint Medicaid Managed Care	$118.53

CFH RW BRONCHODILATOR ADMIN

Facility

$171.00

Service Code	HCPCS 94664
Hospital Charge Code	83652381
Hospital Revenue Code	419
Min. Negotiated Rate	$25.65
Max. Negotiated Rate	$25.65
Rate for Payer: Qualcare PPO/HMO/WC	$25.65

CFH RW BRONCHODILATOR ADMIN

Facility

$171.00

Service Code	HCPCS 94664
Hospital Charge Code	83652381
Hospital Revenue Code	419
Min. Negotiated Rate	$4.86
Max. Negotiated Rate	$1,440.00
Rate for Payer: Aetna Commercial	$707.61
Rate for Payer: Aetna Medicare Advantage	$842.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$943.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$943.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$943.69
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: Cigna Medicare Advantage	$260.15
Rate for Payer: Clover Medicare Advantage	$247.14
Rate for Payer: EmblemHealth Commercial	$780.45
Rate for Payer: Humana Medicare Advantage	$267.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$260.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.46
Rate for Payer: Oxford Commercial	$1,367.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.65
Rate for Payer: UnitedHealthcare Commercial	$1,440.00
Rate for Payer: UnitedHealthcare Community & State	$5.40
Rate for Payer: UnitedHealthcare Medicare Advantage	$260.15
Rate for Payer: Wellcare Medicare Advantage	$260.15
Rate for Payer: Wellpoint Medicaid Managed Care	$4.86

CFH RW HEPATITS A VACC ADULT

Facility

$91.00

Service Code	HCPCS 90632
Hospital Charge Code	83652303
Hospital Revenue Code	636
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$22.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.02
Rate for Payer: Qualcare PPO/HMO/WC	$13.65

CFH RW HEPATITS A VACC ADULT

Facility

$91.00

Service Code	HCPCS 90632
Hospital Charge Code	83652303
Hospital Revenue Code	636
Min. Negotiated Rate	$2.58
Max. Negotiated Rate	$87.27
Rate for Payer: Aetna Commercial	$34.58
Rate for Payer: Aetna Medicare Advantage	$27.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.20
Rate for Payer: Cigna Commercial	$45.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.02
Rate for Payer: Qualcare PPO/HMO/WC	$13.65
Rate for Payer: UnitedHealthcare Community & State	$2.88
Rate for Payer: Wellpoint Medicaid Managed Care	$2.58

CFH RW PSYCHATRIC DIAGNOSTIC

Facility

$1,296.00

Service Code	HCPCS 90801
Hospital Charge Code	83652343
Hospital Revenue Code	900
Min. Negotiated Rate	$194.40
Max. Negotiated Rate	$194.40
Rate for Payer: Qualcare PPO/HMO/WC	$194.40

CFH RW PSYCHATRIC DIAGNOSTIC

Facility

$1,296.00

Service Code	HCPCS 90801
Hospital Charge Code	83652343
Hospital Revenue Code	900
Min. Negotiated Rate	$36.81
Max. Negotiated Rate	$3,080.00
Rate for Payer: Aetna Commercial	$492.48
Rate for Payer: Aetna Medicare Advantage	$388.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.48
Rate for Payer: Cigna Commercial	$648.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$336.96
Rate for Payer: Oxford Commercial	$2,715.00
Rate for Payer: Qualcare PPO/HMO/WC	$194.40
Rate for Payer: UnitedHealthcare Commercial	$3,080.00
Rate for Payer: UnitedHealthcare Community & State	$40.95
Rate for Payer: Wellpoint Medicaid Managed Care	$36.81

CFH RW PSY INDIV. 20-30MTS

Facility

$730.00

Service Code	HCPCS 90805
Hospital Charge Code	83652347
Hospital Revenue Code	914
Min. Negotiated Rate	$109.50
Max. Negotiated Rate	$109.50
Rate for Payer: Qualcare PPO/HMO/WC	$109.50

CFH RW PSY INDIV. 20-30MTS

Facility

$730.00

Service Code	HCPCS 90805
Hospital Charge Code	83652347
Hospital Revenue Code	914
Min. Negotiated Rate	$20.73
Max. Negotiated Rate	$365.00
Rate for Payer: Aetna Commercial	$277.40
Rate for Payer: Aetna Medicare Advantage	$219.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$186.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$186.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$186.15
Rate for Payer: Cigna Commercial	$365.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.80
Rate for Payer: Qualcare PPO/HMO/WC	$109.50
Rate for Payer: UnitedHealthcare Community & State	$23.07
Rate for Payer: Wellpoint Medicaid Managed Care	$20.73

CFH RW PSY INDIV MD 45-50 MIN

Facility

$1,080.00

Service Code	HCPCS 90807
Hospital Charge Code	83652351
Hospital Revenue Code	914
Min. Negotiated Rate	$162.00
Max. Negotiated Rate	$162.00
Rate for Payer: Qualcare PPO/HMO/WC	$162.00

CFH RW PSY INDIV MD 45-50 MIN

Facility

$1,080.00

Service Code	HCPCS 90807
Hospital Charge Code	83652351
Hospital Revenue Code	914
Min. Negotiated Rate	$30.67
Max. Negotiated Rate	$540.00
Rate for Payer: Aetna Commercial	$410.40
Rate for Payer: Aetna Medicare Advantage	$324.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.40
Rate for Payer: Cigna Commercial	$540.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$280.80
Rate for Payer: Qualcare PPO/HMO/WC	$162.00
Rate for Payer: UnitedHealthcare Community & State	$34.13
Rate for Payer: Wellpoint Medicaid Managed Care	$30.67

CFH RW TETANUS/DIPHTHERIA (TD)

Facility

$49.00

Service Code	HCPCS 90718
Hospital Charge Code	83652333
Hospital Revenue Code	250
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$24.50
Rate for Payer: Aetna Commercial	$18.62
Rate for Payer: Aetna Medicare Advantage	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.49
Rate for Payer: Cigna Commercial	$24.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.74
Rate for Payer: Oxford Commercial	$9.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.35
Rate for Payer: UnitedHealthcare Commercial	$9.80
Rate for Payer: UnitedHealthcare Community & State	$1.55
Rate for Payer: Wellpoint Medicaid Managed Care	$1.39

CFH RW TETANUS/DIPHTHERIA (TD)

Facility

$49.00

Service Code	HCPCS 90718
Hospital Charge Code	83652333
Hospital Revenue Code	250
Min. Negotiated Rate	$7.35
Max. Negotiated Rate	$7.35
Rate for Payer: Qualcare PPO/HMO/WC	$7.35

CFH RW TETANUS TOXOID

Facility

$130.00

Hospital Charge Code	83652323
Hospital Revenue Code	636
Min. Negotiated Rate	$19.50
Max. Negotiated Rate	$31.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.46
Rate for Payer: Qualcare PPO/HMO/WC	$19.50

CFH RW TETANUS TOXOID

Facility

$130.00

Hospital Charge Code	83652323
Hospital Revenue Code	636
Min. Negotiated Rate	$3.69
Max. Negotiated Rate	$65.00
Rate for Payer: Aetna Commercial	$49.40
Rate for Payer: Aetna Medicare Advantage	$39.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.15
Rate for Payer: Cigna Commercial	$65.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.46
Rate for Payer: Qualcare PPO/HMO/WC	$19.50
Rate for Payer: UnitedHealthcare Community & State	$4.11
Rate for Payer: Wellpoint Medicaid Managed Care	$3.69

CFH SCREENING PELVIC EXAM

Facility

$125.00

Service Code	HCPCS G0101
Hospital Charge Code	83652525
Hospital Revenue Code	770
Min. Negotiated Rate	$3.55
Max. Negotiated Rate	$437.80
Rate for Payer: Aetna Commercial	$328.28
Rate for Payer: Aetna Medicare Advantage	$391.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$437.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$437.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$120.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$437.80
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: Cigna Medicare Advantage	$120.69
Rate for Payer: Clover Medicare Advantage	$114.66
Rate for Payer: EmblemHealth Commercial	$362.07
Rate for Payer: Humana Medicare Advantage	$124.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$120.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$25.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$25.00
Rate for Payer: UnitedHealthcare Community & State	$3.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$120.69
Rate for Payer: Wellcare Medicare Advantage	$120.69
Rate for Payer: Wellpoint Medicaid Managed Care	$3.55

Know your out-of-pocket cost for care.

All Charges