Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

COLD AGGLUTININ TITER

Facility

$390.00

Service Code	HCPCS 86157
Hospital Charge Code	3000841
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

COLD HEMAGGLUTINATION

Facility

$55.45

Service Code	HCPCS 86157
Hospital Charge Code	39900195
Hospital Revenue Code	302
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$21.92
Rate for Payer: Aetna Medicare Advantage	$26.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.06
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	$29.24
Rate for Payer: Cigna Commercial	$27.73
Rate for Payer: Cigna Medicare Advantage	$8.06
Rate for Payer: Clover Medicare Advantage	$7.66
Rate for Payer: EmblemHealth Commercial	$24.18
Rate for Payer: Humana Medicare Advantage	$8.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.42
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.32
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$6.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.06
Rate for Payer: Wellcare Medicare Advantage	$8.06
Rate for Payer: Wellpoint Medicaid Managed Care	$1.57

COLD HEMAGGLUTINATION

Facility

$55.45

Service Code	HCPCS 86157
Hospital Charge Code	39900195
Hospital Revenue Code	302
Min. Negotiated Rate	$8.32
Max. Negotiated Rate	$8.32
Rate for Payer: Qualcare PPO/HMO/WC	$8.32

COLD HEMAGGLUTINS

Facility

$55.00

Hospital Charge Code	39708012
Hospital Revenue Code	302
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$20.90
Rate for Payer: Aetna Medicare Advantage	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.03
Rate for Payer: Cigna Commercial	$27.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.30
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.25
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$1.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1.56

COLD HEMAGGLUTINS

Facility

$55.00

Hospital Charge Code	39708012
Hospital Revenue Code	302
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

COLD KNIFE ROUND

Facility

$1,140.00

Hospital Charge Code	270684368
Hospital Revenue Code	272
Min. Negotiated Rate	$32.38
Max. Negotiated Rate	$570.00
Rate for Payer: Aetna Commercial	$433.20
Rate for Payer: Aetna Medicare Advantage	$342.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$290.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$290.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$290.70
Rate for Payer: Cigna Commercial	$570.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.40
Rate for Payer: Oxford Commercial	$228.00
Rate for Payer: Qualcare PPO/HMO/WC	$171.00
Rate for Payer: UnitedHealthcare Commercial	$228.00
Rate for Payer: UnitedHealthcare Community & State	$36.02
Rate for Payer: Wellpoint Medicaid Managed Care	$32.38

COLD KNIFE ROUND

Facility

$1,140.00

Hospital Charge Code	270684368
Hospital Revenue Code	272
Min. Negotiated Rate	$171.00
Max. Negotiated Rate	$171.00
Rate for Payer: Qualcare PPO/HMO/WC	$171.00

COLD KNIFE SACHSE STR

Facility

$1,140.00

Hospital Charge Code	270684366
Hospital Revenue Code	272
Min. Negotiated Rate	$32.38
Max. Negotiated Rate	$570.00
Rate for Payer: Aetna Commercial	$433.20
Rate for Payer: Aetna Medicare Advantage	$342.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$290.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$290.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$290.70
Rate for Payer: Cigna Commercial	$570.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.40
Rate for Payer: Oxford Commercial	$228.00
Rate for Payer: Qualcare PPO/HMO/WC	$171.00
Rate for Payer: UnitedHealthcare Commercial	$228.00
Rate for Payer: UnitedHealthcare Community & State	$36.02
Rate for Payer: Wellpoint Medicaid Managed Care	$32.38

COLD KNIFE SACHSE STR

Facility

$1,140.00

Hospital Charge Code	270684366
Hospital Revenue Code	272
Min. Negotiated Rate	$171.00
Max. Negotiated Rate	$171.00
Rate for Payer: Qualcare PPO/HMO/WC	$171.00

COLD PACK PERINEAL KWIK KOL

Facility

$3.02

Hospital Charge Code	270642518
Hospital Revenue Code	270
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$1.51
Rate for Payer: Aetna Commercial	$1.15
Rate for Payer: Aetna Medicare Advantage	$0.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.79
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.09

COLD PACK PERINEAL KWIK KOL

Facility

$3.02

Hospital Charge Code	270642518
Hospital Revenue Code	270
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

COLD THERAPY UNIT ICEMAN CLEAR

Facility

$725.00

Hospital Charge Code	270678392
Hospital Revenue Code	270
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$108.75
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

COLD THERAPY UNIT ICEMAN CLEAR

Facility

$725.00

Hospital Charge Code	270678392
Hospital Revenue Code	270
Min. Negotiated Rate	$20.59
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$275.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.50
Rate for Payer: Oxford Commercial	$145.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.75
Rate for Payer: UnitedHealthcare Commercial	$145.00
Rate for Payer: UnitedHealthcare Community & State	$22.91
Rate for Payer: Wellpoint Medicaid Managed Care	$20.59

COLECTMY P W RESECT/MUCOFISTLA

Facility

$28,649.20

Service Code	HCPCS 44141
Hospital Charge Code	1600000444
Hospital Revenue Code	360
Min. Negotiated Rate	$4,297.38
Max. Negotiated Rate	$4,297.38
Rate for Payer: Qualcare PPO/HMO/WC	$4,297.38

COLECTMY P W RESECT/MUCOFISTLA

Facility

$28,649.20

Service Code	HCPCS 44141
Hospital Charge Code	1600000444
Hospital Revenue Code	360
Min. Negotiated Rate	$813.64
Max. Negotiated Rate	$14,324.60
Rate for Payer: Aetna Commercial	$10,886.70
Rate for Payer: Aetna Medicare Advantage	$8,594.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,305.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,305.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,305.55
Rate for Payer: Cigna Commercial	$14,324.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,448.79
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,297.38
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$905.31
Rate for Payer: Wellpoint Medicaid Managed Care	$813.64

COLECTMY P,W RESECT/MUCOFISTLA

Facility

$21,300.62

Service Code	HCPCS 44144
Hospital Charge Code	1600000849
Hospital Revenue Code	360
Min. Negotiated Rate	$3,195.09
Max. Negotiated Rate	$3,195.09
Rate for Payer: Qualcare PPO/HMO/WC	$3,195.09

COLECTMY P,W RESECT/MUCOFISTLA

Facility

$21,300.62

Service Code	HCPCS 44144
Hospital Charge Code	1600000849
Hospital Revenue Code	360
Min. Negotiated Rate	$604.94
Max. Negotiated Rate	$10,650.31
Rate for Payer: Aetna Commercial	$8,094.24
Rate for Payer: Aetna Medicare Advantage	$6,390.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,431.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,431.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,431.66
Rate for Payer: Cigna Commercial	$10,650.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,538.16
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,195.09
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$673.10
Rate for Payer: Wellpoint Medicaid Managed Care	$604.94

COLECTOMY PARTIAL,W ANASTOMOSI

Facility

$14,894.10

Service Code	HCPCS 44140
Hospital Charge Code	16000642
Hospital Revenue Code	360
Min. Negotiated Rate	$422.99
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$5,659.76
Rate for Payer: Aetna Medicare Advantage	$4,468.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,798.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,798.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,798.00
Rate for Payer: Cigna Commercial	$7,447.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,872.47
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,234.11
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$470.65
Rate for Payer: Wellpoint Medicaid Managed Care	$422.99

COLECTOMY PARTIAL,W ANASTOMOSI

Facility

$14,894.10

Service Code	HCPCS 44140
Hospital Charge Code	16000642
Hospital Revenue Code	360
Min. Negotiated Rate	$2,234.11
Max. Negotiated Rate	$2,234.11
Rate for Payer: Qualcare PPO/HMO/WC	$2,234.11

COLECTOMY, PARTIAL; WITH COLOPROCTOSTOMY (LOW PELVIC ANASTOMOSIS)

Facility

$10,269.00

Service Code	CPT 44145
Hospital Revenue Code	360
Min. Negotiated Rate	$3,536.00
Max. Negotiated Rate	$10,269.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: UnitedHealthcare Commercial	$10,269.00

COLISTIMETHATE 150 MG REC

Facility

$381.90

Service Code	HCPCS J0770
Hospital Charge Code	60629961
Hospital Revenue Code	636
Min. Negotiated Rate	$10.85
Max. Negotiated Rate	$190.95
Rate for Payer: Aetna Commercial	$145.12
Rate for Payer: Aetna Medicare Advantage	$114.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.38
Rate for Payer: Cigna Commercial	$190.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.42
Rate for Payer: Qualcare PPO/HMO/WC	$57.28
Rate for Payer: UnitedHealthcare Community & State	$12.07
Rate for Payer: Wellpoint Medicaid Managed Care	$10.85

COLISTIMETHATE 150 MG REC

Facility

$381.90

Service Code	HCPCS J0770
Hospital Charge Code	60629961
Hospital Revenue Code	636
Min. Negotiated Rate	$57.28
Max. Negotiated Rate	$92.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.42
Rate for Payer: Qualcare PPO/HMO/WC	$57.28

COLLAGENASE 30GM

Facility

$367.95

Hospital Charge Code	60630082W
Hospital Revenue Code	250
Min. Negotiated Rate	$10.45
Max. Negotiated Rate	$183.97
Rate for Payer: Aetna Commercial	$139.82
Rate for Payer: Aetna Medicare Advantage	$110.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.83
Rate for Payer: Cigna Commercial	$183.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.67
Rate for Payer: Oxford Commercial	$73.59
Rate for Payer: Qualcare PPO/HMO/WC	$55.19
Rate for Payer: UnitedHealthcare Commercial	$73.59
Rate for Payer: UnitedHealthcare Community & State	$11.63
Rate for Payer: Wellpoint Medicaid Managed Care	$10.45

COLLAGENASE 30GM

Facility

$367.95

Hospital Charge Code	60630082W
Hospital Revenue Code	250
Min. Negotiated Rate	$55.19
Max. Negotiated Rate	$55.19
Rate for Payer: Qualcare PPO/HMO/WC	$55.19

COLLAGENASE OINT 30GM

Facility

$1,493.56

Service Code	NDC 64501090
Hospital Charge Code	60628876
Hospital Revenue Code	250
Min. Negotiated Rate	$42.42
Max. Negotiated Rate	$746.78
Rate for Payer: Aetna Commercial	$567.55
Rate for Payer: Aetna Medicare Advantage	$448.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$380.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$380.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$380.86
Rate for Payer: Cigna Commercial	$746.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$388.33
Rate for Payer: Oxford Commercial	$298.71
Rate for Payer: Qualcare PPO/HMO/WC	$224.03
Rate for Payer: UnitedHealthcare Commercial	$298.71
Rate for Payer: UnitedHealthcare Community & State	$47.20
Rate for Payer: Wellpoint Medicaid Managed Care	$42.42

Know your out-of-pocket cost for care.

All Charges