Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ACUTE MYOCARDIAL INFARCTION

Facility

$10,697.16

Service Code	APR-DRG 1901
Min. Negotiated Rate	$10,487.41
Max. Negotiated Rate	$10,697.16
Rate for Payer: UnitedHealthcare Community & State	$10,487.41
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,697.16
Rate for Payer: Wellpoint Medicaid Managed Care	$10,487.41

ACUTE MYOCARDIAL INFARCTION

Facility

$11,569.26

Service Code	APR-DRG 1902
Min. Negotiated Rate	$11,342.41
Max. Negotiated Rate	$11,569.26
Rate for Payer: UnitedHealthcare Community & State	$11,342.41
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,569.26
Rate for Payer: Wellpoint Medicaid Managed Care	$11,342.41

ACUTE MYOCARDIAL INFARCTION

Facility

$15,064.78

Service Code	APR-DRG 1903
Min. Negotiated Rate	$14,769.39
Max. Negotiated Rate	$15,064.78
Rate for Payer: UnitedHealthcare Community & State	$14,769.39
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$15,064.78
Rate for Payer: Wellpoint Medicaid Managed Care	$14,769.39

ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC

Facility

$48,502.24

Service Code	MSDRG 281
Min. Negotiated Rate	$14,768.31
Max. Negotiated Rate	$48,502.24
Rate for Payer: Aetna Commercial	$36,402.36
Rate for Payer: Aetna Medicare Advantage	$48,502.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,211.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,211.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,545.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25,211.55
Rate for Payer: Cigna Commercial	$20,489.50
Rate for Payer: Cigna Medicare Advantage	$15,545.59
Rate for Payer: Clover Medicare Advantage	$14,768.31
Rate for Payer: EmblemHealth Commercial	$46,636.77
Rate for Payer: Humana Medicare Advantage	$16,011.96
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,545.59
Rate for Payer: Oxford Commercial	$16,194.54
Rate for Payer: UnitedHealthcare Commercial	$21,676.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,545.59
Rate for Payer: Wellcare Medicare Advantage	$15,545.59

ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC

Facility

$70,143.87

Service Code	MSDRG 280
Min. Negotiated Rate	$21,357.91
Max. Negotiated Rate	$70,143.87
Rate for Payer: Aetna Commercial	$51,815.79
Rate for Payer: Aetna Medicare Advantage	$70,143.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44,050.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44,050.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22,482.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44,050.95
Rate for Payer: Cigna Commercial	$35,760.20
Rate for Payer: Cigna Medicare Advantage	$22,482.01
Rate for Payer: Clover Medicare Advantage	$21,357.91
Rate for Payer: EmblemHealth Commercial	$67,446.03
Rate for Payer: Humana Medicare Advantage	$23,156.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22,482.01
Rate for Payer: Oxford Commercial	$28,264.24
Rate for Payer: UnitedHealthcare Commercial	$37,832.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$22,482.01
Rate for Payer: Wellcare Medicare Advantage	$22,482.01

ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC

Facility

$42,309.95

Service Code	MSDRG 282
Min. Negotiated Rate	$12,741.02
Max. Negotiated Rate	$42,309.95
Rate for Payer: Aetna Commercial	$31,992.16
Rate for Payer: Aetna Medicare Advantage	$42,309.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19,947.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19,947.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,560.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19,947.60
Rate for Payer: Cigna Commercial	$16,120.07
Rate for Payer: Cigna Medicare Advantage	$13,560.88
Rate for Payer: Clover Medicare Advantage	$12,882.84
Rate for Payer: EmblemHealth Commercial	$40,682.64
Rate for Payer: Humana Medicare Advantage	$13,967.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,560.88
Rate for Payer: Oxford Commercial	$12,741.02
Rate for Payer: UnitedHealthcare Commercial	$17,054.31
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,560.88
Rate for Payer: Wellcare Medicare Advantage	$13,560.88

ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC

Facility

$41,333.73

Service Code	MSDRG 284
Min. Negotiated Rate	$12,196.56
Max. Negotiated Rate	$41,333.73
Rate for Payer: Aetna Commercial	$31,296.86
Rate for Payer: Aetna Medicare Advantage	$41,333.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20,501.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20,501.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,247.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20,501.70
Rate for Payer: Cigna Commercial	$15,431.21
Rate for Payer: Cigna Medicare Advantage	$13,247.99
Rate for Payer: Clover Medicare Advantage	$12,585.59
Rate for Payer: EmblemHealth Commercial	$39,743.97
Rate for Payer: Humana Medicare Advantage	$13,645.43
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,247.99
Rate for Payer: Oxford Commercial	$12,196.56
Rate for Payer: UnitedHealthcare Commercial	$16,325.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,247.99
Rate for Payer: Wellcare Medicare Advantage	$13,247.99

ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC

Facility

$82,045.20

Service Code	MSDRG 283
Min. Negotiated Rate	$24,981.71
Max. Negotiated Rate	$82,045.20
Rate for Payer: Aetna Commercial	$60,292.06
Rate for Payer: Aetna Medicare Advantage	$82,045.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54,578.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54,578.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26,296.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54,578.85
Rate for Payer: Cigna Commercial	$44,157.97
Rate for Payer: Cigna Medicare Advantage	$26,296.54
Rate for Payer: Clover Medicare Advantage	$24,981.71
Rate for Payer: EmblemHealth Commercial	$78,889.62
Rate for Payer: Humana Medicare Advantage	$27,085.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26,296.54
Rate for Payer: Oxford Commercial	$34,901.70
Rate for Payer: UnitedHealthcare Commercial	$46,717.17
Rate for Payer: UnitedHealthcare Medicare Advantage	$26,296.54
Rate for Payer: Wellcare Medicare Advantage	$26,296.54

ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC

Facility

$38,386.02

Service Code	MSDRG 285
Min. Negotiated Rate	$10,552.62
Max. Negotiated Rate	$38,386.02
Rate for Payer: Aetna Commercial	$29,197.48
Rate for Payer: Aetna Medicare Advantage	$38,386.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,575.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,575.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,303.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,575.45
Rate for Payer: Cigna Commercial	$13,351.28
Rate for Payer: Cigna Medicare Advantage	$12,303.21
Rate for Payer: Clover Medicare Advantage	$11,688.05
Rate for Payer: EmblemHealth Commercial	$36,909.63
Rate for Payer: Humana Medicare Advantage	$12,672.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,303.21
Rate for Payer: Oxford Commercial	$10,552.62
Rate for Payer: UnitedHealthcare Commercial	$14,125.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,303.21
Rate for Payer: Wellcare Medicare Advantage	$12,303.21

ACUTHERM DECOMPRS. CATH

Facility

$2,550.00

Hospital Charge Code	270339464
Hospital Revenue Code	272
Min. Negotiated Rate	$382.50
Max. Negotiated Rate	$382.50
Rate for Payer: Qualcare PPO/HMO/WC	$382.50

ACUTHERM DECOMPRS. CATH

Facility

$2,550.00

Hospital Charge Code	270339464
Hospital Revenue Code	272
Min. Negotiated Rate	$72.42
Max. Negotiated Rate	$1,275.00
Rate for Payer: Aetna Commercial	$969.00
Rate for Payer: Aetna Medicare Advantage	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$650.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$650.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$650.25
Rate for Payer: Cigna Commercial	$1,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$510.00
Rate for Payer: Qualcare PPO/HMO/WC	$382.50
Rate for Payer: UnitedHealthcare Commercial	$510.00
Rate for Payer: UnitedHealthcare Community & State	$80.58
Rate for Payer: Wellpoint Medicaid Managed Care	$72.42

ACYCLOVIR 200 MG CAP

Facility

$8.78

Service Code	HCPCS J8499
Hospital Charge Code	60627335
Hospital Revenue Code	636
Min. Negotiated Rate	$1.32
Max. Negotiated Rate	$2.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.12
Rate for Payer: Qualcare PPO/HMO/WC	$1.32

ACYCLOVIR 200 MG CAP

Facility

$8.78

Service Code	HCPCS J8499
Hospital Charge Code	60627335
Hospital Revenue Code	636
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$4.39
Rate for Payer: Aetna Commercial	$3.34
Rate for Payer: Aetna Medicare Advantage	$2.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.24
Rate for Payer: Cigna Commercial	$4.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.12
Rate for Payer: Qualcare PPO/HMO/WC	$1.32
Rate for Payer: UnitedHealthcare Community & State	$0.28
Rate for Payer: Wellpoint Medicaid Managed Care	$0.25

ACYCLOVIR 500 MG INJ

Facility

$36.18

Service Code	HCPCS J0133
Hospital Charge Code	6007652
Hospital Revenue Code	636
Min. Negotiated Rate	$5.43
Max. Negotiated Rate	$8.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.76
Rate for Payer: Qualcare PPO/HMO/WC	$5.43

ACYCLOVIR 500 MG INJ

Facility

$36.18

Service Code	HCPCS J0133
Hospital Charge Code	6007652
Hospital Revenue Code	636
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$18.09
Rate for Payer: Aetna Commercial	$13.75
Rate for Payer: Aetna Medicare Advantage	$10.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.23
Rate for Payer: Cigna Commercial	$18.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.76
Rate for Payer: Qualcare PPO/HMO/WC	$5.43
Rate for Payer: UnitedHealthcare Community & State	$1.14
Rate for Payer: Wellpoint Medicaid Managed Care	$1.03

ACYCLOVIR 5% OINT 15GM

Facility

$2,671.96

Service Code	NDC 51079055067
Hospital Charge Code	6005854
Hospital Revenue Code	250
Min. Negotiated Rate	$400.79
Max. Negotiated Rate	$400.79
Rate for Payer: Qualcare PPO/HMO/WC	$400.79

ACYCLOVIR 5% OINT 15GM

Facility

$2,671.96

Service Code	NDC 51079055067
Hospital Charge Code	6005854
Hospital Revenue Code	250
Min. Negotiated Rate	$75.88
Max. Negotiated Rate	$1,335.98
Rate for Payer: Aetna Commercial	$1,015.34
Rate for Payer: Aetna Medicare Advantage	$801.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$681.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$681.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$681.35
Rate for Payer: Cigna Commercial	$1,335.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$694.71
Rate for Payer: Oxford Commercial	$534.39
Rate for Payer: Qualcare PPO/HMO/WC	$400.79
Rate for Payer: UnitedHealthcare Commercial	$534.39
Rate for Payer: UnitedHealthcare Community & State	$84.43
Rate for Payer: Wellpoint Medicaid Managed Care	$75.88

ACYCLOVIR 800 MG TAB

Facility

$28.27

Service Code	NDC 63304050501
Hospital Charge Code	6010631
Hospital Revenue Code	251
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$14.13
Rate for Payer: Aetna Commercial	$10.74
Rate for Payer: Aetna Medicare Advantage	$8.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.21
Rate for Payer: Cigna Commercial	$14.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.35
Rate for Payer: Oxford Commercial	$5.65
Rate for Payer: Qualcare PPO/HMO/WC	$4.24
Rate for Payer: UnitedHealthcare Commercial	$5.65
Rate for Payer: UnitedHealthcare Community & State	$0.89
Rate for Payer: Wellpoint Medicaid Managed Care	$0.80

ACYCLOVIR 800 MG TAB

Facility

$28.27

Service Code	NDC 63304050501
Hospital Charge Code	6010631
Hospital Revenue Code	251
Min. Negotiated Rate	$4.24
Max. Negotiated Rate	$4.24
Rate for Payer: Qualcare PPO/HMO/WC	$4.24

ACYCLOVIR SSP 200MG/ML 120 ML

Facility

$31.56

Service Code	HCPCS J8499
Hospital Charge Code	60628562
Hospital Revenue Code	636
Min. Negotiated Rate	$4.73
Max. Negotiated Rate	$7.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.64
Rate for Payer: Qualcare PPO/HMO/WC	$4.73

ACYCLOVIR SSP 200MG/ML 120 ML

Facility

$31.56

Service Code	HCPCS J8499
Hospital Charge Code	60628562
Hospital Revenue Code	636
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$15.78
Rate for Payer: Aetna Commercial	$11.99
Rate for Payer: Aetna Medicare Advantage	$9.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.05
Rate for Payer: Cigna Commercial	$15.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.64
Rate for Payer: Qualcare PPO/HMO/WC	$4.73
Rate for Payer: UnitedHealthcare Community & State	$1.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.90

ACYLCARNITINE PLASMA

Facility

$390.00

Service Code	HCPCS 82017
Hospital Charge Code	39708050
Hospital Revenue Code	307
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ACYLCARNITINE PLASMA

Facility

$390.00

Service Code	HCPCS 82017
Hospital Charge Code	39708050
Hospital Revenue Code	307
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$45.89
Rate for Payer: Aetna Medicare Advantage	$54.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$16.87
Rate for Payer: Clover Medicare Advantage	$16.03
Rate for Payer: EmblemHealth Commercial	$50.61
Rate for Payer: Humana Medicare Advantage	$17.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.87
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	$13.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.87
Rate for Payer: Wellcare Medicare Advantage	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

ACYLCARNITINES QUANT EA

Facility

$119.00

Service Code	HCPCS 82017
Hospital Charge Code	38477142
Hospital Revenue Code	307
Min. Negotiated Rate	$17.85
Max. Negotiated Rate	$17.85
Rate for Payer: Qualcare PPO/HMO/WC	$17.85

ACYLCARNITINES QUANT EA

Facility

$119.00

Service Code	HCPCS 82017
Hospital Charge Code	38477142
Hospital Revenue Code	307
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$45.89
Rate for Payer: Aetna Medicare Advantage	$54.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$59.50
Rate for Payer: Cigna Medicare Advantage	$16.87
Rate for Payer: Clover Medicare Advantage	$16.03
Rate for Payer: EmblemHealth Commercial	$50.61
Rate for Payer: Humana Medicare Advantage	$17.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.94
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.85
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.87
Rate for Payer: Wellcare Medicare Advantage	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$3.38

Know your out-of-pocket cost for care.

All Charges