Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

COXSACKIE B1-B6 AB III

Facility

$390.00

Service Code	HCPCS 8665891
Hospital Charge Code	39990040C
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

COXSACKIE B1-B6 AB IV

Facility

$390.00

Service Code	HCPCS 8665891
Hospital Charge Code	39990040D
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

COXSACKIE B1-B6 AB IV

Facility

$390.00

Service Code	HCPCS 8665891
Hospital Charge Code	39990040D
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

COXSACKIE B1-B6 AB V

Facility

$390.00

Service Code	HCPCS 8665891
Hospital Charge Code	39990040E
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

COXSACKIE B1-B6 AB V

Facility

$390.00

Service Code	HCPCS 8665891
Hospital Charge Code	39990040E
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

COXSACKIE B1-B6 AB VI

Facility

$390.00

Service Code	HCPCS 8665891
Hospital Charge Code	39990040F
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

COXSACKIE B1-B6 AB VI

Facility

$390.00

Service Code	HCPCS 8665891
Hospital Charge Code	39990040F
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

COXSACKIE B ANTIBODIES

Facility

$225.00

Service Code	HCPCS 86658
Hospital Charge Code	38476091
Hospital Revenue Code	302
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$35.44
Rate for Payer: Aetna Medicare Advantage	$42.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.27
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: Cigna Medicare Advantage	$13.03
Rate for Payer: Clover Medicare Advantage	$12.38
Rate for Payer: EmblemHealth Commercial	$39.09
Rate for Payer: Humana Medicare Advantage	$13.42
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.50
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.03
Rate for Payer: Wellcare Medicare Advantage	$13.03
Rate for Payer: Wellpoint Medicaid Managed Care	$6.39

COXSACKIE B ANTIBODIES

Facility

$225.00

Service Code	HCPCS 86658
Hospital Charge Code	38476091
Hospital Revenue Code	302
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

COZAAR, 100MG TAB

Facility

$20.64

Service Code	NDC 65862020330
Hospital Charge Code	60635415
Hospital Revenue Code	250
Min. Negotiated Rate	$3.10
Max. Negotiated Rate	$3.10
Rate for Payer: Qualcare PPO/HMO/WC	$3.10

COZAAR, 100MG TAB

Facility

$20.64

Service Code	NDC 65862020330
Hospital Charge Code	60635415
Hospital Revenue Code	250
Min. Negotiated Rate	$0.59
Max. Negotiated Rate	$10.32
Rate for Payer: Aetna Commercial	$7.84
Rate for Payer: Aetna Medicare Advantage	$6.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.26
Rate for Payer: Cigna Commercial	$10.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.37
Rate for Payer: Oxford Commercial	$4.13
Rate for Payer: Qualcare PPO/HMO/WC	$3.10
Rate for Payer: UnitedHealthcare Commercial	$4.13
Rate for Payer: UnitedHealthcare Community & State	$0.65
Rate for Payer: Wellpoint Medicaid Managed Care	$0.59

CPAP/BIPAP CIRCUIT

Facility

$33.24

Hospital Charge Code	270600621
Hospital Revenue Code	272
Min. Negotiated Rate	$4.99
Max. Negotiated Rate	$4.99
Rate for Payer: Qualcare PPO/HMO/WC	$4.99

CPAP/BIPAP CIRCUIT

Facility

$33.24

Hospital Charge Code	270600621
Hospital Revenue Code	272
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$16.62
Rate for Payer: Aetna Commercial	$12.63
Rate for Payer: Aetna Medicare Advantage	$9.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.48
Rate for Payer: Cigna Commercial	$16.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.64
Rate for Payer: Oxford Commercial	$6.65
Rate for Payer: Qualcare PPO/HMO/WC	$4.99
Rate for Payer: UnitedHealthcare Commercial	$6.65
Rate for Payer: UnitedHealthcare Community & State	$1.05
Rate for Payer: Wellpoint Medicaid Managed Care	$0.94

CPAP PROCEDURE

Facility

$585.00

Service Code	HCPCS 94660
Hospital Charge Code	9500431
Hospital Revenue Code	410
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$87.75
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

CPAP PROCEDURE

Facility

$585.00

Service Code	HCPCS 94660
Hospital Charge Code	9500431
Hospital Revenue Code	410
Min. Negotiated Rate	$16.61
Max. Negotiated Rate	$1,440.00
Rate for Payer: Aetna Commercial	$707.61
Rate for Payer: Aetna Medicare Advantage	$842.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$943.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$943.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$943.69
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: Cigna Medicare Advantage	$260.15
Rate for Payer: Clover Medicare Advantage	$247.14
Rate for Payer: EmblemHealth Commercial	$780.45
Rate for Payer: Humana Medicare Advantage	$267.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$260.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.10
Rate for Payer: Oxford Commercial	$1,367.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.75
Rate for Payer: UnitedHealthcare Commercial	$1,440.00
Rate for Payer: UnitedHealthcare Community & State	$18.49
Rate for Payer: UnitedHealthcare Medicare Advantage	$260.15
Rate for Payer: Wellcare Medicare Advantage	$260.15
Rate for Payer: Wellpoint Medicaid Managed Care	$16.61

CP CLOPIDOGREL CYP2C19 GENOTYP

Facility

$1,456.80

Service Code	HCPCS 81225
Hospital Charge Code	401181225
Hospital Revenue Code	310
Min. Negotiated Rate	$41.37
Max. Negotiated Rate	$1,056.91
Rate for Payer: Aetna Commercial	$792.50
Rate for Payer: Aetna Medicare Advantage	$944.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,056.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,056.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$291.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,056.91
Rate for Payer: Cigna Commercial	$728.40
Rate for Payer: Cigna Medicare Advantage	$291.36
Rate for Payer: Clover Medicare Advantage	$276.79
Rate for Payer: EmblemHealth Commercial	$874.08
Rate for Payer: Humana Medicare Advantage	$300.10
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$291.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$378.77
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$218.52
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$233.09
Rate for Payer: UnitedHealthcare Medicare Advantage	$291.36
Rate for Payer: Wellcare Medicare Advantage	$291.36
Rate for Payer: Wellpoint Medicaid Managed Care	$41.37

CP CLOPIDOGREL CYP2C19 GENOTYP

Facility

$1,456.80

Service Code	HCPCS 81225
Hospital Charge Code	401181225
Hospital Revenue Code	310
Min. Negotiated Rate	$218.52
Max. Negotiated Rate	$218.52
Rate for Payer: Qualcare PPO/HMO/WC	$218.52

C-PEPTIDE

Facility

$667.59

Service Code	HCPCS 84681
Hospital Charge Code	39900154
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

C-PEPTIDE

Facility

$667.59

Service Code	HCPCS 84681
Hospital Charge Code	39900154
Hospital Revenue Code	301
Min. Negotiated Rate	$16.65
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$56.60
Rate for Payer: Aetna Medicare Advantage	$67.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.49
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$20.81
Rate for Payer: Clover Medicare Advantage	$19.77
Rate for Payer: EmblemHealth Commercial	$62.43
Rate for Payer: Humana Medicare Advantage	$21.43
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.57
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$16.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.81
Rate for Payer: Wellcare Medicare Advantage	$20.81
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

C-PEPTIDE

Facility

$292.00

Service Code	HCPCS 84681
Hospital Charge Code	38472230
Hospital Revenue Code	301
Min. Negotiated Rate	$43.80
Max. Negotiated Rate	$43.80
Rate for Payer: Qualcare PPO/HMO/WC	$43.80

C-PEPTIDE

Facility

$292.00

Service Code	HCPCS 84681
Hospital Charge Code	38472230
Hospital Revenue Code	301
Min. Negotiated Rate	$8.29
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$56.60
Rate for Payer: Aetna Medicare Advantage	$67.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.49
Rate for Payer: Cigna Commercial	$146.00
Rate for Payer: Cigna Medicare Advantage	$20.81
Rate for Payer: Clover Medicare Advantage	$19.77
Rate for Payer: EmblemHealth Commercial	$62.43
Rate for Payer: Humana Medicare Advantage	$21.43
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.92
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.80
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$16.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.81
Rate for Payer: Wellcare Medicare Advantage	$20.81
Rate for Payer: Wellpoint Medicaid Managed Care	$8.29

CPM MOTION RENTAL

Facility

$156.85

Hospital Charge Code	270607645
Hospital Revenue Code	270
Min. Negotiated Rate	$23.53
Max. Negotiated Rate	$23.53
Rate for Payer: Qualcare PPO/HMO/WC	$23.53

CPM MOTION RENTAL

Facility

$156.85

Hospital Charge Code	270607645
Hospital Revenue Code	270
Min. Negotiated Rate	$4.45
Max. Negotiated Rate	$78.42
Rate for Payer: Aetna Commercial	$59.60
Rate for Payer: Aetna Medicare Advantage	$47.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.00
Rate for Payer: Cigna Commercial	$78.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.78
Rate for Payer: Oxford Commercial	$31.37
Rate for Payer: Qualcare PPO/HMO/WC	$23.53
Rate for Payer: UnitedHealthcare Commercial	$31.37
Rate for Payer: UnitedHealthcare Community & State	$4.96
Rate for Payer: Wellpoint Medicaid Managed Care	$4.45

CPM RENTAL CUSTOM

Facility

$133.65

Service Code	HCPCS E0935
Hospital Charge Code	270612974
Hospital Revenue Code	291
Min. Negotiated Rate	$20.05
Max. Negotiated Rate	$20.05
Rate for Payer: Qualcare PPO/HMO/WC	$20.05

CPM RENTAL CUSTOM

Facility

$133.65

Service Code	HCPCS E0935
Hospital Charge Code	270612974
Hospital Revenue Code	291
Min. Negotiated Rate	$3.80
Max. Negotiated Rate	$66.83
Rate for Payer: Aetna Commercial	$50.79
Rate for Payer: Aetna Medicare Advantage	$40.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.08
Rate for Payer: Cigna Commercial	$66.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.75
Rate for Payer: Qualcare PPO/HMO/WC	$20.05
Rate for Payer: UnitedHealthcare Community & State	$4.22
Rate for Payer: Wellpoint Medicaid Managed Care	$3.80

Know your out-of-pocket cost for care.

All Charges