Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CONTRAST ECHO DEFINTY INJ UNIT

Facility

$559.10

Service Code	HCPCS Q9957
Hospital Charge Code	5300170
Hospital Revenue Code	636
Min. Negotiated Rate	$83.86
Max. Negotiated Rate	$135.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.30
Rate for Payer: Qualcare PPO/HMO/WC	$83.86

CONTRAST EXAM THORACIC AORTA

Facility

$21,323.35

Service Code	HCPCS 75605
Hospital Charge Code	366875605
Hospital Revenue Code	323
Min. Negotiated Rate	$3,198.50
Max. Negotiated Rate	$3,198.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,198.50

CONTRAST EXAM THORACIC AORTA

Facility

$21,323.35

Service Code	HCPCS 75605
Hospital Charge Code	366875605
Hospital Revenue Code	323
Min. Negotiated Rate	$236.49
Max. Negotiated Rate	$23,980.53
Rate for Payer: Aetna Commercial	$17,981.27
Rate for Payer: Aetna Medicare Advantage	$21,418.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,610.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$236.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,980.53
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: Cigna Medicare Advantage	$4,627.53
Rate for Payer: Clover Medicare Advantage	$6,280.22
Rate for Payer: EmblemHealth Commercial	$19,832.28
Rate for Payer: Humana Medicare Advantage	$6,809.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,610.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,544.07
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,198.50
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$673.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,610.76
Rate for Payer: Wellcare Medicare Advantage	$6,610.76
Rate for Payer: Wellpoint Medicaid Managed Care	$605.58

CONTRAST EXAM THORACIC AORTA

Facility

$21,323.35

Service Code	HCPCS 75605
Hospital Charge Code	411075605
Hospital Revenue Code	323
Min. Negotiated Rate	$3,198.50
Max. Negotiated Rate	$3,198.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,198.50

CONTRAST EXAM THORACIC AORTA

Facility

$21,323.35

Service Code	HCPCS 75605
Hospital Charge Code	411075605
Hospital Revenue Code	323
Min. Negotiated Rate	$236.49
Max. Negotiated Rate	$23,980.53
Rate for Payer: Aetna Commercial	$17,981.27
Rate for Payer: Aetna Medicare Advantage	$21,418.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,610.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$236.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,980.53
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: Cigna Medicare Advantage	$4,627.53
Rate for Payer: Clover Medicare Advantage	$6,280.22
Rate for Payer: EmblemHealth Commercial	$19,832.28
Rate for Payer: Humana Medicare Advantage	$6,809.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,610.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,544.07
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,198.50
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$673.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,610.76
Rate for Payer: Wellcare Medicare Advantage	$6,610.76
Rate for Payer: Wellpoint Medicaid Managed Care	$605.58

CONTRAST INJECTOR LEVEREDGE

Facility

$995.50

Hospital Charge Code	270669885
Hospital Revenue Code	272
Min. Negotiated Rate	$28.27
Max. Negotiated Rate	$497.75
Rate for Payer: Aetna Commercial	$378.29
Rate for Payer: Aetna Medicare Advantage	$298.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.85
Rate for Payer: Cigna Commercial	$497.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.83
Rate for Payer: Oxford Commercial	$199.10
Rate for Payer: Qualcare PPO/HMO/WC	$149.32
Rate for Payer: UnitedHealthcare Commercial	$199.10
Rate for Payer: UnitedHealthcare Community & State	$31.46
Rate for Payer: Wellpoint Medicaid Managed Care	$28.27

CONTRAST INJECTOR LEVEREDGE

Facility

$995.50

Hospital Charge Code	270669885
Hospital Revenue Code	272
Min. Negotiated Rate	$149.32
Max. Negotiated Rate	$149.32
Rate for Payer: Qualcare PPO/HMO/WC	$149.32

CONTRAST MEDIA CYSTOGRAFIN

Facility

$171.00

Hospital Charge Code	270331233
Hospital Revenue Code	636
Min. Negotiated Rate	$4.86
Max. Negotiated Rate	$85.50
Rate for Payer: Aetna Commercial	$64.98
Rate for Payer: Aetna Medicare Advantage	$51.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.60
Rate for Payer: Cigna Commercial	$85.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.38
Rate for Payer: Qualcare PPO/HMO/WC	$25.65
Rate for Payer: UnitedHealthcare Community & State	$5.40
Rate for Payer: Wellpoint Medicaid Managed Care	$4.86

CONTRAST MEDIA CYSTOGRAFIN

Facility

$171.00

Hospital Charge Code	270331233
Hospital Revenue Code	636
Min. Negotiated Rate	$25.65
Max. Negotiated Rate	$41.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.38
Rate for Payer: Qualcare PPO/HMO/WC	$25.65

CONTRAST MEDIA GASTROGRAFIN

Facility

$82.00

Hospital Charge Code	270331234
Hospital Revenue Code	255
Min. Negotiated Rate	$2.33
Max. Negotiated Rate	$41.00
Rate for Payer: Aetna Commercial	$31.16
Rate for Payer: Aetna Medicare Advantage	$24.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.91
Rate for Payer: Cigna Commercial	$41.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.32
Rate for Payer: Oxford Commercial	$16.40
Rate for Payer: Qualcare PPO/HMO/WC	$12.30
Rate for Payer: UnitedHealthcare Commercial	$16.40
Rate for Payer: UnitedHealthcare Community & State	$2.59
Rate for Payer: Wellpoint Medicaid Managed Care	$2.33

CONTRAST MEDIA GASTROGRAFIN

Facility

$82.00

Hospital Charge Code	270331234
Hospital Revenue Code	255
Min. Negotiated Rate	$12.30
Max. Negotiated Rate	$12.30
Rate for Payer: Qualcare PPO/HMO/WC	$12.30

CONTRAST MEDIA HYPAQUE 120ML

Facility

$98.00

Hospital Charge Code	270331240
Hospital Revenue Code	255
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$14.70
Rate for Payer: Qualcare PPO/HMO/WC	$14.70

CONTRAST MEDIA HYPAQUE 120ML

Facility

$98.00

Hospital Charge Code	270331240
Hospital Revenue Code	255
Min. Negotiated Rate	$2.78
Max. Negotiated Rate	$49.00
Rate for Payer: Aetna Commercial	$37.24
Rate for Payer: Aetna Medicare Advantage	$29.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.99
Rate for Payer: Cigna Commercial	$49.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.48
Rate for Payer: Oxford Commercial	$19.60
Rate for Payer: Qualcare PPO/HMO/WC	$14.70
Rate for Payer: UnitedHealthcare Commercial	$19.60
Rate for Payer: UnitedHealthcare Community & State	$3.10
Rate for Payer: Wellpoint Medicaid Managed Care	$2.78

CONTRAST MEDIA ISOVUE-300 50ML

Facility

$1,638.00

Hospital Charge Code	270331229
Hospital Revenue Code	255
Min. Negotiated Rate	$46.52
Max. Negotiated Rate	$819.00
Rate for Payer: Aetna Commercial	$622.44
Rate for Payer: Aetna Medicare Advantage	$491.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$417.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$417.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$417.69
Rate for Payer: Cigna Commercial	$819.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$425.88
Rate for Payer: Oxford Commercial	$327.60
Rate for Payer: Qualcare PPO/HMO/WC	$245.70
Rate for Payer: UnitedHealthcare Commercial	$327.60
Rate for Payer: UnitedHealthcare Community & State	$51.76
Rate for Payer: Wellpoint Medicaid Managed Care	$46.52

CONTRAST MEDIA ISOVUE-300 50ML

Facility

$1,638.00

Hospital Charge Code	270331229
Hospital Revenue Code	255
Min. Negotiated Rate	$245.70
Max. Negotiated Rate	$245.70
Rate for Payer: Qualcare PPO/HMO/WC	$245.70

CONTRAST MEDIA RENOGRAFIN-60

Facility

$31.00

Hospital Charge Code	270331232
Hospital Revenue Code	255
Min. Negotiated Rate	$4.65
Max. Negotiated Rate	$4.65
Rate for Payer: Qualcare PPO/HMO/WC	$4.65

CONTRAST MEDIA RENOGRAFIN-60

Facility

$31.00

Hospital Charge Code	270331232
Hospital Revenue Code	255
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$15.50
Rate for Payer: Aetna Commercial	$11.78
Rate for Payer: Aetna Medicare Advantage	$9.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.91
Rate for Payer: Cigna Commercial	$15.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.06
Rate for Payer: Oxford Commercial	$6.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.65
Rate for Payer: UnitedHealthcare Commercial	$6.20
Rate for Payer: UnitedHealthcare Community & State	$0.98
Rate for Payer: Wellpoint Medicaid Managed Care	$0.88

CONTRAST MED OPTISON 3M 270703

Facility

$205.50

Service Code	HCPCS Q9956
Hospital Charge Code	270629560
Hospital Revenue Code	636
Min. Negotiated Rate	$5.84
Max. Negotiated Rate	$102.75
Rate for Payer: Aetna Commercial	$78.09
Rate for Payer: Aetna Medicare Advantage	$61.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.40
Rate for Payer: Cigna Commercial	$102.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.73
Rate for Payer: Qualcare PPO/HMO/WC	$30.82
Rate for Payer: UnitedHealthcare Community & State	$6.49
Rate for Payer: Wellpoint Medicaid Managed Care	$5.84

CONTRAST MED OPTISON 3M 270703

Facility

$205.50

Service Code	HCPCS Q9956
Hospital Charge Code	270629560
Hospital Revenue Code	636
Min. Negotiated Rate	$30.82
Max. Negotiated Rate	$49.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.73
Rate for Payer: Qualcare PPO/HMO/WC	$30.82

CONTRAST SAVER

Facility

$55.00

Hospital Charge Code	270663919
Hospital Revenue Code	272
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$27.50
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	$11.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.25
Rate for Payer: UnitedHealthcare Commercial	$11.00
Rate for Payer: UnitedHealthcare Community & State	$1.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1.56

CONTRAST SAVER

Facility

$56.50

Hospital Charge Code	270663919N
Hospital Revenue Code	272
Min. Negotiated Rate	$1.60
Max. Negotiated Rate	$28.25
Rate for Payer: Aetna Commercial	$21.47
Rate for Payer: Aetna Medicare Advantage	$16.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.41
Rate for Payer: Cigna Commercial	$28.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.69
Rate for Payer: Oxford Commercial	$11.30
Rate for Payer: Qualcare PPO/HMO/WC	$8.47
Rate for Payer: UnitedHealthcare Commercial	$11.30
Rate for Payer: UnitedHealthcare Community & State	$1.79
Rate for Payer: Wellpoint Medicaid Managed Care	$1.60

CONTRAST SAVER

Facility

$55.00

Hospital Charge Code	270663919
Hospital Revenue Code	272
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

CONTRAST SAVER

Facility

$56.50

Hospital Charge Code	270663919N
Hospital Revenue Code	272
Min. Negotiated Rate	$8.47
Max. Negotiated Rate	$8.47
Rate for Payer: Qualcare PPO/HMO/WC	$8.47

CONTRAST VISIPAQUE 320mg 200ml

Facility

$393.73

Hospital Charge Code	270642173
Hospital Revenue Code	272
Min. Negotiated Rate	$59.06
Max. Negotiated Rate	$59.06
Rate for Payer: Qualcare PPO/HMO/WC	$59.06

CONTRAST VISIPAQUE 320mg 200ml

Facility

$393.73

Hospital Charge Code	270642173
Hospital Revenue Code	272
Min. Negotiated Rate	$11.18
Max. Negotiated Rate	$196.87
Rate for Payer: Aetna Commercial	$149.62
Rate for Payer: Aetna Medicare Advantage	$118.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.40
Rate for Payer: Cigna Commercial	$196.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.37
Rate for Payer: Oxford Commercial	$78.75
Rate for Payer: Qualcare PPO/HMO/WC	$59.06
Rate for Payer: UnitedHealthcare Commercial	$78.75
Rate for Payer: UnitedHealthcare Community & State	$12.44
Rate for Payer: Wellpoint Medicaid Managed Care	$11.18

Know your out-of-pocket cost for care.

All Charges