Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

HYDROGEL SKINTEGRITY 1 OZ

Facility

$5.19

Hospital Charge Code	270350290
Hospital Revenue Code	272
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$2.60
Rate for Payer: Aetna Commercial	$1.97
Rate for Payer: Aetna Medicare Advantage	$1.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.32
Rate for Payer: Cigna Commercial	$2.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.35
Rate for Payer: Oxford Commercial	$1.04
Rate for Payer: Qualcare PPO/HMO/WC	$0.78
Rate for Payer: UnitedHealthcare Commercial	$1.04
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

HYDROGEL SKINTEGRITY 1 OZ

Facility

$5.19

Hospital Charge Code	270350290
Hospital Revenue Code	272
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$0.78
Rate for Payer: Qualcare PPO/HMO/WC	$0.78

HYDROGEN PEROXIDE 3% SOLN

Facility

$105.26

Service Code	NDC 49348003138
Hospital Charge Code	60628351
Hospital Revenue Code	250
Min. Negotiated Rate	$15.79
Max. Negotiated Rate	$15.79
Rate for Payer: Qualcare PPO/HMO/WC	$15.79

HYDROGEN PEROXIDE 3% SOLN

Facility

$105.26

Service Code	NDC 49348003138
Hospital Charge Code	60628351
Hospital Revenue Code	250
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$52.63
Rate for Payer: Aetna Commercial	$40.00
Rate for Payer: Aetna Medicare Advantage	$31.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.84
Rate for Payer: Cigna Commercial	$52.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.37
Rate for Payer: Oxford Commercial	$21.05
Rate for Payer: Qualcare PPO/HMO/WC	$15.79
Rate for Payer: UnitedHealthcare Commercial	$21.05
Rate for Payer: UnitedHealthcare Community & State	$3.33
Rate for Payer: Wellpoint Medicaid Managed Care	$2.99

HYDROGLIDE WIRE

Facility

$75.50

Hospital Charge Code	270702095
Hospital Revenue Code	278
Min. Negotiated Rate	$2.14
Max. Negotiated Rate	$37.75
Rate for Payer: Aetna Commercial	$28.69
Rate for Payer: Aetna Medicare Advantage	$22.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.25
Rate for Payer: Cigna Commercial	$37.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.27
Rate for Payer: Qualcare PPO/HMO/WC	$11.32
Rate for Payer: UnitedHealthcare Community & State	$2.39
Rate for Payer: Wellpoint Medicaid Managed Care	$2.14

HYDROGLIDE WIRE

Facility

$75.50

Hospital Charge Code	270702095
Hospital Revenue Code	278
Min. Negotiated Rate	$11.32
Max. Negotiated Rate	$18.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.27
Rate for Payer: Qualcare PPO/HMO/WC	$11.32

HYDROLYSATE COLLAGEN WND FILL

Facility

$4,251.25

Service Code	HCPCS A6010
Hospital Charge Code	270695509
Hospital Revenue Code	272
Min. Negotiated Rate	$120.74
Max. Negotiated Rate	$2,125.62
Rate for Payer: Aetna Commercial	$1,615.47
Rate for Payer: Aetna Medicare Advantage	$1,275.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,084.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,084.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,084.07
Rate for Payer: Cigna Commercial	$2,125.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,105.33
Rate for Payer: Oxford Commercial	$850.25
Rate for Payer: Qualcare PPO/HMO/WC	$637.69
Rate for Payer: UnitedHealthcare Commercial	$850.25
Rate for Payer: UnitedHealthcare Community & State	$134.34
Rate for Payer: Wellpoint Medicaid Managed Care	$120.74

HYDROLYSATE COLLAGEN WND FILL

Facility

$4,251.25

Service Code	HCPCS A6010
Hospital Charge Code	270695509
Hospital Revenue Code	272
Min. Negotiated Rate	$637.69
Max. Negotiated Rate	$637.69
Rate for Payer: Qualcare PPO/HMO/WC	$637.69

HYDROMORPHONE 0.2 MG/ML (25ML)

Facility

$84.82

Service Code	HCPCS J1171
Hospital Charge Code	60629207
Hospital Revenue Code	636
Min. Negotiated Rate	$2.41
Max. Negotiated Rate	$42.41
Rate for Payer: Aetna Commercial	$32.23
Rate for Payer: Aetna Medicare Advantage	$25.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.63
Rate for Payer: Cigna Commercial	$42.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.53
Rate for Payer: Qualcare PPO/HMO/WC	$12.72
Rate for Payer: UnitedHealthcare Community & State	$2.68
Rate for Payer: Wellpoint Medicaid Managed Care	$2.41

HYDROMORPHONE 0.2 MG/ML (25ML)

Facility

$84.82

Service Code	HCPCS J1171
Hospital Charge Code	60629207
Hospital Revenue Code	636
Min. Negotiated Rate	$12.72
Max. Negotiated Rate	$20.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.53
Rate for Payer: Qualcare PPO/HMO/WC	$12.72

HYDROMORPHONE 0.2 MG/ML PCA

Facility

$67.00

Service Code	HCPCS J1171
Hospital Charge Code	6063943360
Hospital Revenue Code	636
Min. Negotiated Rate	$1.90
Max. Negotiated Rate	$33.50
Rate for Payer: Aetna Commercial	$25.46
Rate for Payer: Aetna Medicare Advantage	$20.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.09
Rate for Payer: Cigna Commercial	$33.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.21
Rate for Payer: Qualcare PPO/HMO/WC	$10.05
Rate for Payer: UnitedHealthcare Community & State	$2.12
Rate for Payer: Wellpoint Medicaid Managed Care	$1.90

HYDROMORPHONE 0.2 MG/ML PCA

Facility

$67.00

Service Code	HCPCS J1171
Hospital Charge Code	6063943360
Hospital Revenue Code	636
Min. Negotiated Rate	$10.05
Max. Negotiated Rate	$16.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.21
Rate for Payer: Qualcare PPO/HMO/WC	$10.05

HYDROMORPHONE 0.5MG/0.5ML

Facility

$18.49

Service Code	HCPCS J1171
Hospital Charge Code	60630189
Hospital Revenue Code	636
Min. Negotiated Rate	$0.53
Max. Negotiated Rate	$9.24
Rate for Payer: Aetna Commercial	$7.03
Rate for Payer: Aetna Medicare Advantage	$5.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.71
Rate for Payer: Cigna Commercial	$9.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.47
Rate for Payer: Qualcare PPO/HMO/WC	$2.77
Rate for Payer: UnitedHealthcare Community & State	$0.58
Rate for Payer: Wellpoint Medicaid Managed Care	$0.53

HYDROMORPHONE 0.5MG/0.5ML

Facility

$18.49

Service Code	HCPCS J1171
Hospital Charge Code	60630189
Hospital Revenue Code	636
Min. Negotiated Rate	$2.77
Max. Negotiated Rate	$4.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.47
Rate for Payer: Qualcare PPO/HMO/WC	$2.77

HYDROMORPHONE 2 MG/ML SYRINGE

Facility

$18.09

Service Code	HCPCS J1171
Hospital Charge Code	6012017
Hospital Revenue Code	636
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$9.04
Rate for Payer: Aetna Commercial	$6.87
Rate for Payer: Aetna Medicare Advantage	$5.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.61
Rate for Payer: Cigna Commercial	$9.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.38
Rate for Payer: Qualcare PPO/HMO/WC	$2.71
Rate for Payer: UnitedHealthcare Community & State	$0.57
Rate for Payer: Wellpoint Medicaid Managed Care	$0.51

HYDROMORPHONE 2 MG/ML SYRINGE

Facility

$18.09

Service Code	HCPCS J1171
Hospital Charge Code	6012017
Hospital Revenue Code	636
Min. Negotiated Rate	$2.71
Max. Negotiated Rate	$4.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.38
Rate for Payer: Qualcare PPO/HMO/WC	$2.71

HYDROMORPHONE 2 MG TAB

Facility

$13.74

Service Code	NDC 42858030125
Hospital Charge Code	6012116
Hospital Revenue Code	250
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$2.06
Rate for Payer: Qualcare PPO/HMO/WC	$2.06

HYDROMORPHONE 2 MG TAB

Facility

$13.74

Service Code	NDC 42858030125
Hospital Charge Code	6012116
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$6.87
Rate for Payer: Aetna Commercial	$5.22
Rate for Payer: Aetna Medicare Advantage	$4.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.50
Rate for Payer: Cigna Commercial	$6.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.57
Rate for Payer: Oxford Commercial	$2.75
Rate for Payer: Qualcare PPO/HMO/WC	$2.06
Rate for Payer: UnitedHealthcare Commercial	$2.75
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.39

HYDROMORPHONE 4 MG/ML SYRINGE

Facility

$7.64

Service Code	HCPCS J1171
Hospital Charge Code	60629024
Hospital Revenue Code	636
Min. Negotiated Rate	$1.15
Max. Negotiated Rate	$1.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.85
Rate for Payer: Qualcare PPO/HMO/WC	$1.15

HYDROMORPHONE 4 MG/ML SYRINGE

Facility

$7.64

Service Code	HCPCS J1171
Hospital Charge Code	60629024
Hospital Revenue Code	636
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$3.82
Rate for Payer: Aetna Commercial	$2.90
Rate for Payer: Aetna Medicare Advantage	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.95
Rate for Payer: Cigna Commercial	$3.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.85
Rate for Payer: Qualcare PPO/HMO/WC	$1.15
Rate for Payer: UnitedHealthcare Community & State	$0.24
Rate for Payer: Wellpoint Medicaid Managed Care	$0.22

HYDROMORPHONE 4 MG TAB

Facility

$4.00

Service Code	NDC 42858030225
Hospital Charge Code	60628872
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

HYDROMORPHONE 4 MG TAB

Facility

$4.00

Service Code	NDC 42858030225
Hospital Charge Code	60628872
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

HYDROMORPHONE ISEC 1MG/ML

Facility

$8.58

Service Code	HCPCS J1171
Hospital Charge Code	60630220
Hospital Revenue Code	636
Min. Negotiated Rate	$1.29
Max. Negotiated Rate	$2.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.08
Rate for Payer: Qualcare PPO/HMO/WC	$1.29

HYDROMORPHONE ISEC 1MG/ML

Facility

$8.58

Service Code	HCPCS J1171
Hospital Charge Code	60630220
Hospital Revenue Code	636
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$4.29
Rate for Payer: Aetna Commercial	$3.26
Rate for Payer: Aetna Medicare Advantage	$2.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.19
Rate for Payer: Cigna Commercial	$4.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.08
Rate for Payer: Qualcare PPO/HMO/WC	$1.29
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

HYDROSCOPIC HUMIDIFIER ADULT

Facility

$9.50

Hospital Charge Code	270655463
Hospital Revenue Code	270
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$4.75
Rate for Payer: Aetna Commercial	$3.61
Rate for Payer: Aetna Medicare Advantage	$2.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.42
Rate for Payer: Cigna Commercial	$4.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.47
Rate for Payer: Oxford Commercial	$1.90
Rate for Payer: Qualcare PPO/HMO/WC	$1.43
Rate for Payer: UnitedHealthcare Commercial	$1.90
Rate for Payer: UnitedHealthcare Community & State	$0.30
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

Know your out-of-pocket cost for care.

All Charges