Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CYLINDER CXR 16CM

Facility

$46,295.00

Hospital Charge Code	270676892
Hospital Revenue Code	278
Min. Negotiated Rate	$1,314.78
Max. Negotiated Rate	$23,147.50
Rate for Payer: Aetna Commercial	$17,592.10
Rate for Payer: Aetna Medicare Advantage	$13,888.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,805.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,805.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9,259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,805.23
Rate for Payer: Cigna Commercial	$23,147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,203.39
Rate for Payer: Qualcare PPO/HMO/WC	$6,944.25
Rate for Payer: UnitedHealthcare Community & State	$1,462.92
Rate for Payer: Wellpoint Medicaid Managed Care	$1,314.78

CYLINDER CXR 16CM

Facility

$46,295.00

Hospital Charge Code	270676892
Hospital Revenue Code	278
Min. Negotiated Rate	$6,944.25
Max. Negotiated Rate	$11,203.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9,259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,203.39
Rate for Payer: Qualcare PPO/HMO/WC	$6,944.25

CYLINDER SET W/PUMP

Facility

$51,010.00

Service Code	HCPCS C1813
Hospital Charge Code	270687910
Hospital Revenue Code	278
Min. Negotiated Rate	$1,448.68
Max. Negotiated Rate	$25,505.00
Rate for Payer: Aetna Commercial	$19,383.80
Rate for Payer: Aetna Medicare Advantage	$15,303.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,007.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,007.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,202.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,007.55
Rate for Payer: Cigna Commercial	$25,505.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,344.42
Rate for Payer: Qualcare PPO/HMO/WC	$7,651.50
Rate for Payer: UnitedHealthcare Community & State	$1,611.92
Rate for Payer: Wellpoint Medicaid Managed Care	$1,448.68

CYLINDER SET W/PUMP

Facility

$51,010.00

Service Code	HCPCS C1813
Hospital Charge Code	270687910
Hospital Revenue Code	278
Min. Negotiated Rate	$7,651.50
Max. Negotiated Rate	$12,344.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,202.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,344.42
Rate for Payer: Qualcare PPO/HMO/WC	$7,651.50

CYLINDRICAL PROBE AND TUBE SET

Facility

$2,983.65

Hospital Charge Code	270704080
Hospital Revenue Code	279
Min. Negotiated Rate	$447.55
Max. Negotiated Rate	$447.55
Rate for Payer: Qualcare PPO/HMO/WC	$447.55

CYLINDRICAL PROBE AND TUBE SET

Facility

$2,983.65

Hospital Charge Code	270704080
Hospital Revenue Code	279
Min. Negotiated Rate	$84.74
Max. Negotiated Rate	$1,491.83
Rate for Payer: Aetna Commercial	$1,133.79
Rate for Payer: Aetna Medicare Advantage	$895.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$760.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$760.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$760.83
Rate for Payer: Cigna Commercial	$1,491.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$775.75
Rate for Payer: Oxford Commercial	$596.73
Rate for Payer: Qualcare PPO/HMO/WC	$447.55
Rate for Payer: UnitedHealthcare Commercial	$596.73
Rate for Payer: UnitedHealthcare Community & State	$94.28
Rate for Payer: Wellpoint Medicaid Managed Care	$84.74

CYPROHEPTADINE 4 MG TAB

Facility

$7.17

Service Code	NDC 93292901
Hospital Charge Code	60627225
Hospital Revenue Code	251
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$1.08
Rate for Payer: Qualcare PPO/HMO/WC	$1.08

CYPROHEPTADINE 4 MG TAB

Facility

$7.17

Service Code	NDC 93292901
Hospital Charge Code	60627225
Hospital Revenue Code	251
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$3.58
Rate for Payer: Aetna Commercial	$2.72
Rate for Payer: Aetna Medicare Advantage	$2.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.83
Rate for Payer: Cigna Commercial	$3.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.86
Rate for Payer: Oxford Commercial	$1.43
Rate for Payer: Qualcare PPO/HMO/WC	$1.08
Rate for Payer: UnitedHealthcare Commercial	$1.43
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

CYPROHEPTADINE SYRP 2MG/5ML

Facility

$4.56

Service Code	NDC 64980050448
Hospital Charge Code	60629033
Hospital Revenue Code	250
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$0.68
Rate for Payer: Qualcare PPO/HMO/WC	$0.68

CYPROHEPTADINE SYRP 2MG/5ML

Facility

$4.56

Service Code	NDC 64980050448
Hospital Charge Code	60629033
Hospital Revenue Code	250
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$2.28
Rate for Payer: Aetna Commercial	$1.73
Rate for Payer: Aetna Medicare Advantage	$1.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.16
Rate for Payer: Cigna Commercial	$2.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.19
Rate for Payer: Oxford Commercial	$0.91
Rate for Payer: Qualcare PPO/HMO/WC	$0.68
Rate for Payer: UnitedHealthcare Commercial	$0.91
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

CYSTAIN C

Facility

$390.00

Service Code	HCPCS 82610
Hospital Charge Code	38479749
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$50.37
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.18
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$18.52
Rate for Payer: Clover Medicare Advantage	$17.59
Rate for Payer: EmblemHealth Commercial	$55.56
Rate for Payer: Humana Medicare Advantage	$19.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.52
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	$14.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.52
Rate for Payer: Wellcare Medicare Advantage	$18.52
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

CYSTAIN C

Facility

$390.00

Service Code	HCPCS 82610
Hospital Charge Code	38479749
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CYST ASP BREAST EA ADDL CYST

Facility

$642.00

Service Code	HCPCS 19001
Hospital Charge Code	75190105
Hospital Revenue Code	510
Min. Negotiated Rate	$15.85
Max. Negotiated Rate	$321.00
Rate for Payer: Aetna Commercial	$243.96
Rate for Payer: Aetna Medicare Advantage	$192.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$163.71
Rate for Payer: Cigna Commercial	$321.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.92
Rate for Payer: Qualcare PPO/HMO/WC	$96.30
Rate for Payer: UnitedHealthcare Community & State	$20.29
Rate for Payer: Wellpoint Medicaid Managed Care	$18.23

CYST ASP BREAST EA ADDL CYST

Facility

$642.00

Service Code	HCPCS 19001
Hospital Charge Code	75190105
Hospital Revenue Code	510
Min. Negotiated Rate	$96.30
Max. Negotiated Rate	$96.30
Rate for Payer: Qualcare PPO/HMO/WC	$96.30

CYST ASP BREAST INITIAL CYST

Facility

$1,874.00

Service Code	HCPCS 19000
Hospital Charge Code	75190100
Hospital Revenue Code	510
Min. Negotiated Rate	$53.22
Max. Negotiated Rate	$3,051.74
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,051.74
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$487.24
Rate for Payer: Qualcare PPO/HMO/WC	$281.10
Rate for Payer: UnitedHealthcare Community & State	$59.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$53.22

CYST ASP BREAST INITIAL CYST

Facility

$1,874.00

Service Code	HCPCS 19000
Hospital Charge Code	75190100
Hospital Revenue Code	510
Min. Negotiated Rate	$281.10
Max. Negotiated Rate	$281.10
Rate for Payer: Qualcare PPO/HMO/WC	$281.10

CYSTATIN C

Facility

$96.00

Service Code	HCPCS 82610
Hospital Charge Code	38477117
Hospital Revenue Code	301
Min. Negotiated Rate	$14.40
Max. Negotiated Rate	$14.40
Rate for Payer: Qualcare PPO/HMO/WC	$14.40

CYSTATIN C

Facility

$96.00

Service Code	HCPCS 82610
Hospital Charge Code	38477117
Hospital Revenue Code	301
Min. Negotiated Rate	$2.73
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$50.37
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.18
Rate for Payer: Cigna Commercial	$48.00
Rate for Payer: Cigna Medicare Advantage	$18.52
Rate for Payer: Clover Medicare Advantage	$17.59
Rate for Payer: EmblemHealth Commercial	$55.56
Rate for Payer: Humana Medicare Advantage	$19.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.96
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.40
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.52
Rate for Payer: Wellcare Medicare Advantage	$18.52
Rate for Payer: Wellpoint Medicaid Managed Care	$2.73

CYSTICERCOSIS ANTIBODY

Facility

$128.00

Service Code	HCPCS 86682
Hospital Charge Code	38479421
Hospital Revenue Code	302
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

CYSTICERCOSIS ANTIBODY

Facility

$128.00

Service Code	HCPCS 86682
Hospital Charge Code	38479421
Hospital Revenue Code	302
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$35.39
Rate for Payer: Aetna Medicare Advantage	$42.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.19
Rate for Payer: Cigna Commercial	$64.00
Rate for Payer: Cigna Medicare Advantage	$13.01
Rate for Payer: Clover Medicare Advantage	$12.36
Rate for Payer: EmblemHealth Commercial	$39.03
Rate for Payer: Humana Medicare Advantage	$13.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.28
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.01
Rate for Payer: Wellcare Medicare Advantage	$13.01
Rate for Payer: Wellpoint Medicaid Managed Care	$3.64

CYSTICERCOSIS ANTIBODY

Facility

$128.00

Service Code	HCPCS 86682
Hospital Charge Code	38476225
Hospital Revenue Code	302
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$35.39
Rate for Payer: Aetna Medicare Advantage	$42.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.19
Rate for Payer: Cigna Commercial	$64.00
Rate for Payer: Cigna Medicare Advantage	$13.01
Rate for Payer: Clover Medicare Advantage	$12.36
Rate for Payer: EmblemHealth Commercial	$39.03
Rate for Payer: Humana Medicare Advantage	$13.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.28
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.01
Rate for Payer: Wellcare Medicare Advantage	$13.01
Rate for Payer: Wellpoint Medicaid Managed Care	$3.64

CYSTICERCOSIS ANTIBODY

Facility

$128.00

Service Code	HCPCS 86682
Hospital Charge Code	38476225
Hospital Revenue Code	302
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

CYSTICERCUS IGG AB,WB

Facility

$390.00

Service Code	HCPCS 86682
Hospital Charge Code	38479748
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CYSTICERCUS IGG AB,WB

Facility

$390.00

Service Code	HCPCS 86682
Hospital Charge Code	38479748
Hospital Revenue Code	302
Min. Negotiated Rate	$10.41
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$35.39
Rate for Payer: Aetna Medicare Advantage	$42.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.19
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$13.01
Rate for Payer: Clover Medicare Advantage	$12.36
Rate for Payer: EmblemHealth Commercial	$39.03
Rate for Payer: Humana Medicare Advantage	$13.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.01
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	$10.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.01
Rate for Payer: Wellcare Medicare Advantage	$13.01
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

CYSTICERCUS IgG AB,WB(SER

Facility

$89.40

Service Code	HCPCS 86682
Hospital Charge Code	39900238
Hospital Revenue Code	302
Min. Negotiated Rate	$13.41
Max. Negotiated Rate	$13.41
Rate for Payer: Qualcare PPO/HMO/WC	$13.41

Know your out-of-pocket cost for care.

All Charges