Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ADENOSINE (ADENOSCAN) 90MG/30M

Facility

$2,125.91

Service Code	HCPCS J0153
Hospital Charge Code	60630194
Hospital Revenue Code	636
Min. Negotiated Rate	$60.38
Max. Negotiated Rate	$1,062.95
Rate for Payer: Aetna Commercial	$807.85
Rate for Payer: Aetna Medicare Advantage	$637.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$542.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$542.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$542.11
Rate for Payer: Cigna Commercial	$1,062.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.47
Rate for Payer: Qualcare PPO/HMO/WC	$318.89
Rate for Payer: UnitedHealthcare Community & State	$67.18
Rate for Payer: Wellpoint Medicaid Managed Care	$60.38

ADENOSINE DEAMINASE

Facility

$390.00

Service Code	HCPCS 84311
Hospital Charge Code	39900343
Hospital Revenue Code	301
Min. Negotiated Rate	$6.48
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$22.03
Rate for Payer: Aetna Medicare Advantage	$26.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.38
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$8.10
Rate for Payer: Clover Medicare Advantage	$7.70
Rate for Payer: EmblemHealth Commercial	$24.30
Rate for Payer: Humana Medicare Advantage	$8.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.10
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	$6.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.10
Rate for Payer: Wellcare Medicare Advantage	$8.10
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

ADENOSINE DEAMINASE

Facility

$390.00

Service Code	HCPCS 84311
Hospital Charge Code	39900343
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ADENOVIRUS AB

Facility

$156.00

Service Code	HCPCS 86603
Hospital Charge Code	38476007
Hospital Revenue Code	302
Min. Negotiated Rate	$23.40
Max. Negotiated Rate	$23.40
Rate for Payer: Qualcare PPO/HMO/WC	$23.40

ADENOVIRUS AB

Facility

$88.45

Service Code	HCPCS 86603
Hospital Charge Code	39900226
Hospital Revenue Code	302
Min. Negotiated Rate	$2.51
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$35.01
Rate for Payer: Aetna Medicare Advantage	$41.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.87
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	$46.69
Rate for Payer: Cigna Commercial	$44.23
Rate for Payer: Cigna Medicare Advantage	$12.87
Rate for Payer: Clover Medicare Advantage	$12.23
Rate for Payer: EmblemHealth Commercial	$38.61
Rate for Payer: Humana Medicare Advantage	$13.26
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.00
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.27
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.87
Rate for Payer: Wellcare Medicare Advantage	$12.87
Rate for Payer: Wellpoint Medicaid Managed Care	$2.51

ADENOVIRUS AB

Facility

$88.45

Service Code	HCPCS 86603
Hospital Charge Code	39900226
Hospital Revenue Code	302
Min. Negotiated Rate	$13.27
Max. Negotiated Rate	$13.27
Rate for Payer: Qualcare PPO/HMO/WC	$13.27

ADENOVIRUS AB

Facility

$156.00

Service Code	HCPCS 86603
Hospital Charge Code	38476007
Hospital Revenue Code	302
Min. Negotiated Rate	$4.43
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$35.01
Rate for Payer: Aetna Medicare Advantage	$41.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.87
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	$46.69
Rate for Payer: Cigna Commercial	$78.00
Rate for Payer: Cigna Medicare Advantage	$12.87
Rate for Payer: Clover Medicare Advantage	$12.23
Rate for Payer: EmblemHealth Commercial	$38.61
Rate for Payer: Humana Medicare Advantage	$13.26
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.56
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.40
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.87
Rate for Payer: Wellcare Medicare Advantage	$12.87
Rate for Payer: Wellpoint Medicaid Managed Care	$4.43

ADENOVIRUS AG,EIA

Facility

$390.00

Service Code	HCPCS 87301
Hospital Charge Code	39900282
Hospital Revenue Code	309
Min. Negotiated Rate	$9.58
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$32.59
Rate for Payer: Aetna Medicare Advantage	$38.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.46
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$11.98
Rate for Payer: Clover Medicare Advantage	$11.38
Rate for Payer: EmblemHealth Commercial	$35.94
Rate for Payer: Humana Medicare Advantage	$12.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.98
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	$9.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.98
Rate for Payer: Wellcare Medicare Advantage	$11.98
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

ADENOVIRUS AG,EIA

Facility

$390.00

Service Code	HCPCS 87301
Hospital Charge Code	39900282
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ADENOVIRUS DNA,QL,RT-PCR

Facility

$390.00

Service Code	HCPCS 87798
Hospital Charge Code	39900403
Hospital Revenue Code	306
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$95.44
Rate for Payer: Aetna Medicare Advantage	$113.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.29
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$35.09
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35.09
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	$28.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Medicare Advantage	$35.09
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

ADENOVIRUS DNA,QL,RT-PCR

Facility

$390.00

Service Code	HCPCS 87798
Hospital Charge Code	39900403
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ADENOVIRUS DNA,QN,RT-PCR

Facility

$390.00

Service Code	HCPCS 87799
Hospital Charge Code	39900405
Hospital Revenue Code	306
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$116.52
Rate for Payer: Aetna Medicare Advantage	$138.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.40
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$42.84
Rate for Payer: Clover Medicare Advantage	$40.70
Rate for Payer: EmblemHealth Commercial	$128.52
Rate for Payer: Humana Medicare Advantage	$44.13
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$42.84
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	$34.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$42.84
Rate for Payer: Wellcare Medicare Advantage	$42.84
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

ADENOVIRUS DNA,QN,RT-PCR

Facility

$390.00

Service Code	HCPCS 87799
Hospital Charge Code	39900405
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ADHESIOLYSIS TUBE OVARY

Facility

$11,114.05

Service Code	HCPCS 58740
Hospital Charge Code	1600000752
Hospital Revenue Code	360
Min. Negotiated Rate	$1,667.11
Max. Negotiated Rate	$1,667.11
Rate for Payer: Qualcare PPO/HMO/WC	$1,667.11

ADHESIOLYSIS TUBE OVARY

Facility

$11,114.05

Service Code	HCPCS 58740
Hospital Charge Code	1600000752
Hospital Revenue Code	360
Min. Negotiated Rate	$315.64
Max. Negotiated Rate	$8,192.00
Rate for Payer: Aetna Commercial	$4,223.34
Rate for Payer: Aetna Medicare Advantage	$3,334.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,834.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,834.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,834.08
Rate for Payer: Cigna Commercial	$5,557.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,889.65
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,667.11
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$351.20
Rate for Payer: Wellpoint Medicaid Managed Care	$315.64

ADHESIVE INDERMIL 0566IND012

Facility

$94.00

Hospital Charge Code	270632492
Hospital Revenue Code	272
Min. Negotiated Rate	$2.67
Max. Negotiated Rate	$47.00
Rate for Payer: Aetna Commercial	$35.72
Rate for Payer: Aetna Medicare Advantage	$28.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.97
Rate for Payer: Cigna Commercial	$47.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.44
Rate for Payer: Oxford Commercial	$18.80
Rate for Payer: Qualcare PPO/HMO/WC	$14.10
Rate for Payer: UnitedHealthcare Commercial	$18.80
Rate for Payer: UnitedHealthcare Community & State	$2.97
Rate for Payer: Wellpoint Medicaid Managed Care	$2.67

ADHESIVE INDERMIL 0566IND012

Facility

$94.00

Hospital Charge Code	270632492
Hospital Revenue Code	272
Min. Negotiated Rate	$14.10
Max. Negotiated Rate	$14.10
Rate for Payer: Qualcare PPO/HMO/WC	$14.10

ADHESIVE OCTYLSEAL 0.7GM M076Z

Facility

$37.00

Hospital Charge Code	270646077
Hospital Revenue Code	272
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$18.50
Rate for Payer: Aetna Commercial	$14.06
Rate for Payer: Aetna Medicare Advantage	$11.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.44
Rate for Payer: Cigna Commercial	$18.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.62
Rate for Payer: Oxford Commercial	$7.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.55
Rate for Payer: UnitedHealthcare Commercial	$7.40
Rate for Payer: UnitedHealthcare Community & State	$1.17
Rate for Payer: Wellpoint Medicaid Managed Care	$1.05

ADHESIVE OCTYLSEAL 0.7GM M076Z

Facility

$37.00

Hospital Charge Code	270646077
Hospital Revenue Code	272
Min. Negotiated Rate	$5.55
Max. Negotiated Rate	$5.55
Rate for Payer: Qualcare PPO/HMO/WC	$5.55

ADHESIVE SURGISEAL STYLUS

Facility

$75.00

Hospital Charge Code	270677308
Hospital Revenue Code	272
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$2.37
Rate for Payer: Wellpoint Medicaid Managed Care	$2.13

ADHESIVE SURGISEAL STYLUS

Facility

$75.00

Hospital Charge Code	270677308
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

ADHSVE SRGISL SKIN 35ML SS035T

Facility

$118.18

Hospital Charge Code	270659973
Hospital Revenue Code	272
Min. Negotiated Rate	$17.73
Max. Negotiated Rate	$17.73
Rate for Payer: Qualcare PPO/HMO/WC	$17.73

ADHSVE SRGISL SKIN 35ML SS035T

Facility

$118.18

Hospital Charge Code	270659973
Hospital Revenue Code	272
Min. Negotiated Rate	$3.36
Max. Negotiated Rate	$59.09
Rate for Payer: Aetna Commercial	$44.91
Rate for Payer: Aetna Medicare Advantage	$35.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.14
Rate for Payer: Cigna Commercial	$59.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.73
Rate for Payer: Oxford Commercial	$23.64
Rate for Payer: Qualcare PPO/HMO/WC	$17.73
Rate for Payer: UnitedHealthcare Commercial	$23.64
Rate for Payer: UnitedHealthcare Community & State	$3.73
Rate for Payer: Wellpoint Medicaid Managed Care	$3.36

ADJECTABLE DRILL BIT

Facility

$986.85

Hospital Charge Code	270663788
Hospital Revenue Code	272
Min. Negotiated Rate	$148.03
Max. Negotiated Rate	$148.03
Rate for Payer: Qualcare PPO/HMO/WC	$148.03

ADJECTABLE DRILL BIT

Facility

$986.85

Hospital Charge Code	270663788
Hospital Revenue Code	272
Min. Negotiated Rate	$28.03
Max. Negotiated Rate	$493.43
Rate for Payer: Aetna Commercial	$375.00
Rate for Payer: Aetna Medicare Advantage	$296.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$251.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$251.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$251.65
Rate for Payer: Cigna Commercial	$493.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$256.58
Rate for Payer: Oxford Commercial	$197.37
Rate for Payer: Qualcare PPO/HMO/WC	$148.03
Rate for Payer: UnitedHealthcare Commercial	$197.37
Rate for Payer: UnitedHealthcare Community & State	$31.18
Rate for Payer: Wellpoint Medicaid Managed Care	$28.03

Know your out-of-pocket cost for care.

All Charges