Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CH HEPATITIS B SURFACE AG

Facility

$667.59

Service Code	HCPCS 87340
Hospital Charge Code	397071158
Hospital Revenue Code	306
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

CH HEPATITIS B SURFACE AG

Facility

$667.59

Service Code	HCPCS 87340
Hospital Charge Code	397071158
Hospital Revenue Code	306
Min. Negotiated Rate	$8.26
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$28.10
Rate for Payer: Aetna Medicare Advantage	$33.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.47
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$10.33
Rate for Payer: Clover Medicare Advantage	$9.81
Rate for Payer: EmblemHealth Commercial	$30.99
Rate for Payer: Humana Medicare Advantage	$10.64
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10.33
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	$8.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.33
Rate for Payer: Wellcare Medicare Advantage	$10.33
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

CH HEPATITIS B SURF AG CONF

Facility

$390.00

Service Code	HCPCS 8734091
Hospital Charge Code	397072009
Hospital Revenue Code	306
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

CH HEPATITIS B SURF AG CONF

Facility

$390.00

Service Code	HCPCS 8734091
Hospital Charge Code	397072009
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH HEPATITIS C AB

Facility

$667.59

Service Code	HCPCS 86803
Hospital Charge Code	397072083
Hospital Revenue Code	302
Min. Negotiated Rate	$11.42
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$38.81
Rate for Payer: Aetna Medicare Advantage	$46.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.76
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$14.27
Rate for Payer: Clover Medicare Advantage	$13.56
Rate for Payer: EmblemHealth Commercial	$42.81
Rate for Payer: Humana Medicare Advantage	$14.70
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.27
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	$11.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.27
Rate for Payer: Wellcare Medicare Advantage	$14.27
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

CH HEPATITIS C AB

Facility

$667.59

Service Code	HCPCS 86803
Hospital Charge Code	397072083
Hospital Revenue Code	302
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

CH HEPATITIS C GENOTYPE

Facility

$1,587.00

Service Code	HCPCS 87902
Hospital Charge Code	397073603
Hospital Revenue Code	306
Min. Negotiated Rate	$238.05
Max. Negotiated Rate	$238.05
Rate for Payer: Qualcare PPO/HMO/WC	$238.05

CH HEPATITIS C GENOTYPE

Facility

$1,587.00

Service Code	HCPCS 87902
Hospital Charge Code	397073603
Hospital Revenue Code	306
Min. Negotiated Rate	$45.07
Max. Negotiated Rate	$933.90
Rate for Payer: Aetna Commercial	$700.26
Rate for Payer: Aetna Medicare Advantage	$834.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$933.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$933.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$257.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$933.90
Rate for Payer: Cigna Commercial	$793.50
Rate for Payer: Cigna Medicare Advantage	$257.45
Rate for Payer: Clover Medicare Advantage	$244.58
Rate for Payer: EmblemHealth Commercial	$772.35
Rate for Payer: Humana Medicare Advantage	$265.17
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$257.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$412.62
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$238.05
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$205.96
Rate for Payer: UnitedHealthcare Medicare Advantage	$257.45
Rate for Payer: Wellcare Medicare Advantage	$257.45
Rate for Payer: Wellpoint Medicaid Managed Care	$45.07

CH HIV 1&2 ANTIBODIES

Facility

$667.59

Service Code	HCPCS 86703
Hospital Charge Code	397043273
Hospital Revenue Code	302
Min. Negotiated Rate	$10.97
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$37.29
Rate for Payer: Aetna Medicare Advantage	$44.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.73
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$13.71
Rate for Payer: Clover Medicare Advantage	$13.02
Rate for Payer: EmblemHealth Commercial	$41.13
Rate for Payer: Humana Medicare Advantage	$14.12
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.71
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	$10.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.71
Rate for Payer: Wellcare Medicare Advantage	$13.71
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

CH HIV 1&2 ANTIBODIES

Facility

$667.59

Service Code	HCPCS 86703
Hospital Charge Code	397043273
Hospital Revenue Code	302
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

CH HOMOCYSTEINE

Facility

$903.82

Service Code	HCPCS 83090
Hospital Charge Code	397073277
Hospital Revenue Code	301
Min. Negotiated Rate	$14.34
Max. Negotiated Rate	$451.91
Rate for Payer: Aetna Commercial	$48.74
Rate for Payer: Aetna Medicare Advantage	$58.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.00
Rate for Payer: Cigna Commercial	$451.91
Rate for Payer: Cigna Medicare Advantage	$17.92
Rate for Payer: Clover Medicare Advantage	$17.02
Rate for Payer: EmblemHealth Commercial	$53.76
Rate for Payer: Humana Medicare Advantage	$18.46
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.99
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.57
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.92
Rate for Payer: Wellcare Medicare Advantage	$17.92
Rate for Payer: Wellpoint Medicaid Managed Care	$25.67

CH HOMOCYSTEINE

Facility

$903.82

Service Code	HCPCS 83090
Hospital Charge Code	397073277
Hospital Revenue Code	301
Min. Negotiated Rate	$135.57
Max. Negotiated Rate	$135.57
Rate for Payer: Qualcare PPO/HMO/WC	$135.57

CH HOMOVANILLIC ACID, URINE

Facility

$390.00

Service Code	HCPCS 83150
Hospital Charge Code	397070016
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$60.96
Rate for Payer: Aetna Medicare Advantage	$72.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.29
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$22.41
Rate for Payer: Clover Medicare Advantage	$21.29
Rate for Payer: EmblemHealth Commercial	$67.23
Rate for Payer: Humana Medicare Advantage	$23.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22.41
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	$17.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.41
Rate for Payer: Wellcare Medicare Advantage	$22.41
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

CH HOMOVANILLIC ACID, URINE

Facility

$390.00

Service Code	HCPCS 83150
Hospital Charge Code	397070016
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH H.PYLORI, IMMUNO 1ST

Facility

$1,082.30

Service Code	HCPCS 88342
Hospital Charge Code	397061372
Hospital Revenue Code	310
Min. Negotiated Rate	$162.34
Max. Negotiated Rate	$162.34
Rate for Payer: Qualcare PPO/HMO/WC	$162.34

CH H.PYLORI, IMMUNO 1ST

Facility

$1,082.30

Service Code	HCPCS 88342
Hospital Charge Code	397061372
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 H PYLORI SERUM

Facility

$464.00

Service Code	HCPCS 86677
Hospital Charge Code	397041254
Hospital Revenue Code	302
Min. Negotiated Rate	$69.60
Max. Negotiated Rate	$69.60
Rate for Payer: Qualcare PPO/HMO/WC	$69.60

CH H PYLORI SERUM

Facility

$464.00

Service Code	HCPCS 86677
Hospital Charge Code	397041254
Hospital Revenue Code	302
Min. Negotiated Rate	$13.18
Max. Negotiated Rate	$232.00
Rate for Payer: Aetna Commercial	$45.83
Rate for Payer: Aetna Medicare Advantage	$54.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.12
Rate for Payer: Cigna Commercial	$232.00
Rate for Payer: Cigna Medicare Advantage	$16.85
Rate for Payer: Clover Medicare Advantage	$16.01
Rate for Payer: EmblemHealth Commercial	$50.55
Rate for Payer: Humana Medicare Advantage	$17.36
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.64
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$69.60
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.85
Rate for Payer: Wellcare Medicare Advantage	$16.85
Rate for Payer: Wellpoint Medicaid Managed Care	$13.18

CHIEF ULTRASOUND GEL.25

Facility

$33.00

Hospital Charge Code	270332498
Hospital Revenue Code	272
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$4.95
Rate for Payer: Qualcare PPO/HMO/WC	$4.95

CHIEF ULTRASOUND GEL.25

Facility

$33.00

Hospital Charge Code	270332498
Hospital Revenue Code	272
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$16.50
Rate for Payer: Aetna Commercial	$12.54
Rate for Payer: Aetna Medicare Advantage	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.41
Rate for Payer: Cigna Commercial	$16.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.58
Rate for Payer: Oxford Commercial	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$4.95
Rate for Payer: UnitedHealthcare Commercial	$6.60
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$0.94

CHIEF ULTRASOUND GEL .25-LIT

Facility

$37.00

Hospital Charge Code	270331031
Hospital Revenue Code	272
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$18.50
Rate for Payer: Aetna Commercial	$14.06
Rate for Payer: Aetna Medicare Advantage	$11.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.44
Rate for Payer: Cigna Commercial	$18.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.62
Rate for Payer: Oxford Commercial	$7.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.55
Rate for Payer: UnitedHealthcare Commercial	$7.40
Rate for Payer: UnitedHealthcare Community & State	$1.17
Rate for Payer: Wellpoint Medicaid Managed Care	$1.05

CHIEF ULTRASOUND GEL .25-LIT

Facility

$37.00

Hospital Charge Code	270331031
Hospital Revenue Code	272
Min. Negotiated Rate	$5.55
Max. Negotiated Rate	$5.55
Rate for Payer: Qualcare PPO/HMO/WC	$5.55

CH IGG 4

Facility

$390.00

Service Code	HCPCS 82787
Hospital Charge Code	397072098
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH IGG 4

Facility

$390.00

Service Code	HCPCS 82787
Hospital Charge Code	397072098
Hospital Revenue Code	301
Min. Negotiated Rate	$6.42
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$21.81
Rate for Payer: Aetna Medicare Advantage	$25.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.09
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$8.02
Rate for Payer: Clover Medicare Advantage	$7.62
Rate for Payer: EmblemHealth Commercial	$24.06
Rate for Payer: Humana Medicare Advantage	$8.26
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.02
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	$6.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.02
Rate for Payer: Wellcare Medicare Advantage	$8.02
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

CH IGG CSF

Facility

$390.00

Service Code	HCPCS 82784
Hospital Charge Code	397073185
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Know your out-of-pocket cost for care.

All Charges