Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

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

ADVAIR 115/21 INH

Facility

$1,291.96

Service Code	NDC 173071622
Hospital Charge Code	6063943050
Hospital Revenue Code	250
Min. Negotiated Rate	$36.69
Max. Negotiated Rate	$645.98
Rate for Payer: Aetna Commercial	$490.94
Rate for Payer: Aetna Medicare Advantage	$387.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$329.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$329.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$329.45
Rate for Payer: Cigna Commercial	$645.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.91
Rate for Payer: Oxford Commercial	$258.39
Rate for Payer: Qualcare PPO/HMO/WC	$193.79
Rate for Payer: UnitedHealthcare Commercial	$258.39
Rate for Payer: UnitedHealthcare Community & State	$40.83
Rate for Payer: Wellpoint Medicaid Managed Care	$36.69

ADVAIR 115/21 INH

Facility

$1,291.96

Service Code	NDC 173071622
Hospital Charge Code	6063943050
Hospital Revenue Code	250
Min. Negotiated Rate	$193.79
Max. Negotiated Rate	$193.79
Rate for Payer: Qualcare PPO/HMO/WC	$193.79

ADVAIR 230/21 INH

Facility

$1,916.07

Service Code	NDC 173071722
Hospital Charge Code	6063943051
Hospital Revenue Code	250
Min. Negotiated Rate	$54.42
Max. Negotiated Rate	$958.03
Rate for Payer: Aetna Commercial	$728.11
Rate for Payer: Aetna Medicare Advantage	$574.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$488.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$488.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$488.60
Rate for Payer: Cigna Commercial	$958.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$498.18
Rate for Payer: Oxford Commercial	$383.21
Rate for Payer: Qualcare PPO/HMO/WC	$287.41
Rate for Payer: UnitedHealthcare Commercial	$383.21
Rate for Payer: UnitedHealthcare Community & State	$60.55
Rate for Payer: Wellpoint Medicaid Managed Care	$54.42

ADVAIR 230/21 INH

Facility

$1,916.07

Service Code	NDC 173071722
Hospital Charge Code	6063943051
Hospital Revenue Code	250
Min. Negotiated Rate	$287.41
Max. Negotiated Rate	$287.41
Rate for Payer: Qualcare PPO/HMO/WC	$287.41

ADVAIR 45/21 INH

Facility

$1,291.96

Service Code	NDC 173071522
Hospital Charge Code	6063943052
Hospital Revenue Code	250
Min. Negotiated Rate	$193.79
Max. Negotiated Rate	$193.79
Rate for Payer: Qualcare PPO/HMO/WC	$193.79

ADVAIR 45/21 INH

Facility

$1,291.96

Service Code	NDC 173071522
Hospital Charge Code	6063943052
Hospital Revenue Code	250
Min. Negotiated Rate	$36.69
Max. Negotiated Rate	$645.98
Rate for Payer: Aetna Commercial	$490.94
Rate for Payer: Aetna Medicare Advantage	$387.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$329.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$329.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$329.45
Rate for Payer: Cigna Commercial	$645.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.91
Rate for Payer: Oxford Commercial	$258.39
Rate for Payer: Qualcare PPO/HMO/WC	$193.79
Rate for Payer: UnitedHealthcare Commercial	$258.39
Rate for Payer: UnitedHealthcare Community & State	$40.83
Rate for Payer: Wellpoint Medicaid Managed Care	$36.69

ADVAIR DSK 250/50 MCG

Facility

$50.28

Service Code	NDC 173069604
Hospital Charge Code	60629363
Hospital Revenue Code	250
Min. Negotiated Rate	$7.54
Max. Negotiated Rate	$7.54
Rate for Payer: Qualcare PPO/HMO/WC	$7.54

ADVAIR DSK 250/50 MCG

Facility

$50.28

Service Code	NDC 173069604
Hospital Charge Code	60629363
Hospital Revenue Code	250
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$25.14
Rate for Payer: Aetna Commercial	$19.11
Rate for Payer: Aetna Medicare Advantage	$15.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.82
Rate for Payer: Cigna Commercial	$25.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.07
Rate for Payer: Oxford Commercial	$10.06
Rate for Payer: Qualcare PPO/HMO/WC	$7.54
Rate for Payer: UnitedHealthcare Commercial	$10.06
Rate for Payer: UnitedHealthcare Community & State	$1.59
Rate for Payer: Wellpoint Medicaid Managed Care	$1.43

ADVANCE EVOLUTION PIN PINPACK

Facility

$2,143.90

Service Code	HCPCS C1713
Hospital Charge Code	270678419
Hospital Revenue Code	278
Min. Negotiated Rate	$60.89
Max. Negotiated Rate	$1,071.95
Rate for Payer: Aetna Commercial	$814.68
Rate for Payer: Aetna Medicare Advantage	$643.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$546.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$546.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$428.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$546.69
Rate for Payer: Cigna Commercial	$1,071.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$518.82
Rate for Payer: Qualcare PPO/HMO/WC	$321.58
Rate for Payer: UnitedHealthcare Community & State	$67.75
Rate for Payer: Wellpoint Medicaid Managed Care	$60.89

ADVANCE EVOLUTION PIN PINPACK

Facility

$2,143.90

Service Code	HCPCS C1713
Hospital Charge Code	270678419
Hospital Revenue Code	278
Min. Negotiated Rate	$321.58
Max. Negotiated Rate	$518.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$428.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$518.82
Rate for Payer: Qualcare PPO/HMO/WC	$321.58

ADVANIX RX PANC ST KIT STR 4FR

Facility

$852.15

Service Code	HCPCS C2625
Hospital Charge Code	270680471
Hospital Revenue Code	278
Min. Negotiated Rate	$24.20
Max. Negotiated Rate	$426.07
Rate for Payer: Aetna Commercial	$323.82
Rate for Payer: Aetna Medicare Advantage	$255.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$217.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$217.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$217.30
Rate for Payer: Cigna Commercial	$426.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.22
Rate for Payer: Qualcare PPO/HMO/WC	$127.82
Rate for Payer: UnitedHealthcare Community & State	$26.93
Rate for Payer: Wellpoint Medicaid Managed Care	$24.20

ADVANIX RX PANC ST KIT STR 4FR

Facility

$852.15

Service Code	HCPCS C2625
Hospital Charge Code	270680471
Hospital Revenue Code	278
Min. Negotiated Rate	$127.82
Max. Negotiated Rate	$206.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.22
Rate for Payer: Qualcare PPO/HMO/WC	$127.82

ADVANIX RX PANC ST KIT STR 4FR

Facility

$852.15

Service Code	HCPCS C2625
Hospital Charge Code	270670852
Hospital Revenue Code	278
Min. Negotiated Rate	$24.20
Max. Negotiated Rate	$426.07
Rate for Payer: Aetna Commercial	$323.82
Rate for Payer: Aetna Medicare Advantage	$255.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$217.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$217.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$217.30
Rate for Payer: Cigna Commercial	$426.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.22
Rate for Payer: Qualcare PPO/HMO/WC	$127.82
Rate for Payer: UnitedHealthcare Community & State	$26.93
Rate for Payer: Wellpoint Medicaid Managed Care	$24.20

ADVANIX RX PANC ST KIT STR 4FR

Facility

$852.15

Service Code	HCPCS C2625
Hospital Charge Code	270670852
Hospital Revenue Code	278
Min. Negotiated Rate	$127.82
Max. Negotiated Rate	$206.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.22
Rate for Payer: Qualcare PPO/HMO/WC	$127.82

ADVANIX RX PANC ST KIT STR 5FR

Facility

$850.00

Service Code	HCPCS C2625
Hospital Charge Code	270679132
Hospital Revenue Code	278
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$205.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

ADVANIX RX PANC ST KIT STR 5FR

Facility

$850.00

Service Code	HCPCS C2625
Hospital Charge Code	270679132
Hospital Revenue Code	278
Min. Negotiated Rate	$24.14
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$323.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Community & State	$26.86
Rate for Payer: Wellpoint Medicaid Managed Care	$24.14

ADV LIFE SUPP (ALS) LVL 1 - ER

Facility

$1,800.00

Hospital Charge Code	26000511
Hospital Revenue Code	540
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$270.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

ADV LIFE SUPP (ALS) LVL 1 - ER

Facility

$1,800.00

Hospital Charge Code	26000511
Hospital Revenue Code	540
Min. Negotiated Rate	$51.12
Max. Negotiated Rate	$3,644.00
Rate for Payer: Aetna Commercial	$684.00
Rate for Payer: Aetna Medicare Advantage	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.00
Rate for Payer: Cigna Commercial	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$468.00
Rate for Payer: Oxford Commercial	$3,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00
Rate for Payer: UnitedHealthcare Commercial	$3,644.00
Rate for Payer: UnitedHealthcare Community & State	$56.88
Rate for Payer: Wellpoint Medicaid Managed Care	$51.12

ADV LIFE SUPP (ALS) LVL 2 - ER

Facility

$2,500.00

Hospital Charge Code	26000514
Hospital Revenue Code	540
Min. Negotiated Rate	$71.00
Max. Negotiated Rate	$3,644.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$650.00
Rate for Payer: Oxford Commercial	$3,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Commercial	$3,644.00
Rate for Payer: UnitedHealthcare Community & State	$79.00
Rate for Payer: Wellpoint Medicaid Managed Care	$71.00

ADV LIFE SUPP (ALS) LVL 2 - ER

Facility

$2,500.00

Hospital Charge Code	26000514
Hospital Revenue Code	540
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

ADV POST TIBIAL TNDON W EXC NA

Facility

$57,834.50

Service Code	HCPCS 28238
Hospital Charge Code	16000364
Hospital Revenue Code	360
Min. Negotiated Rate	$8,675.17
Max. Negotiated Rate	$8,675.17
Rate for Payer: Qualcare PPO/HMO/WC	$8,675.17

ADV POST TIBIAL TNDON W EXC NA

Facility

$57,834.50

Service Code	HCPCS 28238
Hospital Charge Code	16000364
Hospital Revenue Code	360
Min. Negotiated Rate	$1,642.50
Max. Negotiated Rate	$31,271.12
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,271.12
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15,036.97
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,675.17
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,827.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1,642.50

AEP NEURODIAGNOSTIC I&R

Facility

$1,597.40

Service Code	HCPCS 92653
Hospital Charge Code	404392653
Hospital Revenue Code	471
Min. Negotiated Rate	$45.37
Max. Negotiated Rate	$1,823.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$930.53
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$415.32
Rate for Payer: Oxford Commercial	$1,606.00
Rate for Payer: Qualcare PPO/HMO/WC	$239.61
Rate for Payer: UnitedHealthcare Commercial	$1,823.00
Rate for Payer: UnitedHealthcare Community & State	$50.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$45.37

AEP NEURODIAGNOSTIC I&R

Facility

$1,597.40

Service Code	HCPCS 92653
Hospital Charge Code	404392653
Hospital Revenue Code	471
Min. Negotiated Rate	$239.61
Max. Negotiated Rate	$239.61
Rate for Payer: Qualcare PPO/HMO/WC	$239.61

Know your out-of-pocket cost for care.

All Charges