Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

HALOPERIDOL 5 MG TAB

Facility

$6.50

Service Code	NDC 781139613
Hospital Charge Code	6022529
Hospital Revenue Code	251
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.25
Rate for Payer: Aetna Commercial	$2.47
Rate for Payer: Aetna Medicare Advantage	$1.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.66
Rate for Payer: Cigna Commercial	$3.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.69
Rate for Payer: Oxford Commercial	$1.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.98
Rate for Payer: UnitedHealthcare Commercial	$1.30
Rate for Payer: UnitedHealthcare Community & State	$0.21
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

HALOPERIDOL DECAN INJ 50MG/ML

Facility

$192.96

Service Code	HCPCS J1631
Hospital Charge Code	60627804
Hospital Revenue Code	636
Min. Negotiated Rate	$5.48
Max. Negotiated Rate	$96.48
Rate for Payer: Aetna Commercial	$73.32
Rate for Payer: Aetna Medicare Advantage	$57.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.20
Rate for Payer: Cigna Commercial	$96.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.70
Rate for Payer: Qualcare PPO/HMO/WC	$28.94
Rate for Payer: UnitedHealthcare Community & State	$6.10
Rate for Payer: Wellpoint Medicaid Managed Care	$5.48

HALOPERIDOL DECAN INJ 50MG/ML

Facility

$192.96

Service Code	HCPCS J1631
Hospital Charge Code	60627804
Hospital Revenue Code	636
Min. Negotiated Rate	$28.94
Max. Negotiated Rate	$46.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.70
Rate for Payer: Qualcare PPO/HMO/WC	$28.94

HALOPERIDOL (HALDOL)

Facility

$324.00

Service Code	HCPCS 80173
Hospital Charge Code	38473128
Hospital Revenue Code	301
Min. Negotiated Rate	$9.20
Max. Negotiated Rate	$162.00
Rate for Payer: Aetna Commercial	$42.92
Rate for Payer: Aetna Medicare Advantage	$51.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.24
Rate for Payer: Cigna Commercial	$162.00
Rate for Payer: Cigna Medicare Advantage	$15.78
Rate for Payer: Clover Medicare Advantage	$14.99
Rate for Payer: EmblemHealth Commercial	$47.34
Rate for Payer: Humana Medicare Advantage	$16.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.24
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.60
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$12.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.78
Rate for Payer: Wellcare Medicare Advantage	$15.78
Rate for Payer: Wellpoint Medicaid Managed Care	$9.20

HALOPERIDOL (HALDOL)

Facility

$324.00

Service Code	HCPCS 80173
Hospital Charge Code	38473128
Hospital Revenue Code	301
Min. Negotiated Rate	$48.60
Max. Negotiated Rate	$48.60
Rate for Payer: Qualcare PPO/HMO/WC	$48.60

HALTER CHIN CERVICAL

Facility

$13.65

Hospital Charge Code	270606650
Hospital Revenue Code	270
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$2.05
Rate for Payer: Qualcare PPO/HMO/WC	$2.05

HALTER CHIN CERVICAL

Facility

$13.65

Hospital Charge Code	270606650
Hospital Revenue Code	270
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$6.83
Rate for Payer: Aetna Commercial	$5.19
Rate for Payer: Aetna Medicare Advantage	$4.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.48
Rate for Payer: Cigna Commercial	$6.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.55
Rate for Payer: Oxford Commercial	$2.73
Rate for Payer: Qualcare PPO/HMO/WC	$2.05
Rate for Payer: UnitedHealthcare Commercial	$2.73
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.39

HALTER HEAD/CHIN CUP UNIVERSAL

Facility

$226.90

Hospital Charge Code	270676394
Hospital Revenue Code	272
Min. Negotiated Rate	$6.44
Max. Negotiated Rate	$113.45
Rate for Payer: Aetna Commercial	$86.22
Rate for Payer: Aetna Medicare Advantage	$68.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.86
Rate for Payer: Cigna Commercial	$113.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.99
Rate for Payer: Oxford Commercial	$45.38
Rate for Payer: Qualcare PPO/HMO/WC	$34.03
Rate for Payer: UnitedHealthcare Commercial	$45.38
Rate for Payer: UnitedHealthcare Community & State	$7.17
Rate for Payer: Wellpoint Medicaid Managed Care	$6.44

HALTER HEAD/CHIN CUP UNIVERSAL

Facility

$226.90

Hospital Charge Code	270676394
Hospital Revenue Code	272
Min. Negotiated Rate	$34.03
Max. Negotiated Rate	$34.03
Rate for Payer: Qualcare PPO/HMO/WC	$34.03

HAMMER 350 GRAMS

Facility

$1,665.00

Hospital Charge Code	270676858
Hospital Revenue Code	272
Min. Negotiated Rate	$47.29
Max. Negotiated Rate	$832.50
Rate for Payer: Aetna Commercial	$632.70
Rate for Payer: Aetna Medicare Advantage	$499.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$424.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$424.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$424.57
Rate for Payer: Cigna Commercial	$832.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$432.90
Rate for Payer: Oxford Commercial	$333.00
Rate for Payer: Qualcare PPO/HMO/WC	$249.75
Rate for Payer: UnitedHealthcare Commercial	$333.00
Rate for Payer: UnitedHealthcare Community & State	$52.61
Rate for Payer: Wellpoint Medicaid Managed Care	$47.29

HAMMER 350 GRAMS

Facility

$1,665.00

Hospital Charge Code	270676858
Hospital Revenue Code	272
Min. Negotiated Rate	$249.75
Max. Negotiated Rate	$249.75
Rate for Payer: Qualcare PPO/HMO/WC	$249.75

HAMMERFIX DISP SIZING KEY

Facility

$550.00

Hospital Charge Code	270693087
Hospital Revenue Code	271
Min. Negotiated Rate	$15.62
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.00
Rate for Payer: Oxford Commercial	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Commercial	$110.00
Rate for Payer: UnitedHealthcare Community & State	$17.38
Rate for Payer: Wellpoint Medicaid Managed Care	$15.62

HAMMERFIX DISP SIZING KEY

Facility

$550.00

Hospital Charge Code	270693087
Hospital Revenue Code	271
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

HAMMERFIX IMPLANT MEDIUM

Facility

$11,455.00

Service Code	HCPCS C1713
Hospital Charge Code	270693049
Hospital Revenue Code	278
Min. Negotiated Rate	$325.32
Max. Negotiated Rate	$5,727.50
Rate for Payer: Aetna Commercial	$4,352.90
Rate for Payer: Aetna Medicare Advantage	$3,436.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,921.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,921.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,291.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,921.03
Rate for Payer: Cigna Commercial	$5,727.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,772.11
Rate for Payer: Qualcare PPO/HMO/WC	$1,718.25
Rate for Payer: UnitedHealthcare Community & State	$361.98
Rate for Payer: Wellpoint Medicaid Managed Care	$325.32

HAMMERFIX IMPLANT MEDIUM

Facility

$11,455.00

Service Code	HCPCS C1713
Hospital Charge Code	270693049
Hospital Revenue Code	278
Min. Negotiated Rate	$1,718.25
Max. Negotiated Rate	$2,772.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,291.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,772.11
Rate for Payer: Qualcare PPO/HMO/WC	$1,718.25

HAMMERFIX INSTRUM SET MED

Facility

$3,420.00

Hospital Charge Code	270693050
Hospital Revenue Code	272
Min. Negotiated Rate	$97.13
Max. Negotiated Rate	$1,710.00
Rate for Payer: Aetna Commercial	$1,299.60
Rate for Payer: Aetna Medicare Advantage	$1,026.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$872.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$872.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$872.10
Rate for Payer: Cigna Commercial	$1,710.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$889.20
Rate for Payer: Oxford Commercial	$684.00
Rate for Payer: Qualcare PPO/HMO/WC	$513.00
Rate for Payer: UnitedHealthcare Commercial	$684.00
Rate for Payer: UnitedHealthcare Community & State	$108.07
Rate for Payer: Wellpoint Medicaid Managed Care	$97.13

HAMMERFIX INSTRUM SET MED

Facility

$3,420.00

Hospital Charge Code	270693050
Hospital Revenue Code	272
Min. Negotiated Rate	$513.00
Max. Negotiated Rate	$513.00
Rate for Payer: Qualcare PPO/HMO/WC	$513.00

HAMMERFIX MEDIUM IMPLANT

Facility

$11,455.00

Service Code	HCPCS C1713
Hospital Charge Code	270693086
Hospital Revenue Code	278
Min. Negotiated Rate	$1,718.25
Max. Negotiated Rate	$2,772.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,291.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,772.11
Rate for Payer: Qualcare PPO/HMO/WC	$1,718.25

HAMMERFIX MEDIUM IMPLANT

Facility

$11,455.00

Service Code	HCPCS C1713
Hospital Charge Code	270693086
Hospital Revenue Code	278
Min. Negotiated Rate	$325.32
Max. Negotiated Rate	$5,727.50
Rate for Payer: Aetna Commercial	$4,352.90
Rate for Payer: Aetna Medicare Advantage	$3,436.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,921.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,921.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,291.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,921.03
Rate for Payer: Cigna Commercial	$5,727.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,772.11
Rate for Payer: Qualcare PPO/HMO/WC	$1,718.25
Rate for Payer: UnitedHealthcare Community & State	$361.98
Rate for Payer: Wellpoint Medicaid Managed Care	$325.32

HAMMERFIX SIZING KEY

Facility

$550.00

Hospital Charge Code	270693053
Hospital Revenue Code	272
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

HAMMERFIX SIZING KEY

Facility

$550.00

Hospital Charge Code	270693053
Hospital Revenue Code	272
Min. Negotiated Rate	$15.62
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.00
Rate for Payer: Oxford Commercial	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Commercial	$110.00
Rate for Payer: UnitedHealthcare Community & State	$17.38
Rate for Payer: Wellpoint Medicaid Managed Care	$15.62

HAMMERFUZE IMPLANT 2.5MM STR

Facility

$6,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270679985
Hospital Revenue Code	278
Min. Negotiated Rate	$191.70
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$213.30
Rate for Payer: Wellpoint Medicaid Managed Care	$191.70

HAMMERFUZE IMPLANT 2.5MM STR

Facility

$6,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270679985
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

HAMMERGRAFT CANC SPACER2.8X6MM

Facility

$2,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270694485
Hospital Revenue Code	278
Min. Negotiated Rate	$61.77
Max. Negotiated Rate	$1,087.50
Rate for Payer: Aetna Commercial	$826.50
Rate for Payer: Aetna Medicare Advantage	$652.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$554.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$554.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$554.62
Rate for Payer: Cigna Commercial	$1,087.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$526.35
Rate for Payer: Qualcare PPO/HMO/WC	$326.25
Rate for Payer: UnitedHealthcare Community & State	$68.73
Rate for Payer: Wellpoint Medicaid Managed Care	$61.77

HAMMERGRAFT CANC SPACER2.8X6MM

Facility

$2,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270694485
Hospital Revenue Code	278
Min. Negotiated Rate	$326.25
Max. Negotiated Rate	$526.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$435.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$526.35
Rate for Payer: Qualcare PPO/HMO/WC	$326.25

Know your out-of-pocket cost for care.

All Charges