Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CONCERTA 18MG TAB

Facility

$65.19

Service Code	NDC 591271501
Hospital Charge Code	6063943086
Hospital Revenue Code	250
Min. Negotiated Rate	$9.78
Max. Negotiated Rate	$9.78
Rate for Payer: Qualcare PPO/HMO/WC	$9.78

CONCERTA 18MG TAB

Facility

$65.19

Service Code	NDC 591271501
Hospital Charge Code	6063943086
Hospital Revenue Code	250
Min. Negotiated Rate	$1.85
Max. Negotiated Rate	$32.59
Rate for Payer: Aetna Commercial	$24.77
Rate for Payer: Aetna Medicare Advantage	$19.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.62
Rate for Payer: Cigna Commercial	$32.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.95
Rate for Payer: Oxford Commercial	$13.04
Rate for Payer: Qualcare PPO/HMO/WC	$9.78
Rate for Payer: UnitedHealthcare Commercial	$13.04
Rate for Payer: UnitedHealthcare Community & State	$2.06
Rate for Payer: Wellpoint Medicaid Managed Care	$1.85

CONCERTA 27MG TAB

Facility

$50.12

Service Code	NDC 55289097590
Hospital Charge Code	6063943087
Hospital Revenue Code	250
Min. Negotiated Rate	$7.52
Max. Negotiated Rate	$7.52
Rate for Payer: Qualcare PPO/HMO/WC	$7.52

CONCERTA 27MG TAB

Facility

$50.12

Service Code	NDC 55289097590
Hospital Charge Code	6063943087
Hospital Revenue Code	250
Min. Negotiated Rate	$1.42
Max. Negotiated Rate	$25.06
Rate for Payer: Aetna Commercial	$19.05
Rate for Payer: Aetna Medicare Advantage	$15.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.78
Rate for Payer: Cigna Commercial	$25.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.03
Rate for Payer: Oxford Commercial	$10.02
Rate for Payer: Qualcare PPO/HMO/WC	$7.52
Rate for Payer: UnitedHealthcare Commercial	$10.02
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.42

CONCERTA 36MG TAB

Facility

$52.46

Service Code	NDC 55289085930
Hospital Charge Code	6063943088
Hospital Revenue Code	250
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$26.23
Rate for Payer: Aetna Commercial	$19.93
Rate for Payer: Aetna Medicare Advantage	$15.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.38
Rate for Payer: Cigna Commercial	$26.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.64
Rate for Payer: Oxford Commercial	$10.49
Rate for Payer: Qualcare PPO/HMO/WC	$7.87
Rate for Payer: UnitedHealthcare Commercial	$10.49
Rate for Payer: UnitedHealthcare Community & State	$1.66
Rate for Payer: Wellpoint Medicaid Managed Care	$1.49

CONCERTA 36MG TAB

Facility

$52.46

Service Code	NDC 55289085930
Hospital Charge Code	6063943088
Hospital Revenue Code	250
Min. Negotiated Rate	$7.87
Max. Negotiated Rate	$7.87
Rate for Payer: Qualcare PPO/HMO/WC	$7.87

CONCERTA 54MG TAB

Facility

$32.16

Service Code	NDC 50458058701
Hospital Charge Code	6063943089
Hospital Revenue Code	250
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$16.08
Rate for Payer: Aetna Commercial	$12.22
Rate for Payer: Aetna Medicare Advantage	$9.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.20
Rate for Payer: Cigna Commercial	$16.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.36
Rate for Payer: Oxford Commercial	$6.43
Rate for Payer: Qualcare PPO/HMO/WC	$4.82
Rate for Payer: UnitedHealthcare Commercial	$6.43
Rate for Payer: UnitedHealthcare Community & State	$1.02
Rate for Payer: Wellpoint Medicaid Managed Care	$0.91

CONCERTA 54MG TAB

Facility

$32.16

Service Code	NDC 50458058701
Hospital Charge Code	6063943089
Hospital Revenue Code	250
Min. Negotiated Rate	$4.82
Max. Negotiated Rate	$4.82
Rate for Payer: Qualcare PPO/HMO/WC	$4.82

CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES

Facility

$363,016.21

Service Code	MSDRG 212
Min. Negotiated Rate	$110,533.78
Max. Negotiated Rate	$363,016.21
Rate for Payer: Aetna Commercial	$260,402.84
Rate for Payer: Aetna Medicare Advantage	$363,016.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$116,351.35
Rate for Payer: Cigna Commercial	$242,416.31
Rate for Payer: Cigna Medicare Advantage	$116,351.35
Rate for Payer: Clover Medicare Advantage	$110,533.78
Rate for Payer: EmblemHealth Commercial	$349,054.05
Rate for Payer: Humana Medicare Advantage	$119,841.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$116,351.35
Rate for Payer: Oxford Commercial	$191,601.64
Rate for Payer: UnitedHealthcare Commercial	$256,465.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$116,351.35
Rate for Payer: Wellcare Medicare Advantage	$116,351.35

CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION

Facility

$230,714.98

Service Code	MSDRG 317
Min. Negotiated Rate	$70,249.75
Max. Negotiated Rate	$230,714.98
Rate for Payer: Aetna Commercial	$166,176.36
Rate for Payer: Aetna Medicare Advantage	$230,714.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$73,947.11
Rate for Payer: Cigna Commercial	$149,062.14
Rate for Payer: Cigna Medicare Advantage	$73,947.11
Rate for Payer: Clover Medicare Advantage	$70,249.75
Rate for Payer: EmblemHealth Commercial	$221,841.33
Rate for Payer: Humana Medicare Advantage	$76,165.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$73,947.11
Rate for Payer: Oxford Commercial	$117,816.13
Rate for Payer: UnitedHealthcare Commercial	$157,701.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$73,947.11
Rate for Payer: Wellcare Medicare Advantage	$73,947.11

CONCORDE INLINE 9mmX13mmX21mm

Facility

$19,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270679700
Hospital Revenue Code	278
Min. Negotiated Rate	$2,887.50
Max. Negotiated Rate	$4,658.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.50

CONCORDE INLINE 9mmX13mmX21mm

Facility

$19,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270679700
Hospital Revenue Code	278
Min. Negotiated Rate	$546.70
Max. Negotiated Rate	$9,625.00
Rate for Payer: Aetna Commercial	$7,315.00
Rate for Payer: Aetna Medicare Advantage	$5,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,908.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,908.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,908.75
Rate for Payer: Cigna Commercial	$9,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.50
Rate for Payer: UnitedHealthcare Community & State	$608.30
Rate for Payer: Wellpoint Medicaid Managed Care	$546.70

CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA

Facility

$25,606.08

Service Code	APR-DRG 0574
Min. Negotiated Rate	$25,104.00
Max. Negotiated Rate	$25,606.08
Rate for Payer: UnitedHealthcare Community & State	$25,104.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$25,606.08
Rate for Payer: Wellpoint Medicaid Managed Care	$25,104.00

CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA

Facility

$16,302.09

Service Code	APR-DRG 0573
Min. Negotiated Rate	$15,982.44
Max. Negotiated Rate	$16,302.09
Rate for Payer: UnitedHealthcare Community & State	$15,982.44
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$16,302.09
Rate for Payer: Wellpoint Medicaid Managed Care	$15,982.44

CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA

Facility

$11,152.21

Service Code	APR-DRG 0572
Min. Negotiated Rate	$10,933.54
Max. Negotiated Rate	$11,152.21
Rate for Payer: UnitedHealthcare Community & State	$10,933.54
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,152.21
Rate for Payer: Wellpoint Medicaid Managed Care	$10,933.54

CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA

Facility

$7,381.44

Service Code	APR-DRG 0571
Min. Negotiated Rate	$7,236.71
Max. Negotiated Rate	$7,381.44
Rate for Payer: UnitedHealthcare Community & State	$7,236.71
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,381.44
Rate for Payer: Wellpoint Medicaid Managed Care	$7,236.71

CONCUSSION WITH CC

Facility

$54,173.34

Service Code	MSDRG 089
Min. Negotiated Rate	$16,495.09
Max. Negotiated Rate	$54,173.34
Rate for Payer: Aetna Medicare Advantage	$54,173.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,860.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,860.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17,363.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,860.75
Rate for Payer: Cigna Commercial	$24,491.09
Rate for Payer: Cigna Medicare Advantage	$17,363.25
Rate for Payer: Clover Medicare Advantage	$16,495.09
Rate for Payer: EmblemHealth Commercial	$52,089.75
Rate for Payer: Humana Medicare Advantage	$17,884.15
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17,363.25
Rate for Payer: Oxford Commercial	$19,357.33
Rate for Payer: UnitedHealthcare Commercial	$25,910.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$17,363.25
Rate for Payer: Wellcare Medicare Advantage	$17,363.25

CONCUSSION WITH MCC

Facility

$62,172.86

Service Code	MSDRG 088
Min. Negotiated Rate	$18,930.84
Max. Negotiated Rate	$62,172.86
Rate for Payer: Aetna Medicare Advantage	$62,172.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42,388.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42,388.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19,927.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42,388.65
Rate for Payer: Cigna Commercial	$30,135.68
Rate for Payer: Cigna Medicare Advantage	$19,927.20
Rate for Payer: Clover Medicare Advantage	$18,930.84
Rate for Payer: EmblemHealth Commercial	$59,781.60
Rate for Payer: Humana Medicare Advantage	$20,525.02
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19,927.20
Rate for Payer: Oxford Commercial	$23,818.72
Rate for Payer: UnitedHealthcare Commercial	$31,882.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$19,927.20
Rate for Payer: Wellcare Medicare Advantage	$19,927.20

CONCUSSION WITHOUT CC/MCC

Facility

$45,472.44

Service Code	MSDRG 090
Min. Negotiated Rate	$13,845.77
Max. Negotiated Rate	$45,472.44
Rate for Payer: Aetna Medicare Advantage	$45,472.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,765.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,765.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14,574.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25,765.65
Rate for Payer: Cigna Commercial	$18,351.60
Rate for Payer: Cigna Medicare Advantage	$14,574.50
Rate for Payer: Clover Medicare Advantage	$13,845.77
Rate for Payer: EmblemHealth Commercial	$43,723.50
Rate for Payer: Humana Medicare Advantage	$15,011.74
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14,574.50
Rate for Payer: Oxford Commercial	$14,504.78
Rate for Payer: UnitedHealthcare Commercial	$19,415.17
Rate for Payer: UnitedHealthcare Medicare Advantage	$14,574.50
Rate for Payer: Wellcare Medicare Advantage	$14,574.50

CONDITIONER SKIN AV 4OZ

Facility

$3.39

Hospital Charge Code	270649379
Hospital Revenue Code	270
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$1.70
Rate for Payer: Aetna Commercial	$1.29
Rate for Payer: Aetna Medicare Advantage	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.86
Rate for Payer: Cigna Commercial	$1.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.88
Rate for Payer: Oxford Commercial	$0.68
Rate for Payer: Qualcare PPO/HMO/WC	$0.51
Rate for Payer: UnitedHealthcare Commercial	$0.68
Rate for Payer: UnitedHealthcare Community & State	$0.11
Rate for Payer: Wellpoint Medicaid Managed Care	$0.10

CONDITIONER SKIN AV 4OZ

Facility

$3.39

Hospital Charge Code	270649379
Hospital Revenue Code	270
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$0.51
Rate for Payer: Qualcare PPO/HMO/WC	$0.51

CONDYLE PEFT LATERA LHEM

Facility

$57,475.00

Service Code	HCPCS C1776
Hospital Charge Code	270686150
Hospital Revenue Code	278
Min. Negotiated Rate	$8,621.25
Max. Negotiated Rate	$13,908.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,908.95
Rate for Payer: Qualcare PPO/HMO/WC	$8,621.25

CONDYLE PEFT LATERA LHEM

Facility

$57,475.00

Service Code	HCPCS C1776
Hospital Charge Code	270686150
Hospital Revenue Code	278
Min. Negotiated Rate	$1,632.29
Max. Negotiated Rate	$28,737.50
Rate for Payer: Aetna Commercial	$21,840.50
Rate for Payer: Aetna Medicare Advantage	$17,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,656.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,656.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,656.12
Rate for Payer: Cigna Commercial	$28,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,908.95
Rate for Payer: Qualcare PPO/HMO/WC	$8,621.25
Rate for Payer: UnitedHealthcare Community & State	$1,816.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1,632.29

CONE HASSON 8MM

Facility

$4,375.00

Hospital Charge Code	270691091
Hospital Revenue Code	272
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$656.25
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

CONE HASSON 8MM

Facility

$4,375.00

Hospital Charge Code	270691091
Hospital Revenue Code	272
Min. Negotiated Rate	$124.25
Max. Negotiated Rate	$2,187.50
Rate for Payer: Aetna Commercial	$1,662.50
Rate for Payer: Aetna Medicare Advantage	$1,312.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,115.62
Rate for Payer: Cigna Commercial	$2,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,137.50
Rate for Payer: Oxford Commercial	$875.00
Rate for Payer: Qualcare PPO/HMO/WC	$656.25
Rate for Payer: UnitedHealthcare Commercial	$875.00
Rate for Payer: UnitedHealthcare Community & State	$138.25
Rate for Payer: Wellpoint Medicaid Managed Care	$124.25

Know your out-of-pocket cost for care.

All Charges