Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

HYDROCHLOROTHIAZIDE/50MG

Facility

$4.00

Service Code	NDC 16729018401
Hospital Charge Code	60633112
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

HYDROCHLOROTHIAZIDE/50MG

Facility

$4.00

Service Code	NDC 16729018401
Hospital Charge Code	60633112
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

HYDROCHLOROTHIAZIDE/LOSARTAN 1

Facility

$38.32

Service Code	NDC 35356041610
Hospital Charge Code	6063943205
Hospital Revenue Code	250
Min. Negotiated Rate	$5.75
Max. Negotiated Rate	$5.75
Rate for Payer: Qualcare PPO/HMO/WC	$5.75

HYDROCHLOROTHIAZIDE/LOSARTAN 1

Facility

$38.32

Service Code	NDC 35356041610
Hospital Charge Code	6063943205
Hospital Revenue Code	250
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$19.16
Rate for Payer: Aetna Commercial	$14.56
Rate for Payer: Aetna Medicare Advantage	$11.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.77
Rate for Payer: Cigna Commercial	$19.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.96
Rate for Payer: Oxford Commercial	$7.66
Rate for Payer: Qualcare PPO/HMO/WC	$5.75
Rate for Payer: UnitedHealthcare Commercial	$7.66
Rate for Payer: UnitedHealthcare Community & State	$1.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.09

HYDROCODONE

Facility

$324.00

Service Code	HCPCS 80361
Hospital Charge Code	38472025
Hospital Revenue Code	301
Min. Negotiated Rate	$9.20
Max. Negotiated Rate	$162.00
Rate for Payer: Aetna Commercial	$123.12
Rate for Payer: Aetna Medicare Advantage	$97.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.62
Rate for Payer: Cigna Commercial	$162.00
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	$22.05
Rate for Payer: Wellpoint Medicaid Managed Care	$9.20

HYDROCODONE

Facility

$324.00

Service Code	HCPCS 80361
Hospital Charge Code	38472025
Hospital Revenue Code	301
Min. Negotiated Rate	$48.60
Max. Negotiated Rate	$48.60
Rate for Payer: Qualcare PPO/HMO/WC	$48.60

HYDROCODONE, URINE

Facility

$164.00

Service Code	HCPCS 80361
Hospital Charge Code	38478099
Hospital Revenue Code	301
Min. Negotiated Rate	$4.66
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$62.32
Rate for Payer: Aetna Medicare Advantage	$49.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.82
Rate for Payer: Cigna Commercial	$82.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.64
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.60
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$22.05
Rate for Payer: Wellpoint Medicaid Managed Care	$4.66

HYDROCODONE, URINE

Facility

$164.00

Service Code	HCPCS 80361
Hospital Charge Code	38478099
Hospital Revenue Code	301
Min. Negotiated Rate	$24.60
Max. Negotiated Rate	$24.60
Rate for Payer: Qualcare PPO/HMO/WC	$24.60

HYDROCORT CRM 0.2% 15GM

Facility

$287.97

Service Code	NDC 45802045535
Hospital Charge Code	60628625
Hospital Revenue Code	250
Min. Negotiated Rate	$43.20
Max. Negotiated Rate	$43.20
Rate for Payer: Qualcare PPO/HMO/WC	$43.20

HYDROCORT CRM 0.2% 15GM

Facility

$287.97

Service Code	NDC 45802045535
Hospital Charge Code	60628625
Hospital Revenue Code	250
Min. Negotiated Rate	$8.18
Max. Negotiated Rate	$143.99
Rate for Payer: Aetna Commercial	$109.43
Rate for Payer: Aetna Medicare Advantage	$86.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.43
Rate for Payer: Cigna Commercial	$143.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.87
Rate for Payer: Oxford Commercial	$57.59
Rate for Payer: Qualcare PPO/HMO/WC	$43.20
Rate for Payer: UnitedHealthcare Commercial	$57.59
Rate for Payer: UnitedHealthcare Community & State	$9.10
Rate for Payer: Wellpoint Medicaid Managed Care	$8.18

HYDROCORT CRM 0.5% 28GM

Facility

$36.85

Service Code	NDC 168001431
Hospital Charge Code	6002935
Hospital Revenue Code	251
Min. Negotiated Rate	$5.53
Max. Negotiated Rate	$5.53
Rate for Payer: Qualcare PPO/HMO/WC	$5.53

HYDROCORT CRM 0.5% 28GM

Facility

$36.85

Service Code	NDC 168001431
Hospital Charge Code	6002935
Hospital Revenue Code	251
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$18.43
Rate for Payer: Aetna Commercial	$14.00
Rate for Payer: Aetna Medicare Advantage	$11.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.40
Rate for Payer: Cigna Commercial	$18.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.58
Rate for Payer: Oxford Commercial	$7.37
Rate for Payer: Qualcare PPO/HMO/WC	$5.53
Rate for Payer: UnitedHealthcare Commercial	$7.37
Rate for Payer: UnitedHealthcare Community & State	$1.16
Rate for Payer: Wellpoint Medicaid Managed Care	$1.05

HYDROCORT CRM 2.5%

Facility

$585.11

Service Code	NDC 64980030130
Hospital Charge Code	60628395
Hospital Revenue Code	250
Min. Negotiated Rate	$16.62
Max. Negotiated Rate	$292.56
Rate for Payer: Aetna Commercial	$222.34
Rate for Payer: Aetna Medicare Advantage	$175.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.20
Rate for Payer: Cigna Commercial	$292.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.13
Rate for Payer: Oxford Commercial	$117.02
Rate for Payer: Qualcare PPO/HMO/WC	$87.77
Rate for Payer: UnitedHealthcare Commercial	$117.02
Rate for Payer: UnitedHealthcare Community & State	$18.49
Rate for Payer: Wellpoint Medicaid Managed Care	$16.62

HYDROCORT CRM 2.5%

Facility

$585.11

Service Code	NDC 64980030130
Hospital Charge Code	60628395
Hospital Revenue Code	250
Min. Negotiated Rate	$87.77
Max. Negotiated Rate	$87.77
Rate for Payer: Qualcare PPO/HMO/WC	$87.77

HYDROCORT ENEMA 100MG/60ML

Facility

$81.20

Service Code	NDC 51991072867
Hospital Charge Code	60628393
Hospital Revenue Code	250
Min. Negotiated Rate	$12.18
Max. Negotiated Rate	$12.18
Rate for Payer: Qualcare PPO/HMO/WC	$12.18

HYDROCORT ENEMA 100MG/60ML

Facility

$81.20

Service Code	NDC 51991072867
Hospital Charge Code	60628393
Hospital Revenue Code	250
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$40.60
Rate for Payer: Aetna Commercial	$30.86
Rate for Payer: Aetna Medicare Advantage	$24.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.71
Rate for Payer: Cigna Commercial	$40.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.11
Rate for Payer: Oxford Commercial	$16.24
Rate for Payer: Qualcare PPO/HMO/WC	$12.18
Rate for Payer: UnitedHealthcare Commercial	$16.24
Rate for Payer: UnitedHealthcare Community & State	$2.57
Rate for Payer: Wellpoint Medicaid Managed Care	$2.31

HYDROCORTISONE 0.5 % OIN

Facility

$26.53

Service Code	NDC 168001631
Hospital Charge Code	60628389
Hospital Revenue Code	250
Min. Negotiated Rate	$3.98
Max. Negotiated Rate	$3.98
Rate for Payer: Qualcare PPO/HMO/WC	$3.98

HYDROCORTISONE 0.5 % OIN

Facility

$26.53

Service Code	NDC 168001631
Hospital Charge Code	60628389
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$13.27
Rate for Payer: Aetna Commercial	$10.08
Rate for Payer: Aetna Medicare Advantage	$7.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.77
Rate for Payer: Cigna Commercial	$13.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.90
Rate for Payer: Oxford Commercial	$5.31
Rate for Payer: Qualcare PPO/HMO/WC	$3.98
Rate for Payer: UnitedHealthcare Commercial	$5.31
Rate for Payer: UnitedHealthcare Community & State	$0.84
Rate for Payer: Wellpoint Medicaid Managed Care	$0.75

HYDROCORTISONE 100 MG INJ

Facility

$59.97

Service Code	HCPCS J1720
Hospital Charge Code	60628196
Hospital Revenue Code	636
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$14.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.51
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

HYDROCORTISONE 100 MG INJ

Facility

$59.97

Service Code	HCPCS J1720
Hospital Charge Code	60628196
Hospital Revenue Code	636
Min. Negotiated Rate	$1.70
Max. Negotiated Rate	$29.98
Rate for Payer: Aetna Commercial	$22.79
Rate for Payer: Aetna Medicare Advantage	$17.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.29
Rate for Payer: Cigna Commercial	$29.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.51
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Community & State	$1.90
Rate for Payer: Wellpoint Medicaid Managed Care	$1.70

HYDROCORTISONE 10 MG TAB

Facility

$7.30

Service Code	NDC 9003101
Hospital Charge Code	60628194
Hospital Revenue Code	250
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$3.65
Rate for Payer: Aetna Commercial	$2.77
Rate for Payer: Aetna Medicare Advantage	$2.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.86
Rate for Payer: Cigna Commercial	$3.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.90
Rate for Payer: Oxford Commercial	$1.46
Rate for Payer: Qualcare PPO/HMO/WC	$1.09
Rate for Payer: UnitedHealthcare Commercial	$1.46
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

HYDROCORTISONE 10 MG TAB

Facility

$7.30

Service Code	NDC 9003101
Hospital Charge Code	60628194
Hospital Revenue Code	250
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

HYDROCORTISONE 1% CREAM

Facility

$45.76

Service Code	NDC 472032126
Hospital Charge Code	60628390
Hospital Revenue Code	250
Min. Negotiated Rate	$6.86
Max. Negotiated Rate	$6.86
Rate for Payer: Qualcare PPO/HMO/WC	$6.86

HYDROCORTISONE 1% CREAM

Facility

$45.76

Service Code	NDC 472032126
Hospital Charge Code	60628390
Hospital Revenue Code	250
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$22.88
Rate for Payer: Aetna Commercial	$17.39
Rate for Payer: Aetna Medicare Advantage	$13.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.67
Rate for Payer: Cigna Commercial	$22.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.90
Rate for Payer: Oxford Commercial	$9.15
Rate for Payer: Qualcare PPO/HMO/WC	$6.86
Rate for Payer: UnitedHealthcare Commercial	$9.15
Rate for Payer: UnitedHealthcare Community & State	$1.45
Rate for Payer: Wellpoint Medicaid Managed Care	$1.30

HYDROCORTISONE 1% OIN

Facility

$32.16

Service Code	NDC 168018131
Hospital Charge Code	60628392
Hospital Revenue Code	250
Min. Negotiated Rate	$4.82
Max. Negotiated Rate	$4.82
Rate for Payer: Qualcare PPO/HMO/WC	$4.82

Know your out-of-pocket cost for care.

All Charges