Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

MASK 1145 CHILD SZ4 BUBBLE

Facility

$15.80

Hospital Charge Code	270667184
Hospital Revenue Code	270
Min. Negotiated Rate	$2.37
Max. Negotiated Rate	$2.37
Rate for Payer: Qualcare PPO/HMO/WC	$2.37

MASK 5-PT HYBRID HEAD/NECK/SHO

Facility

$450.00

Hospital Charge Code	270676902
Hospital Revenue Code	272
Min. Negotiated Rate	$12.78
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$171.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Commercial	$90.00
Rate for Payer: UnitedHealthcare Community & State	$14.22
Rate for Payer: Wellpoint Medicaid Managed Care	$12.78

MASK 5-PT HYBRID HEAD/NECK/SHO

Facility

$450.00

Hospital Charge Code	270676902
Hospital Revenue Code	272
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

MASK 5 PTS HYBRID HEAD

Facility

$450.00

Hospital Charge Code	270675791
Hospital Revenue Code	272
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

MASK 5 PTS HYBRID HEAD

Facility

$450.00

Hospital Charge Code	270675791
Hospital Revenue Code	272
Min. Negotiated Rate	$12.78
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$171.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Commercial	$90.00
Rate for Payer: UnitedHealthcare Community & State	$14.22
Rate for Payer: Wellpoint Medicaid Managed Care	$12.78

MASK AEROSOL ADULT 00126

Facility

$5.65

Hospital Charge Code	270200105
Hospital Revenue Code	272
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$2.83
Rate for Payer: Aetna Commercial	$2.15
Rate for Payer: Aetna Medicare Advantage	$1.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.44
Rate for Payer: Cigna Commercial	$2.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.47
Rate for Payer: Oxford Commercial	$1.13
Rate for Payer: Qualcare PPO/HMO/WC	$0.85
Rate for Payer: UnitedHealthcare Commercial	$1.13
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

MASK AEROSOL ADULT 00126

Facility

$5.65

Hospital Charge Code	270200105
Hospital Revenue Code	272
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.85

MASK BIPAP LG NON-VENTED

Facility

$120.45

Hospital Charge Code	270655468
Hospital Revenue Code	270
Min. Negotiated Rate	$3.42
Max. Negotiated Rate	$60.23
Rate for Payer: Aetna Commercial	$45.77
Rate for Payer: Aetna Medicare Advantage	$36.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.71
Rate for Payer: Cigna Commercial	$60.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.32
Rate for Payer: Oxford Commercial	$24.09
Rate for Payer: Qualcare PPO/HMO/WC	$18.07
Rate for Payer: UnitedHealthcare Commercial	$24.09
Rate for Payer: UnitedHealthcare Community & State	$3.81
Rate for Payer: Wellpoint Medicaid Managed Care	$3.42

MASK BIPAP LG NON-VENTED

Facility

$120.45

Hospital Charge Code	270655468
Hospital Revenue Code	270
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$18.07
Rate for Payer: Qualcare PPO/HMO/WC	$18.07

MASK BIPAP MED NON-VENTED

Facility

$108.14

Hospital Charge Code	270655466
Hospital Revenue Code	270
Min. Negotiated Rate	$3.07
Max. Negotiated Rate	$54.07
Rate for Payer: Aetna Commercial	$41.09
Rate for Payer: Aetna Medicare Advantage	$32.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.58
Rate for Payer: Cigna Commercial	$54.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.12
Rate for Payer: Oxford Commercial	$21.63
Rate for Payer: Qualcare PPO/HMO/WC	$16.22
Rate for Payer: UnitedHealthcare Commercial	$21.63
Rate for Payer: UnitedHealthcare Community & State	$3.42
Rate for Payer: Wellpoint Medicaid Managed Care	$3.07

MASK BIPAP MED NON-VENTED

Facility

$108.14

Hospital Charge Code	270655466
Hospital Revenue Code	270
Min. Negotiated Rate	$16.22
Max. Negotiated Rate	$16.22
Rate for Payer: Qualcare PPO/HMO/WC	$16.22

MASK BIPAP ME WIDE DISP

Facility

$153.65

Hospital Charge Code	270606855
Hospital Revenue Code	272
Min. Negotiated Rate	$4.36
Max. Negotiated Rate	$76.83
Rate for Payer: Aetna Commercial	$58.39
Rate for Payer: Aetna Medicare Advantage	$46.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.18
Rate for Payer: Cigna Commercial	$76.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.95
Rate for Payer: Oxford Commercial	$30.73
Rate for Payer: Qualcare PPO/HMO/WC	$23.05
Rate for Payer: UnitedHealthcare Commercial	$30.73
Rate for Payer: UnitedHealthcare Community & State	$4.86
Rate for Payer: Wellpoint Medicaid Managed Care	$4.36

MASK BIPAP ME WIDE DISP

Facility

$153.65

Hospital Charge Code	270606855
Hospital Revenue Code	272
Min. Negotiated Rate	$23.05
Max. Negotiated Rate	$23.05
Rate for Payer: Qualcare PPO/HMO/WC	$23.05

MASK BIPAP SM NON-VENTED

Facility

$108.14

Hospital Charge Code	270655465
Hospital Revenue Code	270
Min. Negotiated Rate	$16.22
Max. Negotiated Rate	$16.22
Rate for Payer: Qualcare PPO/HMO/WC	$16.22

MASK BIPAP SM NON-VENTED

Facility

$108.14

Hospital Charge Code	270655465
Hospital Revenue Code	270
Min. Negotiated Rate	$3.07
Max. Negotiated Rate	$54.07
Rate for Payer: Aetna Commercial	$41.09
Rate for Payer: Aetna Medicare Advantage	$32.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.58
Rate for Payer: Cigna Commercial	$54.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.12
Rate for Payer: Oxford Commercial	$21.63
Rate for Payer: Qualcare PPO/HMO/WC	$16.22
Rate for Payer: UnitedHealthcare Commercial	$21.63
Rate for Payer: UnitedHealthcare Community & State	$3.42
Rate for Payer: Wellpoint Medicaid Managed Care	$3.07

MASK CUSHION INFANT 20 EA

Facility

$30.43

Hospital Charge Code	270684076
Hospital Revenue Code	272
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$15.21
Rate for Payer: Aetna Commercial	$11.56
Rate for Payer: Aetna Medicare Advantage	$9.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.76
Rate for Payer: Cigna Commercial	$15.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.91
Rate for Payer: Oxford Commercial	$6.09
Rate for Payer: Qualcare PPO/HMO/WC	$4.56
Rate for Payer: UnitedHealthcare Commercial	$6.09
Rate for Payer: UnitedHealthcare Community & State	$0.96
Rate for Payer: Wellpoint Medicaid Managed Care	$0.86

MASK CUSHION INFANT 20 EA

Facility

$30.43

Hospital Charge Code	270684076
Hospital Revenue Code	272
Min. Negotiated Rate	$4.56
Max. Negotiated Rate	$4.56
Rate for Payer: Qualcare PPO/HMO/WC	$4.56

MASK FACE FILTER DUCK BILL

Facility

$19.25

Hospital Charge Code	270061035C
Hospital Revenue Code	270
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$2.89
Rate for Payer: Qualcare PPO/HMO/WC	$2.89

MASK FACE FILTER DUCK BILL

Facility

$19.25

Hospital Charge Code	270061035C
Hospital Revenue Code	270
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$9.62
Rate for Payer: Aetna Commercial	$7.32
Rate for Payer: Aetna Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.91
Rate for Payer: Cigna Commercial	$9.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.00
Rate for Payer: Oxford Commercial	$3.85
Rate for Payer: Qualcare PPO/HMO/WC	$2.89
Rate for Payer: UnitedHealthcare Commercial	$3.85
Rate for Payer: UnitedHealthcare Community & State	$0.61
Rate for Payer: Wellpoint Medicaid Managed Care	$0.55

MASK FACE TENT - AIRLIFE

Facility

$10.45

Hospital Charge Code	270600878
Hospital Revenue Code	272
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$1.57
Rate for Payer: Qualcare PPO/HMO/WC	$1.57

MASK FACE TENT - AIRLIFE

Facility

$10.45

Hospital Charge Code	270600878
Hospital Revenue Code	272
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$5.22
Rate for Payer: Aetna Commercial	$3.97
Rate for Payer: Aetna Medicare Advantage	$3.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.66
Rate for Payer: Cigna Commercial	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.72
Rate for Payer: Oxford Commercial	$2.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.57
Rate for Payer: UnitedHealthcare Commercial	$2.09
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

MASK FULL FACE LG DISP VENTED

Facility

$108.15

Hospital Charge Code	270652265
Hospital Revenue Code	270
Min. Negotiated Rate	$16.22
Max. Negotiated Rate	$16.22
Rate for Payer: Qualcare PPO/HMO/WC	$16.22

MASK FULL FACE LG DISP VENTED

Facility

$108.15

Hospital Charge Code	270652265
Hospital Revenue Code	270
Min. Negotiated Rate	$3.07
Max. Negotiated Rate	$54.08
Rate for Payer: Aetna Commercial	$41.10
Rate for Payer: Aetna Medicare Advantage	$32.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.58
Rate for Payer: Cigna Commercial	$54.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.12
Rate for Payer: Oxford Commercial	$21.63
Rate for Payer: Qualcare PPO/HMO/WC	$16.22
Rate for Payer: UnitedHealthcare Commercial	$21.63
Rate for Payer: UnitedHealthcare Community & State	$3.42
Rate for Payer: Wellpoint Medicaid Managed Care	$3.07

MASK FULL FACE MD. 1004849

Facility

$121.45

Hospital Charge Code	270618251
Hospital Revenue Code	272
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$60.73
Rate for Payer: Aetna Commercial	$46.15
Rate for Payer: Aetna Medicare Advantage	$36.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.97
Rate for Payer: Cigna Commercial	$60.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.58
Rate for Payer: Oxford Commercial	$24.29
Rate for Payer: Qualcare PPO/HMO/WC	$18.22
Rate for Payer: UnitedHealthcare Commercial	$24.29
Rate for Payer: UnitedHealthcare Community & State	$3.84
Rate for Payer: Wellpoint Medicaid Managed Care	$3.45

MASK FULL FACE MD. 1004849

Facility

$121.45

Hospital Charge Code	270618251
Hospital Revenue Code	272
Min. Negotiated Rate	$18.22
Max. Negotiated Rate	$18.22
Rate for Payer: Qualcare PPO/HMO/WC	$18.22

Know your out-of-pocket cost for care.

All Charges