Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ACID HEMOLYSIN (HAMS)

Facility

$159.00

Service Code	HCPCS 85475
Hospital Charge Code	38476041
Hospital Revenue Code	305
Min. Negotiated Rate	$4.52
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$24.13
Rate for Payer: Aetna Medicare Advantage	$28.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.18
Rate for Payer: Cigna Commercial	$79.50
Rate for Payer: Cigna Medicare Advantage	$8.87
Rate for Payer: Clover Medicare Advantage	$8.43
Rate for Payer: EmblemHealth Commercial	$26.61
Rate for Payer: Humana Medicare Advantage	$9.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.34
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.85
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$7.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.87
Rate for Payer: Wellcare Medicare Advantage	$8.87
Rate for Payer: Wellpoint Medicaid Managed Care	$4.52

ACIDOPHILUS/BULGASRICUS PACKET

Facility

$13.60

Service Code	NDC 64980014612
Hospital Charge Code	6063943049
Hospital Revenue Code	250
Min. Negotiated Rate	$2.04
Max. Negotiated Rate	$2.04
Rate for Payer: Qualcare PPO/HMO/WC	$2.04

ACIDOPHILUS/BULGASRICUS PACKET

Facility

$13.60

Service Code	NDC 64980014612
Hospital Charge Code	6063943049
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$6.80
Rate for Payer: Aetna Commercial	$5.17
Rate for Payer: Aetna Medicare Advantage	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.47
Rate for Payer: Cigna Commercial	$6.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.54
Rate for Payer: Oxford Commercial	$2.72
Rate for Payer: Qualcare PPO/HMO/WC	$2.04
Rate for Payer: UnitedHealthcare Commercial	$2.72
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.39

ACID PHOSPHATASE,PROSTATI

Facility

$390.00

Service Code	HCPCS 84066
Hospital Charge Code	39900118
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ACID PHOSPHATASE,PROSTATI

Facility

$390.00

Service Code	HCPCS 84066
Hospital Charge Code	39900118
Hospital Revenue Code	301
Min. Negotiated Rate	$7.73
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$26.28
Rate for Payer: Aetna Medicare Advantage	$31.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.66
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	$35.04
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$9.66
Rate for Payer: Clover Medicare Advantage	$9.18
Rate for Payer: EmblemHealth Commercial	$28.98
Rate for Payer: Humana Medicare Advantage	$9.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.66
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	$7.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.66
Rate for Payer: Wellcare Medicare Advantage	$9.66
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

ACID PHOSPHATASE,PROSTATIC (PA

Facility

$251.00

Service Code	HCPCS 84066
Hospital Charge Code	38472029
Hospital Revenue Code	301
Min. Negotiated Rate	$7.13
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$26.28
Rate for Payer: Aetna Medicare Advantage	$31.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.66
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	$35.04
Rate for Payer: Cigna Commercial	$125.50
Rate for Payer: Cigna Medicare Advantage	$9.66
Rate for Payer: Clover Medicare Advantage	$9.18
Rate for Payer: EmblemHealth Commercial	$28.98
Rate for Payer: Humana Medicare Advantage	$9.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.26
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.65
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$7.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.66
Rate for Payer: Wellcare Medicare Advantage	$9.66
Rate for Payer: Wellpoint Medicaid Managed Care	$7.13

ACID PHOSPHATASE,PROSTATIC (PA

Facility

$251.00

Service Code	HCPCS 84066
Hospital Charge Code	38472029
Hospital Revenue Code	301
Min. Negotiated Rate	$37.65
Max. Negotiated Rate	$37.65
Rate for Payer: Qualcare PPO/HMO/WC	$37.65

ACID PHOSPHATASE,TOTAL

Facility

$203.00

Service Code	HCPCS 84060
Hospital Charge Code	38472032
Hospital Revenue Code	301
Min. Negotiated Rate	$30.45
Max. Negotiated Rate	$30.45
Rate for Payer: Qualcare PPO/HMO/WC	$30.45

ACID PHOSPHATASE,TOTAL

Facility

$203.00

Service Code	HCPCS 84060
Hospital Charge Code	38472032
Hospital Revenue Code	301
Min. Negotiated Rate	$5.77
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$20.78
Rate for Payer: Aetna Medicare Advantage	$24.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.71
Rate for Payer: Cigna Commercial	$101.50
Rate for Payer: Cigna Medicare Advantage	$7.64
Rate for Payer: Clover Medicare Advantage	$7.26
Rate for Payer: EmblemHealth Commercial	$22.92
Rate for Payer: Humana Medicare Advantage	$7.87
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.78
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.45
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$6.11
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.64
Rate for Payer: Wellcare Medicare Advantage	$7.64
Rate for Payer: Wellpoint Medicaid Managed Care	$5.77

ACIS SPACER 7MM 16X14

Facility

$9,080.00

Service Code	HCPCS C1765
Hospital Charge Code	270705056
Hospital Revenue Code	278
Min. Negotiated Rate	$1,362.00
Max. Negotiated Rate	$2,197.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,816.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,197.36
Rate for Payer: Qualcare PPO/HMO/WC	$1,362.00

ACIS SPACER 7MM 16X14

Facility

$9,080.00

Service Code	HCPCS C1765
Hospital Charge Code	270705056
Hospital Revenue Code	278
Min. Negotiated Rate	$257.87
Max. Negotiated Rate	$4,540.00
Rate for Payer: Aetna Commercial	$3,450.40
Rate for Payer: Aetna Medicare Advantage	$2,724.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,315.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,315.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,816.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,315.40
Rate for Payer: Cigna Commercial	$4,540.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,197.36
Rate for Payer: Qualcare PPO/HMO/WC	$1,362.00
Rate for Payer: UnitedHealthcare Community & State	$286.93
Rate for Payer: Wellpoint Medicaid Managed Care	$257.87

ACL DISP KIT

Facility

$3,165.00

Hospital Charge Code	270678191
Hospital Revenue Code	272
Min. Negotiated Rate	$474.75
Max. Negotiated Rate	$474.75
Rate for Payer: Qualcare PPO/HMO/WC	$474.75

ACL DISP KIT

Facility

$3,165.00

Hospital Charge Code	270678191
Hospital Revenue Code	272
Min. Negotiated Rate	$89.89
Max. Negotiated Rate	$1,582.50
Rate for Payer: Aetna Commercial	$1,202.70
Rate for Payer: Aetna Medicare Advantage	$949.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$807.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$807.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$807.08
Rate for Payer: Cigna Commercial	$1,582.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$822.90
Rate for Payer: Oxford Commercial	$633.00
Rate for Payer: Qualcare PPO/HMO/WC	$474.75
Rate for Payer: UnitedHealthcare Commercial	$633.00
Rate for Payer: UnitedHealthcare Community & State	$100.01
Rate for Payer: Wellpoint Medicaid Managed Care	$89.89

ACL DISPOSABLE PACK

Facility

$2,470.00

Hospital Charge Code	270670502
Hospital Revenue Code	272
Min. Negotiated Rate	$370.50
Max. Negotiated Rate	$370.50
Rate for Payer: Qualcare PPO/HMO/WC	$370.50

ACL DISPOSABLE PACK

Facility

$2,470.00

Hospital Charge Code	270670502
Hospital Revenue Code	272
Min. Negotiated Rate	$70.15
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$938.60
Rate for Payer: Aetna Medicare Advantage	$741.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$629.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$629.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$629.85
Rate for Payer: Cigna Commercial	$1,235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$642.20
Rate for Payer: Oxford Commercial	$494.00
Rate for Payer: Qualcare PPO/HMO/WC	$370.50
Rate for Payer: UnitedHealthcare Commercial	$494.00
Rate for Payer: UnitedHealthcare Community & State	$78.05
Rate for Payer: Wellpoint Medicaid Managed Care	$70.15

ACL DISP PACK BONE-TENDON-BONE

Facility

$1,482.00

Hospital Charge Code	270675672
Hospital Revenue Code	272
Min. Negotiated Rate	$42.09
Max. Negotiated Rate	$741.00
Rate for Payer: Aetna Commercial	$563.16
Rate for Payer: Aetna Medicare Advantage	$444.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$377.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$377.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$377.91
Rate for Payer: Cigna Commercial	$741.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$385.32
Rate for Payer: Oxford Commercial	$296.40
Rate for Payer: Qualcare PPO/HMO/WC	$222.30
Rate for Payer: UnitedHealthcare Commercial	$296.40
Rate for Payer: UnitedHealthcare Community & State	$46.83
Rate for Payer: Wellpoint Medicaid Managed Care	$42.09

ACL DISP PACK BONE-TENDON-BONE

Facility

$1,482.00

Hospital Charge Code	270675672
Hospital Revenue Code	272
Min. Negotiated Rate	$222.30
Max. Negotiated Rate	$222.30
Rate for Payer: Qualcare PPO/HMO/WC	$222.30

ACL GRAFTLINK

Facility

$10,865.00

Service Code	HCPCS C1713
Hospital Charge Code	270667100
Hospital Revenue Code	278
Min. Negotiated Rate	$1,629.75
Max. Negotiated Rate	$2,629.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,173.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,629.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,629.75

ACL GRAFTLINK

Facility

$10,865.00

Service Code	HCPCS C1713
Hospital Charge Code	270667100
Hospital Revenue Code	278
Min. Negotiated Rate	$308.57
Max. Negotiated Rate	$5,432.50
Rate for Payer: Aetna Commercial	$4,128.70
Rate for Payer: Aetna Medicare Advantage	$3,259.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,770.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,770.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,173.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,770.57
Rate for Payer: Cigna Commercial	$5,432.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,629.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,629.75
Rate for Payer: UnitedHealthcare Community & State	$343.33
Rate for Payer: Wellpoint Medicaid Managed Care	$308.57

ACL INSTRUMENTATION SYSTEM

Facility

$1,250.00

Hospital Charge Code	270675673
Hospital Revenue Code	272
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

ACL INSTRUMENTATION SYSTEM

Facility

$1,250.00

Hospital Charge Code	270675673
Hospital Revenue Code	272
Min. Negotiated Rate	$35.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$325.00
Rate for Payer: Oxford Commercial	$250.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Commercial	$250.00
Rate for Payer: UnitedHealthcare Community & State	$39.50
Rate for Payer: Wellpoint Medicaid Managed Care	$35.50

ACL INST SYSTEM USAGE

Facility

$2,500.00

Hospital Charge Code	270670503
Hospital Revenue Code	272
Min. Negotiated Rate	$71.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$650.00
Rate for Payer: Oxford Commercial	$500.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Commercial	$500.00
Rate for Payer: UnitedHealthcare Community & State	$79.00
Rate for Payer: Wellpoint Medicaid Managed Care	$71.00

ACL INST SYSTEM USAGE

Facility

$2,500.00

Hospital Charge Code	270670503
Hospital Revenue Code	272
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

ACL KIT DISP

Facility

$2,730.00

Hospital Charge Code	270635264
Hospital Revenue Code	272
Min. Negotiated Rate	$409.50
Max. Negotiated Rate	$409.50
Rate for Payer: Qualcare PPO/HMO/WC	$409.50

ACL KIT DISP

Facility

$2,730.00

Hospital Charge Code	270635264
Hospital Revenue Code	272
Min. Negotiated Rate	$77.53
Max. Negotiated Rate	$1,365.00
Rate for Payer: Aetna Commercial	$1,037.40
Rate for Payer: Aetna Medicare Advantage	$819.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$696.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$696.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$696.15
Rate for Payer: Cigna Commercial	$1,365.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$709.80
Rate for Payer: Oxford Commercial	$546.00
Rate for Payer: Qualcare PPO/HMO/WC	$409.50
Rate for Payer: UnitedHealthcare Commercial	$546.00
Rate for Payer: UnitedHealthcare Community & State	$86.27
Rate for Payer: Wellpoint Medicaid Managed Care	$77.53

Know your out-of-pocket cost for care.

All Charges