Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CFH WC VENIPUNCTURE

Facility

$51.00

Service Code	HCPCS 36415
Hospital Charge Code	83652101
Hospital Revenue Code	300
Min. Negotiated Rate	$7.65
Max. Negotiated Rate	$7.65
Rate for Payer: Qualcare PPO/HMO/WC	$7.65

CFH WC VENIPUNCTURE

Facility

$51.00

Service Code	HCPCS 36415
Hospital Charge Code	83652101
Hospital Revenue Code	300
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$25.40
Rate for Payer: Aetna Medicare Advantage	$30.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.88
Rate for Payer: Cigna Commercial	$25.50
Rate for Payer: Cigna Medicare Advantage	$9.34
Rate for Payer: Clover Medicare Advantage	$8.87
Rate for Payer: EmblemHealth Commercial	$28.02
Rate for Payer: Humana Medicare Advantage	$9.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.26
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.65
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$4.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.34
Rate for Payer: Wellcare Medicare Advantage	$9.34
Rate for Payer: Wellpoint Medicaid Managed Care	$1.45

CFH WC WET MOUNT/KOH

Facility

$390.00

Service Code	HCPCS 87210
Hospital Charge Code	83652287
Hospital Revenue Code	309
Min. Negotiated Rate	$3.96
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$15.83
Rate for Payer: Aetna Medicare Advantage	$18.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.11
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.82
Rate for Payer: Clover Medicare Advantage	$5.53
Rate for Payer: EmblemHealth Commercial	$17.46
Rate for Payer: Humana Medicare Advantage	$5.99
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.82
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	$4.66
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.82
Rate for Payer: Wellcare Medicare Advantage	$5.82
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

CFH WC WET MOUNT/KOH

Facility

$390.00

Service Code	HCPCS 87210
Hospital Charge Code	83652287
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CFH WELLNESS EST PT 18-39 YRS

Facility

$64.00

Service Code	HCPCS 99395
Hospital Charge Code	83652491
Hospital Revenue Code	514
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$9.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.60

CFH WELLNESS EST PT 18-39 YRS

Facility

$64.00

Service Code	HCPCS 99395
Hospital Charge Code	83652491
Hospital Revenue Code	514
Min. Negotiated Rate	$1.82
Max. Negotiated Rate	$32.00
Rate for Payer: Aetna Commercial	$24.32
Rate for Payer: Aetna Medicare Advantage	$19.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.32
Rate for Payer: Cigna Commercial	$32.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.64
Rate for Payer: Qualcare PPO/HMO/WC	$9.60
Rate for Payer: UnitedHealthcare Community & State	$2.02
Rate for Payer: Wellpoint Medicaid Managed Care	$1.82

CFH WELLNESS EST PT 40-64 YRS

Facility

$84.00

Service Code	HCPCS 99396
Hospital Charge Code	83652493
Hospital Revenue Code	514
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.60

CFH WELLNESS EST PT 40-64 YRS

Facility

$84.00

Service Code	HCPCS 99396
Hospital Charge Code	83652493
Hospital Revenue Code	514
Min. Negotiated Rate	$2.39
Max. Negotiated Rate	$42.00
Rate for Payer: Aetna Commercial	$31.92
Rate for Payer: Aetna Medicare Advantage	$25.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.42
Rate for Payer: Cigna Commercial	$42.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.84
Rate for Payer: Qualcare PPO/HMO/WC	$12.60
Rate for Payer: UnitedHealthcare Community & State	$2.65
Rate for Payer: Wellpoint Medicaid Managed Care	$2.39

CFH WELLNESS EST PT >64 YRS

Facility

$97.00

Service Code	HCPCS 99397
Hospital Charge Code	83652495
Hospital Revenue Code	514
Min. Negotiated Rate	$14.55
Max. Negotiated Rate	$14.55
Rate for Payer: Qualcare PPO/HMO/WC	$14.55

CFH WELLNESS EST PT >64 YRS

Facility

$97.00

Service Code	HCPCS 99397
Hospital Charge Code	83652495
Hospital Revenue Code	514
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$48.50
Rate for Payer: Aetna Commercial	$36.86
Rate for Payer: Aetna Medicare Advantage	$29.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.73
Rate for Payer: Cigna Commercial	$48.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.22
Rate for Payer: Qualcare PPO/HMO/WC	$14.55
Rate for Payer: UnitedHealthcare Community & State	$3.07
Rate for Payer: Wellpoint Medicaid Managed Care	$2.75

CFH WELLNESS NEW PT 18-39 YRS

Facility

$92.00

Service Code	HCPCS 99385
Hospital Charge Code	83652477
Hospital Revenue Code	514
Min. Negotiated Rate	$13.80
Max. Negotiated Rate	$13.80
Rate for Payer: Qualcare PPO/HMO/WC	$13.80

CFH WELLNESS NEW PT 18-39 YRS

Facility

$92.00

Service Code	HCPCS 99385
Hospital Charge Code	83652477
Hospital Revenue Code	514
Min. Negotiated Rate	$2.61
Max. Negotiated Rate	$46.00
Rate for Payer: Aetna Commercial	$34.96
Rate for Payer: Aetna Medicare Advantage	$27.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.46
Rate for Payer: Cigna Commercial	$46.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.92
Rate for Payer: Qualcare PPO/HMO/WC	$13.80
Rate for Payer: UnitedHealthcare Community & State	$2.91
Rate for Payer: Wellpoint Medicaid Managed Care	$2.61

CFH WELLNESS NEW PT 40-64 YRS

Facility

$126.00

Service Code	HCPCS 99386
Hospital Charge Code	83652479
Hospital Revenue Code	514
Min. Negotiated Rate	$18.90
Max. Negotiated Rate	$18.90
Rate for Payer: Qualcare PPO/HMO/WC	$18.90

CFH WELLNESS NEW PT 40-64 YRS

Facility

$126.00

Service Code	HCPCS 99386
Hospital Charge Code	83652479
Hospital Revenue Code	514
Min. Negotiated Rate	$3.58
Max. Negotiated Rate	$63.00
Rate for Payer: Aetna Commercial	$47.88
Rate for Payer: Aetna Medicare Advantage	$37.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.13
Rate for Payer: Cigna Commercial	$63.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.76
Rate for Payer: Qualcare PPO/HMO/WC	$18.90
Rate for Payer: UnitedHealthcare Community & State	$3.98
Rate for Payer: Wellpoint Medicaid Managed Care	$3.58

CFH WELLNESS NEW PT >64 YRS

Facility

$138.00

Service Code	HCPCS 99387
Hospital Charge Code	83652481
Hospital Revenue Code	514
Min. Negotiated Rate	$20.70
Max. Negotiated Rate	$20.70
Rate for Payer: Qualcare PPO/HMO/WC	$20.70

CFH WELLNESS NEW PT >64 YRS

Facility

$138.00

Service Code	HCPCS 99387
Hospital Charge Code	83652481
Hospital Revenue Code	514
Min. Negotiated Rate	$3.92
Max. Negotiated Rate	$69.00
Rate for Payer: Aetna Commercial	$52.44
Rate for Payer: Aetna Medicare Advantage	$41.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.19
Rate for Payer: Cigna Commercial	$69.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.88
Rate for Payer: Qualcare PPO/HMO/WC	$20.70
Rate for Payer: UnitedHealthcare Community & State	$4.36
Rate for Payer: Wellpoint Medicaid Managed Care	$3.92

CH ABO BLOOD TYPING

Facility

$626.42

Service Code	HCPCS 86900
Hospital Charge Code	397031153
Hospital Revenue Code	300
Min. Negotiated Rate	$2.39
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Commercial	$8.13
Rate for Payer: Aetna Medicare Advantage	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.85
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$2.99
Rate for Payer: Clover Medicare Advantage	$2.84
Rate for Payer: EmblemHealth Commercial	$8.97
Rate for Payer: Humana Medicare Advantage	$3.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.87
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.96
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$2.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.99
Rate for Payer: Wellcare Medicare Advantage	$2.99
Rate for Payer: Wellpoint Medicaid Managed Care	$17.79

CH ABO BLOOD TYPING

Facility

$626.42

Service Code	HCPCS 86900
Hospital Charge Code	397031153
Hospital Revenue Code	300
Min. Negotiated Rate	$93.96
Max. Negotiated Rate	$93.96
Rate for Payer: Qualcare PPO/HMO/WC	$93.96

CH ACID FAST SMEAR

Facility

$390.00

Service Code	HCPCS 87206
Hospital Charge Code	397041036
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH ACID FAST SMEAR

Facility

$390.00

Service Code	HCPCS 87206
Hospital Charge Code	397041036
Hospital Revenue Code	309
Min. Negotiated Rate	$4.31
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$14.66
Rate for Payer: Aetna Medicare Advantage	$17.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.55
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.39
Rate for Payer: Clover Medicare Advantage	$5.12
Rate for Payer: EmblemHealth Commercial	$16.17
Rate for Payer: Humana Medicare Advantage	$5.55
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.39
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	$4.31
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.39
Rate for Payer: Wellcare Medicare Advantage	$5.39
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

CH ACUTE HEPATITIS PANEL

Facility

$2,220.17

Service Code	HCPCS 80074
Hospital Charge Code	397073343
Hospital Revenue Code	301
Min. Negotiated Rate	$38.10
Max. Negotiated Rate	$1,110.09
Rate for Payer: Aetna Commercial	$129.55
Rate for Payer: Aetna Medicare Advantage	$154.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$47.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.78
Rate for Payer: Cigna Commercial	$1,110.09
Rate for Payer: Cigna Medicare Advantage	$47.63
Rate for Payer: Clover Medicare Advantage	$45.25
Rate for Payer: EmblemHealth Commercial	$142.89
Rate for Payer: Humana Medicare Advantage	$49.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$47.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$577.24
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$333.03
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$38.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$47.63
Rate for Payer: Wellcare Medicare Advantage	$47.63
Rate for Payer: Wellpoint Medicaid Managed Care	$63.05

CH ACUTE HEPATITIS PANEL

Facility

$2,220.17

Service Code	HCPCS 80074
Hospital Charge Code	397073343
Hospital Revenue Code	301
Min. Negotiated Rate	$333.03
Max. Negotiated Rate	$333.03
Rate for Payer: Qualcare PPO/HMO/WC	$333.03

CH ALICIAN BLUE

Facility

$1,529.00

Service Code	HCPCS 88313
Hospital Charge Code	397061079
Hospital Revenue Code	310
Min. Negotiated Rate	$229.35
Max. Negotiated Rate	$229.35
Rate for Payer: Qualcare PPO/HMO/WC	$229.35

CH ALICIAN BLUE

Facility

$1,529.00

Service Code	HCPCS 88313
Hospital Charge Code	397061079
Hospital Revenue Code	310
Min. Negotiated Rate	$43.42
Max. Negotiated Rate	$573.36
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.36
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$397.54
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$229.35
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$68.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$43.42

CH ALPHA 1 ANTIT, PHENOT

Facility

$390.00

Service Code	HCPCS 82104
Hospital Charge Code	397073056
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$39.33
Rate for Payer: Aetna Medicare Advantage	$46.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.45
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$14.46
Rate for Payer: Clover Medicare Advantage	$13.74
Rate for Payer: EmblemHealth Commercial	$43.38
Rate for Payer: Humana Medicare Advantage	$14.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.46
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	$11.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.46
Rate for Payer: Wellcare Medicare Advantage	$14.46
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

Know your out-of-pocket cost for care.

All Charges