Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

EYE CONFORMER SMALL HOLE

Facility

$315.00

Hospital Charge Code	270688506
Hospital Revenue Code	278
Min. Negotiated Rate	$47.25
Max. Negotiated Rate	$76.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.23
Rate for Payer: Qualcare PPO/HMO/WC	$47.25

EYE INFECTIONS AND OTHER EYE DISORDERS

Facility

$7,461.44

Service Code	APR-DRG 0821
Min. Negotiated Rate	$7,315.14
Max. Negotiated Rate	$7,461.44
Rate for Payer: UnitedHealthcare Community & State	$7,315.14
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,461.44
Rate for Payer: Wellpoint Medicaid Managed Care	$7,315.14

EYE INFECTIONS AND OTHER EYE DISORDERS

Facility

$13,299.47

Service Code	APR-DRG 0823
Min. Negotiated Rate	$13,038.70
Max. Negotiated Rate	$13,299.47
Rate for Payer: UnitedHealthcare Community & State	$13,038.70
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,299.47
Rate for Payer: Wellpoint Medicaid Managed Care	$13,038.70

EYE INFECTIONS AND OTHER EYE DISORDERS

Facility

$9,128.48

Service Code	APR-DRG 0822
Min. Negotiated Rate	$8,949.49
Max. Negotiated Rate	$9,128.48
Rate for Payer: UnitedHealthcare Community & State	$8,949.49
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,128.48
Rate for Payer: Wellpoint Medicaid Managed Care	$8,949.49

EYE INFECTIONS AND OTHER EYE DISORDERS

Facility

$24,427.81

Service Code	APR-DRG 0824
Min. Negotiated Rate	$23,948.83
Max. Negotiated Rate	$24,427.81
Rate for Payer: UnitedHealthcare Community & State	$23,948.83
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,427.81
Rate for Payer: Wellpoint Medicaid Managed Care	$23,948.83

EYE PACK (CUSTOM)

Facility

$2,034.00

Hospital Charge Code	270332288
Hospital Revenue Code	272
Min. Negotiated Rate	$305.10
Max. Negotiated Rate	$305.10
Rate for Payer: Qualcare PPO/HMO/WC	$305.10

EYE PACK (CUSTOM)

Facility

$2,034.00

Hospital Charge Code	270332288
Hospital Revenue Code	272
Min. Negotiated Rate	$57.77
Max. Negotiated Rate	$1,017.00
Rate for Payer: Aetna Commercial	$772.92
Rate for Payer: Aetna Medicare Advantage	$610.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$518.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$518.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$518.67
Rate for Payer: Cigna Commercial	$1,017.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$528.84
Rate for Payer: Oxford Commercial	$406.80
Rate for Payer: Qualcare PPO/HMO/WC	$305.10
Rate for Payer: UnitedHealthcare Commercial	$406.80
Rate for Payer: UnitedHealthcare Community & State	$64.27
Rate for Payer: Wellpoint Medicaid Managed Care	$57.77

EYE PAD OVAL CURITY

Facility

$19.55

Hospital Charge Code	270655032
Hospital Revenue Code	272
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$9.78
Rate for Payer: Aetna Commercial	$7.43
Rate for Payer: Aetna Medicare Advantage	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.99
Rate for Payer: Cigna Commercial	$9.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.08
Rate for Payer: Oxford Commercial	$3.91
Rate for Payer: Qualcare PPO/HMO/WC	$2.93
Rate for Payer: UnitedHealthcare Commercial	$3.91
Rate for Payer: UnitedHealthcare Community & State	$0.62
Rate for Payer: Wellpoint Medicaid Managed Care	$0.56

EYE PAD OVAL CURITY

Facility

$19.55

Hospital Charge Code	270655032
Hospital Revenue Code	272
Min. Negotiated Rate	$2.93
Max. Negotiated Rate	$2.93
Rate for Payer: Qualcare PPO/HMO/WC	$2.93

EYE SPHERE 20 MM

Facility

$270.00

Hospital Charge Code	270688500
Hospital Revenue Code	278
Min. Negotiated Rate	$7.67
Max. Negotiated Rate	$135.00
Rate for Payer: Aetna Commercial	$102.60
Rate for Payer: Aetna Medicare Advantage	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.85
Rate for Payer: Cigna Commercial	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.34
Rate for Payer: Qualcare PPO/HMO/WC	$40.50
Rate for Payer: UnitedHealthcare Community & State	$8.53
Rate for Payer: Wellpoint Medicaid Managed Care	$7.67

EYE SPHERE 20 MM

Facility

$270.00

Hospital Charge Code	270688500
Hospital Revenue Code	278
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$65.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.34
Rate for Payer: Qualcare PPO/HMO/WC	$40.50

EYE SPHERE 22 MM

Facility

$270.00

Hospital Charge Code	270688501
Hospital Revenue Code	278
Min. Negotiated Rate	$7.67
Max. Negotiated Rate	$135.00
Rate for Payer: Aetna Commercial	$102.60
Rate for Payer: Aetna Medicare Advantage	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.85
Rate for Payer: Cigna Commercial	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.34
Rate for Payer: Qualcare PPO/HMO/WC	$40.50
Rate for Payer: UnitedHealthcare Community & State	$8.53
Rate for Payer: Wellpoint Medicaid Managed Care	$7.67

EYE SPHERE 22 MM

Facility

$270.00

Hospital Charge Code	270688501
Hospital Revenue Code	278
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$65.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.34
Rate for Payer: Qualcare PPO/HMO/WC	$40.50

EYE SPHERE IMPLANT (SILICONE)

Facility

$48.00

Hospital Charge Code	270335006
Hospital Revenue Code	278
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$11.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.62
Rate for Payer: Qualcare PPO/HMO/WC	$7.20

EYE SPHERE IMPLANT (SILICONE)

Facility

$48.00

Hospital Charge Code	270335006
Hospital Revenue Code	278
Min. Negotiated Rate	$1.36
Max. Negotiated Rate	$24.00
Rate for Payer: Aetna Commercial	$18.24
Rate for Payer: Aetna Medicare Advantage	$14.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.24
Rate for Payer: Cigna Commercial	$24.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.62
Rate for Payer: Qualcare PPO/HMO/WC	$7.20
Rate for Payer: UnitedHealthcare Community & State	$1.52
Rate for Payer: Wellpoint Medicaid Managed Care	$1.36

EYE SPHERE W/ CONFORMER SILICO

Facility

$284.00

Hospital Charge Code	270335226
Hospital Revenue Code	278
Min. Negotiated Rate	$42.60
Max. Negotiated Rate	$68.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.73
Rate for Payer: Qualcare PPO/HMO/WC	$42.60

EYE SPHERE W/ CONFORMER SILICO

Facility

$284.00

Hospital Charge Code	270335226
Hospital Revenue Code	278
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$142.00
Rate for Payer: Aetna Commercial	$107.92
Rate for Payer: Aetna Medicare Advantage	$85.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.42
Rate for Payer: Cigna Commercial	$142.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.73
Rate for Payer: Qualcare PPO/HMO/WC	$42.60
Rate for Payer: UnitedHealthcare Community & State	$8.97
Rate for Payer: Wellpoint Medicaid Managed Care	$8.07

E-Z CLEAN BLADE

Facility

$26.91

Hospital Charge Code	270646995
Hospital Revenue Code	270
Min. Negotiated Rate	$0.76
Max. Negotiated Rate	$13.46
Rate for Payer: Aetna Commercial	$10.23
Rate for Payer: Aetna Medicare Advantage	$8.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.86
Rate for Payer: Cigna Commercial	$13.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.00
Rate for Payer: Oxford Commercial	$5.38
Rate for Payer: Qualcare PPO/HMO/WC	$4.04
Rate for Payer: UnitedHealthcare Commercial	$5.38
Rate for Payer: UnitedHealthcare Community & State	$0.85
Rate for Payer: Wellpoint Medicaid Managed Care	$0.76

E-Z CLEAN BLADE

Facility

$26.91

Hospital Charge Code	270646995
Hospital Revenue Code	270
Min. Negotiated Rate	$4.04
Max. Negotiated Rate	$4.04
Rate for Payer: Qualcare PPO/HMO/WC	$4.04

EZETIMIBE 10 MG TAB

Facility

$57.69

Service Code	NDC 66582041431
Hospital Charge Code	60629852
Hospital Revenue Code	250
Min. Negotiated Rate	$8.65
Max. Negotiated Rate	$8.65
Rate for Payer: Qualcare PPO/HMO/WC	$8.65

EZETIMIBE 10 MG TAB

Facility

$57.69

Service Code	NDC 66582041431
Hospital Charge Code	60629852
Hospital Revenue Code	250
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$28.84
Rate for Payer: Aetna Commercial	$21.92
Rate for Payer: Aetna Medicare Advantage	$17.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.71
Rate for Payer: Cigna Commercial	$28.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.00
Rate for Payer: Oxford Commercial	$11.54
Rate for Payer: Qualcare PPO/HMO/WC	$8.65
Rate for Payer: UnitedHealthcare Commercial	$11.54
Rate for Payer: UnitedHealthcare Community & State	$1.82
Rate for Payer: Wellpoint Medicaid Managed Care	$1.64

E-Z GAS II GRANULES

Facility

$18.96

Service Code	NDC 10361079301
Hospital Charge Code	606380028
Hospital Revenue Code	250
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$9.48
Rate for Payer: Aetna Commercial	$7.20
Rate for Payer: Aetna Medicare Advantage	$5.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.83
Rate for Payer: Cigna Commercial	$9.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.93
Rate for Payer: Oxford Commercial	$3.79
Rate for Payer: Qualcare PPO/HMO/WC	$2.84
Rate for Payer: UnitedHealthcare Commercial	$3.79
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.54

E-Z GAS II GRANULES

Facility

$18.96

Service Code	NDC 10361079301
Hospital Charge Code	606380028
Hospital Revenue Code	250
Min. Negotiated Rate	$2.84
Max. Negotiated Rate	$2.84
Rate for Payer: Qualcare PPO/HMO/WC	$2.84

E-Z HD 98%

Facility

$45.16

Service Code	NDC 32909076401
Hospital Charge Code	60635822
Hospital Revenue Code	250
Min. Negotiated Rate	$6.77
Max. Negotiated Rate	$6.77
Rate for Payer: Qualcare PPO/HMO/WC	$6.77

E-Z HD 98%

Facility

$45.16

Service Code	NDC 32909076401
Hospital Charge Code	60635822
Hospital Revenue Code	250
Min. Negotiated Rate	$1.28
Max. Negotiated Rate	$22.58
Rate for Payer: Aetna Commercial	$17.16
Rate for Payer: Aetna Medicare Advantage	$13.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.52
Rate for Payer: Cigna Commercial	$22.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.74
Rate for Payer: Oxford Commercial	$9.03
Rate for Payer: Qualcare PPO/HMO/WC	$6.77
Rate for Payer: UnitedHealthcare Commercial	$9.03
Rate for Payer: UnitedHealthcare Community & State	$1.43
Rate for Payer: Wellpoint Medicaid Managed Care	$1.28

Know your out-of-pocket cost for care.

All Charges