Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CHANNEL SIDE CARE EXTERNAL

Facility

$625.00

Hospital Charge Code	270679449
Hospital Revenue Code	272
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

CHANNEL SIDE CARE EXTERNAL

Facility

$625.00

Hospital Charge Code	270679449
Hospital Revenue Code	272
Min. Negotiated Rate	$17.75
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.50
Rate for Payer: Oxford Commercial	$125.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Commercial	$125.00
Rate for Payer: UnitedHealthcare Community & State	$19.75
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

CH ANTIBIOTIC SENSITIVITY

Facility

$587.57

Service Code	HCPCS 87181
Hospital Charge Code	397041335
Hospital Revenue Code	309
Min. Negotiated Rate	$3.80
Max. Negotiated Rate	$293.79
Rate for Payer: Aetna Commercial	$12.92
Rate for Payer: Aetna Medicare Advantage	$15.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.23
Rate for Payer: Cigna Commercial	$293.79
Rate for Payer: Cigna Medicare Advantage	$4.75
Rate for Payer: Clover Medicare Advantage	$4.51
Rate for Payer: EmblemHealth Commercial	$14.25
Rate for Payer: Humana Medicare Advantage	$4.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.77
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$88.14
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$3.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.75
Rate for Payer: Wellcare Medicare Advantage	$4.75
Rate for Payer: Wellpoint Medicaid Managed Care	$16.69

CH ANTIBIOTIC SENSITIVITY

Facility

$587.57

Service Code	HCPCS 87181
Hospital Charge Code	397041335
Hospital Revenue Code	309
Min. Negotiated Rate	$88.14
Max. Negotiated Rate	$88.14
Rate for Payer: Qualcare PPO/HMO/WC	$88.14

CH ANTI NEUTROPHIL CYTO AB

Facility

$435.00

Service Code	HCPCS 86021
Hospital Charge Code	397041155
Hospital Revenue Code	302
Min. Negotiated Rate	$12.04
Max. Negotiated Rate	$217.50
Rate for Payer: Aetna Commercial	$40.94
Rate for Payer: Aetna Medicare Advantage	$48.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.05
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	$54.59
Rate for Payer: Cigna Commercial	$217.50
Rate for Payer: Cigna Medicare Advantage	$15.05
Rate for Payer: Clover Medicare Advantage	$14.30
Rate for Payer: EmblemHealth Commercial	$45.15
Rate for Payer: Humana Medicare Advantage	$15.50
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.10
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$65.25
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$12.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.05
Rate for Payer: Wellcare Medicare Advantage	$15.05
Rate for Payer: Wellpoint Medicaid Managed Care	$12.35

CH ANTI NEUTROPHIL CYTO AB

Facility

$435.00

Service Code	HCPCS 86021
Hospital Charge Code	397041155
Hospital Revenue Code	302
Min. Negotiated Rate	$65.25
Max. Negotiated Rate	$65.25
Rate for Payer: Qualcare PPO/HMO/WC	$65.25

CH ANTI STREPTOLYSIN O

Facility

$390.00

Service Code	HCPCS 86060
Hospital Charge Code	397041230
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH ANTI STREPTOLYSIN O

Facility

$390.00

Service Code	HCPCS 86060
Hospital Charge Code	397041230
Hospital Revenue Code	302
Min. Negotiated Rate	$5.84
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$19.86
Rate for Payer: Aetna Medicare Advantage	$23.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.48
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$7.30
Rate for Payer: Clover Medicare Advantage	$6.93
Rate for Payer: EmblemHealth Commercial	$21.90
Rate for Payer: Humana Medicare Advantage	$7.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.30
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	$5.84
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.30
Rate for Payer: Wellcare Medicare Advantage	$7.30
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

CHARCOAL 50 G SUSP

Facility

$158.46

Service Code	NDC 574012108
Hospital Charge Code	60628110
Hospital Revenue Code	250
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$79.23
Rate for Payer: Aetna Commercial	$60.21
Rate for Payer: Aetna Medicare Advantage	$47.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.41
Rate for Payer: Cigna Commercial	$79.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.20
Rate for Payer: Oxford Commercial	$31.69
Rate for Payer: Qualcare PPO/HMO/WC	$23.77
Rate for Payer: UnitedHealthcare Commercial	$31.69
Rate for Payer: UnitedHealthcare Community & State	$5.01
Rate for Payer: Wellpoint Medicaid Managed Care	$4.50

CHARCOAL 50 G SUSP

Facility

$158.46

Service Code	NDC 574012108
Hospital Charge Code	60628110
Hospital Revenue Code	250
Min. Negotiated Rate	$23.77
Max. Negotiated Rate	$23.77
Rate for Payer: Qualcare PPO/HMO/WC	$23.77

CHARGER KIT SENSA 2500

Facility

$5,000.00

Hospital Charge Code	270693285
Hospital Revenue Code	272
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$750.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

CHARGER KIT SENSA 2500

Facility

$5,000.00

Hospital Charge Code	270693285
Hospital Revenue Code	272
Min. Negotiated Rate	$142.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.00
Rate for Payer: Oxford Commercial	$1,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Commercial	$1,000.00
Rate for Payer: UnitedHealthcare Community & State	$158.00
Rate for Payer: Wellpoint Medicaid Managed Care	$142.00

CHARGING SYSTEM

Facility

$7,875.00

Hospital Charge Code	270675087
Hospital Revenue Code	272
Min. Negotiated Rate	$223.65
Max. Negotiated Rate	$3,937.50
Rate for Payer: Aetna Commercial	$2,992.50
Rate for Payer: Aetna Medicare Advantage	$2,362.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,008.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,008.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,008.12
Rate for Payer: Cigna Commercial	$3,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,047.50
Rate for Payer: Oxford Commercial	$1,575.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,181.25
Rate for Payer: UnitedHealthcare Commercial	$1,575.00
Rate for Payer: UnitedHealthcare Community & State	$248.85
Rate for Payer: Wellpoint Medicaid Managed Care	$223.65

CHARGING SYSTEM

Facility

$7,875.00

Hospital Charge Code	270675087
Hospital Revenue Code	272
Min. Negotiated Rate	$1,181.25
Max. Negotiated Rate	$1,181.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,181.25

CHARGING SYSTEM EON MINI LE

Facility

$7,875.00

Hospital Charge Code	270659616
Hospital Revenue Code	272
Min. Negotiated Rate	$223.65
Max. Negotiated Rate	$3,937.50
Rate for Payer: Aetna Commercial	$2,992.50
Rate for Payer: Aetna Medicare Advantage	$2,362.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,008.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,008.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,008.12
Rate for Payer: Cigna Commercial	$3,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,047.50
Rate for Payer: Oxford Commercial	$1,575.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,181.25
Rate for Payer: UnitedHealthcare Commercial	$1,575.00
Rate for Payer: UnitedHealthcare Community & State	$248.85
Rate for Payer: Wellpoint Medicaid Managed Care	$223.65

CHARGING SYSTEM EON MINI LE

Facility

$7,875.00

Hospital Charge Code	270659616
Hospital Revenue Code	272
Min. Negotiated Rate	$1,181.25
Max. Negotiated Rate	$1,181.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,181.25

CH ASO TITER

Facility

$390.00

Service Code	HCPCS 86060
Hospital Charge Code	397041298
Hospital Revenue Code	300
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH ASO TITER

Facility

$390.00

Service Code	HCPCS 86060
Hospital Charge Code	397041298
Hospital Revenue Code	300
Min. Negotiated Rate	$5.84
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$19.86
Rate for Payer: Aetna Medicare Advantage	$23.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.48
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$7.30
Rate for Payer: Clover Medicare Advantage	$6.93
Rate for Payer: EmblemHealth Commercial	$21.90
Rate for Payer: Humana Medicare Advantage	$7.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.30
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	$5.84
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.30
Rate for Payer: Wellcare Medicare Advantage	$7.30
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

CH BACTERIAL ANTIGENS

Facility

$390.00

Service Code	HCPCS 86403
Hospital Charge Code	397041120
Hospital Revenue Code	302
Min. Negotiated Rate	$9.23
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$31.39
Rate for Payer: Aetna Medicare Advantage	$37.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.54
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	$41.86
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$11.54
Rate for Payer: Clover Medicare Advantage	$10.96
Rate for Payer: EmblemHealth Commercial	$34.62
Rate for Payer: Humana Medicare Advantage	$11.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.54
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	$9.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.54
Rate for Payer: Wellcare Medicare Advantage	$11.54
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

CH BACTERIAL ANTIGENS

Facility

$390.00

Service Code	HCPCS 86403
Hospital Charge Code	397041120
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH BACTERIAL CULTURE SPECIAL

Facility

$390.00

Service Code	HCPCS 87070
Hospital Charge Code	397072161
Hospital Revenue Code	306
Min. Negotiated Rate	$6.90
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$23.45
Rate for Payer: Aetna Medicare Advantage	$27.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.62
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	$31.27
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$8.62
Rate for Payer: Clover Medicare Advantage	$8.19
Rate for Payer: EmblemHealth Commercial	$25.86
Rate for Payer: Humana Medicare Advantage	$8.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.62
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	$6.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.62
Rate for Payer: Wellcare Medicare Advantage	$8.62
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

CH BACTERIAL CULTURE SPECIAL

Facility

$390.00

Service Code	HCPCS 87070
Hospital Charge Code	397072161
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH BCL1 (CYCLIN D1) 1ST

Facility

$1,082.30

Service Code	HCPCS 88342
Hospital Charge Code	397061377
Hospital Revenue Code	310
Min. Negotiated Rate	$162.34
Max. Negotiated Rate	$162.34
Rate for Payer: Qualcare PPO/HMO/WC	$162.34

CH BCL1 (CYCLIN D1) 1ST

Facility

$1,082.30

Service Code	HCPCS 88342
Hospital Charge Code	397061377
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

CH BLOOD TRANSFUSION

Facility

$1,403.75

Service Code	HCPCS 36430
Hospital Charge Code	397031003
Hospital Revenue Code	391
Min. Negotiated Rate	$39.87
Max. Negotiated Rate	$1,901.28
Rate for Payer: Aetna Commercial	$1,425.63
Rate for Payer: Aetna Medicare Advantage	$1,698.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,901.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,901.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$524.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,901.28
Rate for Payer: Cigna Commercial	$1,050.61
Rate for Payer: Cigna Medicare Advantage	$524.13
Rate for Payer: Clover Medicare Advantage	$497.92
Rate for Payer: EmblemHealth Commercial	$1,572.39
Rate for Payer: Humana Medicare Advantage	$539.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$524.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.98
Rate for Payer: Oxford Commercial	$1,028.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.56
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$44.36
Rate for Payer: UnitedHealthcare Medicare Advantage	$524.13
Rate for Payer: Wellcare Medicare Advantage	$524.13
Rate for Payer: Wellpoint Medicaid Managed Care	$39.87

Know your out-of-pocket cost for care.

All Charges