Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CNTRL VENOUS CATHTER STRPNG

Facility

$5,100.00

Service Code	HCPCS 75901
Hospital Charge Code	321075901
Hospital Revenue Code	320
Min. Negotiated Rate	$67.65
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.00
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$161.16
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

CNTRSNK 1.7STRYKR END 60-80117

Facility

$1,000.00

Hospital Charge Code	270655380
Hospital Revenue Code	272
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CNTRSNK 1.7STRYKR END 60-80117

Facility

$1,000.00

Hospital Charge Code	270655380
Hospital Revenue Code	272
Min. Negotiated Rate	$28.40
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Oxford Commercial	$200.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$200.00
Rate for Payer: UnitedHealthcare Community & State	$31.60
Rate for Payer: Wellpoint Medicaid Managed Care	$28.40

CO2 SMART CAPNOLINE ADULT CO2

Facility

$70.40

Hospital Charge Code	270676818
Hospital Revenue Code	272
Min. Negotiated Rate	$10.56
Max. Negotiated Rate	$10.56
Rate for Payer: Qualcare PPO/HMO/WC	$10.56

CO2 SMART CAPNOLINE ADULT CO2

Facility

$70.40

Hospital Charge Code	270676818
Hospital Revenue Code	272
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$35.20
Rate for Payer: Aetna Commercial	$26.75
Rate for Payer: Aetna Medicare Advantage	$21.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.95
Rate for Payer: Cigna Commercial	$35.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.30
Rate for Payer: Oxford Commercial	$14.08
Rate for Payer: Qualcare PPO/HMO/WC	$10.56
Rate for Payer: UnitedHealthcare Commercial	$14.08
Rate for Payer: UnitedHealthcare Community & State	$2.22
Rate for Payer: Wellpoint Medicaid Managed Care	$2.00

COAG FACTOR VIII ACTIVITY

Facility

$390.00

Service Code	HCPCS 85240
Hospital Charge Code	39900347
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

COAG FACTOR VIII ACTIVITY

Facility

$390.00

Service Code	HCPCS 85240
Hospital Charge Code	39900347
Hospital Revenue Code	305
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$48.69
Rate for Payer: Aetna Medicare Advantage	$58.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.93
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$17.90
Rate for Payer: Clover Medicare Advantage	$17.00
Rate for Payer: EmblemHealth Commercial	$53.70
Rate for Payer: Humana Medicare Advantage	$18.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.90
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	$14.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.90
Rate for Payer: Wellcare Medicare Advantage	$17.90
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

COAG/FRIBINOLYSIS FUNCT ACT EA

Facility

$161.00

Service Code	HCPCS 85397
Hospital Charge Code	38477173
Hospital Revenue Code	305
Min. Negotiated Rate	$24.15
Max. Negotiated Rate	$24.15
Rate for Payer: Qualcare PPO/HMO/WC	$24.15

COAG/FRIBINOLYSIS FUNCT ACT EA

Facility

$161.00

Service Code	HCPCS 85397
Hospital Charge Code	38477173
Hospital Revenue Code	305
Min. Negotiated Rate	$4.57
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$83.94
Rate for Payer: Aetna Medicare Advantage	$99.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.94
Rate for Payer: Cigna Commercial	$80.50
Rate for Payer: Cigna Medicare Advantage	$30.86
Rate for Payer: Clover Medicare Advantage	$29.32
Rate for Payer: EmblemHealth Commercial	$92.58
Rate for Payer: Humana Medicare Advantage	$31.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$30.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.86
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.15
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$24.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$30.86
Rate for Payer: Wellcare Medicare Advantage	$30.86
Rate for Payer: Wellpoint Medicaid Managed Care	$4.57

COAGULATION AND PLATELET DISORDERS

Facility

$9,702.84

Service Code	APR-DRG 6611
Min. Negotiated Rate	$9,512.59
Max. Negotiated Rate	$9,702.84
Rate for Payer: UnitedHealthcare Community & State	$9,512.59
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,702.84
Rate for Payer: Wellpoint Medicaid Managed Care	$9,512.59

COAGULATION AND PLATELET DISORDERS

Facility

$12,777.09

Service Code	APR-DRG 6612
Min. Negotiated Rate	$12,526.56
Max. Negotiated Rate	$12,777.09
Rate for Payer: UnitedHealthcare Community & State	$12,526.56
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,777.09
Rate for Payer: Wellpoint Medicaid Managed Care	$12,526.56

COAGULATION AND PLATELET DISORDERS

Facility

$31,973.55

Service Code	APR-DRG 6614
Min. Negotiated Rate	$31,346.62
Max. Negotiated Rate	$31,973.55
Rate for Payer: UnitedHealthcare Community & State	$31,346.62
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$31,973.55
Rate for Payer: Wellpoint Medicaid Managed Care	$31,346.62

COAGULATION AND PLATELET DISORDERS

Facility

$16,257.11

Service Code	APR-DRG 6613
Min. Negotiated Rate	$15,938.34
Max. Negotiated Rate	$16,257.11
Rate for Payer: UnitedHealthcare Community & State	$15,938.34
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$16,257.11
Rate for Payer: Wellpoint Medicaid Managed Care	$15,938.34

COAGULATION DISORDERS

Facility

$67,654.27

Service Code	MSDRG 813
Min. Negotiated Rate	$20,599.86
Max. Negotiated Rate	$67,654.27
Rate for Payer: Aetna Commercial	$50,042.66
Rate for Payer: Aetna Medicare Advantage	$67,654.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43,219.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43,219.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,684.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43,219.80
Rate for Payer: Cigna Commercial	$34,003.51
Rate for Payer: Cigna Medicare Advantage	$21,684.06
Rate for Payer: Clover Medicare Advantage	$20,599.86
Rate for Payer: EmblemHealth Commercial	$65,052.18
Rate for Payer: Humana Medicare Advantage	$22,334.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21,684.06
Rate for Payer: Oxford Commercial	$26,875.79
Rate for Payer: UnitedHealthcare Commercial	$35,974.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$21,684.06
Rate for Payer: Wellcare Medicare Advantage	$21,684.06

COALESCE STRAIGHT 10X10X28MM8D

Facility

$24,200.00

Service Code	HCPCS L8699
Hospital Charge Code	270692908
Hospital Revenue Code	278
Min. Negotiated Rate	$3,630.00
Max. Negotiated Rate	$5,856.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,856.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,630.00

COALESCE STRAIGHT 10X10X28MM8D

Facility

$24,200.00

Service Code	HCPCS L8699
Hospital Charge Code	270692908
Hospital Revenue Code	278
Min. Negotiated Rate	$687.28
Max. Negotiated Rate	$12,100.00
Rate for Payer: Aetna Commercial	$9,196.00
Rate for Payer: Aetna Medicare Advantage	$7,260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,171.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,171.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,171.00
Rate for Payer: Cigna Commercial	$12,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,856.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,630.00
Rate for Payer: UnitedHealthcare Community & State	$764.72
Rate for Payer: Wellpoint Medicaid Managed Care	$687.28

COALESCE STRAIGHT 12X10X28MM8D

Facility

$24,200.00

Service Code	HCPCS L8699
Hospital Charge Code	270693048
Hospital Revenue Code	278
Min. Negotiated Rate	$687.28
Max. Negotiated Rate	$12,100.00
Rate for Payer: Aetna Commercial	$9,196.00
Rate for Payer: Aetna Medicare Advantage	$7,260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,171.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,171.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,171.00
Rate for Payer: Cigna Commercial	$12,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,856.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,630.00
Rate for Payer: UnitedHealthcare Community & State	$764.72
Rate for Payer: Wellpoint Medicaid Managed Care	$687.28

COALESCE STRAIGHT 12X10X28MM8D

Facility

$24,200.00

Service Code	HCPCS L8699
Hospital Charge Code	270693048
Hospital Revenue Code	278
Min. Negotiated Rate	$3,630.00
Max. Negotiated Rate	$5,856.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,856.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,630.00

COAPTITE INJECTABLE IMPLANT

Facility

$1,675.00

Service Code	HCPCS L8606
Hospital Charge Code	270662270
Hospital Revenue Code	278
Min. Negotiated Rate	$251.25
Max. Negotiated Rate	$405.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$405.35
Rate for Payer: Qualcare PPO/HMO/WC	$251.25

COAPTITE INJECTABLE IMPLANT

Facility

$1,675.00

Service Code	HCPCS L8606
Hospital Charge Code	270662270
Hospital Revenue Code	278
Min. Negotiated Rate	$47.57
Max. Negotiated Rate	$837.50
Rate for Payer: Aetna Commercial	$636.50
Rate for Payer: Aetna Medicare Advantage	$502.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$427.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$427.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$335.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$427.12
Rate for Payer: Cigna Commercial	$837.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$405.35
Rate for Payer: Qualcare PPO/HMO/WC	$251.25
Rate for Payer: UnitedHealthcare Community & State	$52.93
Rate for Payer: Wellpoint Medicaid Managed Care	$47.57

COARTEM TAB 20-120MG

Facility

$34.04

Service Code	NDC 78056845
Hospital Charge Code	606390530
Hospital Revenue Code	250
Min. Negotiated Rate	$5.11
Max. Negotiated Rate	$5.11
Rate for Payer: Qualcare PPO/HMO/WC	$5.11

COARTEM TAB 20-120MG

Facility

$34.04

Service Code	NDC 78056845
Hospital Charge Code	606390530
Hospital Revenue Code	250
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$17.02
Rate for Payer: Aetna Commercial	$12.94
Rate for Payer: Aetna Medicare Advantage	$10.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.68
Rate for Payer: Cigna Commercial	$17.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.85
Rate for Payer: Oxford Commercial	$6.81
Rate for Payer: Qualcare PPO/HMO/WC	$5.11
Rate for Payer: UnitedHealthcare Commercial	$6.81
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$0.97

COBALT, SERUM/PLASMA

Facility

$150.95

Service Code	HCPCS 83018
Hospital Charge Code	39900090
Hospital Revenue Code	301
Min. Negotiated Rate	$22.64
Max. Negotiated Rate	$22.64
Rate for Payer: Qualcare PPO/HMO/WC	$22.64

COBALT, SERUM/PLASMA

Facility

$150.95

Service Code	HCPCS 83018
Hospital Charge Code	39900090
Hospital Revenue Code	301
Min. Negotiated Rate	$4.29
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$59.73
Rate for Payer: Aetna Medicare Advantage	$71.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.66
Rate for Payer: Cigna Commercial	$75.47
Rate for Payer: Cigna Medicare Advantage	$21.96
Rate for Payer: Clover Medicare Advantage	$20.86
Rate for Payer: EmblemHealth Commercial	$65.88
Rate for Payer: Humana Medicare Advantage	$22.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.25
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.64
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$17.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.96
Rate for Payer: Wellcare Medicare Advantage	$21.96
Rate for Payer: Wellpoint Medicaid Managed Care	$4.29

COBAN 4 ROLL STER 1584S

Facility

$10.50

Hospital Charge Code	270600350
Hospital Revenue Code	272
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$1.57
Rate for Payer: Qualcare PPO/HMO/WC	$1.57

Know your out-of-pocket cost for care.

All Charges