Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CUVETTE CLOTTING TIME TEST

Facility

$18.56

Hospital Charge Code	270632189
Hospital Revenue Code	272
Min. Negotiated Rate	$0.53
Max. Negotiated Rate	$9.28
Rate for Payer: Aetna Commercial	$7.05
Rate for Payer: Aetna Medicare Advantage	$5.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.73
Rate for Payer: Cigna Commercial	$9.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.83
Rate for Payer: Oxford Commercial	$3.71
Rate for Payer: Qualcare PPO/HMO/WC	$2.78
Rate for Payer: UnitedHealthcare Commercial	$3.71
Rate for Payer: UnitedHealthcare Community & State	$0.59
Rate for Payer: Wellpoint Medicaid Managed Care	$0.53

CUVETTE CLOTTING TIME TEST

Facility

$19.74

Hospital Charge Code	270632189N
Hospital Revenue Code	272
Min. Negotiated Rate	$2.96
Max. Negotiated Rate	$2.96
Rate for Payer: Qualcare PPO/HMO/WC	$2.96

CUVETTE CLOTTING TIME TEST

Facility

$18.56

Hospital Charge Code	270632189S
Hospital Revenue Code	272
Min. Negotiated Rate	$2.78
Max. Negotiated Rate	$2.78
Rate for Payer: Qualcare PPO/HMO/WC	$2.78

CUVETTE CLOTTING TIME TEST

Facility

$19.74

Hospital Charge Code	270632189N
Hospital Revenue Code	272
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$9.87
Rate for Payer: Aetna Commercial	$7.50
Rate for Payer: Aetna Medicare Advantage	$5.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.03
Rate for Payer: Cigna Commercial	$9.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.13
Rate for Payer: Oxford Commercial	$3.95
Rate for Payer: Qualcare PPO/HMO/WC	$2.96
Rate for Payer: UnitedHealthcare Commercial	$3.95
Rate for Payer: UnitedHealthcare Community & State	$0.62
Rate for Payer: Wellpoint Medicaid Managed Care	$0.56

CUVETTE CLOTTING TIME TEST

Facility

$18.56

Hospital Charge Code	270632189
Hospital Revenue Code	272
Min. Negotiated Rate	$2.78
Max. Negotiated Rate	$2.78
Rate for Payer: Qualcare PPO/HMO/WC	$2.78

CUVETTES

Facility

$169.06

Hospital Charge Code	270655423N
Hospital Revenue Code	270
Min. Negotiated Rate	$25.36
Max. Negotiated Rate	$25.36
Rate for Payer: Qualcare PPO/HMO/WC	$25.36

CUVETTES

Facility

$1,955.00

Hospital Charge Code	270655423
Hospital Revenue Code	270
Min. Negotiated Rate	$293.25
Max. Negotiated Rate	$293.25
Rate for Payer: Qualcare PPO/HMO/WC	$293.25

CUVETTES

Facility

$1,955.00

Hospital Charge Code	270655423S
Hospital Revenue Code	270
Min. Negotiated Rate	$293.25
Max. Negotiated Rate	$293.25
Rate for Payer: Qualcare PPO/HMO/WC	$293.25

CUVETTES

Facility

$1,955.00

Hospital Charge Code	270655423S
Hospital Revenue Code	270
Min. Negotiated Rate	$55.52
Max. Negotiated Rate	$977.50
Rate for Payer: Aetna Commercial	$742.90
Rate for Payer: Aetna Medicare Advantage	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$498.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$498.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$498.52
Rate for Payer: Cigna Commercial	$977.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$508.30
Rate for Payer: Oxford Commercial	$391.00
Rate for Payer: Qualcare PPO/HMO/WC	$293.25
Rate for Payer: UnitedHealthcare Commercial	$391.00
Rate for Payer: UnitedHealthcare Community & State	$61.78
Rate for Payer: Wellpoint Medicaid Managed Care	$55.52

CUVETTES

Facility

$1,955.00

Hospital Charge Code	270655423
Hospital Revenue Code	270
Min. Negotiated Rate	$55.52
Max. Negotiated Rate	$977.50
Rate for Payer: Aetna Commercial	$742.90
Rate for Payer: Aetna Medicare Advantage	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$498.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$498.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$498.52
Rate for Payer: Cigna Commercial	$977.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$508.30
Rate for Payer: Oxford Commercial	$391.00
Rate for Payer: Qualcare PPO/HMO/WC	$293.25
Rate for Payer: UnitedHealthcare Commercial	$391.00
Rate for Payer: UnitedHealthcare Community & State	$61.78
Rate for Payer: Wellpoint Medicaid Managed Care	$55.52

CUVETTES

Facility

$169.06

Hospital Charge Code	270655423N
Hospital Revenue Code	270
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$84.53
Rate for Payer: Aetna Commercial	$64.24
Rate for Payer: Aetna Medicare Advantage	$50.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.11
Rate for Payer: Cigna Commercial	$84.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.96
Rate for Payer: Oxford Commercial	$33.81
Rate for Payer: Qualcare PPO/HMO/WC	$25.36
Rate for Payer: UnitedHealthcare Commercial	$33.81
Rate for Payer: UnitedHealthcare Community & State	$5.34
Rate for Payer: Wellpoint Medicaid Managed Care	$4.80

CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION

Facility

$13,196.97

Service Code	APR-DRG 0452
Min. Negotiated Rate	$12,938.21
Max. Negotiated Rate	$13,196.97
Rate for Payer: UnitedHealthcare Community & State	$12,938.21
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,196.97
Rate for Payer: Wellpoint Medicaid Managed Care	$12,938.21

CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION

Facility

$10,631.13

Service Code	APR-DRG 0451
Min. Negotiated Rate	$10,422.68
Max. Negotiated Rate	$10,631.13
Rate for Payer: UnitedHealthcare Community & State	$10,422.68
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,631.13
Rate for Payer: Wellpoint Medicaid Managed Care	$10,422.68

CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION

Facility

$17,724.67

Service Code	APR-DRG 0453
Min. Negotiated Rate	$17,377.13
Max. Negotiated Rate	$17,724.67
Rate for Payer: UnitedHealthcare Community & State	$17,377.13
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,724.67
Rate for Payer: Wellpoint Medicaid Managed Care	$17,377.13

CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION

Facility

$27,216.92

Service Code	APR-DRG 0454
Min. Negotiated Rate	$26,683.25
Max. Negotiated Rate	$27,216.92
Rate for Payer: UnitedHealthcare Community & State	$26,683.25
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27,216.92
Rate for Payer: Wellpoint Medicaid Managed Care	$26,683.25

CWS 400 KIT DRAIN 3/16

Facility

$207.00

Hospital Charge Code	270331370
Hospital Revenue Code	272
Min. Negotiated Rate	$31.05
Max. Negotiated Rate	$31.05
Rate for Payer: Qualcare PPO/HMO/WC	$31.05

CWS 400 KIT DRAIN 3/16

Facility

$207.00

Hospital Charge Code	270331370
Hospital Revenue Code	272
Min. Negotiated Rate	$5.88
Max. Negotiated Rate	$103.50
Rate for Payer: Aetna Commercial	$78.66
Rate for Payer: Aetna Medicare Advantage	$62.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.78
Rate for Payer: Cigna Commercial	$103.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.82
Rate for Payer: Oxford Commercial	$41.40
Rate for Payer: Qualcare PPO/HMO/WC	$31.05
Rate for Payer: UnitedHealthcare Commercial	$41.40
Rate for Payer: UnitedHealthcare Community & State	$6.54
Rate for Payer: Wellpoint Medicaid Managed Care	$5.88

CX PRECONNECT MS 21 CM PS OTL

Facility

$70,325.00

Service Code	HCPCS C1776
Hospital Charge Code	270703662
Hospital Revenue Code	278
Min. Negotiated Rate	$1,997.23
Max. Negotiated Rate	$35,162.50
Rate for Payer: Aetna Commercial	$26,723.50
Rate for Payer: Aetna Medicare Advantage	$21,097.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17,932.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17,932.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14,065.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17,932.88
Rate for Payer: Cigna Commercial	$35,162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17,018.65
Rate for Payer: Qualcare PPO/HMO/WC	$10,548.75
Rate for Payer: UnitedHealthcare Community & State	$2,222.27
Rate for Payer: Wellpoint Medicaid Managed Care	$1,997.23

CX PRECONNECT MS 21 CM PS OTL

Facility

$70,325.00

Service Code	HCPCS C1776
Hospital Charge Code	270703662
Hospital Revenue Code	278
Min. Negotiated Rate	$10,548.75
Max. Negotiated Rate	$17,018.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14,065.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17,018.65
Rate for Payer: Qualcare PPO/HMO/WC	$10,548.75

CYANIDE

Facility

$301.00

Service Code	HCPCS 82600
Hospital Charge Code	38473105
Hospital Revenue Code	301
Min. Negotiated Rate	$45.15
Max. Negotiated Rate	$45.15
Rate for Payer: Qualcare PPO/HMO/WC	$45.15

CYANIDE

Facility

$301.00

Service Code	HCPCS 82600
Hospital Charge Code	38473105
Hospital Revenue Code	301
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$52.77
Rate for Payer: Aetna Medicare Advantage	$62.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.37
Rate for Payer: Cigna Commercial	$150.50
Rate for Payer: Cigna Medicare Advantage	$19.40
Rate for Payer: Clover Medicare Advantage	$18.43
Rate for Payer: EmblemHealth Commercial	$58.20
Rate for Payer: Humana Medicare Advantage	$19.98
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.26
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.15
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$15.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.40
Rate for Payer: Wellcare Medicare Advantage	$19.40
Rate for Payer: Wellpoint Medicaid Managed Care	$8.55

CYANIDE ANTIDOTE KIT

Facility

$3,079.86

Service Code	NDC 11098050701
Hospital Charge Code	60628548
Hospital Revenue Code	250
Min. Negotiated Rate	$461.98
Max. Negotiated Rate	$461.98
Rate for Payer: Qualcare PPO/HMO/WC	$461.98

CYANIDE ANTIDOTE KIT

Facility

$3,079.86

Service Code	NDC 11098050701
Hospital Charge Code	60628548
Hospital Revenue Code	250
Min. Negotiated Rate	$87.47
Max. Negotiated Rate	$1,539.93
Rate for Payer: Aetna Commercial	$1,170.35
Rate for Payer: Aetna Medicare Advantage	$923.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$785.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$785.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$785.36
Rate for Payer: Cigna Commercial	$1,539.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$800.76
Rate for Payer: Oxford Commercial	$615.97
Rate for Payer: Qualcare PPO/HMO/WC	$461.98
Rate for Payer: UnitedHealthcare Commercial	$615.97
Rate for Payer: UnitedHealthcare Community & State	$97.32
Rate for Payer: Wellpoint Medicaid Managed Care	$87.47

CYANOCOBALAMIN 1,000MCG/ML

Facility

$7.00

Hospital Charge Code	83652559
Hospital Revenue Code	636
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

CYANOCOBALAMIN 1,000MCG/ML

Facility

$7.00

Hospital Charge Code	83652559
Hospital Revenue Code	636
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.66
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

Know your out-of-pocket cost for care.

All Charges