Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ADJ TXFR LID NOSEEARSLIPS10CM

Facility

$9,508.95

Service Code	HCPCS 14060
Hospital Charge Code	5792295
Hospital Revenue Code	450
Min. Negotiated Rate	$1,426.34
Max. Negotiated Rate	$1,426.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,426.34

ADJ TXFR LID NOSEEARSLIPS10CM

Facility

$9,508.95

Service Code	HCPCS 14060
Hospital Charge Code	5792295
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$8,891.84
Rate for Payer: Aetna Commercial	$6,667.35
Rate for Payer: Aetna Medicare Advantage	$7,941.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,891.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,891.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,451.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$331.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,891.84
Rate for Payer: Cigna Commercial	$4,913.48
Rate for Payer: Cigna Medicare Advantage	$2,451.23
Rate for Payer: Clover Medicare Advantage	$2,328.67
Rate for Payer: EmblemHealth Commercial	$7,353.69
Rate for Payer: Humana Medicare Advantage	$2,524.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,451.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,472.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,426.34
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,451.23
Rate for Payer: Wellcare Medicare Advantage	$2,451.23
Rate for Payer: Wellpoint Medicaid Managed Care	$270.05

ADJUST BONE FIXATION DEVICE

Facility

$30,894.64

Service Code	HCPCS 30894.64
Hospital Charge Code	1600000408
Hospital Revenue Code	360
Min. Negotiated Rate	$877.41
Max. Negotiated Rate	$15,447.32
Rate for Payer: Aetna Commercial	$11,739.96
Rate for Payer: Aetna Medicare Advantage	$9,268.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,878.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,878.13
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	$7,878.13
Rate for Payer: Cigna Commercial	$15,447.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,032.61
Rate for Payer: Qualcare PPO/HMO/WC	$4,634.20
Rate for Payer: UnitedHealthcare Community & State	$976.27
Rate for Payer: Wellpoint Medicaid Managed Care	$877.41

ADJUST BONE FIXATION DEVICE

Facility

$30,894.64

Service Code	HCPCS 30894.64
Hospital Charge Code	1600000408
Hospital Revenue Code	360
Min. Negotiated Rate	$4,634.20
Max. Negotiated Rate	$4,634.20
Rate for Payer: Qualcare PPO/HMO/WC	$4,634.20

ADJUSTMENT DISORDERS

Facility

$15,872.30

Service Code	APR-DRG 7554
Min. Negotiated Rate	$15,561.08
Max. Negotiated Rate	$15,872.30
Rate for Payer: UnitedHealthcare Community & State	$15,561.08
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$15,872.30
Rate for Payer: Wellpoint Medicaid Managed Care	$15,561.08

ADJUSTMENT DISORDERS

Facility

$5,812.77

Service Code	APR-DRG 7552
Min. Negotiated Rate	$5,698.79
Max. Negotiated Rate	$5,812.77
Rate for Payer: UnitedHealthcare Community & State	$5,698.79
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,812.77
Rate for Payer: Wellpoint Medicaid Managed Care	$5,698.79

ADJUSTMENT DISORDERS

Facility

$9,125.63

Service Code	APR-DRG 7553
Min. Negotiated Rate	$8,946.70
Max. Negotiated Rate	$9,125.63
Rate for Payer: UnitedHealthcare Community & State	$8,946.70
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,125.63
Rate for Payer: Wellpoint Medicaid Managed Care	$8,946.70

ADJUSTMENT DISORDERS

Facility

$4,006.69

Service Code	APR-DRG 7551
Min. Negotiated Rate	$3,928.13
Max. Negotiated Rate	$4,006.69
Rate for Payer: UnitedHealthcare Community & State	$3,928.13
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,006.69
Rate for Payer: Wellpoint Medicaid Managed Care	$3,928.13

ADMIN OF NITRIC OXIDE

Facility

$545.00

Hospital Charge Code	31701000
Hospital Revenue Code	410
Min. Negotiated Rate	$15.48
Max. Negotiated Rate	$1,440.00
Rate for Payer: Aetna Commercial	$207.10
Rate for Payer: Aetna Medicare Advantage	$163.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.97
Rate for Payer: Cigna Commercial	$272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.70
Rate for Payer: Oxford Commercial	$1,367.00
Rate for Payer: Qualcare PPO/HMO/WC	$81.75
Rate for Payer: UnitedHealthcare Commercial	$1,440.00
Rate for Payer: UnitedHealthcare Community & State	$17.22
Rate for Payer: Wellpoint Medicaid Managed Care	$15.48

ADMIN OF NITRIC OXIDE

Facility

$545.00

Hospital Charge Code	31701000
Hospital Revenue Code	410
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$81.75
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

ADMIN VACCINE FLU

Facility

$254.15

Service Code	HCPCS 90471
Hospital Charge Code	260122
Hospital Revenue Code	771
Min. Negotiated Rate	$7.22
Max. Negotiated Rate	$310.30
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$310.30
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.08
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.12
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$8.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$7.22

ADMIN VACCINE FLU

Facility

$254.15

Service Code	HCPCS 90471
Hospital Charge Code	260122
Hospital Revenue Code	771
Min. Negotiated Rate	$38.12
Max. Negotiated Rate	$38.12
Rate for Payer: Qualcare PPO/HMO/WC	$38.12

A & D OINTMENT 5 GM

Facility

$5.00

Hospital Charge Code	60628432W
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

A & D OINTMENT 5 GM

Facility

$5.00

Hospital Charge Code	60628432W
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.90
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.30
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$1.00
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

ADRENAL AB W/RFX

Facility

$390.00

Service Code	HCPCS 86255
Hospital Charge Code	39900203
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ADRENAL AB W/RFX

Facility

$390.00

Service Code	HCPCS 86255
Hospital Charge Code	39900203
Hospital Revenue Code	302
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.71
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
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	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC

Facility

$88,711.43

Service Code	MSDRG 614
Min. Negotiated Rate	$27,011.49
Max. Negotiated Rate	$88,711.43
Rate for Payer: Aetna Commercial	$65,039.81
Rate for Payer: Aetna Medicare Advantage	$88,711.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62,336.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62,336.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$28,433.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62,336.25
Rate for Payer: Cigna Commercial	$48,861.80
Rate for Payer: Cigna Medicare Advantage	$28,433.15
Rate for Payer: Clover Medicare Advantage	$27,011.49
Rate for Payer: EmblemHealth Commercial	$85,299.45
Rate for Payer: Humana Medicare Advantage	$29,286.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$28,433.15
Rate for Payer: Oxford Commercial	$38,619.52
Rate for Payer: UnitedHealthcare Commercial	$51,693.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$28,433.15
Rate for Payer: Wellcare Medicare Advantage	$28,433.15

ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC

Facility

$63,673.52

Service Code	MSDRG 615
Min. Negotiated Rate	$19,387.77
Max. Negotiated Rate	$63,673.52
Rate for Payer: Aetna Commercial	$47,207.51
Rate for Payer: Aetna Medicare Advantage	$63,673.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40,726.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40,726.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,408.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40,726.35
Rate for Payer: Cigna Commercial	$31,194.59
Rate for Payer: Cigna Medicare Advantage	$20,408.18
Rate for Payer: Clover Medicare Advantage	$19,387.77
Rate for Payer: EmblemHealth Commercial	$61,224.54
Rate for Payer: Humana Medicare Advantage	$21,020.43
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20,408.18
Rate for Payer: Oxford Commercial	$24,655.67
Rate for Payer: UnitedHealthcare Commercial	$33,002.49
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,408.18
Rate for Payer: Wellcare Medicare Advantage	$20,408.18

ADRENAL PROCEDURES

Facility

$67,296.52

Service Code	APR-DRG 4014
Min. Negotiated Rate	$65,976.98
Max. Negotiated Rate	$67,296.52
Rate for Payer: UnitedHealthcare Community & State	$65,976.98
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$67,296.52
Rate for Payer: Wellpoint Medicaid Managed Care	$65,976.98

ADRENAL PROCEDURES

Facility

$31,004.49

Service Code	APR-DRG 4012
Min. Negotiated Rate	$30,396.56
Max. Negotiated Rate	$31,004.49
Rate for Payer: UnitedHealthcare Community & State	$30,396.56
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$31,004.49
Rate for Payer: Wellpoint Medicaid Managed Care	$30,396.56

ADRENAL PROCEDURES

Facility

$40,676.46

Service Code	APR-DRG 4013
Min. Negotiated Rate	$39,878.88
Max. Negotiated Rate	$40,676.46
Rate for Payer: UnitedHealthcare Community & State	$39,878.88
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$40,676.46
Rate for Payer: Wellpoint Medicaid Managed Care	$39,878.88

ADRENAL PROCEDURES

Facility

$17,915.69

Service Code	APR-DRG 4011
Min. Negotiated Rate	$17,564.40
Max. Negotiated Rate	$17,915.69
Rate for Payer: UnitedHealthcare Community & State	$17,564.40
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,915.69
Rate for Payer: Wellpoint Medicaid Managed Care	$17,564.40

ADRENOCORTITROPHIC HORMONE ACT

Facility

$383.00

Service Code	HCPCS 82024
Hospital Charge Code	38472035
Hospital Revenue Code	309
Min. Negotiated Rate	$10.88
Max. Negotiated Rate	$191.50
Rate for Payer: Aetna Commercial	$105.05
Rate for Payer: Aetna Medicare Advantage	$125.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$38.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.09
Rate for Payer: Cigna Commercial	$191.50
Rate for Payer: Cigna Medicare Advantage	$38.62
Rate for Payer: Clover Medicare Advantage	$36.69
Rate for Payer: EmblemHealth Commercial	$115.86
Rate for Payer: Humana Medicare Advantage	$39.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$38.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.58
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.45
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$30.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$38.62
Rate for Payer: Wellcare Medicare Advantage	$38.62
Rate for Payer: Wellpoint Medicaid Managed Care	$10.88

ADRENOCORTITROPHIC HORMONE ACT

Facility

$383.00

Service Code	HCPCS 82024
Hospital Charge Code	38472035
Hospital Revenue Code	309
Min. Negotiated Rate	$57.45
Max. Negotiated Rate	$57.45
Rate for Payer: Qualcare PPO/HMO/WC	$57.45

ADULT PULSE OXIMETER SENSOR

Facility

$28.75

Hospital Charge Code	270652476
Hospital Revenue Code	270
Min. Negotiated Rate	$4.31
Max. Negotiated Rate	$4.31
Rate for Payer: Qualcare PPO/HMO/WC	$4.31

Know your out-of-pocket cost for care.

All Charges