Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

LACTATED RINGERS 1000cc

Facility

$5.72

Hospital Charge Code	270650053
Hospital Revenue Code	258
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$0.86
Rate for Payer: Qualcare PPO/HMO/WC	$0.86

LACTATED RINGERS 1000cc

Facility

$5.72

Hospital Charge Code	270650053
Hospital Revenue Code	258
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$2.86
Rate for Payer: Aetna Commercial	$2.17
Rate for Payer: Aetna Medicare Advantage	$1.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.46
Rate for Payer: Cigna Commercial	$2.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.49
Rate for Payer: Oxford Commercial	$1.14
Rate for Payer: Qualcare PPO/HMO/WC	$0.86
Rate for Payer: UnitedHealthcare Commercial	$1.14
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

LACTATED RINGER'S 1000 ML SOL

Facility

$16.48

Service Code	NDC 338011704
Hospital Charge Code	60627910
Hospital Revenue Code	258
Min. Negotiated Rate	$2.47
Max. Negotiated Rate	$2.47
Rate for Payer: Qualcare PPO/HMO/WC	$2.47

LACTATED RINGER'S 1000 ML SOL

Facility

$16.48

Service Code	NDC 338011704
Hospital Charge Code	60627910
Hospital Revenue Code	258
Min. Negotiated Rate	$0.47
Max. Negotiated Rate	$8.24
Rate for Payer: Aetna Commercial	$6.26
Rate for Payer: Aetna Medicare Advantage	$4.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.20
Rate for Payer: Cigna Commercial	$8.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.28
Rate for Payer: Oxford Commercial	$3.30
Rate for Payer: Qualcare PPO/HMO/WC	$2.47
Rate for Payer: UnitedHealthcare Commercial	$3.30
Rate for Payer: UnitedHealthcare Community & State	$0.52
Rate for Payer: Wellpoint Medicaid Managed Care	$0.47

LACTATED RINGERS 500ml

Facility

$5.60

Hospital Charge Code	270649837
Hospital Revenue Code	258
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$0.84
Rate for Payer: Qualcare PPO/HMO/WC	$0.84

LACTATED RINGERS 500ml

Facility

$5.60

Hospital Charge Code	270649837
Hospital Revenue Code	258
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$2.80
Rate for Payer: Aetna Commercial	$2.13
Rate for Payer: Aetna Medicare Advantage	$1.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.43
Rate for Payer: Cigna Commercial	$2.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.46
Rate for Payer: Oxford Commercial	$1.12
Rate for Payer: Qualcare PPO/HMO/WC	$0.84
Rate for Payer: UnitedHealthcare Commercial	$1.12
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

LACTIC ACID

Facility

$191.00

Service Code	HCPCS 83605
Hospital Charge Code	38472443
Hospital Revenue Code	301
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$31.47
Rate for Payer: Aetna Medicare Advantage	$37.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.97
Rate for Payer: Cigna Commercial	$95.50
Rate for Payer: Cigna Medicare Advantage	$11.57
Rate for Payer: Clover Medicare Advantage	$10.99
Rate for Payer: EmblemHealth Commercial	$34.71
Rate for Payer: Humana Medicare Advantage	$11.92
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.66
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.65
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.57
Rate for Payer: Wellcare Medicare Advantage	$11.57
Rate for Payer: Wellpoint Medicaid Managed Care	$5.42

LACTIC ACID

Facility

$191.00

Service Code	HCPCS 83605
Hospital Charge Code	38472443
Hospital Revenue Code	301
Min. Negotiated Rate	$28.65
Max. Negotiated Rate	$28.65
Rate for Payer: Qualcare PPO/HMO/WC	$28.65

LACTIC ACID, ALL SOURCES

Facility

$636.05

Service Code	HCPCS 83605
Hospital Charge Code	3008380
Hospital Revenue Code	301
Min. Negotiated Rate	$95.41
Max. Negotiated Rate	$95.41
Rate for Payer: Qualcare PPO/HMO/WC	$95.41

LACTIC ACID, ALL SOURCES

Facility

$636.05

Service Code	HCPCS 83605
Hospital Charge Code	3008380
Hospital Revenue Code	301
Min. Negotiated Rate	$9.26
Max. Negotiated Rate	$318.02
Rate for Payer: Aetna Commercial	$31.47
Rate for Payer: Aetna Medicare Advantage	$37.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.97
Rate for Payer: Cigna Commercial	$318.02
Rate for Payer: Cigna Medicare Advantage	$11.57
Rate for Payer: Clover Medicare Advantage	$10.99
Rate for Payer: EmblemHealth Commercial	$34.71
Rate for Payer: Humana Medicare Advantage	$11.92
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.37
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$95.41
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.57
Rate for Payer: Wellcare Medicare Advantage	$11.57
Rate for Payer: Wellpoint Medicaid Managed Care	$18.06

LACTIC ACID DEHYDROGENASE LDH

Facility

$717.44

Service Code	HCPCS 83615
Hospital Charge Code	3001757
Hospital Revenue Code	301
Min. Negotiated Rate	$107.62
Max. Negotiated Rate	$107.62
Rate for Payer: Qualcare PPO/HMO/WC	$107.62

LACTIC ACID DEHYDROGENASE LDH

Facility

$717.44

Service Code	HCPCS 83615
Hospital Charge Code	3001757
Hospital Revenue Code	301
Min. Negotiated Rate	$4.83
Max. Negotiated Rate	$358.72
Rate for Payer: Aetna Commercial	$16.43
Rate for Payer: Aetna Medicare Advantage	$19.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.91
Rate for Payer: Cigna Commercial	$358.72
Rate for Payer: Cigna Medicare Advantage	$6.04
Rate for Payer: Clover Medicare Advantage	$5.74
Rate for Payer: EmblemHealth Commercial	$18.12
Rate for Payer: Humana Medicare Advantage	$6.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.53
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$107.62
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$4.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.04
Rate for Payer: Wellcare Medicare Advantage	$6.04
Rate for Payer: Wellpoint Medicaid Managed Care	$20.38

LACTOBACILLUS ACIDPH CAP 500MG

Facility

$4.00

Service Code	NDC 904660861
Hospital Charge Code	60628158
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

LACTOBACILLUS ACIDPH CAP 500MG

Facility

$4.00

Service Code	NDC 904660861
Hospital Charge Code	60628158
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

LACTOFERRIN QNT STOOL

Facility

$390.00

Service Code	HCPCS 83631
Hospital Charge Code	38479742
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

LACTOFERRIN QNT STOOL

Facility

$390.00

Service Code	HCPCS 83631
Hospital Charge Code	38479742
Hospital Revenue Code	306
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$53.39
Rate for Payer: Aetna Medicare Advantage	$63.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.21
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$19.63
Rate for Payer: Clover Medicare Advantage	$18.65
Rate for Payer: EmblemHealth Commercial	$58.89
Rate for Payer: Humana Medicare Advantage	$20.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$15.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.63
Rate for Payer: Wellcare Medicare Advantage	$19.63
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

LACTULOSE 10 GM/15 ML SOL

Facility

$11.19

Service Code	NDC 66689003850
Hospital Charge Code	60627892
Hospital Revenue Code	250
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$5.59
Rate for Payer: Aetna Commercial	$4.25
Rate for Payer: Aetna Medicare Advantage	$3.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.85
Rate for Payer: Cigna Commercial	$5.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.91
Rate for Payer: Oxford Commercial	$2.24
Rate for Payer: Qualcare PPO/HMO/WC	$1.68
Rate for Payer: UnitedHealthcare Commercial	$2.24
Rate for Payer: UnitedHealthcare Community & State	$0.35
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

LACTULOSE 10 GM/15 ML SOL

Facility

$11.19

Service Code	NDC 66689003850
Hospital Charge Code	60627892
Hospital Revenue Code	250
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$1.68
Rate for Payer: Qualcare PPO/HMO/WC	$1.68

LACTULOSE 10 GM/15 ML SYRUP

Facility

$9.25

Service Code	NDC 54868310100
Hospital Charge Code	60627893
Hospital Revenue Code	250
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$1.39
Rate for Payer: Qualcare PPO/HMO/WC	$1.39

LACTULOSE 10 GM/15 ML SYRUP

Facility

$9.25

Service Code	NDC 54868310100
Hospital Charge Code	60627893
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$4.62
Rate for Payer: Aetna Commercial	$3.52
Rate for Payer: Aetna Medicare Advantage	$2.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.36
Rate for Payer: Cigna Commercial	$4.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.40
Rate for Payer: Oxford Commercial	$1.85
Rate for Payer: Qualcare PPO/HMO/WC	$1.39
Rate for Payer: UnitedHealthcare Commercial	$1.85
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

LAG SCREW 10.5MMX115MM

Facility

$4,478.50

Service Code	HCPCS C1713
Hospital Charge Code	270705155
Hospital Revenue Code	278
Min. Negotiated Rate	$671.77
Max. Negotiated Rate	$1,083.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,083.80
Rate for Payer: Qualcare PPO/HMO/WC	$671.77

LAG SCREW 10.5MMX115MM

Facility

$4,478.50

Service Code	HCPCS C1713
Hospital Charge Code	270705155
Hospital Revenue Code	278
Min. Negotiated Rate	$127.19
Max. Negotiated Rate	$2,239.25
Rate for Payer: Aetna Commercial	$1,701.83
Rate for Payer: Aetna Medicare Advantage	$1,343.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,142.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,142.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,142.02
Rate for Payer: Cigna Commercial	$2,239.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,083.80
Rate for Payer: Qualcare PPO/HMO/WC	$671.77
Rate for Payer: UnitedHealthcare Community & State	$141.52
Rate for Payer: Wellpoint Medicaid Managed Care	$127.19

LAG SCREW 10.5X110MM

Facility

$4,478.50

Service Code	HCPCS C1713
Hospital Charge Code	270705861
Hospital Revenue Code	278
Min. Negotiated Rate	$671.77
Max. Negotiated Rate	$1,083.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,083.80
Rate for Payer: Qualcare PPO/HMO/WC	$671.77

LAG SCREW 10.5X110MM

Facility

$4,478.50

Service Code	HCPCS C1713
Hospital Charge Code	270705861
Hospital Revenue Code	278
Min. Negotiated Rate	$127.19
Max. Negotiated Rate	$2,239.25
Rate for Payer: Aetna Commercial	$1,701.83
Rate for Payer: Aetna Medicare Advantage	$1,343.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,142.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,142.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,142.02
Rate for Payer: Cigna Commercial	$2,239.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,083.80
Rate for Payer: Qualcare PPO/HMO/WC	$671.77
Rate for Payer: UnitedHealthcare Community & State	$141.52
Rate for Payer: Wellpoint Medicaid Managed Care	$127.19

LAG SCREW 10.5X90MM

Facility

$4,478.50

Service Code	HCPCS C1713
Hospital Charge Code	270705681
Hospital Revenue Code	278
Min. Negotiated Rate	$671.77
Max. Negotiated Rate	$1,083.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,083.80
Rate for Payer: Qualcare PPO/HMO/WC	$671.77

Know your out-of-pocket cost for care.

All Charges