Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

HYDROCORTISONE 1% OIN

Facility

$32.16

Service Code	NDC 168018131
Hospital Charge Code	60628392
Hospital Revenue Code	250
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$16.08
Rate for Payer: Aetna Commercial	$12.22
Rate for Payer: Aetna Medicare Advantage	$9.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.20
Rate for Payer: Cigna Commercial	$16.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.36
Rate for Payer: Oxford Commercial	$6.43
Rate for Payer: Qualcare PPO/HMO/WC	$4.82
Rate for Payer: UnitedHealthcare Commercial	$6.43
Rate for Payer: UnitedHealthcare Community & State	$1.02
Rate for Payer: Wellpoint Medicaid Managed Care	$0.91

HYDROCORTISONE 20 MG TAB

Facility

$7.30

Service Code	NDC 54505033310
Hospital Charge Code	60628813
Hospital Revenue Code	250
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

HYDROCORTISONE 20 MG TAB

Facility

$7.30

Service Code	NDC 54505033310
Hospital Charge Code	60628813
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 2.5% CREAM

Facility

$32.83

Service Code	NDC 45802000402
Hospital Charge Code	6063943316
Hospital Revenue Code	250
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$16.41
Rate for Payer: Aetna Commercial	$12.48
Rate for Payer: Aetna Medicare Advantage	$9.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.37
Rate for Payer: Cigna Commercial	$16.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.54
Rate for Payer: Oxford Commercial	$6.57
Rate for Payer: Qualcare PPO/HMO/WC	$4.92
Rate for Payer: UnitedHealthcare Commercial	$6.57
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$0.93

HYDROCORTISONE 2.5% CREAM

Facility

$32.83

Service Code	NDC 45802000402
Hospital Charge Code	6063943316
Hospital Revenue Code	250
Min. Negotiated Rate	$4.92
Max. Negotiated Rate	$4.92
Rate for Payer: Qualcare PPO/HMO/WC	$4.92

HYDROCORTISONE 2.5% LOTION

Facility

$348.60

Service Code	NDC 168028802
Hospital Charge Code	6063943112
Hospital Revenue Code	250
Min. Negotiated Rate	$9.90
Max. Negotiated Rate	$174.30
Rate for Payer: Aetna Commercial	$132.47
Rate for Payer: Aetna Medicare Advantage	$104.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.89
Rate for Payer: Cigna Commercial	$174.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.64
Rate for Payer: Oxford Commercial	$69.72
Rate for Payer: Qualcare PPO/HMO/WC	$52.29
Rate for Payer: UnitedHealthcare Commercial	$69.72
Rate for Payer: UnitedHealthcare Community & State	$11.02
Rate for Payer: Wellpoint Medicaid Managed Care	$9.90

HYDROCORTISONE 2.5% LOTION

Facility

$348.60

Service Code	NDC 168028802
Hospital Charge Code	6063943112
Hospital Revenue Code	250
Min. Negotiated Rate	$52.29
Max. Negotiated Rate	$52.29
Rate for Payer: Qualcare PPO/HMO/WC	$52.29

HYDROCORTISONE 25 MG SUPP

Facility

$64.72

Service Code	NDC 65649041124
Hospital Charge Code	60628397
Hospital Revenue Code	250
Min. Negotiated Rate	$1.84
Max. Negotiated Rate	$32.36
Rate for Payer: Aetna Commercial	$24.59
Rate for Payer: Aetna Medicare Advantage	$19.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.50
Rate for Payer: Cigna Commercial	$32.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.83
Rate for Payer: Oxford Commercial	$12.94
Rate for Payer: Qualcare PPO/HMO/WC	$9.71
Rate for Payer: UnitedHealthcare Commercial	$12.94
Rate for Payer: UnitedHealthcare Community & State	$2.05
Rate for Payer: Wellpoint Medicaid Managed Care	$1.84

HYDROCORTISONE 25 MG SUPP

Facility

$64.72

Service Code	NDC 65649041124
Hospital Charge Code	60628397
Hospital Revenue Code	250
Min. Negotiated Rate	$9.71
Max. Negotiated Rate	$9.71
Rate for Payer: Qualcare PPO/HMO/WC	$9.71

HYDROCORTISONE 2.5% OIN

Facility

$77.99

Service Code	NDC 168014630
Hospital Charge Code	60628396
Hospital Revenue Code	250
Min. Negotiated Rate	$11.70
Max. Negotiated Rate	$11.70
Rate for Payer: Qualcare PPO/HMO/WC	$11.70

HYDROCORTISONE 2.5% OIN

Facility

$77.99

Service Code	NDC 168014630
Hospital Charge Code	60628396
Hospital Revenue Code	250
Min. Negotiated Rate	$2.21
Max. Negotiated Rate	$38.99
Rate for Payer: Aetna Commercial	$29.64
Rate for Payer: Aetna Medicare Advantage	$23.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.89
Rate for Payer: Cigna Commercial	$38.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.28
Rate for Payer: Oxford Commercial	$15.60
Rate for Payer: Qualcare PPO/HMO/WC	$11.70
Rate for Payer: UnitedHealthcare Commercial	$15.60
Rate for Payer: UnitedHealthcare Community & State	$2.46
Rate for Payer: Wellpoint Medicaid Managed Care	$2.21

HYDROCORTISONE 2.5% OINT

Facility

$33.23

Service Code	NDC 45802001402
Hospital Charge Code	60635805
Hospital Revenue Code	250
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$16.61
Rate for Payer: Aetna Commercial	$12.63
Rate for Payer: Aetna Medicare Advantage	$9.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.47
Rate for Payer: Cigna Commercial	$16.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.64
Rate for Payer: Oxford Commercial	$6.65
Rate for Payer: Qualcare PPO/HMO/WC	$4.98
Rate for Payer: UnitedHealthcare Commercial	$6.65
Rate for Payer: UnitedHealthcare Community & State	$1.05
Rate for Payer: Wellpoint Medicaid Managed Care	$0.94

HYDROCORTISONE 2.5% OINT

Facility

$33.23

Service Code	NDC 45802001402
Hospital Charge Code	60635805
Hospital Revenue Code	250
Min. Negotiated Rate	$4.98
Max. Negotiated Rate	$4.98
Rate for Payer: Qualcare PPO/HMO/WC	$4.98

HYDROCORTISONE 5 MG TAB

Facility

$4.36

Service Code	NDC 9001201
Hospital Charge Code	60628195
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.18
Rate for Payer: Aetna Commercial	$1.66
Rate for Payer: Aetna Medicare Advantage	$1.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.11
Rate for Payer: Cigna Commercial	$2.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.13
Rate for Payer: Oxford Commercial	$0.87
Rate for Payer: Qualcare PPO/HMO/WC	$0.65
Rate for Payer: UnitedHealthcare Commercial	$0.87
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.12

HYDROCORTISONE 5 MG TAB

Facility

$4.36

Service Code	NDC 9001201
Hospital Charge Code	60628195
Hospital Revenue Code	250
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$0.65
Rate for Payer: Qualcare PPO/HMO/WC	$0.65

HYDROCORTISONE OINT 0.2%/15GM

Facility

$659.28

Service Code	NDC 45802045535
Hospital Charge Code	60628866
Hospital Revenue Code	250
Min. Negotiated Rate	$18.72
Max. Negotiated Rate	$329.64
Rate for Payer: Aetna Commercial	$250.53
Rate for Payer: Aetna Medicare Advantage	$197.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.12
Rate for Payer: Cigna Commercial	$329.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.41
Rate for Payer: Oxford Commercial	$131.86
Rate for Payer: Qualcare PPO/HMO/WC	$98.89
Rate for Payer: UnitedHealthcare Commercial	$131.86
Rate for Payer: UnitedHealthcare Community & State	$20.83
Rate for Payer: Wellpoint Medicaid Managed Care	$18.72

HYDROCORTISONE OINT 0.2%/15GM

Facility

$659.28

Service Code	NDC 45802045535
Hospital Charge Code	60628866
Hospital Revenue Code	250
Min. Negotiated Rate	$98.89
Max. Negotiated Rate	$98.89
Rate for Payer: Qualcare PPO/HMO/WC	$98.89

HYDROCORTISONE-PRAMOXINE FOAM

Facility

$1,006.21

Service Code	NDC 37682210
Hospital Charge Code	6007397
Hospital Revenue Code	251
Min. Negotiated Rate	$150.93
Max. Negotiated Rate	$150.93
Rate for Payer: Qualcare PPO/HMO/WC	$150.93

HYDROCORTISONE-PRAMOXINE FOAM

Facility

$1,006.21

Service Code	NDC 37682210
Hospital Charge Code	6007397
Hospital Revenue Code	251
Min. Negotiated Rate	$28.58
Max. Negotiated Rate	$503.11
Rate for Payer: Aetna Commercial	$382.36
Rate for Payer: Aetna Medicare Advantage	$301.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$256.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$256.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$256.58
Rate for Payer: Cigna Commercial	$503.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.61
Rate for Payer: Oxford Commercial	$201.24
Rate for Payer: Qualcare PPO/HMO/WC	$150.93
Rate for Payer: UnitedHealthcare Commercial	$201.24
Rate for Payer: UnitedHealthcare Community & State	$31.80
Rate for Payer: Wellpoint Medicaid Managed Care	$28.58

HYDROCORTISONE SUCC 250MG VIAL

Facility

$127.57

Service Code	HCPCS J1720
Hospital Charge Code	6063943206
Hospital Revenue Code	636
Min. Negotiated Rate	$19.14
Max. Negotiated Rate	$30.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.87
Rate for Payer: Qualcare PPO/HMO/WC	$19.14

HYDROCORTISONE SUCC 250MG VIAL

Facility

$127.57

Service Code	HCPCS J1720
Hospital Charge Code	6063943206
Hospital Revenue Code	636
Min. Negotiated Rate	$3.62
Max. Negotiated Rate	$63.78
Rate for Payer: Aetna Commercial	$48.48
Rate for Payer: Aetna Medicare Advantage	$38.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.53
Rate for Payer: Cigna Commercial	$63.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.87
Rate for Payer: Qualcare PPO/HMO/WC	$19.14
Rate for Payer: UnitedHealthcare Community & State	$4.03
Rate for Payer: Wellpoint Medicaid Managed Care	$3.62

HYDRO DISSECTION SUCTION

Facility

$372.52

Hospital Charge Code	270650793
Hospital Revenue Code	272
Min. Negotiated Rate	$55.88
Max. Negotiated Rate	$55.88
Rate for Payer: Qualcare PPO/HMO/WC	$55.88

HYDRO DISSECTION SUCTION

Facility

$372.52

Hospital Charge Code	270650793
Hospital Revenue Code	272
Min. Negotiated Rate	$10.58
Max. Negotiated Rate	$186.26
Rate for Payer: Aetna Commercial	$141.56
Rate for Payer: Aetna Medicare Advantage	$111.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.99
Rate for Payer: Cigna Commercial	$186.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.86
Rate for Payer: Oxford Commercial	$74.50
Rate for Payer: Qualcare PPO/HMO/WC	$55.88
Rate for Payer: UnitedHealthcare Commercial	$74.50
Rate for Payer: UnitedHealthcare Community & State	$11.77
Rate for Payer: Wellpoint Medicaid Managed Care	$10.58

HYDROFLEX HD HYSTER DIST TUBIN

Facility

$125.00

Hospital Charge Code	270339089
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

HYDROFLEX HD HYSTER DIST TUBIN

Facility

$125.00

Hospital Charge Code	270339089
Hospital Revenue Code	272
Min. Negotiated Rate	$3.55
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$25.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$25.00
Rate for Payer: UnitedHealthcare Community & State	$3.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3.55

Know your out-of-pocket cost for care.

All Charges